(272 days)
The Focal One device is indicated for transrectal high intensity focused ultrasound (HIFU) ablation of prostate tissue.
The Focal One® is an evolution from the previous generation device, designed by EDAP: Ablatherm Integrated Imaging (K153023) and Ablatherm Fusion (K172285). The Focal One® consists of the Focal One® module with a software control system, an endorectal dynamic focusing probe, a leg holder, a set of single use disposables and a coupling liquid pouch.
The Focal One® module consists of a motorized and manual endorectal dynamic focusing probe positioning unit, a RF amplifier to power the transducer, a computer to control device operation, a cooling system to cool Ablasonic (coupling liquid) and built-in safety features. It also allows the user to control the treatment while providing different user interfaces: two dual touch-screens, mouse, keyboard and printer. The Focal One® energy is delivered via an endorectal dynamic focusing probe, which includes an imaging system. The high-energy ultrasound waves propagate through the rectal wall and are focused on a portion of the prostate, generating intense heat and causing the ablation of tissue within the focal area. The process is then repeated in a stepwise fashion to destroy the targeted tissues within the prostate. The endorectal dynamic focusing probe is attached to a support, enabling movements in the longitudinal, transverse, vertical and angular directions, and in rotation. A coupling liquid pouch (Ablasonic®) included in the FocalPak disposable kit, attached to a stand, maintained at a controlled temperature flows continuously (via a peristaltic pump) into the balloon to preserve the rectal wall from heating associated with the treatment. The module is mounted on four multidirectional wheels allowing an easy positioning of the device in the treatment room.
The document describes the Focal One device, a high-intensity focused ultrasound (HIFU) system for prostate tissue ablation, and its substantial equivalence to predicate devices (Ablatherm Integrated Imaging and Sonablate) for 510(k) clearance. The provided text, however, does not contain a specific table detailing "acceptance criteria" for the device's performance followed by reported device performance against those criteria. Instead, it presents clinical data as evidence for the device's safety and effectiveness to support substantial equivalence.
Based on the information provided in the document, here's an attempt to answer your request, focusing on the evidence presented to demonstrate the device's performance, even without a formal "acceptance criteria table":
The study described is a clinical report summarizing data on subjects treated with the Focal One® HIFU device to provide evidence of the safety and effectiveness of the ablation of prostate tissue.
1. A table of acceptance criteria and the reported device performance
As mentioned, the document does not explicitly state predetermined "acceptance criteria" in a table format that the device had to meet. However, it presents clinical outcomes that serve as performance metrics to demonstrate efficacy and safety. These would implicitly be the "performance targets" or "evidence of effectiveness" that the FDA considered acceptable for substantial equivalence.
Here's an interpretation of the performance metrics and the reported device performance:
| Performance Metric (Implicit Acceptance Criteria) | Reported Device Performance (Clinical Study Results) |
|---|---|
| Prostate Volume Reduction | Demonstrate significant reduction in prostate volume post-HIFU. |
| Reported: Prostate volume reduced from 49.8 ± 23.1 mL (median 44.0 mL) to 38.6 ± 25.5 mL (median 31.5 mL) for paired cases (n=78). This represents a 22.7% reduction (95% CI 17.6%; 27.8%), with p |
§ 876.4340 High intensity ultrasound system for prostate tissue ablation.
(a)
Identification. A high intensity ultrasound system for prostate tissue ablation is a prescription device that transmits high intensity therapeutic ultrasound energy into the prostate to thermally ablate a defined, targeted volume of tissue, performed under imaging guidance. This classification does not include devices that are intended for the treatment of any specific prostate disease and does not include devices that are intended to ablate non-prostatic tissues/organs.(b)
Classification. Class II (special controls). The special controls for this device are:(1) Non-clinical performance data must demonstrate that the device performs as intended under anticipated conditions of use. The following performance characteristics must be tested:
(i) Characterization of acoustic pressure and power output at clinically relevant levels;
(ii) Measurement of targeting accuracy and reproducibility of high intensity ultrasound output;
(iii) Ultrasound-induced heating verification testing at target and non-target tissues;
(iv) Electrical safety testing; and
(v) Electromagnetic compatibility testing.
(2) Software verification, validation, and hazard analysis must be performed.
(3) The elements of the device that may contact the patient's mucosal tissue must be demonstrated to be biocompatible.
(4) Performance data must demonstrate the sterility of the device components that contact the patient's mucosal tissue.
(5) Performance data must support shelf life by demonstrating continued sterility of the device or the sterile components, package integrity, and device functionality over the identified shelf life.
(6) Performance data must support the instructions for reprocessing all reusable components.
(7)
In vivo testing must demonstrate that the device thermally ablates targeted tissue in a controlled manner without thermal injury to adjacent, non-target tissues.(8) Clinical testing must document the adverse event profile, provide evidence of prostatic ablation, and demonstrate that the device performs as intended under anticipated conditions of use.
(9) Training must be provided so that upon completion of the training program, the physician can:
(i) Use all safety features of the device;
(ii) Accurately target the high intensity ultrasound energy within the desired region of the prostate; and
(iii) Perform the ablation procedure in a manner that minimizes damage to non-target tissues.
(10) Labeling must include:
(i) A section that summarizes the clinical testing results, including the adverse event profile and evidence of prostate ablation achieved; and
(ii) An expiration date or shelf life for single use components.