K Number
K173741
Manufacturer
Date Cleared
2018-03-05

(88 days)

Product Code
Regulation Number
878.4400
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Reprocessed ArthroCare Ablation Wands are indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures.

Device Description

Reprocessed ArthroCare Ablation Wands are radiofrequency surgical devices intended for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures. Ablation wands are powered by a radiofrequency generator or controller. The device variations include various diameters, lengths, or electrode configurations. The materials of construction are generally polycarbonate handles, stainless steel shafts, PET insulation, tungsten electrodes, alumina ceramic tips and PVC suction lines. The electrode design contributes to the performance differences across different model devices.

AI/ML Overview

This document is a 510(k) summary for a reprocessed medical device, specifically "Reprocessed ArthroCare Ablation Wands." It does not contain information about an AI/ML-driven device or study that uses acceptance criteria in the typical sense of measuring algorithm performance against ground truth in a clinical or diagnostic context.

Instead, the "acceptance criteria" and "study" mentioned here refer to the validation of the reprocessing process to demonstrate that the reprocessed device is substantially equivalent to the original, new device. The "performance" being reported is related to the physical and functional integrity of the reprocessed wands.

Therefore, many of the requested fields are not applicable in this context (e.g., sample size for test/training sets, experts for ground truth, adjudication methods, MRMC studies, standalone performance, type of ground truth for AI, etc.) because this is not an AI/ML device.

Here's an interpretation based on the provided document:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance Criteria (Demonstrated by Testing)Reported Device Performance
Cleaning: Residual Protein, Carbohydrates, Visual Inspection, Cleaning Performance Qualification meet predetermined standards.Cleaning tests confirmed devices meet established safety and cleanliness standards for reprocessing.
Functional: Thermal Effects, Probe Bending, Probe Drop Performance are equivalent to the predicate (new) device.The subject (reprocessed) devices performed equivalently to the predicate (new) devices in thermal effects, probe bending, and probe drop tests.
Sterilization & Packaging: EtO Sterilization, EtO Residuals, Simulated Shipment Testing meet safety and effectiveness requirements.Tests confirmed effective sterilization, acceptable EtO residuals, and packaging integrity after simulated shipment.
Product Stability: Accelerated aging demonstrates 1-year shelf life. (Real-time studies ongoing.)Accelerated aging demonstrated a 1-year shelf life. Real-time studies are ongoing.
Biocompatibility: Cytotoxicity, Irritation, Acute Systemic, Material Mediated Pyrogenicity, Sensitization meet ISO 10993 standards.Biocompatibility tests (cytotoxicity, irritation, acute systemic, pyrogenicity, sensitization) confirmed material safety.
Electrical Safety & EMC: IEC 60601-1-2 EMC Testing and IEC 60601-2-2 Electrical Safety Testing (high frequency equipment/accessories) are met.Electrical safety and EMC tests confirmed compliance with relevant IEC standards.

2. Sample size used for the test set and the data provenance:

  • Test Set Sample Size: The document does not specify the exact sample sizes for each type of benchtop performance test (e.g., how many wands were subjected to thermal effects testing, how many for bending, etc.). It generally refers to "the subject devices" and "predicate devices" being tested.
  • Data Provenance: The data is from benchtop performance testing conducted by ReNovo, Inc. (the submitter), comparing their reprocessed devices against the predicate (OEM) devices. This is prospective testing for the 510(k) submission. No country of origin is explicitly stated for the "data," but the submitter is based in Bend, OR, USA.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

  • Not Applicable. This is not an AI/ML device, and "ground truth" in the diagnostic context is not relevant here. The "ground truth" for these tests are objective, measurable physical and chemical properties and functional performance characteristics, often against established industry standards. These are not established by human experts in a subjective manner.

4. Adjudication method for the test set:

  • Not Applicable. As this is not an AI/ML device, there's no diagnostic output requiring expert adjudication. Performance is measured against predefined, objective pass/fail criteria or equivalence to a predicate device.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:

  • Not Applicable. This is not an AI/ML device. No human-in-the-loop studies or MRMC studies were performed.

6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done:

  • Not Applicable. This is not an AI/ML device. There is no algorithm.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):

  • The "ground truth" here is the established physical, chemical, and functional performance characteristics of the original, new (predicate) medical device and compliance with relevant engineering and biocompatibility standards (e.g., ISO 10993, IEC 60601). The "ground truth" for cleaning effectively would be specific limits on residual protein/carbohydrates, for example. For functional performance, it would be the performance of the new device.

8. The sample size for the training set:

  • Not Applicable. This is not an AI/ML device. No training set was used.

9. How the ground truth for the training set was established:

  • Not Applicable. This is not an AI/ML device. No training set was used.

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Image /page/0/Picture/0 description: The image contains the logos of the Department of Health & Human Services and the Food and Drug Administration (FDA). The Department of Health & Human Services logo is on the left, and the FDA logo is on the right. The FDA logo includes the text "FDA U.S. FOOD & DRUG ADMINISTRATION" in blue.

March 5, 2018

ReNovo, Inc. % Mr. Robert Packard Medical Device Academy, Inc. 345 Lincoln Hill Rd. Shrewsbury, Vermont 05738

Re: K173741

Trade/Device Name: Reprocessed ArthoCare Ablation Wand Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical Cutting and Coagulation Device and Accessories Regulatory Class: Class II Product Code: NUJ Dated: December 15, 2018 Received: February 16, 2018

Dear Mr. Packard:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976. the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820);

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and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerelv. Jennifer R. Stevenson For Binita S. Ashar, M.D., M.B.A., F.A.C.S Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K173741

Device Name

Reprocessed ArthroCare Ablation Wands

Indications for Use (Describe)

The Reprocessed ArthroCare Ablation Wands are indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures.

Type of Use (Select one or both, as applicable)
X Prescription Use (Part 21 CFR 801 Subpart D) Over-The-Counter Use (21 CFR 801 Subpart C)

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Arthroscopic and OrthopedicProceduresJoint Specific or All Joints(ankle, elbow, hip, knee,shoulder, wrist)
Ablation and Debridement
ACL/PCLKnee
AcromioplastyShoulder
Articular CartilageAll Joints
BursectomyAll Joints
ChondroplastyAll Joints
FaciaAll Joints
LigamentAll Joints
NotchplastyKnee
Scar TissueAll Joints
Soft TissueAll Joints
Subacromial DecompressionShoulder
SynovectomyAll Joints
TendonAll Joints
Excision and Resection
Accetabular LabrumHip
Articular LabrumAll Joints
CapsuleAll Joints
Capsular ReleaseKnee
Cartilage FlapsKnee
CystsAll Joints
Discoid MeniscusKnee
Frozen Shoulder ReleaseShoulder
Glenoidale LabrumShoulder
Lateral ReleaseKnee
LigamentAll Joints
Loose BodiesAll Joints
Meniscal CystectomyKnee
MenisccotmyKnee
Pilca RemovalAll Joints
Scar TissueAll Joints
Soft TissueAll Joints
Synovial MembraneAll Joints
TendonAll Joints
Triangular Fibrocarilage (TFCC)Wrist
VillusectomyKnee
Coagulation
ACL/PCLKnee
Articular CartilageAll Joints
Carpal LigamentsWrist
Glenohumoral CapsuleShoulder
LigamentAll Joints
Medial RetinaculumKnee
Rotator CuffShoulder
TendonAll Joints
Wrist TendonsWrist

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K173741 Reprocessed ArthroCare Ablation Wands - Device Models Subject to Clearance
--------------------------------------------------------------------------------------
OEM ModelNumberDescriptionShaft Diameter, descriptionPictureOEM 510(k)
ASC4251-01STARVAC5.5mm tip diameter, 3.5MM SHAFTSIZE, 90° Tip Angle, 1 screen and 4 ballelectrodes,Image: STARVACK083306
ASH4830-01SUPER MULTIVAC50 with IntegratedFinger Switches (IFS)3.0mm Tip Diameter, 3.75mm ShaftDiameter, Flat electrode, 50° tip angleImage: SUPER MULTIVACK082980
ASC4830-01SUPER MULTIVAC503.0mm Tip Diameter, 3.75mm ShaftDiameter, Flat electrode, 50° tip angleImage: SUPER MULTIVAC 50K082323
ASH4250-01SUPER TURBOVAC90 with integratedfinger switches (IFS)5.25mm Tip diameter, 3.75 shaftdiameter, screen shape electrode,9050° tip angleImage: SUPER TURBOVACK072865
AS1335-01TurboVac 903.75mm shaft diameter, 90° Tip AngleImage: TurboVac 90K071963
ASC1335-01TurboVac ™ 90Integrated CableWand3.75mm shaft diameter, 90° Tip AngleImage: TurboVac 90 Integrated Cable WandK070958
AS1336-01TurboVac 90 XL3.75mm shaft diameter, 90° Tip AngleImage: TurboVac 90 XLK052686
ASC1336-01TurboVac 90 XLIntegrated CableWand3.75mm shaft diameter, 90° Tip AngleImage: TurboVac 90 XL Integrated Cable Wand
AS1337-01TuboVac 90 HP3.75 shaft diameter, 90° Tip AngleK033584
AS4360-01TriStar 503.0mm shaft diameter, 50° Tip AngleImage: TriStar 50K032504
ASC4630-01TriStar 50 IntegratedCable Wand3.0mm shaft diameter, 50° Tip AngleK030551
AS4730-01MultiVac 50 XL3.0mm shaft diameter, 50° Tip AngleK020557
ASC4730-01MultiVac 50 XLIntegrated CableWand3.0mm shaft diameter, 50° Tip AngleImage: MultiVac 50 XL Integrated Cable WandK011083

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K173741 - 510(k) SUMMARY

This summary of 510(k) safety and effectiveness information is submitted in accordance with the requirements of 21 CFR §807.92:

  • SUBMITTER l. ReNovo, Inc. Mark K. Wells 340 SW Columbia St. Bend OR, 97702 USA Tel: +1.541.422.8880 Fax: +1.541.422.8881
  • II. CONTACT PERSON Mary Vater, BS Medical Device Academy 345 Lincoln Hill Rd. Shrewsbury, VT 05738 USA Tel: +1.913.274-9899 Email: mary@fdaecopy.com
  • lll. DEVICE
Name of Device:Reprocessed ArthroCare Ablation Wand
Classification Name:Electrosurgical Cutting and Coagulation Device and Accessories
Regulation:21 CFR §878.4400
Regulatory Class:Class II
Product Classification Code:NUJ

PREDICATE DEVICE IV.

PredicateManufacturerPredicate Submission Name510(k)
ArthroCare Corp.Modification To Arthrocare ArthrowandsK083306
ArthroCare Corp.Arthrocare ArthrowandsK082980
ArthroCare Corp.Arthrocare ArthrowandsK082323
ArthroCare Corp.Modification To: Arthrocare ArthrowandsK072865
ArthroCare Corp.Modification To: Arthrocare ArthrowandsK071963
ArthroCare Corp.Modification To Arthrocare ArthrowandsK070958
ArthroCare Corp.Arthrocare ArthrowandsK052686
ArthroCare Corp.Arthrocare ArthrowandsK033584
ArthroCare Corp.ArthroCare SystemK032504
ArthroCare Corp.ArthroCare ArthroWandsK030551
ArthroCare Corp.ArthroCare ArthroWandsK020557
ArthroCare Corp.ArthroCare SystemK011083

No reference devices were used in this submission.

DEVICE DESCRIPTION V.

Reprocessed ArthroCare Ablation Wands are radiofrequency surgical devices intended for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and

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orthopedic procedures. Ablation wands are powered by a radiofrequency generator or controller. The device variations include various diameters, lengths, or electrode configurations. The materials of construction are generally polycarbonate handles, stainless steel shafts, PET insulation, tungsten electrodes, alumina ceramic tips and PVC suction lines. The electrode design contributes to the performance differences across different model devices.

INDICATIONS FOR USE VI.

The Reprocessed ArthroCare Ablation Wands are indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures:

Arthroscopic and OrthopedicProceduresJoint Specific or AllJoints (ankle, elbow, hip,knee, shoulder, wrist)
Ablation and Debridement
ACL/PCLKnee
AcromioplastyShoulder
Articular CartilageAll Joints
BursectomyAll Joints
ChondroplastyAll Joints
FaciaAll Joints
LigamentAll Joints
NotchplastyKnee
Scar TissueAll Joints
Soft TissueAll Joints
Subacromial DecompressionShoulder
SynovectomyAll Joints
TendonAll Joints
Excision and Resection
Acetabular LabrumHip
Articular LabrumAll Joints
CapsuleAll Joints
Capsular ReleaseKnee
Cartilage FlapsKnee
CystsAll Joints
Discoid MeniscusKnee
Frozen Shoulder ReleaseShoulder
Glenoidale LabrumShoulder
Lateral ReleaseKnee
LigamentAll Joints
Loose BodiesAll Joints
Meniscal CystectomyKnee
MeniscotomyKnee
Pilca RemovalAll Joints
Scar TissueAll Joints
Soft TissueAll Joints
Synovial MembraneAll Joints
TendonAll Joints
Triangular Fibrocartilage(TFCC)Wrist
VillusectomyKnee
Coagulation
ACL/PCLKnee
Articular CartilageAll Joints
Carpal LigamentsWrist
Glenohumoral CapsuleShoulder
LigamentAll Joints
Medial RetinaculumKnee
Rotator CuffShoulder
TendonAll Joints
Wrist TendonsWrist

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VII. COMPARISON OF TECHNOLOGICAL CHARACTERISTICS WITH THE PREDICATE DEVCE

The fundamental technological characteristics of the subject device are identical to the predicate devices. The subject devices are reprocessed versions of the predicate devices. Validation was done to ensure that the reprocessing activities did not affect the form or function of the device, and that the reprocessed device performs as well as the original, new device.

The following characteristics were compared between the subject device and the predicate device in order to demonstrate substantial equivalence:

  • . Indications for Use – The indications for use of the subject device is identical to the predicate (OEM) devices' indications for use other than the device name, and therefore are substantially equivalent. All are indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures.
  • Materials The subject devices are identical reprocessed versions of the predicate OEM ● devices, therefore the subject devices materials are identical to the predicate.
  • . Design - The predicate and subject devices are identical in design changes are made during reprocessing.
  • . Energy Source - The predicate and subject devices are both powered by external RF Generators.
  • Performance Testing The subject devices were tested side by side with predicate devices for ● thermal effects, probe bending, and probe drop performance. The subject device performed equivalent to the predicate.

VIII. PERFORMANCE DATA

The following performance data were provided in support of the substantial equivalence determination.

Performance Testing

  • · Cleaning
    • Residual Protein and Carbohydrates O
    • Visual Inspection O
    • Cleaning Performance Qualification O

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  • · Functional
    • Thermal Effects Performance Testing O
    • Probe Bending Performance Testing O
    • Probe Drop Performance Testing O
  • · Sterilization and Packaging
    • EtO Sterilization Testing O
    • EtO Residuals Testing O
    • Simulated Shipment Testing O
  • · Product Stability
    • Shelf Life Testing 1-year Accelerated Aging O
    • O Real-Time Shelf Life studies are on-going and are not complete for inclusion in this submission.

Biocompatibility Testing

The following biocompatibility tests were conducted to ensure the safety of the devices:

  • · Cytotoxicity
  • · Irritation
  • · Acute Systemic
  • · Material Mediated Pyrogenicity
  • · Sensitization

Electrical Safety and Electromagnetic Compatibility (EMC)

The following electrical safety and EMC tests have been performed:

  • IEC 60601-1-2 EMC Testing
  • IEC 60601-2-2 Electrical Safety Testing (high frequency equipment/accessories) .

Software Verification and Validation Testing

Software Testing is not applicable, because the device does not contain software or firmware.

Mechanical and Acoustic Testing

Mechanical and acoustic performance testing was not required to demonstrate safety and effectiveness of the device.

Animal Study

Animal performance testing was not required to demonstrate safety and effectiveness of the device.

Clinical Studies

Clinical testing was not required to demonstrate the safety and effectiveness of the Reprocessed ArthroCare Ablation Wand. Instead, substantial equivalence is based upon benchtop performance testing.

IX. CONCLUSIONS

Based on a comparison of technological characteristics, indications for use, and performance data, it can be concluded that the proposed Reprocessed ArthroCare Ablation Wand devices are substantially equivalent to the predicate (OEM) devices.

§ 878.4400 Electrosurgical cutting and coagulation device and accessories.

(a)
Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.(b)
Classification. Class II.