K Number
K173921
Device Name
HD-500 Video Endoscope System
Date Cleared
2018-09-05

(253 days)

Product Code
Regulation Number
876.1500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
HD-500 Video Endoscope System The HD-500 Video Endoscope System, which includes a video colonoscope, image processor, light source, monitor, accessories and other peripheral devices, is intended for endoscopies examination, diagnosis and treatment of the disease of the upper and lower gastrointestinal tract. HDL-500 Series Light Source, HDL-500E, HDL-500X The HDL-500 Series Light Source has been designed to be used with the endoscope, image processor and other peripheral devices for endoscopic observation, diagnosis and treatment. HD-500 Series Image Processor, HD-500, HD-500S, HD-330Plus The HD-500 Series Image Processor has been designed to be used with the endoscope, light source, monitor and other peripheral devices for endoscopic observation, diagnosis, treatment, and video recording. EG-500 Series Video Gastroscope, EG-500, EG-500L The EG-500 Series Video Gastroscope has been designed to be used with the image processor, light source, monitor and other peripheral devices for endoscopic observation, diagnosis and treatment of the upper digestive tract (including the esophagus, stomach and duodenum). EC-500 Series Video Colonoscope, EC-500, EC-500T, EC-500L, EC-500L/T The EC-500 Series Video Colonoscope has been designed to be used with the image processor, light source, monitor and other peripheral devices for endoscopic observation, diagnosis and treatment of the lower digestive tract (including the anus, rectum, colon and ileocecal segment).
Device Description
The proposed device, HD-500 Video Endoscope System, which includes a video gastroscope /video colonoscope, image processor, light source, monitor, accessories and other peripheral devices. HD-500 Video Endoscope System can be offered in several configurations with the options of different models of primary components The EG-500 Series Video Gastroscope/ EC-500 Series Video Colonoscope is the hand-held, direct-viewing flexible endoscope used for endoscopy and endoscopic surgery within the upper and lower gastrointestinal tract. The HD-500 Series Image Processor is a video processing system which is designed to be used with endoscopes, light source, monitor of the proposed system. Apart from the image processing functions, it also provides power supply for the endoscopes. The HDL-500 Series Light Source provides illumination for endoscopic diagnosis, treatment and video observation.
More Information

Not Found

No
The summary describes a standard video endoscope system with image processing capabilities, but there is no mention of AI, ML, or related terms, nor any description of training or test sets typically associated with AI/ML development.

Yes
The 'Intended Use / Indications for Use' section explicitly states that the system is intended for "treatment of the disease of the upper and lower gastrointestinal tract," which clearly indicates a therapeutic purpose.

Yes

The "Intended Use / Indications for Use" section explicitly states that the system is intended for "diagnosis" of diseases of the gastrointestinal tract. The "Device Description" also mentions providing "illumination for endoscopic diagnosis."

No

The device description explicitly lists multiple hardware components including a video colonoscope, image processor, light source, and monitor.

Based on the provided information, this device is not an In Vitro Diagnostic (IVD).

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices intended for use in vitro for the examination of specimens, including blood, tissue, and urine, derived from the human body, solely or principally for the purpose of providing information concerning a physiological state, state of health, or disease or congenital abnormality.
  • Device Function: The HD-500 Video Endoscope System is used for direct visualization of the internal organs (gastrointestinal tract) through endoscopy. It captures images and video of the anatomical structures.
  • Lack of Specimen Analysis: The device does not analyze biological specimens (blood, tissue, etc.) in vitro. It is used for in vivo observation and procedures.

The device is a medical device used for direct visualization and intervention within the body, not for laboratory testing of specimens.

N/A

Intended Use / Indications for Use

HD-500 Video Endoscope System
The HD-500 Video Endoscope System, which includes a video colonoscope, image processor, light source, monitor, accessories and other peripheral devices, is intended for endoscopies examination, diagnosis and treatment of the disease of the upper and lower gastrointestinal tract.

HDL-500 Series Light Source, HDL-500E, HDL-500X
The HDL-500 Series Light Source has been designed to be used with the endoscope, image processor and other peripheral devices for endoscopic observation, diagnosis and treatment.

HD-500 Series Image Processor, HD-500, HD-500S, HD-330Plus
The HD-500 Series Image Processor has been designed to be used with the endoscope, light source, monitor and other peripheral devices for endoscopic observation, diagnosis, treatment, and video recording.

EG-500 Series Video Gastroscope, EG-500, EG-500L
The EG-500 Series Video Gastroscope has been designed to be used with the image processor, light source, monitor and other peripheral devices for endoscopic observation, diagnosis and treatment of the upper digestive tract (including the esophagus, stomach and duodenum).

EC-500 Series Video Colonoscope, EC-500, EC-500T, EC-500L, EC-500L/T
The EC-500 Series Video Colonoscope has been designed to be used with the image processor, light source, monitor and other peripheral devices for endoscopic observation, diagnosis and treatment of the lower digestive tract (including the anus, rectum, colon and ileocecal segment).

Product codes

NWB, FDF, FDS

Device Description

The proposed device, HD-500 Video Endoscope System, which includes a video gastroscope /video colonoscope, image processor, light source, monitor, accessories and other peripheral devices.
HD-500 Video Endoscope System can be offered in several configurations with the options of different models of primary components
The EG-500 Series Video Gastroscope/ EC-500 Series Video Colonoscope is the hand-held, direct-viewing flexible endoscope used for endoscopy and endoscopic surgery within the upper and lower gastrointestinal tract.
The HD-500 Series Image Processor is a video processing system which is designed to be used with endoscopes, light source, monitor of the proposed system. Apart from the image processing functions, it also provides power supply for the endoscopes.
The HDL-500 Series Light Source provides illumination for endoscopic diagnosis, treatment and video observation.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Upper and lower gastrointestinal tract, upper digestive tract (esophagus, stomach and duodenum), lower digestive tract (anus, rectum, colon and ileocecal segment).

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Non clinical tests were conducted to verify that the proposed device met all design specifications as was Substantially Equivalent (SE) to the predicate device. The test results demonstrated that the proposed device complies with the following standards:

  • IEC 60601-1-2005+CORR.1:2006+CORR.2:2007+A1:2012, Medical Electrical Equipment-Part 1: General requirements for basic safety and essential performance, including the US National Differences
  • IEC 60601-1-2:2007, Medical electrical equipment- Part 1-2: General requirements for basic safety and essential performance- Collateral standard: Electromagnetic compatibility-Requirements and tests
  • IEC 60601-2-18:2009, Medical electrical equipment - Part 2-18: Particular requirements for the basic safety and essential performance of endoscopic equipment
  • ISO 8600-1:2015 Endoscopes--Medical endoscopes and endotherapy devices - part 1: General requirements
  • ISO 8600-7:2012 Endoscopes --Medical endoscopes and endotherapy devices - part 7: Basic requirements for medical endoscopes of water-resistant type
  • ISO 10993-5:2009 Biological evaluation of medical devices - Part 5: Tests for in vitro cytotoxicity
  • ISO 10993-10:2010 Biological evaluation of medical devices – Part 10: Tests for irritation and skin sensitization

Optical performance testing:

  • Photobiological safety
  • Resolution (test results comparison between the proposed device and predicate device)
  • Depth of field (test results comparison between the proposed device and predicate device)
  • Optical magnification and distortion (test results comparison between the proposed device and predicate device)
  • Image intensity uniformity (test results comparison between the proposed device and predicate device)

Physical/functional performance testing:

  • The endoscope performance test was conducted to evaluate the ability of proposed endoscope to maintain the maximum angulation/deflection when in use, the physical/functional performance of the proposed device, including a) Appearance visual inspection and handle strength inspection, b) Image function visual inspection, c) Sealing performance, and d) Maximum bending angle measurement and body model testing.

Imaging performance testing:

  • The imaging performance testing was conducted to demonstrate that the imaging quality of the proposed device is still in a better condition when the device is over its lifetime of clinical use. The degradations of imaging performance are very little which will not affect the normal use of the endoscope.

No clinical study is included in this submission.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K100584

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.1500 Endoscope and accessories.

(a)
Identification. An endoscope and accessories is a device used to provide access, illumination, and allow observation or manipulation of body cavities, hollow organs, and canals. The device consists of various rigid or flexible instruments that are inserted into body spaces and may include an optical system for conveying an image to the user's eye and their accessories may assist in gaining access or increase the versatility and augment the capabilities of the devices. Examples of devices that are within this generic type of device include cleaning accessories for endoscopes, photographic accessories for endoscopes, nonpowered anoscopes, binolcular attachments for endoscopes, pocket battery boxes, flexible or rigid choledochoscopes, colonoscopes, diagnostic cystoscopes, cystourethroscopes, enteroscopes, esophagogastroduodenoscopes, rigid esophagoscopes, fiberoptic illuminators for endoscopes, incandescent endoscope lamps, biliary pancreatoscopes, proctoscopes, resectoscopes, nephroscopes, sigmoidoscopes, ureteroscopes, urethroscopes, endomagnetic retrievers, cytology brushes for endoscopes, and lubricating jelly for transurethral surgical instruments. This section does not apply to endoscopes that have specialized uses in other medical specialty areas and that are covered by classification regulations in other parts of the device classification regulations.(b)
Classification —(1)Class II (special controls). The device, when it is an endoscope disinfectant basin, which consists solely of a container that holds disinfectant and endoscopes and accessories; an endoscopic magnetic retriever intended for single use; sterile scissors for cystoscope intended for single use; a disposable, non-powered endoscopic grasping/cutting instrument intended for single use; a diagnostic incandescent light source; a fiberoptic photographic light source; a routine fiberoptic light source; an endoscopic sponge carrier; a xenon arc endoscope light source; an endoscope transformer; an LED light source; or a gastroenterology-urology endoscopic guidewire, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I for the photographic accessories for endoscope, miscellaneous bulb adapter for endoscope, binocular attachment for endoscope, eyepiece attachment for prescription lens, teaching attachment, inflation bulb, measuring device for panendoscope, photographic equipment for physiologic function monitor, special lens instrument for endoscope, smoke removal tube, rechargeable battery box, pocket battery box, bite block for endoscope, and cleaning brush for endoscope. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807of this chapter, subject to the limitations in § 876.9.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

September 5, 2018

Sonoscape Medical Corp. % Diana Hong General Manager Mid-Link Consulting Co., Ltd P.O. Box 120-119 Shanghai, 200120 CHINA

Re: K173921

Trade/Device Name: HD-500 Video Endoscope System Regulation Number: 21 CFR 876.1500 Regulation Name: Endoscope and accessories Regulatory Class: Class II Product Code: NWB, FDF, FDS Dated: July 13, 2018 Received: July 24, 2018

Dear Diana Hong:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, 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.

1

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) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.html; good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; 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 comprehensive regulatory information about mediation-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).

Sincerely,

Glenn B. Bell -S

for Benjamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K173921

Device Name HD-500 Video Endoscope System

Indications for Use (Describe)

HD-500 Video Endoscope System

The HD-500 Video Endoscope System, which includes a video colonoscope, image processor, light source, monitor, accessories and other peripheral devices, is intended for endoscopies examination, diagnosis and treatment of the disease of the upper and lower gastrointestinal tract.

HDL-500 Series Light Source, HDL-500E, HDL-500X

The HDL-500 Series Light Source has been designed to be used with the endoscope, image processor and other peripheral devices for endoscopic observation, diagnosis and treatment.

HD-500 Series Image Processor, HD-500, HD-500S, HD-330Plus

The HD-500 Series Image Processor has been designed to be used with the endoscope, light source, monitor and other peripheral devices for endoscopic observation, diagnosis, treatment, and video recording.

EG-500 Series Video Gastroscope, EG-500, EG-500L

The EG-500 Series Video Gastroscope has been designed to be used with the image processor, light source, monitor and other peripheral devices for endoscopic observation, diagnosis and treatment of the upper digestive tract (including the esophagus, stomach and duodenum).

EC-500 Series Video Colonoscope, EC-500, EC-500T, EC-500L, EC-500L/T

The EC-500 Series Video Colonoscope has been designed to be used with the image processor, light source, monitor and other peripheral devices for endoscopic observation, diagnosis and treatment of the lower digestive tract (including the anus, rectum, colon and ileocecal segment).

Type of Use (Select one or both, as applicable)

☑ Prescription Use (Part 21 CFR 801 Subpart D)
☐ Over-The-Counter Use (21 CFR 801 Subpart C)

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510(k) Summary

This 510(k) Summary is being submitted in accordance with requirements of SMDA 1990 and Title 21, CFR Section 807.92.

The assigned 510(k) Number: K173921

    1. Date of Preparation: 11/30/2017
    1. Sponsor Identification

SONOSCAPE MEDICAL CORP.

4/F, 5/F, 8/F, 9/F & 10/F, Yizhe Building, Yuquan Road, Nanshan, Shenzhen, 518051, Guangdong, China

Establishment Registration Number: 3004705634

Contact Person: Toki Wu Position: Regulatory Affairs Manager Tel: 0755-26722890 Fax: 0755-26722850 Email: ra@sonoscape.net

    1. Designated Submission Correspondent
      Ms. Diana Hong (Primary Contact Person) Ms. Jing Cheng (Alternative Contact Person)

Mid-Link Consulting Co., Ltd P.O. Box 120-119, Shanghai, 200120, China

Tel: +86-21-22815850, Fax: 001-3609253199 Email: info@mid-link.net

4

4. Identification of Proposed Device

Trade Name: HD-500 Video Endoscope System

Common Name: Endoscopic Video Imaging System

Components and Component Models:

EG-500 Series Video Gastroscope:EG-500, EG-500L
EC-500 Series Video Colonoscope:EC-500, EC-500T, EC-500L, EC-500L/T
HD-500 Series Image Processor:HD-500, HD-500S, HD-330Plus
HDL-500 Series Light Source:HDL-500E, HDL-500X

Regulatory Information

Classification Name: Endoscope and accessories Classification: II Product Code: NWB, FDF and FDS Regulation Number: 21 CFR 876.1500 Endoscope and accessories Review Panel: Gastroenterology/Urology

Intended Use Statement:

HD-500 Video Endoscope System

The HD-500 Video Endoscope System, which includes a video gastroscope /video colonoscope, image processor, light source, monitor, accessories and other peripheral devices, is intended for endoscopies examination, diagnosis and treatment of the disease of the upper and lower gastrointestinal tract.

EG-500 Series Video Gastroscope, EG-500, EG-500L

The EG-500 Series Video Gastroscope has been designed to be used with the image processor, light source, monitor and other peripheral devices for endoscopic observation, diagnosis and treatment of the upper digestive tract (including the esophagus, stomach and duodenum).

EC-500 Series Video Colonoscope, EC-500, EC-500T, EC-500L, EC-500L/T

The EC-500 Series Video Colonoscope has been designed to be used with the image processor, light source, monitor and other peripheral devices for endoscopic observation, diagnosis and treatment of the lower digestive tract (including the anus, rectum, colon and ileocecal segment).

HD-500 Series Image Processor, HD-500, HD-500S, HD-330Plus

The HD-500 Series Image Processor has been designed to be used with the endoscope, light source, monitor and other peripheral devices for endoscopic observation, diagnosis, treatment, and video recording.

HDL-500 Series Light Source, HDL-500E, HDL-500X

The HDL-500 Series Light Source has been designed to be used with the endoscope, image processor and other peripheral devices for endoscopic observation, diagnosis and treatment.

5

Device Description

The proposed device, HD-500 Video Endoscope System, which includes a video gastroscope /video colonoscope, image processor, light source, monitor, accessories and other peripheral devices.

HD-500 Video Endoscope System can be offered in several configurations with the options of different models of primary components

The EG-500 Series Video Gastroscope/ EC-500 Series Video Colonoscope is the hand-held, direct-viewing flexible endoscope used for endoscopy and endoscopic surgery within the upper and lower gastrointestinal tract.

The HD-500 Series Image Processor is a video processing system which is designed to be used with endoscopes, light source, monitor of the proposed system. Apart from the image processing functions, it also provides power supply for the endoscopes.

The HDL-500 Series Light Source provides illumination for endoscopic diagnosis, treatment and video observation.

  • Identification of Predicate Device న.
    510(k) Number: K100584 Product Name: EVIS EXERA II 180 System Primary components and Component Models:

| EVIS EXERA II GASTROINTESTINAL VIDEOSCOPE | OLYMPUS GIF TYPE Q180,
OLYMPUS GIF TYPE H180 |
|-------------------------------------------|--------------------------------------------------|
| EVIS EXERA II COLONOVIDEOSCOPE | OLYMPUS CF TYPE Q180AL
OLYMPUS CF TYPE Q180AI |
| EVIS EXERA II VIDEO SYSTEM CENTER | OLYMPUS CV-180 |
| EVIS EXERA II XENON LIGHT SOURCE | OLYMPUS CLV-180 |

    1. Non-Clinical Test Conclusion
      Non clinical tests were conducted to verify that the proposed device met all design specifications as was Substantially Equivalent (SE) to the predicate device. The test results demonstrated that the proposed device complies with the following standards:
  • IEC 60601-1-2005+CORR.1:2006+CORR.2:2007+A1:2012, Medical Electrical Equipment-Part 1: General requirements for basic safety and essential performance, including the US National Differences

  • IEC 60601-1-2:2007, Medical electrical equipment- Part 1-2: General requirements for basic safety and essential performance- Collateral standard: Electromagnetic compatibility-Requirements and tests

6

  • IEC 60601-2-18:2009, Medical electrical equipment - Part 2-18: Particular requirements for the basic safety and essential performance of endoscopic equipment

  • ISO 8600-1:2015 Endoscopes--Medical endoscopes and endotherapy devices - part 1: General requirements

  • ISO 8600-7:2012 Endoscopes --Medical endoscopes and endotherapy devices - part 7: Basic requirements for medical endoscopes of water-resistant type

  • ISO 10993-5:2009 Biological evaluation of medical devices - Part 5: Tests for in vitro cytotoxicity

  • ISO 10993-10:2010 Biological evaluation of medical devices – Part 10: Tests for irritation and skin sensitization

Optical performance testing

The following testing was conducted to evaluate the optical performance characteristics for each endoscopic system mode.

  • A Photobiological safety
  • A Resolution (test results comparison between the proposed device and predicate device)
  • A Depth of field (test results comparison between the proposed device and predicate device)
  • Optical magnification and distortion (test results comparison between the proposed device and predicate device)

  • Image intensity uniformity (test results comparison between the proposed device and predicate device)

Physical/functional performance testing

The endoscope performance test was conducted to evaluate the ability of proposed endoscope to maintain the maximum angulation/deflection when in use, the physical/functional performance of the proposed device, including a) Appearance visual inspection and handle strength inspection, b) Image function visual inspection, c) Sealing performance, and d) Maximum bending angle measurement and body model testing.

Imaging performance testing

The imaging performance testing was conducted to demonstrate that the imaging quality of the proposed device is still in a better condition when the device is over its lifetime of clinical use. The degradations of imaging performance are very little which will not affect the normal use of the endoscope.

    1. Clinical Test Conclusion
      No clinical study is included in this submission.

7

Substantially Equivalent (SE) Comparison 8.

The whole system and components of the proposed device is basically identical to its predicate device in indication for use, and similar in specification. Comparisons between the proposed device and predicate device are shown in Table 1 to Table 6.

Table 1 General Comparison
Proposed device: HD-500 Video Endoscope System
ITEMProposed DevicePredicate Device
Product CodeNWB, FDF and FDSK100584
Regulation
Number21 CFR 876.150021 CFR 876.1500
ClassIIII
Indications
for Use
(SE Analysis 1)HD-500 Video Endoscope System
The HD-500 Video Endoscope System, which
includes a video gastroscope /video
colonoscope, image processor, light source,
monitor, accessories and other peripheral /
devices, is intended for endoscopies
examination, diagnosis and treatment of the
disease of the upper and lower gastrointestinal
tract.EVIS EXERA II XENON LIGHT
SOURCE OLYMPUS CLV-180
This light source has been designed
to be used with Olympus
endoscopes, video system center, and
other ancillary equipment for
endoscopic diagnosis, treatment and
video observation.
HDL-500 Series Light Source, HDL-500E,
HDL-500X
The HDL-500 Series Light Source has been
designed to be used with the endoscope,
image processor and other peripheral devices
for endoscopic observation, diagnosis and
treatment.
HD-500 Series Image Processor, HD-500,
HD-500S, HD-330Plus
The HD-500 Series Image Processor has been
designed to be used with the endoscope, light
source, monitor and other peripheral devices
for endoscopic observation, diagnosis,
treatment, and video recording.EVIS EXERA II VIDEO SYSTEM
CENTER OLYMPUS CV-180
This video system center has been
designed to be used with OLYMPUS
camera heads, endoscopes, light
sources, monitors, endo-therapy
accessories and other ancillary
equipment for endoscopic diagnosis,
treatment and video observation.
EG-500 Series Video Gastroscope, EG-500,
EG-500IEVIS EXERA II
GASTROINTESTINAL
Configuration
(primary
components)The EG-500 Series Video Gastroscope has
been designed to be used with the image
processor, light source, monitor and other
peripheral devices for endoscopic
observation, diagnosis and treatment of the
upper digestive tract (including the
esophagus, stomach and duodenum).VIDEOSCOPE OLYMPUS GIF
TYPE Q180, OLYMPUS GIF TYPE
H180
These instruments have been
designed to be used with an Olympus
video system center, light source,
documentation equipment, monitor,
EndoTherapy accessories (such as a
biopsy) and other ancillary
equipment for endoscopy and
endoscopic surgery within the upper
digestive tract (including the
esophagus, stomach, and duodenum).
EC-500 Series Video Colonoscope, EC-500,
EC-500T, EC-500L, EC-500L/TEVIS EXERA II
COLONOVIDEOSCOPE
OLYMPUS CF TYPE Q180AL.
OLYMPUS CF TYPE Q180AI.
The EC-500 Series Video Colonoscope has
been designed to be used with the image
processor, light source, monitor and other
peripheral devices for endoscopic
observation, diagnosis and treatment of the
lower digestive tract (including the anus,
rectum, colon and ileocecal segment).These instruments have been
designed to be used with an Olympus
video system center, light source,
documentation equipment, monitor,
EndoTherapy accessories (such as a
biopsy forceps), and other ancillary
equipment for endoscopy and
endoscopic surgery within the lower
digestive tract (including the anus,
rectum, sigmoid colon, colon, and
ileocecal valve).
Light SourceLight Source
Image processorImage processor
Video GastroscopeVideo Gastroscope
Video ColonoscopeVideo Colonoscope
Accessories and peripheral devicesAccessories and peripheral devices

Predicate device: EVIS EXERA II 180 SYSTEM

8

SE Analysis 1-Indications for Use

The indications for use of proposed device is summarized for the whole video endoscope system and the primary components, the indications for use of predicate device is only summarized for the primary components. It is only the different expressions on indications for use, actually the proposed device and the predicate device have the same primary components, each of the primary component has the same intended use. Therefore, this item is considered as substantial equivalence.

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Table 2 Specifications Comparison of Image Processor Proposed device: HD-500 Series Image Processor (HD-500, HD-500S, HD-330Plus)

Predicate device: EVIS EXERA II VIDEO SYSTEM CENTER (OLYMPUS CV-180)

ITEMProposed DevicePredicate Device
ModelHD-330PlusHD-500HD-500SOLYMPUS CV-180
Power supply100-240V AC, 50/60Hz100-240V AC, 50/60Hz100-240V AC, 50/60Hz100-240V AC, 50/60Hz
Over-current protectionFuse typeFuse typeFuse typeFuse type
Input current
(SE Analysis 2)160VA160VA160VA150VA
Size
(SE Analysis 3)370(W)×124(H)×455(D)mm370(W)×124(H)×455(D)mm370(W)×124(H)×455(D)mm383(W)×162(H)×536(D)mm
Weight
(SE Analysis 3)9.5 Kg9.5 Kg9.5 Kg15.4kg
compatible endoscopeVideoscopeVideoscopeVideoscopeFiber/rigid scope with camera head
Videoscope
Video signal
output
(SE Analysis 4)DVI:1
VGA:1
Y/C:1
VBS:1DVI:1
VGA:1
SDI:1
Y/C:1
VBS:1DVI:1
VGA:1
SDI:1
Y/C:1
VBS:1RGB:3
Y/C:4
VBS:4
HDTV:1
ObservationAuto
white
balanceAutomatically adjusted using
the white balance switch. At the
time of connection with the
scope in which the scope ID is
provide, compensation is
performed automaticallyAutomatically adjusted using
the white balance switch. At the
time of connection with the
scope in which the scope ID is
provide, compensation is
performed automaticallyAutomatically adjusted using
the white balance switch. At the
time of connection with the
scope in which the scope ID is
provide, compensation is
performed automatically
Standard color
char outputColor bar imageColor bar imageColor bar imageColor bar image
Color
tone
adjustmentR: ±8 steps B:±8 steps
Chroma:±8 stepsR: ±8 steps
B:±8 steps
Chroma:±8 stepsR: ±8 steps
B:±8 steps
Chroma:±8 stepsR:±8 steps
B:±8 steps
Chroma:±8 steps
Automatic
gain controlProvidedProvidedProvidedProvided
Image
enhancement
(SE Analysis 5)Edge enhancement: [1][2][3] 3-mode selectable and each mode have 9 levels adjustable by the user
Structure enhancement: [1][2][3] 3-mode selectable and each mode have 9 levels adjustable by the
user
Contrast enhancement: [low][med][high] 3 levels available
Color enhancement: [1][2][3] 3-mode selectable and each mode have 9 levels adjustable by the userEdge enhancement:
[off][low][med][high] 4 levels
available
structure enhancement:
[off][low][med][high] 4 levels
available
IRIS mode
selection
(SE Analysis 6)Peak/AVE/Auto
photometry modePeak/AVE/Auto
photometry modePeak/AVE/Auto
photometry modePeak/Auto photometry mode
Zoom
(SE Analysis 7)×1.4 /×1.6/×1.8×1.4 /×1.6/×1.8×1.4 /×1.6/×1.8×1/×1.2/×1.5 3-mode
Imaging
modes
(SE Analysis 8)Common observation mode;
VIST observation modeCommon observation mode;
VIST observation modeCommon observation mode;
VIST observation modeWhite-light imaging mode
Narrow Band Imaging (NBI) modes
Foot switch connectorProvidedProvidedProvidedProvided
record to memory cardProvidedProvidedProvidedProvided

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SE Analysis 2-Input Current

The input current of proposed devices is similar as that of the input current proposed device comples with IEC 60601-1 standard. Therefore, this difference on input current is considered not effectiveness of the proposed device.

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SE Analysis 3-Size and Weight

The physical specifications are different between the proposed device; the difference on physical specification will not affect the safety and effectiveness of the proposed device.

SE Analysis 4-Video Signal Output

The types of video signal output are different between the difference on video signal output will not affect the safety and effectiveness of the proposed device based on the following reasons:

  • a. Both the proposed system and predicate system are the high-definition endoscope system; they all have the standard -definition interface and high-definition interface. The proposed system has of the predicate system, these interfaces improve the system's versatility.
  • Standard -definition interface: Y/C interface and VBC interface belong to the standard -definition interface. b.
  • High-definition interface DVI interface is substantially equivalent to the HDTV interface is substantially equivalent to the RGB C. interface.
  • d. SDI interface belongs to the direct output interface. The display of the monitor can be switched to SDI signal output in case of the image processor suddenly doesn't work or the system suddenly crashes.

SE Analysis 5- Image enhancement

The proposed devices provide more selection about the image enhancement; it will offer the physician to adjust the observation. This difference will not affect the safety and effectiveness of the proposed device.

SE Analysis 6- IRIS mode selection

The proposed devices provide more selection about the IRIS mode; it will offer the physician more selection. This difference will not affect the safety and effectiveness of the proposed device.

SE Analysis 7- Zoom

The zoom of image processor is similar as that of the processor. This difference will not affect the safety and effectiveness of the proposed device.

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SE Analysis 8- Imaging modes

The predicate device has both white-light inaging (NB), modes. The NBI mode selectively processes green and blue light images by filtering the white light spectum with an optical filter, and thus enhances visualization of superficial vacce also has two modes, the common observation modes. In the VIST observation mode, a dedicated light filter is insetted into the light path to filter out the light of a specific color, theress. The common observation mode of proposed device is same as the white-light imaging mode of the predicate device) and NBI technology (proposed device) and NBI technology (predicate device) are special light imaging technologies taking advantage of the extinction spectra between mucosal vessels and mucosa. Both of them utilize optical filtering and digital image processing to enhance the visibility of mucosal vesses. Although there are digital filtering parameters, leading to slight difference in the corresponding images, they are not the essential differences. VIST can still achieve the same clinical application purposes as NBI does. Therefore, the VIST observation mode of proposed device is substantially equivalent to the NBI imaging mode of the predicate device.

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Table 3 Specifications Comparison of Video Gastroscope

Proposed device: EG-500 Series Video Gastroscope

Predicate device: EVIS EXERA II GASTROINTESTINAL VIDEOSCOPE OLYMPUS
-----------------------------------------------------------------------
ITEMProposed devicePredicate device
ModelEG-500EG-500LGIF-Q180GIF-H180
Field of view140°140°140°140°
Depth of focus3-100mm3-100mm3-100mm2-100mm
Front view\
Sensor type
(SE Analysis 9)color CMOScolor CMOScolor CCDcolor CCD
Distal end outer diameter
(SE Analysis 10)9.3mm9.8mm8.8mm9.8mm
Insertion section outer diameter
(SE Analysis 10)9.3mm9.8mm8.8mm9.8mm
Bend angleUP:210°
DOWN:90°
RIGHT:100°
LEFT:100°UP:210°
DOWN:90°
RIGHT:100°
LEFT:100°UP:210°
DOWN:90°
RIGHT:100°
LEFT: 100°UP:210°
DOWN:90°
RIGHT:100°
LEFT: 100°
Insertion section length
(SE Analysis 11)1050mm1050mm1030mm1030mm
Biopsy channel inner diameter
(SE Analysis 10)2.8mm3.2mm2.8mm2.8mm

SE Analysis 9- Sensor type

Although the CMOS sensor and CCD sensor have logic, but both they can provide high quality image. And the CMOS sensor has been commonly used in the endoscope systems. This difference on sensor type does not affect the safety and effectiveness of the proposed device.

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SE Analysis 10- Diameters

The Distal end outer diameter, Insertion outer diameter and Biopsy chamel inner diameter of proposed device are similar as those of the predicate device. Those diameters meet the industrial standard. Therefore, this item is considered as substantial equivalence.

SE Analysis 11- Insertion section length

The insertion length of proposed device is similar as that of the predicate device. Therefore this item is considered as substantial equivalence.

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Table 4 Specifications Comparison of Video Colonoscope

Proposed device: EC-500 Series Video Colonoscope

Predicate device: EVIS EXERA II COLONOVIDEOSCOPE OLYMPUS CF TYPE

ITEMProposed devicePredicate device
ModelEC-500EC-500TEC-500LEC-500L/TCF-Q180AL/ CF-Q180AI
Field of view (SE Analysis 12)140°140°140°140°170°
Depth of focus3-100mm3-100mm3-100mm3-100mm3-100mm
Front view
Sensor type (SE Analysis 9)color CMOScolor CMOScolor CMOScolor CMOScolor CCD
Distal end outer diameter (SE Analysis 10)12mm12mm12.9mm12.9mm13.2mm
Insertion section outer diameter
(SE Analysis 10)12.5mm12.5mm12.9mm12.9mm12.8mm
Bend angleUP:180°
DOWN:180°
RIGHT:160°
LEFT: 160°UP:180°
DOWN:180°
RIGHT:160°
LEFT: 160°UP:180°
DOWN:180°
RIGHT:160°
LEFT: 160°UP:180°
DOWN:180°
RIGHT:160°
LEFT: 160°UP:180°
DOWN:180°
RIGHT:160°
LEFT: 160°
Insertion section length (SE Analysis 11)1350mm1700mm1350mm1700mm1680mm

SE Analysis 12- Field of view

Although the field of view of the proposed video colonoscope is different than that of the predicate video colonoscope, the field of view of the proposed video colonoscope meets the requirements of ISO 8600-1 standard. Therefore, this difference on field of view does not affect the safety and effectiveness of the proposed device.

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Table 5 Specifications Comparison of Light Source Proposed device: HDL-500E Light Source/ HDL-500X Light Source Predicate device: EVIS EXERA II XENON LIGHT SOURCE (OLYMPUS CLV-180)

ITEMHDL-500E Light SourceHDL-500X Light SourcePredicate device
Power supply (SE Analysis 13)AC 100-240V
50Hz/60HzAC 100-240V
50Hz/60HzAC 100-120V,
50/60HZ ±1Hz
Over-current protectionFuse typeFuse typeFuse type
Input current (SE Analysis 14)160VA500VA500VA
Examination lamp (SE Analysis 15)50W LED300W xenon lamp300W Xenon lamp
Average lamp life (SE Analysis 16)50000 hours500 hoursApproximately 500 hours of
continuous use
Emergency lamp (SE Analysis 15)14W LED12V 60W halogen lamp12V 35W Halogen lamp
Average emergency lamp life (SE Analysis 17)50000 hours4000 hoursApproximately 500 hours
Brightness controlAutomatic and manualAutomatic and manualAutomatic and manual
Automatic exposure (SE Analysis 18)19 steps19 steps17 steps
Air feeding4 levels available (off, low,
mid, high)4 levels available (off, low,
mid, high)4 levels available (off, low,
mid, high)
System connectorProvidedProvidedProvided
Foot switch connectorProvidedProvidedProvided
CV connectorProvidedProvidedProvided

SE Analysis 13-Power supply

Although the power supply of proposed light source is different from that of the electrical safety testing of proposed device demonstrates that the power supply of the proposed device meets the requirements of IEC 60601-1 Standard. Therefore, on power supply does not affect the safety and effectiveness of the proposed device.

SE Analysis 14-Input current

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The input current of proposed HDL-500X Light Source is same as that of the input current of proposed HDL-500E Light Source is different from that of the predicate device, the input current of proposed HDL-500E Light Standard), Therefore this difference on input current is considered not affectiveness of the proposed device.

SE Analysis 15- Examination lamp and Emergency lamp

The proposed HDL-500X Light Source has that of the predicate device. The proposed HDL-500E has different light source from that of the predicate device. The LED light source of HDL-500E is also a common light source used in endoscope system, therefore this difference on examination lamp and emergency lamp does not affect the safety and effectiveness of the proposed device.

SE Analysis 16- Average lamp life

The proposed HDL-500X Light Source has that of the predicate device. The proposed HDL-500E has longer lamp life than that of the predicate device. The LED ight source of HDL-500E is also a common light source used in endoxope system. Therefore on lamp life does not affect the safety and effectiveness of the proposed device.

SE Analysis 17- Average emergency lamp life

The proposed Light Sources have longency lamp life than that of the predicate device. This difference on average emergency lamp life does not affect the safety and effectiveness of the proposed device.

SE Analysis 18- Automatic exposure

Both the proposed device and predicate device provide the fination of automatic exposure. Although the adjustable levels the proposed device and predicate device, the purpose of image brightness adjustment. Therefore this item is considered as substantial equivalence.

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Predicate device: EVIS EXERA II 180 SYSTEM
ITEMProposed DevicePredicate Device
HD-500 Video Endoscope SystemK100584
EVIS EXERA II 180 SYSTEM
Electrical SafetyComply with IEC 60601-1Comply with IEC 60601-1
EMCComply with IEC 60601-1-2Comply with IEC 60601-1-2
Particular
requirementsComply with IEC 60601-2-18Comply with IEC 60601-2-18
Product
PerformanceComply with ISO 8600-1 and ISO
8600-7Comply with ISO 8600-1 and ISO
8600-7
Patient-contact
component and
material
(SE Analysis 19)Insertion sectionUnknown
Distal endUnknown
AdhesiveUnknown
Biocompatibility
(SE Analysis 19)Cytotoxicity, ISO 10993-5
Sensitization, ISO 10993-10
Irritation, ISO 10993-10

Table 6 Safety Comparison Proposed device: HD-500 Video Endoscope System

SE Analysis 19- Patient-contact component and material /Biocompatibility

The patient-contact components of the proposed device are same as those of the predicate device. Although the patient-contacting materials of the predicated device are unknown, the proposed device is biocompatible and conforms to ISO 10993 series standards. Therefore, the proposed device is claimed to be substantially equivalent to the predicate devices.

Substantially Equivalent (SE) Conclusion 9.

Based on the comparison and analysis in section 8 and the side-by-side optical performance tests, the proposed device and the predicate device have the same intended use, comparable product specification and optical performance. Therefore, the proposed device is determined to be Substantially Equivalent (SE) to the predicate device.