K Number
K190827
Device Name
Luminelle DTx Hysteroscopy System, Luminelle 360 Rotatable Sterile Disposable Sheath Rigid
Manufacturer
Date Cleared
2019-06-06

(66 days)

Product Code
Regulation Number
884.1690
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Hysteroscopy: The LUMINELLE DTx Hysteroscopy System is used to permit direct viewing of the cervical canal and uterine cavity for the purpose of performing diagnostic and surgical procedures. Note: Hysteroscopes are used as tools to access the uterine cavity and of themselves, a method of surgery. Generally recognized indications for diagnostic hysteroscopy include: - Abnormal bleeding - Infertility and pregnancy wastage - Evaluation of abnormal hysterosalpingogram - Intrauterine foreign body - Amenorrhea - Pelvic pain Generally recognized indications for operative hysteroscopy include: - Directed endometrial biopsy - Polypectomy - Submucous myomectomy - Transection of intrauterine adhesions - Transection of intrauterine septa - Endometrial ablation Cystoscopy: The LUMINELLE DTx Hysteroscopy System is intended for use in endoscopic access to and examination of the lower urinary tract, including the bladder. When combined with accessory instruments, the user to perform various diagnostic and therapeutic procedures.
Device Description
The LUMINELLE DTx Hysteroscopy System previously received 510(k) clearance (K181909) in 2018 as a hysteroscopic and cystoscopic system. To provide the user with a more rigid option for the RotoSheath and Introducer, UVision360, Inc. (hereafter UVision) proposes the addition of a new component to the system, the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid in addition to the currently available flexible Rotatable Disposable Sheath option cleared during the previous submission (K181909). No changes are proposed for the previously cleared components or the principles of operation of the LUMINELLE DTx Hysteroscopy System. The proposed change includes only the addition of a new component which is a modification to the previously cleared flexible LUMINELLE DTx 360° Rotatable Disposable Sheath.
More Information

No
The 510(k) summary describes a modification to a previously cleared hysteroscopy/cystoscopy system by adding a new, rigid sheath component. There is no mention of AI/ML in the intended use, device description, performance studies, or any other section. The focus is on the mechanical and material properties of the new component.

Yes
The device is used to perform diagnostic and surgical procedures, including directed endometrial biopsy, polypectomy, and endometrial ablation, which are therapeutic in nature.

Yes
The "Intended Use / Indications for Use" section explicitly states that the device is used for "direct viewing of the cervical canal and uterine cavity for the purpose of performing diagnostic and surgical procedures" and in the context of cystoscopy, to "perform various diagnostic and therapeutic procedures".

No

The device description explicitly states the addition of a new hardware component, a rigid disposable sheath, to a previously cleared hysteroscopy system.

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

Here's why:

  • Intended Use: The intended use clearly states the device is used for "direct viewing of the cervical canal and uterine cavity" and "endoscopic access to and examination of the lower urinary tract, including the bladder" for the purpose of performing diagnostic and surgical procedures. This describes a device used for direct visualization and intervention within the body, not for testing samples taken from the body.
  • Device Description: The description focuses on the physical components of the hysteroscopy and cystoscopy system, including sheaths and their rigidity. This aligns with a surgical/endoscopic instrument, not an IVD.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), reagents, or any form of in vitro testing. The device's function is purely observational and procedural within the body.

Therefore, the LUMINELLE DTx Hysteroscopy System is a medical device used for endoscopic procedures, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

Hysteroscopy: The LUMINELLE DTx Hysteroscopy System is used to permit direct viewing of the cervical canal and uterine cavity for the purpose of performing diagnostic and surgical procedures.

Note: Hysteroscopes are used as tools to access the uterine cavity and of themselves, a method of surgery. Generally recognized indications for diagnostic hysteroscopy include:

  • Abnormal bleeding
  • · Infertility and pregnancy wastage
  • · Evaluation of abnormal hysterosalpingogram
  • · Intrauterine foreign body
  • · Amenorrhea
  • · Pelvic pain

Generally recognized indications for operative hysteroscopy include:

  • · Directed endometrial biopsy
  • · Polypectomy
  • Submucous myomectomy
  • Transection of intrauterine adhesions
  • · Transection of intrauterine septa
  • · Endometrial ablation

Cystoscopy: The LUMINELLE DTx Hysteroscopy System is intended for use in endoscopic access to and examination of the lower urinary tract, including the bladder. When combined with accessory instruments, the user to perform various diagnostic and therapeutic procedures.

Product codes

HIH, FAJ

Device Description

The LUMINELLE DTx Hysteroscopy System previously received 510(k) clearance (K181909) in 2018 as a hysteroscopic and cystoscopic system. To provide the user with a more rigid option for the RotoSheath and Introducer, UVision360, Inc. (hereafter UVision) proposes the addition of a new component to the system, the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid in addition to the currently available flexible Rotatable Disposable Sheath option cleared during the previous submission (K181909).

No changes are proposed for the previously cleared components or the principles of operation of the LUMINELLE DTx Hysteroscopy System. The proposed change includes only the addition of a new component which is a modification to the previously cleared flexible LUMINELLE DTx 360° Rotatable Disposable Sheath.

The LUMINELLE DTx Hysteroscopy System is used to permit direct viewing of the cervical canal and uterine cavity for the purpose of performing diagnostic and surgical procedures.

The LUMINELLE DTx Hysteroscopy System is also intended for use in endoscopic access to and examination of the lower urinary tract, including the bladder. When combined with accessory instruments, the System allows the user to perform various diagnostic and therapeutic procedures.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

cervical canal, uterine cavity, lower urinary tract, bladder

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)

Sterility and shelf-life:
LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid is packaged in the same packaging as the predicate Rotatable Disposable Sheath, with the same sealing parameters. As the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid has the same dimensions as the predicate LUMINELLE DTx 360° Rotatable Disposable Sheath and the packaging materials and sealing parameters are identical, previous sterilization, simulated distribution and packaging shelf-life test documentation from the predicate was leveraged to support the sterilization and seal integrity of the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid. The shelf-life of the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid of 1 year was demonstrated through pull testing on the stainless steel hypotube bond. The device was demonstrated to maintain specifications after accelerated aging.

Design validation:
Design validation testing and usability testing was conducted on the LUMINELLE DTx Hysteroscopy System with the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid to confirm that the sheath performs to its intended use in in vivo models, the user is able to operate the system as intended, and the product conforms to user needs. Testing was identical to that conducted on the predicate LUMINELLE DTx 360° Rotatable Disposable Sheath. The LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid met all predefined acceptance criteria.

Biocompatibility:
There is no difference in patient-contacting materials, manufacturing or processing between the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid and the predicate Rotatable Disposable Sheath. Therefore, biocompatibility data from the predicate was leveraged to support the biocompatibility of the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid.

Electrical Safety:
Due to the additional stainless steel utilized in the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid, dielectric strength testing was conducted for the LUMINELLE DTx Rigid 360° Rotatable Disposable Sheath Rigid to confirm that the rigid sheath can withstand dielectric strength voltages in accordance with IEC 60601-1:2005/(R)2012 and A1:2012. Results of the testing were acceptable per IEC 60601-2-2 Medical electrical equipment—Part 2-2: Particular requirements for the basic safety and essential performance of high frequency surgical equipment and high frequency surgical accessories, which is specified by IEC 60601-2-18 Particular requirements for the basic safety and essential performance of endoscopic equipment.

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

Not Found

Predicate Device(s)

K181909

Reference Device(s)

K150158

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 884.1690 Hysteroscope and accessories.

(a)
Identification. A hysteroscope is a device used to permit direct viewing of the cervical canal and the uterine cavity by a telescopic system introduced into the uterus through the cervix. It is used to perform diagnostic and surgical procedures other than sterilization. This generic type of device may include obturators and sheaths, instruments used through an operating channel, scope preheaters, light sources and cables, and component parts.(b)
Classification. (1) Class II (performance standards).(2) Class I for hysteroscope accessories that are not part of a specialized instrument or device delivery system; do not have adapters, connectors, channels, or do not have portals for electrosurgical, laser, or other power sources. Such hysteroscope accessory instruments include: lens cleaning brush, cannula (without trocar or valves), clamp/hemostat/grasper, curette, instrument guide, forceps, dissector, mechanical (noninflatable), and scissors. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 884.9.

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June 6, 2019

UVision360, Inc. % Rita King CEO MethodSense, Inc. 1 Copley Pkwy, Suite 410 Morrisville, NC 27560

Re: K190827

Trade/Device Name: LUMINELLE DTx Hysteroscopy System Regulation Number: 21 CFR§ 884.1690 Regulation Name: Hysteroscope and Accessories Regulatory Class: II Product Code: HIH, FAJ Dated: May 6, 2019 Received: May 10, 2019

Dear Rita King:

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.

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.

1

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,

Sharon M. Andrews Assistant Division Director DHT3B: Division of Reproductive, Gynecology and Urology Devices OHT3: Office of Gastrorenal, ObGyn, General Hospital and Urology Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K190827

Device Name

LUMINELLE DTx Hysteroscopy System

Indications for Use (Describe)

Hysteroscopy: The LUMINELLE DTx Hysteroscopy System is used to permit direct viewing of the cervical canal and uterine cavity for the purpose of performing diagnostic and surgical procedures.

Note: Hysteroscopes are used as tools to access the uterine cavity and of themselves, a method of surgery. Generally recognized indications for diagnostic hysteroscopy include:

  • Abnormal bleeding
  • · Infertility and pregnancy wastage
  • · Evaluation of abnormal hysterosalpingogram
  • · Intrauterine foreign body
  • · Amenorrhea
  • · Pelvic pain

Generally recognized indications for operative hysteroscopy include:

  • · Directed endometrial biopsy
  • · Polypectomy
  • Submucous myomectomy
  • Transection of intrauterine adhesions
  • · Transection of intrauterine septa
  • · Endometrial ablation

Cystoscopy: The LUMINELLE DTx Hysteroscopy System is intended for use in endoscopic access to and examination of the lower urinary tract, including the bladder. When combined with accessory instruments, the user to perform various diagnostic and therapeutic procedures.

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

UVision360 Inc. K190827

| Submitter: | UVision360 Inc.
158 Wind Chime Ct.
Suite 201
Raleigh, NC 27615
Phone: 888-855-9360
Fax: |
|------------------|--------------------------------------------------------------------------------------------------------------------|
| Primary Contact: | Rita King, CEO
MethodSense, Inc.
Email: ritaking@methodsense.com
Phone: 919-313-3961
Fax: 919-313-3979 |
| Company Contact: | Allison London Brown
CEO |

Date Prepared: June 4, 2019

Device Name and Classification

Trade Name:LUMINELLE DTx Hysteroscopy System
Common Name:Hysteroscope with sheath
Classification:Class II
Regulation Number:21 CFR 884.1690 Hysteroscope and accessories
21 CFR 876.1500 Endoscope and accessories
Classification Panel:Obstetrics/Gynecology, Gastroenterology/Urology
Product Code:HIH Hysteroscope (And Accessories)
FAJ Cystoscope And Accessories; Flexible/Rigid

Predicate Device:

Predicate DeviceReference Device
Trade NameLUMINELLE DTx
Hysteroscopy SystemSchoelly
Cystoscopies/Hysteroscope
and Accessories
Common NameHysteroscope (and
accessories); Cystoscope
(and accessories)Hysteroscope and
accessories
510(k) Submitter / HolderUVision360 Inc.Schoelly Fiberoptic GmbH
510(k) NumberK181909K150158
Regulation Number21 CFR 876.1500
21 CFR 884.169021 CFR 876.1500
21 CFR 884.1690
Classification PanelGastroenterology/Urology
Obstetrics/GynecologyObstetrics/Gynecology
Product CodeFAJ, HIHFAJ, HIH

The predicate device has not been subject to a design-related recall.

4

Device Description

The LUMINELLE DTx Hysteroscopy System previously received 510(k) clearance (K181909) in 2018 as a hysteroscopic and cystoscopic system. To provide the user with a more rigid option for the RotoSheath and Introducer, UVision360, Inc. (hereafter UVision) proposes the addition of a new component to the system, the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid in addition to the currently available flexible Rotatable Disposable Sheath option cleared during the previous submission (K181909).

No changes are proposed for the previously cleared components or the principles of operation of the LUMINELLE DTx Hysteroscopy System. The proposed change includes only the addition of a new component which is a modification to the previously cleared flexible LUMINELLE DTx 360° Rotatable Disposable Sheath.

The LUMINELLE DTx Hysteroscopy System is used to permit direct viewing of the cervical canal and uterine cavity for the purpose of performing diagnostic and surgical procedures.

The LUMINELLE DTx Hysteroscopy System is also intended for use in endoscopic access to and examination of the lower urinary tract, including the bladder. When combined with accessory instruments, the System allows the user to perform various diagnostic and therapeutic procedures.

Indications for Use

Hysteroscopy: The LUMINELLE DTx Hysteroscopy System is used to permit direct viewing of the cervical canal and uterine cavity for the purpose of performing diagnostic and surgical procedures.

Note: Hysteroscopes are used as tools to access the uterine cavity and are not, in and of themselves, a method of surgery.

Generally recognized indications for diagnostic hysteroscopy include:

  • Abnormal bleeding
  • Infertility and pregnancy wastage .
  • Evaluation of abnormal hysterosalpingogram ●
  • . Intrauterine foreign body
  • Amenorrhea
  • Pelvic pain .

Generally recognized indications for operative hysteroscopy include:

  • Directed endometrial biopsy .
  • . Polypectomy
  • . Submucous myomectomy
  • . Transection of intrauterine adhesions
  • Transection of intrauterine septa ●
  • . Endometrial ablation

Cystoscopy: The LUMINELLE DTx Hysteroscopy System is intended for use in endoscopic access to and examination of the lower urinary tract, including the bladder. When combined with accessory instruments, the System allows the user to perform various diagnostic and therapeutic procedures.

5

Substantial Equivalence

The table below provides a detailed comparison of the LUMINELLE DTx Hysteroscopy System to the predicate device.

6

ItemSubject DevicePredicate DeviceComparison
LUMINELLE DTx
Hysteroscopy SystemLUMINELLE DTx
Hysteroscopy System
(K181909)
Intended Use
Indications for UseHysteroscopy:
The LUMINELLE DTx Hysteroscopy System is used to permit viewing of the cervical canal and uterine cavity for the purpose of performing diagnostic and surgical procedures.
NOTE: Hysteroscopes are used as tools to access the uterine cavity and are not, in and of themselves, a method of surgery
Generally recognized indications for diagnostic hysteroscopy include:
• Abnormal bleeding
• Infertility and pregnancy wastage
• Evaluation of abnormal hysterosalpingogramHysteroscopy:
The LUMINELLE DTx Hysteroscopy System is used to permit viewing of the cervical canal and uterine cavity for the purpose of performing diagnostic and surgical procedures.
NOTE: Hysteroscopes are used as tools to access the uterine cavity and are not, in and of themselves, a method of surgery
Generally recognized indications for diagnostic hysteroscopy include:
• Abnormal bleeding
• Infertility and pregnancy wastage
• Evaluation of abnormal hysterosalpingogram
• Intrauterine foreign body
• Amenorrhea
• Pelvic PainThe Indications for Use of the LUMINELLE DTx Hysteroscopy System are identical to the Indications for Use of the previously cleared LUMINELLE DTx Hysteroscopy System (K181909).
ItemSubject DevicePredicate DeviceComparison
LUMINELLE DTx
Hysteroscopy SystemLUMINELLE DTx
Hysteroscopy System
(K181909)
Intrauterine foreign body Amenorrhea Pelvic Pain Generally recognized indications for use for operative hysteroscopy include: Directed endometrial biopsy Polypectomy Submucous myomectomy Transection of intrauterine adhesions Endometrial ablation Cystoscopy: The LUMINELLE DTx Hysteroscopy System is intended for use in endoscopic access and examination of the lowerGenerally recognized indications for use for operative hysteroscopy include: Directed endometrial biopsy Polypectomy Submucous myomectomy Transection of intrauterine adhesions Endometrial ablation Cystoscopy: The LUMINELLE DTx Hysteroscopy System is intended for use in endoscopic access and examination of the lower urinary tract, including the bladder. When combined with accessory instruments, the System allows the user to perform various
ItemSubject DevicePredicate DeviceComparison
LUMINELLE DTx
Hysteroscopy SystemLUMINELLE DTx
Hysteroscopy System
(K181909)
urinary tract, including
the bladder. When
combined with
accessory instruments,
the System allows the
user to perform various
diagnostic and
therapeutic procedures.diagnostic and therapeutic
procedures.
Technological Characteristics
Rigid/Flexible
SheathFlexible and rigid
sheaths available:
• Flexible sheath
(LUMINELLE DTx
360° Rotatable
Disposable Sheath)
contains a PEEK
(polyetheretherketone)
hypotube for
flexibility.
• Rigid sheath
(LUMINELLE DTx
360° Rotatable
Disposable Sheath
Rigid) contains a
304 stainless steel
inner tube for
rigidity.Flexible sheath only
(LUMINELLE DTx 360°
Rotatable Disposable
Sheath), contains a PEEK
(polyetheretherketone)
hypotube for flexibility.The flexibility of the LUMINELLE DTx 360° Rotatable
Disposable Sheath of the LUMINELLE DTx
Hysteroscopy System is identical to the flexibility of the
sheath of the previously cleared LUMINELLE DTx
Hysteroscopy System (K181909).

The rigidity of the LUMINELLE DTx 360° Rotatable
Disposable Sheath Rigid of the LUMINELLE DTx
Hysteroscopy System is higher than that of the predicate
Rotatable Disposable Sheath. However, this difference
does not raise different questions of safety and
effectiveness. The reference device, Schoelly
Cystoscopes/ Hysteroscopes and Accessories
(K150158) includes a rigid sheath similar to the
proposed device.

All other technological characteristics are the same
between the subject and predicate device. |

Detailed Comparison of the Subject and Predicate Device

UVision360 LUMINELLE DTx Hysteroscopy System Special 510(k)

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K190827 Page 5 of 8

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K190827 Page 6 of 8

9

Testing

Sterility and shelf-life

LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid is packaged in the same packaging as the predicate Rotatable Disposable Sheath, with the same sealing parameters. As the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid has the same dimensions as the predicate LUMINELLE DTx 360° Rotatable Disposable Sheath and the packaging materials and sealing parameters are identical, previous sterilization, simulated distribution and packaging shelf-life test documentation from the predicate was leveraged to support the sterilization and seal integrity of the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid.

The shelf-life of the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid of 1 year was demonstrated through pull testing on the stainless steel hypotube bond. The device was demonstrated to maintain specifications after accelerated aging.

Design validation

Design validation testing and usability testing was conducted on the LUMINELLE DTx Hysteroscopy System with the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid to confirm that the sheath performs to its intended use in in vivo models, the user is able to operate the system as intended, and the product conforms to user needs. Testing was identical to that conducted on the predicate LUMINELLE DTx 360° Rotatable Disposable Sheath. The LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid met all predefined acceptance criteria.

Biocompatibility

There is no difference in patient-contacting materials, manufacturing or processing between the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid and the predicate Rotatable Disposable Sheath. Therefore, biocompatibility data from the predicate was leveraged to support the biocompatibility of the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid.

Electrical Safety

Due to the additional stainless steel utilized in the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid, dielectric strength testing was conducted for the LUMINELLE DTx Rigid 360° Rotatable Disposable Sheath Rigid to confirm that the rigid sheath can withstand dielectric strength voltages in accordance with IEC 60601-1:2005/(R)2012 and A1:2012. Results of the testing were acceptable per IEC 60601-2-2 Medical electrical equipment—Part 2-2: Particular requirements for the basic safety and essential performance of high frequency surgical equipment and high frequency surgical accessories, which is specified by IEC 60601-2-18 Particular requirements for the basic safety and essential performance of endoscopic equipment.

Substantial Equivalence Discussion

The intended use for LUMINELLE DTx Hysteroscopy System is the same as that of the previously cleared LUMINELLE DTx Hysteroscopy System (K181909). The technological characteristics of the LUMINELLE DTx Hysteroscopy System are different from the LUMINELLE DTx Hysteroscopy System (K181909) in that the LUMINELLE DTx Hysteroscopy System includes the LUMINELLE DTx 360° Rotatable Disposable Sheath Rigid, a modified version of

10

the LUMINELLE DTx 360° Rotatable Disposable Sheath (K181909). However, this difference does not raise different questions of safety and effectiveness. Performance testing shows that the LUMINELLE DTx Hysteroscopy System is as safe and effective as the previously cleared LUMINELLE DTx Hysteroscopy System (K181909).

Conclusion

The LUMINELLE DTx Hysteroscopy System is substantially equivalent to the legally marketed predicate device K181909.