K Number
K191080
Manufacturer
Date Cleared
2019-05-22

(28 days)

Product Code
Regulation Number
874.4760
Panel
EN
Reference & Predicate Devices
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The endoscope is a sterile, single endoscope intended for endoscopic procedures and examination within the nasal lumens and upper airway anatomy. The endoscope is intended to provide visualization via a monitor.

The endoscope is intended for use in a hospital environment. It is designed for use in adults.

Device Description

The Ambu® aScope™ 4 RhinoLaryngo Slim is a sterile single use flexible endoscope for examination of the nasal lumens and upper airway anatomy.

Ambu® aScope™ 4 RhinoLaryngo Slim has the following physical and performance characteristics:
Maneuverable tip controlled by the user Flexible insertion cord Camera and LED light source at the distal tip Sterilized by Ethylene Oxide For single use

AI/ML Overview

This document is a 510(k) Summary for the Ambu aScope 4 RhinoLaryngo Slim, indicating that it is a sterile, single-use, flexible endoscope for examination of the nasal lumens and upper airway anatomy. It provides an overview of the device's characteristics and a comparison to predicate devices to establish substantial equivalence.

Here's an analysis of the acceptance criteria and study information:

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria are generally established by compliance with recognized consensus standards and performance tests. The device performance is reported as meeting these standards.

Acceptance Criteria (Test Category)Specific Standard/TestReported Device Performance
Product Specific StandardsISO 8600-1All tests were passed.
ISO 8600-3All tests were passed.
ISO 8600-4All tests were passed.
ISO 594-1All tests were passed.
Performance TestsLength and diameters of insertion cordAll tests were passed.
Bending angle, endurance and radiusAll tests were passed.
Image SharpnessAll tests were passed.
Shelf Life and Sterile BarrierASTM F1980 (Accelerated Aging)All tests were passed.
ASTM D4169 (Shipping Containers)All tests were passed.
ASTM F1886/F1886M (Seal Integrity - Visual)All tests were passed.
ASTM F2096 (Gross Leaks - Bubble Test)All tests were passed.
EN 868-5 (Seal Strength)All tests were passed.
ASTM F88 (Seal Strength)All tests were passed.
Electromagnetic CompatibilityIEC 60601-1-2All tests were passed.
Electrical SafetyIEC 60601-1All tests were passed.
IEC 60601-2-18All tests were passed.
BiocompatibilityISO10993 (cytotoxicity, irritation, sensitization)Compliant

2. Sample Size Used for the Test Set and Data Provenance

The document does not specify a "test set" in the context of clinical data or human subject studies. The data provenance described is primarily bench testing data for device performance, compliance with standards, and material properties. There is no information about country of origin for any human subject data, nor whether it was retrospective or prospective, as no such data is presented.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Their Qualifications

Not applicable. The ground truth for this submission is established through bench testing and compliance with recognized industry standards. There is no mention of expert consensus based on human clinical data for a "test set."

4. Adjudication Method for the Test Set

Not applicable. As described above, there is no "test set" in the context of clinical data requiring an adjudication method.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No, an MRMC comparative effectiveness study was not done. The document explicitly states "Not applicable" under the "Performance Data - Clinical" section, indicating no clinical studies were performed. This submission relies on substantial equivalence based on technological characteristics and bench testing compared to predicate devices.

6. Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study

Not applicable. This device is an endoscope, a physical medical instrument, not a software algorithm that would have standalone performance in the absence of a human operator. The device's performance is intrinsically linked to its physical properties and intended use by a clinician.

7. Type of Ground Truth Used

The ground truth used for demonstrating compliance and performance is based on engineering specifications, compliance with international and national standards (e.g., ISO, ASTM, IEC), and results from bench testing. For example, the measurement of bending angles, image sharpness, and seal integrity tests against predefined limits or standards constitute the ground truth.

8. Sample Size for the Training Set

Not applicable. This is not a machine learning or AI-based device that requires a "training set." The device is a physical medical instrument.

9. How the Ground Truth for the Training Set Was Established

Not applicable, as there is no training set mentioned or implied for this device.

§ 874.4760 Nasopharyngoscope (flexible or rigid) and accessories.

(a)
Identification. A nasopharyngoscope (flexible or rigid) and accessories is a tubular endoscopic device with any of a group of accessory devices which attach to the nasopharyngoscope and is intended to examine or treat the nasal cavity and nasal pharynx. It is typically used with a fiberoptic light source and carrier to provide illumination. The device is made of materials such as stainless steel and flexible plastic. This generic type of device includes the antroscope, nasopharyngolaryngoscope, nasosinuscope, nasoscope, postrhinoscope, rhinoscope, salpingoscope, flexible foreign body claw, flexible biopsy forceps, rigid biopsy curette, flexible biospy brush, rigid biopsy forceps and flexible biopsy curette, but excludes the fiberoptic light source and carrier.(b)
Classification. Class II.