K Number
K192499
Device Name
Cyber Blade
Manufacturer
Date Cleared
2020-07-31

(324 days)

Product Code
Regulation Number
876.1500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Cyber BLADE is intended for use under endoscopic visualization and removal of dissected benign prostatic hyperplasia (BPH) tissue during endoscopic surgical procedures in urology.
Device Description
Cyber Blade provides efficient and rapid morcellation under endoscopic visualization. The cutting action is driven by the motor in the handpiece. Cyber Blade comprises: a single use sterile blade fixed to a handpiece where controls are placed, a re-usable internal motor provided with integrated battery pack, an AC powered charger for the battery pack. Cyber blade is also supplied with aspiration tubing and canister for the collection of evacuated tissue.
More Information

Not Found

No
The description focuses on mechanical morcellation and tissue removal, with no mention of AI or ML capabilities in the device description, intended use, or performance studies.

No
The device is used for the removal of dissected benign prostatic hyperplasia (BPH) tissue, which is a surgical procedure. Therapeutic devices are typically defined as those that treat or cure a disease or condition. While the removal of tissue can alleviate symptoms of BPH, the device itself is a surgical tool for tissue excision rather than directly treating the underlying physiological condition in a therapeutic sense (e.g., drug delivery, radiation therapy, or stimulation). It facilitates a surgical intervention.

No

This device is designed for the removal of dissected benign prostatic hyperplasia (BPH) tissue during endoscopic surgical procedures, not for diagnosing a condition. Its function is morcellation and tissue collection, which are surgical interventions, not diagnostic processes.

No

The device description explicitly lists hardware components such as a handpiece, motor, battery pack, charger, aspiration tubing, and canister. While software verification and validation were conducted, the device is not solely software.

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

Here's why:

  • Intended Use: The intended use is the "removal of dissected benign prostatic hyperplasia (BPH) tissue during endoscopic surgical procedures in urology." This is a surgical procedure performed on the patient's body, not a test performed on a sample taken from the body.
  • Device Description: The device is a surgical tool for cutting and removing tissue. It does not involve analyzing biological samples for diagnostic purposes.
  • Lack of IVD Characteristics: The description does not mention any components or functions related to analyzing blood, urine, tissue samples, or any other biological material for diagnostic information.

IVD devices are used to examine specimens derived from the human body to provide information for the diagnosis, prevention, monitoring, treatment, or alleviation of disease. The Cyber BLADE's function is purely surgical tissue removal.

N/A

Intended Use / Indications for Use

Cyber BLADE is intended for use under endoscopic visualization and removal of dissected benign prostatic hyperplasia (BPH) tissue during endoscopic surgical procedures in urology.

Product codes (comma separated list FDA assigned to the subject device)

GCJ

Device Description

Cyber Blade provides efficient and rapid morcellation under endoscopic visualization. The cutting action is driven by the motor in the handpiece.

Cyber Blade comprises:

  • a single use sterile blade fixed to a handpiece where controls are placed
  • a re-usable internal motor provided with integrated battery pack
  • an AC powered charger for the battery pack

Cyber blade is also supplied with aspiration tubing and canister for the collection of evacuated tissue.

Cyber Blade is comprehensive of the following parts:

REFDescriptionnotes
20041001Cyber Blade Morcellatorsterile single use
20042001Battery-powered motornon sterile - reusable
20049001Charging station100-220V, 50/60Hz
ABM000091Suction tubesterile single use
077.0562Canister (tissue collector)
Key Specifications, mechanism of action, device function
Principle of operationmorcellation through the cutting effect of the cutting window, produced by the relative movement of the internal tube and the external tube.
Vacuum intensity regulationPossible through the leverage on the morcellator
Speed regulationPossible through the button on the morcellator
Morcellation velocityAbout 17 grams per minute
Handpiece dimension (external tube)38 cm length 0.47 cm external diameter
Materials in contact with the tissueStainless steel
Power supplyThe morcellator is battery powered. The battery charger is AC power supplied.
Supplied SterileYes (only the morcellator)
Re-usableNo. The morcellator is single use only. Its internal motor is reusable

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

endoscopic visualization

Anatomical Site

prostatic hyperplasia (BPH) tissue

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)

Software Verification and Validation Testing were conducted and documentation was provided as recommended by FDA's Guidance for Industry and FDA Staff, "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices".

The following additional testing were performed: morcellation efficiency, suction test, dimensional specification verification, tensile strength of blade, comparative testing with Richard Wolf morcellator, risk analysis on the performance test, battery testing.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

VERSACUT + TISSUE MORCELLATOR (K133272), MORCE SCOPE SET 8970 (K041610)

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

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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July 31, 2020

SIDAM s.r.1. Andrea Tromba Regulatory Affairs Manager Via Statale Sud, 169 Mirandola (MO), 41037 Italy

Re: K192499 Trade/Device Name: Cyber Blade Regulation Number: 21 CFR§ 876.1500 Regulation Name: Endoscope and Accessories Regulatory Class: II Product Code: GCJ Dated: June 18, 2020 Received: June 22, 2020

Dear Andrea Tromba:

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/combination-products/guidance-regulatoryinformation/postmarketing-safety-reporting-combination-products); 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Martha W. Betz, Ph.D. Acting Assistant 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

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Indications for Use

510(k) Number (if known) K192499

Device Name Cyber Blade

Indications for Use (Describe)

Cyber BLADE is intended for use under endoscopic visualization and removal of dissected benign prostatic hyperplasia (BPH) tissue during endoscopic surgical procedures in urology.

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

2 Prescription Use (Part 21 CFR 801 Subpart D)

__ Over-The-Counter Use (21 CFR 801 Subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

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DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

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Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement below.

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5. 510(K) SUMMARY

| Applicant /
Manufacturer
Name and Address: | SIDAM s.r.l.
Via Statale Sud, 169
41037 San Giacomo Roncole
MIRANDOLA (MO) - Italy |
|-----------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------|
| 510(k) Contact Person: | Andrea Tromba
Regulatory Affairs Manager
SIDAM s.r.l.
Email: andrea@sidamit.it
Phone: +39 0535.25523
Fax:
+39 0535.25635 |
| Date Prepared: | 31/07/2020 |
| Device Name: | Cyber Blade |
| Classification: | Class II |
| Classification Name: | Endoscopes and accessories |
| Common name: | Laparoscope, General and Plastic Surgery |
| Regulation Number: | 21 CFR 876.1500 |
| Product Code: | GCJ |
| Main Predicate device
Secondary predicate device | Versacut + Tissue Morcellator (K133272), Lumenis Ltd
Morce Scope Set 8970 (K041610), Richard Wolf Medical
Instruments Corp. |

Performance Standards:

There are no mandatory performance standards for this device.

Description of the device:

Cyber Blade provides efficient and rapid morcellation under endoscopic visualization. The cutting action is driven by the motor in the handpiece.

Cyber Blade comprises:

  • a single use sterile blade fixed to a handpiece where controls are placed
  • a re-usable internal motor provided with integrated battery pack
  • an AC powered charger for the battery pack

Cyber blade is also supplied with aspiration tubing and canister for the collection of evacuated tissue.

4

REFDescriptionnotes
20041001Cyber Blade Morcellatorsterile single use
20042001Battery-powered motornon sterile - reusable
20049001Charging station100-220V, 50/60Hz
ABM000091Suction tubesterile single use
077.0562Canister (tissue collector)

Cyber Blade is comprehensive of the following parts:

Key Specifications, mechanism of action, device function
Principle of operationmorcellation through the cutting effect of the cutting window, produced by the relative movement of the internal tube and the external tube.
Vacuum intensity regulationPossible through the leverage on the morcellator
Speed regulationPossible through the button on the morcellator
Morcellation velocity 1About 17 grams per minute
Handpiece dimension (external tube)38 cm length
0.47 cm external diameter
Materials in contact with the tissueStainless steel
Power supplyThe morcellator is battery powered.
The battery charger is AC power supplied.
Supplied SterileYes (only the morcellator)
Re-usableNo. The morcellator is single use only.
Its internal motor is reusable

Indications for Use

Cyber BLADE is intended for use under endoscopic visualization for the morcellation and removal of dissected benign prostatic hyperplasia (BPH) tissue during endoscopic surgical procedures in urology.

Comparison of Technological Characteristics:

The subject device and the identified predicate devices have comparable general intended use and technological characteristics.

Any differences compared to the predicate devices do not present any new types of safety or effectiveness concern.

A comparison of the technical characteristics between the subject and predicate devices follows:

1 The morcellated tissue coincides with the removed tissue, as all is aspired with the vacuum system

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SpecificationSubject devicemain predicate deviceSecondary predicate deviceComparison to Predicate
Device Name
(K #)Cyber BladeVERSACUT + TISSUE
MORCELLATOR (K133272)MORCE SCOPE SET 8970
(K041610)
SubmitterSIDAM s.r.l.LUMENIS LTD.RICHARD WOLF MEDICAL
INSTRUMENTS CORP.
Principle of operationmorcellation through the cutting
effect of the cutting window,
produced by the relative
movement of the internal tube
and the external tube.Morcellation through the cutting
effect of the cutting window,
produced by the relative
movement of the internal tube
and the external tube.Morcellation through the cutting
effect of the cutting window,
produced by the relative
movement of the internal tube
and the external tube.Same
Vacuum intensity
regulationPossible through the leverage on
the morcellatorPossible from the vacuum
generatorPossible from the vacuum
generatorequivalent
Speed regulationPossible through the button on
the morcellatorPossible from the vacuum
generatorPossible from the vacuum
generatorequivalent
Handpiece dimension
(external tube)38 cm length
0.47 cm external diameter39.5 cm length
0.47 cm external diameter35 or 38 cm length
0.475 cm external diameterIn the same range
Materials in contact
with the tissueStainless steelStainless steelStainless steelequivalent
Power supplyThe morcellator is battery
powered.
The battery charger is AC power
supplied.AC power suppliedAC power suppliedA device battery powered
raises less concerns compared
to a device AC powered
Suction pumpNot part of the system, must use
an external suction system.Part of the systemPart of the systemExternal FDA cleared suction
system to be used.
Supplied SterileYesNoYesA device provided sterile raises
less concerns compared to a
device intended to be sterilized
before use.
Re-usableNo. The morcellator is single use
only.
Its internal motor is reusable,
but it never comes in contact
with the patientYesAvailable either single use and
reusableA single use device raises less
concerns than a re-usable one.

Comparison of indications: as detailed in the comparison table below, the indications of the subject device are a sub-set of the indications of its predicate devices.

SpecificationSubject devicemain predicate deviceadditional predicate deviceComparison to Predicate
Device Name
(K #)Cyber BladeVERSACUT + TISSUE
MORCELLATOR (K133272)MORCE SCOPE SET 8970
(K041610)
SubmitterSIDAM s.r.l.LUMENIS LTD.RICHARD WOLF MEDICAL
INSTRUMENTS CORP.
Intended useCyber BLADE is intended for use
under endoscopic visualization
for the morcellation and
removal of dissected benign
prostatic hyperplasia (BPH)
tissue during endoscopic surgical
procedures in urology.The VersaCut + Tissue
Morcellator is intended for use
under
direct or endoscopic
visualization for the
morcellation and removal
of dissected tissue during
pelviscopic, laparascopic,
percutaneous
and open surgical procedures
whenever access to the surgical
site is limited.MORCE Scope Set 8970, in
conjunction with a
morcellation probe, and with
its sheaths and obturators, is
used in the cutting
(morcellation) and continuous
removal of large tissue masses.
In combination with the
corresponding auxiliary
instruments, it can be used as a
nephroscope in the
disintegration and
removal/aspiration of kidney
and bladder stones and
the removal of tumors via
percutaneous (kidney) or
transurethral (bladder)
passages, in conjunction withSub-set of the indications of
the predicate devices.
Endoscopy is a less invasive
access to the body compared
to laparoscopy or other
invasive techniques.

6

SpecificationSubject devicemain predicate deviceadditional predicate deviceComparison to Predicate
Device Name
(K #)Cyber BladeVERSACUT + TISSUE
MORCELLATOR (K133272)MORCE SCOPE SET 8970
(K041610)
SubmitterSIDAM s.r.l.LUMENIS LTD.RICHARD WOLF MEDICAL
INSTRUMENTS CORP.
intracorporeal 5-4ithotripters
e.g. operated pneumatically,
by ultrasound, electro-
hydraulically or by laser, under
endoscopic control.
The POWER CONTROL 2303 in
conjunction with POWER STICK
M4 serves to drive WOLF
morcellators for the
continuous removal of ablated
tissue in endoscopic
operations.
The SUCTION PUMP is used for
aspirating irrigation fluid in
conjunction with a
resectoscope or a morcellator
following laser TURP.

Summary of Non-Clinical Performance Testing :

Cyber Blade devices comply with the following recognized consensus standards or guidelines:

| STANDARD TITLE or guidelines | standard
recognized
by FDA? | FDA
recognition
number | exclusions
from the
standard |
|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------|------------------------------|------------------------------------|
| IEC 60601-1:2012, ed 3.1, Medical Electrical Equipment - Part 1:
General Requirements For Basic Safety And Essential Performance | Yes | 19-4 | No |
| IEC 60601-1-2 Edition 4: 2014, Medical Electrical Equipment - Part 1-
2: General Requirements For Basic Safety And Essential Performance

  • Collateral Standard: Electromagnetic Compatibility - Requirements
    And Tests | Yes | 19-8 | No |
    | EN 556-1:2001/AC:2006 Sterilization of medical devices –
    Requirements for medical devices to be designated "STERILE" – Part
    1: requirements for terminally sterilized medical devices | No | N/A | No |
    | ISO 15223-1 Third Edition 2016-11-01 Medical devices - Symbols to
    be used with medical device labels, labelling, and information to be
    supplied - Part 1: General requirements | Yes | 5-117 | No |
    | EN 1041:2008 Information supplied by the manufacturer of medical
    devices. | No | N/A | No |
    | ISO 10993-5 Third edition 2009-06-01 Biological evaluation of
    medical devices - Part 5: Tests for in vitro cytotoxicity | Yes | 2-245 | No |
    | ISO 10993-1 Fourth edition 2009-10-15 Biological evaluation of
    medical devices – Part 1: Evaluation and testing within a risk
    management process [Including: Technical Corrigendum 1 (2010)] | Yes | 2-220 | No |
    | STANDARD TITLE or guidelines | standard
    recognized
    by FDA? | FDA
    recognition
    number | exclusions
    from the
    standard |
    | ISO 10993-7 Second edition 2008-10-15 Biological evaluation of
    medical devices - Part 7: Ethylene oxide sterilization residuals
    [Including: Technical Corrigendum 1 (2009)] | Yes | 14-408 | No |
    | ISO 10993-10 Third Edition 2010-08-01 Biological evaluation of
    medical devices - Part 10: Tests for irritation and skin sensitization | Yes | 2-174 | No |
    | ISO 11135 Second edition 2014-07-15 Sterilization of health-
    care products - Ethylene oxide - Requirements for the development,
    validation and routine control of a sterilization process for medical
    devices [Including: Amendment 1 (2018)] | Yes | 14-529 | No |
    | ISO 11138-1 Third edition 2017-03 Sterilization of health care
    products - Biological indicators - Part 1: General requirements | Yes | 14-502 | No |
    | ISO 11607-1 First edition 2006-04-15 Packaging for
    terminally sterilized medical devices - Part 1: Requirements for
    materials, sterile barrier systems and packaging systems [Including:
    Amendment 1 (2014)] | Yes | 14-454 | No |
    | ISO 11607-2 First edition 2006-04-15 Packaging for
    terminally sterilized medical devices - Part 2: Validation
    requirements for forming, sealing and assembly processes
    [Including: Amendment 1 (2014)] | Yes | 14-455 | No |
    | ISO 11737-1 Third edition 2018-01 Sterilization of health care
    products - Microbiological methods - Part 1: Determination of a
    population of microorganisms on product | Yes | 14-514 | No |
    | ISO 14971 Second edition 2007-03-01 Medical devices -
    Application of risk management to medical devices | Yes | 5-40 | No |
    | ISO 17664 Second edition 2017-10 Processing of health care
    products - Information to be provided by the medical device
    manufacturer for the processing of medical devices | Yes | 14-515 | No |
    | ISO 17664 Second Edition 2017-10 Processing Of Health Care
    Products - Information To Be Provided By The Medical Device
    Manufacturer For The Processing Of Medical Devices | Yes | 14-515 | No |
    | Software Verification and Validation Testing
    Software verification and validation testing were conducted and
    documentation was provided as recommended by FDA's Guidance
    for Industry and FDA Staff, "Guidance for the Content of Premarket
    Submissions for Software Contained in Medical Devices | - | - | - |

7

The following additional testing were performed: morcellation efficiency, suction test, dimensional specification verification, tensile strength of blade, comparative testing with Richard Wolf morcellator, risk analysis on the performance test, battery testing.

8

Conclusion

As the indications for use are a sub-set of its predicate devices and the principle of operation and specifications are equivalent, Cyber Blade is substantially equivalent to its predicate devices.