K Number
K200609
Manufacturer
Date Cleared
2021-01-13

(310 days)

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

The ENTity WiFi Video Nasopharyngoscope System is intended to be used for oral or nasal introduction for the examination of the upper airway from the nasal passage to the vocal cords.

Device Description

The ENTity WiFi Video Nasopharyngoscope System is a complete video nasopharyngoscopy system that includes a rechargeable, battery-powered, flexible videoscope with an integral LED light source and WiFi connectivity; a video processor box that receives WiFi signals from the videoscope and provides HDMI output to a video monitor; image management and user interface software; a battery charger accessory for the videoscope; and an active touchscreen monitor accessory that can be used to view images and/or to communicate with the software user interface. Light generated by the LED light source located in the videoscope handle is transmitted through glass fiber optic bundles to the distal tip of the scope, where it illuminates the anatomy to be examined. A CMOS image sensor (camera chip) located at the distal tip of the videoscope captures still or video images in the form of electrical signals, which are wirelessly transmitted to the ENTity WiFi Video Processor. The video processor incorporates user interface and image management software. Still and/or video images may be viewed on the ENTity WiFi Active Touchscreen Monitor; the touchscreen features on the monitor can also be used to interact with the ENTity WiFi Video Processor.

AI/ML Overview

The provided text describes the ENTity WiFi Video Nasopharyngoscope System and its substantial equivalence to a predicate device. However, it does not contain a specific study proving the device meets particular clinical acceptance criteria for diagnostic performance (e.g., sensitivity, specificity for identifying specific conditions). The document focuses on showing substantial equivalence based on technical characteristics, non-clinical performance data, and compliance with various engineering and safety standards.

Therefore, I cannot provide a table of acceptance criteria and reported device performance related to diagnostic accuracy, nor can I detail a study that proves such criteria were met, as that information is not present in the provided text.

I can, however, extract information about the non-clinical performance and testing performed to demonstrate safety and technical equivalence.

Here's a breakdown of the requested information based on the provided text:


1. A table of acceptance criteria and the reported device performance

The document does not provide a table with clinical acceptance criteria (e.g., diagnostic sensitivity/specificity) and corresponding device performance data for ENTity WiFi Video Nasopharyngoscope System. Instead, it lists technical features and compliance with standards.

Here's a table based on the technical comparison and performance verification mentioned, rather than clinical acceptance criteria for diagnostic efficacy.

Acceptance Criteria (Technical/Performance Standard)Reported Device Performance (Compliance/Result)
Biocompatibility (ISO 10993-1, -5, -10)Evaluation and testing performed; passed cytotoxicity, sensitization, and intracutaneous irritation tests.
Reprocessing Validation (FDA guidance, AAMI TIR 12, TIR 30, ASTM E1837)Validated for manual cleaning and high-level disinfection.
Software Life Cycle Processes (IEC 62304)Compliant with IEC 62304.
Cybersecurity Risk Management (FDA 2014 Guidance)Risks assessed and mitigated.
Wireless Communication Performance (FDA 2013 Guidance, AAMI TIR69, ANSI C63.27)WPA2 encrypted 2.4 GHz WLAN 802.11 communication; wireless coexistence testing conducted.
End-to-End (E2E) LatencyComparable to predicate device + reference device; measured >160ms and <200ms.
Dimensional AccuracyMet design specifications.
Optical MeasurementMet design specifications.
Surface Temperature MeasurementMet design specifications.
Color PerformanceMet design specifications.
Limiting Spatial ResolutionMet design specifications.
Modulation Transfer Function (MTF)Met design specifications.
DistortionMet design specifications.
Image Intensity UniformityMet design specifications.
Signal to Noise RatioMet design specifications.
Dynamic RangeMet design specifications.
Rechargeable Battery & Charger PerformancePerformance verification conducted.
Camera PerformanceEvaluation conducted.
Videoscope Moisture ResistanceTesting conducted.
Hazard MitigationsVerification conducted.
System Performance EvaluationEvaluation conducted.
Electrical Safety (IEC 60601-1, IEC 60601-2-18)Tested in accordance with these standards.
Electromagnetic Compatibility (IEC 60601-1-2)Tested in accordance with this standard.
Usability (IEC 62366-1, FDA 2016 Guidance)Usability evaluated in a user validation study.

2. Sample size used for the test set and the data provenance (e.g., country of origin of the data, retrospective or prospective)

The document primarily describes non-clinical performance testing and compliance with standards. It does not specify sample sizes for test sets related to human data or diagnostic performance. Details like country of origin or retrospective/prospective nature are not provided for the described tests, as they are largely engineering and bench testing rather than clinical trials.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g., radiologist with 10 years of experience)

This information is not provided in the document because it does not detail a study involving expert-established ground truth for diagnostic accuracy. The testing described is overwhelmingly technical and engineering-focused.

4. Adjudication method (e.g., 2+1, 3+1, none) for the test set

This information is not provided as there is no described clinical study involving human judgment and adjudication.

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

There is no mention of an MRMC comparative effectiveness study, nor any AI assistance in the context of this device. The device is a "Video Nasopharyngoscope System," implying a direct visualization tool, not an AI-powered diagnostic system.

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

This information is not applicable as the device described is a video nasopharyngoscope system for direct visualization, not an algorithm or AI system for standalone performance evaluation.

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

For the non-clinical performance and safety testing, the "ground truth" was established by engineering specifications, recognized consensus standards, and guidance documents. For example, the ground truth for biocompatibility was adherence to ISO 10993-1, and for electrical safety, it was compliance with IEC 60601-1. There is no mention of clinical ground truth (e.g., pathology, outcomes data) as this document focuses on technical and safety equivalence.

8. The sample size for the training set

This information is not applicable as the device is not an AI/ML algorithm that requires a training set.

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

This information is not applicable as the device is not an AI/ML algorithm that requires a training set.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food & 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.

January 13, 2021

Optim, LLC % Pamela Papineau Consultant Delphi Medical Device Consulting, Inc. 5 Whitcomb Avenue Ayer, Massachusetts 01432

Re: K200609

Trade/Device Name: ENTity WiFi Video Nasopharyngoscope System Regulation Number: 21 CFR 874.4760 Regulation Name: Nasopharyngoscope (Flexible Or Rigid) And Accessories Regulatory Class: Class II Product Code: EOB Dated: December 4, 2020 Received: December 14, 2020

Dear Pamela Papineau:

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/cfpmr/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

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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/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-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 medical devices and radiation-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.

for Malvina B. Eydelman, M.D. Director OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental 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) K200609

Device Name

ENTity WiFi Video Nasopharyngoscope System

Indications for Use (Describe)

The ENTity WiFi Video Nasopharyngoscope System is intended to be used for oral or nasal introduction for the examination of the upper airway from the nasal passage to the vocal cords.

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

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Section 5 – 510(k) Summary (K200609)

A. General Information

510(k) SponsorOptim, LLC
Address:64 Technology Park RoadSturbridge, MA 01566 USA
FDA Registration #:1218141
Regulation:21 CFR 874.4760
Contact:Jenna Lipka, QA Manager
Contact Information:Tel: 508-347-5100Fax: 508-347-2380
Date Prepared:12 January 2021

B. Device Identification

Subject Device
Trade Name:ENTity WiFi Video Nasopharyngoscope System
Common Name:Flexible Nasopharyngoscope
Classification Name:Nasopharyngoscope (flexible or rigid)
Regulation:21 CFR 874.4760
Product Code:EOB
Device Classification:Class II
Reviewing Panel:Ear, Nose & Throat Devices
Indications for Use:For oral or nasal introduction for the examination of the upperairway from the nasal passage to the vocal cords
Predicate Device
Trade Name:Karl Storz CMOS Video Rhino-Laryngoscope System
Common Name:Flexible Nasopharyngoscope
Classification Name:Nasopharyngoscope (flexible or rigid)
Regulation:21 CFR 874.4760
Product Code:EOB
Device Classification:Class II
Reviewing Panel:Ear, Nose & Throat Devices
510(k) Number:K103467
Indications for Use:For endoscopic diagnosis within the nasal lumens and airwayanatomy, and is intended to provide visualization via a videomonitor
Reference Device
Trade Name:NDS Surgical Imaging, LLC ZeroWire Duo Wireless HDVideo Transfer System G2 (“ZeroWire G2")
Common Name:Wireless Device

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Classification Name:Endoscope and accessories
Regulation:21 CFR 876.1500
Product Code:GCJ
Device Classification:Class II
Reviewing Panel:General & Plastic Surgery Devices
510(k) Number:K151609
Indications for Use:For the delivery of video signals from a source such as anendoscopy camera/processor, or other video source over aradio-frequency link to a ZeroWire Receiver for display ofimages during endoscopic and general surgical procedures

C. Device Description

The ENTity WiFi Video Nasopharyngoscope System is a complete video nasopharyngoscopy system that includes a rechargeable, battery-powered, flexible videoscope with an integral LED light source and WiFi connectivity; a video processor box that receives WiFi signals from the videoscope and provides HDMI output to a video monitor; image management and user interface software; a battery charger accessory for the videoscope; and an active touchscreen monitor accessory that can be used to view images and/or to communicate with the software user interface. Light generated by the LED light source located in the videoscope handle is transmitted through glass fiber optic bundles to the distal tip of the scope, where it illuminates the anatomy to be examined. A CMOS image sensor (camera chip) located at the distal tip of the videoscope captures still or video images in the form of electrical signals, which are wirelessly transmitted to the ENTity WiFi Video Processor. The video processor incorporates user interface and image management software. Still and/or video images may be viewed on the ENTity WiFi Active Touchscreen Monitor; the touchscreen features on the monitor can also be used to interact with the ENTity WiFi Video Processor.

D. Indications for Use

The indications for use of the ENTity WiFi Video Nasopharyngoscope (for oral or nasal introduction for the examination of the upper airway from the nasal passage to the vocal cords) and the predicate Karl Storz CMOS Video Rhino-Laryngoscope System cleared in K103467 (for endoscopic diagnosis within the nasal lumens and airway anatomy, and is intended to provide visualization via a video monitor) are the same with minor differences in wording. The indications for use for the ZeroWire G2 reference device (for the delivery of video signals from a source such as an endoscopy camera/processor, or other video source over a radio-frequency link to a ZeroWire Receiver for display of images during endoscopic and general surgical procedures) describe the same type of wireless communication found in the ENTity WiFi System.

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E. Substantial Equivalence Comparison

Substantial equivalence for the ENTity WiFi Video Nasopharyngoscope System is primarily based on a comparison of design features and performance characteristics to those of the Karl Storz CMOS Video Rhino-Laryngoscope System cleared in K103467. This comparison is supported by non-clinical testing to confirm that the ENTity WiFi System meets design specifications for physical characteristics, performance, and safety. Wherever possible, test methods and acceptance criteria were based on FDA-recognized consensus standards and guidance documents. The NDS Surgical Imaging, LLC ZeroWire Duo Wireless HD Video Transfer System G2 (the "ZeroWire G2") cleared in K151609 is cited as a reference device to establish substantial equivalence of the wireless video image transmission capabilities of the ENTity WiFi Video Nasopharyngoscope System.

F. Comparison of Technical Characteristics with the Predicate Device

A summary of the differences between the subject and predicate devices is provided in accordance with 21 CFR 807.92(a)(6).

FeatureENTity WiFi VideoNasopharyngoscope System(subject device)Karl Storz CMOS VideoRhino-Laryngoscope System;K103467 (predicate device)Similarities andDifferences
Common NameFlexible NasopharyngoscopeSystemFlexible NasopharyngoscopeSystemSame
Classification NameNasopharyngoscope(flexible or rigid)Nasopharyngoscope(flexible or rigid)Same
Device ClassClass IIClass IISame
Regulation21 CFR 874.476021 CFR 874.4760Same
Product CodeEOBEOBSame
Indications for UseFor oral ornasal introduction forthe examination of the upperairway from the nasal passage tothe vocal cordsFor endoscopic diagnosis withinthe nasal lumens and airwayanatomy; intended to providevisualization via a videomonitorSame
Use EnvironmentHospital, clinic, medical officeHospital, clinic, medical officeSame
Principle of OperationCMOS videoscope with integralbattery and LED illuminationlight source; video processorwith user interface and imagemanagement capabilities; WiFidata transfer between videoscopeand video processorCMOS videoscope with integralbattery and LED illuminationlight source; video processorwith user interface and imagemanagement capabilities; wiredconnection between videoscopeand video processorDifferent
System Components &AccessoriesENTity WiFi VideoNasopharyngoscope; ENTityVideo Processor with ENTityICS Software; ActiveTouchscreen Monitor;Videoscope Battery ChargerKarl Storz CMOS VideoRhino-Laryngoscope scope;Karl Storz C-MAC MonitorDifferent
Device Design -VideoscopeFlexible videoscope withintegrated LED light sourceFlexible videoscope withintegrated LED light sourceSame
Scope Insertion TubeOD4.0 mm (distal tip)3.8 mm (shaft)3.7 mmSimilar
Scope Insertion TubeLength300 mm300 mmSame
FeatureENTity WiFi VideoNasopharyngoscope System(subject device)Karl Storz CMOS VideoRhino-Laryngoscope System;K103467 (predicate device)Similarities andDifferences
Scope Internal ChannelNoneNoneSame
Scope Direction ofViewSame
Scope Field of View85°85°Same
Scope Distal TipArticulation135° up / down140° up / downSimilar
Scope Image Sensor(camera) TypeCMOSCMOSSame
Scope Power SourceRechargeable Li-ion batterylocated in scope handpieceWired connection betweenvideoscope and monitorDifferent
Illumination LightSource TypeLEDLEDSame
Illumination LightOutput (min)6 LumensUnknownUnknown
Light SourcePhotobiological SafetyIEC 62471UnknownUnknown
Video ProcessorFunctionalityImage processing for displayon monitor; wirelesscommunication withvideoscope; imagemanagement and storageImage processing for displayon monitor; imagemanagement and storageDifferent
Video ProcessorSoftware FunctionalityUser interface; set/changescope button assignment, whitebalance & light output; imagemanagementUnknownUnknown
Scope – VideoProcessor ConnectionWireless (WiFi)WiredDifferent
BiocompatibilityISO 10993-1ISO 10993-1Same
Scope ReprocessingManual cleaning followed byHigh-Level Disinfection(AAMI TIR 12, AAMI TIR30, ASTM E1837)Manual cleaning followed byHigh-Level Disinfection(AAMI TIR 12, AAMI TIR30, ASTM E1837)Same
Scope Patient-Contacting Materials303 stainless steel; glass;polyurethane;polyetheretherketone (PEEK);fluorocarbon rubber; epoxyGlass; metal; plasticSimilar
Electrical Safety &Scope SafetyPerformanceIEC 60601-1IRC 60601-2-18IEC 60601-1IRC 60601-2-18Same
ElectromagneticCompatibilityIEC 60601-1-2IEC 60601-1-2Same
Scope OpticsIEC 8600-xIEC 8600-xSame

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G. Non-Clinical Performance Data

The ENTity WiFi Video Nasopharyngoscope has been tested in accordance with FDArecognized consensus standards and guidance documents to confirm that the product meets design specifications for physical characteristics, performance, and safety.

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Biocompatibilitv

Biocompatibility of the patient contacting materials contained in the ENTity WiFi Videoscope was established through evaluation and testing performed in accordance with ISO 10993-1:2009 Biological evaluation of medical devices – Part 1: Evaluation and testing within a risk management process and FDA's June 2016 guidance for the use of ISO 10993-1. The videoscope insertion tube has direct contact with the mucosal surfaces in the nasal passages and the nasopharynx; the duration of contact category according to ISO 10993-1 is "limited" (< 24 hours). The endoscope insertion tube was tested for cytotoxicity in accordance with ISO 10993-5:2009 Biological evaluation of medical devices – Part 5: Tests for in vitro cvtotoxicity, and for sensitization and intracutaneous irritation and ISO 10993-10:2010 Biological evaluation of medical devices – Part 10: Tests for in irritation and skin sensitization.

Reprocessing Validation

The ENTity WiFi Videoscope is a reusable device for which validated reprocessing instructions and reprocessing validation data are required in accordance with the June 9, 2017 Federal Register Notice Medical Devices; Validated Instructions for Use and Validation Data Requirements for Certain Reusable Medical Devices in Premarket Notifications. Detailed instructions for manual cleaning and high-level disinfection are included in the ENTity WiFi System labeling; these methods have been validated in accordance with FDA's 2015 Guidance for Reprocessing Medical Devices in Health Care Settings: Validation Methods and Labeling and recognized technical guidelines such as AAMI TIR 12:2010 Designing, testing, and labeling reusable medical devices for reprocessing in health care settings: A guide for medical device manufacturers, AAMI TIR 30:2011/R2016 A compendium of processes, materials, test methods, and acceptance criteria for cleaning reusable medical devices, and ASTM E1837-96 Standard test method to determine the efficacy of disinfection processes for medical devices (simulated use test).

Software

The ENTity ICS Software consists of user interface software that allows the user to enter and access patient data stored in the ENTity WiFi Video Processor, perform still image and streaming video capture during an examination, control some ENTity WiFi Videoscope settings, and to generate reports. Software life cycle processes are compliant with IEC 62304 Medical Device Software - Software Life Cycle Processes. Software documentation has been provided in accordance with FDA's 2005 Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices. Cybersecurity risks have been assessed and mitigated according to FDA's 2014 Guidance for the Content of Premarket Submissions Management of Cybersecurity in Medical Devices.

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Wireless Communication

The ENTity WiFi Videoscope and the ENTity WiFi Video Processor exchange data, including streaming image data, over a 2.4 GHz WLAN 802.11 wireless radio connection. All wireless data is encrypted using WPA2 technology for IEEE 802.11. FDA's 2013 Guidance for Industry and FDA Staff – Radio Frequency Wireless Technology in Medical Devices was applied for RF wireless technology design, documentation, and testing. Wireless coexistence testing was conducted using a test plan based on AAMI TIR69 and ANSI C63.27.

Dimensional, Functional, and Performance Testing

The ENTity WiFi System has been tested at the component and system level to ensure that all design specifications were met; testing included endoscope dimensional and optical measurement, endoscope surface temperature measurement, color performance, limiting spatial resolution, modulation transfer function (MTF), distortion, image intensity uniformity, signal to noise, dynamic range, rechargeable battery and battery charger performance verification, camera performance evaluation, videoscope moisture resistance testing, verification of hazards mitigations, and system performance evaluation. Comparative end-to-end (E2E) latency testing demonstrated that the E2E latency of the ENTity WiFi System is comparable to that of the predicate device system when used together with the reference device. The measured E2E latency of both the ENTity WiFi System and the predicate Karl Storz System with the reference NDS Surgical Imaging ZeroWire G2 was greater than 160ms and less than 200ms.

The ENTity WiFi System has been tested in accordance with IEC 60601-1 Medical Electrical Equipment, Part 1: General Requirements for Basic Safety and Essential Performance, IEC 60601-1-2 Medical Electrical Equipment, Part 1-2: General Requirements for Safety -Collateral Standard: Electromagnetic Compatibility Requirements and Tests, IEC 60601-1-6 Medical Electrical Equipment, Part 1-6: General Requirements for Basic Safety and Essential Performance – Collateral Standard: Usability, and IEC 60601-2-18 Medical Electrical Equipment, Part 2: Particular Requirements for the Safety of Endoscopic Equipment.

Usability

The usability engineering principles contained in IEC 62366-1 Medical Devices – Application of Usability Engineering to Medical Devices were utilized in the design and development of the ENTity WiFi System. Usability has been evaluated in a user validation study designed and conducted in accordance with FDA's 2016 guidance Applying Human Factors and Usability Engineering to Medical Devices.

H. Conclusion

Based on a comparison of the proposed and predicate device systems in terms of indications for use, technology, physical characteristics and performance specifications, together with the results of performance testing conducted in accordance with FDA guidance documents and recognized standards, the ENTity WiFi System raises no new questions of safety and effectiveness, and is substantially equivalent to predicate 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.