K Number
K200770
Device Name
Mini PCNL-System
Manufacturer
Date Cleared
2021-07-30

(492 days)

Product Code
Regulation Number
876.1500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The nephroscopy accessory set is intended for minimally invasive procedures in nephroscopy. The shaft is a reusable, surgically invasive device for shortterm use. It is designed to bring instruments, telescopes, and fluids to the surgical site. The Dilator is a reusable, surgically invasive device for temporary use. It is designed to widen existing surgically invasive openings.
Device Description
The TROKAMED GmbH Mini PCNL-System consists of shaft and dilator. The diameter is specified directly on the shaft and dilator. This ensures that the instrument can be assigned easily and only suitable components are used. The instruments cannot be disassembled. The puncture is expanded with the dilator at the beginning of surgery. The procedure, during which kidney stones can be destroyed, is then performed via the shaft. The kidney stones are automatically transported out of the proximal end of the shaft as a result of the cleaning pressure and by the irrigation fluid. The nephroscope may not be fully mounted on the shaft here.
More Information

Not Found

No
The description focuses on mechanical components and their function in a surgical procedure, with no mention of AI/ML terms, image processing, or data-driven features.

No
The device is described as an accessory set for minimally invasive procedures in nephroscopy, designed to bring instruments, telescopes, and fluids to a surgical site and widen existing openings. It facilitates a procedure to destroy kidney stones but does not directly provide a therapeutic effect itself; rather, it enables the delivery of other instruments that perform the therapy. It's a surgical tool, not a therapeutic device.

No

Explanation: The device is described as an accessory set for nephroscopy, designed to bring instruments, telescopes, and fluids to a surgical site and widen surgical openings. Its purpose is for minimally invasive procedures to destroy kidney stones, not to diagnose a condition.

No

The device description clearly outlines physical components (shaft and dilator) and their mechanical functions in a surgical procedure, indicating it is a hardware-based medical device.

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 for "minimally invasive procedures in nephroscopy" and is designed to "bring instruments, telescopes, and fluids to the surgical site" and "widen existing surgically invasive openings." This describes a surgical instrument used in vivo (within the body) during a procedure.
  • Device Description: The description details a "Mini PCNL-System" consisting of a shaft and dilator used for expanding a puncture and performing a procedure to destroy kidney stones. This is a surgical tool.
  • Lack of IVD Characteristics: An IVD is a medical device used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health. The provided information does not mention any testing of samples or analysis of biological materials.

Therefore, this device is a surgical instrument, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The nephroscopy accessory set is intended for minimally invasive procedures in nephroscopy. The shaft is a reusable, surgically invasive device for shortterm use. It is designed to bring instruments, telescopes, and fluids to the surgical site. The Dilator is a reusable, surgically invasive device for temporary use. It is designed to widen existing surgically invasive openings.

Product codes

FED

Device Description

The TROKAMED GmbH Mini PCNL-System consists of shaft and dilator. The diameter is specified directly on the shaft and dilator. This ensures that the instrument can be assigned easily and only suitable components are used. The instruments cannot be disassembled. The puncture is expanded with the dilator at the beginning of surgery. The procedure, during which kidney stones can be destroyed, is then performed via the shaft. The kidney stones are automatically transported out of the proximal end of the shaft as a result of the cleaning pressure and by the irrigation fluid. The nephroscope may not be fully mounted on the shaft here.

The nephroscopic shafts are rigid reusable instruments with inner lumen and are used as an introducer for the instrument into the surgical site. The shaft itself is introduced into the surgical site by the help of the dilator.

The dilators are rigid reusable instruments. They are equipped with two lumens: one lumen in the center and one on the side. The quide wire (not included in this submission) is fed through the medial lumen. An additional safety wire (not included in this submission) can be guided through the lateral lumen. Markings indicate when the conical tip of the dilator is protruding from the shaft. Both types of dilators has the same total and working length, but different diameters.

The Mini PCNL-System is used together with a suitable nephroscope. The nephroscope is not part of the subject device and not included in this submission.

The Mini PCNL-System is delivered in non-sterile conditions and has to be processed before using it for the first time and before each use afterwards.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

kidney or upper urinary tract

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Prescription Use

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)

Reprocessing Study:
Standard Reference to Tests: EN ISO 17664 / ANSI AAMI ISO 17664: 2017, AAMI TIR30: 2011 (reapproved 2016), ANSI/AAMI ST79: 2017, ASTM E2314: 2003 (reapproved 2014), ASTM F3208: 2018, ASTM E1766: 2015, ANSI/AAMI ST67: 2011 (reapproved 2017), FDA guidance: 2015/2017.
Results: A sufficient ability of the tested master Worst Case products for an effective cleaning can be stated. All tested products showed a sufficient spore log reduction (SLR > 12) by use of standard sterilization parameters. Therefore, a sufficient ability of the tested master Worst-Case products for an effective steam sterilization can be stated.

Life Expectancy Testing:
Standard Reference to Tests: TROKAMED standard FB-26_07_010_Product Life expectancy, TROKAMED Standard Operating Procedures, FB-15_02_001_TR_Mini PCNL_01_mechanical test_15Sep2020.
Results: Material durability and functionality are verified for the given lifetime. Mechanical strength test with unaged and aged subject device.

Biocompatibility Evaluation:
Standard Reference to Tests: ISO 10993-1:2018, ISO 10993-5:2009, ISO 10993-10: 2010, ISO 10993-12:2012, ISO 10993-18:2020, FDA blue book memorandum (#G95-1).
Results: A cytotoxicity testing of Worst Case AUF11020 has verified that no substances of cell toxic concentration are released. The chemical characterization has shown that solvable substances or degradation products of Worst case AUF11020 do not exceed the toxicological relevant concentrations.

Mechanical Testing:
Standard Reference to Tests: none (TROKAMED Standard Operating Procedures only) for Tensile tests with tubes and Bending load of the shaft tubes.
Results for Tensile tests with tubes: Summary of bending and breaking forces of stainless steel TROKAMED instruments.
Results for Bending load of the shaft tubes: Shaft of subject device withstands maximal loading forces within minimally invasive surgery.
Results for FB-15_02_001_TR_Mini PCNL_01_mechanical test_15Sep2020: Stability and strength of connecting points of the subject device, unaged and aged.

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

Not Found

Predicate Device(s)

K994223

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.

0

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, with the letters "FDA" in a blue square. Next to that is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

July 30, 2021

TROKAMED GmbH Stefan Weiland Regulatory Affairs Manager Kleine Breite 17 Geisingen, BW 78187 Germany

Re: K200770 Trade/Device Name: Mini PCNL-System Regulation Number: 21 CFR§ 876.1500 Regulation Name: Endoscope and Accessories Regulatory Class: II Product Code: FED Dated: June 10, 2021 Received: June 14, 2021

Dear Stefan Weiland:

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,

Mark J. Antonino, M.S. 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

2

Indications for Use

510(k) Number (if known) K200770

Device Name

Mini PCNL-System

Indications for Use (Describe)

The nephroscopy accessory set is intended for minimally invasive procedures in nephroscopy.

The shaft is a reusable, surgically invasive device for shortterm use. It is designed to bring instruments, telescopes, and fluids to the surgical site.

The Dilator is a reusable, surgically invasive device for temporary use. It is designed to widen existing surgically invasive openings.

Patient Target Group

Patients with kidney or upper urinary tract conditions who require a nephroscopic procedure.

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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Image /page/3/Picture/1 description: The image shows the logo for TROKAMED GmbH. The logo features the company name in bold, gray letters, with a blue semi-circle design element on the left side. Below the company name, in smaller letters, is the phrase "ZUVERLÄSSIGE PRÄZISION" which translates to "RELIABLE PRECISION".

TROKAMED GmbH · Kleine Breite 17 · 78187 Geisingen U.S. Food and Drug Administration Center for Devices and Radiological Health Document Control Center (DCC) - WO66-G609 10903 New Hampshire Avenue Silver Spring, MD 20993-0002

July 28, 2021

510(k) Summary

| Submitted by: | TROKAMED GmbH
Kleine Breite 17
78187 Geisingen
Germany |

--------------------------------------------------------------------------------

Contact Information

Primary contact personAlternate contact person
Karlheinz TröndleStefan Weiland
CEORegulatory Affairs
Phone: +49 (0)7704/9244-0Phone: +49 (0)7704/9244-51
Fax: +49 (0)7704/9244-44Fax: +49 (0)7704/9244-84
E-Mail: troendle@trokamed.deE-Mail: stefan.weiland@trokamed.de

www.trokamed.de mail: info@trokamed.de Fon +49 (0) 7704 / 92 44-0 Fax +49 (0) 7704 / 9244-44 VAT-No. DE279596571

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Image /page/4/Picture/1 description: The image is a logo for TROKAMED GmbH. The logo features the company name in gray letters, with a blue semi-circle underlining the "TRO" portion of the name. Below the company name is the phrase "ZUVERLÄSSIGE PRÄZISION" in blue letters.

Predicate Device

Manufacturer510(k) NumberDevice Name
RICHARD WOLF Medical
Instruments CorporationK994223Nephroscope Set

Comparison of Technological Characteristics with the Predicate Device

DescriptionSubject devicePredicate Device (K994223)
Picture of the deviceImage: Subject deviceImage: Predicate Device
Design of dilatorCannulated, two lumensCannulated
Design of shaftRound, without irrigation tap, meatus
ring, distal end straightRound, fixed irrigation tap, distal end
straight
Material of the shaftStainless steel, plasticTitanium, stainless steel, plastic
Material of dilatorStainless steelStainless steel
Lumen/Inner diameter of
the dilator1 mm, 1mm; 1 mm, 1.3 mm4 mm; 5 mm
Outer diameter of the
dilator15 Fr.; 17 Fr.12 Fr.; 15 Fr.
Wall thickness0.5 mm0.25 mm
Working length of the
dilator370 mm320 mm
Outer diameter of the
sheath18 Fr., 20 Fr.18 Fr.
Working length of the
sheath130 mm; 160 mm150 mm
Device packaged as
sterileNoNo
Requires sterilization
prior to useYesYes
Single-Use/ReusableReusableReusable
Sterilization methodSteam sterilizationMoist Heat or Steam Sterilization
Ethylene Oxide
Hydrogen Peroxide

www.trokamed.de mail: info@trokamed.de
Fon +49 (0) 7704 / 92 44-0
Fax +49 (0) 7704 / 9244-44 VAT-No. DE279596571

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Image /page/5/Picture/1 description: The image shows the logo for TROKAMED GmbH. The logo features the company name in gray, with the "TRO" portion partially encircled by a blue arc. Below the company name, the phrase "ZUVERLÄSSIGE PRÄZISION" is written in a smaller, gray font.

TROKAMED GmbH · Kleine Breite 17 · 78187 Geisingen Subject Device Description

Trade Name: Common Name: Classification Name: Product code:

Mini PCNL-System Endoscopic Access Overtube. Gastroenterology-Urology Endoscope and accessories (21 CFR 876.1500) FED (Endoscopic Access Overtube, Gastroenterology-Urology)

The TROKAMED GmbH Mini PCNL-System consists of shaft and dilator. The diameter is specified directly on the shaft and dilator. This ensures that the instrument can be assigned easily and only suitable components are used. The instruments cannot be disassembled. The puncture is expanded with the dilator at the beginning of surgery. The procedure, during which kidney stones can be destroyed, is then performed via the shaft. The kidney stones are automatically transported out of the proximal end of the shaft as a result of the cleaning pressure and by the irrigation fluid. The nephroscope may not be fully mounted on the shaft here.

Shafts

The nephroscopic shafts are rigid reusable instruments with inner lumen and are used as an introducer for the instrument into the surgical site. The shaft itself is introduced into the surgical site by the help of the dilator.

Example WA2PS20S:

Image /page/5/Figure/9 description: The image shows a diagram of a medical instrument. The instrument has three labeled parts: "Meatusring/Meatus ring", "Schaft/Shaft", and "Hauptteil/Main part". The "Hauptteil/Main part" is located on the left side of the image, the "Meatusring/Meatus ring" is in the middle, and the "Schaft/Shaft" is on the right side.

Dilators

The dilators are rigid reusable instruments. They are equipped with two lumens: one lumen in the center and one on the side. The quide wire (not included in this submission) is fed through the medial lumen. An additional safety wire (not included in this submission) can be guided through the lateral lumen. Markings indicate when the conical tip of the dilator is protruding from the shaft. Both types of dilators has the same total and working length, but different diameters. Example: WA2PD20A:

Image /page/5/Figure/12 description: The image shows a diagram of a long, thin object labeled with its parts in both German and English. The left end is labeled "Spitze/Tip", the middle section is labeled "Schaft/Shaft", and the right end is labeled "Griff/Handle". Below the diagram is contact information for TROKAMED GmbH, including their address, website, phone and fax numbers, VAT number, managing director, court of registration, HRB number, and bank details.

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Image /page/6/Picture/1 description: The image is a logo for TROKAMED GmbH. The logo features the company name in gray, with the "TRO" portion of the name partially encircled by a blue arc. Below the company name is the phrase "ZUVERLÄSSIGE PRÄZISION" in a smaller, gray font.

The Mini PCNL-System is used together with a suitable nephroscope. The nephroscope is not part of the subject device and not included in this submission.

The Mini PCNL-System is delivered in non-sterile conditions and has to be processed before using it for the first time and before each use afterwards.

The following table identifies all models included in this submission:

| Article Number | Description | Key
components | Material | Product Dimensions |
|----------------|-------------------------------------------------------------|-------------------------------------|----------------------------|-----------------------------------------------------------------------------------------|
| WA2PS18S | Shaft, 18 Fr. | Main part,
Meatus ring,
Shaft | 1.4301
PPSU
1.4301 | Total length: 165 mm
Working length: 130 mm
Outer Ø: 18 Fr
Inner Ø: 15 Fr |
| WA2PS18L | Shaft, 18 Fr. | Main part,
Meatus Ring,
Shaft | 1.4301
PPSU
1.4301 | Total length: 195 mm
Working length: 160 mm
Outer Ø: 18 Fr
Inner Ø: 15 Fr |
| WA2PS20S | Shaft, 20 Fr. | Main part,
Meatus Ring,
Shaft | 1.4301
PPSU
1.4301 | Total length: 165 mm
Working length: 130 mm
Outer Ø: 20 Fr
Inner Ø: 17 Fr |
| WA2PS20L | Shaft, 20 Fr. | Main part,
Meatus Ring,
Shaft | 1.4301
PPSU
1.4301 | Total length: 195 mm
Working length: 160 mm
Outer Ø: 20 Fr
Inner Ø: 17 Fr |
| WA2PD18A | Dilator, 15 Fr.,
(to be used with
WA2PS18S, WA2PS18L) | Handle,
Shaft
Tip | 1.4301
1.4301
1.4301 | Total length: 390 mm
Working length: 370 mm
Outer Ø: 15 Fr
Inner Ø: 3 Fr, 3 Fr |
| WA2PD20A | Dilator, 17 Fr.,
(to be used with
WA2PS20S, WA2PS20L) | Handle,
Shaft
Tip | 1.4301
1.4301
1.4301 | Total length: 390 mm
Working length: 370 mm
Outer Ø: 17 Fr
Inner Ø: 3 Fr, 4 Fr |

Table 1: Information about subject device

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Image /page/7/Picture/1 description: The image is a logo for TROKAMED GmbH. The logo features the company name in a bold, sans-serif font, with the "TRO" portion in gray and partially encircled by a blue arc. The "KAMED" portion is also in gray, with "GmbH" stacked vertically to the right and a registered trademark symbol. Below the company name, in a smaller font, is the phrase "ZUVERLÄSSIGE PRÄZISION" in blue, which translates to "RELIABLE PRECISION".

Indications for Use

The nephroscopy accessory set is intended for minimally invasive procedures in nephroscopy. The shaft is a reusable, surgically invasive device for shortterm use. It is designed to bring instruments, telescopes, and fluids to the surgical site.

The Dilator is a reusable, surgically invasive device for temporary use. It is designed to widen existing surgically invasive openings.

Patient Target Group:

Patients with kidney or upper urinary tract conditions who require a nephroscopic procedure.

Comparison of Indications for Use with Predicate Device

Indications for Use Predicate Device:

The nephroscope, with its accessories, is used, with suction for the disintegration and removal/extraction of kidney and bladder stones are removed, under endoscopic control, through percutaneous or transurethral passages, in conjunction with intercorporeal pneumatic, ultrasound, electrohydraulic or laser lithotripters.

We state that the Indications for Use are the same for the subject and the predicate device because both are used in the percutaneous treatment of renal calculi and are to be controlled by endoscopes during surgery.

TROKAMED GmbH
Kleine Breite 17
78187 Geisingen
Germany

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Image /page/8/Picture/1 description: The image is a logo for TROKAMED GmbH. The logo features the company name in gray letters, with the "TRO" portion of the name partially encircled by a blue arc. Below the company name is the phrase "ZUVERLÄSSIGE PRÄZISION" in smaller, gray letters.

Non-Clinical Performance Testing

(only the non-clinical studies used for the determination of the substantial equivalence (SE) of the subject device to the predicate device)

TestsStandard Reference to TestsResults
ReprocessingEN ISO 17664 / ANSI AAMI ISO 17664: 2017,Summarizing the results
Processing of health care products –of improved protein test
Reprocessing StudyInformation to be provided by the medicaland indirect microbial
194101-45,device manufacturer for the processing oftest, a sufficient ability of
02 AUG 2019medical devices.the tested master Worst
AAMI TIR30: 2011 (reapproved 2016), ACase products for an
(Worst Case principle)compendium of processes, materials, testeffective cleaning can be
methods, and acceptance criteria for cleaningstated.
reusable medical devices.
ANSI/AAMI ST79: 2017, ComprehensiveAll tested products
guide to steam sterilization and sterilityshowed a sufficient
assurance in health care facilities.spore log reduction (SLR
ASTM E2314: 2003 (reapproved 2014),> 12) by use of standard
Standard test method for determination ofsterilization parameters.
effectiveness of cleaning processes forTherefore, a sufficient
reusable medical instruments using aability of the tested
microbiologic method (simulated use test).master Worst-Case
ASTM F3208: 2018, Standard Guide forproducts for an effective
selecting test soils for validation of cleaningsteam sterilization can
methods for reusable medical devices.be stated.
ASTM E1766: 2015, Standard test method for
determination of effectiveness of sterilization
processes for reusable medical devices.
ANSI/AAMI ST67: 2011 (reapproved 2017),
Sterilization of health care products –
Requirements and guidance for selecting a
sterility assurance level (SAL) for products
labelled „sterile“.
FDA guidance: 2015/2017, Reprocessing
Medical Devices in Health Care Settings –
Validation Methods and Labelling.
Life Expectancy
Testing:TROKAMED standard FB-26_07_010_Product
Life expectancy
TROKAMED Standard Operating ProceduresMaterial durability and
functionality are verified
for the given lifetime.
(Worst-Case principle)
Mechanical strength test
with unaged and aged
subject device.
FB-
15_02_001_TR_Mini
PCNL_01_mechanical
test_15Sep2020
(Subject device
tested)
TestsStandard Reference to TestsResults
Biocompatibility Evaluation:
  • Evaluation of basic biological
    assessment
  • 091924-20 "Cytotoxicity, L929-
    Proliferation"
  • 091925-20 "chemical analysis
    (characterizations of organic
    release products)"
    (Worst Case principle) | ISO 10993-1:2018 Biological
    evaluation of medical devices
    Part 1: Evaluation and testing
    within a risk management
    process
    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
    ISO 10993-12:2012 Biological
    evaluation of medical devices
    Part 12: Sample preparation and
    reference materials
    ISO 10993-18:2020 Biological
    evaluation of medical devices
    Part 18: Chemical
    characterization of medical
    device materials within a risk
    management process
    FDA blue book memorandum
    (#G95-1) | A cytotoxicity testing of
    Worst Case AUF11020 has
    verified that no substances
    of cell toxic concentration
    are released.

The chemical
characterization has shown
that solvable substances or
degradation products of
Worst case AUF11020 do
not exceed the toxicological
relevant concentrations. |
| Mechanical Testing:

  • 2006-02-06 UB Tensile tests
    with tubes_english
    (Worst Case principle) | none
    (TROKAMED Standard
    Operating Procedures only) | Summary of bending and
    breaking forces of stainless
    steel TROKAMED
    instruments. |
    | - 2014-09-23 Bending load of the
    shaft tubes English_10Jun2021
    (Worst Case principle) | none
    (TROKAMED Standard
    Operating Procedures only) | Shaft of subject device
    withstands maximal loading
    forces within minimally
    invasive surgery. |
    | - FB-15_02_001_TR_Mini
    PCNL_01_mechanical
    test_15Sep2020
    (Subject device tested) | none
    (TROKAMED Standard
    Operating Procedures only) | Stability and strength of
    connecting points of the
    subject device, unaged and
    aged. |

TROKAMED GmbH Kleine Breite 17 78187 Geisingen Germany

www.trokamed.d mail: info@trokam Fon +49 (0) 7704 / 92 44-0 Fax + 49 (0) 7704 / 9244-44

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Image /page/9/Picture/1 description: The image shows the logo for TROKAMED GmbH. The logo features the company name in gray letters, with a blue semi-circle design element on the left side. Below the company name, the words "ZUVERLASSIGE PRAZISION" are written in blue.

ww.trokamed.de
mail: info@trokamed.de
Fon +49 (0) 7704 / 92 44-0
Fax +49 (0) 7704 / 92 44-0
Fax +49 (0) 7704 / 9244-44 VAT-No. DE279596571

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Image /page/10/Picture/1 description: The image shows the logo for TROKAMED GmbH. The logo features the company name in bold, gray letters, with a blue semi-circle design element on the left side. Below the company name, the words "ZUVERLÄSSIGE PRÄZISION" are written in a smaller font.

Reprocessing

The TROKAMED Mini PCNL-System is covered by the reprocessing validation (Worst Case principle) of study 194101-45 (02 AUG 2019, accredited laboratory Medical Device Services) including manual and automated cleaning before steam sterilization. Both, the subject and the predicate device are reusable, non-sterile instruments that have to be reprocessed by manual and automated cleaning before steam sterilization after receipt by the end user (before the first and after each subsequent use).

Life Expectancy Testing:

General product lifetime is according to 1.4301/ 304 instruments listed in document "FB-26 07 010 Product Life expectancy", nephroscopic instruments: these instruments are exposed to very low mechanical stress during minimally invasive surgery. Material durability, labeling and functionality are verified for the given lifetime. To test mechanical resistance, unaged and aged subject devices have been used and no difference between them was recognizable.

Biocompatibilitv

The biocompatibility of the device components has been stated in TROKAMED's biological assessment (Worst Case principle, Biocompatibility 2021-06-08, cytotoxicity, sensitization and irritation tests performed by accredited laboratories eurofins Medical Device Testing and Medical Device Services). The biological assessment is based on a Worst Case principle with a sample instrument (AUF11020) covering the subject device in all aspects of biocompatibility. The tests confirm that the materials used are biocompatible, separately as well as combined in the final subject device and including possible manufacturing contamination and residues. No potentially dangerous interactions or consequences have been identified if there is short termed contact to tissue, biological cells and body fluids of the human body.

Mechanical Testing:

Mechanical Test Report "2006-02-06 UB Tensile tests with tubes english" (Worst Case principle) lists details of tensile tests with TROKAMED shafts according to length and wall thickness, covering the dimensions of the subject device.

Mechanical Test Report "2014-09-23 Bending load of the shaft tubes English 10Jun2021" (Worst Case principle) shows that mechanical safety of the TROKAMED tube shaft instruments made of 1.4301/ 304 (welded and cold redrawn several times) based on strength of the tube material is given. The tested tube shaft instruments show that the TROKAMED shafts and dilators withstand the forces during application in minimally invasive surgery.

Mechanical Test Report "FB-15 02 001 TR Mini PCNL 01 mechanical test 15Sep2020" (subject device tested) is to show that the stability and strength of the connecting points of the subject device are solid enough for the forces applied during regular application according to the intended use. A cumulative simulation of processing had been performed. When used as intended, mainly axial forces occur. If at all, only very small lever forces occur in practice, which neither influence nor endanger the strength of the welded joints, nor the stability and dimensional stability of the instrument itself.

A comparison of technological characteristics between subject and predicate device shaft show that with comparable length and diameter, the wall thickness is 0.5 mm on the subject device compared to 0.25 mm on the predicate device. As a result, the mechanical stability of the subject device is at least the same as of the predicate device. The dilators are equivalent as well: the subject device has a larger working length (370 mm to 320 mm) but the larger outer diameter (4.9 mm to 4.0 mm) equalizes the mechanical stability.

Kleine Breite 17 78187 Geisingen Germany

Fon +49 (0) 7704 / 92 / Fax +49 (0) 7704 / 9244-44 /AT-No. DE279596571

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Image /page/11/Picture/1 description: The image shows the logo for TROKAMED GmbH. The logo features the company name in gray letters, with a blue semi-circle around the "TRO" portion. Below the company name is the phrase "ZUVERLÄSSIGE PRÄZISION" in smaller, gray letters.

Conclusion

The Mini PCNL-System has the same intended use and the same major design and technical characteristics as the predicate device.

The results of the non-clinical performance tests demonstrate that the subject device is as safe and effective as the predicate device.

Overall, the subject device is equivalent to the predicate device.

TROKAMED GmbH Kleine Breite 17 78187 Geisingen Germany

www.trokamed.de mail: info@trokamed.de Fon +49 (0) 7704 / 92 44-0 Fax +49 (0) 7704 / 9244-44 VAT-No. DE279596571

Geschäftsführer: Karlheinz Tröndle Amtsgericht Stuttgart HRB 736615

Commerzbank Villingen-Schwenningen BLZ: 694 400 07 Konto: 245 932 900 Swift: (BIC) COBADEFFXXX IBAN DE50 6944 0007 0245 9329 00