K Number
K201113
Device Name
Resascope RS-01/B
Date Cleared
2020-12-21

(238 days)

Product Code
Regulation Number
888.1100
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
When used with a fibreoptic endoscope, Resascope is a video guided catheter intended to be used in the lumbar and sacral spine for observing epidural anatomy, pathology and delivery of drugs approved for epidural indications
Device Description
The Resascope video guided catheter can be used in the lumbar and sacral epidural space to view the epidural anatomy, the pathology and to deliver approved drugs for epidural administration. It can also be used by physicians to light and view the tissues in the epidural space of the lumbar and sacral spine, and in order to assist in the diagnosis of related pathologies, using a percutaneous approach through the sacral hiatus. It is designed to be used by trained medical staff for less than 60 minutes usage time period. lt is design with a soft tip and the addition of some blocks inside that allow the catheter to remain locked and therefore oriented, without return to zero. The medical device is basically structured by two parts: the orientable catheter, intended to enter the peridural space, and the knob, to be used for the orientation of the catheter tip (tip flexion); on the knob there are connection tubes for inserting the endoscope and for connection to the infusion sets.
More Information

Not Found

No
The description focuses on the mechanical and optical aspects of a video-guided catheter for visualization and drug delivery, with no mention of AI, ML, or image processing for analysis or interpretation.

Yes
The device is described as delivering "drugs approved for epidural indications," which implies a therapeutic function by administering medication to treat conditions.

Yes
The device is described as assisting in the "diagnosis of related pathologies" in the epidural space.

No

The device description clearly describes a physical catheter with a soft tip, blocks, an orientable catheter, and a knob for orientation. It also mentions connection tubes for an endoscope and infusion sets, indicating a hardware component. The performance studies also focus on physical tests like tensile, bend, leak, and lock tests, further confirming it is a physical device.

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

Here's why:

  • Intended Use: The intended use is for observing epidural anatomy, pathology, and delivering drugs in vivo (within the living body) using a fiberoptic endoscope.
  • Device Description: The description details a catheter designed to be inserted into the epidural space of the spine for visualization and drug delivery. This is an in vivo procedure.
  • Lack of IVD Characteristics: There is no mention of analyzing samples in vitro (outside the body), such as blood, urine, or tissue samples, which is the defining characteristic of an IVD.

The device is clearly intended for direct use within the patient's body for diagnostic and therapeutic purposes, not for testing samples in a laboratory setting.

N/A

Intended Use / Indications for Use

When used with a fibreoptic endoscope, Resascope is a video guided catheter intended to be used in the lumbar and sacral spine for observing epidural anatomy, pathology and delivery of drugs approved for epidural indications

Product codes

HRX

Device Description

The Resascope video guided catheter can be used in the lumbar and sacral epidural space to view the epidural anatomy, the pathology and to deliver approved drugs for epidural administration.

It can also be used by physicians to light and view the tissues in the epidural space of the lumbar and sacral spine, and in order to assist in the diagnosis of related pathologies, using a percutaneous approach through the sacral hiatus.

It is designed to be used by trained medical staff for less than 60 minutes usage time period.

lt is design with a soft tip and the addition of some blocks inside that allow the catheter to remain locked and therefore oriented, without return to zero.

The medical device is basically structured by two parts: the orientable catheter, intended to enter the peridural space, and the knob, to be used for the orientation of the catheter tip (tip flexion); on the knob there are connection tubes for inserting the endoscope and for connection to the infusion sets.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

lumbar and sacral spine

Indicated Patient Age Range

Not Found

Intended User / Care Setting

The device is to be used by trained personnel only
Medical centers

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)

Non-clinical tests were conducted to demonstrate substantial equivalence to the predicate device. The test results demonstrated that the proposed device complies with the applicable sections of the standards listed below:

Biocompatibility
The materials used to manufacture the subject device are largely used for other legally marketed devices under the same product code as the submitted Resascope RS-01/B.

Biocompatibility has been tested according to the requirements of

ISO 10993-1:2018, Biological Evaluation of Medical Devices, Part 1: Evaluation and Testing.

The following biocompatibility tests were performed:

  • Cytotoxicity, ISO 10993-5:2009 Biological evaluation of medical devices Part 5: Tests for in vitro cytotoxicity - Sensitization and Intracutaneous reactivity, ISO 10993-10: 2010 Biological evaluation of medical devices -Part 10: Tests for irritation and skin sensitization.

  • Acute Systemic Toxicity, ISO 10993-11:2006 Biological evaluation of medical devices — Part 11: Tests for systemic toxicity

  • Haemolysis, ISO 10993-4:2017 Biological Evaluation of Medical Devices - Part 4: Selection of Tests for Interactions with Blood, ASTM F756-17, Standard practice for assessment of hemolytic properties of materials, ASTM F-619-14, Standard Practice for Extraction of Medical Plastic.

  • Hemocompatibility, ISO 10993-4:2017 Biological Evaluation of Medical Devices - Part 4: Selection of Tests for Interactions with Blood, ASTM F2888-19, Standard Practice for Platelet Leukocyte Count - An In-Vitro Measure for Hemocompatibility Assessment of Cardiovascular Materials, ASTM F2382-18, Standard Test Method for Assessment of Intravascular Medical Device Materials on Partial Thromboplastin Time (PTT).

Sterilization Validation
A sterilization validation process was performed on the subject device according to

Recognized Consensus Standard: ISO 11135:2014, Sterilization of health-care products -- Ethylene oxide --Requirements for the development, validation and routine control of a sterilization process for medical devices.

ISO 11138-1: 2017, Sterilization of health care products - Biological indicators - Part 1: General requirements; ISO 10993-7 :2008, Biological evaluation of medical devices - Part 7: Ethylene oxide sterilization residuals;

ISO 11737-2 :2009, Sterilization of medical devices -- Microbiological methods- Part 2: Tests of sterility performed in the definition, validation and maintenance of a sterilization process.

The method used to make the determination of non pyrogenicity was Bacterials Endotoxines by LAL test and Rabbit pyrogen test.

LAL test was performed according to:

  • LAL test/USP chapter Bacterial Endotoxins Test.
  • ANSI/AAMI ST72 Bacterial endotoxins - Test methods, routine monitoring, and alternatives to batch testing, - European Pharmacopoeia current edition: 2.6.14 Bacterial Endotoxins.

Pyrogen Test was performed in compliance with:

  • ISO 10993-1:2018 "Biological Evaluation of Medical Devices - Part1: Evaluation and Testing within a Risk Management Process

  • ISO 10993-2:2006 "Biological Evaluation of Medical Devices Part 2: Animal welfare requirements"

  • ISO 10993-11 "Biological Evaluation of Medical Devices Part 11: Tests for Systemic Toxicity"

  • ISO 10993-12:2012 "Biological Evaluation of Medical Devices - Part 12: Sample Preparation and Reference Materials".

  • U.S. Pharmacopoeia, 2011 USPC Official and General Chapters: Pyrogen test.

Benching tests
The performances of the Resoscope video guided catheter are tested as follows:

Tensile Test to verify the tensile of the shaft welded joints and strain relief bond

Bend Test to verify the proper functioning of the Resascope wheels control

Leak Test to verify there is no leakage in the device

Lock Test to verify the locking mechanism operates correctly

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.

K980734

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

§ 888.1100 Arthroscope.

(a)
Identification. An arthroscope is an electrically powered endoscope intended to make visible the interior of a joint. The arthroscope and accessories also is intended to perform surgery within a joint.(b)
Classification. (1) Class II (performance standards).(2) Class I for the following manual arthroscopic instruments: cannulas, currettes, drill guides, forceps, gouges, graspers, knives, obturators, osteotomes, probes, punches, rasps, retractors, rongeurs, suture passers, suture knotpushers, suture punches, switching rods, and trocars. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 888.9.

0

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo is in blue and includes the letters "FDA" followed by the words "U.S. FOOD & DRUG ADMINISTRATION".

December 21, 2020

Advanced Medical Systems Group SRL Francesco Sgarbi R&D Manager Via Europa 12 35020 San Pietro Viminario, Padova Italy

Re: K201113

Trade/Device Name: Resascope RS-01/B Regulation Number: 21 CFR 888.1100 Regulation Name: Arthroscope Regulatory Class: Class II Product Code: HRX Dated: November 18, 2020 Received: November 25, 2020

Dear Francesco Sgarbi:

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. You must comply with all the Act's

1

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 (OS) 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,

for

Laura C. Rose, Ph.D. Assistant Director DHT6C: Division of Restorative, Repair and Trauma Devices OHT6: Office of Orthopedic Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known)

K201113

Device Name Resascope RS-01/B

Indications for Use (Describe)

When used with a fibreoptic endoscope, Resascope is a video guided catheter intended to be used in the lumbar and sacral spine for observing epidural anatomy, pathology and delivery of drugs approved for epidural indications

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

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

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

The burden time for this collection of information is estimated to average 79 hours per response, including the
time to review instructions, search existing data sources, gather and maintain the data needed and complete
and review the collection of information. Send comments regarding this burden estimate or any other aspect
of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services

Food and Drug Administration

Office of Chief Information Officer

Paperwork Reduction Act (PRA) Staff

PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB number."

3

510(k) Summary

Applicant:

Company Name:Advanced Medical Systems Group SRL
Company Address:Via Europa 12
35020
San Pietro Viminario (Padova) - Italy
Company Phone:+39 049 9719511
Company Fax:+39 049 9719542
Official Contact for Correspondence:Francesco Sgarbi
Phone:+39 0429 719378
E-mail:sgarbi@amsvita.com
Date Summary Prepared:November 18, 2020
DEVICE IDENTIFICATION
Trade name:Resascope RS-01/B
Generic/ Common Name:Video guided catheter
Classification:21 CFR§ 888.1100, Class II
Classification name:Arthroscope
Product Code:HRX
Panel:Orthopedic

PREDICATE DEVICE:

Myelotec video guided catheter, Myelotec Inc, K980734

DEVICE DESCRIPTION

The Resascope video guided catheter can be used in the lumbar and sacral epidural space to view the epidural anatomy, the pathology and to deliver approved drugs for epidural administration.

It can also be used by physicians to light and view the tissues in the epidural space of the lumbar and sacral spine, and in order to assist in the diagnosis of related pathologies, using a percutaneous approach through the sacral hiatus.

It is designed to be used by trained medical staff for less than 60 minutes usage time period.

lt is design with a soft tip and the addition of some blocks inside that allow the catheter to remain locked and therefore oriented, without return to zero.

The medical device is basically structured by two parts: the orientable catheter, intended to enter the peridural space, and the knob, to be used for the orientation of the catheter tip (tip flexion); on the knob there are connection tubes for inserting the endoscope and for connection to the infusion sets.

4

INDICATIONS FOR USE

When used with a fibreoptic endoscope, Resascope is a video guided catheter intended to be used in the lumbar and sacral spine for observing epidural anatomy, pathology and delivery of drugs approved for epidural indications.

DISCUSSION OF NON-CLINICAL TESTS

Non-clinical tests were conducted to demonstrate substantial equivalence to the predicate device. The test results demonstrated that the proposed device complies with the applicable sections of the standards listed below:

Biocompatibility

The materials used to manufacture the subject device are largely used for other legally marketed devices under the same product code as the submitted Resascope RS-01/B.

Biocompatibility has been tested according to the requirements of

ISO 10993-1:2018, Biological Evaluation of Medical Devices, Part 1: Evaluation and Testing.

The following biocompatibility tests were performed:

  • Cytotoxicity, ISO 10993-5:2009 Biological evaluation of medical devices Part 5: Tests for in vitro cytotoxicity - Sensitization and Intracutaneous reactivity, ISO 10993-10: 2010 Biological evaluation of medical devices -Part 10: Tests for irritation and skin sensitization.

  • Acute Systemic Toxicity, ISO 10993-11:2006 Biological evaluation of medical devices — Part 11: Tests for systemic toxicity

  • Haemolysis, ISO 10993-4:2017 Biological Evaluation of Medical Devices - Part 4: Selection of Tests for Interactions with Blood, ASTM F756-17, Standard practice for assessment of hemolytic properties of materials, ASTM F-619-14, Standard Practice for Extraction of Medical Plastic.

  • Hemocompatibility, ISO 10993-4:2017 Biological Evaluation of Medical Devices - Part 4: Selection of Tests for Interactions with Blood, ASTM F2888-19, Standard Practice for Platelet Leukocyte Count - An In-Vitro Measure for Hemocompatibility Assessment of Cardiovascular Materials, ASTM F2382-18, Standard Test Method for Assessment of Intravascular Medical Device Materials on Partial Thromboplastin Time (PTT).

Sterilization Validation

A sterilization validation process was performed on the subject device according to

Recognized Consensus Standard: ISO 11135:2014, Sterilization of health-care products -- Ethylene oxide --Requirements for the development, validation and routine control of a sterilization process for medical devices.

ISO 11138-1: 2017, Sterilization of health care products - Biological indicators - Part 1: General requirements; ISO 10993-7 :2008, Biological evaluation of medical devices - Part 7: Ethylene oxide sterilization residuals;

ISO 11737-2 :2009, Sterilization of medical devices -- Microbiological methods- Part 2: Tests of sterility performed in the definition, validation and maintenance of a sterilization process.

The method used to make the determination of non pyrogenicity was Bacterials Endotoxines by LAL test and Rabbit pyrogen test.

LAL test was performed according to:

  • LAL test/USP chapter Bacterial Endotoxins Test.
  • ANSI/AAMI ST72 Bacterial endotoxins - Test methods, routine monitoring, and alternatives to batch testing, - European Pharmacopoeia current edition: 2.6.14 Bacterial Endotoxins.

Pyrogen Test was performed in compliance with:

  • ISO 10993-1:2018 "Biological Evaluation of Medical Devices - Part1: Evaluation and Testing within a Risk Management Process

  • ISO 10993-2:2006 "Biological Evaluation of Medical Devices Part 2: Animal welfare requirements"

  • ISO 10993-11 "Biological Evaluation of Medical Devices Part 11: Tests for Systemic Toxicity"

  • ISO 10993-12:2012 "Biological Evaluation of Medical Devices - Part 12: Sample Preparation and Reference Materials".

  • U.S. Pharmacopoeia, 2011 USPC Official and General Chapters: Pyrogen test.

5

Benching tests

The performances of the Resoscope video guided catheter are tested as follows:

Tensile Test to verify the tensile of the shaft welded joints and strain relief bond

Bend Test to verify the proper functioning of the Resascope wheels control

Leak Test to verify there is no leakage in the device

Lock Test to verify the locking mechanism operates correctly

SUBSTANTIAL EQUIVALENCE

The Resacope RS-01/B is same or similar in intended use, design and operating principles to the predicate device (K980734).

Both the subject and the predicate device are indicated for use in clinical environments. Both the devices have the same principle of operation, same overall design; the same method of use and limited duration of contact with the patient; similar sizes of the catheter.

The minor differences in design do not raise any new types of safety or effectiveness questions. Performance data (design verification testing) demonstrate that the subject device is as safe and effective as the cited predicate.

In further support of a substantial equivalence determination, hereunder is a comparison chart with the submitted device and the predicate device.

| SPECIFICATIONS &

CHARACTERISTICS
Subject deviceK980734
ManufacturerAdvanced Medical Systems
Group SRLMyelotec Inc
Device NameResascope RS-01/BMyelotec video guided catheter
Common nameVideo guided catheterVideo guided cathetersame
Indications For UseWhen used with a fibreoptic
endoscope, Resascope is a video
guided catheter intended to be
used in the lumbar and sacral
spine for observing epidural
anatomy, pathology and delivery
of drugs approved for epidural
indications.When used with a fibreoptic
endoscope, this device can be
used in the lumbar and sacral
spine for observing epidural
anatomy, pathology and delivery
of drugs approved for epidural
indicationssame
Type of usePrescription Use (Part 21 CFR
801 Subpart D)Prescription Use (Part 21 CFR
801 Subpart D)same
Product CodeHRXHRXsame
Classification21 CFR 888.1100 Arthroscope21 CFR 888.1100 Arthroscopesame
Intended UserThe device is to be used by trained personnel onlyThe device is to be used by trained personnel onlysame
Intended EnvironmentMedical centersHospital/surgery centersubstantially equivalent
Sterileyesyessame
Single useyesyessame
Designtwo parts: the orientable catheter intended to enter the peridural space and the knob for the orientation of the catheter, connection tubes on the knob for visualization through endoscope and for connection to the infusion sets, soft tip, radiopaque distal tip, steel wires in the catheter body render it visible in X-raystwo parts: the orientable catheter intended to enter the peridural space and the knob for the orientation of the catheter, connection tubes on the knob for visualization through endoscope and for connection to the infusion sets, soft tip, radiopaque shaftsubstantially equivalent
Insertion pointSacral HiatusSacral Hiatussame
Infusion port22same
Catheter Length30 cm30 cmsame
Catheter Outer diameterfrom 3.3 mm to 3.5 mm2.7 mm, 3.0 mmSubstantially equivalent. The difference in the size does not impact safety or effectiveness considering that it is a slight difference also in respect of the mean diameter of the insertion point (sacral hiatus) and the adjacent sacral canal
Lumen inner diameter1.29 mm1 mm, 1.3 mmSubstantially equivalent, the size of the lumen inner diameter of the subject device is comprised in the sizes of those of the subject device
Number of lumens for optics and micro instruments22same
for surgical
treatments
Endoscope capableyesyessame
Steerableyesyessame
Catheter tube
MaterialsPolyether - Poliammide +
Barium Sulfatenot availableThe materials used for
the components of the
device that come in
contact with the patient
are largely used for
medical devices and
they have a long history
of safe use for the same
or equivalent
indications. The testing
performed on the
subject device
demonstrate that no
issues of safety and
effectiveness arise.
BiocompatibilityMeet requirements for ISO
10993-1not available

6

7

SUBSTANTIAL EQUIVALENCE DISCUSSION:

COMPARISON OF TECHNOLOGICAL CHARACTERISTICS

Both the medical devices are basically structured by two parts: the adjustable catheter, intended to enter the peridural space, and the knob, to be used for the orientation of the catheter tip; on the handle of both devices there are connection tubes for inserting the endoscope and for connection to the infusion sets.

The subject and predicate devices are based on the same or similar technological elements and are made with the materials largely used for the same type of medical devices already on the market. The minor differences in the technological characteristics of the devices do not impact the safety and effectiveness of the subject device. The performance data (design verification testing) demonstrate that the subject device is as safe and effective as the cited predicate.

AMS Group believes that the submitted Resascope is substantially equivalent in its intended use, design, materials, function and biocompatibility to the currently cleared device and is therefore as safe and effective.

CONCLUSION:

Based on the available information, we conclude that the Resascope RS-01/B is substantially equivalent to the existing legally marketed device under Federal Food, Drug and Cosmetic Act. Therefore, the subject device is determined to be equivalent to the predicate device.