K Number
K201349
Device Name
Smith+Nephew Arthroscopes
Manufacturer
Date Cleared
2020-07-20

(60 days)

Product Code
Regulation Number
888.1100
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Smith+Nephew Arthroscopes is indicated to provide illumination and visualization in: · Diagnostic and Operative arthroscopic procedures for the hip, knee, shoulder, wrist, ankle, elbow, and feet. In addition, Smith+Nephew 4 mm diameter rigid athroscopes are indicated to provide illumination and visualization in the removal of loose bodies and soft tissue within the hip joint as size/length appropriate.
Device Description
The proposed Smith+Nephew 4KO Direct View/Video Arthroscopes are a line extension to the previously cleared K971253 and are surgical instruments used for illumination and visualization of surgical sites within articular cavities, body cavities, hollow organs and canals. The Arthroscopes are designed with various angle specifications for directions of view and working lengths for access to various locations. The Arthroscopes are shipped non-sterile and must be cleaned, inspected and sterilized prior to each use. Both designs consist of a long tube containing a series of rod lenses that work to transfer the image of the patient's anatomy, through an associated visualization camera system, to a central monitor for clinical use in treatment. The direct view scopes require attachment to an endocoupler and the VideoEndoscopes are attached to a Smith+Nephew C-Mount camera head. Illumination is provided through a bundle of optical fibers internal to the Endoscope that transmits light from an external source to illuminate the image.
More Information

No
The description focuses on optical and mechanical components for visualization and illumination, with no mention of AI/ML algorithms or data processing for analysis or interpretation.

No.
The device is a surgical instrument used for visualization during diagnostic and operative arthroscopic procedures; it does not directly provide therapy.

Yes

Explanation: The "Intended Use / Indications for Use" section explicitly states that the device is indicated for "Diagnostic and Operative arthroscopic procedures".

No

The device description clearly outlines physical components like tubes, lenses, optical fibers, and the need for cleaning and sterilization, indicating it is a hardware device.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • Device Function: The Smith+Nephew Arthroscopes are surgical instruments used for illumination and visualization within the body during surgical procedures. They provide a direct view of internal anatomy.
  • Intended Use: The intended use clearly states "Diagnostic and Operative arthroscopic procedures" and "provide illumination and visualization." This is about directly observing internal structures, not analyzing samples taken from the body.
  • Device Description: The description focuses on the optical components and how they transmit images of the patient's anatomy. There is no mention of analyzing biological samples.

The device is a surgical endoscope used for direct visualization during minimally invasive procedures, which falls under the category of surgical instruments, not in vitro diagnostics.

N/A

Intended Use / Indications for Use

The Smith+Nephew Arthroscopes is indicated to provide illumination and visualization in: Diagnostic and Operative arthroscopic procedures for the hip, knee, shoulder, wrist, ankle, elbow, and feet.
In addition, Smith+Nephew 4 mm diameter rigid athroscopes are indicated to provide illumination and visualization in the removal of loose bodies and soft tissue within the hip joint as size/length appropriate.

Product codes

HRX

Device Description

The proposed Smith+Nephew 4KO Direct View/Video Arthroscopes are a line extension to the previously cleared K971253 and are surgical instruments used for illumination and visualization of surgical sites within articular cavities, body cavities, hollow organs and canals.
The Arthroscopes are designed with various angle specifications for directions of view and working lengths for access to various locations. The Arthroscopes are shipped non-sterile and must be cleaned, inspected and sterilized prior to each use. Both designs consist of a long tube containing a series of rod lenses that work to transfer the image of the patient's anatomy, through an associated visualization camera system, to a central monitor for clinical use in treatment.
The direct view scopes require attachment to an endocoupler and the VideoEndoscopes are attached to a Smith+Nephew C-Mount camera head.
Illumination is provided through a bundle of optical fibers internal to the Endoscope that transmits light from an external source to illuminate the image.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

optical

Anatomical Site

hip, knee, shoulder, wrist, ankle, elbow, and feet; articular cavities, body cavities, hollow organs and canals

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies

Performance Testing demonstrates that the Smith+Nephew Arthroscopes have met the performance specifications:

  • Optical Performance
  • Leakage Integrity
  • Electrical Safety Testing
  • Electromagnetic Compatibility
  • Cleaning Validation
  • Sterilization Validation
  • Biocompatibility

Smith+Nephew validated cleaning and sterilization of the Arthroscopes against the requirement of AAMI TIR 12:2010 and AAMI TIR 30:2011 and all acceptance criteria were met. Biocompatibility assessment of the Arthroscopes against the requirements per ISO 10993-1:2018 and all acceptance criteria were met.

Key Metrics

Not Found

Predicate Device(s)

K080560

Reference Device(s)

K971253

Predetermined Change Control Plan (PCCP) - All Relevant Information

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.

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July 20, 2020

Image /page/0/Picture/1 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, which is a blue square with the letters "FDA" in white. To the right of the FDA logo is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

Smith & Nephew Kathleen Solomon Principal Regulatory Affairs Specialist 150 Minuteman Rd Andover, Massachusetts 01810

Re: K201349

Trade/Device Name: Smith+Nephew Arthroscopes Regulation Number: 21 CFR 888.1100 Regulation Name: Arthroscope Regulatory Class: Class II Product Code: HRX Dated: May 20, 2020 Received: May 21, 2020

Dear Ms. Solomon:

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 requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part

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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,

Laura C. Rose, Ph.D. Acting 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

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Indications for Use

510(k) Number (if known) K201349

Device Name Smith+Nephew Arthroscopes

Indications for Use (Describe)

The Smith+Nephew Arthroscopes is indicated to provide illumination and visualization in:

· Diagnostic and Operative arthroscopic procedures for the hip, knee, shoulder, wrist, ankle, elbow, and feet.

In addition, Smith+Nephew 4 mm diameter rigid athroscopes are indicated to provide illumination and visualization in the removal of loose bodies and soft tissue within the hip joint as size/length appropriate.

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)

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T: + 1 978 749 1000 T: + 1 800 343 8386 (USA toll free) www.smith-nephew.com

K201349

510(k) SUMMARY OF SAFETY AND EFFECTIVENESS INFORMATION

as required by the Safe Medical Devices Act of 1990 and codified in 21 CFR 807.92 upon which the substantial equivalence is based.

Smith & Nephew: Smith+Nephew Arthroscopes

Date Prepared: July 20, 2020

A. Submitter's Name:

Smith+Nephew, Inc., Endoscopy Division

150 Minuteman Road, Andover MA. 01810

B. Company Contact:

Kathleen Solomon Principal Regulatory Affairs Specialist T 978-749-1605

C. Device Name

Trade Name: Smith+Nephew Arthroscopes Common Name: Arthroscopes Classification Name: Arthroscopes per 888.1100 Regulatory class: II Product Code: HRX

D. Predicate Devices

The Smith+Nephew Arthroscope are substantially equivalent in intended use and fundamental scientific technology to the following legally marketed devices in commercial distribution: Henke Sass Wolf Arthroscopes, K080560.

Description of Device ن

The proposed Smith+Nephew 4KO Direct View/Video Arthroscopes are a line extension to the previously cleared K971253 and are surgical instruments used for illumination and visualization of surgical sites within articular cavities, body cavities, hollow organs and canals.

4

The Arthroscopes are designed with various angle specifications for directions of view and working lengths for access to various locations. The Arthroscopes are shipped non-sterile and must be cleaned, inspected and sterilized prior to each use. Both designs consist of a long tube containing a series of rod lenses that work to transfer the image of the patient's anatomy, through an associated visualization camera system, to a central monitor for clinical use in treatment.

The direct view scopes require attachment to an endocoupler and the VideoEndoscopes are attached to a Smith+Nephew C-Mount camera head.

Illumination is provided through a bundle of optical fibers internal to the Endoscope that transmits light from an external source to illuminate the image.

F. Intended Use

The Smith+Nephew Arthroscopes are intended to provide illumination and visualization in diagnostic and operative arthroscopic procedures.

Indication for Use:

The Smith+Nephew Arthroscopes is indicated to provide illumination and visualization in:

  • Diagnostic and Operative arthroscopic procedures for the hip, knee, shoulder, wrist, ankle, elbow, and feet.
    In addition, Smith+Nephew 4 mm diameter rigid arthroscopes are indicated to provide illumination and visualization in the removal of loose bodies and soft tissue within the hip joint as size/length appropriate.

G. Comparison of Technological Characteristics

The S+N Arthroscopes maintain the following similarities as the predicate devices cleared in K080560. In that:

  • The proposed and predicate devices have similar indications for use/intended use.
  • Both the proposed and predicate devices utilize the same principle of operation and incorporate the same basic design
  • Incorporate the same materials

The difference in the new Smith+Nephew Arthroscopes as compared to the predicate devices are:

  • . The new Smith+Nephew 4KO Arthroscopes have an improved optical design in order to provide 4K resolution capabilities for sharper visualization compared to the predicate HD.
  • The new Smith + Nephew VideoArthroscopes have an updated focusing mechanism design with similar shape and smaller focus ring size comparing to HD endoscopes

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The differences between the proposed and predicate devices do not constitute a new Intended use, there are no major differences in technological characteristics and does not introduce new risks or questions of safety or effectiveness.

H. Performance Data

Performance Testing demonstrates that the Smith+Nephew Arthroscopes have met the performance specifications:

  • Optical Performance
  • Leakage Integrity
  • · Electrical Safety Testing
  • Electromagnetic Compatibility
  • · Cleaning Validation
  • Sterilization Validation
  • · Biocompatibility

Smith+Nephew validated cleaning and sterilization of the Arthroscopes against the requirement of AAMI TIR 12:2010 and AAMI TIR 30:2011 and all acceptance criteria were met. Biocompatibility assessment of the Arthroscopes against the requirements per ISO 10993-1:2018 and all acceptance criteria were met.

Therefore, the Arthroscopes are considered substantially equivalent the currently marketed predicate.

G. Conclusion:

The Smith+Nephew Arthroscopes met all specified criteria and did not raise new safety or effectiveness questions. The substantial equivalence of the modified device is based on the same fundamental technology. Based on the similarities to the predicate and the performance data, the S+N Arthroscopes are considered substantially equivalent to the predicate K080560.