AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The SmartBand® EMR Device is intended for endoscopic mucosal resection in the upper GI tract.

Device Description

The SmartBand EMR Device is an endoscopic mucosal resection device that is provided as a kit or a pack that is designed for ligation assisted endoscopic mucosal resection (EMR) in the upper gastrointestinal (GI) tract. The SmartBand EMR Kit consists of the SmartBand Ligator Kit, supplied non-sterile and the SmartSnare EMR Hexagonal Snare, supplied sterile. The ligator kit contains a ligation handle, loading device, connector tube and a cylindrical barrel with 5 bands separated by a deployment cord. The SmartBand EMR Pack consists of a cylindrical barrel with 5 bands separated by a deployment cord. The SmartBand EMR Pack can be used when more bands are needed to complete a procedure. The SmartSnare EMR Hexagonal Snare consists of a handle, finger slide and a hexagonal snare loop on the distal end.

AI/ML Overview

This document is a 510(k) summary for the STERIS SmartBand EMR Kit. It is a submission to the FDA regarding a modified device and argues for its substantial equivalence to a legally marketed predicate device. As such, it does not contain a study proving the device meets specific acceptance criteria in the context of clinical performance or diagnostic accuracy.

Instead, this document focuses on demonstrating that the modified device is as safe and effective as the predicate device by showing that the changes made do not affect the fundamental scientific technology or how it is used. The "acceptance criteria" here refer to the regulatory standard of substantial equivalence, and "performance" refers to non-clinical testing performed to support this claim.

Here's an analysis based on the provided text, focusing on the available information:

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria are not explicitly defined as numerical thresholds for clinical performance but rather are inferred from the requirements for demonstrating substantial equivalence to a predicate device. The "performance" reported is related to non-clinical testing to ensure safety and functionality of the modified components.

Acceptance Criteria (Inferred from Substantial Equivalence)Reported Device Performance (Non-Clinical)
Maintain Intended UseIntended use is "Same"
Maintain Device FunctionalityNo negative impact from changes in device components (band color, universal connector, band lock, additional barrel diameter)
Materials of Construction are biocompatible and safeSimilar materials; new materials for Universal Connector and Band Lock do not affect intended use or fundamental technology. Biocompatibility testing performed per ISO 10993-4, -5, -10 and -11 and USP38-NF33.
Sterilization efficacy maintainedSterilization method (Ethylene Oxide) and Assurance Level (10-6) are "Same".
Single use and energy compatibility maintainedSingle use and diathermic energy use are "Same". Compatible with new electrosurgical generator (US Endoscopy gi4000) with no change to intended use or fundamental technology.
Manual application maintainedManual application is "Same".
Packaging changes do not affect device performanceBand lock prevents band dislodgement during shipping; additional box for snare is a convenience. No effect on device use or fundamental technology.
Shelf life change maintained device integrityExtended shelf life (24 months vs 12 months) provides greater flexibility with no effect on device use or fundamental technology.
Overall safety and effectiveness as predicate device"Modified device is as safe and effective as the legally marketed predicate device."

2. Sample size used for the test set and the data provenance

  • Test set sample size: Not applicable in the context of a clinical performance study. The non-clinical testing would have involved specific numbers of devices or components for each test (e.g., specific number of devices for biocompatibility, simulated use, ship testing), but these numbers are not detailed in the summary.
  • Data provenance: Not explicitly stated as country of origin, but it's internal testing conducted by STERIS Corporation. The nature of the tests (biocompatibility, simulated use) suggests laboratory or engineering testing. It is retrospective in the sense that the justification is made after the modifications.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable for this type of submission. "Ground truth" in this context would likely refer to established engineering standards, regulatory guidelines (e.g., ISO for biocompatibility), and internal quality control specifications, rather than expert clinical consensus on patient data.

4. Adjudication method for the test set

Not applicable. This is a technical submission, not a clinical study requiring adjudication of diagnoses or outcomes.

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

Not applicable. This device is a medical accessory for endoscopic mucosal resection, not an AI-powered diagnostic or interpretive device. Therefore, no MRMC study or AI-related effectiveness was assessed.

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

Not applicable. This device does not involve an algorithm.

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

The "ground truth" for the non-clinical testing would be established engineering specifications, material standards (e.g., for biocompatibility), and performance benchmarks derived from the predicate device's known characteristics. For example, the ground truth for biocompatibility is meeting the requirements of ISO 10993 standards.

8. The sample size for the training set

Not applicable. This is not an AI/machine learning device requiring a training set.

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

Not applicable. See point 8.

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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, 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.

October 7, 2021

Steris Corporation Carroll Martin Regulatory Affairs Director 5976 Heislev Road Mentor, OH 44060

Re: K212860

Trade/Device Name: SmartBand EMR Kit (SB-EMR-K, SB-EMR-K-12, SB-EMR-K-9.4), SmartBand EMR Pack (SB-EMR-P, SB-EMR-P-12, SB-EMR-P-9.4), SmartSnare EMR Hexagonal Snare (SS-230-1 or packaged with kit) Regulation Number: 21 CFR 876.4300 Regulation Name: Endoscopic Electrosurgical unit and accessories Regulatory Class: Class II Product Code: FDI Dated: September 7, 2021 Received: September 8, 2021

Dear Carroll Martin:

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, 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 801); medical device reporting (reporting of medical

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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 (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 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 Shanil P. Haugen, Ph.D. Assistant Director DHT3A: Division of Renal, Gastrointestinal, Obesity and Transplant Devices OHT3: Office of GastroRenal, ObGyn, General Hospital and Urology Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K212860

Device Name

SmartBand® EMR Kit (SB-EMR-K, SB-EMR-K-12, SB-EMR-K-9.4) SmartBand® EMR Pack (SB-EMR-P, SB-EMR-P-12, SB-EMR-P-9.4) SmartSnare™ EMR Hexagonal Snare (SS-230-1 or packaged with Kit)

Indications for Use (Describe)

The SmartBand® EMR Device is intended for endoscopic mucosal resection in the upper GI tract.

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/0 description: The image shows the first page of a document with the identifier K212860 and page number 1 of 6. The document features the STERIS logo in a large, bold font. Below the company name is a graphic of several horizontal, curved lines, resembling waves.

510(k) Summary for the SmartBand EMR Kit (SB-EMR-K, SB-EMR-K-12, SB-EMR-K-9.4) SmartBand EMR Pack (SB-EMR-P, SB-EMR-P-12, SB-EMR-P-9.4) SmartSnare EMR Hexagonal Snare (SS-230-1 or packaged with Kit)

STERIS Corporation 5976 Heisley Road Mentor, OH 44060

Contact: Carroll Martin Regulatory Affairs Director Tel: 440-358-6259 Email: Carroll Martin@steris.com

Submission Date: September 7, 2021

STERIS Corporation ■ 5960 Heisley Road ■ Mentor, OH 44060-1834 USA ■ 440-354-2600

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1. Device Name

Trade Name:SmartBand EMR Kit (SB-EMR-K, SB-EMR-K-12, SB-EMR-K-9.4)SmartBand EMR Pack (SB-EMR-P, SB-EMR-P-12, SB-EMR-P-9.4)SmartSnare EMR Hexagonal Snare (SS-230-1 or packaged with Kit)
Device Class:Class II
Regulation Name:Endoscopic Electrosurgical Unit and Accessories
Common/usual Name:Ligation Device
Regulation Number:21 CFR 876.4300
Product Code:FDI
Review Panel:Gastroenterology/Urology

2. Predicate Device

SmartBand EMR Kit (SB-EMR-K, SB-EMR-K-12) SmartBand EMR Pack (SB-EMR-P, SB-EMR-P-12) SmartSnare EMR Hexagonal Snare (SS-230-1 or packaged with Kit) All cleared under K190512

3. Device Description

The SmartBand EMR Device is an endoscopic mucosal resection device that is provided as a kit or a pack that is designed for ligation assisted endoscopic mucosal resection (EMR) in the upper gastrointestinal (GI) tract. The SmartBand EMR Kit consists of the SmartBand Ligator Kit, supplied non-sterile and the SmartSnare EMR Hexagonal Snare, supplied sterile. The ligator kit contains a ligation handle, loading device, connector tube and a cylindrical barrel with 5 bands separated by a deployment cord. The SmartBand EMR Pack consists of a cylindrical barrel with 5 bands separated by a deployment cord. The SmartBand EMR Pack can be used when more bands are needed to complete a procedure. The SmartBand EMR Hexagonal Snare consists of a handle, finger slide and a hexagonal snare loop on the distal end.

4. Indications for Use

The SmartBand® EMR Device is intended for endoscopic mucosal resection in the upper GI tract.

న్. Technological Characteristics Comparison Table

A comparison of technical characteristics between the proposed and predicate devices is summarized in Table 1.

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FeaturesSmartBand EMR DevicePredicate Device K190512Modified DeviceComparison
Intended UseThe SmartBand® EMR Device isintended for endoscopic mucosalresection in the upper GI tract.The SmartBand® EMR Device isintended for endoscopic mucosalresection in the upper GI tract.Same
DeviceComponentsLigation Device5 non-latex bands (4 green and 1blue)Trigger cordLoading DeviceFlush TubeDeployment HandlePentax AdaptorLigation Device5 non-latex bands (4 green and 1black)Trigger cordLoading DeviceFlush TubeDeployment HandlePentax AdaptorUniversal ConnectorBand LockSimilar. The colorchange of one bandand the addition ofthe UniversalConnector andBand Lock do notaffect the intendeduse or fundamentaltechnology of thedevice.
SnareStainless steel snare loopShaftFinger SlideSnare Handle BodySnareStainless steel snare loopShaftFinger RingsSnare Handle BodySame
Materials ofConstructionSnareSnare loop - stainless steel(patient contacting)Sheath - Teflon (patientcontacting)Core Wire - Nitinol (patientcontacting)Stainless steel (snare loop) Strainrelief - polyurethane (non-patientcontacting)Finger slide - ABS (non-patientcontacting)Snare handle body - ABS (non-patient contacting)Ligation DeviceBands - Non-latex syntheticpolyisoprene (patient contacting)Barrel - Polycarbonate (patientcontacting)Trigger cord - Liquid crystalpolymer (patient contacting)Loading device - Stainless steel(non-patient contacting)Flush tube - ABS (non-patientcontacting)Handle - ABS (non-patientcontacting)SnareSnare loop - stainless steel(patient contacting)Sheath - Teflon (patientcontacting)Core Wire - Nitinol (patientcontacting)Stainless steel (snare loop) Strainrelief - polyurethane (non-patient contacting)Finger slide - ABS (non-patientcontacting)Snare handle body - ABS (non-patient contacting)Ligation DeviceBands - Non-latex syntheticpolyisoprene (patient contacting)Barrel - Polycarbonate (patientcontacting)Trigger cord - Liquid crystalpolymer (patient contacting)Loading device - Stainless steel(non-patient contacting)Flush tube - ABS (non-patientcontacting)Handle - ABS (non-patientcontacting)Universal Connector - Silicone(non-patient contacting)Band Lock - Polyurethane (non-patient contacting)Similar. Thematerials of theUniversalConnector andBand Lock do notaffect the intendeduse or fundamentaltechnology of thedevice.
FeaturesSmartBand EMR DevicePredicate Device K190512Modified DeviceComparison
# of bands/color5 non-latex bands (4 green and 1blue)5 non-latex bands (4 green and 1black)Similar. Thischange aids theuser in determiningwhen they aregetting close tousing all of thebands, as the blackband is the secondto last band in lineon the barrel. Thechange in colordoes not affect theintended use orfundamentaltechnology of thedevice.
BarrelDimensionsInside diameter:10.75mm and 12.0mmDepth: 7.75mmInside diameter9.4mm, 10.75mm, and12.0mmDepth 7.75mm (10.75mm and12.0mm sizes)Depth 9.5mm (9.4mm size)Similar. Thischange gives theuser more optionsbased on the sizeof the treatmentarea.
Sterile/Non-sterileSterile (snare) and Non-sterile(ligation device)Sterile (snare) and Non-sterile(ligation device)Same
SterilizationMethodEthylene OxideEthylene OxideSame
SterilizationAssurance Level10-610-6Same
UsageSingle used; snare is used withdiathermic energySingle used; snare is used withdiathermic energySame
TargetPopulationPatients undergoing an endoscopicmucosal resection procedurePatients undergoing anendoscopic mucosal resectionprocedureSame
EnergyUsed/DeliveredDiathermic energy (snare)Diathermic energy (snare)Same
Method ofApplicationManualManualSame
FeaturesSmartBand EMR DevicePredicate Device K190512Modified DeviceComparison
PackagingChangeNo band lockBand lock present to securethe bands during shippingDifferent. The band lockprevents the bands fromdislodging from the barrelduring shipping. Theadditional box is aconvenience for the user.These changes have no effecton how the device is used orits fundamental technology.
No stand-alone box for thesnareAddition of stand-alone boxfor snare
CompatibleendoscopesPentax, Fujinon and OlympusPentax, Fujinon and OlympusSameSimilar. The function of theelectrical snare of theproposed device remains thesame in that it is attached tothe electrical surgicalgenerator to allow the flow ofelectrical energy to the snareloop for the purpose ofresecting tissue. The use ofthe modified device with theUS Endoscopy gi4000Electrosurgical Generatordoes not change the intendeduse or fundamentaltechnology of the modifieddevice.
Compatibleelectrical surgicalgeneratorsERBE VIO 300-DERBE VIO 300-DUS Endoscopy gi4000Electrosurgical Generator
Addition ofuniversalconnectorNot present.PresentDifferent. The universalconnector allows the user toattach the ligation devicehandle directly to theaccessory ports of endoscopesthat do not have a luerconnection on the accessoryport. This change has noeffect on how the device isused or its fundamentaltechnology.
ExpirationDating12 months24 monthsDifferent. The extended shelflife of the proposed deviceprovides the user greaterflexibility related to deviceuse. It has no effect on howthe device is used or itsfundamental technology.

Table 1. Technological Characteristics Comparison Table

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6. Summarv of Non-Clinical Performance Testing

Verification testing consisting of measurements, visual inspection, ship testing and packaging testing.

Biocompatibility testing in accordance with ISO 10993-4, -5, -10 and -11 and USP38-NF33.

Simulated use testing.

7. Conclusion

The minor changes that are the subject of this submission have no impact on the fundamental scientific technology of the device or how it is used. STERIS has determined that the modified device is as safe and effective as the legally marketed predicate device.

§ 876.4300 Endoscopic electrosurgical unit and accessories.

(a)
Identification. An endoscopic electrosurgical unit and accessories is a device used to perform electrosurgical procedures through an endoscope. This generic type of device includes the electrosurgical generator, patient plate, electric biopsy forceps, electrode, flexible snare, electrosurgical alarm system, electrosurgical power supply unit, electrical clamp, self-opening rigid snare, flexible suction coagulator electrode, patient return wristlet, contact jelly, adaptor to the cord for transurethral surgical instruments, the electric cord for transurethral surgical instruments, and the transurethral desiccator.(b)
Classification. Class II (performance standards).