K Number
K223923
Device Name
HOPKINS Telescopes
Date Cleared
2023-03-30

(90 days)

Product Code
Regulation Number
876.1500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For telescopes with diameter ranging from 3mm-5mm The HOPKINS Telescopes are intended to provide visualization during laparoscopy and general surgery in adults and pediatrics. For telescopes with diameter ranging from 5.5mm- 11mm The HOPKINS Telescopes are intended to provide visualization during laparoscopy and general surgery in adults.
Device Description
The HOPKINS Telescopes are rigid telescopes that utilize the rod lens technology. At the distal end of the telescope's shaft is the lens and the other end of the shaft is attached to the eyepiece. Throughout the central lumen of the HOPKINS Telescopes, optical glass rods are used to transmit and magnify the image received from the lens. The HOPKINS Telescopes are available with 0°, 6°, 30° and 45° direction of view, diameters ranging from 3mm to 11mm and working lengths from 18cm- 50cm.
More Information

No
The device description and performance studies focus on traditional optical technology and bench testing, with no mention of AI/ML, image processing, or data sets for training/testing.

No
The device is described as a "telescope" intended to "provide visualization during laparoscopy and general surgery," which indicates it is used for imaging and diagnostic purposes, not for treating a condition.

No

The device is intended to provide visualization during surgical procedures, not to diagnose medical conditions. It helps the surgeon see the surgical field, which is a tool for intervention, not diagnosis.

No

The device description explicitly states that the HOPKINS Telescopes are rigid telescopes that utilize rod lens technology and have physical components like a shaft, lens, eyepiece, and optical glass rods. This indicates a hardware-based medical device, not a software-only one.

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

Here's why:

  • Intended Use: The intended use is to "provide visualization during laparoscopy and general surgery." This describes a device used during a surgical procedure to allow the surgeon to see inside the body.
  • Device Description: The description details a rigid telescope with optical components for transmitting and magnifying images. This is consistent with a surgical visualization 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 diagnostic information derived from such tests.

The device is clearly intended for direct visualization in vivo (within the living body) during surgery, which is not the function of an IVD.

N/A

Intended Use / Indications for Use

For telescopes with diameter ranging from 3mm-5mm

The HOPKINS Telescopes are intended to provide visualization during laparoscopy and general surgery in adults and pediatrics.

For telescopes with diameter ranging from 5.5mm- 11mm

The HOPKINS Telescopes are intended to provide visualization during laparoscopy and general surgery in adults.

Product codes

GCJ

Device Description

The HOPKINS Telescopes are rigid telescopes that utilize the rod lens technology. At the distal end of the telescope’s shaft is the lens and the other end of the shaft is attached to the eyepiece. Throughout the central lumen of the HOPKINS Telescopes, optical glass rods are used to transmit and magnify the image received from the lens. The HOPKINS Telescopes are available with 0°, 6°, 30° and 45° direction of view, diameters ranging from 3mm to 11mm and working lengths from 18cm- 50cm.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Adults and pediatrics (for 3mm-5mm diameter telescopes). Adults (for 5.5mm-11mm diameter telescopes).

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

Non-Clinical Performance Data: There are no performance standards or special controls developed under Section 514 of the FD&C Act for endoscopes. However, the HOPKINS Telescopes follows the FDA recognized consensus standards and is tested according to the following standards and FDA Guidance:

ISO Endoscopic Standards ISO 8600-1 ISO 8600-3 ISO 8600-5 ISO 8600-6 Biocompatibility Summary Cytotoxicity (ISO 10993-5) Acute Systemic Toxicity (ISO 10993-11) Intracutaneous Irritation (ISO 10993-10) Maximization Sensitization (ISO 10993-10) Electrical and Thermal Safety IEC 60601-2-18:2009 (3RD Edition) Reprocessing (Cleaning and Sterilization) AAMI TIR12: 2010 AAMI TIR30: 2011 ANSI/AAMI ST8: 2013 ANSI/AAMI ST77:2013 ANSI/AAMI ST79:2017 ANSI/AAMI ST81:2004/(R)2010 AAMI/ISO 14937:2009 ANSI/AAMI/ISO 17655-1:2006/2013 Reprocessing Medical Device in Health Care Settings: Validation Methods and Labeling Comparative bench testing between the subject and predicate device demonstrated that the HOPKINS Telescopes has met all its design specification and is substantially equivalent to its predicate device.

Clinical Performance Data: Published literature was provided to support the safety and effectiveness of the HOPKINS Telescopes ranging in diameters from 3mm to 5mm for use in pediatrics during laparoscopy, thoracoscopy and general surgery.

Conclusion: The conclusions drawn from the nonclinical test demonstrate that the subject device is as safe and effective as the predicate device.

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

Not Found

Predicate Device(s)

K935279

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.

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Image /page/0/Picture/0 description: The image shows 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. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

March 30, 2023

KARL STORZ Endoscopy-America, Inc Alita Mcelroy Senior Regulatory Affairs Specialist 2151 E. Grand Avenue El Segundo, California 90245

Re: K223923

Trade/Device Name: HOPKINS Telescopes Regulation Number: 21 CFR 876.1500 Regulation Name: Endoscope And Accessories Regulatory Class: Class II Product Code: GCJ Dated: December 29, 2022 Received: December 30, 2022

Dear Alita Mcelroy:

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,

Jianting Wang -S

For Long Chen Assistant Director DHT4A: Division of General Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K223923

Device Name HOPKINS Telescopes

Indications for Use (Describe)

For telescopes with diameter ranging from 3mm-5mm

The HOPKINS Telescopes are intended to provide visualization during laparoscopy and general surgery in adults and pediatrics.

For telescopes with diameter ranging from 5.5mm- 11mm

The HOPKINS Telescopes are intended to provide visualization during laparoscopy and general surgery in adults.

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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Image /page/3/Picture/0 description: The image shows the logo for Karl Storz Endoskope. The logo is in blue and features the word "STORZ" in large, bold letters. Below the word "STORZ" is the phrase "KARL STORZ - ENDOSKOPE" in smaller letters.

510(k) Summary

This 510(k) Summary is being submitted in accordance with the requirements of the Safe Medical Devices Act (SMDA) of 1990 and 21 CFR 807.92. All data included in this document is accurate and complete to the best of KSEA's knowledge.

| Submitter: | KARL STORZ Endoscopy-America, Inc.
2151 E. Grand Avenue
EI Segundo, CA 90245 |
|---------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact: | Alita McElroy
Senior Regulatory Affairs Specialist
Phone: (424) 218-8376
Email: Alita.McElroy@karlstorz.com |
| Date of
Preparation: | December 29, 2022 |
| Type of 510(k)
Submission: | Traditional |
| Device
Identification: | Trade Name: HOPKINS Telescopes
Classification Name: Laparoscope, General and Plastic Surgery (21 CFR
876.1500) |
| Regulatory Class: | II |
| Product Code: | GCJ |
| Classification
Panel: | General and Plastic Surgery |
| Predicate
Device(s): | KARL STORZ HOPKINS I and II Rigid Autoclavable Telescopes (K935279) |
| Device
Description: | The HOPKINS Telescopes are rigid telescopes that utilize the rod lens
technology. At the distal end of the telescope's shaft is the lens and the other
end of the shaft is attached to the eyepiece. Throughout the central lumen of
the HOPKINS Telescopes, optical glass rods are used to transmit and magnify
the image received from the lens. The HOPKINS Telescopes are available
with 0°, 6°, 30° and 45° direction of view, diameters ranging from 3mm to
11mm and working lengths from 18cm- 50cm. |
| Intended Use and
Indications for
Use: | For telescopes with diameter ranging from 3mm-5mm
The HOPKINS Telescopes are intended to provide visualization during
laparoscopy, thoracoscopy and general surgery in adults and pediatrics.
For telescopes with diameter ranging from 5.5mm- 11mm
The HOPKINS Telescopes are intended to provide visualization during |

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Image /page/4/Picture/0 description: The image shows the logo for Karl Storz Endoskope. The word "STORZ" is in large, bold, blue letters. Below that, the words "KARL STORZ - ENDOSKOPE" are in smaller, blue letters.

laparoscopy, thoracoscopy and general surgery in adults.
Technological
Characteristics.Technological
CharacteristicsHOPKINS
TelescopesKARL STORZ
HOPKINS I and II
Rigid Autoclavable
TelescopesComparison
Subject
DevicePredicate
Device K935279
Physical Characteristics
Endoscope TypeRigid, rod
lensRigid, rod lenssame
Outer Diameter3mm- 11mm4mm-10mmdifferent
Working Length18cm- 50cm29cm-35cmdifferent
Optical Characteristics
Direction of
View0°, 6°, 30°, 45°
Endocamele
on: 10°- 90°0°, 30°different
Field of View55°- 80°65°- 70°different
Depth of Field4.8mm- 200mm
8.9mm –
200mm
16mm – 200mm
20.8mm-200mm11.4mm- 200mm
21.6mm- 200mmdifferent
Light sourceExternalExternalsame
Reprocessing Methods
CleaningManual,
AutomaticManualdifferent
Sterilization
modalitiesSteam (pre-
vacuum),
STERRAD
100S,
STERRAD
NX,
STERRAD
100NX,
STERIS V-
PRO 1, V-PRO 1Steam (pre-
vacuum), EO,
Chemical
Disinfectiondifferent

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Image /page/5/Picture/0 description: The image shows the logo for Karl Storz Endoskope. The logo is in blue and features the word "STORZ" in large, bold letters. Below the word "STORZ" is the phrase "KARL STORZ - ENDOSKOPE" in smaller letters.

| Non-Clinical

Performance Data:There are no performance standards or special controls developed under Section 514 of the FD&C Act for endoscopes. However, the HOPKINS Telescopes follows the FDA recognized consensus standards and is tested according to the following standards and FDA Guidance:
ISO Endoscopic Standards ISO 8600-1 ISO 8600-3 ISO 8600-5 ISO 8600-6 Biocompatibility Summary Cytotoxicity (ISO 10993-5) Acute Systemic Toxicity (ISO 10993-11) Intracutaneous Irritation (ISO 10993-10) Maximization Sensitization (ISO 10993-10) Electrical and Thermal Safety IEC 60601-2-18:2009 (3RD Edition) Reprocessing (Cleaning and Sterilization) AAMI TIR12: 2010 AAMI TIR30: 2011 ANSI/AAMI ST8: 2013 ANSI/AAMI ST77:2013 ANSI/AAMI ST79:2017 ANSI/AAMI ST81:2004/(R)2010 AAMI/ISO 14937:2009 ANSI/AAMI/ISO 17655-1:2006/2013 Reprocessing Medical Device in Health Care Settings: Validation Methods and Labeling Comparative bench testing between the subject and predicate device demonstrated that the HOPKINS Telescopes has met all its design specification and is substantially equivalent to its predicate device.
Clinical
Performance Data:Published literature was provided to support the safety and effectiveness of the HOPKINS Telescopes ranging in diameters from 3mm to 5mm for use in pediatrics during laparoscopy, thoracoscopy and general surgery.
Conclusion:The conclusions drawn from the nonclinical test demonstrate that the subject device is as safe and effective as the predicate device.