K Number
K231473
Device Name
Monarch Bronchoscope
Date Cleared
2023-11-28

(190 days)

Product Code
Regulation Number
874.4680
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The reprocessed Monarch Bronchoscope, used in conjunction with the Monarch Platform, is intended to provide bronchoscopic visualization of and access to patient airways for diagnostic and therapeutic procedures.
Device Description
The 4x reprocessed Monarch Bronchoscope. MBR-000211-B. (hereafter referred to as "Proposed Device") is similar to the 2x reprocessed Monarch Bronchoscope, MBR-000211-B, (hereafter referred to as "Predicate Device"). The Original Monarch Bronchoscope. MBR-000211-A. (hereafter referred to as "Co-Predicate Device") cleared under K193534 is identical to the 2x reprocessed Monarch Bronchoscope ("Predicate Device"), cleared under K203614. Both device designs are controlled by Auris Health, Inc., throughout their total product lifecycle. The Monarch Bronchoscope is a component of, and must be used with, the Monarch Platform, cleared under K193534. The Monarch Bronchoscope is connected to the robotic arms of the Monarch Platform to provide bronchoscopic visualization of and access to patient airways for diagnostic and therapeutic procedures. The Proposed Device is a reprocessed single-use device that is either discarded or returned to Auris for reprocessing after clinical use. The original singleuse Monarch Bronchoscope was cleared for one clinical use under K193534. The reprocessed single-use (rSUD) Monarch Bronchoscope was cleared for two (2) clinical uses under K203614. This premarket notification intends to gain market clearance for a reprocessed single-use (rSUD) Monarch Bronchoscope that can be reprocessed up to three (3) times, for a total of four (4) clinical uses. Identical to the Predicate Device, the Reprocessed Monarch Bronchoscope, consisting of the Inner Scope ("scope") and the Outer Sheath ("sheath"), has 4-way articulation controlled by continuous, direct, visual control of the physician using the Monarch Platform. The Proposed Device contains a working channel through which biopsy devices, or other working channel instruments, may be introduced. The distal tip of the Proposed Device has a camera control unit (CCU) that collects live images that are then transmitted to the physician's display interface of the Monarch Platform. The camera transmits vision data to the Monarch Tower through the camera cable. The single-use, manually controlled, working channel instruments compatible with the Proposed Device are identical to the working channel instruments compatible with the Predicate Device.
More Information

No
The summary describes a reprocessed bronchoscope and its compatibility with a robotic platform, focusing on mechanical function, visualization, and reprocessing cycles. There is no mention of AI or ML in the intended use, device description, or performance studies.

Yes
The "Intended Use / Indications for Use" section states that the device is intended for "diagnostic and therapeutic procedures," indicating a therapeutic purpose.

Yes

The "Intended Use / Indications for Use" section explicitly states that the device is "intended to provide bronchoscopic visualization of and access to patient airways for diagnostic and therapeutic procedures." The term "diagnostic" directly indicates its use for diagnosis.

No

The device description clearly details a physical bronchoscope with hardware components like a camera, working channel, and articulation mechanism, which is part of a larger robotic platform. It is not solely software.

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 bronchoscopic visualization of and access to patient airways for diagnostic and therapeutic procedures." This describes a device used within the body for direct observation and intervention, not a device used to examine specimens outside the body.
  • Device Description: The description details a bronchoscope with a camera, working channel, and articulation, designed to be used with a robotic platform to navigate airways. This is consistent with an endoscopic device used for in-vivo procedures.
  • Lack of IVD Characteristics: There is no mention of analyzing biological specimens (blood, urine, tissue samples, etc.) or providing information about a patient's health status based on such analysis. The device's function is visualization and access, not diagnostic testing of samples.

Therefore, the reprocessed Monarch Bronchoscope is a medical device used for in-vivo procedures, not an in-vitro diagnostic device.

N/A

Intended Use / Indications for Use

The reprocessed Monarch Bronchoscope, used in conjunction with the Monarch Platform, is intended to provide bronchoscopic visualization of and access to patient airways for diagnostic and therapeutic procedures.

Product codes (comma separated list FDA assigned to the subject device)

QNW

Device Description

The 4x reprocessed Monarch Bronchoscope. MBR-000211-B. (hereafter referred to as "Proposed Device") is similar to the 2x reprocessed Monarch Bronchoscope, MBR-000211-B, (hereafter referred to as "Predicate Device").

The Original Monarch Bronchoscope. MBR-000211-A. (hereafter referred to as "Co-Predicate Device") cleared under K193534 is identical to the 2x reprocessed Monarch Bronchoscope ("Predicate Device"), cleared under K203614.

Both device designs are controlled by Auris Health, Inc., throughout their total product lifecycle.

The Monarch Bronchoscope is a component of, and must be used with, the Monarch Platform, cleared under K193534. The Monarch Bronchoscope is connected to the robotic arms of the Monarch Platform to provide bronchoscopic visualization of and access to patient airways for diagnostic and therapeutic procedures. The Proposed Device is a reprocessed single-use device that is either discarded or returned to Auris for reprocessing after clinical use. The original single-use Monarch Bronchoscope was cleared for one clinical use under K193534. The reprocessed single-use (rSUD) Monarch Bronchoscope was cleared for two (2) clinical uses under K203614. This premarket notification intends to gain market clearance for a reprocessed single-use (rSUD) Monarch Bronchoscope that can be reprocessed up to three (3) times, for a total of four (4) clinical uses.

Identical to the Predicate Device, the Reprocessed Monarch Bronchoscope, consisting of the Inner Scope ("scope") and the Outer Sheath ("sheath"), has 4-way articulation controlled by continuous, direct, visual control of the physician using the Monarch Platform. The Proposed Device contains a working channel through which biopsy devices, or other working channel instruments, may be introduced. The distal tip of the Proposed Device has a camera control unit (CCU) that collects live images that are then transmitted to the physician's display interface of the Monarch Platform. The camera transmits vision data to the Monarch Tower through the camera cable. The single-use, manually controlled, working channel instruments compatible with the Proposed Device are identical to the working channel instruments compatible with the Predicate Device.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

patient airways

Indicated Patient Age Range

Not Found

Intended User / Care Setting

physician / 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)

The Reprocessed Monarch Bronchoscope was tested for performance in accordance with internal design specification and with the applicable performance standards to demonstrate safety and effectiveness to support substantial equivalence. This includes the following tests:

  • Cleaning Validation: Ensures the device can be returned to a like new condition. Worst case device conditioning was taken into consideration while conducting this testing. Results: Pass
  • Functional Performance and System Compatibility: Functional performance and system compatibility were performed to verify the performance of the Proposed Device was not negatively impacted by reprocessing. Worst case device conditioning was taken into consideration while conducting this testing. Results: Pass
  • Electromagnetic Compatibility and Electrical Safety: The Proposed Device has been fully evaluated for electrical safety and EMC compliance to the following standards: AAMI/ANSI ES60601-1, IEC 60601-1-2, and IEC 60601-2-18. Results: Pass
  • Biocompatibility: Evaluates the end of life biocompatibility of the limited contact device in accordance with ISO 10993-1:2018. Worst case device conditioning was taken into consideration while conducting this testing. Results: Pass
  • Sterilization: Sterilization was assessed in accordance with ISO 11135: 2018. Sterilization residuals were assessed in accordance with ISO 10993-7:2008. The Proposed Device uses a validated ethylene oxide sterilization process using a half-cycle overkill approach to achieve a minimum sterility assurance level of 10-6. Results: Pass

The performance testing demonstrates that the 4x reprocessed Monarch Bronchoscope is as safe and effective as the legally marketed 2x reprocessed Monarch Bronchoscope and operates as originally intended.

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.

K203614

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.

K193534

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

§ 874.4680 Bronchoscope (flexible or rigid) and accessories.

(a)
Identification. A bronchoscope (flexible or rigid) and accessories is a tubular endoscopic device with any of a group of accessory devices which attach to the bronchoscope and is intended to examine or treat the larynx and tracheobronchial tree. It is typically used with a fiberoptic light source and carrier to provide illumination. The device is made of materials such as stainless steel or flexible plastic. This generic type of device includes the rigid ventilating bronchoscope, rigid nonventilating bronchoscope, nonrigid bronchoscope, laryngeal-bronchial telescope, flexible foreign body claw, bronchoscope tubing, flexible biopsy forceps, rigid biopsy curette, flexible biopsy brush, rigid biopsy forceps, flexible biopsy curette, and rigid bronchoscope aspirating tube, but excludes the fiberoptic light source and carrier.(b)
Classification. Class II.

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".

November 28, 2023

Auris Health Inc., a Johnson and Johnson Family Company Patrick Garvey Director, Regulatory Affairs 150 Shoreline Drive Redwood City, California 94065

Re: K231473

Trade/Device Name: Monarch Bronchoscope Regulation Number: 21 CFR 874.4680 Regulation Name: Bronchoscope (Flexible Or Rigid) And Accessories Regulatory Class: Class II Product Code: QNW Dated: October 30, 2023 Received: October 31, 2023

Dear Patrick Garvey:

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 (the 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 available 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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device" (https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

1

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30, Design controls; 21 CFR 820.90, Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review. the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 of medical device-related adverse events) (21 CFR Part 803) for devices or postmarketing safety reporting (21 CFR Part 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 Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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,

Shuchen Peng -S Shu-Chen Peng, Ph.D. Assistant Director DHT1B: Division of Dental and ENT Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

2

Indications for Use

510(k) Number (if known) K231473

Device Name Monarch Bronchoscope

Indications for Use (Describe)

The reprocessed Monarch Bronchoscope, used in conjunction with the Monarch Platform, is intended to provide bronchoscopic visualization of and access to patient airways for diagnostic and therapeutic procedures

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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General Information

| 510(k) Submitter | Auris Health, Inc.
150 Shoreline Drive
Redwood City, CA 94065
USA |
|------------------------------------|------------------------------------------------------------------------------------------------------------------|
| Original Device
Manufacturer | Auris Health, Inc.
150 Shoreline Drive
Redwood City, CA 94065
USA |
| FDA Registration Number | 3014447948 |
| Reprocessed Device
Manufacturer | Sterilmed, Inc., a Johnson and Johnson Family
Company
5010 Cheshire Pkwy N, Suite 2, Plymouth, MN
55446 |
| FDA Registration Number | 3011276773 |
| Primary Correspondent | James Patrick Garvey II
Director, Regulatory Affairs
Auris Health, Inc. |
| Contact Information | Email: pgarvey@its.jnj.com
Phone: (650) 590-6907 |
| Date Prepared | 28 November 2023 |

Device Identification

Proposed Reprocessed Device:

Proprietary NameMonarch Bronchoscope
Common NameReprocessed Bronchoscope
Classification NameBronchoscope (flexible or rigid) and accessories
Regulation Number21 CFR 874.4680
Product CodeQNW
Regulatory ClassII
Model NumberMBR-000211-B

Primary Predicate Device:

Proprietary NameMonarch Bronchoscope
Common NameReprocessed Bronchoscope
Premarket NotificationK203614
Classification NameBronchoscope (flexible or rigid) and accessories
Regulation Number21 CFR 874.4680
Product CodeQNW
Regulatory ClassII
Model NumberMBR-000211-B

4

Proprietary NameMonarch Platform
Common NameBronchoscope (Flexible or Rigid)
Premarket NotificationK193534
Classification NameBronchoscope (flexible or rigid) and accessories
Regulation Number21 CFR 874.4680
Product CodeEOQ
Regulatory ClassII
Model NumberMBR-000211-A

Secondary Predicate OEM Device:

Device Description

The 4x reprocessed Monarch Bronchoscope. MBR-000211-B. (hereafter referred to as "Proposed Device") is similar to the 2x reprocessed Monarch Bronchoscope, MBR-000211-B, (hereafter referred to as "Predicate Device").

The Original Monarch Bronchoscope. MBR-000211-A. (hereafter referred to as "Co-Predicate Device") cleared under K193534 is identical to the 2x reprocessed Monarch Bronchoscope ("Predicate Device"), cleared under K203614.

Both device designs are controlled by Auris Health, Inc., throughout their total product lifecycle.

The Monarch Bronchoscope is a component of, and must be used with, the Monarch Platform, cleared under K193534. The Monarch Bronchoscope is connected to the robotic arms of the Monarch Platform to provide bronchoscopic visualization of and access to patient airways for diagnostic and therapeutic procedures. The Proposed Device is a reprocessed single-use device that is either discarded or returned to Auris for reprocessing after clinical use. The original singleuse Monarch Bronchoscope was cleared for one clinical use under K193534. The reprocessed single-use (rSUD) Monarch Bronchoscope was cleared for two (2) clinical uses under K203614. This premarket notification intends to gain market clearance for a reprocessed single-use (rSUD) Monarch Bronchoscope that can be reprocessed up to three (3) times, for a total of four (4) clinical uses.

Identical to the Predicate Device, the Reprocessed Monarch Bronchoscope, consisting of the Inner Scope ("scope") and the Outer Sheath ("sheath"), has 4-way articulation controlled by continuous, direct, visual control of the physician using the Monarch Platform. The Proposed Device contains a working channel through which biopsy devices, or other working channel instruments, may be introduced. The distal tip of the Proposed Device has a camera control unit (CCU) that collects live images that are then transmitted to the physician's display interface of the Monarch Platform. The camera transmits vision data to the Monarch Tower through the camera cable. The single-use, manually controlled, working channel instruments compatible with the Proposed Device are identical to the working channel instruments compatible with the Predicate Device.

5

Intended Use/Indications for Use

The reprocessed Monarch Bronchoscope, used in conjunction with the Monarch Platform, is intended to provide bronchoscopic visualization of and access to patient airways for diagnostic and therapeutic procedures.

Summary of Key Technological Characteristics

The Proposed Device is a single-use device similar to the Predicate Device in design. Both devices have the same clinical applications, patient population, performance specifications, and principles of operation. All key technological characteristics including articulation, vision, and compatibility with working channel instruments are identical. Key technological characteristics are listed in the table below.

Key AttributesProposed Device (MBR-000211-B)
Product CodeQNW
Regulation Number21 CFR 874.4680
ClassificationII
Intended for Single UseYes
Field of View (FOV) in air90 degrees
Direction of view0 degrees
FOV depth3-30mm
Imaging typeCMOS Imager
Illumination typeLED
Active angulation degrees up/down or
4 directions180/180/180/180
Pixel resolution200 x 200
Camera lensAluminosilicate glass
Light sourceLED (covered in cyanoacrylate adhesive)
Working Channel Instruments
CompatibilityAuris working channel instruments and third party
instruments that meet working channel length and
diameter requirements (e.g., REBUS probe)

This premarket notification is submitted to demonstrate the ability to reprocess the Monarch Bronchoscope three (3) times without impacting safety or effectiveness as compared to the predicate device. Reprocessing of the device includes removal of adherent soil and decontamination. Each individual device is tested for appropriate function of its components prior to packaging, labeling, and sterilization operations.

6

Performance Testing

The Reprocessed Monarch Bronchoscope was tested for performance in accordance with internal design specification and with the applicable performance standards to demonstrate safety and effectiveness to support substantial equivalence. This includes the following tests:

Test NameDescriptionResults
Cleaning ValidationEnsures the device can be returned to a like new condition.
Worst case device conditioning was taken into
consideration while conducting this testing.Pass
Functional
Performance and
System
CompatibilityFunctional performance and system compatibility were
performed to verify the performance of the Proposed Device
was not negatively impacted by reprocessing. Worst case
device conditioning was taken into consideration while
conducting this testing.Pass
Electromagnetic
Compatibility and
Electrical SafetyThe Proposed Device has been fully evaluated for electrical
safety and EMC compliance to the following standards:
AAMI/ANSI ES60601-1, IEC 60601-1-2, and IEC 60601-
2-18.Pass
BiocompatibilityEvaluates the end of life biocompatibility of the limited
contact device in accordance with ISO 10993-1:2018. Worst
case device conditioning was taken into consideration while
conducting this testing.Pass
SterilizationSterilization was assessed in accordance with ISO 11135:
  1. Sterilization residuals were assessed in accordance
    with ISO 10993-7:2008. The Proposed Device uses a
    validated ethylene oxide sterilization process using a half-
    cycle overkill approach to achieve a minimum sterility
    assurance level of 10-6. | Pass |

The performance testing demonstrates that the 4x reprocessed Monarch Bronchoscope is as safe and effective as the legally marketed 2x reprocessed Monarch Bronchoscope and operates as originally intended.

Conclusion

The indications for use/intended use, clinical applications, patient population, performance specifications, technological characteristics, biological safety, and principles of operation of the Proposed Device are identical to the Predicate Device.

Test results demonstrated substantial equivalence to the Predicate Device with respect to safety and effectiveness. We therefore conclude that the 4x reprocessed Monarch Bronchoscope is as safe, and effective as, and substantially equivalent to the Predicate Device, 2x reprocessed Monarch Bronchoscope.

7


The following device is included in this submission:

| Description | OEM Model Number | Reprocessed Model
Number |
|----------------------|------------------|-----------------------------|
| Monarch Bronchoscope | MBR-000211-A | MBR-000211-B |