K Number
K232003
Date Cleared
2024-02-12

(221 days)

Product Code
Regulation Number
884.1690
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Single-Use Video Hysteroscope is intended to be used for viewing of the adult cervical canal and uterine cavity for the purpose of performing diagnostic and operative procedures. The devices is suitable for professional healthcare facility environments such as hospitals and clinics.

Device Description

The Single-Use Video Hysteroscope is intended to be used for viewing of the adult cervical canal and uterine cavity and it is provided sterile (sterilized by EO) and intended for single use only. The Single-Use Video Hysteroscope is composed of a handle part, including the video cable interface, working channel port and instrument channel port, and an insertion portion, of which a camera module and LED light source are integrated inside the distal tip. There are two models of The Single-Use Video Hysteroscope, RP-G-C24 and RP-G-C0101. The model RP-G-C24 is identical to RP-G-C0101 except for the direction of view, width size of insertion port and width size of instrument channel. The principle of optical imaging: the light source illuminates the inspected site of the patient, which is imaged by the photosensitive surface of CMOS camera module. The optical signal received by the CMOS sensor is converted into electrical signal after processing. The electrical signal is then transmitted by the cable to the signal processing chip embedded on the Endoscopic Video Image Processor where it is restored after processing and finally displayed on the screen of Endoscopic Video Image Processor.

AI/ML Overview

The FDA 510(k) summary provided does not describe an AI/ML-based device, but rather a Single-Use Video Hysteroscope. Therefore, the acceptance criteria and study detailed in the document pertain to the safety and performance of this medical device, not an AI/ML algorithm.

The request asks for information relevant to an AI/ML device, such as acceptance criteria based on performance metrics (e.g., sensitivity, specificity), sample size for test sets (distinguishing between training and test sets), expert adjudication, multi-reader multi-case studies, and ground truth establishment using pathology or outcomes data. These concepts are not applicable to the evaluation of the hysteroscope as described in the document.

The document discusses performance data related to:

  • Biocompatibility (cytotoxicity, skin sensitization, intracutaneous test, acute systemic toxicity)
  • Electrical Safety and Electromagnetic Compatibility
  • Photobiological safety
  • Sterilization Validation
  • Shelf Life and Sterile Barrier System (Packaging)
  • Bench Performance Data for optical (Direction of view, Resolution, Depth of Field, Field of view, Geometric Distortion, Signal-To-Noise Ratio, Dynamic Range, Image Intensity Uniformity (IIU), Color Performance, Surface Safety) and mechanical properties (Basic Size, Water Supply System, Sealing Performance, Tensile strength).

Therefore, I cannot provide the requested information in the format of AI/ML device evaluation criteria based on the provided text. The document confirms that clinical evidence and animal studies were not applicable for this device submission (Sections VIII.A and IX).

If the intent was to understand the regulatory submission for the RP-G-C24, RP-G-C0101 Single-Use Video Hysteroscope, the relevant acceptance criteria and studies would be derived from the non-clinical performance testing summarized in Section VIII. These are performance metrics for a physical device, not an AI algorithm.

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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, 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.

February 12, 2024

Guangzhou Red Pine Medical Instrument Co.,Ltd. Xiangfei Li Regulatory Affairs Manager 12 F, No.87 Luoxuan Avenue, Guangzhou International Bioisland, Huangpu District Guangzhou, Guangdong 510200 China

Re: K232003

Trade/Device Name: Single-Use Video Hysteroscope: RP-G-C24. RP-G-C0101 Regulation Number: 21 CFR§ 884.1690 Regulation Name: Hysteroscope and Accessories Regulatory Class: II Product Code: HIH Dated: January 9, 2024 Received: January 9, 2024

Dear Xiangfei Li:

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.

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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).

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 QS 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.

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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,

Jason Roberts -S

Jason R. Roberts, Ph.D. Assistant Director DHT3B: Division of Reproductive, Gynecology and Urology 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) K232003

Device Name Single-Use Video Hysteroscope: RP-G-C24, RP-G-C0101

Indications for Use (Describe)

The Single-Use Video Hysteroscope is intended to be used for viewing of the adult cervical canal and uterine cavity for the purpose of performing diagnostic and operative procedures

The devices is suitable for professional healthcare facility environments such as hospitals and clinics.

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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510(k) SUMMARY

510(k) Number: K232004

I. SUBMITTER

Name: Guangzhou Red Pine Medical Instrument Co., Ltd. Address: 12 F, No.87 Luoxuan Avenue, Guangzhou International Bioisland, Huangpu District, 510000 Guangzhou City, Guangdong Province, PEOPLE'S REPUBLIC OF CHINA Name of contact person: Xiangfei Li Tel: +86 20-38315611 Fax: +86 20-38315611 E-mail: regulation@gzredpine.com Date prepared: February 5, 2024

II. Proposed Device

Submission Number: K232003 Trade/Device Name: Single-Use Video Hysteroscope: RP-G-C24, RP-G-C0101 Regulation Number: 21 CFR 884.1690 Regulation Name: Hysteroscope and accessories Regulation class: II Review Panel: Obstetrics/Gynecology Product code: HIH

III. Predicate Device

510(k) Number: K202445 Device name: Hystero-V Hysteroscope Applicant: Hysterovue, Inc. Regulation number:21 CFR 884.1690

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Regulation Name: Hysteroscope and accessories Regulation class: II Review Panel: Obstetrics/Gynecology Product code: HIH Note: This predicate device has not been subject to a design-related recall.

IV. Reference Device

510(k) Number: K210270 Device name: Medical Endoscope Image Processing System Applicant: Jiangsu Jiyuan Medical Technology Co., Ltd Regulation number:21 CFR 884.1690 Regulation Name: Hysteroscope and accessories Regulation class: II Review Panel: Obstetrics/Gynecology Product code: HIH Note: This reference device has not been subject to a design-related recall.

V. Indications for use

Single-Use Video Hysteroscope is intended to be used for viewing of the adult cervical canal and uterine cavity for the purpose of performing diagnostic and operative procedures.

The device is suitable for professional healthcare facility environments such as hospitals and clinics.

Although the subject device lacks integrated biopsy functionality compared to the predicate device, the intended use of both is the same. In addition, the indications for use is the same for the subject and reference device.

VI. Description of the Device

The Single-Use Video Hysteroscope is intended to be used for viewing of the adult cervical canal and uterine cavity and it is provided sterile (sterilized by EO) and intended for single use only.

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The Single-Use Video Hysteroscope is composed of a handle part, including the video cable interface, working channel port and instrument channel port, and an insertion portion, of which a camera module and LED light source are integrated inside the distal tip. There are two models of The Single-Use Video Hysteroscope, RP-G-C24 and RP-G-C0101. The model RP-G-C24 is identical to RP-G-C0101 except for the direction of view, width size of insertion port and width size of instrument channel, as shown in the table below:

Spec.ModelRP-G-C24RP-G-C0101
Direction of View22°30°
Maximum width of insertion portion5.5mm(16.7Fr)4.8mm(14.4Fr)
Minimum width of instrument channel2.3mm(6.9Fr)2.0mm(6.0Fr)

The principle of optical imaging: the light source illuminates the inspected site of the patient, which is imaged by the photosensitive surface of CMOS camera module. The optical signal received by the CMOS sensor is converted into electrical signal after processing. The electrical signal is then transmitted by the cable to the signal processing chip embedded on the Endoscopic Video Image Processor where it is restored after processing and finally displayed on the screen of Endoscopic Video Image Processor. The materials used in construction of the insertion of Hysteroscope are lowdensity polyethylene (LDPE), Polyether-polyamide block copolymers (PEBAX), and polycarbonate (PC). The insertion portion is considered to contact a breached or compromised surface for a duration of less than 24 hours. The biocompatibility evaluation was conducted in accordance with the FDA guidance "Use of International Standard ISO 10993-1, 'Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process" and International Standard ISO 10993-1 "Biological Evaluation

of Medical Devices - Part 1: Evaluation and Testing Within a Risk Management Process," as recognized by FDA.

The handle does not contact the patient.

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The Single-Use Video Hysteroscope shall be used in conjunction with REDPINE Endoscopic Video Image Processor, which has been cleared under another 510(k) (K221158) to process the images collected by the video endoscope and send it to the display screen, as well as to provide power to the hysteroscope.

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VII. Comparison with the Predicate Devices

> Comparison of Indications with the Predicate Devices

Regarding the indications for use, although the subject device lacks integrated biopsy functionality compared to the intended use of both of them are the same.

> Comparison of Technological Characteristics with the Predicate Devices

Subjective device and the predicate device have intended use. The subject and predicate device have similar technological characteristics as evidenced by the table below. All differences have been discussed in detail and chat these differences in technological characteristics do not raise new questions regarding safety or effectiveness of the subject device.

a. The following basic technological elements are the same or similar for the subject and predicate devices:

Table VI Descriptive Comparison
ItemSubject DeviceHysteroscope SystemPredicate deviceHystero-V hysteroscopeReference deviceMedical Endoscope ImageProcessing SystemDiscussion
510(k) numberK232003K202445K210270
ClassificationProduct CodeHIHHIHHIHsame

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K232003 Page 6 of 14

Indicationsfor useSingle-Use Video Hysteroscopeis intended to be used forviewing of the adult cervicalcanal and uterine cavity for thepurpose of performingdiagnostic and operativeprocedures.The Hystero-V hysteroscope isintended to be used to permitviewing of the cervical canal anduterine cavity for the purpose ofperforming diagnostic proceduresand to obtain an endometrial tissuesample (biopsy) in an outpatient oroffice setting.The Medical Endoscope ImageProcessing System is intended tobe used for viewing of the adultcervical canal and uterine cavityfor the purpose of performingdiagnostic and operativeprocedures.Difference 1
Route ofAdvancementAdvanced to uterine cavity viathe cervical canalAdvanced to uterine cavity via thecervical canalAdvanced to uterine cavity via thecervical canalSame
Site of useHospitals and physician officesHospitals and physician officesHospitals and physician officesSame
Device Features
ComponentsThe hysteroscope system iscomposed of Single-Use VideoHysteroscope and endoscopicvideo image processor.Reusable handle with video screenAttachable cannula with a workingchannel along its length and anillumination source and camera at itstipThe medical endoscope system iscomposed of disposable electronichysteroscope and medicalendoscope image processor.Difference 2
Cannula OuterRP-G-C24:5.5mm
DiameterRP-G-C0101:4.8mm4.25mm4.8mmDifference 3
Cannula TotalLength270mm±3%254mm200mm±3%Difference 4
Illuminationlight sourceLEDLEDLEDSame
ImagetransmissionTransmits images aretransmitted to the user by thevideo processor with a CMOSchip at the distal end of theendoscope and the imageshowing on a monitor.Image transmitted from a videocamera at the tip of the cannula toa video monitor on the handleTransmits images are transmittedto the user by the video processorwith a CMOS chip at the distalend of the endoscope and theimage showing on a monitor.Same
LCD DisplaySize10.1 inches3.5 inches (diagonal)on the handleThe image processor of referencedevice with no display (It isconnected by an external displayto display images)Difference 5
Optical ImageCMOSCMOSCMOSSame
ImageResolution160,000 pixelsUnknown160,000 pixelsSame as thereference device
Field of View120°140°120°Same as thereference device;similar to thepredicate device
Depth of fieldRP-G-C24: 3 to 50 mmRP-G-C0101: 5 to 50 mm5 to 50 mm3 to 50 mmModel RP-G-C24is the same as thereference device;RP-G-C0101 isthe same as thepredicate device
Direction ofview fromcenter axisRP-G-C24:22°RP-G-C0101:30°30°16±3°Difference 6
Adjustbrightness ofilluminationPress the Brightness +/- buttonin the Processor to adjust to theappropriate brightness level.Adjust by depressing a button onthe handle to change settingsThe brightness of the LED can beadjusted with a button on themedical endoscope imageprocessing systemSame
Capture stillimages orvideo imagesduring theCapture images or video duringprocedure by the imageprocessorCapture still images or video duringprocedure by depressing a camerabutton on the handleCapture images or video duringprocedure by the image processorSame
procedure
Duration ofuse≤ 24 hours≤ 24 hours≤ 24 hoursSame
SterilizationThe Endoscopic Video ImageProcessor is not sterile.The Single-Use VideoHysteroscopes is sterilefollowing exposure to ethyleneoxide (EO)The handle is not provided sterile.The handle is cleaned anddisinfected following companyinstructions.Disposable cannula is sterilefollowing exposure toethylene oxide (EO) and issingle use; it is disposed afterthe procedure following theinstitution's procedures.Video Processor: Non-SterileThe Disposable ElectronicHysteroscope is provided sterilizedby EO.Re-sterilization is not permitted.Same
Tissue contactmaterialsCompliant with ISO 10993Compliant with ISO 10993Compliant with ISO 10993Same

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K232003

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b. Discussion on differences between the subject and the predicate device Difference 1 Indication for use

Although the subject device lacks integrated biopsy functionality compared to the predicate device, the intended use of both is the same. In addition, the indications for use is the same for the subject and reference device.

Difference 2 Components

Regarding Components, both the subject and reference device are composed of a singleuse (disposable) endoscope and an image processor (for displaying imaging). The difference from the predicate device is that the image processor (video screen) and reusable handle of the predicate device are designed as one, and the handle is connected to the insertion part, while the handle and insertion part of the subject device and the reference device are integrated (which are single use), and the handle is connected to the image processor. These differences do not raise different questions of safety and effectiveness.

Difference 3 Cannula outer diameter

The diameter of the hysteroscope is usually in the range of 4-6 mm; thus there are no new risks associated with 4.8 or 5.5 mm diameter.

Difference 4 Cannula total length

Longer cannula length does not affect the safety and effectiveness of the product.

Difference 5 LCD display size

Larger screen size does not affect the safety and performance of the product.

Difference 6 Direction of view from center axis

The difference in this parameter has only a minor effect on the observed image and does not affect the effectiveness of its use.

VIII. Summary of Non-clinical Performance

All non-clinical testing performed on new devices is to demonstrate the substantial equivalence to the predicate device and reference device. Tests setup and execution were performed in accordance with applicable standards. Results of the testing

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demonstrate compliance to the standards and matching the performance of subject device to the reference device. The following performance data were provided in support of the substantial equivalence determination.

A Biocompatibility

The biocompatibility evaluation for the Single-Use Video Hysteroscope was conducted in accordance with the FDA guidance "Use of International Standard ISO 10993-1, 'Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process"" and International Standard ISO 10993-1 "Biological Evaluation of Medical Devices - Part 1: Evaluation and Testing Within a Risk Management Process," as recognized by FDA. The insertion portion of Single-Use Video Hysteroscope is considered to contact a breached or compromised surface for a duration of less than 24 hours; therefore, the following tests are considered and passed:

Biocompatibility testing summary
TestTesting Summary
Cytotoxicity test (ISO 10993-5:2009 Biologicalevaluation of medical devices - Part 5: Tests for in vitrocytotoxicity, Annex C)Pass-Non-cytotoxic
Skin Sensitization test (ISO 10993-10:2010 Biologicalevaluation of medical devices - Part 10: Tests forirritation and sensitization, GPMT)Pass-Non-irritation
Intracutaneous test (ISO 10993-10:2010 Biologicalevaluation of medical devices - Part 10: Tests forirritation and sensitization)Pass-Non-sensitization
Acute Systemic Toxicity test (ISO 10993-11:2017Biological evaluation of medical devices – Part 11: Testsfor systemic toxicity)Pass-Non-acutely toxic

A Electrical Safety and Electromagnetic Compatibility

Electrical safety and EMC testing were conducted on the Hysteroscope System and

the device complies with the following standards:

  • AAMI ES 60601-1:2005 + AMD1:2012 + AMD2:2021 Medical electrical

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equipment - Part 1: General requirements for basic safety and essential performance. • IEC 60601-2-18: 2009 Medical electrical equipment Part 2: Particular requirements for the basic safety and essential performance of endoscopic equipment. • IEC 60601-1-2: 2014 + A1: 2020 Medical electrical equipment-Part 1-2: General requirements for basic safety and essential performance -Collateral Standard: Electromagnetic disturbances -Requirements and tests.

A Photobiological safety

The subject device was tested according to the following FDA recognized standards: • IEC 62471:2006 Medical electrical equipment, Photobiological safety of lamps and lamp systems.

A Sterilization Validation

The EO sterilization of the Single-Use Video Hysteroscope has been validated according to the following applicable standards:

• ISO11135:2014+A1:2018 Sterilization of medical device- validation and routine control of ethylene oxide sterilization

· ISO 11737-2:2019 Sterilization of Medical Device-Microbiological methods part 2: Tests of sterility performed in the validation of a sterilization process

• ISO 10993-7:2008 Biological evaluation of medical devices - Part 7: Ethylene oxide sterilization residuals

• USP <85> Bacterial endotoxins test

A Shelf Life and Sterile Barrier System (Packaging)

Shelf Life and Sterile Barrier System of the Single-Use Video Hysteroscope has been validated according to the following applicable standards:

• ASTM F1980-16 Standard Guide for Accelerated Aging of Sterile Barrier Systems for Medical Devices

• ISO11607-1:2019 Packaging for terminally sterilized Medical Device Part 1:

Requirement for materials, sterile barrier systems and packaging systems

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• ISO11607-2:2019 Packaging for terminally sterilized Medical Device Part 2: Validation Requirement for forming, sealing and assembly process

• ASTM F 1929-15 Standard Test Method for Detecting Seal Leaks in Porous Medical Packaging by Dye Penetration

• ASTM F88/F88M-15 Standard Test Method for Seal Strength of Flexible Barrier Materials

A Performance Data - Bench

The following performance data were provided in support of the substantial equivalence, as shown in the table below.

The optical performance testing was conducted in accordance with applicable parts of ISO 8600-1:2015, ISO 8600-3:2019, ISO 12233-2017, ISO15739-2017 and ISO/CIE 11664-4 standards, and the mechanical performance testing was conducted in accordance with applicable parts of ISO 8600-1:2015, ISO 8600-4:2014, YY/T 1028-2023 standards. The field of view was measured according to the test method in the article: Wang et al., "Endoscope field of view measurement." Biomedical Optics Express 8, no. 3 (2017): 1441-1454, and geometric distortion was measured according to section 3 of the article: Wang, et al., "Development of the local magnification method for quantitative evaluation of endoscope geometric distortion." Journal of Biomedical Optics 21, no. 5 (2016): 056003. The tensile strength of each joint in the insertion portion should be greater than 15 N and be free of any breakage, splitting, or deformation.

Test categoryTest item
OpticalperformanceDirection of view
Resolution
Depth of Field
Field of view
Geometric Distortion

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Signal-To-Noise Ratio
Dynamic Range
Image Intensity Uniformity (IIU)
Color Performance
Surface Safety (Surface and Edges)
MechanicalperformanceBasic Size
Water Supply System
Sealing Performance
Tensile strength

A Performance Data – Animal

N/A, no animal studies are available for the subject device.

IX. Clinical Evidence

N/A.

X. Conclusion

In conclusion, the technological characteristics, features, specifications, and intended use of the subject device are substantially equivalent to the predicate device quoted above. The differences between the subjective device and the predicate device do not raise new questions of safety and effectiveness. Performance testing demonstrated that the subject device is as safe and effective as the predicate. Therefore, the subject device is substantially equivalent to the predicate device.

§ 884.1690 Hysteroscope and accessories.

(a)
Identification. A hysteroscope is a device used to permit direct viewing of the cervical canal and the uterine cavity by a telescopic system introduced into the uterus through the cervix. It is used to perform diagnostic and surgical procedures other than sterilization. This generic type of device may include obturators and sheaths, instruments used through an operating channel, scope preheaters, light sources and cables, and component parts.(b)
Classification. (1) Class II (performance standards).(2) Class I for hysteroscope accessories that are not part of a specialized instrument or device delivery system; do not have adapters, connectors, channels, or do not have portals for electrosurgical, laser, or other power sources. Such hysteroscope accessory instruments include: lens cleaning brush, cannula (without trocar or valves), clamp/hemostat/grasper, curette, instrument guide, forceps, dissector, mechanical (noninflatable), and scissors. 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 § 884.9.