K Number
K972693
Device Name
DEROYAL INDUSTRIES, INC. SURGICAL EYE SPEAR
Date Cleared
1997-09-30

(74 days)

Product Code
Regulation Number
886.4790
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The DeRoyal Industries Inc., Surgical Eye Spear is indicated for use in ophthalmic or microscopic surgical procedures to absorb fluids from the operative field. The DeRoyal Industries Inc., Surgical Eye Spear is to be used to absorb fluids from the operative field during ophthalmic and microscopic surgical procedures.
Device Description
The DeRoyal Industries, Inc., Surgical Eye Spear functions in the same manner as predicate devices in that it is comprised of an absorbent spear attached to a plastic handle. Device Design/Materials Used Physical Properties: The DeRoyal Industries, Inc., Surgical Eye Spear is made of materials commonly used in predicate devices. The spear is comprised of cellulose and the handle is made of a high density plastic.
More Information

Not Found

No
The device description and intended use are purely mechanical and absorbent, with no mention of AI/ML terms or functionalities.

No
The device is described as an absorbent spear used to absorb fluids during surgical procedures, not to treat a disease or condition.

No

The device is described as a "Surgical Eye Spear" used to "absorb fluids from the operative field" during surgical procedures, which indicates a therapeutic/interventional function, not a diagnostic one.

No

The device description explicitly states it is comprised of an absorbent spear attached to a plastic handle, indicating it is a physical medical device, not software only.

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

Here's why:

  • Intended Use: The intended use is to "absorb fluids from the operative field during ophthalmic and microscopic surgical procedures." This is a physical action performed during a surgical procedure on a patient, not a test performed in vitro (outside the body) on a sample to diagnose a condition.
  • Device Description: The device is described as an absorbent spear attached to a handle, made of cellulose and plastic. This aligns with a surgical tool for fluid management, not a diagnostic test kit or instrument.
  • Lack of Diagnostic Information: There is no mention of analyzing biological samples, detecting biomarkers, or providing diagnostic information.
  • Anatomical Site: The device is used on the "Ophthalmic" anatomical site, which is the eye, during surgery.

IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for the diagnosis, monitoring, or treatment of diseases or conditions. This device does not fit that description.

N/A

Intended Use / Indications for Use

The DeRoyal Industries Inc., Surgical Eye Spear is to be used to absorb fluids from the operative field during ophthalmic and microscopic surgical procedures.

Product codes

86HOZ

Device Description

The DeRoyal Industries, Inc., Surgical Eye Spear functions in the same manner as predicate devices in that it is comprised of an absorbent spear attached to a plastic handle.

Device Design/Materials Used Physical Properties: The DeRoyal Industries, Inc., Surgical Eye Spear is made of materials commonly used in predicate devices. The spear is comprised of cellulose and the handle is made of a high density plastic.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

operative field (during ophthalmic surgical procedures)

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

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

Not Found

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

Not Found

Summary of Performance Studies

Clinical Data was not required for this submission.

Key Metrics

Not Found

Predicate Device(s)

K923922

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 886.4790 Ophthalmic sponge.

(a)
Identification. An ophthalmic sponge is a device that is an absorbant sponge, pad, or spear made of folded gauze, cotton, cellulose, or other material intended to absorb fluids from the operative field in ophthalmic surgery.(b)
Classification. Class II (special controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 886.9.

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DeRoyal Industries, Inc. Surgical Eye Spear

K972693

510(k) Summarv

SEP 3 0 1997

SUMMARY OF THE SAFETY AND EFFECTIVENESS INFORMATION UPON WHICH AN EQUIVALENCE DETERMINATION COULD BE BASED

SUBMITTER INFORMATION

DeRoyal Industries, Inc. TELEPHONE: NAME: CONTACT: 200 DeBusk Lane ADDRESS: DATE OF PREPARATION: Powell, TN 37849

(423) 938-7828 Camille Matlock September 19, 1997

DEVICE NAMES

NAME: COMMON/USUAL NAME: CLASSIFICATION NAME (if known):

DeRoyal Industries, Inc., Surgical Eye Spear Eve Spear Sponge, Ophthalmic (86HOZ)

PREDICATE OR LEGALLY MARKETED DEVICE

Ultracell Medical Technologies (K923922)

DEVICE DESCRIPTION

The DeRoyal Industries, Inc., Surgical Eye Spear functions in the same manner as predicate devices in that it is comprised of an absorbent spear attached to a plastic handle.

Device Design/Materials Used Physical Properties: The DeRoyal Industries, Inc., Surgical Eye Spear is made of materials commonly used in predicate devices. The spear is comprised of cellulose and the handle is made of a high density plastic.

Clinical Data was not required for this submission.

DEVICE INTENDED USE

The DeRoyal Industries, Inc., Surgical Eye Spear is indicated for use in ophthalmic or microscopic surgical procedures to absorb fluids from the operative field.

Characteristics & MaterialsDeRoyal Surgical Eye SpearPredicate Device
Sponge MaterialCelluloseSame
Handle MaterialHigh Density PolyethyleneSame
ShapeTriangular Sponge HeadSame
Sponge Tip Measurements11/16 inch (length)
9/32 inch (width)~Same
Plastic Handle Measurements2-3/16 inch (length)
.092 inch - .125 inch (diameter)~Same
SizesOne SizeSame
SterilitySterileSame

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STERILITY INFORMATION

The device shall be offered sterile. The method of sterilization is Ethylene Oxide with a Sterility Assurance Level of 10°. The maximum levels of residues of ethylene oxide, ethylene chlorohydrin, and ethylene glycol allowed to remain on the device will meet the proposed maximum residual limits stated in the Federal Register, June 23, 1978.

BIOCOMPATIBILITY TESTING

The following Biocompatibility tests were performed. All test results were deemed acceptable.

TESTREFERENCE
CytotoxicityISO 10993-1
SensitizationISO 10993-1
Intraocular IrritationISO 10993-1
Systemic InjectionISO 10993-1 &
USP Class VI
HemolysisISO 10993-1
Intracutaneous ToxicityUSP Class VI
Intracutaneous ImplantationUSP Class VI

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Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features the department's name encircling a stylized emblem. The emblem consists of four abstract human profiles facing right, arranged in a stacked, overlapping manner. The profiles are black, and the text is in a simple, sans-serif font.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

SEP 3 0 1997

Ms. Camille Matlock Regulatory Affairs DeRoyal Industries, Inc. 200 DeBusk Lane Powell, TN 37849

Re: K972693

Trade Name: DeRoyal Industries, Inc. Surgical Eye Spear Regulatory Class: II Product Code: 86 HOZ Dated: July 17, 1997 Received: July 18, 1997

Dear Ms. Matlock:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). You may, therefore, market the device, subject to the general controls provisions of the Act. 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.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

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Page 2 - Ms. Camille Matlock

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4613. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

A Roerl Rosenthal

A. Ralph Rosenthal, M.D. Director Division of Ophthalmic Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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510(k) Number (if known):

6912693

Device Name:

DeRoyal Industries Inc., Surgical Eye Spear

Indications for Use:

The DeRoyal Industries Inc., Surgical Eye Spear is to be used to absorb fluids from the operative field during ophthalmic and microscopic surgical procedures.

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Daniel W. C. Brown

(Division Sign-Off)
Division of Ophthalmic Devices
510(k) Number K912693

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OR

Over-The-Counter Use__________________________________________________________________________________________________________________________________________________________