K Number
K973229
Device Name
D.O.R.C. HEXON ILLUMINATION SYSTEM
Date Cleared
1997-11-25

(90 days)

Product Code
Regulation Number
876.1500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The D.O.R.C. HEXON Illumination System is indicated for intraocular illumination in vitreoretinal surgery.
Device Description
The D.O.R.C. HEXON Illumination System consists of the Illumination Unit and accessories. The Illumination Unit uses a metal halide discharge lamp and utilizes an internal focusing system to focus the light into the end of the optical fiber. Accessories to the Illumination Unit include adapters and color filters. Accessories to the system include single use and reusable fiberoptic probes, fibers, and microinstruments which require storilization prior to use.
More Information

Not Found

No
The description focuses on the hardware components and light source technology, with no mention of AI, ML, image processing, or data-driven algorithms.

No.
The device's intended use is for intraocular illumination, which is a supportive function during surgery, not a direct therapeutic action on the disease or condition. It helps the surgeon see but does not treat the patient.

No

The device is indicated for intraocular illumination during surgery, which is a therapeutic rather than a diagnostic function. It provides light for the surgeon to see, but does not identify or characterize diseases or conditions.

No

The device description explicitly details hardware components such as an "Illumination Unit," "metal halide discharge lamp," "optical fiber," "adapters," "color filters," "fiberoptic probes," "fibers," and "microinstruments." This indicates it is a hardware-based 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 "intraocular illumination in vitreoretinal surgery." This describes a device used during a surgical procedure to provide light within the eye.
  • Device Description: The description details a light source, fiberoptic probes, and instruments used for illumination and manipulation within the body.
  • Anatomical Site: The anatomical site is "intraocular," meaning inside the eye.

IVD devices are used to examine specimens (like blood, urine, tissue) outside the body to provide information about a person's health. This device is used inside the body during surgery.

N/A

Intended Use / Indications for Use

The D.O.R.C. HEXON Illumination System is indicated for intraocular illumination in vitreoretinal surgery.

Product codes

86 MPA

Device Description

The D.O.R.C. HEXON Illumination System consists of the Illumination Unit and accessories. The Illumination Unit uses a metal halide discharge lamp and utilizes an internal focusing system to focus the light into the end of the optical fiber. Accessories to the Illumination Unit include adapters and color filters. Accessories to the system include single use and reusable fiberoptic probes, fibers, and microinstruments which require storilization prior to use.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

intraocular

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

K963417

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.

0

K973229

e 2

510(k) Summary Dutch Ophthalmic, USA D.O.R.C. HEXON Illumination System (per 21 CFR 807.92)

NOV 2 5 1997

SUBMITTER NAME AND ADDRESS 1.

Dutch Ophthalmic, USA One Little River Roud P.O. Box 968 Kingston, NH 03848

Mark W. Furlong, President Contact Person: Telephone: 603-642-8468

August 26, 1997 Date Prepared: Date Amended: November 24, 1997

2. DEVICE NAME

Proprietary Name: HEXON Illumination System Common/Usual Name: Endoillumination System Ophthalmic Light Source Classification Name:

PREDICATE DEVICE/S 3.

Grieshaber Light Source Escalon VitLite I (K963417)

DEVICE DESCRIPTION 4.

The D.O.R.C. HEXON Illumination System consists of the Illumination Unit and accessories. The Illumination Unit uses a metal halide discharge lamp and utilizes an internal focusing system to focus the light into the end of the optical fiber. Accessories to the Illumination Unit include adapters and color filters. Accessories to the system include single use and reusable fiberoptic probes, fibers, and microinstruments which require storilization prior to use.

INTENDED USE ડ.

The D.O.R.C. HEXON Illumination System is indicated for intraocular illumination in vitreoretinal surgery.

1

1973220

BASIS FOR SUBSTANTIAL EQUIVALENCE 6.

Operational and technological cliaracteristics for the determination of aubstantial Operational and technological clisition with hegally marketed predicate
equivalence of the D.O.R.C. HEXON Illumination System with hegally marketed predicate equivalence of the D.O.R.C. HEXON Inumilation includes desoriptive information
devices. Information supplied in this prematical obserciptive information devices. Information supplied in this president includes . The following table about the intended use, operation and technological characteristics - HEXON Illumination System in
summarizes the toch of the D.O.R.C. HEXON Illumination System in comparison to the prodicate devices.

Comparison of HEXON Illumination System to Predicate Devices
HEXON
Illum. SystemGrieshaber
Light SourceEscalon
VitLite
Characteristic
Indication: Endollumination for
vitreoretinal surgeryYESYESYES
Lamp TypeMetal HalideHalogenMetal Halide
Lamp Rating24 wattsnot specifiednot specified
Light Output (lumens)1850not specifiednot specified
Color Temperature (degrees K)4700not specified5300
Variable IntensityYesYesYes
Wavelength Range (nm)400-800not specified450-700
UV filtrationYesYesYes
Infrared filtrationYesYesYes
Additional color filtrationGreenYesYesnot specified
YellowYesYesnot specified
RedYesYesnot specified
BlueYesYesnot specified
DaylightYesnot specifiednot specified
Multiple probe diametersYesYesYes
Panoramic light probeYesnot specifiedYes
Straight probeYesYesYes
Illuminated accessoriesYesYesYes

D.O.R.C. HEXON Illumination System 510(k) 8/26/97

2

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

2 5 1997 NOV

Mr. Mark W. Furlong Dutch Ophthalmic, U.S.A., Inc. One Little River Road P.O. Box 968 Kingston, NH 03848

Re: K973229

Trade Name: D.O.R.C. Hexon Illumination System Regulatory Class: II Product Code: 86 MPA Dated: August 25, 1997 Received: August 27, 1997

Dear Mr. Furlong:

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 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 Good Manufacturing Practice for Medical Devices: General (GMP) regulation (21 CFR Part 820) and that, through periodic GMP 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.

3

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 Ralph Rosenthal

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

Enclosure

4

K973229 ----------------------------------------------------------------------------------------------------------------------------------------------------------------------510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

D.Q.R.C. Hexon Illumination System Device Name:

Indications For Use:

The D.O.R.C. Hexon Illumination System is indicated for intraocular illumination in vitreoretinal surgery.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Bruce Drum

(Division Sign-Off)
Division of Ophthalmic Devices
510(k) Number K973229

Prescription Use (Per 21 CFR 801.109)

OR

Over-The-Counter Use ------------