K Number
K980401
Device Name
FLEXIBLE FIBERSCOPES AND ACCESSORIES
Date Cleared
1998-05-21

(108 days)

Product Code
Regulation Number
876.1500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For examination, diagnosis and/or therapy in connection with endoscopic accessories and auxiliary instruments used through the working channel of the instrument for use in urology, surgery, and GYN.
Device Description
The flexible fiberscopes consist of a flexible insertion part, a control part and an eyepiece for direct view or connection to a video camera.
More Information

Not Found

No
The summary describes a standard flexible fiberscope and does not mention any AI/ML capabilities or image processing features typically associated with such technology.

Yes
The 'Intended Use / Indications for Use' explicitly states "diagnosis and/or therapy". Additionally, the device is used with "endoscopic accessories and auxiliary instruments" in procedures in urology, surgery, and GYN, which often involve therapeutic interventions.

Yes
The "Intended Use / Indications for Use" explicitly states "For examination, diagnosis and/or therapy". The mention of diagnosis clearly indicates it is a diagnostic device.

No

The device description explicitly states it consists of a flexible insertion part, a control part, and an eyepiece, which are all hardware components.

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

Here's why:

  • Intended Use: The intended use clearly states "For examination, diagnosis and/or therapy in connection with endoscopic accessories and auxiliary instruments used through the working channel of the instrument for use in urology, surgery, and GYN." This describes a device used within the body for direct visualization and intervention, not for testing samples outside the body.
  • Device Description: The description of a "flexible fiberscope" with an insertion part, control part, and eyepiece aligns with an endoscopic device used for internal examination.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.) or performing tests on these samples to provide diagnostic information.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information for diagnosis, monitoring, or screening. This device's function is direct visualization and access for procedures within the body.

N/A

Intended Use / Indications for Use

For examination, diagnosis and/or therapy in connection with endoscopic accessories and auxiliary instruments used through the working channel of the instrument for use in urology, surgery, and OB/GYN.

Product codes

78 FAJ, GCJ, 84 HIH

Device Description

The flexible fiberscopes consist of a flexible insertion part, a control part and an eyepiece for direct view or connection to a video camera.

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

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

No known FDA performance standard exists. The electrodes in combination with the fiberscopes were tested to meet the appropriate sections of the ANSI/ AAMI standard on high frequency devices HF18 and IEC601-1/ IEC601-2-2.

Key Metrics

Not Found

Predicate Device(s)

K962172

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

353 Corporatio Woods Parkway Vernon Hills, Illinois 60061 Phone: 847.913.1113 Fax: 847.913.1488

K980401

RICHARD WOLF
MEDICAL INSTRUMENTS CORPORATION

142

MAY 2 1 1999

510(k) Summary of Safety and EffectivenessMAY 21 1998
---------------------------------------------------------
Date of Preparation:May 1, 1998
Company / Institution name:RICHARD WOLF MEDICAL INSTRUMENTS CORP.
FDA establishment registration number:14 184 79
Division name (if applicable):N.A.
Phone number (include area code):(847) 913-1113
Street address:353 Corporate Woods Parkway
FAX number (include area code):(847) 913-0924
City:Vernon Hills
State/Province:Illinois
Country:USA
ZIP / Postal Code:60061
Contact name:Mr. Robert L. Casarsa
Contact title:Quality Assurance Manager

Product Information:

Trade name:Flexible fiberscopes and accessories
Model number:7305.xxx
Common name:Flexible fiberscopes
Classification name:Flexible endoscopes

Information on devices to which substantial equivalence is claimed:

510(k) NumberTrade or proprietary or model nameManufacturer
1K962172Flexible Mini-FiberscopesRichard Wolf
2Flexible CystoNephroscope ACNCircon/ ACMI
3Flexible Hysteroscope, AUR-FHCircon/ACMI
4Cysto-Urethro-Fiberscope 11272 AAKarl Storz
5Flexible Hysteroscope, 11261 BBKarl Storz
6Flexible Cystofiberscope CYF-3Olympus
7Hysterofiberscope, HYF-1TOlympus

1.0 Description

The flexible fiberscopes consist of a flexible insertion part, a control part and an eyepiece for direct view or connection to a video camera.

1

MEDICAL INSTR

K980401
2.12

2.0 Intended Use

Flexible fiberscopes are used for examination, diagnosis, and/or therapy in connection with endoscopic accessories and auxiliary instruments used through the working channel of the instrument for use in urology, surgery, and OB/GYN.

3.0 Technological Characteristics

There are no significant technological changes or characteristics to the new devices compared to the existing devices.

The tip of the sheath has an active deflection up to 360°, depending on the fiberscope. The deflecting position can be locked with a brake at the 7305.001. The image is transmitted via objective, fiber bundle and eyepiece for direct view or connection to a video camera. The total number of pixels and the fibers per mm2 are increased to get an image with higher resolution. Biopsy material can be taken by the wide working channel, which is simultaneously used for irrigation. Auxiliary instruments such as grasping forceps, stone extractors or HF button electrode are inserted via a proximal mounted insertion cock with supply and discharge. A leakage test unit or a gas sterilization valve can be connected to an attachment of the fiberscope.

4.0 Substantial Equivalence

The submitted devices pose the same type of questions about safety or effectiveness as the compared devices. The new technological characteristics have not diminished safety or effectiveness. The submitted devices are substantially equivalent to existing pre-enactment and 510(k) devices sold by Richard Wolf in the urology branch. In addition, the submitted devices are substantially equivalent to devices sold by Circon, Karl Storz and Olympus.

5.0 Performance Data

No known FDA performance standard exists. The electrodes in combination with the fiberscopes were tested to meet the appropriate sections of the ANSI/ AAMI standard on high frequency devices HF18 and IEC601-1/ IEC601-2-2.

6.0 Clinical Tests

Clinical tests performed were not performed.

7.0 Conclusions Drawn

These devices are designed and tested to assure their safety and effectiveness when used according to the instructions manual.

By: Robert L Casasa

Robert L. Casarsa Quality Assurance Manager

Date: May 1, 1998

9 - 2

2

Image /page/2/Picture/0 description: The image shows a logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of an eagle or bird-like figure with three curved lines representing its body and wings. The text "DEPARTMENT OF HEALTH & HUMAN" is arranged in a circular fashion around the logo.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Robert L. Casarsa Richard Wolf Medical Instruments Corporation 353 Corporate Woods Parkway Vernon Hills, Illinois 60061

MAY 2 | 1998

Re: K980401 Flexible Fiberscopes and Accessories Dated: May 1, 1998 Received: May 4, 1998 Regulatory Class: II 21 CFR §876.1500 and §884.1690 Product Code: 78 FAJ GCJ, and 84 HIH

Dear Mr. Casarsa:

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, narket 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 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 (OS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic OS 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.

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 pronotion 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/cdrb/dsmaldsmam.html".

Sincerely yours,

Lillian Yin, Ph.D.

Director, Division of Reproductive, Abdominal, Ear, Nose and Throat and Radial -------------------------------------------------------------------------------------------------------------------------------------------------------------------Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

3

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________ K980401

Device Name: __ Flexible Fiberscopes and Accessories (7305.001, 7305.011)

Intended Use:

For examination, diagnosis and/or therapy in connection with endoscopic accessories and auxiliary instruments used through the working channel of the instrument for use in urology, surgery, and GYN.

(PLEASE DO NOT WRITE BELOW TIJIS LINE - CONTINUE ON ANOTHER PAGE IF NEFFICED)

Robert R. Satting/
(Division Sign-Off)

Division of Reproductive, Abdominal, ENT, and Radiological Devices

510(k) Number K984401

Prescription Use
Per 21 CFR 801.109


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