K Number
K983797
Date Cleared
1999-03-03

(126 days)

Product Code
Regulation Number
886.4150
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The D.O.R.C. Harmony Total Vitrectomy System is a surgical system for ophthalmic surgery intended for use in surgery of the posterior segment (vitrectomy).

Device Description

The D.O.R.C. Harmony Total Vitrectomy System is an integrated system for posterior segment eye surgery. It provides the majority of functions required by the ophthalmic surgeon for performing a vitrectomy including vitreous cutting and aspiration, phacofragmentation, illumination, diathermy, air system and viscous fluid injection/extraction. The system is operated from one multifunction footswitch which gives the surgeon control over all of the surgical functions. The D.O.R.C. Harmony Total Vitrectomy System which includes the system, multifunction footswitch, trolley, automatic infusion pole and various sterile and non-sterile accessories provides the majority of functions needed to complete a posterior segment vitrectomy. The system is ac powered and also requires a source of medical grade compressed air to provide for some of the system functions.

AI/ML Overview

The provided text is a 510(k) premarket notification for the D.O.R.C. Harmony Total Vitrectomy System. This document focuses on demonstrating substantial equivalence to existing predicate devices, rather than presenting a study with specific acceptance criteria and performance metrics in the way one might for a novel diagnostic or AI-powered medical device.

Therefore, many of the requested elements (e.g., sample size for test/training sets, number of experts, adjudication methods, MRMC studies, standalone performance, type of ground truth) are not applicable to this type of regulatory submission.

The "study" in this context is the comparison of technological characteristics of the D.O.R.C. Harmony Total Vitrectomy System to its predicate devices. The acceptance criteria are implicit in the FDA's "substantial equivalence" determination, meaning the new device must be as safe and effective as a legally marketed predicate device.

Here's an breakdown based on the provided text, addressing the points where information is available:

1. Table of Acceptance Criteria and Reported Device Performance

For a 510(k) submission like this, there isn't a formally stated "acceptance criteria" in terms of specific performance metrics with PASS/FAIL thresholds for a novel diagnostic. Instead, the acceptance criteria are satisfied by demonstrating that the new device's technological characteristics are substantially equivalent to legally marketed predicate devices. The "reported device performance" is essentially the listed specifications of the D.O.R.C. Harmony Total Vitrectomy System, as compared to the predicate devices.

Feature/SpecificationAcceptance Criteria (Implicit: Comparable to Predicate)D.O.R.C. Harmony Total PerformancePredicate Devices (Range/Example)
Intended UsePosterior segment ophthalmic surgeryPosterior segment ophthalmic surgerySame
Vitrectomy TypeGuillotine cutter (or equivalent)Guillotine cutterGuillotine or radial reciprocating
Vitrectomy Drive MechanismPneumatic or electricPneumatic or electricPneumatic
Maximum Cut RateComparable to predicate devices800 cuts/minute750 - 2500 cuts/minute (predicates show a range)
Aspiration TypeVenturi (or equivalent)VenturiVenturi
Linear ControlPresentYESYES
Maximum VacuumComparable to predicate devices500 mm Hg500 - 600 mm Hg
PhacofragmentationPresent (if predicate has it)YESYES
Phaco FrequencyComparable to predicate devices40 kHz28.5 kHz - 40 kHz
DiathermyPresent (if predicate has it)YESYES
Diathermy FrequencyComparable to predicate devices13.56 MHz600 kHz (one predicate)
Diathermy Max PowerComparable to predicate devices12 watts7.5 - 10 watts
Fiber Optic Light SourcePresent (if predicate has it)YESYES
Light OutputDual/SingleDualDual
Lamp TypeHalogen (or equivalent)HalogenUnknown for predicates
Lamp WattageComparable to predicate devices150 wattsUnknown for predicates
Air InfusionPresent (if predicate has it)YESYES
Air Infusion Max PressureComparable to predicate devices95 mm Hg99 - 120 mm Hg
Viscous Fluid InjectionPresent (if predicate has it)YESNO (for Storz, MID Labs, Scieran)
Viscous Fluid Injection Viscosities1000 or 5000 cs1000 or 5000 cs1000 or 5000 cs (Alcon)
Viscous Fluid ExtractionPresent (if predicate has it)YESNO (for Storz, MID Labs, Scieran)
Multifunction FootswitchPresentYESYES

2. Sample size used for the test set and the data provenance

  • Not Applicable. This is a comparison of device specifications to predicate devices, not a study involving patient data or a "test set" in the context of diagnostic accuracy. The provenance of the data is the device's own specifications and publicly available information about predicate devices.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

  • Not Applicable. No "ground truth" derived from expert assessment of a test set is mentioned or required for this type of submission. The "ground truth" is the demonstrated functionality and specifications of the device itself and its predicates.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

  • Not Applicable. No adjudication process is described for a test set.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

  • Not Applicable. This is not an AI or diagnostic device that involves human readers.

6. If a standalone (i.e. algorithm only without human-in-the loop performance) was done

  • Not Applicable. This is a surgical system, not an algorithm.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

  • The "ground truth" for this submission is the functional specifications and intended use of the D.O.R.C. Harmony Total Vitrectomy System and its predicate devices. Substantial equivalence is established by demonstrating that these characteristics are similar enough to ensure equivalent safety and effectiveness.

8. The sample size for the training set

  • Not Applicable. This is a hardware surgical system, not a machine learning model requiring a training set.

9. How the ground truth for the training set was established

  • Not Applicable. See point 8.

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3/3/99

K983797

510(k) Summary Dutch Ophthalmic, USA D.O.R.C. Harmony Total (per 21 CFR 807.92)

SUBMITTER NAME AND ADDRESS 1.

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

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

Date Prepared: October 26, 1998

2. DEVICE NAME

Proprietary Name:D.O.R.C. Harmony Total Vitrectomy System
Common/Usual Name:Vitrectomy System
Classification Name:Vitreous Aspiration & Cutting Instrument
(86HOE & 21CFR 886.4150)

3. PREDICATE DEVICE/S

ManufacturerProduct Name510(k) Number
Alcon SurgicalAccurusunknown
StorzMilleniumK961310
MID LabsSupraVit/VitMateK932669/K924222
ScieranVit CommanderK961738

4. DEVICE DESCRIPTION

The D.O.R.C. Harmony Total Vitrectomy System is an integrated system for posterior segment eye surgery. It provides the majority of functions required by the ophthalmic

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surgeon for performing a vitrectomy including vitreous cutting and aspiration, phacofragmentation, illumination, diathermy, air system and viscous fluid injection/extraction. The system is operated from one multifunction footswitch which gives the surgeon control over all of the surgical functions.

The D.O.R.C. Harmony Total Vitrectomy System which includes the system, multifunction footswitch, trolley, automatic infusion pole and various sterile and non-sterile accessories provides the majority of functions needed to complete a posterior segment vitrectomy. The system is ac powered and also requires a source of medical grade compressed air to provide for some of the system functions.

న. INTENDED USE

The D.O.R.C. Harmony Total Vitrectomy System is a surgical system for ophthalmic surgery intended for use in surgery of the posterior segment (vitrectomy).

BASIS FOR SUBSTANTIAL EQUIVALENCE 6.

Operational and technological characteristics form the basis for the determination of substantial equivalence of the D.O.R.C. Harmony Total with legally marketed predicate devices. Information supplied in this premarket notification includes descriptive information about the intended use, operation and technological characteristics. The following table summarizes the technological characteristics of the D.O.R.C. Harmony Total in comparison to the predicate devices.

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D.O.R.C. HarmonyTotalAlcon SurgicalAccurusStorz MilleniumMID LabsSupraVit/VitMateVitreoretinalSystemScieranTechnologiesVit Commander
510(k) numbercurrent submissionunknownK961310K932669/K24222K961738
Intended UsePosterior segmentophthalmic surgeryPosterior segmentophthalmic surgeryPosterior segmentophthalmic surgeryPosterior segmentophthalmic surgeryPosterior segmentophthalmic surgery
Features/Specifications
Computer Based SystemNOYESYESunknownunknown
VitrectomyYESYESYESYESYES
type:guillotine cutterguillotine or radialreciprocating cutterguillotine cutterguillotine cutterguillotine cutter
drive mechanism:pneumatic or electricpneumatic800 or 1200cuts/minutepneumaticpneumaticelectric
maximum cut rate800 cuts/minute750 cuts/minute800 cuts/minute2500 cuts/minute
Irrigation/AspirationYESYESYESYESYES
aspiration type:venturiventuriventuriunknownunknown
linear control:YESYESYESYESYES
maximum vacuum:500 mm Hg600 mm Hg550 mm Hg500 mm Hg600 mm Hg
PhacofragmentationYESYESYESYESNO
frequency:40 kHz40 kHz28.5 khz40 khz
DiathermyYESYESYESYESYES
frequency:13.56 MHzunknownunknown600 khzunknown
maximum power:12 wattsunknown7.5 watts10 wattsunknown
Fiber Optic Light SourceYESYESYESYESNO
dual/single output:dualdualdualdual
lamp type:halogenunknownunknownunknown
lamp wattage:150 wattsunknownunknownunknown
Air InfusionYESYESYESYESNO
maximum pressure:95 mm Hg120 mm Hg100 mm Hg99 mm Hg
Viscous Fluid InjectionYESYESNONONO
viscosities:1000 or 5000 cs1000 or 5000 cs
Viscous Fluid ExtractionYESYESNONONO
Multifunction FootswitchYESYESYESYESYES

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus, a symbol often associated with medicine and healthcare. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" are arranged around the caduceus in a circular fashion. The logo is black and white.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR - 3 1999

Mr. Mark W. Furlong President Dutch Ophthalmic, USA One Little River Road P.O. Box 968 Kingston, NH 03848

Re: K983797

Trade Name: D.O.R.C. Harmony Total Vitrectomy System Regulatory Class: II Product Code: HQE Dated: February 17, 1999 Received: February 24, 1999

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 (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 (OS) 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 -Mr. Mark W. Furlong, President

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 Iegally 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

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510(k) Number (if known):_____________________________________________________________________________________________________________________________________________________

Device Name:__________________________________________________________________________________________________________________________________________________________________

Indications For Use:


. .. .

The D.O.R.C. Harmony Total vitrectomy system is a surgical system for ophthalmic surgery intended for use in surgery of the posterior segment (vitrectomy).

:

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Everetta Boom
(Division Sign-Off)

(Division Sign-Off) Division of Ophthalmic Device 510(k) Number.

Prescription Use
(Per 21 CFR 801.109) ✓

Over-The-Counter Use_

§ 886.4150 Vitreous aspiration and cutting instrument.

(a)
Identification. A vitreous aspiration and cutting instrument is an electrically powered device, which may use ultrasound, intended to remove vitreous matter from the vitreous cavity or remove a crystalline lens.(b)
Classification. Class II (special controls). The device, when it is phacofragmentation unit replacement tubing, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 886.9.