K Number
K990372
Device Name
MODULAR INSTRUMENT SYSTEM FOR MINIMAL INVASIVE SURGERY
Manufacturer
Date Cleared
1999-10-14

(248 days)

Product Code
Regulation Number
884.1720
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Viewing of and access to, the surgical site during endoscopic gynecological surgical procedures
Device Description
Modular Instrument System for Minimal Invasive Surgery. [Endoscope Accessories]
More Information

Not Found

Not Found

No
The summary explicitly states "Not Found" for mentions of AI, DNN, or ML, and there is no description of training or test sets, which are typical for AI/ML devices.

No
The device is used for viewing and access during surgical procedures, which is a diagnostic or assistive function, not a direct therapeutic intervention.

No
The device is described as a "Modular Instrument System for Minimal Invasive Surgery" primarily for "Viewing of and access to, the surgical site during endoscopic gynecological surgical procedures." Its function is to facilitate viewing and access during surgery, not to diagnose medical conditions.

No

The device is described as a "Modular Instrument System for Minimal Invasive Surgery" and "Endoscope Accessories," which strongly suggests it includes physical hardware components.

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

Here's why:

  • Intended Use: The intended use is "Viewing of and access to, the surgical site during endoscopic gynecological surgical procedures." This describes a device used during a surgical procedure to visualize and access the body, not a device used to test samples outside the body to diagnose a condition.
  • Device Description: The description "Modular Instrument System for Minimal Invasive Surgery. [Endoscope Accessories]" further supports that this is a surgical instrument used for visualization and manipulation during surgery.
  • Lack of IVD Characteristics: The information does not mention any of the typical characteristics of an IVD, such as:
    • Testing of biological samples (blood, urine, tissue, etc.)
    • Diagnosis, monitoring, or screening of diseases or conditions based on test results.
    • Reagents, calibrators, or controls.

Therefore, this device falls under the category of a surgical instrument used for visualization and access, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

Viewing of and access to, the surgical site during endoscopic gynecological surgical procedures

Product codes

HET

Device Description

Modular Instrument System for Minimal Invasive Surgery. [Endoscope Accessories]

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

Not Found

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

Not Found

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 884.1720 Gynecologic laparoscope and accessories.

(a)
Identification. A gynecologic laparoscope is a device used to permit direct viewing of the organs within the peritoneum by a telescopic system introduced through the abdominal wall. It is used to perform diagnostic and surgical procedures on the female genital organs. This generic type of device may include: Trocar and cannula, instruments used through an operating channel, scope preheater, light source and cables, and component parts.(b)
Classification. (1) Class II (performance standards).(2) Class I for gynecologic laparoscope accessories that are not part of a specialized instrument or device delivery system, do not have adapters, connector channels, or do not have portals for electrosurgical, lasers, or other power sources. Such gynecologic laparosope accessory instruments include: the lens cleaning brush, biopsy brush, clip applier (without clips), applicator, cannula (without trocar or valves), ligature carrier/needle holder, clamp/hemostat/grasper, curette, instrument guide, ligature passing and knotting instrument, suture needle (without suture), retractor, mechanical (noninflatable), snare, stylet, forceps, dissector, mechanical (noninflatable), scissors, and suction/irrigation probe. 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.

0

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Image /page/0/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract image of an eagle or bird-like figure with three stylized lines representing its body and wings.

OCT 1 4 1999

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Dr. Fritz GmbH c/o Mr. James Chitty Official Correspondent Altomec Service Center 13311 Brooks Drive, Suite E Baldwin Park, California 91706

Re: K990372 Trade Name: Modular Instrument System for Minimal Invasive Surgery Regulatory Class: II Product Code: HET Dated: August 30, 1999 Received: September 21, 1999

Dear Mr. Chitty:

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 enclosures) 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 requirement, 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 - Mr. James Chitty

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) 594-4595. 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,

Celia M. Witten, Ph.D., M.D.

Celia M. Witten, Ph.D., M.D. Director Division of General and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosures

2

Indications for use

ﺎﺭ ﺍﻟﻤﺮﺍﺟﻊ

Center for Devices and Radiological Health

510(k) Number (if known): K990372

:

Modular Instrument System for Minimal Invasive Device Name: Surgery. [Endoscope Accessories]

Indications for Use:

Viewing of and access to, the surgical site during endoscopic gynecological surgical procedures

(do not write below this line - continue on another page if needed)

س بہ جہ دیتھا ، وقت ،

Concurrence of CDRH, Office of Device Evaluation (ODE)
(Division Sign-Off)
Division of General Restorative Devices
510(k) NumberK 990372

OR

| Prescription Use
(Per 21 CFR 801.109) | Over-The-Counter-Use
(Optional Format 1-2-9) |

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