K Number
K992353
Device Name
BLUNT TIP TROCAR PORT
Date Cleared
1999-07-30

(16 days)

Product Code
Regulation Number
876.1500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Blunt Tip Trocar Port has applications for surgery in the legs for establishment of a port of entry for endoscopic instruments.
Device Description
Not Found
More Information

Not Found

Not Found

No
The summary describes a physical surgical instrument (trocar) and contains no mention of software, algorithms, image processing, or AI/ML terms.

No.
The device is a port of entry for endoscopic instruments, it does not directly treat a disease or condition.

No
The device is described as a "Trocar Port" for establishing a port of entry for endoscopic instruments in surgery, indicating a therapeutic or surgical tool, not a diagnostic one.

No

The device is described as a "Blunt Tip Trocar Port," which is a physical surgical instrument, not software.

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

Here's why:

  • Intended Use: The intended use is for establishing a port of entry for endoscopic instruments during surgery in the legs. This is a surgical tool used in vivo (within the living body) for a surgical procedure.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing samples (blood, urine, tissue, etc.)
    • Providing information about a patient's health status, disease, or condition based on the analysis of samples.
    • Use in a laboratory setting.

IVDs are devices used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or screening purposes. This device's function is purely mechanical and procedural within a surgical context.

N/A

Intended Use / Indications for Use

The Blunt Tip Trocar Port has applications for surgery in the legs for establishment of a port of entry for endoscopic instruments.

Product codes (comma separated list FDA assigned to the subject device)

GCJ

Device Description

Not Found

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

legs

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

§ 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

Image /page/0/Picture/1 description: The image shows the seal of the Department of Health & Human Services - USA. The seal is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is an abstract image of an eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUL 30 1331

Lori E. Adels, Ph.D. Vice President, Regulatory Affairs Origin Medsystems, Inc. A Subsidiary of Guident Corp. 1525 O'Brien Drive Menlo Park, California 94025

K992353 Re: Trade Name: Blunt Tip Trocar Port Regulatory Class: II Product Code: GCJ Dated: July 13, 1999 Received: July 14, 1999

Dear Dr. Adels:

We have reviewed your Section 510(k) notification of intent to market the device referenced We have reviewed your Section 910(x) notification of the indications for above and we have determined this es marketed in interstate commerce prior to use stated in the enclosure) to devices manetical Device Amendments, or to devices that May 28, 1976, the enactified 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 Cosment Act (7Nc). Tournaly, therefers, Includers, Include requirements for provisions of the Act. The general condinations 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 (Fremarket Approval), It may be subject to sam rain the Code of Federal Regulations, Title 21, regulations arrecting your device can or round to mination assumes compliance with the I arts 600 to 675. A 54.55.41.24.2017. In the Quality System Station in the Quality System Current Cloxi Manufacturing Practices: General regulation (21 CFR Part 820) and that, Regulation (QS) inspections, the Food and Drug Administration (FDA) will verify all ough portually (QD) inspections) with the GMP regulation may result in regulatory sucir assumptions. FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission docs I cuctar Register. Frease noter initit have under sections 531 through 542 of the Act for not antect ary obtigation you might Radiation Control provisions, or other Federal laws or regulations.

1

Page 2 - Lori E. Adels, Ph.D.

This letter will allow you to begin marketing your device as described in your 510(k)
and the country of the FD to dian of substantial equivalence of your device to This letter will allow you to begin marketing of substantial equivalence of your device to a
premarket notification. The FDA finding of substantial equivalence of your devic premarket notification. The FDA finding of substantial equivals. So 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 the subseries in the same and advailable sentact the Office of If you desire specific advice for your devices), please contact the Office of
and additionally 809.10 for in vitro diagnostic devices on the promotion and and additionally 809.10 for in Vitto didn't on 1000) for questions on the promotion and Compliance at (301) 594-4391. Adultionally, Ior quotice of Compliance at (301) 594-4639.
advertising of your device, please contact the Office of Compliance at (301) of the Also, please note the regulation entitled, "Misbranding by reference to premarket. Also, please note the regulation entitled, "Misoration on your responsibilities under the notification" (21 CFK 807.97). Onlie genchi internets Assistance at its toll-free
Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free
10 Act may be obtained from (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

fu Celia M. Witten, Ph.D., M.D.
Director
Division of General and
Restorative Devices
Office of Device Evaluation

Center for Devices and Radiological Health

Enclosure

2


. .

ﺴﺐ

510(k) Number (if known):Unknown
Device Name:Blunt Tip Trocar Port

Indications For Use:

.

l

i . .

The Blunt Tip Trocar Port has applications for surgery in the legs for establishment
of a port of entry for endoscopic instruments.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)
Prescription UseXOROver-The-Counter Use

(Division Sign-Off)

Division of General Restorative Dr.

510(k) NumberK992353(Optional Format 1-2-96)
--------------------------------------------------