K Number
K993055
Device Name
DEXIDE BIPOLAR FORCEPS II** DEVICE
Date Cleared
1999-10-05

(22 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Dexide Bipolar Forceps II** device is indicated for use in laparoscopic and open bipolar procedures, to grasp, coagulate and transect tissues.
Device Description
The Dexide Bipolar Forceps II** device is a grasping, coagulating, and transecting bipolar forceps, which is intended for use in laparoscopic and open procedures. The device is intended for use with bipolar outputs of compatible electrosurgical generators.
More Information

Not Found

Not Found

No
The summary describes a standard electrosurgical bipolar forceps for grasping, coagulating, and transecting tissue. There is no mention of AI, ML, image processing, or any other technology typically associated with AI/ML functionality in medical devices. The performance study focuses on compliance with an electrical safety standard.

No
The device description indicates it is a surgical tool used to grasp, coagulate, and transect tissues, not administer therapy.

No
Explanation: The device description clearly states its purpose is for grasping, coagulating, and transecting tissues during surgical procedures (laparoscopic and open bipolar procedures), not for diagnosing conditions or diseases.

No

The device description clearly states it is a "grasping, coagulating, and transecting bipolar forceps," which is a physical hardware device used in surgical procedures.

Based on the provided information, the Dexide Bipolar Forceps II device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is for grasping, coagulating, and transecting tissues during surgical procedures (laparoscopic and open). This is an in vivo (within a living organism) application, not an in vitro (outside of a living organism) diagnostic test.
  • Device Description: The description reinforces its use as a surgical tool for tissue manipulation and coagulation.
  • Lack of IVD Characteristics: The description does not mention any analysis of biological samples (blood, urine, tissue samples, etc.) or any diagnostic purpose.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. The Dexide Bipolar Forceps II is a surgical instrument used directly on tissue within the body.

N/A

Intended Use / Indications for Use

The Dexide Bipolar Forceps II** device is indicated for use in laparoscopic and open bipolar procedures, to grasp, coagulate and transect tissues.

Product codes

GEI

Device Description

The Dexide Bipolar Forceps II** device is a grasping, coagulating, and transecting bipolar forceps, which is intended for use in laparoscopic and open procedures. The device is intended for use with bipolar outputs of compatible electrosurgical generators.

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)

The Dexide Bipolar Forceps II** device is in compliance with ANSI/AAMI American National Standard for Electrosurgical Devices HF-18/1993

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

Not Found

Predicate Device(s)

Not Found

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4400 Electrosurgical cutting and coagulation device and accessories.

(a)
Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.(b)
Classification. Class II.

0

IX. 510(k)_Summary of Safety and Effectiveness

| SUBMITTER: | United States Surgical
150 Glover Avenue
Norwalk, CT 06856 |
|----------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| CONTACT PERSON: | Christopher A. Graham |
| DATE PREPARED: | September 8, 1999 |
| CLASSIFICATION NAME: | Electrosurgical cutting and coagulation device and accessories |
| COMMON NAME: | Bipolar Forceps |
| PROPRIETARY NAME: | Dexide Bipolar Forceps II** device |
| DEVICE DESCRIPTION: | The Dexide Bipolar Forceps II** device is a grasping,
coagulating, and transecting bipolar forceps, which is intended
for use in laparoscopic and open procedures. The device is
intended for use with bipolar outputs of compatible
electrosurgical generators. |
| INTENDED USE: | The Dexide Bipolar Forceps II** device is indicated for use in
laparoscopic and open bipolar procedures, to grasp, coagulate
and transect tissues. |
| MATERIALS: | All component materials of the Dexide Bipolar Forceps II **
device are comprised of materials which are in accordance with
ISO Standard # 10993-1. |
| PERFORMANCE DATA: | The Dexide Bipolar Forceps II** device is in compliance with
ANSI/AAMI American National Standard for Electrosurgical
Devices HF-18/1993 |

1

Image /page/1/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle or bird with outstretched wings, depicted in a minimalist, flowing design.

OCT 5 1999 Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Christopher A. Graham Senior Associate, Regulatory Affairs United States Surgical Corporation 150 Glover Avenue Norwalk, Connecticut 06856

Re: K993055

Trade Name: Dexide Bipolar Forceps II** Device Regulatory Class: II Product Code: GEI Dated: September 8, 1999 Received: September 13, 1999

Dear Mr. Graham:

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 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.

2

Page 2 - Mr. Christopher A. Graham

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 vour 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. Director Division of General and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

3

IV. Indications For Use:

510(k) Number (if known): _ K 993055

Name: Dexide Bipolar Forceps II** device

Indications For Use:

The Dexide Bipolar Forceps II** device is indicated for use in laparoscopic and open bipolar procedures, to grasp, coagulate and transect tissues.

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

Concurrence of CDRH, Office of Evaluation (ODE)

Prescription Use: \checkmark OR Over-The-Counter Use: __
(Per 21 CFR §801.109)

(Division Sign-Off)
Division of General Restorative Devices K993055
510(k) Number_