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510(k) Data Aggregation

    K Number
    K172846
    Date Cleared
    2018-06-26

    (280 days)

    Product Code
    Regulation Number
    884.4530
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Beijing HangTian KaDi Technology R&D Institute

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The HK-WQ-II are indicated for manipulation of the uterus, and injection of fluids during laparoscopic gynecologic procedures such as lapacervical hysterectomy, minilap tubal ligation, laparoscopic tubal occlusion or diagnostic laparoscopy.

    The HK-ZQ-I and HK-ZQ-II are intended for use in laparoscopic procedures where it is desirable to delineate the vaginal fornices and the surgeon intends to remove or access intraperitonial tissue through the vagina by use of a colpotomy or culdotomy incision; such as laparoscopically assisted vaginal hysterectomies, total laparoscopic hysterectomies, while maintaining pneumoperitoneum by sealing the vagina while a colpotomy is performed.

    Device Description

    There are four versions of the subject device. HK-WQ-I and HK-WO-II have a curved central guide rod, while the HK-ZQ-I and HK-ZQ-II have a central guide rod which can be rotated (or "flexed") up or down using a dial on the handle.

    Each device is a sterile, disposable, single-patient use device which consists of a manipulator shaft with an inflatable intrauterine balloon at the proximal end. The intrauterine balloon is inflated by liquid via a standard syringe injected through the check valve. The internal injection tip of the manipulator shaft is open to allow direct intrauterine introduction of medicine liquid via the injector port. The device also incorporates a vaginal sealing balloon which is inflated by liquid via a standard syringe injected through the check valve to seal the vagina and maintain pneumoperitoneum. The location of the uterus can be adjusted by the handle.

    Each device version can be used with a cervical cup. During use, the open-end of the cup rests on the cervix. There are two versions of the cup- a ceramic version and a polyphenylene sulfite version. For both materials, the cup is available in four different sizes - 30mm, 35mm, 40mm and 46mm.

    AI/ML Overview

    This document is a 510(k) premarket notification for uterine manipulators (HK-WQ-I, HK-WQ-II, HK-ZQ-I, and HK-ZQ-II). As such, it primarily focuses on demonstrating substantial equivalence to predicate devices rather than proving a device meets specific acceptance criteria through a clinical study with detailed performance metrics.

    Therefore, much of the requested information (like acceptance criteria, specific performance metrics, sample sizes for test/training sets, expert qualifications, adjudication methods, MRMC studies, standalone performance, and ground truth provenance) is not present in this type of regulatory submission, as these devices are not AI/ML-based.

    However, I can extract the information that is available regarding non-clinical performance tests:

    1. A table of acceptance criteria and the reported device performance

    The document does not provide a table of acceptance criteria with specific numerical targets. Instead, it lists the types of non-clinical performance tests conducted to demonstrate that the subject devices perform similarly to their predicate devices and meet safety requirements. The "reported device performance" is implied to be successful, as the conclusion states that the devices are substantially equivalent.

    Non-Clinical Performance Tests Conducted:

    Test CategorySpecific Tests PerformedOutcome (Implied)
    BiocompatibilityCytotoxicity (ISO 10993-5:2009)Pass
    Sensitization (ISO 10993-10:2010)Pass
    Irritation (ISO 10993-10:2010)Pass
    Acute systemic toxicity (ISO 10993-11:2006)Pass
    Pyrogenicity (USP and ISO 10993-11:2006)Pass
    Mechanical PerformanceDimensional specifications (all versions)Pass
    (HK-WQ-I, -WQ-II,Intrauterine balloon tensile and burst strength testsPass
    -ZQ-I, -ZQ-II)Uterus shaft deflection force testPass
    Movement force testPass
    Intrauterine balloon inflation cyclingPass
    Mechanical PerformanceVaginal sealing balloon maximum inflation volume test (HK-WQ-II, -ZQ-II only)Pass
    (Vaginal Balloon)Vaginal sealing balloon tensile strength under maximum inflation volume (HK-WQ-II, -ZQ-II)Pass
    Vaginal sealing balloon sealing characteristics (HK-WQ-II, -ZQ-II only)Pass
    Vaginal sealing balloon air leakage test (HK-WQ-II, -ZQ-II only)Pass
    Mechanical PerformanceDimensional specifications (cervical cup)Pass
    (Cervical Cup)Structural strengthPass
    Tension resistancePass
    Locking forcePass
    Movement forcePass
    SterilizationSterilization validation per ISO 11135:2017Pass
    Shelf LifePackage integrity and mechanical performance testingPass

    2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

    This information is not provided in the document. The tests are non-clinical (laboratory/benchtop) and do not involve human or patient data in the sense of a clinical study.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

    This is not applicable as the studies are non-clinical performance and safety tests, not studies requiring expert interpretation or ground truth establishment in a diagnostic context.

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

    Not applicable for non-clinical performance tests.

    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 device is a manual surgical instrument, not an AI/ML-based diagnostic or assistive technology.

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

    Not applicable. This device is a manual surgical instrument, not an algorithm.

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

    Not applicable. For non-clinical tests, "ground truth" would be the measured physical properties against a standard or specification.

    8. The sample size for the training set

    Not applicable. There is no training set as this is not an AI/ML device.

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

    Not applicable. There is no training set.

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    K Number
    K172789
    Date Cleared
    2018-02-01

    (139 days)

    Product Code
    Regulation Number
    876.1500
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Beijing HangTian KaDi Technology R&D Institute

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The device is indicated for use as a receptacle for the collection of tissue, organs and calculi during general and laparoscopic procedures.

    Device Description

    The proposed device, Specimen Retrieval Bag, is comprised of retracted bag, opening support, outer introducer shaft, outer introducer handle, inner introducer handle, string and pull loop. The device is available in a series of models. The difference between each model is the retracted bag size and volume. The device is provided sterile and single use.

    AI/ML Overview

    The provided text describes a 510(k) premarket notification for a Specimen Retrieval Bag. It focuses on demonstrating substantial equivalence to a predicate device rather than presenting a study proving the device meets specific performance acceptance criteria for a novel medical device.

    Therefore, many of the requested categories for a study proving acceptance criteria cannot be extracted because such a study was not presented in this document.

    Here's what can be extracted and what cannot:

    1. A table of acceptance criteria and the reported device performance

    The document provides a comparison of the proposed device against a predicate device, focusing on technological characteristics and compliance with general standards. It does not explicitly state "acceptance criteria" for a study to prove performance but rather lists the tests performed to demonstrate substantial equivalence to the predicate.

    Test ItemAcceptance Criteria (Implicit - achieved SE to predicate)Reported Device Performance (Proposed Device)
    BiocompatibilityConform with ISO 10993 requirements (for predicate)
    CytotoxicityNo cytotoxicityNo cytotoxicity
    Skin SensitizationNo skin sensitization
    IrritationNo irritationNo irritation
    Physical Performance TestsMet design specifications and demonstrated SE to predicate
    Retracted Bag Peeling Force Test(Not explicitly stated, but performed)Test performed (results not detailed, but implied to be sufficient for SE)
    String Tensile Strength Test(Not explicitly stated, but performed)Test performed (results not detailed, but implied to be sufficient for SE)
    Force to Withdraw Retracted Bag Test(Not explicitly stated, but performed)Test performed (results not detailed, but implied to be sufficient for SE)
    Force to Push out Retracted Bag Test(Not explicitly stated, but performed)Test performed (results not detailed, but implied to be sufficient for SE)
    Penetration Force Test(Not explicitly stated, but performed)Test performed (results not detailed, but implied to be sufficient for SE)
    Leak Test(Not explicitly stated, but performed)Test performed (results not detailed, but implied to be sufficient for SE)
    Standards ComplianceCompliance with relevant ISO and ASTM standardsComplies with ISO 10993-1, -5, -7, -10; ASTM F88/F88M-15; ASTM F 1929-15
    Label/LabelingComplied with 21 CFR part 801Complied with 21 CFR part 801

    2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

    The document does not provide details on the sample sizes used for the non-clinical tests or the data provenance. It only states that "performance tests were performed on both proposed device and predicate device."

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

    This information is not applicable and not provided. The study is a non-clinical, bench-testing evaluation designed to demonstrate substantial equivalence, not a clinical study involving human readers or expert ground truth for interpretation.

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

    This information is not applicable and not provided, as there was no clinical study or expert adjudication described.

    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

    No MRMC or clinical study was done. The document explicitly states: "No clinical study is included in this submission."

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

    This concept is not applicable as the device is a physical specimen retrieval bag, not an AI algorithm. The tests performed are non-clinical, bench tests.

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

    For the non-clinical performance tests, the "ground truth" would be the established scientific and engineering principles and the performance of the predicate device, as well as compliance with recognized standards (e.g., ISO, ASTM). It's not a clinical "ground truth."

    8. The sample size for the training set

    This information is not applicable as there is no mention of a "training set." The device is a physical medical device, not an AI or machine learning model that requires training data.

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

    Not applicable as there is no training set mentioned.

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