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510(k) Data Aggregation

    K Number
    K223064
    Date Cleared
    2022-10-28

    (28 days)

    Product Code
    Regulation Number
    884.4530
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The ALLY II UPS™ (Uterine Positioning System) is intended to assist the surgical staff in mounting, positioning and holding uterine manipulators during gynecological laparoscopic surgical procedures. It is intended for use by trained operating room personnel in an operating room environment.

    Device Description

    The ALLY II UPS™ (Uterine Positioning System) attaches to the operating room table and enables the bed-side assistant to readily mount, hold, and position the manipulator during laparoscopic surgical procedures. The ALLY II UPS enables access and provides the ability to maneuver and maintain the manipulator in a desired position. The ALLY II UPS consists of the ALLY II UPS and a manipulator adapter with built-in sterile drape, known as the adapter drape.

    The CooperSurgical ALLY II UPS is a non-patient contacting, electromechanical device that consists of a single, multi-segmented, articulated arm. The ALLY II UPS can be attached to the standard operating room bed rail, and a separate, sterile, disposable Adapter Drape that is used to attach a uterine manipulator to the ALLY II UPS. When unlocked, the flexible arm allows the attached manipulator to be positioned by the user. The arm can then be locked in the desired position by releasing a foot pedal, activating a linear actuator that applies tension to an internal cable, drawing the segments together and thus locking the arm. The segmented design of the arm allows lateral/medial movement from a single point to position the uterine manipulator.

    The purpose of this submission is to gain clearance for minor modifications made to the ALL Y Uterine Positioning System to meet user needs and allow for user convenience. The overall functionality and interface of the ALLY II UPS for the user remains the same.

    AI/ML Overview

    The provided document is a 510(k) Premarket Notification from the FDA for a medical device called the ALLY II UPS™ (Uterine Positioning System). This type of document is for medical devices, not AI/ML algorithms. Therefore, the questions related to AI/ML specific aspects like training data, ground truth establishment, MRMC studies, and standalone algorithm performance are not applicable to this submission.

    The acceptance criteria and performance data described in this document relate to the physical and mechanical performance of the revamped medical device compared to its predicate.

    Here's an analysis based on the provided text, focusing on the device's acceptance criteria and proven performance:

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

    The document doesn't provide a direct table of acceptance criteria with corresponding performance values for the ALLY II UPS™. Instead, it broadly states that "The ALLY II UPS met the pre-determined acceptance criteria for each intended output." It lists the types of tests performed.

    Implied Acceptance Criteria and Performance (based on Section VII. Performance Data):

    Performance MetricAcceptance Criteria (Implied)Reported Device Performance (Summary)
    Durability (Useful Life)Device sustains intended function, material integrity, and performance over its expected lifespan."was performed" (details not provided, but implies met criteria given substantial equivalence conclusion)
    Holding ForceDevice can consistently and securely hold uterine manipulators in desired positions without slippage or movement beyond acceptable tolerances."was performed" (details not provided, but implies met criteria given substantial equivalence conclusion)
    Range of MotionDevice can manipulate to designated 6 points of extension in anteverted hand position and designated 5 points of extension in retroverted hand position.Subject device has "greater Range of Motion than the predicate" and met the specified extension points.
    Link SoakMaterials of the flexible arm (17-4 stainless steel, PEEK inserts) maintain integrity and function after exposure to relevant cleaning/sterilization protocols."was performed" (details not provided, but implies met criteria given substantial equivalence conclusion)
    Foot Pedal Cable RetentionThe detachable foot pedal cable remains securely connected during use and does not pose a safety risk."Justification" submitted (details not provided, but implies met criteria given substantial equivalence conclusion)
    Electrical Safety (IEC 60601-1)Compliance with general requirements for basic safety and essential performance of medical electrical equipment.Device is "compliant with the following standards: IEC 60601-1: 2005+AMD1:2012+AMD2:2020 CSV"
    EMC (IEC 60601-1-2)Compliance with requirements for electromagnetic compatibility for medical electrical equipment.Device is "compliant with the following standards: IEC 60601-1-2: 2014"

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

    • Sample Size: The document does not specify the sample size for any of the tests (Durability, Holding force, Range of motion, Link Soak, Foot Pedal Cable Retention).
    • Data Provenance: The data provenance is internal testing performed by CooperSurgical, Inc. It is a prospective test in the sense that newly designed units of the ALLY II UPS™ were manufactured and then tested to demonstrate their performance. The country of origin for the testing is not explicitly stated but is implied to be within the company's operational context (likely US, given the FDA submission).

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

    This question is not applicable as this is a mechanical device, not an AI/ML system that requires expert interpretation for ground truth. The "ground truth" for this device would be defined by engineering specifications and objective measurements (e.g., force in Newtons, angles in degrees, material integrity).

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

    Not applicable for this type of device. Adjudication methods are typically used in clinical studies or for establishing ground truth from human interpretations (e.g., radiology reads). The performance of this device is assessed through engineering and mechanical testing against predefined specifications.

    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 mechanical uterine positioning system, not an AI-assisted diagnostic or therapeutic tool with human readers.

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

    Not applicable. This is a purely mechanical device; there is no AI algorithm to test for "standalone" performance.

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

    The "ground truth" in this context is defined by engineering specifications, mechanical measurements, and compliance with recognized standards. For example:

    • Holding Force: Measured in units of force (e.g., Newtons or pounds) against a specified minimum.
    • Range of Motion: Measured in degrees or specific positions achievable, defined by design.
    • Durability: Performance over a specified number of cycles or operating hours.
    • Material Integrity: Assessed through material science tests and visual inspection post-soak/cycle.
    • Electrical Safety/EMC: Compliance verified against the specified IEC standards (60601-1 and 60601-1-2).

    8. The sample size for the training set

    Not applicable. This is a physical medical device, not a machine learning model that requires a training set.

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

    Not applicable. As stated above, this is not an AI/ML device.

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    K Number
    K201086
    Date Cleared
    2020-05-21

    (28 days)

    Product Code
    Regulation Number
    884.1640
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The CooperSurgical Advincula Delineator™ Uterine Manipulator is indicated to provide delineation of the vaginal fornices and maintain pneumoperitoneum as a uterine manipulator during Total Laparoscopic Hysterectomy, Laparoscopic Assisted Vaginal Hysterectomy and/or Laparoscopic Supra-Cervical Hysterectomy.

    Device Description

    The Advincula Delineator Uterine Manipulator is intended for use during total laparoscopic hysterectomy (TLH), laparoscopic assisted vaginal hysterectomy (LAVH), and/or laparoscopic supracervical hysterectomy (LSH) procedures. It is single-use, disposable, and provided sterile. The device has a distal balloon built into the arched shaft, and a sliding colpotomy cup, called a Koh-Cup, that locks into place with a position lock. The handle at the proximal end allows the user to hold the device and to manipulate the uterus. When properly positioned, the outer rim of the Koh-Cup delineates the vaginal fornices and provides an anatomical landmark to facilitate uterine resection. An occluder balloon is used to maintain pneumoperitoneum during the procedure.

    The Advincula Delineator Uterine Manipulator is available with Koh-Cups sized 2.5cm or 4.0cm in diameter. The Koh-Cup is made of Hytrel and the manipulator is made of stainless steel, silicone, various plastics, adhesives and inks. The subject device is intended to be used in hospitals.

    AI/ML Overview

    This document describes the premarket notification (510(k)) for the Advincula Delineator™ Uterine Manipulator, which is a medical device and not an AI/ML powered device. As such, it does not involve the type of acceptance criteria and study designs typically associated with AI/ML device performance (e.g., sensitivity, specificity, MRMC studies, ground truth established by experts).

    The acceptance criteria presented here are for the substantial equivalence of a modified medical device to a predicate device, focusing on material changes and packaging, rather than an AI algorithm's diagnostic or predictive performance.

    Therefore, the requested information, specifically regarding AI/ML device performance, acceptance criteria, test set details, expert involvement, and ground truth methodologies, cannot be extracted from this document as it is not relevant to the described device and its review process.

    Instead, the document focuses on:

    • Acceptance Criteria (for device modification equivalence): The "acceptance criteria" here refer to demonstrating that changes made to the device (specifically, the Koh-Cup material and packaging) do not raise new questions of safety or effectiveness compared to the predicate device.

      • The criteria are met by passing a series of non-clinical performance tests.
    • Study Proving Acceptance Criteria Met: The study undertaken was a series of non-clinical performance tests on the modified device.

    Here's a breakdown of the relevant information provided in the document:


    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance Criteria CategorySpecific Test PerformedReported Device Performance and Acceptance
    SterilizationISO 10993-7:2008 (Ethylene oxide sterilization residuals)Not explicitly stated "passed," but implied by "The subject device passed all the testing in accordance with internal requirements and applicable standards to support substantial equivalence."
    ISO 11135:2014 (Ethylene Oxide Sterilization Process Requirements)Not explicitly stated "passed," but implied as above.
    Shelf Life & ShippingShelf life demonstration up to 1 yearDemonstrated up to 1 year.
    ISO 11607-1:2006 (Packaging for Terminally Sterilized Medical Devices)Not explicitly stated "passed," but implied as above.
    ISTA 3A:2008 (Packaged-Products for Parcel Delivery System Shipment)Not explicitly stated "passed," but implied as above.
    ASTM F1980-16 (Accelerated Aging of Sterile Barrier Systems)Design verification testing was performed after accelerated aging (equivalent to one year real-time aging). Devices met predetermined acceptance criteria.
    Design VerificationCompression test (for Koh-Cup)The test results show that the subject Koh-Cup met the predetermined acceptance criterion. (To verify it can withstand adequate compression force).
    Pull Off test (for Koh-Cup)The test results show that the subject Koh-Cup met the predetermined acceptance criterion. (To verify it does not disassemble from the device when used as intended).
    Distortion test (for Koh-Cup)The test results show that the subject Koh-Cup met the predetermined acceptance criterion. (To verify it can withstand adequate force).
    Temperature Testing (for Koh-Cup)The test results show that the subject Koh-Cup met the predetermined acceptance criterion. (To verify it can withstand adequate temperature).
    BiocompatibilityCytotoxicity (per ISO 10993-5:2009)Results demonstrated the new Koh-Cup was non-cytotoxic.
    Sensitization (per ISO 10993-10:2010)Results demonstrated the new Koh-Cup was non-sensitizing.
    Irritation (per ISO 10993-10:2010)Results demonstrated the new Koh-Cup was non-irritating.

    Regarding the AI/ML specific questions (2-9), this document does not contain that information as the device is not an AI/ML product.

    • 2. Sample size used for the test set and the data provenance: Not applicable. Testing was performed on physical device samples, not data sets.
    • 3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. Ground truth for an AI/ML model is not relevant here. Device performance was assessed against engineering and biocompatibility standards.
    • 4. Adjudication method (e.g., 2+1, 3+1, none) for the test set: Not applicable.
    • 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-assisted device.
    • 6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done: Not applicable. This is not an algorithm.
    • 7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.): Not applicable. "Ground truth" here refers to the pre-established engineering and biocompatibility specifications and standards the physical device needed to meet.
    • 8. The sample size for the training set: Not applicable. There is no training data set for this physical medical device.
    • 9. How the ground truth for the training set was established: Not applicable.

    In summary, the document details the testing performed to demonstrate that a physical medical device with material and packaging changes is substantially equivalent to a previously cleared predicate device, rather than the performance of an AI/ML algorithm.

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    K Number
    K200038
    Device Name
    Endosee System
    Date Cleared
    2020-02-05

    (28 days)

    Product Code
    Regulation Number
    884.1690
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Endosee System is used to permit viewing of the adult cervical canal and uterine cavity for the purpose of performing diagnostic and therapeutic procedures The types of procedures where the Endosee System could offer visualization include:

    • Abnormal bleeding
    • Infertility and pregnancy wastage
    • · Evaluation of abnormal hysterosalpingogram
    • · Intrauterine foreign body
    • · Amenorrhea
    • · Pelvic pain
    • · Directed biopsy
    • Removal of fibroids and polyps
    • · Transection of intrauterine adhesions
    • · Transection of intrauterine septa

    The Endosee System can also be used to permit viewing of the adult urinary bladder through a minimally invasive approach by utilizing natural orifices for the purpose of performing diagnostic and therapeutic procedures.

    Device Description

    The Endosee System is a handheld, battery-operated, portable endoscope that consists of a reusable Display Module with an LCD touchscreen monitor and a sterile, single-use cannula. It is intended for use in viewing the adult cervical canal, uterine cavity, or female urinary tract, including the bladder, during diagnostic or therapeutic hysteroscopy or cystoscopy procedures in an operating room, outpatient, or office setting. The Cannula has a light source and camera at the distal end, which are used for visualization and to capture image and video of the diagnostic area. The image and video signals are electronically transferred from the Cannula to the Display module via an electrical connector and cable, and the LCD monitor is used for viewing. The Endosee is provided with a Docking Station that recharges the battery in the Display Module and allows the user to download images/video from the internal device memory to an external computer.

    AI/ML Overview

    The Endosee System is a handheld, battery-operated, portable endoscope used for viewing the adult cervical canal, uterine cavity, or female urinary tract during diagnostic or therapeutic procedures. The device under review (K200038) is a modification of a previously cleared device (K190639), with the primary changes being to indirect patient-contacting materials and additional shielding on the cannula board.

    Here's the information regarding the acceptance criteria and the study that proves the device meets them:

    1. Table of Acceptance Criteria and Reported Device Performance:

    Assessment CategorySpecific TestAcceptance Criteria (Implicitly "Pass" based on predicate)Reported Device Performance
    Sterilization & BiocompatibilitySterilization Evaluation (per ISO 11135:2014)Met ISO 11135:2014 standards for sterilization.Passed (subject device)
    Bioburden (per ISO 11737-1:2018)Met ISO 11737-1:2018 standards for bioburden levels.Passed (subject device)
    Cytotoxicity (per ISO 10993-5:2009)No unacceptable cytotoxic effects.Passed (subject device)
    Irritation (per ISO 10993-10:2010)No unacceptable irritation effects.Passed (subject device)
    Sensitization (per ISO 10993-10:2010)No unacceptable sensitization effects.Passed (subject device)
    EO Residuals (per ISO 10993-7:2008)Met ISO 10993-7:2008 standards for ethylene oxide residuals.Passed (leveraged from predicate)
    Stability & Shelf LifeLeak Test (on accelerated aged samples)Maintained integrity and absence of leaks after accelerated aging for 6 months.Passed (subject device)
    Seal Tensile Strength (on accelerated aged samples)Maintained seal strength after accelerated aging for 6 months.Passed (leveraged from predicate)
    Seal Peel (on accelerated aged samples)Maintained seal integrity after accelerated aging for 6 months.Passed (leveraged from predicate)
    Performance (Image Quality, Flow Rate, Leak, Bend, Tip Retention, Instrument Access) (on accelerated aged samples)Maintained specified performance characteristics after accelerated aging for 6 months.Passed (leveraged from predicate)
    Physical & Electrical PerformanceFixed Pattern Noise TestMet internal requirements for acceptable image noise levels.Passed (subject device)
    Ship Testing (per ISTA 3A:2008)Withstood shipping stresses without damage or performance degradation.Passed (leveraged from predicate)
    Bubble Leak (per ASTM 2096-11)Absence of bubble leaks.Passed (leveraged from predicate)
    UL Electrical Safety (per ANSI/AAMI ES 60601-1:2005/(R)2012 and IEC 60601-2-18:2009)Met electrical safety standards.Passed (leveraged from predicate)
    UL EMC (per IEC 60601-1-2:2014 and IEC 60601-2-18:2009)Met electromagnetic compatibility standards.Passed (leveraged from predicate)
    Optical Distortion TestMet specifications for optical distortion.Passed (leveraged from predicate)
    Saline Flow Rate TestMet specifications for saline flow rate.Passed (leveraged from predicate)
    90° Bend TestWithstood specified bending cycles without compromise.Passed (leveraged from predicate)
    3-Point Bend TestWithstood specified bending stress without compromise.Passed (leveraged from predicate)
    LED Temperature TestMaintained LED temperature within acceptable limits.Passed (leveraged from predicate)
    Drop Test (per IEC 60601-1-15)Withstood specified drop conditions without damage or performance degradation.Passed (leveraged from predicate)
    IPX2 Ingress Test (per IEC 60529:2004)Met specifications for protection against ingress of water.Passed (leveraged from predicate)
    System Level VerificationConfirmed overall system functionality and performance.Passed (leveraged from predicate)
    Software Verification (per IEC 62304:2006)Met software safety and performance standards.Passed (leveraged from predicate)
    Cybersecurity/Interoperability InformationProvided as recommended in FDA guidance.Information provided (leveraged from predicate)
    Wireless InformationProvided as recommended in FDA guidance.Information provided (leveraged from predicate)
    Design ValidationConfirmed that the design meets user needs and requirements.Passed (leveraged from predicate)

    2. Sample Size Used for the Test Set and Data Provenance:

    The document does not explicitly state the numerical sample size for each specific non-clinical test conducted. However, it indicates tests were performed on "samples accelerated aged to 6-months per ASTM F1980-16." This implies that a sufficient number of devices were tested to draw statistically sound conclusions, in accordance with the specified standard.

    The data provenance for the tests is entirely non-clinical bench testing. There is no mention of human patient data (retrospective or prospective) being used to evaluate the device's performance in this submission, as the submission focuses on demonstrating substantial equivalence through engineering and laboratory testing related to the physical changes.

    3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts:

    Not applicable. This submission is for a medical device that does not involve algorithmic diagnostic or prognostic capabilities requiring expert interpretation for ground truth establishment. The ground truth for the non-clinical tests is based on established engineering and materials standards (e.g., ISO, ASTM, IEC).

    4. Adjudication Method for the Test Set:

    Not applicable. No expert adjudication method (e.g., 2+1, 3+1) was used as the evaluation was based on objective, quantifiable non-clinical test results against established engineering standards.

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done:

    No, an MRMC comparative effectiveness study was not done. This device is a physical medical instrument, not an AI or imaging diagnostic tool that would typically involve human readers interpreting cases.

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

    Not applicable. The Endosee System is a physical endoscope, not an algorithm. Therefore, "standalone" performance in the context of AI algorithms is not relevant to this submission.

    7. The Type of Ground Truth Used:

    The ground truth used for proving the device meets the acceptance criteria is established engineering and materials standards, along with internal company specifications for performance. These include:

    • ISO 11135:2014 (Sterilization)
    • ISO 11737-1:2018 (Bioburden)
    • ISO 10993 (Biocompatibility series: -5, -10, -7)
    • ASTM F1980-16 (Accelerated Aging)
    • ISTA 3A:2008 (Ship Testing)
    • ASTM 2096-11 (Bubble Leak)
    • ANSI/AAMI ES 60601-1:2005/(R)2012 (Electrical Safety)
    • IEC 60601-2-18:2009 (Electrical Safety for Endoscopes)
    • IEC 60601-1-2:2014 (EMC)
    • IEC 60601-1-15 (Drop Test)
    • IEC 60529:2004 (IPX2 Ingress Test)
    • IEC 62304:2006 (Software Verification)

    8. The Sample Size for the Training Set:

    Not applicable. This is a medical device, not an AI or machine learning model. There is no concept of a "training set" for the type of evaluation presented in this submission.

    9. How the Ground Truth for the Training Set Was Established:

    Not applicable. As there is no training set, there is no ground truth established for it in the context of this device.

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    K Number
    K191291
    Date Cleared
    2019-06-12

    (29 days)

    Product Code
    Regulation Number
    884.6100
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Wallace Dual Lumen Oocyte Recovery System is a sterile, single-use device for ultrasonic-guided transvaginal collection of oocytes from the ovarian follicles.

    Device Description

    The Wallace Dual Lumen Oocyte Recovery System consists of a 33 cm dual lumen stainless steel needle with a plastic needle hub, and aspiration, flushing, and vacuum tubing. The needle hub acts as a handle and is designed for the user to hold between the thumb and index finger. It has two ports: the central port through which oocytes are aspirated via the central lumen, and a secondary side port to allow flushing of follicles via the secondary lumen that is attached to the flushing tubing. The needle aspiration tubing connects to a silicone bung that allows connection to a sample tube. The silicone bung is also connected to the vacuum tubing that allows connection to a vacuum source. The Wallace Dual Lumen Oocyte Recovery System is available in 16 or 17-gauge color-coded sizes (16G-Blue and 17G-Red). The needles are available in three aspiration tubing lengths: 500, 750, and 950 mm. The system includes flushing tubing of 700 mm length and vacuum tubing of 500 mm length. The device is provided sterile and is for single-use only.

    AI/ML Overview

    The provided text is a 510(k) summary for a medical device (Wallace Dual Lumen Oocyte Recovery System) and does not contain information about studies related to AI or algorithm performance. The content focuses on demonstrating substantial equivalence to a predicate device through non-clinical performance testing of physical attributes, such as needle size, biocompatibility, stability, shelf life, and mechanical performance.

    Therefore, I cannot provide the requested information regarding acceptance criteria and studies that prove a device meets criteria in the context of AI/algorithm performance, as these details are not present in the given document.

    The document indicates that the device is a sterile, single-use system for ultrasonic-guided transvaginal collection of oocytes and does not mention any AI or software components.

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    K Number
    K190639
    Device Name
    Endosee System
    Date Cleared
    2019-05-15

    (63 days)

    Product Code
    Regulation Number
    884.1690
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Endosee System is used to permit viewing of the adult cervical canal and uterine cavity for the purpose of performing diagnostic and therapeutic procedures. The types of procedures where the Endosee System could offer visualization include:

    • · Abnormal bleeding
    • · Infertility and pregnancy wastage
    • · Evaluation of abnormal hysterosalpingogram
    • · Intrauterine foreign body
    • · Amenorrhea
    • · Pelvic pain
    • · Directed biopsy
    • · Removal of fibroids and polyps
    • · Transection of intrauterine adhesions
    • · Transection of intrauterine septa

    The Endosee System can also be used to permit viewing of the adult urinary bladder through a minimally invasive approach by utilizing natural orifices for the purpose of performing diagnostic and therapeutic procedures.

    Device Description

    The Endosee System is a handheld, battery-operated, portable endoscope that consists of a reusable Display Module with an LCD touchscreen monitor and a sterile, single-use cannula. It is intended for use in viewing the adult cervical canal, uterine cavity, or female urinary tract, including the bladder, to perform diagnostic and therapeutic hysteroscopy or cystoscopy procedures in an operating room, outpatient, or office setting. The Cannula has a light source and camera at the distal end, which are used for visualization and to capture image and video of the diagnostic area. The image and video signals are electronically transferred from the Cannula to the Display module via an electrical connector and cable, and the LCD monitor is used for viewing. The Endosee is provided with a Docking Station that recharges the battery in the Display Module and allows the user to download images/video from the internal device memory to an external computer.

    AI/ML Overview

    The Endosee® System is a handheld, battery-operated endoscope used for viewing the adult cervical canal, uterine cavity, or female urinary tract for diagnostic and therapeutic procedures.

    Here's an analysis of the provided information regarding its acceptance criteria and supporting studies:

    1. Table of Acceptance Criteria and Reported Device Performance:

    The document does not explicitly state formal "acceptance criteria" with specific thresholds or metrics for the device's performance in a table format. However, it does describe the areas of non-clinical performance testing conducted to demonstrate substantial equivalence to its predicate device (K183020). The conclusion states that the results of the testing demonstrate that the subject Endosee System is substantially equivalent to the predicate. This implies that the device met the performance expectations in these tested areas to be considered substantially equivalent.

    Performance CharacteristicAcceptance Criteria (Implied)Reported Device Performance
    Design ValidationDesigned to meet intended specifications and uses.Successfully completed. (Implied by substantial equivalence claim)
    Functional TestingMaintained functionality after aging.Successfully completed on 6-month aged samples.
    * Tip Retention *Tip securely attached and functional.Passed. (Implied by substantial equivalence claim)
    * Instrument Access *Working channel allowed for instrument insertion.Passed. (Specific to this device, the working channel allows for both fluid infusion and instrument insertion.)
    EMC/Electrical SafetyCompliance with relevant electrical safety standards.Reevaluated with Essential Performance per IEC 60601-2-18. (Implied to have met standards)
    1. Sample Size Used for the Test Set and Data Provenance:

    The document does not specify the sample size for the test set in the non-clinical performance testing. It also doesn't mention data provenance such as country of origin or whether the data was retrospective or prospective, as the testing described is non-clinical performance (bench testing) rather than clinical studies on patients.

    1. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications:

    This information is not applicable. The non-clinical performance testing described involved validating the device's design, functional aspects, and safety standards, not comparisons against expert interpretation of medical images or patient outcomes. Therefore, no medical experts were involved in establishing ground truth for this type of testing.

    1. Adjudication Method for the Test Set:

    This information is not applicable. Adjudication methods like 2+1 or 3+1 are typically used in clinical studies involving interpretation of data by multiple readers, which is not the type of testing described here.

    1. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:

    No MRMC comparative effectiveness study was done. The submission focuses on non-clinical performance testing to demonstrate substantial equivalence to a predicate device, not on comparing reader performance with and without AI assistance.

    1. Standalone (Algorithm Only) Performance Study:

    No standalone (algorithm only) performance study was done. This device is a physical endoscope system, not an AI-powered diagnostic algorithm.

    1. Type of Ground Truth Used:

    For the non-clinical performance testing, the "ground truth" would be the engineering specifications, functional requirements, and safety standards (e.g., IEC 60601-2-18) against which the device's performance was measured. It is not expert consensus, pathology, or outcomes data.

    1. Sample Size for the Training Set:

    This information is not applicable. There is no mention of a "training set" as this device is not an AI/ML algorithm that requires training data.

    1. How the Ground Truth for the Training Set Was Established:

    This information is not applicable, as there is no training set for this device.

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    K Number
    K183020
    Device Name
    Endosee System
    Date Cleared
    2019-01-31

    (91 days)

    Product Code
    Regulation Number
    884.1690
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Endosee System is used to permit viewing of the adult cervical canal and uterine cavity for the purpose of performing diagnostic procedures. Generally recognized indications for diagnostic hysteroscopy include:

    • Abnormal bleeding
    • Infertility and pregnancy wastage
    • Evaluation of abnormal hysterosalpingogram
    • Intrauterine foreign body
    • Amenorrhea
    • Pelvic pain

    The Endosee System can also be used to permit viewing of the adult urinary bladder through a minimally invasive approach by utilizing natural orifices for the purpose of performing diagnostic procedures.

    Device Description

    The Endosee System is a handheld, battery-operated, portable endoscope that consists of a reusable display module with an LCD touchscreen monitor and a sterile, single-use cannula. It is intended for use in viewing the adult cervical canal, uterine cavity, or female urinary tract, including the bladder, to perform diagnostic hysteroscopy or cystoscopy procedures in an operating room, outpatient, or office setting. The cannula has a light source and camera at the distal end, which are used for visualization and to capture image and video of the diagnostic area. The image and video signals are electronically transferred from the cannula to the display module via an electrical connector and cable, and the LCD monitor is used for viewing. The Endosee is provided with a docking station that recharges the battery in the display module and allows the user to download images/video from the internal device memory to an external computer.

    AI/ML Overview

    The provided text describes the Endosee® System, a medical device used for diagnostic hysteroscopy and cystoscopy. The document, an FDA 510(k) summary, focuses on demonstrating substantial equivalence to a predicate device rather than detailing specific acceptance criteria for performance, a standalone study, or an MRMC study related to AI.

    Therefore, many of the requested details about acceptance criteria, study design, and ground truth are not present in the provided text. The document primarily reports on non-clinical performance testing conducted to ensure safety and equivalence.

    Here's a breakdown of the information that can be extracted and what cannot:

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

    The document doesn't provide a table of acceptance criteria with corresponding performance metrics for diagnostic accuracy or clinical effectiveness. Instead, it lists various non-clinical engineering and safety tests performed. While these tests have internal acceptance criteria, they are not typically clinical performance metrics. The closest general "performance" reported are the specifications that match the predicate device, such as Field of View and Direction of View, which are design specifications rather than clinical performance outcomes.

    Test CategorySpecific Test (with implicit acceptance criteria of meeting standards)Reported Device Performance
    SterilitySterility Testing per ISO 11135-1:2014, EO Residuals per ISO 10993-7:2008, Bioburden per ISO 11737-1:2006 & 11737-2:2009Not explicitly stated as pass/fail in detail, but the overall conclusion of substantial equivalence implies these tests were met.
    BiocompatibilityCytotoxicity per ISO 10993-5:2009, Sensitization per ISO 10993-10:2010, Irritation per ISO 10993-10:2010Not explicitly stated as pass/fail in detail, but the overall conclusion of substantial equivalence implies these tests were met.
    Shelf LifeAged to 6-months per ASTM F1980-16. Tested for Seal Tensile Strength, Seal Peel, Functional (Image Quality, Flow Rate, Leak, Bend), and Bubble Leak per ASTM 2096-11 on aged samples.Cannula Shelf-Life: 6 months (This implies acceptance criteria related to maintaining functionality and integrity for 6 months). For the aged samples, the functional tests (Image Quality, Flow Rate, Leak, Bend) were performed.
    Functional TestingImage Quality Test (Including Resolution), Optical Distortion Test, Saline Flow Rate Test, Leak Test, 90° Bend Test, 3-Point Bend Test, LED Temperature Test, Drop Test per IEC 60601-1-15, IPX2 Ingress Test per IEC 60529:2004, System Level VerificationNot explicitly stated as pass/fail in detail, but the overall conclusion of substantial equivalence implies these tests were met. For basic specifications, the device's Field of View is $100° ± 5°$ and Direction of View is $20° ± 3°$, matching the predicate.
    Electrical StandardsUL Electrical Safety per ANSI/AAMI ES 60601-1:2005/(R)2012 and IEC 60601-2-18:2009, UL EMC per IEC 60601-1-2:2014 and IEC 60601-2-18:2009Not explicitly stated as pass/fail in detail, but the overall conclusion of substantial equivalence implies these tests were met.
    SoftwareSoftware Verification per IEC 62304:2006 and FDA guidanceInformation provided as recommended in FDA guidance.
    Cybersecurity/WirelessCybersecurity/Intraoperability Information, Wireless information provided as recommended in FDA guidanceInformation provided as recommended in FDA guidance.
    Design ValidationPerformed (no specific criteria or results detailed)Not detailed.

    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 describe a clinical test set or data provenance in terms of patient data. The "test set" refers to physical samples of the device components (cannulas, display modules) subjected to various engineering and safety tests. For example, for shelf-life testing, samples were "Aged to 6-months" but the number of samples is not specified. There is no information about country of origin for any clinical data as none was presented.

    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 to the provided document. The "ground truth" in this context would typically refer to diagnostic accuracy established by expert clinicians (e.g., confirming the presence or absence of abnormalities in patient images). The provided document focuses on engineering and safety testing, not clinical diagnostic performance, and thus does not involve human experts establishing a clinical ground truth for a diagnostic test set.

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

    This information is not applicable. Adjudication methods are used in clinical studies to resolve discrepancies among expert interpretations. The tests described are engineering and safety tests, which do not involve expert adjudication in this manner.

    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

    There is no mention of an MRMC comparative effectiveness study, nor is there any indication that the Endosee System incorporates AI or is intended for AI-assisted interpretation. The device is a direct visualization tool.

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

    Not applicable. The Endosee System is a hardware device for direct visualization; it does not feature an algorithm that would operate in a "standalone" mode for diagnostic interpretation.

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

    Not applicable. As noted above, since no clinical performance study focused on diagnostic accuracy is described, there's no mention of how clinical ground truth would be established. The "ground truth" for the engineering tests would be adherence to the specified technical standards and design requirements.

    8. The sample size for the training set

    Not applicable. The document does not describe any machine learning or algorithm development that would involve a "training set."

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

    Not applicable, as there is no training set described.

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    K Number
    K180429
    Date Cleared
    2018-03-14

    (26 days)

    Product Code
    Regulation Number
    884.1640
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The CooperSurgical Advincula Delineator Uterine Manipulator is indicated to provide delineation of the vaginal fornices and maintain pneumoperitoneum as a uterine manipulator during Total Laparoscopic Hysterectomy (TLH), Laparoscopic Assisted Vaginal Hysterectomy (LAVH) and/or Laparoscopic Supracervical Hysterectomy (LSH).

    Device Description

    The Advincula Delineator is a uterine manipulator that is intended for use during total laparoscopic hysterectomy (TLH), laparoscopic assisted vaginal hysterectomy (LAVH), and/or laparoscopic supracervical hysterectomy (LSH) procedures. It is single-use, disposable, and provided sterile. The device has a distal balloon built into the arched shaft, and a sliding colpotomy cup, called a Koh-Cup, that locks into place with a position lock. The handle at the proximal end allows the user to hold the device and to manipulate the uterus. When properly positioned, the outer rim of the Koh-Cup delineates the vaginal fornices and provides an anatomical landmark to facilitate uterine resection. An occluder balloon is used to maintain pneumoperitoneum during the procedure.

    The Advincula Delineator is available with Koh-Cups sized 2.5cm, 3.5cm or 4.0cm in diameter. There are flexible plastic and Ultem plastic Koh-Cups available for use in electrocautery procedures, and a version with a stainless-steel outer rim for use in harmonic scalpel or laser procedures.

    AI/ML Overview

    Here's a breakdown of the acceptance criteria and the study that proves the device meets them, based on the provided text.

    Device: Advincula Delineator™ Uterine Manipulator (K180429)

    Type of Device: Uterine Manipulator, Class II

    This device is not an AI/ML powered device, so all the acceptance criteria and study information is related to mechanical and material performance, not algorithmic performance. Therefore, sections pertaining to expert review, MRMC studies, standalone performance, and training/test set details for AI/ML will be marked as "Not Applicable (N/A)".

    1. Table of Acceptance Criteria and Reported Device Performance

    This device is a physical medical device, not a software or AI/ML product. The acceptance criteria focus on mechanical performance and biocompatibility.

    Acceptance Criterion (Test Performed)Reported Device Performance
    Design Verification Testing
    Pull-Off TestMet predetermined acceptance criterion.
    Compression TestMet predetermined acceptance criterion.
    Design Validation Testing
    Cadaveric Model EvaluationPerformed as intended and met user needs.
    Biocompatibility Testing (ISO 10993)
    Cytotoxicity (ISO 10993-5:2009)Non-cytotoxic.
    Sensitization (ISO 10993-10:2010)Non-sensitizing.
    Irritation (ISO 10993-10:2010)Non-irritating.
    Shelf Life Testing (ASTM F1980-07)
    After 1 year of accelerated agingMet predetermined acceptance criteria.

    2. Sample Size Used for the Test Set and Data Provenance

    The document does not explicitly state the numerical sample size for each test (e.g., number of devices tested in the pull-off or compression tests). However, it implies testing was performed on a sufficient number of devices to demonstrate the device meets acceptance criteria.

    • Data Provenance: The tests are explicitly non-clinical performance and design validation tests on the physical device itself. The "cadaveric model" implies testing was performed using human cadavers.
      • Country of Origin of the Data: Not specified, but likely performed by or for CooperSurgical, Inc. in the US.
      • Retrospective or Prospective: These are prospective tests performed specifically for regulatory submission.

    3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications

    N/A. This is a physical device, not an AI/ML system requiring expert interpretation or ground truth establishment in a diagnostic context. The "ground truth" here is the physical performance of the device against engineering specifications.

    4. Adjudication Method for the Test Set

    N/A. Adjudication methods like 2+1 or 3+1 are relevant for subjective interpretations (e.g., in medical image reading). For objective engineering tests (pull-off, compression, biocompatibility), the results are typically quantitative and directly measured against a specification.

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was Done

    No. An MRMC study is not applicable to a uterine manipulator. These studies are typically performed to assess the impact of AI on human reader performance for diagnostic tasks.

    6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) was Done

    No. This a physical medical device, not an algorithm.

    7. The Type of Ground Truth Used

    The "ground truth" for this device's performance is based on engineering specifications, material science principles, and established biocompatibility standards (e.g., ISO 10993). For the design validation, the "ground truth" was the device "performs as intended and meets user needs" in a cadaveric model, which would be an outcome-based assessment in a simulated use environment.

    8. The Sample Size for the Training Set

    N/A. This term is applicable to AI/ML models. For a physical device, the concept of a "training set" is not relevant in the same way. The design and manufacturing processes are iterative, but there's no defined "training set" as in machine learning.

    9. How the Ground Truth for the Training Set was Established

    N/A. As above, this concept doesn't apply to this kind of device.

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    K Number
    K170660
    Date Cleared
    2017-07-13

    (132 days)

    Product Code
    Regulation Number
    884.1690
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Endosee Hysteroscope and Disposable Diagnostic (Dx) Cannula are used to permit viewing of the adult cervical canal and uterine cavity for the purpose of performing diagnostic procedures.

    Generally recognized indications for diagnostic hysteroscopy include:

    • Abnormal bleeding
    • Infertility and pregnancy wastage
    • Evaluation of abnormal hysterosalpingogram
    • Intrauterine foreign body
    • Amenorrhea
    • Pelvic Pain

    The Endosee Hysteroscope and Disposable (Dx) Cannula can also be used to permit viewing of the adult urinary bladder through a minimally invasive approach by utilizing natural orifices for the purpose of performing diagnostic procedures.

    Device Description

    The Endosee system is a handheld, battery-operated endoscope that consists of two components: a reusable Handheld Monitor and a sterile, single use cannula. The Endosee is intended for use in viewing the cervical canal and uterine cavity for the purpose of performing diagnostic hysteroscopy procedures in an outpatient or in an office setting. The Endosee can also be used to permit viewing of the urinary bladder, via the urethra, for the purpose of performing diagnostic cystoscopy procedures in an outpatient or office setting.

    The Disposable Diagnostic (Dx) Cannula is inserted through the cervix to view the cervical canal and uterine cavity. The Dx Cannula can also be inserted through the urethra to view the bladder. This enables the evaluation and diagnosis of the uterine cavity or the urinary bladder for pathology. The cannula includes a camera and LED light source at the distal end to illuminate the desired location for better user visualization, as well as to capture image and video of the diagnostic site. The video signal is electronically transferred to the Handheld Monitor of the Endosee Hysteroscope by an electrical connector, and an LCD touchscreen monitor on the reusable Handheld Monitor is used for viewing.

    AI/ML Overview

    The provided text describes non-clinical performance testing for the Endosee Hysteroscope with Disposable Diagnostic (Dx) Cannula to support expanding its indications for use to include cystoscopy applications.

    Here's the breakdown of the acceptance criteria and study information:

    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance CriteriaReported Device Performance
    Cannula enables acceptable visualization of the bladder in a standard urological procedure.The subject device met all acceptance criteria. All participants affirmed that the cannula enabled visualization of all intended targets in the bladder.

    2. Sample Size and Data Provenance

    • Test Set Sample Size: Not explicitly stated, but the study utilized "cadaveric specimens."
    • Data Provenance: Retrospective (cadaveric specimens) from an unspecified country (likely the US, given the FDA submission).

    3. Number of Experts and Qualifications

    • Number of Experts: Not explicitly stated. The text mentions "all participants" in the simulated operating room environment, but their specific qualifications are not detailed beyond being able to "affirm that the cannula enabled visualization." It can be inferred they are likely medical professionals, potentially urologists, given the context of cystoscopy applications and a simulated operating room.

    4. Adjudication Method

    • Adjudication Method: Not explicitly stated. The acceptance criteria indicate that "all participants must affirm" the visualization. This suggests a form of consensus or agreement among the participants, but the specific method (e.g., voting, discussion) is not described.

    5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

    • MRMC Study: No, a multi-reader multi-case comparative effectiveness study was not explicitly conducted as described in the provided text. The study focused on the standalone performance of the device's visualization capabilities.

    6. Standalone Performance Study

    • Standalone Study: Yes, a standalone performance study was conducted. The purpose was to "determine that the subject device enables acceptable visualization of the bladder in a standard urological procedure as it is currently designed." This refers to the algorithm/device itself (the cannula with its camera and light source) and its ability to provide clear visuals, not its performance in conjunction with human interpretation in a comparative effectiveness study.

    7. Type of Ground Truth Used

    • Ground Truth: Expert consensus based on direct visualization. The ground truth was established by the "participants" in the simulated operating room environment affirming that they could see all intended targets in the bladder using the device.

    8. Sample Size for the Training Set

    • Training Set Sample Size: Not applicable/not mentioned. This was a direct performance validation study of a physical device's visualization capabilities, not an AI/algorithm development study.

    9. How Ground Truth for the Training Set was Established

    • Ground Truth for Training Set: Not applicable. As this was not an AI/algorithm development study, there was no separate training set for which ground truth would need to be established by experts for machine learning purposes.
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    K Number
    K151845
    Date Cleared
    2016-03-18

    (255 days)

    Product Code
    Regulation Number
    890.5710
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    An instant warm pack intended to be used on an infant's heel to increase blood circulation to the area to aid in the drawing of blood for analysis. It is a single use, non-toxic, non-sterile, disposable warmer.

    Device Description

    The CooperSurgical Infant Heel Warmer, which is available in both a liquid version (The Infant Heel Warmer, Model 24401) and a gel version (WarmGel® Infant Heel Warmer, Model 20418), is a non-sterile, single-use, disposable device comprised of a biaxially oriented nylon (BON)/polyethylene outer pouch filled with a supersaturated solution of food grade sodium acetate and water (liquid version), or food grade sodium acetate, water, and hydroxyethylcellulose, a common thickener (gel version). An adhesive tape is attached to the pouch, which can hold the warmer in place if desired. The pouch also contains a stainless steel disc that, when flexed, initiates an exothermic crystallization of the sodium acetate, generating heat. When activated at 75° + 1° F, the maximum peak temperature of the CooperSurgical Infant Heel Warmer is 107° F, which is reached in approximately 40 seconds and then gradually decreases over time.

    AI/ML Overview

    The provided text describes the 510(k) premarket notification for the CooperSurgical Infant Heel Warmer (Model 24401) and WarmGel Infant Heel Warmer (Model 20418). This device is a hot or cold disposable pack and is classified as Class I. The submission primarily focuses on demonstrating substantial equivalence to predicate devices rather than proving specific numerical acceptance criteria for a novel AI/software medical device.

    Therefore, many of the requested categories related to AI/software device studies (e.g., sample size for test set, data provenance, number of experts, adjudication method, MRMC studies, standalone performance, training set details) are not applicable to this traditional medical device submission.

    Here's a breakdown of the available information regarding acceptance criteria and the study that proves the device meets them, adapted to the context of this manual heating device:


    Acceptance Criteria and Device Performance

    The core "acceptance criteria" for this device are implicitly tied to demonstrating substantial equivalence to legally marketed predicate devices, particularly regarding safety and effectiveness for its intended use. The primary performance aspect evaluated is its temperature profile and its effect on infant skin.

    Acceptance Criteria (Implicit from Substantial Equivalence Goal)Reported Device Performance
    Intended Use: Instant warm pack to increase blood circulation in infant's heel to aid blood drawing.Device is an instant warm pack with this stated intended use.
    Maximum Peak Temperature: Safe and comparable to predicates.107°F (reported for subject device). Predicates: Rapid Aid (Unknown), DeRoyal (105°F average max temp).
    Average Maximum Temperature: Safe and comparable to predicates.104°F (reported for subject device). Predicates: Rapid Aid (104°F), DeRoyal (105°F).
    Temperature Profile: Equivalent to predicate device.Temperature profiles were "equivalent" between CooperSurgical Infant Heel Warmer and DeRoyal Infant Heel Warmer.
    Biocompatibility: Patient-contacting parts conform to ISO standards.Passed AAMI/ANSI/ISO 10993-5:2003 and AAMI/ANSI/ISO 10993-10:2010.
    Shelf Life/Stability: Device maintains performance over time.Stability testing was performed to confirm shelf life.
    Skin Safety (Thermal Injury/Erythema): No evidence of thermal injury or significant erythema on application to skin.No evidence of thermal injury; all but one animal received an erythema score of 0 (one received 1, barely perceptible).

    Study Details

    The primary "study" described is a combination of non-clinical performance testing and an animal study.

    1. Sample Size used for the test set and the data provenance:

      • Temperature Profile Testing: "For each sample, a calibrated thermocouple was attached to the center..." The exact number of samples tested for temperature profiling is not explicitly stated. It implies multiple samples were tested to establish the profile.
      • Animal Study: 6 pigs (3 light-skinned, 3 dark-skinned), aged 3 to 3.5 weeks.
      • Data Provenance: Not specified, but generally assumed to be internal laboratory testing by the manufacturer or contracted labs. The animal study involved "pigs."
    2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

      • Not Applicable in the context of an AI/software device. For this device, "ground truth" for temperature was measured by calibrated thermocouples. For the animal study, grading of thermal insult and erythema was done against "established criteria," implying veterinary or pathology expertise, but the number and specific qualifications of graders are not provided.
    3. Adjudication method for the test set:

      • Not Applicable. This is not a human-reader-based diagnostic device.
    4. 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/software diagnostic device that involves human readers.
    5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

      • Not Applicable. This is a physical heating device, not an algorithm.
    6. The type of ground truth used (expert consensus, pathology, outcomes data, etc):

      • Temperature Profile: Objective measurements from calibrated thermocouples.
      • Biocompatibility: Adherence to international standards (AAMI/ANSI/ISO 10993-5:2003, AAMI/ANSI/ISO 10993-10:2010), likely involving established lab tests for cytotoxicity and sensitization/irritation.
      • Animal Study (Skin Safety): Visual grading against "established criteria" for thermal insult and erythema, which would typically involve macroscopic and potentially microscopic (pathology) assessment by trained personnel/veterinarians, but the specific detail is not explicitly provided.
    7. The sample size for the training set:

      • Not Applicable. This is not a device based on trained algorithms.
    8. How the ground truth for the training set was established:

      • Not Applicable.

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    K Number
    K153092
    Date Cleared
    2015-12-21

    (56 days)

    Product Code
    Regulation Number
    884.4530
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Ally Uterine Positioning System™ (UPS) is intended to assist the surgical staff in mounting, positioning and holding uterine manipulators during gynecological laparoscopic surgical procedures. It is intended for use by trained operating room personnel in an operating room environment.

    The Advincula Delineator™ Adapter Drape for the Ally Uterine Positioning System™ UPS is intended to assist the surgical staff in mounting, positioning, and holding uterine manipulators during gynecological laparoscopic surgical procedures. It is intended for use by trained operating room personnel in an operating room environment.

    Device Description

    The CooperSurgical Ally Uterine Positioning System™ (UPS) consists of a single, multi- segmented, articulating arm that attaches to a standard operating room bed rail, and a separate, sterile, disposable Ally UPS Adapter Drape that is used to attach a uterine manipulator to the Ally UPS. When unlocked, the articulation of the arm allows the attached manipulator to be positioned by the user. The segmented design of the arm allows lateral/medial movement from a single point to position the uterine manipulator. The arm is then locked in the desired position by releasing a food pedal, activating a linear actuator that applies tension to an internal cable, drawing the segments together and thus locking the arm.

    The Ally UPS is not intended for patient contact. The Adapter Drape for the Ally UPS is single- use and sterilized by ethylene oxide. The Ally UPS Adapter Drape secures either the Cooper Surgical RUMI II Uterine Manipulator Handle, or the Advincula Arch Uterine Manipulator Handle, to the distal end of the Ally UPS arm. The purpose of this submission is to gain clearance to add the new Advincula Delineator™ Adapter Drape to the system, which allows the Ally UPS to be used with the CooperSurgical Advincula Delineator™ Uterine Manipulator.

    AI/ML Overview

    This document describes a 510(k) premarket notification for the CooperSurgical Ally Uterine Positioning System™ (UPS), specifically an update to include the Advincula Delineator™ Adapter Drape. This is a medical device, and the information provided focuses on demonstrating substantial equivalence to a predicate device rather than presenting a study of diagnostic performance or AI effectiveness.

    Therefore, many of the requested categories for AI-related studies (like MRMC, human-in-the-loop, training set details) are not applicable here. The document details non-clinical performance testing for a physical device.

    Here's an analysis based on the provided text, focusing on the acceptance criteria and the study that proves the device meets those criteria:

    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance Criteria (Performance Characteristic)Reported Device Performance
    Adapter Pull-off ForceMaintained specifications (specific values not provided in this summary, but implies it met predetermined thresholds).
    Drape Pull-off ForceMaintained specifications (specific values not provided in this summary, but implies it met predetermined thresholds).
    Handle Push ForceMaintained specifications (specific values not provided in this summary, but implies it met predetermined thresholds).
    Sterilization ValidationAdvincula Delineator™ Adapter Drape meets appropriate ethylene oxide and ethylene chlorohydrin residual levels per ANSVAAMI/ISO 10993-7:2008(R)2012, and achieved a Sterility Assurance Level (SAL) of 10-6 per ISO 11135-1:2007 and ISO 11135-2:2008.
    Shelf Life (Stability Testing)Advincula Delineator™ Adapter Drape maintained its specifications for the duration of its shelf life as demonstrated by stability testing in accordance with ASTM F1980-07.
    Electrical Safety & PerformanceAlly UPS is in compliance with IEC 60601-1 CORR 1 & 2 2007 and IEC 60601-1-2.

    2. Sample Size Used for the Test Set and Data Provenance

    The document does not explicitly state sample sizes for each specific test (e.g., number of adapters tested for pull-off force). This is common for this type of summary, where the focus is on the type of test and the outcome rather than the granular details of the test execution (which would be in a full test report).

    The data provenance is from non-clinical performance testing conducted by CooperSurgical, Inc. The document does not specify country of origin for the data; it's assumed to be part of the manufacturer's internal testing process. The testing is prospective in the sense that it was conducted specifically to evaluate the modified device before market clearance.

    3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

    This information is not applicable. This is a physical medical device, not an AI or diagnostic tool where human experts establish ground truth. The "ground truth" here is determined by engineering specifications, safety standards, and performance metrics measured in laboratory settings.

    4. Adjudication Method for the Test Set

    Not applicable. This is not a study requiring adjudication of human-interpreted data.

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

    No, a Multi-Reader Multi-Case (MRMC) comparative effectiveness study was not done. This type of study is relevant for evaluating the impact of AI on human diagnostic performance, which is not the purpose of this device submission. The document explicitly states: "Clinical testing was not required to support the conclusion of substantial equivalence."

    6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

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

    7. The Type of Ground Truth Used

    The "ground truth" for this device's performance evaluation is based on:

    • Engineering Specifications and Performance Metrics: Pre-defined thresholds for forces (pull-off, push), material properties, and functionality.
    • International Standards: Compliance with standards like ISO 11135, ISO 10993, ASTM F1980, and IEC 60601 for sterilization, shelf life, and electrical safety. These standards themselves are established through expert consensus and scientific validation.

    8. The Sample Size for the Training Set

    Not applicable. This is a physical device, not an AI algorithm that requires a training set.

    9. How the Ground Truth for the Training Set Was Established

    Not applicable.

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