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510(k) Data Aggregation

    K Number
    K210394
    Date Cleared
    2021-05-19

    (98 days)

    Product Code
    Regulation Number
    876.4300
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Dornier Bipolar Cable is indicated to be used with a compatible electrosurgical generator and an HF electrode for endoscopic treatment in urological applications: Cutting, ablation, resection, vaporization and coagulation with HF current.

    Device Description

    The Dornier Bipolar Cable is a sterile, single use, disposable device that allows connection of an electrosurgical generator to an HF electrosurgical resection and vaporization electrode. The outer body of the Dornier Bipolar Cables are constructed of a medical grade thermoplastic elastomer. The cable consists of a double wire zip cord with one plug end which has four (4) banana and one (1) straight pin, style of connector that is then attached to the generator. The other end is separated and has two (2) overmolded connectors, one male pin on a wire and one female pin on a wire which are compatible with the HF Electrode.

    AI/ML Overview

    The provided text describes the 510(k) summary for the Dornier Bipolar Cable. This is a submission for a medical device that does not involve Artificial Intelligence (AI). The submission focuses on demonstrating substantial equivalence to a predicate device through conventional engineering and safety testing.

    Therefore, many of the requested categories related to AI performance, such as sample sizes for test and training sets, expert consensus, adjudication methods, and MRMC studies, are not applicable to this document.

    Here's the information that can be extracted or deduced from the provided text:

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

    Acceptance Criteria CategoryReported Device Performance
    SterilityFound to be acceptable
    PackagingFound to be acceptable
    BiocompatibilityFound to be acceptable
    Electrical Safety Testing (IEC 60601-1-2:2014)Limited to Radiated Emissions (EN 55011), Radiated and Conducted Immunity (EN 61000-4-3 and EN 61000-4-6). Found to be acceptable.
    Electrical Safety Testing (ANSI/AAMI/IEC 60601-2-2: 2009)ACTIVE ACCESSORY HF leakage, ACTIVE ACCESSORY HF dielectric strength, ACTIVE ACCESSORY mains frequency dielectric strength. Found to be acceptable.
    Dimensional TestsFound to be acceptable
    Connector grip testFound to be acceptable
    Continuity testFound to be acceptable
    Cable insulation HF and Mains Dielectric Strength testFound to be acceptable
    Cable tensile strength testsFound to be acceptable
    Activation recognition and operationFound to be acceptable
    Insulation ResistanceFound to be acceptable
    Endurance TestFound to be acceptable
    Connector pull forceFound to be acceptable
    Surface temperature measurement testFound to be acceptable

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

    This information is not applicable as the device is a physical electrosurgical cable and its evaluation did not involve a "test set" in the context of an AI algorithm or data analysis study. The testing performed was engineering and safety validation. The provenance of test data for physical components is not usually detailed in this manner for 510(k) submissions.

    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. "Ground truth" in this context typically refers to the confirmed diagnostic or clinical reality for evaluating an AI model. For a physical medical device, the "ground truth" is established through adherence to engineering standards and validated test methods by qualified engineers and technicians, not through expert consensus on medical images or diagnoses.

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

    This information is not applicable as there was no test set requiring expert adjudication in the context of an AI system.

    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

    This information is not applicable as the device is a physical electrosurgical cable and does not involve AI assistance for human readers or direct comparative effectiveness in that manner.

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

    This information is not applicable as there is no algorithm or AI component in this device.

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

    The "ground truth" for this device's performance is based on meeting established engineering standards and validated test methods for its physical and electrical properties. This is typically determined by physical measurements, electrical tests, and adherence to regulatory standards (e.g., IEC 60601 series).

    8. The sample size for the training set

    This information is not applicable as there is no AI component or training set for this device.

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

    This information is not applicable as there is no AI component or training set for this device.

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    K Number
    K190312
    Date Cleared
    2019-11-15

    (276 days)

    Product Code
    Regulation Number
    876.4620
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Dornier CASCADE Ureteral Stent is indicated to relieve obstruction in a variety of benign, malignant and post-traumatic conditions in the ureter such as presence of stones and/or stone fragments, or other ureteral obstructions such as those associated with ureteral stricture, carcinoma of abdominal organs, retroperitoneal fibrosis or ureteral trauma, or in association with Extracorporeal Shock Wave Lithotripsy (ESWL). The stent may be placed using endoscopic surgical techniques or percutaneously using standard radiographic technique.

    Device Description

    The Dornier CASCADE Ureteral Stents are sterile, single-use devices. The stents are available in 4.9 to 8.0 French (Fr) diameter, with lengths ranging from 14.0 to 32.0 centimeters (cm). The stents are constructed of a thermoplastic polyurethane elastomer. The base polyurethane material is compounded with BaSO4 to render the stent radiopaque under x-ray fluoroscopy.

    Drainage holes extend along the body of the stent as well as on the pigtails to provide drainage. The stents are secured in the urinary tract with pigtail loops on the proximal and distal ends. A monofilament tether for repositioning and removal of the device is located on the proximal pigtail (bladder end) of the stent. Along the stent are graduation marks to provide visualization during stent advancement and placement. The CASCADE Ureteral Stent includes a pigtail straightener, a small polymer tube to aid in placement over a wire guide. The pigtail straightener is removed prior to use. The CASCADE Ureteral Stents are labeled for a maximum 30day indwell time.

    The stents are packaged into a pre-formed tray and sealed within a Tyvek pouch. The individually sealed Tyvek pouches are labeled with identification labeling and then packaged into a corrugated shipping box. The packaged stents are sterilized by a contract sterilizer using ethylene oxide.

    AI/ML Overview

    The provided text is a 510(k) summary for the Dornier CASCADE Ureteral Stent. It describes the device, its indications for use, and the studies conducted to demonstrate its substantial equivalence to a predicate device. However, it does not contain specific acceptance criteria or detailed results of a study designed to prove the device meets those criteria in a format applicable to evaluating AI/ML models.

    The document states: "All testing was found to be acceptable and bench performance testing comparable to the predicate device." This is a general statement of compliance, not a detailed report of acceptance criteria and performance data for a particular device function.

    Therefore, many of the requested details about acceptance criteria, specific device performance, sample sizes for test and training sets, expert qualifications, adjudication methods, or MRMC studies are not present in this regulatory document.

    However, I can extract the information that is available from the document:

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

    The document does not provide a table of specific numerical acceptance criteria or reported device performance values. It generally states that "All testing was found to be acceptable and bench performance testing comparable to the predicate device." The types of tests performed are listed, implying that the device met the requirements of these tests.

    Summary of available information for Section 1:

    Acceptance Criteria (General)Reported Device Performance (General)
    Sterilization validation requirementsFound to be acceptable
    Shelf life, including packaging validation and functional performance testing requirementsFound to be acceptable
    Biocompatibility requirements (cytotoxicity, skin sensitization, skin irritation, acute systemic toxicity, material-mediated pyrogenicity, genotoxicity, implantation studies, chemical characterization)Found to be acceptable for stent and pusher
    Bench Performance Testing requirements (visual inspection, dimensional analysis, pigtail retention, suture retention, coefficient of friction, tensile strength, elongation, radiopacity, and flow rate)Found to be acceptable and comparable to the predicate device

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

    Not applicable/Not provided in this document. This document pertains to a physical medical device (ureteral stent), not a software or AI/ML device that operates on a "test set" of data in the common sense of the term for AI/ML. The "testing" refers to physical and biological evaluations of the stent itself.

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

    Not applicable/Not provided in this document. Ground truth as typically defined for AI/ML models (e.g., expert consensus on medical images) is not relevant for the types of physical and biological tests described for this ureteral stent.

    4. Adjudication method for the test set

    Not applicable/Not provided in this document. Adjudication methods are typically for evaluating discrepancies in human or AI interpretations of data, which is not what this document describes.

    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. This document does not mention any MRMC study or AI assistance, as it concerns a physical medical device.

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

    No. This document does not describe an algorithm or AI performance.

    7. The type of ground truth used

    Not applicable/Not provided in this document in the context of expert consensus or pathology for data interpretation. The "ground truth" for the physical device would be the validated standards and specifications against which the stent's physical properties and biological interactions were measured (e.g., ISO standards, ASTM standards for material properties, specified biocompatibility limits).

    8. The sample size for the training set

    Not applicable/Not provided. This concept is for AI/ML models, not for physical device testing.

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

    Not applicable/Not provided. This concept is for AI/ML models, not for physical device testing.


    In summary, the provided document is a 510(k) summary for a physical medical device, not an AI/ML device. Therefore, most of the requested information regarding AI/ML model evaluation, such as sample sizes for test/training sets, data provenance, expert ground truth, adjudication methods, and MRMC studies, is not present or applicable. The document confirms that the Dornier CASCADE Ureteral Stent underwent standard sterilization, shelf-life, biocompatibility, and bench performance testing, and was found to be acceptable and comparable to its predicate device.

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