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510(k) Data Aggregation

    K Number
    K072629
    Date Cleared
    2008-08-06

    (324 days)

    Product Code
    Regulation Number
    882.4560
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    INTEGRATED SURGICAL SYSTEMS, INC.

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

    The DigiMatch™ ROBODOC® Surgical System is intended for use as a device, which uses diagnostic images of the patient acquired specifically to assist the physician with presurgical planning and to provide orientation and reference information during intra-operative procedures, The robotic surgical tool, under the direction of the surgeon, precisely implements the presurgical software plan.

    The preoperative planning software and robotic surgical tool is used as an alternative to manual planning and broaching/reaming techniques for femoral canal preparation in primary total hip arthroplasty (THA).

    The DigiMatch ROBODOC Surgical System is indicated for Orthopedic procedures in which the broaching/reaming in primary total hip arthroplasty (THA) may be considered to be safe and effective and where references to rigid anatomical structures may be made.

    Device Description

    The DigiMatch™ ROBODOC® Surgical System consists of the 510(k)-cleared (K960685) ORTHODOC® Preoperative Planning Workstation (ORTHODOC), and a Robot composed of an electromechanical arm, electronics control cabinet, display monitor and miscellaneous accessories (ROBODOC). The System (ORTHODOC and ROBODOC) is a threedimensional graphical preoperative planner and implementation tool and is indicated as an alternative to template planning and manual broaching for treatment of patients who require primary total hip arthroplasty (THA). The ORTHODOC component of the System allows a surgeon to preoperatively assess a patient's femoral anatomy and state of hip disease, select an optimally sized femoral stem implant from a library of prostheses, and determine where the implant should be positioned within the femur. Then ROBODOC component of the System, under direct control by the surgeon, will precisely implement the preoperative plan.

    AI/ML Overview

    The provided text describes the DigiMatch™ ROBODOC® Surgical System and its premarket notification (K072629) to the FDA. However, the document does not explicitly state specific quantitative acceptance criteria for performance metrics. Instead, it focuses on demonstrating substantial equivalence to predicate devices and proving safety and efficacy through various studies.

    The closest to "acceptance criteria" is the demonstration of "equivalence in Harris Hip Scores" in the clinical trials, implying that the device's performance should be at least as good as manual methods in this regard. The non-clinical studies focus on accuracy and biological response.

    Here's a breakdown of the requested information based on the provided text, with caveats where information is not explicitly stated:

    Acceptance Criteria and Reported Device Performance

    Acceptance Criteria (Implied)Reported Device Performance
    Accuracy of Femur Cutting (Non-clinical)ROBODOC was more accurate than manual broaching in the cadaver study and animal study.
    Gaps between Implant and Bone (Non-clinical)Significant reduction in gaps between the implant and bone with ROBODOC compared to manual broaching in the cadaver study. In the animal study, ROBODOC showed better apposition of implants with cortical and cancellous bone.
    Bone Integrity/Damage (Non-clinical)Animal study revealed many instances of fracture or osteotomy in the control group (manual) compared to none in the ROBODOC group. ROBODOC group had more consistent cortical bone continuity.
    Clinical Efficacy (Harris Hip Scores)Equivalence in Harris Hip Scores was demonstrated between the ROBODOC group and the manual control group in both the First and Second U.S. Trials.
    Precise and Reliable Implantation of Preoperative PlanDemonstrated in the First U.S. Trial through fit and alignment of the femoral implant.
    SafetyConfirmed as safe and effective through the First and Second U.S. Trials, as well as non-clinical studies (e.g., absence of fractures/osteotomies in the animal study and histological findings related to bone integrity). The FDA's substantial equivalence determination implies it meets safety benchmarks comparable to predicate devices.
    Substantial Equivalence to Predicate DevicesThe device was determined to be substantially equivalent to Voyager/Tactile Guidance System - CT (K052851), Frameless Neuromate (K991081), and da Vinci Surgical System (K043153) based on technological characteristics and principles of operation (Table 1) and confirmed by the FDA's 510(k) clearance letter.

    Study Details:

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

      • Cadaver Study: Sample size not specified. Data provenance: Not explicitly stated, but typically cadaver studies are conducted in a controlled lab environment.
      • Animal Study: 20 male greyhounds. Data provenance: Not explicitly stated, but typically animal studies are conducted in a controlled lab environment.
      • First U.S. Trial (Clinical): Sample size for ROBODOC group and manual control group not specified. Data provenance: U.S., prospective clinical trial.
      • Second U.S. Trial (Clinical): Sample size for ROBODOC group and manual control group not specified. Data provenance: U.S., prospective clinical trial (IDE # G000071).
    2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:
      The document does not specify the number of experts or their qualifications for establishing ground truth for any of the studies (cadaver, animal, or clinical). For clinical trials, "Harris Hip Scores" are typically evaluated by orthopedic surgeons or trained clinicians. Histological examinations would involve pathologists.

    3. Adjudication method (e.g., 2+1, 3+1, none) for the test set:
      The document does not specify any adjudication methods (e.g., 2+1, 3+1 consensus) for establishing ground truth in any of the studies.

    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:
      No, an MRMC study was NOT done. The studies described compare the robotic system (ROBODOC) to manual techniques for hip arthroplasty, not human readers with or without AI assistance in an imaging interpretation context. The device is a surgical system that implements a plan, not an AI diagnostic tool that assists human interpretation.

    5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:
      Yes, in essence, the "ROBODOC" component operates in a standalone manner in terms of implementing the presurgical plan. The document states: "The ROBODOC component of the System, under direct control by the surgeon, will precisely implement the preoperative plan." While under "direct control by the surgeon," the precision and execution of the plan by the robot itself is an algorithmic function. The performance of the robotic cutting was evaluated against manual cutting in cadaver and animal studies, and clinicallly, its implementation of the plan led to equivalent Harris Hip Scores.

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

      • Cadaver Study: "Accuracy of cutting the femur" and "measurement of the gap between the bone and implant." Implies objective measurements.
      • Animal Study: "Accuracy of cutting the femur," "histological examinations of the cavity/implant interface" (pathology), and observation of "fracture or osteotomy."
      • Clinical Studies (First & Second U.S. Trials): "Fit and alignment of the femoral implant" (likely based on imaging and surgical assessment) and "Harris Hip Scores" (patient-reported outcomes and clinical assessment of hip function).
    7. The sample size for the training set:
      The document does not specify any separate "training set" for the DigiMatch™ ROBODOC® Surgical System. The device's "training" and validation would have occurred during its development and prior testing, which is not detailed here. The studies mentioned (cadaver, animal, clinical) serve as validation/test sets to demonstrate safety and effectiveness for regulatory approval.

    8. How the ground truth for the training set was established:
      As no specific "training set" is described for the device's algorithmic development, this information is not available in the provided text. The ORTHODOC component is described as being "510(k)-cleared (K960685)," indicating prior regulatory review, but details of its development and ground truth establishment are not in this K072629 summary.

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    K Number
    K991081
    Date Cleared
    1999-06-25

    (86 days)

    Product Code
    Regulation Number
    882.4560
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    INTEGRATED SURGICAL SYSTEMS, INC.

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

    Stereotactic spatial positioning and orientation of an instrument holder or tool guide to be used by a surgeon to manually guide standard neurosurgical instruments.

    Device Description

    A stereotactic system with an electromechanical, multijointed arm for spatial positioning and orientation of an instrument holder or tool guide. Guidance is based on a preoperative plan developed with three-dimensional imaging software and utilizes ultrasonic registration. The system is intended for use by neurosurgeous to guide standard neurosurgical instruments.

    AI/ML Overview

    The provided text is a 510(k) summary for the Frameless NeuroMate Stereotactic System. It focuses on establishing substantial equivalence to a predicate device rather than presenting a study demonstrating the device meets specific performance acceptance criteria. Therefore, most of the requested information cannot be extracted directly from this document.

    Here's what can be gathered and what is missing:

    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance CriteriaReported Device Performance
    Not specifiedNot specified

    Explanation: The document does not provide specific quantitative acceptance criteria or corresponding performance data for the device itself. It primarily states that the device has "no substantive change in materials, basic components, or method of manufacture" compared to the predicate, and that the registration system is "similar to that currently used in other medical devices." It also mentions "commercially available imaging software for stereotactic planning, which has been developed, verified and validated to applicable standards, and guidance documents." These are general statements of compliance or similarity, not specific performance metrics.

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

    • Sample Size: Not specified.
    • Data Provenance: Not specified (retrospective or prospective, country of origin).

    Explanation: No clinical or performance study with a test set is described.

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

    • Number of Experts: Not applicable.
    • Qualifications of Experts: Not applicable.

    Explanation: No test set or ground truth establishment is described.

    4. Adjudication Method for the Test Set

    • Adjudication Method: Not applicable.

    Explanation: No test set or adjudication process is described.

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

    • MRMC Study: No.
    • Effect Size of Human Readers Improvement with AI vs. without AI assistance: Not applicable.

    Explanation: The document describes a medical device for surgical guidance, not an AI-assisted diagnostic tool that would typically undergo an MRMC study.

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

    • Standalone Study: No.

    Explanation: The device is a stereotactic system intended for use by neurosurgeons to manually guide instruments. Its function inherently involves human interaction, and there's no mention of a standalone algorithm performance measurement.

    7. The Type of Ground Truth Used

    • Type of Ground Truth: Not applicable.

    Explanation: Since no performance study is detailed, no ground truth is described.

    8. The Sample Size for the Training Set

    • Sample Size for Training Set: Not applicable.

    Explanation: The device involves "imaging software for stereotactic planning," which is stated to be "commercially available" and "developed, verified and validated to applicable standards." However, there is no mention of a separate "training set" or "algorithm training" in the context of this 510(k) submission. The focus is on the substantial equivalence of the overall system and its components.

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

    • Ground Truth Establishment for Training Set: Not applicable.

    Explanation: As no training set or specific algorithm training is detailed in this document, the method for establishing its ground truth is not provided.

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    K Number
    K960685
    Date Cleared
    1997-01-17

    (332 days)

    Product Code
    Regulation Number
    888.4800
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Applicant Name (Manufacturer) :

    INTEGRATED SURGICAL SYSTEMS, INC.

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

    The ORTHODOC Preoperative Planner is a software device indicated for the planning of primary total hip arthroplasties on a personal computer. The software is intended to import computed tomography data, provide a constructed image of the data, and use computerized files, representing implant patterns of femoral components, to overlay the constructed image to aid surgeons in their selection and positioning of the femoral components.

    Device Description

    This software is designed to run on a PentiumR-based personal computer. The device is a software-only product and is not intended to operate any other medical device or act directly on a patient. The application stores scaled graphic images of femoral stem components and provides a means for surgeons to superimpose these patterns on a CT image of the patient's femur. The implant patterns can be moved over the femur images to select what in the surgeon's judgement is the best stem size, position, neck length, and head diameter to achieve the physician's surgical goal.

    The library of implant patterns, called surface model files, is developed from computer-aided-design (CAD) geometric data supplied by the implant's manufacturer. The implant surface model file used by ORTHODOC contains implant identification information as well as geometric data which defines the shape and dimensions of the implant surface.

    AI/ML Overview

    This premarket notification describes a software device (ORTHODOC Model 500 Preoperative Planning Software) and does not provide an acceptance criterion or a study proving that the device meets an acceptance criterion. The document explicitly states:

    "There has been no pre-clinical or clinical performance data Performance data: generated upon which to make a decision of substantial equivalence."

    Therefore, I cannot populate the requested table or answer the questions regarding acceptance criteria, study details, sample sizes, expert involvement, or ground truth, as this information is not present in the provided text.

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