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510(k) Data Aggregation

    K Number
    K122818
    Date Cleared
    2013-01-04

    (112 days)

    Product Code
    Regulation Number
    880.6850
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    OLYMPUS KEYMED (MEDICAL & INDUSTRIAL EQUIPMENT) LT

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

    The Olympus MAJ-172 Instrument Tray for LTF Videoscope is intended to be used to enclose Olympus medical devices including hand instruments, trocars, camera heads, adapter, and endoscopes to be sterilized by a health care provider. It is intended to allow steam or ethylene oxide sterilization of the enclosed medical device. The Olympus MAJ-172 Instrument Tray for LTF Videoscope is a purpose designed transport and sterilization case indicated for use in medical facilities to accommodate an endoscope from the Olympus LTF range of videoscopes, plus certain identified accessories, for reprocessing by autoclaving (steam) or ETO sterilization (depending on the model). LTF Type 160 and VH videoscopes are compatible with Steam and ETO sterilization cycles. LTF Type V3 and VP are compatible only with ETO sterilization cycles.

    The Olympus MAJ-172 Instrument Tray for LTF Videoscope is designed to secure and store a single videoscope and its accessories for sterilization at a healthcare facility. Refer to the instrument tray instructions for use for the proper orientation of the videoscope and accessories within the instrument tray. The recommended sterilization cycles for the LTF videoscopes are as follows:

    ETO Sterilization .. . .. 100% ETO concentration: 735 mg/L Temp: 57 °C -------------Relative Humidity: 70% Processing (Hold) Time: 1 hour Aeration Time: 12 hours

    Steam Sterilization: Vacuum: 0.016 MPa minimum Pressure: 0.101 MPa minimum Temp: 135 °C Exposure Time: 3 minutes Drving Time: 20 minutes

    Device Description

    The Olympus MAJ-172 Instrument Tray for LTF Videoscope is a polymer tray with a perforated lid intended to secure an endoscope and accessories during exposure to gaseous sterilization methods.

    AI/ML Overview

    The provided document, K122818, is a 510(k) summary for the Olympus MAJ-172 Instrument Tray for LTF Videoscope. This document details the device's substantial equivalence to predicate devices based on non-clinical performance testing. It is important to note that this document is for a medical device tray used for sterilization, not an AI/ML-driven diagnostic or prognostic device, therefore many of the requested criteria regarding AI model evaluation (e.g., sample sizes for test/training sets, expert ground truth, MRMC studies) are not applicable.

    Here's an analysis based on the available information:

    1. Acceptance Criteria and Reported Device Performance

    The device is a non-measuring, non-analytical, and non-AI product. Its "performance" is determined by its ability to safely contain and allow sterilization of specific medical instruments without degradation or compromise. The acceptance criteria are implicitly derived from the design specifications and the tests conducted.

    Acceptance Criteria (Implicit from Testing)Reported Device Performance
    Maintain structural integrity during useMet requirements (simulated use, drop testing, resistance to chemicals)
    Be resistant to cleaning agentsMet requirements (resistance to chemicals, cleaning)
    Successfully allow steam sterilizationMet requirements (steam sterilization studies)
    Successfully allow ethylene oxide (ETO) sterilizationMet requirements (ethylene oxide sterilization studies)
    Ensure safekeeping of instruments during sterilization, storage, and transportationMet requirements (customized for specific instruments, simulated use)
    Have an expected useful life of five yearsDevice has an expected useful life of five years

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

    This is not applicable as the device is a physical instrument tray, not an AI model that processes data. The "test set" would refer to the physical units of the instrument tray used in the non-clinical studies. The document does not specify the exact number of trays tested.

    • Data Provenance: The (non-clinical) studies were conducted by KeyMed (Medical & Industrial) Ltd. in the United Kingdom, as indicated by the submitter's address. The studies are by nature prospective with respect to the testing of the specific MAJ-172 trays.

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

    This is not applicable for a physical device like a sterilization tray. "Ground truth" in this context would be established by validated engineering and microbiological testing methods, rather than expert interpretation of data.

    4. Adjudication Method for the Test Set

    This is not applicable. The performance was assessed through established laboratory and engineering testing protocols, not through expert adjudication of ambiguous cases.

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

    No, an MRMC study was not done as this is a physical medical device, not a diagnostic or prognostic AI/ML system.

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

    Yes, in a sense, the performance described is "standalone" in that it refers to the intrinsic capabilities of the physical device to withstand various sterilization processes and functional demands. There is no "algorithm" or "human-in-the-loop" concept applicable here. The device's performance was evaluated independently.

    7. The Type of Ground Truth Used

    The "ground truth" for the performance of the sterilization tray was established through:

    • Engineering and Physical Testing: Such as simulated use tests, drop testing, and resistance to chemical agents, which evaluate the physical integrity and durability of the tray.
    • Sterilization Efficacy Studies: These studies confirm that the tray allows effective sterilization of its contents without impeding the sterilant's penetration or compromising the sterility maintenance, as validated by microbiological assays in accordance with relevant standards. These would involve monitoring parameters like temperature, pressure, exposure time, and potentially biological indicators to confirm sterilization.

    8. The Sample Size for the Training Set

    This is not applicable. As a physical device, there is no "training set" in the context of machine learning. The design and manufacturing process would involve engineering specifications and quality control, not AI model training.

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

    This is not applicable for the reasons stated above. The "ground truth" for product development would be established through engineering design principles, material science, and regulatory standards for medical device manufacturing.

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