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510(k) Data Aggregation

    K Number
    K133629
    Date Cleared
    2014-02-14

    (80 days)

    Product Code
    Regulation Number
    870.5150
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    POSSIS MEDICAL, INC.

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

    The AngioJet Ultra AVX Thrombectomy Set is intended for use with the AngioJet Ultra System in breaking apart and removing thrombus from A-V access conduits ≥ 3 mm in diameter.

    Device Description

    AngioJet Ultra AVX Thrombectomy Set is a sterile, single use, disposable set that includes a Thrombectomy Catheter and Pump in one combined unit. The AngioJet Ultra AVX Thrombectomy Set is used with the AngioJet Ultra Console.

    AI/ML Overview

    The provided text describes a 510(k) submission for the AngioJet® Ultra AVX® Thrombectomy Set, which is a medical device and not an AI/ML software device. Therefore, many of the requested categories related to AI/ML device performance and ground truth establishment are not applicable.

    However, I can extract the relevant acceptance criteria and study information available for this medical device from the provided text.

    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance Criteria CategorySpecific Tests/CriteriaReported Device Performance
    Biocompatibilityo Cytotoxicity (ISO 10993-5)Testing performed, results provide assurance of conformity.
    O Sensitization (ISO 10993-10)Testing performed, results provide assurance of conformity.
    o Intracutaneous Reactivity (ISO 10993-10)Testing performed, results provide assurance of conformity.
    o Acute Systemic Toxicity (ISO 10993-11)Testing performed, results provide assurance of conformity.
    o ASTM Hemolysis (ISO 10993-4)Testing performed, results provide assurance of conformity.
    o Material Mediated Pyrogen (ISO 10993-11)Testing performed, results provide assurance of conformity.
    o Physiochemical (ISO 10993-18)Testing performed, results provide assurance of conformity.
    Design Verificationo Operation PressureTesting performed at zero time and 2 years accelerated aging, results provide assurance of conformity.
    o Net EvacuationTesting performed at zero time and 2 years accelerated aging, results provide assurance of conformity.
    o Infusion rateTesting performed at zero time and 2 years accelerated aging, results provide assurance of conformity.
    o Extended UseTesting performed at zero time and 2 years accelerated aging, results provide assurance of conformity.
    o Dimensional testingTesting performed at zero time and 2 years accelerated aging, results provide assurance of conformity.
    o System leak testingTesting performed at zero time and 2 years accelerated aging, results provide assurance of conformity.
    o Contrast InjectionTesting performed at zero time and 2 years accelerated aging, results provide assurance of conformity.
    o Guide Wire PassageTesting performed at zero time and 2 years accelerated aging, results provide assurance of conformity.
    o Mechanical Integrity testingTesting performed at zero time and 2 years accelerated aging, results provide assurance of conformity.
    Overall EquivalenceSubstantially equivalent to predicate device (K082382 AngioJet Ultra AVX Thrombectomy Set)Based on similarities in functional design, materials, indications for use, and principles of operation.

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

    The document states that "Bench and laboratory testing was performed" for biocompatibility and design verification. It does not specify a "test set" in the context of patient data or a specific sample size for a test set. This device is a physical medical device, not an AI/ML algorithm that processes data.

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

    Not applicable. Ground truth as typically defined for AI/ML performance evaluation (e.g., expert labels on medical images) is not relevant for this device's non-clinical testing. The "ground truth" for the device's performance is established by meeting predefined engineering and biocompatibility specifications through bench and lab testing.

    4. Adjudication method for the test set

    Not applicable. This concept is typically relevant for human review of AI outputs or image interpretation, which is not the nature of this submission.

    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 thrombectomy set, a physical medical instrument, not an AI/ML software.

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

    Not applicable. This device is a physical medical instrument, not an AI/ML algorithm.

    7. The type of ground truth used

    For biocompatibility, the ground truth is established by the specifications defined in the ISO 10993 standards. For design verification, the ground truth is established by engineering specifications for operational pressure, evacuation, infusion rate, dimensions, leak thresholds, etc.

    8. The sample size for the training set

    Not applicable. This device is a physical medical instrument and does not involve a "training set" in the context of machine learning.

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

    Not applicable, as there is no training set for this device.

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