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The ACMI® DUR-Digital Ureteroscope and Choledochoscope (DUR®-D) System includes the DUR-Digital Invisio™ Flexible Ureteroscope and (which Choledochoscope and IDC Invisio™ Controller) is intended for use to examine bedy cavities, hollow organs and canals in the body, in the urinary tract, and can be used percutaneously to examine the interior of the kidney; and, using additional accessories, can be used to perform various diagnostic and therapeutic procedures.

The DUR®-D System is also indicated for the examination of bile ducts, and using additional accessories, to perform various diagnostic and therapeutic procedures during cholecystectomy.

The ACMI® DUR®- Digital Ureteroscope and Choledochoscope (DUR®-D) is a flexible endoscope that incorporates CMOS (complimentary medical oxide semiconductor) sensor technology to generate an image. There is a miniature CMOS sensor located in the distal tip, wiring running through the endoscope shaft, a printed circuit board (PCB), a light-emitting diode (LED) light source located in the handle, and an electrical cord that connects the endoscope to the Camera Control Unit.

The DUR®-Digital Ureteroscope and Choledochoscope can be introduced either through the urethra into the bladder or through a percutaneous tract into the abdominal cavity or kidney. The DUR®- Digital Ureteroscope and Choledochoscope may also be used to manage biliary calculi in a choledochoscope indication. The DUR®-D System uses a Camera Control Unit (CCU) that contains printed circuits boards (PCBs), software, power supply and power cables to process and display the images transmitted by the camera.

The provided text describes the ACMI® DUR-Digital Ureteroscope and Choledochoscope System. However, it does not contain a detailed study report with specific acceptance criteria, sample sizes, expert qualifications, or quantitative performance metrics typically found in a clinical study or even a rigorous design verification and validation report for a complex medical device.

The information primarily focuses on demonstrating substantial equivalence to predicate devices for 510(k) clearance, rather than a standalone performance study with defined acceptance criteria and statistical proof.

Here's an analysis based on the provided text, highlighting what is and is not available:

Acceptance Criteria and Device Performance (Based on Provided Text)

The document states that the new device met performance requirements by demonstrating comparable performance to predicate devices. It does not define explicit, quantitative acceptance criteria in this summary.

Study Details and Missing Information:

Here's a breakdown of the requested information, indicating what is present and what is absent from the summary:

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

   • Availability: Partially available (implied criteria, general statement of performance). No specific quantitative criteria are provided.
   • Details: The "acceptance criteria" are implied to be "performance characteristics comparable to predicate devices." The "reported device performance" is a general statement that these characteristics were met or exhibited.

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

   • Availability: Not available.
   • Details: The document refers to "design verification" and "testing" but does not specify the sample size of devices tested or the data provenance. It's likely these were internal engineering tests rather than a clinical study.

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)

   • Availability: Not available.
   • Details: No information is provided about experts, ground truth establishment, or any form of expert review for testing. This type of submission focuses on technical equivalence rather than clinical performance evaluated by experts.

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

   • Availability: Not available.
   • Details: No adjudication method is mentioned, as there's no reported expert-based evaluation.

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

   • Availability: Not available.
   • Details: No MRMC study was mentioned. This device is an endoscope system (a direct visualization tool), not an AI-powered diagnostic or assistive tool, so such a study would not be applicable or expected for this type of 510(k) submission.

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

   • Availability: Not applicable/Not available.
   • Details: This device is a manual medical imaging instrument (endoscope) used by a medical professional, not an algorithm, so a standalone algorithm performance study is irrelevant. The comparison focused on the technical performance of the device itself (e.g., image quality, physical dimensions) against predicate devices.

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

   • Availability: Not available.
   • Details: Since the "testing" focused on comparing physical and visualization characteristics against predicate devices, the "ground truth" would likely be the established performance specifications or measured characteristics of those predicate devices, rather than clinical ground truth (like pathology or outcomes) for this type of submission. The summary does not elaborate on how this was established.

8. The sample size for the training set

   • Availability: Not applicable/Not available.
   • Details: This device is a hardware system, not a machine learning algorithm. Therefore, there is no "training set" in the AI sense.

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

   • Availability: Not applicable/Not available.
   • Details: As there is no training set, this question is not relevant.

Summary of the Study:

The "study" described is a design verification and validation process conducted internally by the manufacturer (ACMI Corporation). Its purpose was to demonstrate substantial equivalence to already legally marketed predicate devices, the ACMI® DUR®-8E (for flexible endoscope technology, physical characteristics, and indications for use) and the ACMI® Invisio™ ICN System (for basic video imaging technology).

The core of the study involved:

• Comparing the physical performance characteristics of the ACMI® DUR-Digital Ureteroscope and Choledochoscope (DUR®-D) against the predicate DUR®-8E.
• Comparing the digital visualization characteristics of the DUR®-D against the predicate Invisio™ ICN.

The conclusion was that the new device met its performance requirements and exhibited comparable performance characteristics to both predicate devices, thus presenting "no new questions of safety or efficacy." This type of demonstration is standard for a Traditional 510(k) submission, where the focus is on showing similarity to existing products rather than proving novel clinical effectiveness through large-scale trials.

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