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510(k) Data Aggregation

    Why did this record match?
    Device Name :

    Broncho Videoscope System (Single-use Broncho Videoscope (SBV-1A-B, SBV-1A-P, SBV-1B-B, SBV-1B-P, SBV

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

    The Broncho videoscope system is designed to be used for endoscopic diagnosis and therapies within the respiratory system such as trachea, bronchi, and lungs. The Broncho videoscope System is for use in a hospital environment.

    The Single-use Broncho Videoscope is intended to use in conjunction with endoscopic image processor to provide images through the video monitor for observation, diagnosis, photography and treatment of the respiratory system such as trachea, bronchi, and lungs.

    The Full HD Visualization Endoscopic Image Processor is used for endoscopic diagnosis and therapies. It connects to the electronic endoscopes, displaying the images on its LCD display and/or within the field of view from the body cavity.

    The Endoscopic Image Processor is used for endoscopic diagnosis and therapies. It connects to the electronic endoscopes, displaying the images on the monitor detected within the field of view from the body cavity.

    Device Description

    The subject device, Broncho Videoscope System, is consisting of a Single-use Broncho Videoscope and a Full HD Visualization Endoscopic Image Processor or Endoscopic Image Processor. The subject device has been designed to be used for endoscopic diagnosis and therapies within the respiratory system such as trachea, bronchi, and lungs.

    The Single-use Broncho Videoscope is a single use in conjunction with Full HD Visualization Endoscopic Image Processor to provide images through the video monitor for observation, diagnosis, photography and treatment of the respiratory system such as trachea, bronchi and lungs. The Single-use Broncho Videoscope has six models, which are available in three kinds of outer diameter of insertion section (02.8mm and 05.6mm), one working length (600mm), two different material of the insertion (Nylon and PEEK) and two plug types (Square type and round type). The six models with round type have been cleared in K210739.

    The Full HD Visualization Endoscopic Image Processor is used for endoscopic diagnosis and therapies. It connects to the Single-use Broncho Videoscope, displaying the images on its LCD display and/or within the field of view from the body cavity. The Full HD Visualization Endoscopic Image Processor has four models, they have and the difference is only on the image adjustment functions.

    The Endoscopic Image Processor is a reusable device. The Endoscopic Image Processor has two models. The only difference between the two models is that the HDVS-S100A has Enhance function and the HDVS-S100D does not have the Enhance function.

    AI/ML Overview

    I am sorry, but the provided text does not contain the acceptance criteria or a study proving the device meets those criteria. The document is an FDA 510(k) clearance letter for a Broncho Videoscope System, indicating that the device has been found substantially equivalent to a legally marketed predicate device.

    The document primarily focuses on regulatory aspects such as:

    • Device Name and Classification: Broncho Videoscope System, classified as Class II, product code EOO.
    • Intended Use/Indications for Use: For endoscopic diagnosis and therapies within the respiratory system (trachea, bronchi, lungs).
    • Regulatory Compliance: Mentions various FDA regulations like annual registration, device listing, good manufacturing practice, labeling, and prohibitions against misbranding.
    • Comparison to Predicate Device: States that the subject device has the same indications for use and technological characteristics as the predicate device.
    • Biocompatibility Testing: Notes that biocompatibility tests (cytotoxicity, sensitization, irritation) were re-conducted on representative models per ISO 1099-1, and the results comply with the requirements. This is presented as non-clinical testing supporting substantial equivalence.

    While biocompatibility testing is mentioned, it is part of the non-clinical tests that support substantial equivalence to a predicate device, rather than a detailed study proving the device meets specific (quantitative) performance acceptance criteria as would be typical for an AI/ML medical device.

    Therefore, I cannot provide the information requested in your prompt regarding acceptance criteria, device performance, sample sizes, ground truth establishment, or any MRMC study details, as these are not present in the provided text.

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    K Number
    K231521
    Date Cleared
    2023-11-14

    (172 days)

    Product Code
    Regulation Number
    874.4680
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    Broncho Videoscope System

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

    The Broncho videoscope system is designed to be used for endoscopic diagnosis and therapies within the respiratory system such as trachea, bronchi, and lungs. The Broncho videoscope System is for use in a hospital environment.

    This Full HD Visualization Endoscopic Image Processor is used for endoscopic diagnosis and therapies. It connects to the electronic endoscopes, displaying the images on its LCD display and/or external monitor within the field of view from the body cavity.

    This Single-use Broncho Videoscope is intended to use in conjunction with endoscopic image processor to provide images through the video monitor for observation, diagnosis, photography and treatment of the respiratory system such as trachea, bronchi, and lungs.

    Device Description

    The subject device, Broncho Videoscope System is consisting of a Single-use Broncho Videoscope and a Full HD Visualization Endoscopic Image Processor. The subject device has been designed to be used for endoscopic diagnosis and therapies within the respiratory system such as trachea, bronchi, and lungs.

    AI/ML Overview

    The provided text is a 510(k) Summary for a medical device called the "Broncho Videoscope System." It details the device's technical specifications and compares it to a predicate device to establish substantial equivalence. However, the document explicitly states that "No clinical study is included in this submission" (page 6, section 7).

    This means there is no information available in this document regarding acceptance criteria, reported device performance against those criteria, or a study proving the device meets those criteria.

    Therefore, I cannot provide the requested information based on the provided input.

    However, I can extract information related to non-clinical testing and general device characteristics as described in the summary:


    Section 1-7: No information available as no clinical study was conducted.

    Section 8: Sample size for the training set - Not applicable, as no clinical study for AI model training is mentioned.

    Section 9: How the ground truth for the training set was established - Not applicable, as no clinical study for AI model training is mentioned.

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    K Number
    K210379
    Date Cleared
    2021-07-28

    (169 days)

    Product Code
    Regulation Number
    874.4680
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    Broncho Videoscope System

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

    The Broncho videoscope system is designed to be used for endoscopic diagnosis and therapies within the respiratory system such as trachea, bronchi, and lungs. The Broncho videoscope System is for use in a hospital environment.

    This Endoscopic Image Processor is used for endoscopic diagnosis and therapies. It connects to the electronic endoscopes, displaying the images on the monitor detected within the field of view from the body cavity.

    This Single-use Broncho Videoscope is intended to use in conjunction with endoscopic image processor (HDVS-S100A and HDVS-S100D) to provide images through the video monitor for observation, diagnosis, photography and treatment of the respiratory system such as trachea, bronchi, and lungs.

    Device Description

    The proposed device, Broncho Videoscope System is consisting of a Single-use Broncho Videoscope and an Endoscopic Image Processor including the foot switch. The proposed device has been designed to be used for endoscopic diagnosis and therapies within the respiratory system such as trachea, bronchi and lungs.

    The Single-use Broncho Videoscope is a single use device. The Single-use Broncho Videoscope has six models which are available in three kinds of outer diameter of insertion (Φ2.8mm, Φ4.2mm and Φ5.6mm), one working length (600mm) and two different material of the insertion (Nylon and PEEK). The single-use Broncho Videoscope is a single-channel endoscope. Only one working channel is in the distal end of the endoscope, and it bifurcates to two channels leading to the irrigation valve and suction section.

    The Single-use Broncho Videoscope is sterilized by Ethylene Oxide Gas to achieve a SAL of 10-6 and supplied in sterility maintenance package which could maintain the sterility of the device during the shelf life of three years.

    The Endoscopic Image Processor is a reusable device. The Endoscopic Image Processor has two models. The only difference between the two models is that the HDVS-S100A has Enhance function and the HDVS-S100D does not have the Enhance function.

    AI/ML Overview

    Here's a breakdown of the requested information based on the provided text, outlining the acceptance criteria and study details for the Broncho Videoscope System:

    1. Table of Acceptance Criteria and Reported Device Performance

    The acceptance criteria here are broad, based on compliance with various international standards and demonstrating equivalence to a predicate device. The performance is reported as meeting these standards and being comparable to or better than the predicate.

    Acceptance Criteria CategorySpecific Acceptance Criteria (Standards/Tests)Reported Device Performance
    BiocompatibilityISO 10993-7:2008 (Ethylene oxide sterilization residuals)Complies; no negative impacts from materials
    ISO 10993-5:2009 (In vitro cytotoxicity)Complies; no negative impacts from materials
    ISO 10993-10:2010 (Irritation and skin sensitization)Complies; no negative impacts from materials
    Intracutaneous (Biocompatibility test)Complies; no negative impacts from materials
    Material/Packaging SterilityASTM F88/F88M-15 (Seal strength of flexible barrier materials)Complies
    ASTM F1929-15 (Detecting Seal Leaks in Porous Medical Packaging by Dye Penetration)Complies
    Endoscope Design/OpticsISO 8600-1:2015 (General requirements for endoscopes)Complies
    ISO 8600-3:1997/Amd1:2003 (Field of view and direction of view)Complies
    ISO 8600-4:2014 (Maximum width of insertion portion)Complies
    SoftwareFDA's Guidance for Industry and FDA Staff, "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices" (Moderate level of concern)Software verification and validation testing conducted and documentation provided as recommended.
    Electrical Safety/EMCIEC 60601-1-2005+ (General requirements for basic safety and essential performance)Complies
    IEC 60601-1-2:2014 (Electromagnetic compatibility)Complies
    IEC 60601-2-18:2009 (Particular requirements for endoscopic equipment)Complies
    Shipping PerformanceASTM D4169-16 (Performance Testing of Shipping Containers and Systems)Complies
    Photobiological SafetyIEC 62471:2006 (Photobiological Safety of Lamps and Lamp Systems)Complies
    Risk ManagementISO 14971:2007 (Application of Risk Management to Medical Devices)Complies
    Bench Performance (Optical)Photobiological safety test according to IEC 62471: 2006Passes
    Color reproduction, Resolution, Depth of view, Geometric distortion, Image intensity uniformity, Image frame frequency and system delay testingCompared with predicate device; results demonstrated equivalence or improvement (e.g., color reproduction better than predicate).
    Bench Performance (Physical/Functional)Suction system function testPerformed and compared with predicate device.
    Irrigation valve leakage testPerformed.
    Use-Life TestingOptical performance comparison (un-aged vs. aged Single-use Broncho Videoscope)Optical performance of aged endoscope similar to un-aged.
    Use-life verification of image system (accelerated aging/running)Performance of system doesn't reduce after accelerated aging/running; use-life of six years accepted. Optical performance of aged image processor similar to new.
    Substantial Equivalence (General)Comparison to predicate device (Vathin Video Bronchoscope System, K191828)Determined to be Substantially Equivalent (SE), with differences in expression of indications, anatomical sites, field of view, depth of field, outer diameter, deflection, work length, instrument channel, dimension, weight, input power, video output, white balance, and patient-contact materials addressed and deemed not to affect safety and effectiveness.

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

    • Test Set Sample Size: Not explicitly stated as a number of devices or "cases" for human studies. The testing appears to be primarily bench/laboratory-based on the device components. For the use-life testing, "un-aged" and "aged" single-use bronchoscopes were compared, and "new" and "accelerated aged and running" image processors were compared, implying at least two samples for these comparisons.
    • Data Provenance: The studies are non-clinical (bench performance, testing against standards). The country of origin for the data is not specified, but the applicant is "Scivita Medical Technology Co., Ltd." in "Suzhou, Jiangsu, China," suggesting the testing may have occurred there. The studies are prospective in nature, as they are conducted specifically to support this 510(k) submission.

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

    Not applicable for this submission. The ground truth for the non-clinical tests is established by compliance with international standards and direct objective measurements, not by expert consensus on clinical data.

    4. Adjudication Method for the Test Set

    Not applicable. This was a non-clinical submission relying on objective measurements against predefined standards and comparative bench testing.

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

    • No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. The document explicitly states: "No clinical study is included in this submission."

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

    • Yes, a standalone performance assessment was conducted for the device itself. The entire non-clinical testing section (bench performance, biocompatibility, electrical safety, etc.) is a standalone assessment of the device's technical specifications and performance against established standards and a predicate device. This is primarily a hardware device with associated software, not an AI algorithm in the typical sense that would necessitate a "human-in-the-loop" study for algorithm performance.

    7. The Type of Ground Truth Used

    The ground truth used for the non-clinical tests includes:

    • International Standards: Compliance with various ISO, ASTM, and IEC standards (e.g., ISO 10993 for biocompatibility, IEC 60601 for electrical safety, ISO 8600 for endoscope performance).
    • Predicate Device Performance: Direct comparison of objective measurements (e.g., optical parameters, suction function) against a legally marketed predicate device (Vathin Video Bronchoscope System K191828).
    • Objective Measurements: Laboratory measurements of device specifications (e.g., field of view, depth of field, dimensions, weight, power).

    8. The Sample Size for the Training Set

    Not applicable. This is a medical device, not a machine learning or AI algorithm in the common sense that would require a "training set" of data for learning purposes. The "software" mentioned is for device control and image processing, not for diagnostic AI interpretation.

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

    Not applicable, as there is no "training set."

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