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510(k) Data Aggregation

    K Number
    K133987
    Date Cleared
    2014-01-24

    (29 days)

    Product Code
    Regulation Number
    876.4300
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    CAPTIVATOR II,SINGLE-USE POLYPECTOMY SNARES

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

    The Polypectomy Snares are used endoscopically in the removal and /or cauterization of diminutive polyps, sessile polyps, pedunculated polyps and tissue from within the GI tract.

    Device Description

    The Polypectomy Snares consists of a flexible wire cable and loop which can be extended and retracted from the snare's flexible outer sheath using a three-ring handle. When passed through an endoscope the snare can be activated to deliver a monopolar electrical current to cut and cauterize tissue with the loop.

    AI/ML Overview

    This document focuses on the Boston Scientific Polypectomy Snares and describes the in-vitro testing performed to demonstrate substantial equivalence to predicate devices. It does not contain information about a study proving the device meets acceptance criteria related to a specific clinical outcome or a multi-reader multi-case study with human readers and AI. The performance data presented is limited to technical specifications of the device itself.

    Here's a breakdown of the available information:

    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance CriteriaReported Device Performance
    Loop Extension FunctionalityMet required specifications during in-vitro testing.
    Loop Retraction FunctionalityMet required specifications during in-vitro testing.
    Cable to Handle TensileMet required specifications during in-vitro testing.
    Active Cord CompatibilityMet required specifications during in-vitro testing.
    Active Cord AttachmentMet required specifications during in-vitro testing.
    Loop WidthMet required specifications during in-vitro testing.
    Electrical ResistanceMet required specifications during in-vitro testing.

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

    • Sample Size: Not specified for individual tests. The document states "all components, subassemblies, and/or full devices met the required specifications," implying that an appropriate number of samples were tested for each characteristic, but the exact count is not given.
    • Data Provenance: The testing was "in-vitro," meaning it was conducted in a laboratory setting, not on human subjects. There is no information about country of origin, retrospective or prospective nature as it's not a clinical study.

    3. Number of Experts Used to Establish Ground Truth and Qualifications of Experts

    • Not applicable. This device's performance was evaluated through engineering and functional testing (in-vitro), not requiring expert-established ground truth related to medical diagnoses or interpretations.

    4. Adjudication Method

    • Not applicable. As noted above, this was a technical performance study, not a clinical trial requiring adjudication of patient cases.

    5. Multi Reader Multi Case (MRMC) Comparative Effectiveness Study

    • No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. The document describes in-vitro engineering tests for device functionality, not a clinical study involving human readers or AI assistance.

    6. Standalone Performance Study (Algorithm Only)

    • No, a standalone study (algorithm only without human-in-the-loop performance) was not done. This device is a physical medical instrument (polypectomy snare), not an AI algorithm.

    7. Type of Ground Truth Used

    • The "ground truth" for the in-vitro performance tests was based on established engineering specifications and requirements for mechanical, electrical, and functional performance of the polypectomy snare.

    8. Sample Size for the Training Set

    • Not applicable. This is not an AI/machine learning device, so there is no "training set."

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

    • Not applicable. As this is not an AI/machine learning device, there is no training set or associated ground truth establishment method.
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