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510(k) Data Aggregation

    K Number
    K113120
    Device Name
    CHF-Y0005
    Date Cleared
    2012-09-25

    (340 days)

    Product Code
    Regulation Number
    876.1500
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    This instrument is intended to be used with an Olympus video system center, light source, documentation equipment, monitor, EndoTherapy accessories (such as a biopsy forceps), and other ancillary equipment. This instrument is intended to be used without DUODENOSCOPE.

    The CHOLEDOCHO VIDEOSCOPE CHF-Y0005 is indicated for endoscopy and endoscopic surgery within the biliary tract and the duodenum.

    Device Description

    The CHF-Y0005 is designed as a flexible video endoscope used for endoscopy and endoscopic surgery within the biliary tract and the duodenum.

    The CHF-Y0005 is modified from the predicate XCHF TYPE T160 as it has two bending sections, a gas feeding function when connected to an Endoscopic CO2 regulation unit, Narrow Band Imaging observation and is now compatible with specified electrosurgical units and electrosurgical accessories.

    AI/ML Overview

    The provided text describes the regulatory clearance of a medical device, the CHOLEDOCHO VIDEOSCOPE CHF-Y0005, and focuses on its substantial equivalence to predicate devices, rather than an independent performance study with clinical endpoints. Therefore, detailed information about acceptance criteria and a study proving the device meets those criteria, as typically found in a clinical trial report, is not present.

    However, based on the Summary of Non-Clinical Testing section, we can infer some aspects related to acceptance criteria and the nature of the evaluation.

    Here's a breakdown of the requested information based on the provided document:


    1. Table of acceptance criteria and the reported device performance

    The document mentions that non-clinical tests were performed and design verification tests and their acceptance criteria were identified and performed as a result of their risk analysis assessment. However, it does not provide a table with specific performance metrics and their corresponding acceptance criteria or actual reported device performance values. Instead, it refers to compliance with general safety and performance standards.

    Acceptance Criteria CategoryReported Device Performance
    Device Safety & PerformanceDemonstrated compliance with IEC 60601-1, 60601-1-1, 60601-1-2, 60601-2-18 standards.
    Mechanical & Functional PerformanceVerification and comparison studies conducted, concluding equivalence to predicate devices.
    Risk AnalysisCarried out in accordance with established in-house acceptance criteria based on ISO 14971:2007. Design verification tests and their acceptance criteria were identified and performed based on risk analysis.
    Substantial Equivalence (Overall)Noted that the device does not incorporate any significant changes in intended use, method of operation, material, or design that could affect safety or effectiveness, thus determined substantially equivalent to predicate devices.

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

    The document describes non-clinical tests, verification and comparison studies, and design verification tests. These are typically engineering or benchtop tests rather than tests on human subjects. Therefore, the concept of "sample size for the test set" in the context of clinical data (e.g., patient images, patient outcomes) is not applicable here.

    • Test Set Sample Size: Not applicable (non-clinical, benchtop testing).
    • Data Provenance: Not applicable. The tests are described as non-clinical and in-house (e.g., "established in-house acceptance criteria").

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

    This information is not provided. Given that the testing described is non-clinical/benchtop, the establishment of "ground truth" by clinical experts (like radiologists) for a test set is not relevant to the described studies.

    4. Adjudication method for the test set

    This information is not provided. As the studies are non-clinical, an adjudication method for clinical test outcomes would not be relevant.

    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

    No such study was mentioned or performed. This submission is for a medical device (endoscope), not an AI algorithm, and therefore an MRMC study comparing human readers with and without AI assistance is not relevant to this filing.

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

    No such study was mentioned or performed. This submission is for a physical medical device (endoscope), not a standalone algorithm.

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

    For the non-clinical and design verification tests, the "ground truth" would be established by engineering specifications, calibration standards, and validated measurement techniques, as dictated by the referenced international standards (e.g., IEC, ISO, ASTM). This is not equivalent to clinical ground truth derived from expert consensus, pathology, or outcomes data.

    8. The sample size for the training set

    Not applicable. This device is an endoscope and does not employ a training set as would be required for an AI/machine learning algorithm.

    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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