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510(k) Data Aggregation

    K Number
    K965086
    Date Cleared
    1997-02-14

    (57 days)

    Product Code
    Regulation Number
    878.4400
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The primary purpose of the device is to provide a convenient and effective surface for cleaning the tips of electrosurgical cutting and coagulation instruments. The design of the pad is such that the device may be used during surgery and in conjunction with the electrosurgical instrument.

    Device Description

    The body of the device is constructed of a polyurethane ester foam. A grit sheet is laminated to the top surface of the foam, and a pressure sensitive adhesive and release liner laminated to the base of the pad. An X-Ray detectable rod is placed between the pressure sensitive adhesive and the foam. The device is available in three sizes. Each pad is individually wrapped and sterilized for use. Sterilization will be by Gamma Ray or ETO and will be conducted and certified by a contract sterilization firm.

    AI/ML Overview

    This document is a 510(k) summary for a medical device (electrosurgical tip protector/cleaner) from 1997. It describes the device, its intended use, and its technological characteristics, primarily comparing it to predicate devices to establish substantial equivalence.

    Based on the provided text, there is no acceptance criteria or a study proving the device meets acceptance criteria in the way typically understood for modern AI/ML medical devices. This document predates the widespread use of such devices and the specific regulatory guidance around their performance evaluation. Instead, the submission relies on establishing "substantial equivalence" to existing, legally marketed predicate devices.

    Therefore, most of the requested fields cannot be populated as there were no explicit performance studies or acceptance criteria defined in this submission as would be expected for a contemporary AI device.

    Here's an attempt to address your request based only on the provided text, noting where information is absent:


    Acceptance Criteria and Device Performance

    For this 1997 510(k) submission, the "acceptance criterion" is implicitly demonstrating substantial equivalence to predicate devices. There are no specific quantitative performance metrics defined for this type of electrosurgical tip cleaner in the document.

    Acceptance CriterionReported Device Performance
    Substantially equivalent to predicate devices (Devon Cautery Tip Polisher, Product - K803055 and similar products on the market) in terms of:
    • Intended Use
    • Technological Characteristics (materials, design, abrasive surface) | The "Cygnus Electrosurgical Tip Protector" is stated to have the "same intended use" as predicate devices and "similar devices products currently cleared for marketing."
      The "composition and technological characteristics" are stated to be "the same as those for the predicate devices."
      Descriptive performance information is stated to show "that the materials of which the Cygnus product is made, is nearly identical to those of similar products currently on the market."
      The #60 Aluminum Oxide Impregnated Vinyl Grit Sheet abrasive surface is stated to have "proven to be effective" for over fifteen years in existing products. |

    Detailed Study Information (Based on provided text):

    Since this is a 510(k) submission for a non-AI/ML device based on substantial equivalence, the following sections either do not apply or the information is not present in the provided text.

    1. Sample size used for the test set and the data provenance: Not applicable. There was no specific "test set" for performance evaluation in the context of an AI/ML device. Substantial equivalence was based on direct comparison of characteristics and known performance of similar materials.
    2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. No ground truth was established by experts for a test set in this context.
    3. Adjudication method (e.g., 2+1, 3+1, none) for the test set: Not applicable.
    4. 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 is not an AI/ML device.
    5. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done: Not applicable. This is not an AI/ML device.
    6. The type of ground truth used (expert consensus, pathology, outcomes data, etc.): Not applicable. The "ground truth" for this submission was the established safety and effectiveness of the predicate devices and the known properties of the materials used.
    7. The sample size for the training set: Not applicable. This is not an AI/ML device.
    8. How the ground truth for the training set was established: Not applicable. This is not an AI/ML device.

    Summary of Approach in the Document:

    The 510(k) submission relies on the "510(k) Substantial Equivalence Decision-Making Process." The argument for substantial equivalence is based on:

    • Identical Intended Use: The device is for cleaning electrosurgical instrument tips, which is the same as predicate devices.
    • Similar Technological Characteristics: The materials (polyurethane ester foam, aluminum oxide grit sheet, adhesive, X-ray detectable rod) used are either the same as or nearly identical to those in predicate and currently marketed devices.
    • Known Efficacy of Materials: The abrasive material (#60 Aluminum Oxide Impregnated Vinyl Grit Sheet) has a proven history of effectiveness for over fifteen years.
    • Manufacturing and Sterilization: These processes are consistent with established medical device practices.

    The submission is essentially a comparison report rather than a performance study with defined acceptance criteria and human-involved evaluations for an AI solution.

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