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510(k) Data Aggregation

    K Number
    K153773
    Date Cleared
    2016-11-22

    (327 days)

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

    The Disposable Lens Cleaning Sheath is an endoscope accessory that uses saline solution and carbon dioxide to remove debris from the lens surface of endoscopes used within the thoracic and abdominal cavities, including female reproductive organs.

    Device Description

    The Disposable Lens Cleaning Sheath is an endoscope accessory that uses saline solution and carbon dioxide to remove debris from the lens surface of endoscopes used within the thoracic and abdominal cavities, including female reproductive organs.

    The subject device is a single use disposable device and is provided to the user sterile. The subject devices consist of an insertion section, main body section, and water/CO2 gas tube section.

    The subject devices are used in combination with flexible endoscope and rigid endoscope.

    Upon use the device is attached to the compatible endoscope, water source, and gas source to remove debris from the objective lens surface of the endoscope by spraying saline solution and CO2 gas.

    AI/ML Overview

    The provided text is a 510(k) summary for a medical device called the "Disposable Lens Cleaning Sheath." It describes the device, its intended use, and the non-clinical testing performed to demonstrate its safety and effectiveness. However, it does not contain information about acceptance criteria and device performance in the context of a clinical study or a study involving human readers or expert ground truth.

    The document focuses on non-clinical performance and a comparison to a predicate device. Therefore, I cannot extract the specific information requested in the prompt, such as:

    • A table of acceptance criteria and reported device performance (in a clinical/expert setting).
    • Sample size used for the test set and data provenance.
    • Number of experts and their qualifications for establishing ground truth.
    • Adjudication method for the test set.
    • Multi-reader multi-case (MRMC) comparative effectiveness study.
    • Standalone (algorithm only) performance.
    • Type of ground truth used (expert consensus, pathology, outcomes data, etc.) for a clinical study.
    • Sample size for the training set.
    • How ground truth for the training set was established.

    The document explicitly states the following, which is relevant to your request about testing:

    Acceptance Criteria and Device Performance (Non-Clinical):

    The document mentions that:

    • "Risk analysis was carried out in accordance with established in-house acceptance criteria based on ISO 14971:2007. The design verification tests and their acceptance criteria were identified and performed as a result of this risk analysis assessment."
    • "Performance testing including sterilization validation, shelf life, and mechanical performance / bench testing was conducted to demonstrate the basic performance of the subject device and confirmed that the subject device performs as intended."

    Table of Acceptance Criteria and Reported Device Performance (Non-Clinical, based on summary in the document):

    Test CategoryAcceptance Criteria (Implicit from "performs as intended" and standard compliance)Reported Device Performance
    Sterilization ValidationCompliance with ISO 11137-1:2006 (Methods VDmax25)Validated according to ISO 11137-1:2006
    Shelf Life TestingCompliance with ASTM F1980-07 for accelerated aging; expectation of longer stability through real-time aging.Demonstrated stability based on accelerated aging
    Mechanical PerformanceDevice performs as intended for each item belowConfirmed to perform as intended
    - Insertion/RemovalInserts and removes from endoscopePerformed as intended
    - Trocar InsertionInserts into trocarPerformed as intended
    - Gas Feeding OperationGas feeding functionalityPerformed as intended
    - Spray Feeding OperationSpray feeding functionalityPerformed as intended
    - Debris RemovalEffective in removing debrisPerformed as intended (Inspection of removing the debris)
    - Insertion Section DurabilityDurablePerformed as intended
    - Main Body Fixing StrengthSecure fixing of main bodyPerformed as intended
    - Package InspectionPackage integrity and qualityPerformed as intended
    Biocompatibility TestingCompliance with FDA Guidance "Required Biocompatibility Training and Toxicology Profiles for Evaluation of Medical Devices, Blue Book Memo, G95-1," including cytotoxicity, sensitization, and irritation.Demonstrated biocompatibility according to FDA guidance
    Risk AnalysisIn accordance with ISO 14971:2007 (in-house acceptance criteria)Carried out and informed design verification tests

    Regarding the other specific points you requested:

    • Sample size, data provenance, expert ground truth, adjudication, MRMC studies, standalone performance, type of ground truth, training set sample size, and ground truth for training set: This information is not available in the provided document. The document describes non-clinical testing for a device, not a diagnostic algorithm or AI system that would typically involve such studies. The device is a "Disposable Lens Cleaning Sheath," an accessory for endoscopes, which implies mechanical and material performance testing rather than diagnostic accuracy studies.
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