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510(k) Data Aggregation

    K Number
    K131161
    Date Cleared
    2013-09-17

    (146 days)

    Product Code
    Regulation Number
    892.1570
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Device Name :

    EX3 STEPPER, CLASSIC STEPPER, MULTI-PURPOSE WORKSTATION STEPPER; MICRO-TOUCH, MICRO-TOUCH LP, MULIT-PURPOSE

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

    This device is indicated for use in adult males with known or suspected prostate cancer.

    Device Description

    The Stepping Unit holds an ultrasound imaging probe and facilitates manual linear and rotational positioning of the probe. The Stepping Unit consists of a Cradle designed to hold a specific ultrasound probe and a Carriage that moves longitudinally along the Stepping Unit. A Grid Platform connected at one end of the Stepper provides support for the Disposable Template Grid. The Stepping Unit connects to the Stabilizer.

    The Stabilizer provides a base for the Stepping Unit and offers fixation and support during insertion and final placement of the ultrasound imaging probe. On certain models, a fine tune mechanism is used to micro-adjust the probe or instrument to the ideal orientation. The Stabilizer mounts to an operating room table or is supported by a floor stand.

    The Disposable Template Grid is a single-use, sterile grid that consists of rows and columns of holes (channels) spaced 5mm apart. These channels are labeled and provide placement of needles in predefined areas of the prostate.

    AI/ML Overview

    Here's a summary of the acceptance criteria and study information for the CIVCO Medical Instruments Co., Inc. devices, based on the provided text:

    Acceptance Criteria and Device Performance

    Acceptance CriteriaReported Device Performance
    New EX3 Stepper Specific Criteria:
    Stepping Unit is able to provide continuous (free) longitudinal movement.Verified.
    Encoders correctly report longitudinal and rotational motion of Stepping Unit.Verified.
    Stepping Unit meets electrical safety requirements of IEC 60601-1 and IEC 60601-1-1.Verified.
    Device remains safe and effective for its intended use, including with treatment planning software (Validation).Validation was conducted to confirm the device remains safe and effective for its intended use and included testing with treatment planning software. All testing confirmed that the EX3 Stepper is substantially equivalent to the predicate device in regards to safety and effectiveness and the new design features have not diminished the safety and effectiveness of the device.
    Existing Devices (Classic Stepper, Multi-Purpose Workstation Stepper, Micro-Touch, Micro-Touch LP, Multi-Purpose Workstation, Multi-Purpose Workstation LP, Disposable Template Grid) with Expanded Indications for Use Criteria:
    Safely and effectively used for cryotherapy, transperineal template-guided biopsy, and fiducial marker placement without new safety/effectiveness issues arising from expanded indications.A literature review was conducted to support the modification of the intended use. The literature demonstrates that these devices have been safely and effectively used in cryotherapy, transperineal template-guided biopsy, and fiducial marker placement. "These changes do not raise new issues of safety and effectiveness because the system continues to be used for positioning in males with suspected or diagnosed prostate cancer. These changes do not impact or modify the therapy and CIVCO did not modify the design of these devices to enable use in these additional applications." (Page 1) "No design changes were made to enable use of the devices in these additional applications." (Page 5)
    Disp. Template Grid: Sterilization method change (EtO Gas vs. Gamma Irradiation) does not impact safety/effectiveness; Material change (ABS vs. Polycarbonate) does not impact safety/effectiveness; 3-year expiration date is acceptable.Implied by substantial equivalence claim; no specific test results for these changes are provided, but the overall conclusion of substantial equivalence covers these modifications.
    Stabilizer: Ability to mount to an operating table (for some models) vs. only a floor stand for predicate (for some Stabilizers). Fine-tune adjustment mechanism on Micro-Touch Stabilizers.Implied by substantial equivalence claim; no specific test results for these changes are provided, but the overall conclusion of substantial equivalence covers these modifications.

    Since this is a 510(k) submission for substantial equivalence for a medical device (specifically a stepping unit, stabilizer, and disposable template grid used in prostate procedures), the "acceptance criteria" and "study that proves the device meets the acceptance criteria" are generally focused on demonstrating that the new/modified device is as safe and effective as a legally marketed predicate device. The evidence provided is primarily through:

    • Comparison to Predicate Devices: Showing similarity in technological characteristics and intended use.
    • Literature Review: For expanding indications of use for existing devices.
    • Verification and Validation Testing: Specifically for the new EX3 Stepper, confirming its new features meet specifications and do not compromise overall safety/effectiveness.

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


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

    • Sample Size for Test Set: Not explicitly stated. The verification and validation testing for the EX3 Stepper (longitudinal movement, encoder reporting, electrical safety, and compatibility with treatment planning software) would have involved specific test units, but the number of units tested is not detailed in this summary.
    • Data Provenance (e.g., country of origin of the data, retrospective or prospective): Not explicitly stated. The verification and validation testing would have been conducted internally or by a contracted lab, likely in the US (where CIVCO is headquartered). This would be prospective testing on the physical device. The literature review for expanded indications of use would involve published, likely retrospective or prospective, clinical data (of various origins) that has already been peer-reviewed and published.

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

    • This type of information is generally not applicable or explicitly stated for a 510(k) submission concerning a mechanical device like a stepping unit. The "ground truth" for mechanical function, electrical safety, or general utility for specific surgical procedures isn't typically established by expert consensus in the same way as an AI diagnostic algorithm's output would be. Instead, the "ground truth" here is the established safety and efficacy of the predicate device, engineering specifications, and universally accepted standards (e.g., IEC 60601-1 for electrical safety).
    • For the validation with "treatment planning software," it implies functionality was checked against expected outputs, likely by engineers or possibly clinical users, but no explicit "expert" review process is described for establishing a ground truth.

    4. Adjudication Method for the Test Set

    • Not applicable/mentioned. Adjudication methods (like 2+1 or 3+1) are typically used in clinical studies, especially for evaluating diagnostic accuracy where there might be disagreements among human readers or between AI and human readers. This submission focuses on the mechanical and electrical performance of hardware, not diagnostic interpretation.

    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, a Multi Reader Multi Case (MRMC) comparative effectiveness study was not done. This study type is highly specific to evaluating the clinical impact of AI-assisted diagnostic tools on human performance, which is not the subject of this 510(k) submission. This device is a mechanical accessory (stepping unit, stabilizer, template grid) used during procedures, not an AI diagnostic tool.

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

    • Not applicable. This device is a mechanical accessory, not an algorithm or AI system. The EX3 Stepper has "firmware in the encoders report position," which is a functional component, but not a standalone algorithm in the typical sense of AI. Its performance (accuracy of position reporting) was verified.

    7. The Type of Ground Truth Used (expert consensus, pathology, outcomes data, etc.)

    • For EX3 Stepper's new features (encoders, continuous movement, electrical safety): The "ground truth" would be established engineering specifications, measurable physical properties, and adherence to recognized electrical safety standards (IEC 60601-1 and IEC 60601-1-1). For compatibility with treatment planning software, the ground truth would be the expected data output/interaction defined by the software's specifications.
    • For expanded indications of use of existing devices: The "ground truth" for safety and effectiveness in cryotherapy, transperineal template-guided biopsy, and fiducial marker placement was established through a literature review. This means previously published clinical studies and outcomes data effectively served as a form of "ground truth" demonstration of safe and effective use.

    8. The Sample Size for the Training Set

    • Not applicable. This is not an AI/machine learning device that requires a training set. The firmware on the EX3 Stepper's encoders is for reporting position, not for learning or prediction from data.

    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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