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510(k) Data Aggregation

    K Number
    K191715
    Manufacturer
    Date Cleared
    2020-01-27

    (215 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 Endoscope Tip Protector is intended to be used on the distal tip of an endoscope for the purpose of protecting the endoscope's delicate lens and the endoscope's bending rubber during transport and storage. It may also be used on the distal tip of medical/surgical instruments to protect delicate components/mechanisms.

    Device Description

    The Endoscope Tip Protector is a single-use molded protective cover to be used to protect endoscopes and medical/surgical instruments. The design of the Endoscope Tip Protector:

    • Is composed on non-porous plastic material that allows for air flow
    • Has minimal contact points with the endoscope or medical/surgical instruments
    • Fits a wide variety of devices: 4.9mm -15mm outer diameter
    • Protects the distal tip of the endoscope or medical/surgical instrument during transport or storage.
      The Endoscope Tip Protector is available both non-sterile and sterile.
    AI/ML Overview

    Based on the provided text, the Acceptance Criteria and Device Performance for the Endoscope Tip Protector are as follows:

    1. Table of Acceptance Criteria and Reported Device Performance:

    TestingAcceptance CriteriaReported Device Performance
    Attachment and Detachment ForceThe Endoscope Tip Protector must be able to be attached and detached with minimal force.PASS
    Scope ProtectionThe Endoscope Tip Protector must reduce the impact force to the endoscope compared to without protection.PASS
    Transport ProtectionThe Endoscope Tip Protector must remain on the endoscope during transport.PASS
    Longevity of Hold on EndoscopeThe Endoscope Tip Protector must remain on the endoscope for at least 7 days.PASS
    Irritation and Skin SensitizationMust meet ISO 10993-10: 2010.PASS
    CytotoxicityMust meet ISO 10993-5:2009.PASS
    SterilityThe Endoscope Tip Protector must have a sterile version.PASS
    Packaging ValidationSterile Packaging must meet ASTM F88/F88M-15, ASTM F2096-11, and ASTM F1886/F1886M-16.PASS

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

    The document does not specify the exact sample sizes used for each test (e.g., number of endoscope tip protectors tested, number of cycles for transport or attachment/detachment). The data provenance is also not explicitly stated in terms of country of origin or whether the studies were retrospective or prospective. It summarily states "Proposed Endoscope Tip Protector" and "PASS" for each criterion.

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

    The document does not mention the use of experts to establish ground truth for this device's testing. The tests appear to be physical and biological performance tests rather than subjective evaluations requiring expert consensus.

    4. Adjudication method (e.g., 2+1, 3+1, none) for the test set:

    There is no mention of an adjudication method, as the tests outlined are objective performance metrics (e.g., force, time, compliance with standards) rather than interpretations.

    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:

    This is not applicable. The device is a physical endoscope tip protector, not an AI-assisted diagnostic tool or system that would involve human readers or comparative effectiveness studies of AI assistance.

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

    This is not applicable. As noted above, the device is a physical product, not an algorithm.

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

    The "ground truth" for the tests appears to be defined by industry standards (ISO 10993-10, ISO 10993-5, ASTM standards) and defined physical/mechanical performance requirements (e.g., "minimal force," "reduce impact force," "remain on the endoscope for at least 7 days"). These are objective, measurable criteria rather than subjective interpretations requiring expert consensus or clinical outcomes data in the traditional sense.

    8. The sample size for the training set:

    This is not applicable. The device is a physical product, not a machine learning model that requires a training set.

    9. How the ground truth for the training set was established:

    This is not applicable, as there is no training set for this type of device.

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