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510(k) Data Aggregation

    K Number
    K131364
    Date Cleared
    2014-01-02

    (234 days)

    Product Code
    Regulation Number
    876.1500
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    FLEXIBLE CMOS-VIDEO-CYSTO-URETHROSCOPE

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

    The Flexible CMOS Video-Cysto-Urethroscope is used to provide visualization and operative access during diagnostic and therapeutic endoscopic procedures of the lower urinary tract including the bladder and urethra.

    Device Description

    The Flexible CMOS-Video-Cysto-Urethroscope system consists of an endoscope and a monitor. The endoscope is a single device and can be said to be made up of an instrument handle, a shaft and a video connector cable. The handle has three camera control buttons, a deflection control lever and a luer connector to the working channel. An LED located in the handle and is use to provide the illumination for visualization of the anatomy under examination. The light is transmitted from the LED to the distal tip via glass fiber light bundles, where it is used to illuminate the body cavity under examination. The CMOS imaging sensor is located at the distaltip of the endoscope shaft captures the reflected light and converts it to a standard NTSC video signal. The luer connector and working channel are used as an introduction port for irrigation fluid and endoscopic instruments. The 8402ZX monitor provides visualization of the image being captured by the CMOS chip in the endoscope. During the procedure, the physician can use the control buttons on the monitor to perform functions, such as video and single image capture.

    AI/ML Overview

    The KARL STORZ Flexible CMOS-Video-Cysto-Urethroscope is a medical device designed for visualizing and providing operative access during diagnostic and therapeutic endoscopic procedures of the lower urinary tract, including the bladder and urethra. The submission does not explicitly list acceptance criteria in a table format with performance metrics. However, it states that "Testing demonstrated that the device is as safe & effective and performs as well as or better than the predicate devices." The predicates are KARL STORZ Video-Urethro-Cystoscope System (K062918) and KARL STORZ Flexible Fiber Optic Cystoscope (K945185).

    Therefore, the implicit acceptance criteria are that the device meets or exceeds the safety and effectiveness of these predicate devices. The study conducted to prove this involves various non-clinical performance and safety tests.

    1. Table of Acceptance Criteria and Reported Device Performance

    Since explicit acceptance criteria are not provided in a quantifiable table, the table below reflects the comparison to predicate devices, which serves as the basis for substantial equivalence.

    ParameterAcceptance Criteria (Performance equivalent to or better than predicate devices)Reported Device Performance (Flexible CMOS-Video-Cysto-Urethroscope)
    Mechanical PerformanceEquivalent to predicate devicesVerified through bench testing
    Optical PerformanceEquivalent to predicate devicesVerified through bench testing
    Illumination PerformanceEquivalent to predicate devicesVerified through bench testing
    Basic Safety & PerformanceConformance to IEC 60601-1, IEC 60601-1-2, IEC 60601-2-18Conforms to specified IEC standards
    Cleaning ValidationEffective cleaning as per instructionsValidated for cleaning instructions in IFU
    Disinfection ValidationHigh-level disinfection (HLD) with Resert XL to SAL of 10⁻⁶Validated for HLD with Resert XL to SAL of 10⁻⁶
    Sterilization ValidationSterilization with STERRAD 100NX to SAL of 10⁻⁶Validated for sterilization with STERRAD 100NX to SAL of 10⁻⁶
    BiocompatibilityPatient-contacting parts comply with ISO 10993-1:2009Evaluated per ISO 10993-1:2009
    Risk AnalysisIn accordance with ISO 14971Performed in accordance with ISO 14971
    Software ValidationSoftware performs as intendedSoftware verified through testing
    Intended UseIdentical to predicate devicesIdentical: Visualization and operative access during diagnostic and therapeutic endoscopic procedures of the lower urinary tract including the bladder and urethra
    Technological CharacteristicsComparable to predicate devicesShows similar key specifications (Distal Tip, Shaft, Working Channel, Working Length, Deflection) with some updates (CMOS chip, LED illumination)

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

    The provided document describes bench testing (non-clinical) and does not mention human subject testing or specific data sets in terms of images or patient cases. Therefore, there is no information on a "test set" in the context of image analysis or algorithm performance, nor is there information on data provenance (country of origin, retrospective/prospective). The testing focused on physical, electrical, and material performance of the device itself.

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

    Not applicable. The study is based on bench testing of the device's physical and functional properties against engineering standards and comparison to predicate devices, not on interpretation of outputs by human experts to establish ground truth.

    4. Adjudication Method for the Test Set

    Not applicable, as no human expert adjudication of a test set is described.

    5. Multi Reader Multi Case (MRMC) Comparative Effectiveness Study

    Not applicable. The submission does not describe a MRMC study or any study comparing human readers with AI assistance versus without. The device itself is an endoscope, not an AI-powered diagnostic tool requiring human-in-the-loop analysis.

    6. Standalone (Algorithm Only) Performance Study

    Not applicable. The device is an endoscope, which is a tool for visualization and access, not a standalone algorithm.

    7. Type of Ground Truth Used

    The "ground truth" for this device's performance is established by:

    • Conformance to recognized international standards such as IEC 60601-1, IEC 60601-1-2, IEC 60601-2-18, ISO 8600-1, ISO 8600-3, ISO 8600-4.
    • Results from bench testing for mechanical, optical, and illumination performance.
    • Successful validation studies for cleaning, disinfection, and sterilization protocols.
    • Biocompatibility testing per ISO 10993-1:2009.
    • Software verification testing.
    • The intended use and technological characteristics being substantially equivalent to legally marketed predicate devices.

    8. Sample Size for the Training Set

    Not applicable. This device is an endoscope, not an AI algorithm that requires a training set.

    9. How the Ground Truth for the Training Set was Established

    Not applicable. There is no training set for this device.

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