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510(k) Data Aggregation

    K Number
    K120870
    Date Cleared
    2012-06-15

    (85 days)

    Product Code
    Regulation Number
    878.4810
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    GREENLIGHT MOXY FIBER OPTIC

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

    Model Number 0010-2400 is a fiber optic delivery device intended for use with the GreenLight™ XPS Laser System for its FDA cleared indications for use.

    Device Description

    Model Number 0010-2400 is supplied as a single-use, sterile product and is compatible with the GreenLight™ XPS Laser System. It can access the tissue in multiple planes. Model Number 0010-2400 is a liguid cooled delivery device which enables the delivery of up to 180W of power and aids in maintaining a clear environment at the fiber cap.

    AI/ML Overview

    The provided document describes a 510(k) premarket notification for a medical device, the American Medical Systems Model Number 0010-2400 GreenLight MoXy™ Fiber Optic. This is a special 510(k) submission, indicating a modification to an already cleared device, the Fiber One (K100746). The submission focuses on demonstrating substantial equivalence to the predicate device, rather than a de novo approval.

    As such, the document does not contain information related to a clinical study with acceptance criteria, reported device performance, sample sizes, ground truth establishment, or expert involvement in the way one would expect for a new or significantly modified device requiring such studies. The assessment here is based on non-clinical (bench) testing and comparison of technological characteristics to the predicate device.

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


    1. Table of Acceptance Criteria and Reported Device Performance

    The document does not explicitly state "acceptance criteria" in the traditional sense of a clinical trial. Instead, the "acceptance criteria" for this Special 510(k) are implied by demonstrating that the modified device (Model 0010-2400) maintains substantial equivalence to the predicate device (Fiber One) through non-clinical testing and comparison of specifications.

    Characteristic / "Acceptance Criteria" MetricPredicate Device (Fiber One) PerformanceModified Device (Model 0010-2400) Performance
    K NumberK100746K120870 (reference number for this submission)
    Regulation Number21 CFR§878.481021 CFR§878.4810
    Regulation NameLaser surgical instrument for use in general and plastic surgery and in dermatologyLaser surgical instrument for use in general and plastic surgery and in dermatology
    ClassificationClass IIClass II
    Product CodeGEXGEX
    Laser System CompatibilityGreenLight XPS Laser SystemGreenLight XPS Laser System
    Endoscope/Cystoscope Compatibility22 to 24 Fr continuous flow22 to 24 Fr continuous flow
    Saline flow≥0.3mL/sec≥0.3mL/sec
    Fiber and Cap Assembly Outer Diameter
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