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Telescopes for adults
KARL STORZ HOPKINS Telescopes for Urology when used with sheaths, obturators, accessories, and instruments are intended to provide visualization and operative access during diagnostic and therapeutic urological procedures in adults.

Telescopes for adults and pediatrics
KARL STORZ HOPKINS Telescopes for Urology when used with sheaths, obturators, accessories, and instruments are intended to provide visualization and operative access during diagnostic and therapeutic urological procedures in adults and pediatrics.

The KARL STORZ HOPKINS Telescopes for Urology are rigid cystoscope systems, which provide visualization and operative access during urological procedures in adults and pediatrics. Urological devices consist of sheaths, obturators, accessories, and instruments, which are combined into a cystoscope system for diagnostic or therapeutic procedures in the lower urinary tract such as prostate, bladder, and urethra. The sheath provides a working channel for therapeutic instruments, as well as ports for irrigation and aspiration. The obturator is inserted through the sheath for atraumatic insertion to the surgical site, then removed after placement. The telescope is inserted through the sheath for visualization of the surgical site. All instruments subject to this submission are optical instruments, and compatible with telescopes; the optical instruments are only compatible with adult systems. Compact telescopes are all-in-one cystoscopes with built-in sheaths, obturators, and optics, they do not require device compilation for use.

The provided text is an FDA 510(k) clearance letter and its accompanying summary for the KARL STORZ HOPKINS Telescopes for Urology. This document details the regulatory pathway for a medical device, specifically rigid endoscopes, not an AI software or system. Therefore, most of the questions regarding acceptance criteria and study design for AI performance are not applicable.

Here's an analysis of the provided information:

Analysis of Acceptance Criteria and Study for a Medical Device (Endoscope):

Given that this is a medical device (endoscope), the "acceptance criteria" are typically related to meeting established performance standards for such devices. The "study" refers to non-clinical bench testing to demonstrate compliance with these standards and substantial equivalence to a predicate device.

1. Table of Acceptance Criteria and Reported Device Performance:

The document doesn't present a formal table of acceptance criteria with specific numerical performance targets and reported values in the way you might see for an AI algorithm's accuracy or sensitivity/specificity. Instead, the acceptance criteria are implicit in the adherence to international and national standards for medical devices, particularly endoscopes. The reported device performance is that it complies with these standards.

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

• Sample Size: Not applicable in the context of an endoscope's non-clinical bench testing. The "test set" here refers to the actual device prototypes or representative samples tested in a laboratory setting to verify compliance with engineering and safety standards. The number of units tested isn't specified but typically involves a sufficient number to ensure reproducibility and meet statistical requirements for the specific test (e.g., several samples for biocompatibility, multiple cycles for reprocessing).
• Data Provenance: The testing is non-clinical bench testing, meaning it does not involve human subjects or real-world patient data. It is performed in a controlled laboratory environment by the manufacturer (KARL STORZ SE & Co. KG), likely in Germany given their address.

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

• Experts for Ground Truth: Not applicable. For a rigid endoscope, "ground truth" is defined by established engineering specifications and compliance with recognized national and international standards. The "truth" is whether the device performs according to these measurable standards, not a subjective interpretation by experts.
• Qualifications of Experts: Not applicable. The "experts" involved are likely engineers, quality assurance personnel, and regulatory specialists within Karl Storz and external testing laboratories who are qualified to conduct and interpret the specified tests according to the standards.

4. Adjudication Method for the Test Set:

• Adjudication Method: Not applicable. Adjudication methods like 2+1 or 3+1 are used for resolving discrepancies in expert interpretations (e.g., in medical image diagnosis). For physical device testing, the results are typically quantitative measurements that either pass or fail against predefined criteria in the standards.

5. If a Multi Reader Multi Case (MRMC) Comparative Effectiveness Study was done:

• MRMC Study: No. MRMC studies are used to evaluate the impact of a new diagnostic aid (like an AI system) on human reader performance across multiple readers and cases. This is not relevant for a rigid endoscope, which is a physical visualization and access tool.

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

• Standalone Performance: Not applicable. This device is a physical endoscope, not an AI algorithm. Its function is to provide visualization, which inherently involves a human user (the clinician) in the loop.

7. The type of ground truth used:

• Type of Ground Truth: The "ground truth" is adherence to established engineering specifications, safety standards (e.g., thermal safety), optical performance metrics (e.g., field of view, resolution), biocompatibility requirements, and validated reprocessing protocols as defined by the numerous ISO, IEC, AAMI, ASTM, and ANSI standards listed. It is a technical and regulatory compliance "ground truth."

8. The sample size for the training set:

• Training Set Sample Size: Not applicable. This is a physical medical device, not an AI algorithm that undergoes training.

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

• Training Set Ground Truth: Not applicable. As this is not an AI device, there is no "training set" or "ground truth for the training set."

In summary, the provided document is a regulatory submission for a physical medical device (an endoscope) and not for an AI/software device. Therefore, the specific questions related to AI performance metrics, sample sizes for AI training/test sets, expert adjudication, and MRMC studies are not applicable to this submission. The "acceptance criteria" are demonstrated through non-clinical bench testing proving compliance with relevant industry standards and substantial equivalence to a predicate device.

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The KARL STORZ Flexible Video-Uretero-Renoscope is indicated for endoscopic examination in the urinary tract and can be used to examine the interior of the kidney, and using additional accessories, to perform various diagnostic and therapeutic procedures.

The KARL STORZ Flexible Video-Uretero-Renoscope (PNs 11278VSE, 11278VSUE) is a video endoscope used for visualization within the upper urinary tract (ureters) and kidneys. The endoscope includes a luer with two ports to allow access for instrumentation, as well as irrigation. The Flexible Video-Uretero-Renoscope models 11278VSE and 11278VSUE differ only in the direction of the distal tip deflection. With 11278VSUE when the control lever is pushed forward towards the distal tip, the distal tip deflects down and with 11278VSE the deflection is opposite.

The provided FDA 510(k) clearance letter and summary describe a medical device (FLEX XC ureteroscope), not an AI or software-based medical device. Therefore, the information requested about acceptance criteria and studies that apply to AI/Software as a Medical Device (SaMD) are not present in this document.

The clearance is based on the substantial equivalence of the KARL STORZ Flexible Video-Uretero-Renoscope (FLEX XC) to a previously cleared predicate device (K141250 KARL STORZ Flexible Video-Uretero-Renoscope).

Here's an analysis of the provided information concerning the device's performance, but it does not include any of the AI/SaMD specific criteria you requested as the device is a physical endoscope.

Device: KARL STORZ Flexible Video-Uretero-Renoscope (FLEX XC)
Product Code: FGB
Regulatory Class: Class II

Acceptance Criteria and Reported Device Performance (Non-AI/SaMD)

Since this is a physical medical device (endoscope), the "acceptance criteria" primarily relate to its physical and functional specifications, and its compliance with relevant performance and safety standards.

Note on Differences: The subject device (FLEX XC) shows an improved deflection range (285° up/down vs. 270°) and a potentially wider field of view range (80-110° vs. 80-95°) compared to the predicate. The submission argues these differences do not raise new questions of safety and effectiveness, supported by non-clinical bench testing.

Study Details (Based on provided document)

The document explicitly states: "Clinical testing was not required to demonstrate the substantial equivalence to the predicate device. Non-clinical bench testing was sufficient to assess safety and effectiveness and to establish the substantial equivalence of the modifications."

Therefore, the following information, which is typically relevant for AI/SaMD clinical validation studies, is not applicable or not provided in this document:

1. Sample sizes used for the test set and the data provenance: Not applicable, as no clinical test set for AI/SaMD performance was used. The reported "performance" comes from bench testing of the physical device.
2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. Ground truth for AI/SaMD performance was not established.
3. Adjudication method (e.g. 2+1, 3+1, none) for the test set: Not applicable.
4. 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: Not applicable. This is a physical device, not an AI-assisted diagnostic tool.
5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not applicable.
6. The type of ground truth used (expert consensus, pathology, outcomes data, etc): Not applicable. The "ground truth" for this medical device is its compliance with recognized performance standards and its physical and functional characteristics being comparable (or superior, without raising new concerns) to a cleared predicate.
7. The sample size for the training set: Not applicable. This device is not an AI/ML model that requires a training set.
8. How the ground truth for the training set was established: Not applicable.

Conclusion: The provided FDA 510(k) clearance documentation for the KARL STORZ Flexible Video-Uretero-Renoscope (FLEX XC) pertains to a traditional physical medical device, not a software-as-a-medical-device (SaMD) or AI-enabled device. The clearance is based on a demonstration of substantial equivalence to a predicate device through non-clinical bench testing, not through clinical studies involving human readers or AI algorithm performance analysis. Therefore, the specific criteria and study details related to AI/SaMD validation are absent from this document.

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The Karma® Fixation System is intended for bilateral facet stabilization for fusion as an adjunct to a 1-level interbody lumbar fusion from L1 to L5 with autogenous and/or allogenic bone graft. The Karma Fixation System must be accompanied by an FDA cleared intervertebral body fusion device implanted at the same spinal level. The Karma Fixation System is indicated for the treatment of patients with lumbar degenerative disc disease at a single level from L1 to L5 in skeletally mature patients who have failed conservative care.

The Karma® Fixation System is a system that provides adjunctive fixation. The system consists of a PEEK band. The Karma band consists of a strap manufactured from PEEK compounded with 7.5% barium sulphate for radiopacity. The leading tip of the device is comprised of a spherical feature followed by a tapered neck to allow for an instrument to assist in advancing the strap around the bony structures to be secured. The spherical tip of the device contains a tantalum insert for visualization when fluoroscopic imaging is used. The device has teeth along its length that interact with a latching mechanism at the opposite end of the strap. The latch allows a loop created by feeding the strap through the latch to be made consecutively shorter or taut by continuing to pull the strap through the latch. Prior to creating the loop, the spherical tip of the device is cut off and discarded to allow for the strap to pass through the latch. The latch resists the lengthening of the loop due to forces that would pull the strap in the opposite direction, thereby securing the bony structures. Once the desired loop length is reached, the unneeded portion of the strap may be cut off and discarded. An instrument, Tensioner, is provided and can be used fully tension the implant.

The provided FDA 510(k) clearance letter and summary for the Karma® Fixation System is for a medical device (spinal fixation system), not a software device or AI-powered system that would typically have acceptance criteria focused on algorithm performance metrics like sensitivity, specificity, or AUC. Therefore, the questions related to AI performance, such as sample size for test sets, expert adjudication, MRMC studies, standalone performance, and training set details, are not applicable to this submission.

The "acceptance criteria" for a medical device like the Karma® Fixation System are typically related to:

• Mechanical and Biomechanical Performance: Ensuring the device can withstand expected physiological loads and perform its intended structural function.
• Biocompatibility: Verifying that the materials used are safe for implantation in the human body.
• Sterilization: Confirming the device can be effectively sterilized.
• Labeling and Packaging: Ensuring proper information is provided.
• Substantial Equivalence: Demonstrating that the device is as safe and effective as a legally marketed predicate device.

The study that proves the device meets its acceptance criteria (i.e., its safety and effectiveness compared to a predicate) is discussed under "Performance Data" and "Clinical Data."

Here's an interpretation based on the information provided, addressing the applicable points:

1. Table of Acceptance Criteria and Reported Device Performance

Since this is a 510(k) submission for a spinal fixation system, the "acceptance criteria" are implied by the need to demonstrate substantial equivalence to a predicate device in terms of safety and effectiveness. The "reported device performance" refers to the studies conducted to support this equivalence. Specific numerical acceptance criteria (e.g., minimum load-bearing capacity, fatigue life) are often part of the detailed testing protocols submitted to the FDA but are not explicitly listed in this summary.

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

• Sample Size for Test Set:
  • Biomechanical studies: Not specified, but typically involves a small number of cadaveric spines.
  • Clinical Data: Not specified, but includes CT evaluations, adverse event data, and patient-reported outcomes at 12 and 24 months. The specific number of patients is not mentioned.
• Data Provenance: Not explicitly stated (e.g., country of origin). The nature of the clinical data (CT evaluations, adverse events, patient-reported outcomes at specific follow-up points) suggests a prospective or retrospective clinical study, but this is not definitively stated.

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

This question is not applicable to this type of device submission. The "ground truth" for a spinal fixation system is typically established through objective measurements in mechanical/biomechanical testing and clinical outcomes, rather than expert consensus on image interpretation. Clinical assessments would be performed by qualified medical professionals (e.g., surgeons, radiologists), but their specific number or qualifications for "ground truth establishment" are not relevant in the context of AI model evaluation.

4. Adjudication Method for the Test Set

This question is not applicable as it pertains to expert disagreement resolution in AI model evaluation, which is not relevant for musculoskeletal implants.

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 question is not applicable. MRMC studies are specific to evaluating AI-assisted diagnostic or interpretative devices, not spinal fixation systems.

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

This question is not applicable. The Karma® Fixation System is a physical implant, not a standalone algorithm.

7. The Type of Ground Truth Used

The "ground truth" for this device's performance assessment relies on a combination of:

• Biomechanical Data: Objective measurements from cadaveric testing (e.g., stability, stiffness).
• Computational Modeling: Results from Finite Element Analysis (FEA) predicting stress distribution and fatigue.
• Clinical Outcomes Data:
  • Imaging: CT evaluations at 12 and 24 months.
  • Adverse Event Data: Reported complications.
  • Patient-Reported Outcomes (PROs): Oswestry Disability Index (ODI) and visual analog scale (VAS) for back and leg pain.

8. The Sample Size for the Training Set

This question is not applicable. The Karma® Fixation System is a physical medical device, not an AI model that requires a "training set."

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

This question is not applicable. There is no "training set" for this type of device.

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The KARL STORZ Cysto-Urethro-Fiberscope and accessories are indicated for visualization and operative access during diagnostic and therapeutic endoscopic procedures of the urinary tract including the urethra and bladder.

The KARL STORZ Cysto-Urethro-Fiberscope and Accessories consists of a flexible fiber endoscope (Model Number: 11272CU1 / 11272C2) which can be used standalone or connected to compatible FDA-cleared camera heads which transfer images to compatible FDA-cleared Computer Control Units (CCUs) for the purposes of visualization and operative access during diagnostic and therapeutic endoscopic procedures of the urinary tract including the urethra and bladder.

Based on the provided FDA 510(k) clearance letter for the KARL STORZ Cysto-Urethro-Fiberscope, it's clear that no clinical performance data was provided or required for this 510(k) submission. The submission relies entirely on non-clinical (bench) performance data.

Therefore, many of the requested elements pertaining to acceptance criteria and clinical study design (e.g., sample size for test set, number of experts, adjudication method, MRMC study, standalone performance, ground truth types for clinical data) are not applicable to this particular device clearance.

The 510(k) summary explicitly states:

Clinical Performance Data Clinical testing was not required to demonstrate substantial equivalence to the predicate device. Non-clinical bench testing was sufficient to assess safety and effectiveness and to support substantial equivalence.

Given this, I will describe the acceptance criteria as implied by the non-clinical tests conducted and the proof that the device met these criteria based on the information provided.

Acceptance Criteria and Study Proving Device Meets Acceptance Criteria for KARL STORZ Cysto-Urethro-Fiberscope

As per the submitted 510(k) summary (K244001), the substantial equivalence of the KARL STORZ Cysto-Urethro-Fiberscope was established through non-clinical performance data only. No clinical studies were conducted or required for this clearance.

Therefore, the "acceptance criteria" are derived from the successful completion of various bench tests and compliance with recognized standards designed to ensure the safety and effectiveness of the device. The "study" proving the device meets these criteria refers to the non-clinical (bench) performance testing.

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria for this device are implicitly tied to the successful completion and passing results of the tests conducted in accordance with the listed standards and internal design specifications. The performance is reported as meeting these standards.

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

• Test Set Sample Size: Not applicable. No clinical test set was used. The "test set" in this context refers to the physical units of the device subjected to bench testing. The specific number of units tested for each non-clinical performance test is not detailed in the 510(k) summary, but it would have been sufficient to meet the requirements of the cited standards and internal quality procedures.
• Data Provenance: Not applicable for a clinical study. The non-clinical testing was conducted by KARL STORZ SE & CO. KG, which is based in Tuttlingen, Germany. The data is from laboratory (bench) testing, not patient data.

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

Not applicable. No clinical test set requiring expert ground truth establishment was used. Bench testing relies on objective measurement against predefined specifications and standard requirements, not subjective expert assessment of clinical data.

4. Adjudication Method for the Test Set

Not applicable. No clinical test set requiring adjudication was used.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was Done

No. An MRMC study was not conducted as no clinical performance study was performed or required.

6. If a Standalone Performance Study (Algorithm Only) Was Done

Not applicable. This device is a medical instrument (fiberscope), not an AI algorithm. Therefore, a standalone algorithm performance study is irrelevant.

7. The Type of Ground Truth Used

• For Non-Clinical Testing: The "ground truth" for the bench tests is the objective, measurable performance of the device against established engineering specifications, safety standards (e.g., IEC, ISO, ANSI/AAMI), and the functional capabilities of the predicate device. This is determined through physical measurements, chemical analyses, and standardized test protocols.

8. The Sample Size for the Training Set

Not applicable. No clinical training set was used as this is a physical medical device (fiberscope), not an AI/ML algorithm requiring data-driven training.

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

Not applicable. No clinical training set was used.

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The KARL STORZ Pediatric Cysto-Urethro-Fiberscope and accessories are intended for use by a physician in the visual examination and treatment of a variety of urological endoscopic procedures for pediatric patients.

The KARL STORZ Pediatric Cysto-Urethro-Fiberscope and Accessories consists of a flexible fiber endoscope (Model Number: 11274BCU1) which can be used standalone or connected to compatible FDA-cleared camera heads which transfer images to compatible FDA-cleared Computer Control Units (CCUs) for the purposes of visual examination and treatment of a variety of urological endoscopic procedures for pediatric patients.

The provided text is a 510(k) Summary for the KARL STORZ Pediatric Cysto-Urethro-Fiberscope. It outlines the characteristics of the device and establishes its substantial equivalence to a predicate device. However, it does not contain acceptance criteria or a study that proves the device meets specific performance criteria in the context of AI/ML or diagnostic accuracy.

The document details non-clinical performance data, primarily focusing on compliance with various international standards for biocompatibility, reprocessing validation, and bench performance testing for mechanical, optical, and thermal/photobiological safety.

Therefore, I cannot fulfill your request for:

1. A table of acceptance criteria and reported device performance related to diagnostic accuracy or AI/ML.
2. Sample size and data provenance for a test set (as no such test set for diagnostic performance is described).
3. Number and qualifications of experts for ground truth.
4. Adjudication method.
5. MRMC comparative effectiveness study results.
6. Standalone (algorithm only) performance.
7. Type of ground truth (as no ground truth for diagnostic performance is mentioned).
8. Sample size for the training set.
9. Ground truth establishment for the training set.

The document explicitly states: "Clinical testing was not required to demonstrate the substantial equivalence to the predicate device." This confirms that there was no study conducted to assess the device's diagnostic performance against specific acceptance criteria using patient data, which is what your questions are geared towards.

The "Non-Clinical Performance Data" section lists various standards the device complies with, but these are related to the physical and functional safety of the endoscope itself, for example:

• Biocompatibility Testing: ISO 10993 series for biological evaluation of medical devices.
• Reprocessing Validation: Standards like ISO 14937, ISO 17665-1, AAMI ST98 for cleaning and sterilization.
• Bench Performance Testing: IEC 60601-2-18, IEC 62471, ISO 8600-3, ISO 8600-5 for mechanical, optical, and thermal/photobiological performance.

These are not acceptance criteria or performance metrics related to diagnostic accuracy or the performance of an AI/ML component. The device is a flexible fiber endoscope, and the regulatory filing focuses on its substantial equivalence to another endoscope based on engineering specifications and safety standards, rather than any AI-driven diagnostic capabilities.

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The KARL STORZ Holders are manually operated surgical devices intended to hold endoscopes (such as arthroscopes, etc) and accessories during general and neurologic diagnostic and therapeutic procedures.

The KARL STORZ Holder is a manually operated surgical instrument intended to hold scopes (such as endoscopes, arthroscopes, etc) in a desired position during diagnostic, therapeutic, and surgical procedures (including neurologic procedures). The holder is manufactured from Stainless Steel and functions by the user manually tightening or loosening a knob, which opens and closes around a surgical scope. The device is intended to attach to the several KARL STORZ holding systems, which are a Class 1, table-mounted, mechanical and electromechanical holding arms that have many general surgical functions in addition to scope holding; it can also be used for instrument holding, retraction, and positioning.

The provided text is a 510(k) summary for the KARL STORZ Holders, which are manually operated surgical devices intended to hold endoscopes and accessories. This document primarily focuses on demonstrating substantial equivalence to a predicate device rather than providing extensive details about a clinical study with acceptance criteria for an AI/CAD-like device.

Therefore, the requested information regarding acceptance criteria, study design, sample sizes, expert involvement, ground truth establishment, and MRMC studies for an AI/CAD device is not available in the provided text. The document describes a traditional medical device (a mechanical holder) and its non-clinical performance testing.

However, based on the information that is available in the document, here's a summary of the non-clinical performance data and the demonstration of substantial equivalence:

1. Table of Acceptance Criteria and Reported Device Performance:

The document does not detail specific quantitative acceptance criteria or reported values in a table format for a clinical outcome beyond demonstrating functional equivalence. The performance data is described qualitatively as meeting the needs for substantial equivalence.

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

• The document describes non-clinical performance testing rather than a clinical test set involving human subjects or AI algorithm evaluation.
• The exact sample size for the "Holding Performance testing" and "Direction of view/Image stability testing" is not specified.
• Data Provenance: The testing was performed on the "subject device" (KARL STORZ Holders). The country of origin of the data is not explicitly stated beyond the submitter being KARL STORZ SE & Co. KG in Tuttlingen, Germany. The data would be considered prospective as it's testing of the new device for regulatory submission.

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

• This information is not applicable as the document describes non-clinical performance testing of a mechanical device, not the evaluation of an AI algorithm requiring expert ground truth for image interpretation.

4. Adjudication Method for the Test Set:

• This is not applicable for the same reason as point 3.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done:

• No, an MRMC comparative effectiveness study was not done. This type of study is relevant for evaluating the impact of AI on human reader performance, which is not the subject of this 510(k) submission for a mechanical endoscope holder.

6. If a Standalone (algorithm only without human-in-the-loop performance) was done:

• No, a standalone algorithm performance study was not done. This device is a mechanical surgical instrument, not an AI algorithm.

7. The Type of Ground Truth Used:

• The concept of "ground truth" as typically used for AI/CAD devices (e.g., expert consensus, pathology, outcome data) is not applicable. For this mechanical device, performance is evaluated against engineering specifications and functional requirements (e.g., ability to hold weight, maintain stability).

8. The Sample Size for the Training Set:

• This is not applicable. The device is a mechanical instrument, not an AI algorithm that requires a training set.

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

• This is not applicable for the same reason as point 8.

In summary, the provided FDA 510(k) summary (K240506) pertains to a mechanical endoscope holder, not an AI/CAD-enabled medical device. Therefore, the detailed requirements for acceptance criteria and study designs related to AI performance are not present in this document. The purpose of this 510(k) is to demonstrate substantial equivalence to a predicate mechanical device through non-clinical performance testing.

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The KARL STORZ Pediatric Cysto-Urethro-Fiberscope and accessories are intended for use by a physician in the visual examination and treatment of a variety of urological endoscopic procedures for pediatric patients.

The KARL STORZ Pediatric Cysto-Urethro-Fiberscope and Accessories consists of a flexible fiber endoscope (Model Numbers: 11278ACU1 and 11278AC2) which can be used standalone or connected to compatible FDA-cleared camera heads which transfer images to compatible FDA-cleared Computer Control Units (CCUs) for the purposes of visual examination and treatment of a variety of urological endoscopic procedures for pediatric patients.

The provided document is an FDA 510(k) clearance letter for the KARL STORZ Ped. Cysto-Urethro-Fiberscope. This type of document declares substantial equivalence to a predicate device, meaning it is similar enough to an existing marketed device that it does not require new efficacy studies or clinical trials for approval.

Therefore, the document explicitly states:

• "Non-Clinical performance data is not provided in this submission as the majority of the technological characteristics of the subject device and predicate device are equivalent. Where differences exist, the results of testing on the reference device are leveraged in support of safety and effectiveness."
• "Clinical testing was not required to demonstrate the substantial equivalence to the predicate device."

This means that the information requested regarding acceptance criteria, performance studies, sample sizes, expert ground truth establishment, adjudication methods, MRMC studies, standalone performance, training set details, and ground truth for the training set are not part of this 510(k) submission and are not present in the provided text. The clearance is based on the device's technological similarity to previously cleared devices, not on new performance studies as would be required for a novel device or a PMA submission.

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The KARL STORZ Flexible Uretero-Reno-Fiberscope is indicated for examination of the upper urinary tract including the ureter and kidneys and, using additional accessories, to perform various diagnostic and therapeutic procedures.

The optical component of the KARL STORZ flexible ureteroscope consists of:
• A light post connection with screw-on adapters for fiberoptic light cables.
• A fiber optic light conductor
• An optical image bundle behind an objective lens
• A flexible shaft housing
• A magnifying eyepiece with a focusing ring that rotates to adjust to the appropriate diopter correction for the user
• A reticle, or marker in the field of view, that indicates the 12 o'clock position as a point of reference

The insertable portion of the instrument is divided into a flexible shaft section and a deflection section. The features of the shaft include:
• A working channel that accepts flexible accessories at the proximal end and features a T-LUER Lock fitting for irrigation
• A deflection lever, for active distal tip deflection
• A proximal strain relief that connects the flexible shaft to the handpiece

The provided document is a 510(k) Summary for a medical device, the KARL STORZ Flexible Uretero-Reno-Fiberscope. It outlines the device's characteristics and compares it to predicate devices to demonstrate substantial equivalence.

However, the document states: "Clinical testing was not required to demonstrate the substantial equivalence to the predicate device. Non-clinical bench testing was sufficient to assess safety and effectiveness and to establish the substantial equivalence of the modifications."

This means that a study proving the device meets acceptance criteria in terms of clinical performance (human-in-the-loop, standalone algorithm performance, or using human experts for ground truth) was not conducted or submitted for this 510(k) clearance.

Therefore, it is not possible to provide the requested information regarding acceptance criteria, device performance, sample sizes for test/training sets, expert qualifications, adjudication methods, MRMC studies, standalone performance, or ground truth establishment based on the provided text.

The document focuses on demonstrating substantial equivalence through:

• Biocompatibility testing (ISO 10993)
• Reprocessing validation (AAMI ST91:2021, ANSI/AAMI/ISO 14937:2009, FDA Guidance Document Reprocessing Medical Devices in Health Care Settings: Validation Methods and Labeling)
• Additional bench testing to meet design specifications, complying with IEC 60601-2-18:2009, IEC 62471:2006, and ISO 8600-5:2020.

These non-clinical tests were deemed sufficient for demonstrating the device's safety and effectiveness and its substantial equivalence to predicate devices for its intended use.

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