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510(k) Data Aggregation

    K Number
    K152591
    Date Cleared
    2015-10-08

    (28 days)

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

    Medilas H RFID Laser Fibers

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

    Dornier's Medilas H RFID Laser Fibers are intended to be used as an accessory to the Dornier Medilas H Holmium Laser ("Laser"). This laser is intended for cutting, vaporization, ablation, and coagulation of soft tissue in conjunction with endoscopic equipment (including laparoscopes, hysteroscopes, bronchoscopes, gastroscopes, and colonoscopes), or for open surgery for contact or non-contact surgery with or without a handpiece for use in incision/excision, vaporization, ablation and coagulation of soft tissue. The Laser is indicated for use in medicine and surgery, in the following medical specialties:

    • Arthroscopy,
    • . Urology,
    • Lithotripsy,
    • Pulmonology,
    • . Gastroenterology,
    • Gynecology,
    • ENT,
    • General Surgery.
    Device Description

    The Medilas H RFID Laser Fiber is a modification to Dornier's currently cleared Dornier Medilas H RFID Laser Fibers (K121938) to include a fiber with a reduced outer diameter. The fiber core and cladding for the subject device are made from silica.

    AI/ML Overview

    This document is a 510(k) premarket notification for a medical device called "Dornier Medilas H RFID Laser Fiber." It is a request for clearance from the FDA to market a modified laser fiber. The document evaluates the new device against previously cleared predicate devices to demonstrate substantial equivalence, rather than establishing acceptance criteria and conducting a study to prove device performance against those criteria in the context of an AI/algorithm-based diagnostic device.

    Therefore, the requested information regarding acceptance criteria, reported device performance, sample sizes, data provenance, expert qualifications, ground truth establishment, MRMC studies, or standalone algorithm performance cannot be provided from this particular document, as it pertains to a different type of device and regulatory submission.

    The document contains information primarily related to:

    • Device Name: Dornier Medilas H RFID Laser Fiber
    • Intended Use/Indications for Use: Used as an accessory to the Dornier Medilas H Holmium Laser for cutting, vaporization, ablation, and coagulation of soft tissue in various medical specialties.
    • Technological Characteristics: Similar to predicate devices, made from silica, manufactured and tested in the identical fashion. The key modification is a "reduced outer diameter" of the fiber.
    • Performance Data (Nonclinical functional testing):
      • Power transmission testing
      • Durability Stress Testing
      • Eccentricity Testing
      • Visual Inspections
      • These methods were the same as used for the cleared predicate.
    • Substantial Equivalence Claim: The device has the same intended use/indications for use, technological characteristics, and principles of operation as predicate devices. The minor difference in outer diameter does not raise new safety or effectiveness concerns, and performance data demonstrates substantial equivalence.
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    K Number
    K121938
    Date Cleared
    2012-08-01

    (30 days)

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

    MEDILAS H RFID LASER FIBER

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

    Dornier's Medilas H RFID Laser Fibers are intended to be used as an accessory for the Dornier Medilas H Holmium Laser ("Laser"). This laser is intended for cutting, vaporization, ablation, and coaqulation of soft tissue in conjunction with endoscopic equipment (including laparoscopes, hysteroscopes, bronchoscopes, gastroscopes, and colonoscopes), or for open surgery for contact or non-contact surgery with or without a handpiece for use in incision/excision, vaporization, ablation and coagulation of soft tissue. The Laser is indicated for use in medicine and surgery, in the following medical specialties:

    Arthroscopy, Urology, Lithotripsy, Pulmonology, Gastroenterology, Gynecology, ENT, General Surgery

    Device Description

    The Medilas H RFID Laser Fiber is a modification to Dornier's currently cleared Dornier Medilas H Laser Fiber K022544.

    AI/ML Overview

    The provided text, K121938, describes Dornier's Medilas H RFID Laser Fibers, which is a modification of an already cleared device. This submission is a Special 510(k) notice, indicating that the device has the same intended use and similar indications, principles of operation, and technological characteristics as its predicate devices, with only minor differences that do not raise new questions of safety or effectiveness.

    Therefore, the submission primarily focuses on demonstrating that the modified device performs as safely and effectively as the predicate devices. This type of submission does not typically involve the extensive clinical studies with human subjects, ground truth establishment, or multi-reader, multi-case studies that would be associated with entirely new medical devices or software algorithms.

    Based on the provided document, here is the information requested, with "N/A" for criteria not addressed in this type of submission:


    1. Table of Acceptance Criteria and Reported Device Performance:

    The document broadly states that "Performance data demonstrates that the Dornier Medilas H RFID Laser Fibers are as safe and effective as the listed predicates." Specific quantitative acceptance criteria and detailed performance metrics are not typically required or presented in this type of 510(k) summary for accessory modifications. The "performance data" likely refers to bench testing to ensure the fiber's physical and functional properties (e.g., power transmission, durability, RFID functionality) are comparable to the predicate.

    Acceptance CriteriaReported Device Performance
    Safety equivalent to predicate devicesPerformance data demonstrates safety equivalent to predicate devices.
    Effectiveness equivalent to predicate devicesPerformance data demonstrates effectiveness equivalent to predicate devices.
    RFID functionality (implied)The RFID functionality, as a new feature, would have been tested to ensure it operates as intended (e.g., communication with the laser system), but specific metrics are not detailed in this summary.
    Physical and functional equivalence to predicate laser fibers (implied)Likely demonstrated through bench testing, but specific metrics are not detailed in this summary.

    2. Sample size used for the test set and the data provenance: N/A (No human subject test set is described for this type of submission.)

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: N/A (Ground truth established by experts is not applicable to this type of device modification submission.)

    4. Adjudication method for the test set: N/A (No human subject test set or adjudication process is described.)

    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: N/A (This is not an AI device, and no MRMC study was conducted.)

    6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done: N/A (This is a physical medical device accessory, not an algorithm.)

    7. The type of ground truth used: N/A (Not applicable. The equivalence is based on engineering design, bench testing, and comparison to existing predicate devices, not clinical ground truth in the context of diagnostic accuracy.)

    8. The sample size for the training set: N/A (Not applicable, as this is a physical device accessory, not a machine learning algorithm.)

    9. How the ground truth for the training set was established: N/A (Not applicable.)

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