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510(k) Data Aggregation

    K Number
    K232370
    Date Cleared
    2024-05-01

    (267 days)

    Product Code
    Regulation Number
    876.1500
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    Percutaneous System for adults
    The KARL STORZ Percutaneous System is intended to be used during percutaneous removal of kidney stones in adults.

    Percutaneous System for adults and pediatrics
    The KARL STORZ Percutaneous System is intended to be used during percutaneous removal of kidney stones in adults and pediatrics >1month of age.

    Device Description

    The Percutaneous Nephroscope System consists of the following:

    • Minimally Invasive Percutaneous Nephrolithopaxy (MIP) Nephroscopes
    • HOPKINS Telescopes for Percutaneous Nephrolithotomy (PCNL)
    • Operating Sheaths
    • One-Step Dilators
    • Telescope Bougie Set
    • Hollow Obturator and Fascial Dilator Applicators
    • Biopsy and Grasping forceps
    • Scissors
    • Knives
    • Insertion Aid
    • Laser Hand Instrument
    • Suction tube
    • Adaptors
    • Luer-Lock tube connectors
    AI/ML Overview

    The provided text is a 510(k) summary for the KARL STORZ Percutaneous Nephroscope System. This document focuses on demonstrating substantial equivalence to a predicate device through non-clinical performance and a literature review for pediatric use.

    Based on the provided text, the sections relating to acceptance criteria and the study that proves the device meets them are primarily about non-clinical bench testing and literature review, as opposed to a complex clinical study for AI or image analysis devices.

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

    1. A table of acceptance criteria and the reported device performance

    The document states: "Comparative bench testing between the subject and predicate DEVICES demonstrated that the endoscopes in the Percutaneous Nephroscope System meets all its design specification and is substantially equivalent to its predicate device. Additional bench testing was performed for the subject device instruments (forceps and scissors) to ensure the device met its design specifications and is substantially equivalent to the predicate."

    However, specific numerical acceptance criteria (e.g., minimum tensile strength, maximum insertion force, specific illumination levels) and the precise reported performance values are not explicitly detailed in this 510(k) summary. The summary only generally states that the device "meets all its design specification."

    Therefore, a table of specific acceptance criteria and reported performance cannot be fully constructed from the provided text. The document refers to compliance with ISO and IEC standards, which would imply that the device met the performance requirements outlined in those standards.

    Acceptance Criteria (Implied)Reported Device Performance (Summary Statement)
    Compliance with design specifications"meets all its design specification"
    Substantial equivalence to predicate device (endoscopes)Demonstrated through comparative bench testing, the endoscopes in the system are "substantially equivalent to its predicate device."
    Substantial equivalence to predicate device (instruments)Demonstrated through additional bench testing for forceps and scissors, ensuring they "met its design specifications and is substantially equivalent to the predicate."
    BiocompatibilityMet requirements of ISO 10993 series for Cytotoxicity, Acute Systemic Toxicity, Irritation, and Maximization Sensitization.
    Thermal SafetyMet requirements of IEC 60601-2-18:2009.
    Reprocessing (Cleaning and Sterilization)Met requirements of AAMI and ISO standards (TIR12, TIR30, ST77, ST79, ISO 14937, DIN EN ISO 11138-1, ANSI/AAMI/ISO 17655-1) and FDA Guidance on Reprocessing Medical Device in Health Care Settings.
    Safety and effectiveness for pediatric use (>1 month)Supported by "Published literature... provided to support the safety and effectiveness of the Percutaneous Nephroscope system for use in pediatrics >1month of age." (Note: This is a clinical performance claim, but the supporting study is a literature review, not a new clinical trial reported within this document.)

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

    • Sample size: The document does not specify a "sample size" in the context of clinical testing of humans or images. The "test set" refers to the specific devices and instruments undergoing bench testing. The document implies that sufficient units were tested to demonstrate compliance with design specifications and substantial equivalence, but the exact number of devices tested is not stated.
    • Data provenance: The document indicates non-clinical bench testing (likely performed internally by the manufacturer or contracted labs) and a literature review. The provenance of the literature is not specified beyond "Published literature." There is no mention of country of origin for any human data (as no new human clinical studies were performed). The testing is implicitly prospective in the sense that the manufacturer conducted the tests for this submission.

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

    This information is not applicable to the data provided. The "ground truth" for this type of device submission (Percutaneous Nephroscope System) is established through engineering and performance specifications validated by bench testing and adherence to recognized standards. There isn't a "test set" of patient images or clinical cases requiring expert interpretation to establish ground truth in the way it would be for an AI diagnostic device. The "ground truth" for the pediatric indication was established through existing published literature, not by new expert consensus specifically for this submission.

    4. Adjudication method for the test set

    This information is not applicable as there are no human-read test sets requiring adjudication of interpretations. The tests are bench tests proving physical and functional characteristics.

    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

    No, an MRMC comparative effectiveness study was not done, and this type of study is not relevant to a Percutaneous Nephroscope System. This device is a surgical instrument, not an AI-assisted diagnostic or image analysis tool.

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

    No, this is not applicable. The device is a physical surgical instrument, not an algorithm.

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

    For the bench testing, the "ground truth" is based on engineering design specifications, established performance standards (ISO, IEC, AAMI), and the performance of the predicate device. For the pediatric indication, the "ground truth" for safety and effectiveness was established from published literature, which likely includes clinical outcomes data, expert opinions, and various study types from prior research involving similar devices/procedures in pediatrics.

    8. The sample size for the training set

    This information is not applicable as there is no "training set" in the context of an AI/machine learning model for this device.

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

    This information is not applicable as there is no "training set" in the context of an AI/machine learning model for this device.

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