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510(k) Data Aggregation

    K Number
    K181864
    Date Cleared
    2019-01-02

    (174 days)

    Product Code
    Regulation Number
    882.4400
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    Polaris RF Ablation System

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

    The Polaris RF Ablation System is intended for the creation of radiofrequency lesions in nervous tissue.

    Device Description

    The Polaris RF Ablation System includes the following components:

    1. Polaris Radiofrequency Generator and Desk Stand
    2. Polaris Pump, Pump Cable and Desk Stand
    3. Polaris Standard Connector Hub / Polaris Cooled Connector Hub
    4. Polaris Footswitch
    5. Polaris Cooled RF Probe Kit:
      i. Polaris Cooled RF Ablation Probe
      ii. Polaris Tube Kit
      iii. Polaris Introducer
    6. Polaris Single-Use RF Probe
    7. Polaris Reusable RF Probe
    8. Polaris RF Cannula
      The Polaris RF Ablation System is intended for the creation of radiofrequency lesions in nervous tissue. The system is designed to deliver controlled RF energy from the Polaris RF Generator to target tissues via the Polaris RF Probes for standard RF procedures or Polaris Cooled RF Probes for cooled RF procedures. RF energy is applied based on the configured RF generator settings to create the desired lesions in the target tissue. The generator also delivers low frequency stimulation pulses during procedures.
      During standard RF procedures, the Polaris RF Probe is used with a compatible Polaris RF Cannula to enable RF energy delivery via the active electrode to the target tissues. During cooled RF procedures with Polaris Cooled RF Probes, the system integrates a cooling mechanism by internally circulating water through the probes using the Polaris Pump Unit. This cooling results in minimal charring of the surrounding tissue and also prevents tissue from adhering to the electrodes. This allows for larger and more consistent ablation volumes to be achieved.
    AI/ML Overview

    The document you provided is a 510(k) summary for a medical device, the Polaris RF Ablation System. It details the device's substantial equivalence to predicate devices, rather than establishing primary effectiveness through clinical trials with defined acceptance criteria for diagnostic output.

    Therefore, the information requested for AI/ML device studies such as sample sizes for test/training sets, ground truth establishment, expert qualifications, and MRMC studies, is not present in this document, as it focuses on demonstrating product safety and performance against established standards and predicate devices.

    However, I can extract the information relevant to performance testing based on the provided tables.

    1. Table of Acceptance Criteria and Reported Device Performance

    The document lists various performance tests conducted on different components of the Polaris RF Ablation System. The general acceptance criterion for all tests is "All samples passed the acceptance criteria," with the reported performance consistently stating that the device or its components met all relevant requirements and confirmed compliance with applicable standards.

    Test CategoryComponentTest Method SummaryAcceptance Criteria (Implied)Reported Device Performance
    MechanicalPolaris Re-Usable RF ProbeTemperature Test, Pull Test, Cleaning and Sterilization Reuse Test, Mechanical Reuse Test, Mechanical Test (Flexion), Continuity Test, Functional TestCompliance with IEC 60601-2-2:2009All samples passed the acceptance criteria. Results confirmed compliance of the device with IEC 60601-2-2:2009 and support substantial equivalence.
    ElectricalPolaris Re-Usable RF ProbeComparison with Polaris Standard Single-Use Probe for electrical stressesCompliance with IEC 60601-1:2005+A1:2012 and IEC 60601-2-2:2009The device was verified to meet the requirements of IEC 60601-1:2005+A1:2012 and IEC 60601-2-2:2009. Results support substantial equivalence.
    BiocompatibilityPolaris Re-Usable RF ProbeComparisons to similar legally marketed devices per ISO 10993-1 and FDA guidance.Compliance with current ISO 10993-1 requirementsResults confirmed compliance of the device with the current ISO 10993-1 requirements and support substantial equivalence.
    PackagingPolaris Re-Usable RF ProbeShip testing for integrity through shipping and handling.Packaging met relevant requirements.All packaging met relevant requirements. Results support substantial equivalence.
    Cleaning and SterilizationReusable componentsValidation of reprocessing methods to achieve SAL of 10-6.Compliance with AAMI TIR12, AAMI TIR30, ANSI/AAMI ST81, and FDA guidance.The device was verified to meet the requirements of AAMI TIR12, AAMI TIR30 and ANSI/AAMI ST81 requirements and the FDA guidance. Results support substantial equivalence.
    MechanicalPolaris Single-Use RF ProbeTemperature Test, Pull Test, Durability Test, Mechanical Test (Flexion), Continuity Test, Functional TestCompliance with IEC 60601-2-2:2009All samples passed the acceptance criteria. Results confirmed compliance of the device with IEC 60601-2-2:2009 and support substantial equivalence.
    ElectricalPolaris Single-Use RF ProbeHigh Frequency Leakage Current Test, High Frequency Dielectric Strength Test, Mains Frequency Dielectric Strength Test (for cable, handle, connector)Compliance with IEC 60601-1:2005+A1:2012 and IEC 60601-2-2:2009All samples passed the acceptance criteria. Results confirmed compliance of the device with IEC 60601-1:2005+A1:2012 and IEC 60601-2-2:2009 and support substantial equivalence.
    BiocompatibilityPolaris Single-Use RF ProbeComparisons to similar legally marketed devices per ISO 10993-1 and FDA guidance.Compliance with current ISO 10993-1 requirementsResults confirmed compliance of the device with the current ISO 10993-1 requirements and support substantial equivalence.
    PackagingPolaris Single-Use RF ProbeShip testing for integrity; Seal strength and sterile barrier validated per ANSI/AAMI/ISO 11607-1 and 11607-2 over shelf life.Packaging met relevant requirements; Compliance with ANSI/AAMI/ISO 11607-1 and 11607-2.The device packaging met relevant requirements. Results confirmed compliance of device packaging with ANSI/AAMI/ISO 11607-1 and 11607-2 and support substantial equivalence.
    MechanicalPolaris RF CannulaPositive Pressure Liquid Leakage Test, Sub-atmospheric Pressure Air Leakage Test, Resistance to Separation Test, Stress Cracking Test, Hub Strength TestCompliance with ISO 80369-7:2016, ISO 594-1:1986, and ISO 7864:2016.All samples passed the acceptance criteria. Results confirmed the device met with the mechanical requirements of ISO 80369-7:2016, ISO 594-1:1986 and ISO 7864:2016 and support substantial equivalence.
    ElectricalPolaris RF CannulaHigh Frequency Leakage Current Test, High Frequency Dielectric Strength Test, Mains Frequency Dielectric Strength TestCompliance with IEC 60601-1:2005+A1:2012 and IEC 60601-2-2:2009All samples passed the acceptance criteria. Results confirmed compliance of the device with IEC 60601-1:2005+A1:2012 and IEC 60601-2-2:2009 and support substantial equivalence.
    BiocompatibilityPolaris RF CannulaBiological testing and comparisons per ISO 10993-1 and FDA guidance.Compliance with current ISO 10993-1 requirementsResults confirmed compliance of the device with the current ISO 10993-1 requirements and support substantial equivalence.
    PackagingPolaris RF CannulaShip testing for integrity; Seal strength and sterile barrier validated per ANSI/AAMI/ISO 11607-1 and 11607-2 over shelf life.Packaging met relevant requirements; Compliance with ANSI/AAMI/ISO 11607-1 and 11607-2.The device packaging met relevant requirements. Results confirmed compliance of device packaging with ANSI/AAMI/ISO 11607-1 and 11607-2 and support substantial equivalence.
    MechanicalPolaris Cooled RF Probe Kit (Probe & Introducer)Leak/Pressure Test, Pull Test, Temperature Test, Tip Compression Test, Mechanical Test (Flexion), Continuity Test, Functional Test (for probe); Resistance to Separation tests (for introducer)Compliance with IEC 60601-2-2:2009 for probe; Relevant mechanical stresses without failure for introducer.All samples passed the acceptance criteria. Results confirmed compliance of the device with IEC 60601-2-2:2009 (probe) and support substantial equivalence.
    ElectricalPolaris Cooled RF Probe Kit (Probe)High Frequency Leakage Current Test, High Frequency Dielectric Strength Test, Mains Frequency Dielectric Strength Test (for cable, shaft, handle, connector)Compliance with IEC 60601-1:2005+A1:2012 and IEC 60601-2-2:2009All samples passed the acceptance criteria. Results confirmed compliance of the device with IEC 60601-1:2005+A1:2012 and IEC 60601-2-2:2009 and support substantial equivalence.
    BiocompatibilityPolaris Cooled RF Probe and Polaris IntroducerBiological testing and comparisons per ISO 10993-1 and FDA guidance.Compliance with current ISO 10993-1 requirementsResults confirmed compliance of the devices with the current ISO 10993-1 requirements and support substantial equivalence.
    PackagingPolaris Cooled RF Probe KitShip testing for integrity; Seal strength and sterile barrier validated per ANSI/AAMI/ISO 11607-1 and 11607-2 over shelf life.Packaging met relevant requirements; Compliance with ANSI/AAMI/ISO 11607-1 and 11607-2.The subject device packaging met relevant requirements. Results confirmed compliance of device packaging with ANSI/AAMI/ISO 11607-1 and 11607-2 and support substantial equivalence.
    VerificationPolaris Radiofrequency GeneratorElectrical testing of hardware components (RF board, User Interface Board, Multiplexer board)Device met all relevant requirements.The subject device met all relevant requirements. Results support substantial equivalence.
    PackagingPolaris Radiofrequency GeneratorShip testing for integrity.Packaging met relevant requirements.All packaging met relevant requirements. Results support substantial equivalence.
    VerificationPolaris Pump UnitAssessment of inspection, configuration, installation, operation, environment, and service life.Device met all relevant requirements.The subject device met all relevant requirements. Results support substantial equivalence.
    PackagingPolaris Pump UnitShip testing for integrity.Packaging met relevant requirements.All packaging met relevant requirements. Results support substantial equivalence.
    VerificationPolaris Connector HubCable Pull Test, Cable Impulse Test, Device Identification.Compliance with Baylis self-enforced requirements.The subject device met all relevant requirements. Results confirmed compliance of the device with Baylis self-enforced requirements and support substantial equivalence.
    PackagingPolaris Connector HubShip testing for integrity.Packaging met relevant requirements; Compliance with Baylis self-enforced requirements.All packaging met relevant requirements. Results confirmed compliance of device packaging with Baylis self-enforced requirements and support substantial equivalence.
    PackagingPolaris FootswitchShip testing for integrity.Packaging met relevant requirements.All packaging met relevant requirements. Results support substantial equivalence.
    Electrical Product SafetyPolaris RF Ablation SystemCompliance with IEC 60601-1:2005+A1:2012 (including national deviations) and IEC 60601-2-2:2009.Device met all relevant requirements; Compliance with specified IEC standards.The subject device met all relevant requirements. Results confirmed compliance of the device with IEC 60601-1:2005+A1:2012 and IEC 60601-2-2:2009 and support substantial equivalence.
    Electromagnetic CompatibilityPolaris RF Ablation SystemCompliance with IEC 60601-1-2:2014.Device met all relevant requirements; Compliance with IEC 60601-1-2:2014.The subject device met all relevant requirements. Results confirmed compliance of the device with IEC 60601-1-2:2014 and support substantial equivalence.
    Benchtop Lesion ValidationPolaris RF Ablation SystemComparative lesion validation testing using a soft tissue model (single and multi-probe scenarios).Device met all relevant requirements; Substantially equivalent ablation performance to predicate.The subject device met all relevant requirements. Results support substantial equivalence.
    UsabilityPolaris RF Ablation SystemVerification and validation of usability requirements including normal use, worst-case scenario, and primary operating functions.Device met all relevant requirements.The device met all relevant requirements. Results support substantial equivalence.
    SoftwarePolaris RF Ablation SystemSoftware V&V per FDA Guidance for Software Contained in Medical Devices.Device met all relevant requirements.The device met all relevant requirements. Results support substantial equivalence.

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

    The document does not specify exact sample sizes (e.g., number of units tested) for most of the performance tests. It mentions "All samples passed" for many tests, indicating that multiple units were likely tested for each category. No information on data provenance (country of origin, retrospective/prospective) is provided, as these are technical performance tests on the device itself, not clinical data.

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

    Not applicable. This is a technical performance and substantial equivalence submission for a medical device, not an AI/ML diagnostic or prognostic device that requires expert-established ground truth for a test set. The "ground truth" here is compliance with engineering standards and predicate device performance.

    4. Adjudication Method for the Test Set

    Not applicable. As this is not an AI/ML diagnostic output, there is no adjudication method in the context of expert review. Test results are compared against predefined technical standards and requirements.

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and Effect Size

    No. This document does not pertain to an AI/ML device that assists human readers, so an MRMC study is not relevant here.

    6. If a Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study Was Done

    No. The Polaris RF Ablation System is a physical medical device, not an algorithm, so a standalone algorithm performance study is not applicable.

    7. The Type of Ground Truth Used

    The "ground truth" in this context refers to established engineering and medical device standards (e.g., IEC 60601 series, ISO 10993 series, ANSI/AAMI ISO 11607) and the performance characteristics of the legally marketed predicate devices. For mechanical and electrical tests, it's compliance with these standards. For lesion validation, it's the demonstration of "substantially equivalent ablation performance" compared to the predicate in a soft tissue model.

    8. The Sample Size for the Training Set

    Not applicable. This is not an AI/ML device, so there is no training set.

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

    Not applicable. As there is no training set for an AI/ML model, this question is not relevant.

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