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510(k) Data Aggregation

    K Number
    K183090
    Manufacturer
    Date Cleared
    2019-04-19

    (164 days)

    Product Code
    Regulation Number
    874.4420
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    Relieva Tract Balloon Dilation System

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

    The RELIEVA TRACT™ Balloon Dilation System is an instrument intended to provide increased intranasal space to facilitate access for endonasal and transnasal procedures and/or temporarily address nasal obstruction by displacing the inferior turbinate and lower nasal septum. The RELIEVA TRACT™ Balloon Dilation System is intended for use in ages 17 years or older.

    Device Description

    The RELIEVA TRACT™ Balloon Dilation System is a single-use, sterile device, which is intended to provide increased intranasal space to facilitate access for endonasal and transnasal procedures and/or temporarily address nasal obstruction by displacing the inferior turbinate and lower nasal septum. It is intended for use in ages 17 years or older. The RELIEVA TRACT™ Balloon Dilation System is composed of:

    • A RELIEVA TRACT™ Balloon Catheter, which consists of an integrated shaft system and a high-pressure balloon near the distal tip. The shaft is a coaxial catheter. The outer lumen is used for inflation of the balloon with sterile water or saline via the ACCLARENT® Balloon Inflation Device (K090660). The inner lumen permits the use of the RELIEVA TRACT™ Stylet to facilitate advancement of the balloon catheter to the target location, such as the nasal passage in the region of the inferior turbinate and nasal septum. The proximal end of the RELIEVA TRACT™ Balloon Catheter consists of a luer that is used for inflation of the balloon and a secondary luer that is used for stylet access. The balloon is inflated by injecting sterile water or saline through the inflation luer.
    • A RELIEVA TRACT™ Stylet, which is an optional accessory and intended to facilitate advancement of the Balloon Dilation Catheters. The proximal end has a luer connector that allows the stylet to lock into the stylet port of the balloon catheter. The distal end consists of an atraumatic tip.
    AI/ML Overview

    This document is a 510(k) Summary for a medical device, the RELIEVA TRACT™ Balloon Dilation System. The request is to describe the acceptance criteria and the study that proves the device meets those criteria, specifically concerning data validation (e.g., test set, experts, ground truth).

    However, this document does not contain information about the performance of a software or AI-based medical device, nor does it detail a study involving a test set, expert consensus for ground truth, or MRMC studies.

    This 510(k) is for a physical medical device (a balloon dilation system) and focuses on demonstrating substantial equivalence to predicate devices through non-clinical performance data (e.g., sterilization validation, biocompatibility, simulated use testing on cadavers).

    Therefore, many of the requested bullet points, which are typically relevant for the validation of AI/software medical devices, cannot be answered from the provided text. The document explicitly states:

    • "Clinical data was not necessary for the RELIEVA TRACT™ Balloon Dilation System." (Page 6)

    Below is an attempt to answer the questions based on the available information, highlighting where the requested details are not present in the document.


    Acceptance Criteria and Device Performance Study (RELIEVA TRACT™ Balloon Dilation System)

    This 510(k) summary focuses on demonstrating substantial equivalence through non-clinical performance and simulated use testing, rather than a clinical study or a study specifically validating a data-driven AI/software component with a test set and ground truth.

    1. Table of acceptance criteria and the reported device performance:

    The document broadly states that the device "met all performance acceptance criteria," and then lists types of testing performed. Specific numerical acceptance criteria for each test are not detailed in this summary.

    Acceptance Criteria Category (Implied)Reported Device Performance
    Packaging Shelf LifeMet a shelf life of 24 months in accordance with ASTM F1980-07, ASTM F88/F88M-09, and ASTM F2096-04 requirements.
    SterilizationValidated per ISO 11135:2014, demonstrating a sterility assurance level of 10^-6 (overkill, half-cycle approach). Ethylene oxide residuals met ISO 10993-7:2008 requirements.
    BiocompatibilitySuccessfully completed testing to determine the device is biocompatible per ISO 10993-1.
    Simulated Use TestingSuccessfully conducted on cadavers, verifying function according to intended use and design specifications in a simulated clinical setting. Packaging and instructions for use were also assessed.

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

    • Sample Size: Not specified. The document mentions "simulated use testing on cadavers." The number of cadavers or specific test instances is not provided.
    • Data Provenance: "Cadavers" are mentioned for simulated use testing. No information on country of origin or whether the testing was retrospective or prospective. Given it's simulated use, it would typically be prospective for the purpose of the study.

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

    • Number of Experts: Not specified.
    • Qualifications of Experts: Not specified. The simulated use testing included "evaluators" who assessed the packaging and instructions for use, but their number and qualifications (e.g., medical professionals, engineers) are not detailed.

    4. Adjudication method (e.g., 2+1, 3+1, none) for the test set:

    • Adjudication Method: Not specified.

    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:

    • MRMC Study: No, this type of study was not performed. This device is a physical medical instrument, not an AI/software. The document explicitly states "Clinical data was not necessary."

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

    • Standalone Performance: Not applicable. This is not an algorithm or AI device.

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

    • For the simulated use testing, the "ground truth" would implicitly be the successful navigation, deployment, and dilation of the device as per its design specifications and intended use in the cadaveric model. This would likely be assessed by professional evaluators (e.g., engineers, medical device specialists, or potentially clinicians), but the specific method (e.g., visual inspection, measurement, functional assessment against a defined standard) is not detailed, nor is it based on expert consensus in the sense of diagnostic image interpretation.

    8. The sample size for the training set:

    • Training Set: Not applicable. This is a physical device, not an AI/machine learning model that requires a training set.

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

    • Ground Truth for Training Set: Not applicable.
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