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The Simplexa COVID-19 / Flu A/B & RSV Direct is a real-time RT-PCR assay intended for use on the LIAISON MDX instrument for the simultaneous in vitro qualitative detection and differentiation of nucleic acid from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A (Flu A) virus, influenza B (Flu B) virus and respiratory syncytial virus (RSV) in nasopharyngeal swab and anterior nasal swab specimens from individuals with signs and symptoms of respiratory tract infection. Clinical signs and symptoms of respiratory tract infection due to SARS-CoV-2, influenza A, influenza B, and RSV can be similar.

The Simplexa COVID-19 / Flu A/B & RSV Direct assay is intended for use as an aid in the differential diagnosis of SARS-CoV-2, influenza A, influenza B and RSV infections if used in conjunction with other clinical and epidemiological information, and laboratory findings. SARS-CoV-2, influenza A, influenza B, and RSV viral RNA are generally detectable in nasopharyngeal swab and anterior nasal swab specimens during the acute phase of infection. This test is not intended to detect influenza C virus infections.

Positive results are indicative of the presence of the identified virus, but do not rule out bacterial infection or co-infection with other pathogens not detected by the test. The agent(s) detected by the Simplexa COVID-19 / Flu A/B & RSV Direct real-time RT-PCR assay may not be the definite cause of the disease. Negative results do not preclude SARS-CoV-2, influenza A, influenza B, or RSV infection and should not be used as the sole basis for patient management decisions.

The Simplexa™ COVID-19 & Flu A/B & RSV Direct assay is a qualitative, multiplex real-time reverse transcription polymerase chain reaction (RT-PCR) test intended for the simultaneous detection and differentiation of RNA from SARS-CoV-2, Influenza A, Influenza B, and Respiratory Syncytial Virus (RSV) in nasopharyngeal swabs (NPS) and anterior nasal swabs (NS) in UTM/UVT and M4RT specimen transport media. The assay is performed on the LIAISON® MDX Instrument using a Direct Amplification Disc (DAD) format, enabling sample-to-answer processing without separate nucleic acid extraction.

The LIAISON® MDX Instrument is a benchtop real-time PCR thermocycler that utilizes a self-contained, single-use direct amplification disc (DAD) to process samples. It performs thermal cycling and real-time fluorescence detection using optical detection modules, each with specific excitation and emission wavelengths. The instrument includes a laser enclosed in a laser product housing, with integrated hardware and software interlocks to ensure user safety. It is operated via a USB connection to a dedicated computer running the LIAISON® MDX Studio software.

The LIAISON® MDX Studio software controls the instrument and provides a user interface for assay setup, execution, and result analysis. The software automatically interprets results for in vitro diagnostic (IVD) assays using pre-defined assay definitions encoded in barcode inserts included with the assay kits. It performs spectral compensation, verifies internal control amplification, and checks for sufficient sample volume prior to amplification. The software also includes user authentication, audit logging, laboratory information system (LIS) connectivity, and cybersecurity features.

The assay kit includes single-use reaction mix vials, a positive control pack with inactivated viral particles in transport media, and the Direct Amplification Disc consumable, which supports up to eight simultaneous reactions.

The assay format is designed for direct amplification, with 24 single-use reaction mix vials per kit. The required sample volume input is 50 µL. The reaction mix is provided in single-use vials and includes DNA polymerase, reverse transcriptase, RNase inhibitor, primers, probes, and encapsulated RNA templates. The buffer component in the reaction mix maintains optimal pH and ionic strength to support enzyme activity and amplification efficiency throughout the RT-PCR process.

The assay includes an encapsulated RNA internal control (RNA IC) in each reaction to monitor for potential RT-PCR inhibition or process failure. The RNA IC is derived from bacteriophage MS2. This non-target RNA is co-amplified with the assay's viral targets and detected independently using post-amplification melting curve analysis. The presence of the RNA IC in a negative specimen confirms that the amplification process functioned as expected, while its absence—along with no target detection—results in an invalid outcome. Detection of the RNA IC is not required in the Positive Control but is expected in the No Template Control (NTC) to verify assay validity.

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The Seguin Annuloplasty Ring is indicated for use in the repair of mitral valves that are diseased or damaged due to acquired or congenital processes.

The Seguin Annuloplasty Ring (SARP) is a semi-rigid or semi-flexible annuloplasty ring designed to support mitral valve repair. The ring is constructed from a polyethylene core covered by a knitted polyester sewing cuff. The Seguin Ring is sterilized by EO sterilization and supplied sterile. The Seguin ring is offered in sizes 24-40mm in increments of 2 mm.

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The Huxley Home Sleep Apnea Test (SANSA) is a wearable device intended for use in the recording, analysis, and storage of biophysical parameters to aid in the evaluation of sleep-related breathing and cardiac disorders of adults suspected of sleep apnea. The device is intended for the clinical and home use setting under the direction of a Healthcare Professional (HCP). The system is prescription use only.

The SANSA device records and stores ECG recording for up to 10 hours of wear time which can be displayed in the software portal for manual annotation and analysis. The SANSA does not provide automated analysis of the ECG and is not intended to be used with a 3rd party automated algorithm and is not intended for pacemaker analysis.

The Huxley Home Sleep Apnea Test (SANSA™) is a wearable device intended for use in the recording, analysis, and storage of biophysical parameters to aid in the evaluation of sleep-related breathing disorders of adults suspected of sleep apnea. The device is intended for clinical and home use setting under the direction of a Healthcare Professional (HCP). The system is prescription use only. The SANSA™ device records and stores ECG recording for up to 10 hours of wear time which can be displayed in the software portal for manual annotation and analysis. The SANSA™ does not provide automated analysis of the ECG and is not intended to be used with a 3rd party automated algorithm and is not intended for pacemaker analysis.

The SANSA HSAT collects multiple physiological signals using a single wearable patch worn on the chest. The SANSA device contains a reflective PPG sensor, a single-lead ECG sensor, and a 3-axis accelerometer. The signals from these sensors are passed into a cloud-based algorithm which utilizes a combination of signal processing and AI/ML components to compute time-series data for clinician review and summary metrics for report output. The device outputs the following time-series channels: Oximetry, Heart Rate, Chest Movement, Snoring, Body Position, Respiratory Effort, Actigraphy, Sleep staging (Sleep/Wake), and ECG. The following summary metrics are calculated: sansa-Apnea Hypopnea Index (sAHI) and Total Sleep Time (TST).

Recorded data are uploaded to a software portal where physiological tracings are made available for review and event editing by a qualified healthcare professional. The device is intended to be worn for 10 hours per study.

Here's a breakdown of the acceptance criteria and the study information for the SANSA HSAT device, based on the provided FDA 510(k) clearance letter:

1. Acceptance Criteria and Reported Device Performance

The acceptance criteria and performance data are primarily found on Page 9 of the document, under the "Performance" section within "Table 1: Device Comparison."

Note: For Heart Rate, SpO2, and OSA diagnosis metrics, the predicate device (iRhythm Zio Monitor) does not provide these analyses or collect SpO2. Therefore, the "acceptance criteria" for these aspects are implicitly met by the absence of safety/effectiveness concerns with the SANSA HSAT's reported performance, which aligns with its intended use in sleep apnea evaluation. The ECG recording accuracy metrics are directly comparable and are identical between the subject device and the predicate.

2. Sample Size and Data Provenance for the Test Set

The document does not explicitly state the sample size used for the clinical performance validation of the SANSA HSAT's ECG, nor does it specify the country of origin or whether the data was retrospective or prospective. It only mentions:

• Sample Size: Not specified.
• Data Provenance: Not specified (country/retrospective/prospective).

For the Aid to Diagnosis of OSA, a sensitivity of 88.2% and specificity of 87.3% are reported. The document does not provide the sample size or provenance for this particular study, but it was leveraged from a previous clearance (K244027).

3. Number of Experts and Qualifications for Ground Truth - Test Set

The document does not provide details on the number or qualifications of experts used to establish ground truth for the test set specifically for the ECG clinical performance validation.

For the "Aid to Diagnosis of Moderate to Severe OSA", the percentages suggest a comparison against a diagnostic standard, which would typically involve expert interpretation, but the details are not provided in this document.

4. Adjudication Method for the Test Set

The document does not specify any adjudication method (e.g., 2+1, 3+1) used for establishing the ground truth for the test set.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No information is provided about a multi-reader multi-case (MRMC) comparative effectiveness study, or any effect size related to human reader improvement with or without AI assistance. The SANSA device explicitly states it "does not provide automated analysis of the ECG and is not intended to be used with a 3rd party automated algorithm." (Pages 4 and 5).

6. Standalone Performance Study

Yes, a standalone performance study was done for the SANSA HSAT's ECG:

• Study Type: "Sansa ECG clinical performance was validated through comparison to a simultaneously collected reference standard Holter monitor." (Page 11)
• Performance: "Clinically acceptable performance was demonstrated through qualitative and quantitative analysis of the ECG signal." (Page 11)

The reported sensitivity and specificity for OSA diagnosis (Page 9) also represent standalone algorithm performance.

7. Type of Ground Truth Used

• For ECG Clinical Performance: "simultaneously collected reference standard Holter monitor." (Page 11)
• For Aid to Diagnosis of OSA (reported sensitivity/specificity): While not explicitly stated, the context of "Aid to Diagnosis" for Sleep Apnea typically implies comparison to a polysomnography (PSG) study, which is the gold standard, interpreted by sleep specialists. This data was "leveraged from previous clearance."

8. Sample Size for the Training Set

The document does not provide any information about the sample size used for a training set. This is consistent with the statement that the device does not provide automated analysis of the ECG and explicitly states that it is not intended for use with a 3rd party automated algorithm. While the device uses "AI/ML components" for other signals (Snoring, Body Position, Respiratory Effort, Actigraphy, Sleep staging), the training set size for these components is not detailed in this document.

9. How Ground Truth for the Training Set Was Established

The document does not provide information on how the ground truth for any potential training set was established. Given the focus on manual annotation and analysis for ECG, and the lack of detail on the AI/ML components for other signals, this information is not present in the clearance letter.

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Synchfix™ EVT is intended for soft tissue and bone fixation for ankle syndesmosis disruptions with or without ankle fractures and as an adjunct in connection with hardware for ankle fractures such as Weber B, Weber C and Maisonneuve in adult and adolescent patient populations.

The subject device, Synchfix™ EVT, is a sterile, single-use, suture-button system intended to stabilize syndesmotic disruptions in the ankle. The subject system consists of a UHMWPE suture tensioned between two titanium alloy buttons and single use instruments to assist in implantation, including a pre-loaded inserter.

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The SER Pen Carain MicroSystem is intended for use as a treatment to improve the appearance of facial acne scars in adults with Fitzpatrick Skin Types I - III, aged 22 years and older and as a treatment to improve the appearance of surgical or traumatic hypertrophic scars on the abdomen in adults aged 22 years or older.

The SER Pen Carain MicroSystem is a handheld powered microneedling device consisting of a rechargeable motorized handpiece and disposable, single-use needle cartridges (12-pin and 36-pin). Microneedles are made of surgical-grade stainless steel (304) and are gamma sterilized.

Design modifications include:

• Addition of a powered 7-speed control head (6,200–9,000 RPM) with direct corded power option.
• Modified disposable cartridge (Model T2.0), shortened by 7 mm, with protective cap and compensatory spring.

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Syngo Carbon Clinicals is intended to provide advanced visualization tools to prepare and process the medical image for evaluation, manipulation and communication of clinical data that was acquired by the medical imaging modalities (for example, CT, MR, etc.)

OrthoMatic Spine provides the means to perform musculoskeletal measurements of the whole spine, in particular spine curve angle measurements.

The TimeLens provides the means to compare a region of interest between multiple time points.

The software package is designed to support technicians and physicians in qualitative and quantitative measurements and in the analysis of clinical data that was acquired by medical imaging modalities.

An interface shall enable the connection between the Syngo Carbon Clinicals software package and the interconnected software solution for viewing, manipulation, communication, and storage of medical images.

Syngo Carbon Clinicals is a software only Medical Device, which provides dedicated advanced imaging tools for diagnostic reading. These tools can be called up using standard interfaces any native/syngo based viewing applications (hosting applications) that is part of the SYNGO medical device portfolio. These tools help prepare and process the medical image for evaluation, manipulation and communication of clinical data that was acquired by medical imaging modalities (e.g., MR, CT etc.)

Deployment Scenario: Syngo Carbon Clinicals is a plug-in that can be added to any SYNGO based hosting applications (for example: Syngo Carbon Space, syngo.via etc…). The hosting application (native/syngo Platform-based software) is not described within this 510k submission. The hosting device decides which tools are used from Syngo Carbon Clinicals. The hosting device does not need to host all tools from the Syngo Carbon Clinicals, a desired subset of the provided tools can be used. The same can be enabled or disabled thru licenses.

When preparing the radiologist's reading workflow on a dedicated workplace or workstation, Syngo Carbon Clinicals can be called to generate additional results or renderings according to the user needs using the tools available.

This document describes performance evaluation for two specific tools within Syngo Carbon Clinicals (VA41): OrthoMatic Spine and TimeLens.

1. Table of Acceptance Criteria and Reported Device Performance

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

• OrthoMatic Spine:

  • Test Set Sample Size: 150 spine X-ray images (75 frontal views, 75 lateral views) were used in a reader study.
  • Data Provenance: The document states that the main dataset for training includes data from USA, Germany, Ukraine, Austria, and Canada. While this specifies the training data provenance, the provenance of the specific 150 images used for the reader study (test set) is not explicitly segregated or stated here. The study involved US board-certified radiologists, implying the test set images are relevant to US clinical practice.
  • Retrospective/Prospective: Not explicitly stated, but the description of "collected" images and patients with various spinal conditions suggests a retrospective collection of existing exams.

• TimeLens: No specific test set details are provided as a reader study/bench test was not required.

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

• OrthoMatic Spine:

  • Number of Experts: Five US board-certified radiologists.
  • Qualifications: US board-certified radiologists. No specific years of experience are mentioned.
  • Ground Truth for Reader Study: The "mean values obtained from the radiologists' assessments" for the 150 spine X-ray images served as the reference for comparison against the algorithm's output.

• TimeLens: Not applicable, as no reader study was conducted.

4. Adjudication Method for the Test Set

• OrthoMatic Spine: The algorithm's output was assessed against the mean values obtained from the five radiologists' assessments. This implies a form of consensus or average from multiple readers rather than a strict 2+1 or 3+1 adjudication.
• TimeLens: Not applicable.

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

• OrthoMatic Spine: A reader study was performed, which is a type of MRMC study. However, this was a standalone performance evaluation of the algorithm against human reader consensus, not a comparative effectiveness study with and without AI assistance for human readers. Therefore, there is no reported "effect size of how much human readers improve with AI vs without AI assistance." The study aimed to show the algorithm replicates average human rater performance.
• TimeLens: Not applicable.

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

• OrthoMatic Spine: Yes, a standalone performance evaluation of the OrthoMatic Spine algorithm (without human-in-the-loop assistance) was conducted. The algorithm's measurements were compared against the mean values derived from five human radiologists.
• TimeLens: The description suggests the TimeLens tool itself is a "simple workflow enhancement algorithm" and its performance was evaluated through non-clinical verification and validation activities rather than a specific standalone clinical study with an AI algorithm providing measurements.

7. The Type of Ground Truth Used (expert consensus, pathology, outcomes data, etc.)

• OrthoMatic Spine:
  • For the reader study (test set performance evaluation): Expert consensus (mean of five US board-certified radiologists' measurements) was used to assess the algorithm's performance.
  • For the training set: The initial annotations were performed by trained non-radiologists and then reviewed by board-certified radiologists. This can be considered a form of expert-verified annotation.
• TimeLens: Not specified, as no clinical ground truth assessment was required.

8. The Sample Size for the Training Set

• OrthoMatic Spine:
  • Number of Individual Patients (Training Data): 6,135 unique patients.
  • Number of Images (Training Data): A total of 23,464 images were collected within the entire dataset, which was split 60% for training, 20% for validation, and 20% for model selection. Therefore, the training set would comprise approximately 60% of both the patient count and image count. So, roughly 3,681 patients and 14,078 images.
• TimeLens: Not specified.

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

• OrthoMatic Spine: Most images in the dataset (used for training, validation, and model selection) were annotated using a dedicated annotation tool (Darwin, V7 Labs) by a US-based medical data labeling company (Cogito Tech LLC). Initial annotations were performed by trained non-radiologists and subsequently reviewed by board-certified radiologists. This process was guided by written guidelines and automated workflows to ensure quality and consistency, with annotations including vertebral landmarks and key vertebrae (C7, L1, S1).
• TimeLens: Not specified.

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The Single-use Fine Needle Biopsy (FNB) device NA-U210H has been designed to be used with an ultrasound endoscope for sampling of submucosal and extramural lesions within or adjacent the gastrointestinal tract.

The Single-Use Fine Needle Biopsy (FNB) Device NA-U210H (SecureFlex) is a sterile, single-use fine needle biopsy device intended for use with an ultrasound endoscope to sample submucosal and extramural lesions within or adjacent to the gastrointestinal tract. It consists of:

• Biopsy Needle Assembly: Handle, needle (19G, 22G, or 25G), and coiled sheath.
• Aspiration System: VACLOK syringe and stopcock (FDA-cleared under K994253).

The device features a bifurcated needle tip for enhanced tissue acquisition, echo-enhanced regions for ultrasound visibility, and is compatible with Olympus GF and TGF endoscopes with ≥2.8 mm channel diameter.

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