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510(k) Data Aggregation

    K Number
    K240364
    Date Cleared
    2024-10-16

    (253 days)

    Product Code
    Regulation Number
    884.4530
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    RELIEEV Uterine Manipulator Injector (CUMI 5.0)

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

    Use of the RELIEEV Uterine Manipulator Injector is indicated in Diagnostic Laparoscopy, Minilaparotomy, Fertility Exams, and Salpingoplasty procedures where manipulation of the uterus is required.

    Device Description

    The "RELIEEV" Uterine Manipulator Injector is intended to be used during medical procedures where manipulation of the uterus or injection of fluids into the uterine lumen are needed. This device is a sterile, single use product consisting of a plastic (PVC) insertion tube that includes two lumens, one for inflation of a 10 mL intrauterine balloon (cuff) at the distal end of the insertion tube via the inflation valve using the provided 10 mL syringe and the other for injection of fluid through a distal end-port using a user-provided syringe via the Leur fitting. The device also includes a movable/removable rigid handle that allows alteration of the device insertion depth and includes a cervical stop, laser etched depth markings to aid in setting the insertion depth, and a pilot balloon to assess maintenance of cuff inflation. The device is curved to facilitate forward uterine manipulation. The device has an overall length of 36 cm and an outer diameter of the catheter component of 5.0 mm. When inflated with 10 mL of air, the balloon has a diameter of 23.0-24.9 mm.

    AI/ML Overview

    This document is an FDA 510(k) summary for the "RELIEEV" Uterine Manipulator Injector. It describes the device and claims substantial equivalence to a predicate device, the Panpac Uterine Manipulator Injector, Model Umi 4.5 (K092980).

    Based on the provided text, the device in question is a medical instrument, not an AI/software device. Therefore, the questions related to AI/software performance, ground truth, human readers, and training/test sets are not applicable to this document.

    The acceptance criteria and study proving the device meets them are related to the physical and biological safety and performance of the Uterine Manipulator Injector, rather than an AI algorithm.

    Here's the information extracted from the document, tailored to the type of device described:


    Acceptance Criteria and Device Performance for "RELIEEV" Uterine Manipulator Injector

    This device is a physical medical instrument, and its performance evaluation focuses on its physical characteristics, sterility, biocompatibility, and mechanical integrity, comparing it to a legally marketed predicate device.

    1. Table of Acceptance Criteria and Reported Device Performance

    The document details various tests performed to ensure the device meets safety and performance standards for a physical medical device. The "acceptance criteria" are implied by the successful completion of these tests per the referenced standards and the statement that "all predetermined acceptance criteria were met."

    Area of PerformanceSpecific Test/EvaluationAcceptance Criteria (Implied by standard and successful outcome)Reported Device Performance
    SterilizationEO sterilization validationConformance to ISO 11135-1:2014 & ISO 10993-7:2008 for residual EtOMet (testing performed)
    PackagingVisual inspectionConformance to ASTM F1886/F1886M-16Met (testing performed)
    Seal Strength testingConformance to ASTM F88/F88M-23Met (testing performed)
    Dye Penetration testConformance to ASTM F1929-15Met (testing performed)
    TransportationTransportation Simulation testingConformance to ASTM D4169-23Met (testing performed)
    BiocompatibilityCytotoxicityNon-cytotoxic per ISO 10993-5:2009Non-cytotoxic
    SensitizationNon-sensitizing per ISO 10993-10:2021Non-sensitizing
    IrritationNon-irritating per ISO 10993-23:2021Non-irritating
    Acute Systemic ToxicityNon-systemically toxic per ISO 10993-11:2017Non-systemically toxic
    Material Mediated PyrogenicityNon-pyrogenic per USPNon-pyrogenic
    Bench Performance (after accelerated aging)Dimensional specificationsMet pre-determined criteriaAll "predetermined acceptance criteria were met"
    Bend test (Force to tip deflection)Met pre-determined criteriaAll "predetermined acceptance criteria were met"
    Cuff Burst TestMet pre-determined criteriaAll "predetermined acceptance criteria were met"
    Tensile strength testing (all joints/connections)Met pre-determined criteriaAll "predetermined acceptance criteria were met"
    Repeated cuff inflationMet pre-determined criteriaAll "predetermined acceptance criteria were met"
    Prolonged inflationMet pre-determined criteriaAll "predetermined acceptance criteria were met"
    Insertion depth marker integrity testingMet pre-determined criteriaAll "predetermined acceptance criteria were met"
    Handle locking mechanism testing (force to move from set position)Met pre-determined criteriaAll "predetermined acceptance criteria were met"

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

    The document does not explicitly state the sample sizes for the various tests. It refers to established testing standards (e.g., ISO, ASTM, USP), which would specify appropriate sample sizes for each test type. The data provenance is from bench testing and laboratory evaluations conducted by the manufacturer (LI Medical Corporation LTD.) to support regulatory submission. This is a prospective assessment of newly manufactured devices under controlled conditions.

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

    This concept is not applicable to the assessment of a physical medical device like a uterine manipulator. "Ground truth" in this context refers to the defined acceptable parameters for physical and biological performance, which are established by international standards and regulatory guidelines, not by individual experts evaluating images or clinical data.

    4. Adjudication Method for the Test Set

    Not applicable for a physical medical device. Performance is judged against specified engineering, material, and biological safety standards, not through adjudication of expert opinions.

    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

    Not applicable, as this is not an AI/software device.

    6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

    Not applicable, as this is not an AI/software device.

    7. The Type of Ground Truth Used

    The "ground truth" for this device's performance is based on established industry standards and regulatory requirements for medical device safety and efficacy. This includes:

    • Physical and mechanical properties (e.g., dimensions, tensile strength, inflation capabilities).
    • Sterility assurance (e.g., EtO residuals).
    • Biocompatibility (e.g., cytotoxicity, sensitization, irritation, systemic toxicity, pyrogenicity).
    • Packaging integrity.

    These are quantitative metrics or pass/fail criteria derived from validated test methods.

    8. The Sample Size for the Training Set

    Not applicable, as this is not an AI/software device. There is no "training set" in the context of a physical medical device's performance validation; rather, there are samples tested according to predefined standards.

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

    Not applicable, as this is not an AI/software device.

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    K Number
    K092980
    Date Cleared
    2010-03-11

    (164 days)

    Product Code
    Regulation Number
    884.4530
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Device Name :

    PANPAC UTERINE MANIPULATOR INJECTOR, MODEL UMI 4.5

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

    This Utenine Manipulator Injector (Model UMI-4,5) is indicated for use in Diagnostic Laparotomy, Minilaparotomy, Fertility, Examinations, and Salpingoplastic procedures where manification of the uterus is required. This product also facilitates, the sealing of cervical os while providing a fluid injection port.

    Device Description

    Panpac Uterine Manipulator Injector, Model UMI-4.5

    AI/ML Overview

    I apologize, but the provided text focuses on an FDA clearance letter for a medical device called the "Panpac Uterine Manipulator Injector (Model UMI - 4.5)". This type of document is a regulatory approval, not a scientific study report.

    Therefore, the information required to populate a table of acceptance criteria, device performance, and details about a study with sample sizes, expert qualifications, adjudication methods, or ground truth types is not present in the provided text.

    The document confirms that the device is "substantially equivalent" to legally marketed predicate devices, which is a regulatory standard, not a performance metric from a specific study as you've requested. It primarily deals with the administrative aspects of FDA clearance.

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    K Number
    K010296
    Date Cleared
    2001-04-11

    (70 days)

    Product Code
    Regulation Number
    884.4530
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Device Name :

    UTERINE MANIPULATOR INJECTOR CANNULA, MODEL R57-450

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use
    Device Description
    AI/ML Overview
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    K Number
    K010056
    Date Cleared
    2001-02-01

    (24 days)

    Product Code
    Regulation Number
    884.4530
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Device Name :

    UTERINE MANIPULATOR INJECTOR CANNULA, STERILE, MODEL R 57-450

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use
    Device Description
    AI/ML Overview
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    K Number
    K974357
    Date Cleared
    1998-02-02

    (75 days)

    Product Code
    Regulation Number
    884.4530
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Device Name :

    UTERINE MANIPULATOR/INJECTOR

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

    To be used during diagnostic laparoscopy, minilaparotomy, fertility examinations, and salpingoplasty.

    Device Description

    Uterine Manipulator / Injector

    AI/ML Overview

    The provided text is a 510(k) clearance letter from the FDA for a Uterine Manipulator/Injector, dated February 2, 1998. It does not contain information about the acceptance criteria or a study proving the device meets acceptance criteria as typically found in submissions for AI/ML-based medical devices.

    The document pertains to a physical medical device (Uterine Manipulator/Injector) cleared through the 510(k) pathway, indicating substantial equivalence to a predicate device. This pathway generally relies on demonstrating that the new device is as safe and effective as a legally marketed predicate device, rather than requiring extensive clinical trials with acceptance criteria thresholds for performance metrics like sensitivity, specificity, or AUC as seen in AI/ML device submissions.

    Therefore, I cannot provide the requested information because it is not present in the provided text. The questions posed in your prompt (e.g., sample size for test/training sets, number of experts, adjudication methods, MRMC studies, standalone performance, ground truth types) are relevant to the evaluation of AI/ML-based devices and are not applicable to the traditional medical device clearance described in this document.

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