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510(k) Data Aggregation

    K Number
    K161656
    Manufacturer
    Date Cleared
    2016-09-01

    (77 days)

    Product Code
    Regulation Number
    874.4680
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The aScope 3 endoscopes have been designed to be used with the aView monitor, endotherapy accessories and other ancillary equipment for endoscopy with the airways and tracheobronchial tree.

    The aScope 3 system is for use in a hospital environment.

    The aScope 3 is a single-use device designed for use in adults. It has been clinically evaluated for the following minimum endotracheal tubes (ETT) and double lumen tubes (DLT) sizes:

    Minimum ETT inner diameterMinimum DLT size
    aScope 3 Slim 3.8/1.25.0 mm37 Fr
    aScope 3 Regular 5.0/2.26.0 mm41 Fr
    aScope 3 Large 5.8/2.87.0 mm-

    Endoscopic accessories designed for a minimum working channel width up to 1.2 mm can be used with the aScope 3 Slim 3.8/1.2.

    Endoscopic accessories designed for a minimum working channel width up to 2.0 mm can be used with the aScope 3 Regular 5.0/2.2.

    Endoscopic accessories designed for a minimum working channel width up to 2.6 mm can be used with the aScope 3 Large 5.8/2.8.

    Device Description

    The Ambu® aScope™ 3 System consists of:
    Ambu® aScope™ 3 Regular 5.0/2.2
    Ambu® aScope™ 3 Slim 3.8/1.2
    Ambu® aScope™ 3 Large 5.8/2.8
    Ambu® aView™ Monitor

    Ambu® aScope™ 3 is a sterile single use flexible bronchoscope and Ambu® aView™ is a reusable monitor.

    Ambu® aScope™ 3 endoscopes has the following physical and performance characteristics:
    Maneuverable tip controlled by the user
    Flexible insertion cord
    Camera and LED light source at the distal tip
    Working channel
    Sterilized by Ethylene Oxide
    For single use

    The differences between the Ambu® aScope™ 3 endoscope sizes are as follows:
    Distal end outer diameter
    Insertion tube outer diameter
    Working channel inner diameter
    Angulation range

    Ambu® aView™ Monitor has the following physical and performance characteristics:
    Displays the image from Ambu® aScope™ 3 endoscope on the screen.
    Can record snapshots or video of image from Ambu® aScope™ 3 endoscope.
    Can connect to an external monitor.
    Reusable device

    AI/ML Overview

    The provided document is a 510(k) summary for the Ambu® aScope™ 3 System, which includes flexible bronchoscopes and an associated monitor. It describes the device, its intended use, and a comparison to predicate devices, along with performance data.

    However, the document states "Performance Data - Clinical: Not applicable." and focuses primarily on bench testing for the product line extension (Ambu® aScope™ 3 Large). This means that a clinical study to prove device performance in the context of patient outcomes or diagnostic accuracy in a clinical setting, or involving human readers and AI assistance, was not required or provided for this particular submission.

    Therefore, many of the requested elements for a study proving acceptance criteria cannot be extracted from this document, as they relate to clinical performance and AI algorithm evaluation, which are not detailed here.

    Here's what can be extracted based on the provided text:

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

    The document primarily details bench testing for the "Ambu® aScope™ 3 Large" product line extension. Acceptance criteria are implied by the successful completion of these tests.

    Acceptance Criteria (Implied by passed tests)Reported Device Performance (Ambu® aScope™ 3 Large)
    Compliance with ISO 8600-1, -3, -4, and ISO 594-1Declaration of Conformity maintained
    Acceptable Bending Angle PerformanceTests passed
    Acceptable Bending Section EnduranceTests passed
    Acceptable Aging PerformanceTests passed
    Acceptable Sterile Packaging IntegrityTests passed
    Electrical Compatibility with IEC 60601-1-2Tests passed
    Electrical Safety with IEC 60601-1 and IEC 60601-2-18Tests passed

    2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

    The document does not detail specific sample sizes for each bench test. It mentions "Performance tests to document the properties" and "Aging Performance Test", but not the number of units tested. This data is from bench testing, not human or clinical data. The submitter is Ambu A/S, based in Denmark.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

    Not applicable. The ground truth for bench tests would be defined by engineering specifications and objective measurements, not expert human assessment in a clinical context.

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

    Not applicable. This type of adjudication method is used for clinical data interpretation or image annotation, not for bench testing of device specifications.

    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. The document explicitly states "Performance Data - Clinical: Not applicable," and this submission does not involve clinical performance evaluation or AI capabilities.

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

    No. This device is a medical instrument (bronchoscope and monitor), not an AI algorithm.

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

    For the bench tests, the ground truth would be established by engineering standards, material specifications, and objective measurement tools. For example, a bending angle would be measured against a defined specification, not an expert's opinion.

    8. The sample size for the training set

    Not applicable. This document describes a medical device (endoscope and monitor), not an AI algorithm that requires a training set.

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

    Not applicable, as there is no training set for an AI algorithm discussed in this document.

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