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510(k) Data Aggregation

    Why did this record match?
    Reference Devices :

    EPK-i5010 (K122470), EPK-i7010 (K150618), HI VISION Preirus (K093466), ARIETTA 70 (K134016)

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

    The PENTAX Medical EG-J10U Endoscopic Ultrasound System is intended to provide optical visualization of, ultrasonic visualization of, and therapeutic access to, the Upper Gastrointestinal Tract including but not restricted to the organs, tissues, and subsystems: Esophagus, Stomach, Duodenum and underlying areas. The instrument is introduced per orally when indications consistent with the requirement for procedure are observed in adult and pediatric patient populations.

    Device Description

    The EG34-J10U, EG36-J10UR and EG38-J10UT Ultrasound Upper GI Video Scopes, are endoscopes used to provide visualization of, and therapeutic access to, the upper gastrointestinal tract. They are used with cleared Pentax Video Processors (a softwarecontrolled device) and cleared Hitachi Ultrasound Scanners (a software-controlled device). The endoscopes have a flexible insertion tube, a control body, PVE umbilical connector, and ultrasound scanner umbilical connector. The PVE umbilical connector will be attached to the Video Processor and has connections for illumination, video signals, air/ water/ and suction. The ultrasound scanner umbilical connector will be attached to the ultrasound scanner unit. A sterile, single use disposable natural rubber latex balloon is fitted over the convex array ultrasound transducer prior to the procedure. During an ultrasound endoscopy procedure, the latex balloon is inflated with water. The water that is contained within the balloon creates a water field that covers the transducer. The water field enables more effectively transport of ultrasonic pulses from the ultrasound transducer to the target anatomical site and back to the ultrasound transducer. The control body includes controls for up/ down/ left/ right angulation, air/ water delivery, and an accessory inlet port. The endoscope contains light carrying bundles to illuminate the body cavity, a charge couple device (CCD) to collect endoscopic image data, and a linear or radial array ultrasound transducer to collect ultrasonic image data. The instrument contains a working channel through which biopsy devices, or other devices, may be introduced.

    AI/ML Overview

    The provided text is a 510(k) premarket notification for the PENTAX Medical EG-J10U Endoscopic Ultrasound System. This document focuses on demonstrating substantial equivalence to a predicate device rather than presenting a detailed study proving the device meets specific acceptance criteria in the context of an AI/ML medical device.

    Therefore, many of the requested details, such as sample sizes for test sets, data provenance, number of experts for ground truth, adjudication methods, MRMC studies, standalone algorithm performance, and training set information (which are typical for AI/ML device submissions), are not present in this document.

    The document primarily addresses hardware, software, and reprocessing aspects of the endoscopic ultrasound system. The "performance data" mentioned refers to non-clinical testing for functionality, safety, human factors, reprocessing validation, sterilization, shelf life, software verification/validation, EMC, electrical safety, and optical testing, rather than clinical performance metrics for a diagnostic or AI/ML algorithm.

    Here's an attempt to answer the questions based on the available information, noting significant gaps:

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

    The document describes performance testing in general terms rather than specific quantifiable acceptance criteria with corresponding results in a table format. It states that the system "has been successfully tested for its functions, performance and safety as per FDA recognized consensus standards." For optical testing, it notes "All results show that there are no differences between the subject device, and the predicate device."

    Acceptance Criteria (Inferred/General)Reported Device Performance (Summary)
    Functions, Performance & SafetySuccessfully tested as per FDA recognized consensus standards.
    Human Factors (Reprocessing)Study conducted to assess reprocessing staff's ability to carry out rIFU. Device found safe and effective for intended patients, users, and use environments.
    Reprocessing ValidationSimulated use testing, soil accumulation analysis, cleaning, and high-level disinfection validation studies conducted; confirmed effectiveness of reprocessing procedures for EG34-J10U, EG36-J10UR, and EG38-J10UT scopes.
    Sterilization & Shelf LifeSystem 1E liquid chemical sterilization validated for EG-J10U scopes. Gamma Ray Sterilization validated for packaging and natural rubber latex balloons; 2-year shelf-life verified for balloons. (Devices not provided sterile.) Warning for natural rubber latex included in labeling.
    Software Verification & ValidationTests conducted; documentation provided as recommended by FDA guidance. Software classified as CLASS A (IEC 62304:2006) with "Moderate" level of concern (FDA Guidance). Cybersecurity risks assessed and mitigated according to FDA guidances (Oct 2014, Dec 2016).
    EMC & Electrical SafetyAcceptable level confirmed by IEC 60601-1-2:2007, IEC 60601-1:2005+A1:2012, IEC 60601-2-18:2009, and IEC 60601-2-37:2007.
    Optical PropertiesMeasured for EG34-J10U, EG36-J10UR, and EG38-J10UT with EPK-i5010 and EPK-i7010 video processors (including signal to noise ratio, spatial resolution (MTF), distortion, light distribution, color (IEEE), spectral distribution, and photobiological safety). All results showed no differences between the subject device and the predicate device.

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

    • Sample Size: Not specified in the document for any of the non-clinical tests.
    • Data Provenance: Not specified. The tests are described as being conducted "as a part of Design Verification and Validation" and for "support of the substantial equivalence determination," implying internal company testing rather than clinical trials.

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

    • Not applicable / Not specified. This document describes a medical device, not an AI/ML algorithm that requires expert ground truth for diagnostic accuracy. The "human factors" study involved reprocessing staff, not clinical experts establishing ground truth for diagnostic images.

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

    • Not applicable / Not specified. No adjudication method is mentioned as it's not a diagnostic AI/ML study.

    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. This is not an AI-assisted device. The document does not describe any MRMC studies or human reader improvement with AI assistance.

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

    • Not applicable. This is not an AI/ML algorithm. The device is a physical endoscope with associated control software.

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

    • Not applicable. The "ground truth" for this device's performance testing would be engineering specifications, industry standards (e.g., IEC standards for electrical safety), and validated reprocessing protocols, rather than clinical ground truth for disease states.

    8. The sample size for the training set:

    • Not applicable. This document describes a medical device, not an AI/ML algorithm requiring a training set.

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

    • Not applicable. As above, no training set for an AI/ML algorithm is described.
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    K Number
    K183516
    Date Cleared
    2019-09-06

    (262 days)

    Product Code
    Regulation Number
    874.4680
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    ™ Diagnostic Ultrasound Scanner (K142368), Hitachi HI VISION Preirus Diagnostic Ultrasound Scanner (K093466

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

    The PENTAX Medical Ultrasound Video Bronchoscope EB19-J10U is intended to provide optical visualization of, ultrasonic visualization of, and therapeutic access to, the Pulmonary Track including but not restricted to organs, tissues, and subsystem: Nasal Passage, Pharynx, Larynx, Trachea, Bronchial Tree (including access beyond the stem), and underlying areas. The instrument is introduced per orally when indications consistent with the requirement for procedure are observed in adult and pediatric patient populations.

    Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows.
    Clinical Application: Endoscopy
    Mode of Operation: B, M, PWD, Color Doppler, Amplitude Doppler

    Device Description

    The PENTAX Medical Ultrasound Video Bronchoscope EB19-J10U connects with a video processor and an ultrasound scanner, both of which are software controlled devices.

    The endoscope has a flexible insertion tube, a control body, PVE connector, and scanning unit connector. The PVE connector attaches to the video processor and has connections for illumination and video signals. The ultrasound umbilical connector attaches to the ultrasound scanner unit.

    The control body includes remote buttons for functions assigned from the video processor. It also includes controls for up/down angulation or neutral position, suction control, and ports for manual balloon insufflation/evacuation and accessory inlet.

    The endoscope contains light carrying bundles to illuminate the body cavity, a change couple device to collect endoscopic image data, and a convex array ultrasound transducer to collect ultrasonic image data. The instrument contains a working channel through which biopsy devices, or other devices may be introduced. The video processor contains a lamp that provides white light focused at the endoscope PVE connector light guide prong. The endoscope light carrying bundles present the light to the body cavity and the CCD collects endoscopic image data. Image data and other screen display information are formatted and presented to the video outputs of the video processor for display.

    The ultrasound transducer delivers ultrasonic pulses, reflections of the pulses are received and the signals are passed to the ultrasound scanner for processing and display. The instrument is immersible (with the use of supplied cleaning accessories). EB19-J10U is connected to the ultrasound scanners Arietta 70 and Noblus via the scanning unit connector of the endoscope directly to the probe connector of the scanning unit. In order to connect to the Preirus scanning unit, junction box PUN-JBP1 is required to connect the scanning unit connector to the probe connector.

    The instrument is immersible (with the use of supplied cleaning accessories).

    AI/ML Overview

    The provided text is a 510(k) Summary for the PENTAX Medical Ultrasound Video Bronchoscope EB19-J10U. It details the device's technical specifications, intended use, and a summary of testing conducted to demonstrate substantial equivalence to predicate devices. However, it does not contain any information about a study proving that the device meets specific acceptance criteria based on performance metrics like sensitivity, specificity, accuracy, or reader performance with or without AI assistance.

    The document focuses on non-clinical testing to demonstrate that the device is equivalent to a legally marketed predicate device, especially regarding safety and effectiveness from a design and manufacturing perspective. It mentions "Performance Testing - Bench" for "System compatibility" and "Optical characteristics," but does not provide specific acceptance criteria or quantitative results for these tests.

    Therefore, I cannot fully answer your request for acceptance criteria and a study that proves the device meets them, as the provided text does not include the necessary information regarding a clinical performance study involving AI, human readers, or specific diagnostic performance metrics.

    Here's an breakdown of what can and cannot be answered based on the provided text:

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

    • Cannot be provided. The document lists various types of non-clinical testing (Sterilization, Reprocessing, Biocompatibility, Software, EMC + Electrical Safety, System Compatibility, Optical Characteristics), and states that "Testing results confirm the subject device is safe and effective as the predicate device, and performs as intended." However, it does not provide specific quantitative acceptance criteria or detailed numerical results for these tests. For example, it says "The subject device demonstrates equivalent or better optical characteristics than the predicate device," but gives no numerical value for either.

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

    • Cannot be provided definitively for a performance study. The document outlines non-clinical bench testing. These tests typically don't involve "samples" in the same way clinical studies do (e.g., patient data). The data provenance (country of origin, retrospective/prospective) is not applicable or mentioned for the types of tests described.

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

    • Not applicable. This information is relevant for studies establishing diagnostic ground truth, often used for AI/clinical performance evaluations. The document describes engineering and safety testing, not clinical diagnostic performance.

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

    • Not applicable. Adjudication methods are used in clinical studies to resolve discrepancies in expert interpretations for ground truth establishment. This document doesn't describe such a study.

    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, such a study was not done according to this document. This device is a bronchoscope, which is a physical instrument for visualization and access, not an AI software intended to assist human readers in image interpretation. The document does not mention any AI component or any MRMC studies.

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

    • No, this is not an AI algorithm. This is a hardware device (bronchoscope) with associated software for its operation. Therefore, a standalone algorithm performance study is not applicable.

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

    • Not applicable in the context of diagnostic performance. The "ground truth" for the tests described relates to engineering specifications and safety standards (e.g., whether the device sterilizes correctly, whether electrical current is within safe limits, whether optical clarity meets design specs).

    8. The sample size for the training set:

    • Not applicable. There is no mention of a "training set" as this is not an AI device being trained.

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

    • Not applicable. (See point 8).

    In summary, the provided FDA 510(k) summary focuses on demonstrating the substantial equivalence of a medical device (a bronchoscope) through non-clinical testing of its physical, electrical, and reprocessing characteristics. It does not involve AI or diagnostic performance studies that would require the types of acceptance criteria and study details you requested for AI-driven devices.

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    Why did this record match?
    Reference Devices :

    K122470, K093466

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

    The PENTAX Medical Endoscopic Ultrasound System is intended to provide optical visualization of, ultrasonic visualization of, and therapeutic access to, the Upper Gastrointestinal Track including but not restricted to the organs, tissues, and subsystems: Esophagus, Stomach, Duodenum, Small Bowel, and underlying areas. The instrument is introduced per orally when indications consistent with the requirement for procedure are observed in adult and pediatric patient populations.

    Device Description

    The EG-3270UK, Ultrasound Upper GI Video Scope, is an endoscope used to provide visualization of, and therapeutic access to, the upper gastrointestinal tract. It is used with cleared Pentax Video processors (a software controlled device) and cleared Hitachi Ultrasound Scanner (a software controlled device). The endoscope has a flexible insertion tube, a control body, PVE umbilical connector, and ultrasound scanner umbilical connector. The PVE umbilical connector will be attached to the Video Processor and has connections for illumination, video signals, air/ water/ and suction. The ultrasound scanner umbilical connector will be attached to the ultrasound scanner unit. A sterile, single use disposable latex balloon is fitted over the convex array ultrasound transducer prior to the procedure. During an ultrasound endoscopy procedure, the latex balloon is inflated with water. The water that is contained within the balloon creates a water field that covers the transducer. The water field enables more effectively transport of ultrasonic pulses from the ultrasound transducer to the target anatomical site and back to the ultrasound transducer. The control body includes controls for up/ down/ left/ right angulation, air/ water delivery, and an accessory inlet port. The endoscope contains light carrying bundles to illuminate the body cavity, a charge couple device (CCD) to collect endoscopic image data, and a linear array ultrasound transducer to collect ultrasonic image data. The instrument contains a working channel through which biopsy devices, or other devices, may be introduced. The video processor contains a lamp that provides white light and is focused at the PVE connector light guide prong. The endoscope light carrying bundles present the light to the body cavity and the CCD collects endoscopic image data. Image data and other screen display information are formatted and presented to the video outputs of the video processor for display. The ultrasound transducer delivers ultrasonic pulses, reflections of the pulses are received and the signals are passed to the ultrasound scanner for processing and display. The instrument is immersable (with the use of supplied cleaning accessories) except for the ultrasound scanner connector (as described in the endoscope operator manual cleaning instructions)

    AI/ML Overview

    The provided text is a 510(k) summary for the PENTAX Medical Endoscopic Ultrasound System. It describes the device, its intended use, and a comparison to a predicate device, along with performance data to support substantial equivalence.

    However, the provided document does not contain information about:

    • A table of acceptance criteria and reported device performance for a specific clinical study.
    • Sample sizes used for test sets or their data provenance (country, retrospective/prospective).
    • Number of experts used or their qualifications for establishing ground truth.
    • Adjudication methods.
    • Multi-reader multi-case (MRMC) comparative effectiveness studies or effect sizes for AI assistance.
    • Standalone algorithm performance studies.
    • Type of ground truth used (expert consensus, pathology, outcomes data, etc.) for a specific clinical evaluation.
    • Sample size for a training set or how its ground truth was established.

    The document primarily focuses on engineering and regulatory performance data, such as biocompatibility, reprocessing validation, electrical safety, software verification, and acoustic output measurements, to demonstrate that the device is as safe and effective as a legally marketed predicate device. These are not clinical performance parameters that would typically be described with the detailed acceptance criteria and study design requested in the prompt.

    Therefore, I cannot fulfill the request for a table of acceptance criteria, device performance, and details about a clinical study based on the provided text. The document refers to various standards and guidance documents (e.g., ISO 10993, IEC 60601, FDA Guidance for Software and Diagnostic Ultrasound Systems) which set out general performance requirements and testing methodologies, but these are not presented as specific acceptance criteria tied to a clinical performance study as typically understood in the context of an AI/algorithm-based device.

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    K Number
    K153277
    Manufacturer
    Date Cleared
    2016-05-04

    (174 days)

    Product Code
    Regulation Number
    892.1550
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    K142008, K134016, K061961, K093466

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

    Esaote's Model 6200 is a mainframe ultrasound system used to perform diagnostic general ultrasound studies including Cardiac, Transesophageal Cardiac, Peripheral Vascular, Neonatal Cephalic, Adult Cephalic, Small Organs, Musculoskeletal (Conventional and Superficial), Abdominal, Fetal, Transrectal, Pediatric, Intraoperative (Abdominal), Intraoperative (Neurological), Laparoscopic and Other: Urologic. The 6200 system provides imaging for guidance of biopsy and imaging to assist in the placement of needler or other anatomical structures as well as peripheral nerve blocks in Musculoskeletal applications.

    Esaote's Model 6250 is a mainframe ultrasound system used to perform diagnostic general ultrasound studies including Cardiac, Transesophageal Cardiac, Peripheral Vascular, Neonatal Cephalic, Adult Cephalic, Small Organs, Musculoskeletal (Conventional and Superficial), Abdominal, Fetal, Transrectal, Pediatric, Intraoperative (Abdominal), Intraoperative (Neurological), Laparoscopic and Other: Urologic. The 6250 system provides imaging for guidance of biopsy and imaging to assist in the placement of needles in vascular or other anatomical structures as well as peripheral nerve blocks in Musculoskeletal applications.

    The Virtual Navigator software option for Esaote models 6200 and 6250 is intended to support a radiological clinical ultrasound examination (first modality) and follow percutaneous procedures or surgical operations providing additional image information from a second imaging modality (CT, MR, US and PET). The second modality provides additional security in assessing the morphology of the ultrasound image.

    Virtual Navigator can be used in the following application: Abdominal, Gynecological, Musculo-skeletal, Obstetrics, Pediatric, Urologic, Small Organs, Peripheral Vascular and Transcranial for radiological examinations only.

    The second modality image is not intended to be used as a standalone diagnostic image since it represents information of a patient that could not be congruent with the current (actual) patient position and shall therefore always been seen as an additional source of information.

    The Virtual Navigator tracking system should not be used on or around persons with a cardiac pacemaker, and should not be used around life supporting equipment.

    Device Description

    Both 6200 and 6250 models are mainframe ultrasound systems used to perform diagnostic general ultrasound studies. The primary modes of operation are for both systems: B-Mode, Tissue Enhancement Imaging (TEI), M-Mode, Multi View (MView), Doppler (both PW and CW), Color Flow Mapping, Amplitude Doppler (AD), Tissue Velocity Mapping (TVM), 3D and 4D, Elastosonography. Both 6200 and 6250 are equipped with an LCD color display where acquired images and advanced image features are shown.

    The Virtual Navigator is a software option designed to support a radiological clinical ultrasound examination (first modality) and follow a percutaneous procedure providing additional image information from a 2nd imaging modality (CT, MR, US and PET). The user is helped in assessing the patient anatomy by displaying the image generated by the 2nd modality.

    6200 and 6250 Upgrades, defined herein, combine the cleared features of both 6200 and 6250 systems with new capabilities, listed below:

      1. Management of Pulsed Wave (PW) Doppler probe on both 6200 and 6250 Upgrades.
      1. Management of Quality Arterial Stiffness (QAS) on both 6200 and 6250 Upgrades.
      1. Addition of Abdominal, Intraoperative abdominal, Transvaginal, Urology applications in Elastosonography analysis on both 6200 and 6250 Upgrades.
      1. Management of Elastosonography measures on both 6200 and 6250 Upgrades.
      1. Management of STIC (Spatio-Temporal Imaging Correlation) with volumetric Probes on both 6200 and 6250 Upgrades.
      1. Management of Intraoperative (Neuro) application on both 6200 and 6250 Upgrades.

    The 6200 and 6250 Upgrades are manufactured under an ISO 9001:2000 and ISO 13485 certified quality system.

    AI/ML Overview

    This document describes the 510(k) premarket notification for the Esaote S.p.A. 6200 Ultrasound System and 6250 Ultrasound System. It outlines the intended use and technological characteristics of the devices and their upgrades, comparing them to several predicate devices.

    1. Table of Acceptance Criteria and Reported Device Performance

    The document does not specify quantitative acceptance criteria with numerical targets. Instead, it describes "Substantial Equivalence" as the primary acceptance criterion. The device performance is deemed acceptable if it demonstrates substantial equivalence to legally marketed predicate devices for their intended uses and technological characteristics, and if it conforms to relevant safety and performance standards.

    Acceptance Criterion (Implicit)Reported Device Performance (Summary of Equivalence Claims)
    Substantial Equivalence to Predicate Devices for Intended Use: The device (6200 and 6250 Ultrasounds Systems and their upgrades) should perform diagnostic general ultrasound studies for listed clinical applications, including Cardiac, Peripheral Vascular, Abdominal, Fetal, Musculoskeletal, etc., as well as provide imaging for guidance of biopsy and needle placement. The Virtual Navigator software option should support radiological clinical ultrasound examinations using additional image information from a second modality.- Esaote 6200 and 6250 models: Cleared via 510(k) K133905 for diagnostic general ultrasound studies across numerous clinical applications including Cardiac, Transesophageal Cardiac, Peripheral Vascular, Neonatal Cephalic, Adult Cephalic, Small Organs, Musculoskeletal (Conventional and Superficial), Abdominal, Fetal, Transvaginal, Transrectal, Pediatric, Intraoperative (Abdominal), Intraoperative (Neurological), Laparoscopic and Urologic. They also provide imaging for guidance of biopsy and needle placement.

    - Virtual Navigator software option: Intended to support radiological clinical ultrasound exams (first modality) and percutaneous procedures/surgical operations by providing additional image information from CT, MR, US, and PET. Can be used in Abdominal, Gynecological, Musculo-skeletal, Obstetrics, Pediatric, Urologic, Small Organs, Peripheral Vascular, and Transcranial applications for radiological examinations only. (The second modality image is not for standalone diagnostic use).

    - New functionalities (Upgrades):
    - Management of Pulsed Wave (PW) Doppler probe: Equivalent to Esaote 6400 (K142008).
    - Management of Quality Arterial Stiffness (QAS): Equivalent to eTracking feature of Hitachi Aloka Arietta 70 (K134016) and Esaote ART.LAB (K061961).
    - Addition of Abdominal, Intraoperative abdominal, Transvaginal, Urology applications in Elastosonography analysis: Equivalent to Hitachi Aloka Arietta 70 (K134016) and Hitachi Preirus (K093466).
    - Management of Elastosonography measures: Equivalent to Hitachi Aloka Arietta 70 (K134016) and Hitachi Preirus (K093466).
    - Management of STIC (Spatio-Temporal Imaging Correlation) with volumetric Probes: Equivalent to STIC feature of Hitachi Aloka Arietta 70 (K134016).
    - Management of Intraoperative (Neuro) application: Equivalent to Hitachi Aloka Arietta 70 (K134016). |
    | Technological Equivalence to Predicate Devices: The device should employ the same fundamental technological characteristics as its predicate devices. | - Fundamental technological characteristics: The 6200 and 6250 Upgrades employ the same fundamental technological characteristics as their predicate devices (Esaote 6200/6250, Esaote 6400, Esaote ART.LAB, Hitachi Preirus, Hitachi Aloka Arietta 70).

    - Modes of operation: Both systems use B-Mode, TEI, M-Mode, MView, Doppler (PW and CW), Color Flow Mapping, Amplitude Doppler (AD), TVM, 3D and 4D, Elastosonography.

    - Safety Standards: Esaote 6200 Upgrade, 6250 Upgrade, 6400, Hitachi Aloka Arietta 70 are designed to meet IEC60601-1 and IEC60601-2-37 safety requirements.

    - Acoustic Output: Ultrasound models provide an Acoustic Output Display feature per AIUM / NEMA standards, with equivalent Ispta and MI maximal values. |
    | Conformity to Medical Device Safety Standards: The device should conform to recognized medical device safety standards. | - Non-Clinical Tests: Evaluated for performance, acoustic output, biocompatibility, cleaning and disinfection effectiveness, thermal, electromagnetic, and mechanical safety. Found to conform to:
    - IEC 60601-1
    - IEC 60601-1-2
    - IEC 60601-2-37
    - NEMA UD-3 (Standard for Real Time Display of Thermal and Mechanical Acoustic Output Indices)
    - NEMA UD-2 (Acoustic Output Measurement Standard) |

    2. Sample size used for the test set and the data provenance:
    The document does not provide any details on a specific "test set" in the context of clinical performance data. The device's substantial equivalence is primarily based on technological comparisons to predicate devices and adherence to recognized standards.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:
    Not applicable, as no clinical test set with corresponding ground truth established by experts is mentioned.

    4. Adjudication method (e.g., 2+1, 3+1, none) for the test set:
    Not applicable, as no clinical test set requiring adjudication is mentioned.

    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. This is a submission for an ultrasound system and its software options, not an AI-assisted diagnostic device that would typically undergo MRMC studies to evaluate reader performance improvement with AI. The Virtual Navigator software supports radiological clinical ultrasound but is explicitly stated as "not intended to be used as a standalone diagnostic image."

    6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done:
    Not applicable for this type of device and software functionality as described. The Virtual Navigator is an aid to a radiological clinical ultrasound examination, implying human-in-the-loop use, but it does not perform standalone diagnostics.

    7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):
    Not applicable, as no clinical performance study requiring a defined ground truth is mentioned. The submission focuses on demonstrating substantial equivalence based on technological characteristics and adherence to existing standards.

    8. The sample size for the training set:
    Not applicable, as no AI/machine learning model requiring a training set is explicitly described or evaluated in this regulatory document for establishing substantial equivalence. The document focuses on hardware (ultrasound systems) and software features (Virtual Navigator, QAS, Elastography, STIC) and their equivalence to previously cleared devices.

    9. How the ground truth for the training set was established:
    Not applicable, as no training set is mentioned.

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    K Number
    K130206
    Date Cleared
    2013-03-20

    (51 days)

    Product Code
    Regulation Number
    876.1500
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    K093466, K063518

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

    The EG-3670URK, Ultrasound Video Gastroscope, is intended to provide optical visualization of, ultrasonic visualization of, and therapeutic access to, the Upper Gastrointestinal Track including but not restricted to the organs, tissues, and subsystems: Esophagus, Stomach, Duodenum, Small Bowel, and underlying areas. The instrument is introduced per orally when indications consistent with the requirement for procedure are observed in adult and pediatric patient populations.

    Diagnostic Ultrasound imaging or fluid flow analysis of the human body as follows: Endoscopy with Mode of Operation B, M, PWD, Color Doppler, Amplitude Doppler.

    Device Description

    PENTAX EG-3670URK Ultrasound Video Gastroscope + HI VISION PREIRUS are the endoscopic ultrasound system consists of an ultrasound endoscope with a radial array type ultrasound transducer, video processor, and Hitachi ultrasound scanner. This modified new system configuration is to work together with the already cleared latest Hitachi HI VISION PREIRUS Diagnostic Ultrasound Scanner (K093466).

    AI/ML Overview

    The provided document is a 510(k) summary for a medical device modification. It states that the submission is a "Special 510(k)" for a system configuration change, specifically replacing an older ultrasound scanner (Hitachi HI VISION 900) with a newer one (Hitachi HI VISION PREIRUS) while keeping the same PENTAX EG-3670URK Ultrasound Video Gastroscope.

    Since this is a Special 510(k) for a modification that does not impact intended use, safety, and/or effectiveness, a detailed clinical study proving device performance against acceptance criteria is generally not required in the same way as a new device submission. Instead, the document focuses on demonstrating substantial equivalence to the predicate device and verification and validation of compatibility.

    Therefore, the document does not contain the information requested in your numbered points about acceptance criteria and detailed study results. It primarily focuses on regulatory compliance and the demonstration that the modified system is equivalent to the predicate device.

    Here's a breakdown of what can be inferred or directly stated from the document, and what is explicitly missing:

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

    • Missing. The document does not provide a table of acceptance criteria or specific performance metrics for the device. As a Special 510(k) for a system configuration change, the focus is on maintaining existing performance, not establishing new performance.

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

    • Missing. No information on a test set sample size or data provenance is provided.

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

    • Missing. No information on experts or ground truth for a test set is provided.

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

    • Missing. No information on an adjudication method is provided.

    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:

    • Missing. This device is an Endoscopic Ultrasound system, not an AI-assisted diagnostic tool. Therefore, an MRMC study or AI-related metrics are not applicable and not mentioned.

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

    • Missing. This is not an AI algorithm, but a medical imaging system. Standalone performance as described is not applicable.

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

    • Missing. No information on ground truth type is provided for a performance study.

    8. The sample size for the training set:

    • Missing. No information on a training set sample size is provided. This is not an AI/machine learning device.

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

    • Missing. No information on how ground truth was established for a training set is provided.

    Summary from the document regarding the study and acceptance:

    The central 'study' mentioned in this Special 510(k) is the verification and validation (V&V) activities performed to ensure compatibility between the PENTAX EG-3670URK Ultrasound Video Gastroscope and the HITACHI HI VISION PREIRUS Ultrasound Scanner.

    • Acceptance Criteria (Implied): The implied acceptance criterion for this submission is that the modified system configuration (Gastroscope + HI VISION PREIRUS) performs "as safe, as effective and substantially equivalent in performance to the above identified cleared predicate device/system" (Gastroscope + HI VISION 900). This is a regulatory acceptance criterion for a Special 510(k), not a clinical performance metric.
    • Study/Proof: "The modified system configuration has been verified and validated according to the company's design control activities as certified in this Special 510(K) Submission's declaration of conformity with design control to ensure the compatibility between the PENTAX EG-3670URK Ultrasound Video Gastroscope and the HITACHI HI VISION PREIRUS Ultrasound Scanner."

    In essence, for this specific type of submission, the "proof" is the successful execution of design control activities, including verification and validation, demonstrating that the new component (HI VISION PREIRUS) is compatible with the existing device (EG-3670URK) and that the overall system maintains its previous safety and effectiveness. No new clinical performance data is presented because the fundamental performance characteristics are not expected to change, and the change is limited to swapping one compatible component for another.

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    K Number
    K130247
    Date Cleared
    2013-03-20

    (47 days)

    Product Code
    Regulation Number
    876.1500
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    K093466, K063518

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

    The EG-3870UTK, Ultrasound Video Gastroscope, is intended to provide optical visualization of, ultrasonic visualization of, and therapeutic access to, the Upper Gastrointestinal Track including but not restricted to the organs, tissues, and subsystems: Esophagus, Stomach, Duodenum, Small Bowel, and underlying areas. The instrument is introduced per orally when indications consistent with the requirement for procedure are observed in adult and pediatric patient populations.

    Diagnostic Ultrasound imaging or fluid flow analysis of the human body as follows: Endoscopy

    Device Description

    PENTAX EG-3870UTK Ultrasound Video Gastroscope + HI VISION PREIRUS are the endoscopic ultrasound system consists of an ultrasound endoscope with a curved linear array type ultrasound transducer, video processor, and Hitachi ultrasound scanner. This modified new system configuration is to work together with the already cleared latest Hitachi HI VISION PREIRUS Diagnostic Ultrasound Scanner (K093466).

    AI/ML Overview

    The provided text is a 510(k) summary for a medical device called "PENTAX EG-3870UTK Ultrasound Video Gastroscope (Curved Linear Array Type) + HI VISION PREIRUS". It describes a modification to an already cleared system. This document is a regulatory submission for premarket notification, not a clinical study report detailing acceptance criteria and performance data for a device.

    Therefore, I cannot provide the requested information about acceptance criteria and device performance based on the provided text for the following reasons:

    • This is a Special 510(k) submission for a modification, not a de novo clearance or a typical 510(k) requiring detailed performance data against acceptance criteria. The submission explicitly states: "There are no software or hardware changes between the PENTAX EG-3870UTK Ultrasound Video Gastroscope subject and predicate device in connecting with the new Hitachi HI VISION PREIRUS Diagnostic Ultrasound Scanner. In addition, there are no change in technology, including features, materials, and principles of operation." The modification is simply a change in the ultrasound scanner used with the endoscope.
    • The justification for clearance is "substantial equivalence" to a predicate device, not demonstration of meeting specific performance acceptance criteria through a clinical study. The document states: "The system configuration modification does not impact the intended use, safety and/or effectiveness. The modified system configuration has been verified and validated according to the company's design control activities as certified in this Special 510(K) Submission's declaration of conformity with design control to ensure the compatibility between the PENTAX EG-3870UTK Ultrasound Video Gastroscope and the HITACHI HI VISION PREIRUS Ultrasound Scanner." This implies compatibility testing, not a formal clinical trial with acceptance criteria for diagnostic performance.
    • No clinical study to demonstrate "device performance" in terms of sensitivity, specificity, accuracy, etc., is described. The document focuses on the equivalence of the modified system.

    In summary, the provided document does not contain the information required to populate the requested table and answer the questions about acceptance criteria, study details, sample sizes, ground truth, experts, or comparative effectiveness studies. This type of information is typically found in full clinical study reports, which are usually not part of a Special 510(k) for a system configuration change like this.

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