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510(k) Data Aggregation

    K Number
    K212202
    Manufacturer
    Date Cleared
    2022-04-13

    (273 days)

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

    K181977

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

    WiScope® Digital Cystoscope System is intended to be used by physicians to access, visualize, and perform procedures in the bladder and lower ureter. The instrument enables delivery and use of accessories such as biopsy forceps, laser fibers, graspers and retrieval baskets at a surgical site.

    Device Description

    WiScope® Digital Cystoscope System is designed for physicians to access, visualize, and perform procedures in the bladder and lower ureter for diagnosis and treatment. This system includes a single-use digital cystoscope and an image system OTU-A. The single-use cystoscope is comprised of a control body with articulation controls and accessory access ports, and a flexible insertion tube with an on-tip camera module and LED lighting source.

    AI/ML Overview

    The provided text describes the WiScope® Digital Cystoscope System, which is a medical device. The document is a 510(k) premarket notification summary submitted to the FDA.

    Here's an analysis of the acceptance criteria and the study that proves the device meets them, based on the provided text:

    1. Table of Acceptance Criteria and Reported Device Performance:

    The document lists numerous tests conducted, and for all of them, the result is "All tests were passed" or "All evaluation acceptance criteria were met." Specific numerical acceptance criteria are not detailed in the provided text, but the claim of passing suggests they were defined and met.

    Test ItemAcceptance Criteria/StandardReported Device Performance
    Electrical SafetyIEC 60601-1, IEC 60601-2-18All evaluation acceptance criteria were met.
    Electromagnetic CompatibilityIEC 60601-1-2All evaluation acceptance criteria were met.
    BiocompatibilityISO 10993-1 (Cytotoxicity, Sensitization, Intracutaneous reactivity test)All tests were passed.
    Shelf LifeASTM F1980 (Performance test, Sterile Packaging Integrity)All tests were passed.
    Sterile Barrier SystemsISO 11607-1:2019All tests were passed.
    Sterilization ProcessISO 11135:2014 (SAL 10⁻⁶)The WiScope® Single-Use Digital Flexible Cystoscope is sterile with a determination of lethal rate of the sterilization process to demonstrate achievement of the required SAL of 10⁻⁶.
    Technological Characteristics (Performance Verification)ISO8600, ISO 12233, and performance characteristics relevant to functions as intended (e.g., Appearance, Working length, Bending radius, Channel diameter, Outer diameter, Depth of field, Field of view, Direction of view, Distal Tip Temp, Tensile Force, Resolution, Illumination, Angulation range, Working channel leakage, Waterproof, Flow rate)All tests were passed.
    Noise and Dynamic RangeISO 15739All evaluation acceptance criteria were met.
    Simulated Shipping Distribution (aged devices)ASTM D4169-16All tests were passed.
    Photobiological SafetyIEC 62471:2006All tests were passed.

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

    The document does not specify the sample sizes used for any of the non-clinical tests. It states that "These tests only used to evaluate non-clinical testing of the subject device." There is no mention of country of origin for the data or whether the studies were retrospective or prospective.

    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):

    This information is not applicable to the provided document. The studies described are non-clinical performance and safety tests, not studies requiring expert interpretation of medical images or diagnostic outcomes. Therefore, there is no mention of experts establishing ground truth in this context.

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

    This information is not applicable. As mentioned above, the studies are non-clinical performance and safety tests, not studies involving human interpretation or adjudication of medical results.

    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 MRMC comparative effectiveness study was done. The document explicitly states: "No clinical study is included in this submission." The submission focuses on demonstrating substantial equivalence through non-clinical testing and comparison to a predicate device. The device itself (a cystoscope) is an imaging tool, not an AI-powered diagnostic system that would typically be evaluated for reader improvement.

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

    This information is not applicable. The WiScope® Digital Cystoscope System is described as a physical medical device (an endoscope) for visualization and procedures, not an algorithm or AI system for standalone performance evaluation.

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

    The concept of "ground truth" as it relates to expert consensus or pathology is not applicable to the non-clinical tests described. The ground truth for these tests would be the established scientific standards, specifications, and physical properties specified in the referenced ISO and ASTM standards. For example, for "Working length of the shaft," the ground truth would be the defined manufacturing specification for the length, and the test verifies if the actual device meets that specification.

    8. The sample size for the training set:

    This information is not applicable as there is no mention of an algorithm or AI model requiring a training set in the document.

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

    This information is not applicable for the reason stated in point 8.

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    Why did this record match?
    Reference Devices :

    K181977

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

    WiScope® OM Endoscope System is intended to be used by physicians to access, visualize, and perform procedures in the urinary tract and the kidney.

    WiScope® OM Endoscope System is also intended to be used by physicians through percutaneous insertion to access, visualize, and perform procedures in the pancreaticobiliary system including the hepatic ducts and the common bile duct. The instrument enables delivery and use of accessories such as biopsy forceps, laser fibers, graspers and retrieval baskets at a surgical site.

    Device Description

    WiScope® OM Endoscope System is intended to be used by physicians to access, visualize, and perform procedures in the urinary tract and the kidney, and the pancreaticobiliary system including the hepatic ducts and the common bile duct. The instrument enables delivery and use of accessories such as biopsy forceps, laser fibers, graspers and retrieval baskets at a surgical site.

    This system includes a single-use digital ureteroscope/choledochoscope and an image system.

    WiScope® Single-Use Digital Flexible Ureteroscope/Choledochoscope is a modified version of the currently marketed WiScope Single-Use Digital Flexible Ureteroscope device that widen its application area from urinary system to bile ducts. Other than that, nothing has changed. The image system stays the same.

    AI/ML Overview

    The provided FDA 510(k) summary for the "WiScope OM Endoscope System" focuses on demonstrating substantial equivalence to predicate devices based on technical characteristics and intended use, rather than on performance against specific acceptance criteria derived from clinical study results of an AI/ML algorithm.

    Therefore, the requested information regarding acceptance criteria, study details for proving device performance (such as sample size, expert ground truth establishment, MRMC studies, standalone performance, and training set information) is not present in the provided document.

    The document states:

    • "No clinical study is included in this submission." (Page 7, Section 10. Clinical Test Conclusion)
    • The comparison focuses on "intended use, technological characteristics, and performance characteristics" relative to predicate devices, and claims the device is "as safe and effective as the predicate devices." (Page 4, Section 8. Comparison of Technological Characteristics)
    • "Non-Clinical Test Conclusion" (Page 7, Section 9) refers to previous 510(k) submission K181977 and explicitly states: "There is no change on product design, materials and packaging. The no-clinical performance test stays the same as K181977." This implies that the current submission relies on previously established non-clinical performance, not new studies proving performance against acceptance criteria for an AI/ML component.

    This 510(k) submission is for an endoscope system (a medical device), not an AI/ML algorithm that identifies or performs automated tasks. Hence, the questions related to AI/ML specific performance metrics (like sensitivity, specificity, clinical outcome improvement via AI, ground truth establishment for AI, etc.) are not applicable to the content provided.

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