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510(k) Data Aggregation

    K Number
    K160103
    Manufacturer
    Date Cleared
    2016-10-12

    (267 days)

    Product Code
    Regulation Number
    878.4400
    Reference & Predicate Devices
    Predicate For
    Why did this record match?
    Reference Devices :

    K962595

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

    The Spetzler™-Malis® Dual Illuminating Bipolar Forceps are designed for use with the Malis® Bipolar electrosurgical generators. The disposable Spetzler™-Malis® Dual Illuminating Bipolar Forceps are single use devices sold sterile and are intended for use in electrosurgery for coagulation of tissue and to supply light for surgical procedures.

    Device Description

    The Spetzler™ Malis® Dual Illuminating Bipolar Forceps are sterile, single-use devices for use in electrosurgery. The forceps are a bayonet style and incorporates a twin pin cord in the proximal end for connection to a bipolar electrosurgical generator via a generic twin pin, female socket receptacle cord set. A fiberoptic cable is bonded to each tine and mates to a proprietary connector at the proximal end. The connector mates with an adaptor that is inserted in the illumination port of an endoscopic ligthsource.

    AI/ML Overview

    The provided text describes a 510(k) summary for the Spetzler™ Malis® Dual Illuminating Bipolar Forceps and details non-clinical testing performed to establish substantial equivalence to a predicate device. It does not contain information about an AI/ML device, a multi-reader multi-case (MRMC) comparative effectiveness study, or a standalone algorithm performance study. Therefore, several requested sections cannot be filled from the given text.

    Here's the information extracted and organized based on your request, with "N/A" for unavailable data:

    1. Table of Acceptance Criteria and Reported Device Performance

    The acceptance criteria are implicitly derived from the comparison to the predicate device and the reference device, aiming for "equivalent" performance.

    ParameterAcceptance Criteria (Implied)Reported Device Performance (Subject Device)
    Non-Stick Coagulation Events (Primary Function)≥ 500+ events (equivalent to predicate)500+
    Illumination Output (Non-Stick Coagulation Testing)N/A (Predicate did not have illumination)200-204 mW
    Beef Liver Steady State Temperature Rise over Ambient (after 30 min. exposure)< 110% of Reference Scope AND < 10 degrees F (equivalent to reference)4 degrees F
    Device Output [mW] MAX (Illumination Transmission Levels)< Reference Scope (Telescope)220 mW
    Device Output [mW] AVG (Illumination Transmission Levels)< Reference Scope (Telescope)207 mW
    Tip Temperature [°F] MAX< 110% of Reference Scope (Telescope)186 °F
    Tip Temperature [°F] AVG< 110% of Reference Scope (Telescope)164.5 °F
    Electrical SafetyConformity to IEC 60601-1, -1-2, -2-2Performed and presumed compliant

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

    • Non-Stick Coagulation: Not explicitly stated, but "500+" events recorded for both subject and predicate devices, implying a significant number of trials.
    • Beef Liver Temperature Rise: Not explicitly stated, but "6pc sample" is mentioned for Average Device Output and Average Tip Temperature, suggesting at least 6 samples were tested for these specific metrics related to illumination.
    • Data Provenance: The devices were tested in a "bench test" setting by internal and independent laboratories. The document does not specify the country of origin of the data or if it was retrospective or prospective, as it's a bench study.

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

    N/A. This was a non-clinical bench testing study, not a study involving human interpretation or ground truth established by experts.

    4. Adjudication Method for the Test Set

    N/A. Not applicable for non-clinical bench testing.

    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

    N/A. No MRMC study was conducted, as this is not an AI/ML device.

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

    N/A. Not applicable, as this is not an AI/ML device. The testing described is for the physical device's performance characteristics.

    7. The Type of Ground Truth Used

    The "ground truth" for the non-clinical tests was based on direct physical measurements and observations during bench testing, compared against the performance of a legally marketed predicate device and a reference device, and against established safety standards (IEC standards).

    • Non-Stick Coagulation: Performance compared to the predicate device (Spetzler™ Malis® Standard Bipolar Forceps K121426) under specific COAG settings.
    • Illumination Output/Temperature: Performance compared to a reference device (Karl Storz Xenon Light Source and Telescope K962595) and specific temperature increase thresholds.
    • Electrical Safety: Conformance to international standards (IEC 60601-1, IEC 60601-1-2, IEC 60601-2-2).

    8. The Sample Size for the Training Set

    N/A. Not applicable, as this is not an AI/ML device and no training set was used.

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

    N/A. Not applicable.

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