UNIMAX SUCTION IRRIGATION SET

K103509 · Unimax Medical Systems, Inc. · GCJ · May 19, 2011 · Gastroenterology, Urology

Device Facts

Record IDK103509
Device NameUNIMAX SUCTION IRRIGATION SET
ApplicantUnimax Medical Systems, Inc.
Product CodeGCJ · Gastroenterology, Urology
Decision DateMay 19, 2011
DecisionSESE
Submission TypeTraditional
Regulation21 CFR 876.1500
Device ClassClass 2

Indications for Use

The Unimax Suction Irrigation Set is available with an array of probe designs to facilitate lavage during laparoscopic surgery. This device has applications in laparoscopic gynecologic, general, thoracic and urology procedures to provide suction and irrigation functions to help flush blood and tissue debris from the operative site during laparoscopy to aid visualization.

Device Story

Single-use, disposable laparoscopic suction irrigation set; consists of handpiece with two trumpet-style valves, probe, and tubing lines. Connects to external irrigation fluid supply and aspiration pump. Operated by surgeon during laparoscopic procedures to deliver sterile irrigation fluid and evacuate blood, tissue debris, and smoke from surgical site. Handpiece features adjustable adapter allowing introduction of various instruments through probe. Device aids visualization during surgery; benefits patient by clearing operative field.

Clinical Evidence

Bench testing only. In vitro and in vivo physical, mechanical, and biocompatibility testing performed. Electrical safety testing conducted per IEC 60601-2-2. Results demonstrate performance meets pre-defined acceptance criteria and is equivalent to predicate device.

Technological Characteristics

Single-use, disposable laparoscopic instrument. Components: handpiece with dual trumpet-style valves, probe, and tubing. Materials: biocompatible (cytotoxicity, intracutaneous, sensitization testing performed). Energy: pneumatic/fluidic (external aspiration pump). Connectivity: manual connection to fluid/suction sources. Sterilization: sterile. Standards: IEC 60601-2-2.

Indications for Use

Indicated for patients undergoing laparoscopic gynecologic, general, thoracic, or urology surgical procedures requiring lavage, suction, and irrigation to flush blood and tissue debris from the operative site to aid visualization.

Regulatory Classification

Identification

An endoscope and accessories is a device used to provide access, illumination, and allow observation or manipulation of body cavities, hollow organs, and canals. The device consists of various rigid or flexible instruments that are inserted into body spaces and may include an optical system for conveying an image to the user's eye and their accessories may assist in gaining access or increase the versatility and augment the capabilities of the devices. Examples of devices that are within this generic type of device include cleaning accessories for endoscopes, photographic accessories for endoscopes, nonpowered anoscopes, binolcular attachments for endoscopes, pocket battery boxes, flexible or rigid choledochoscopes, colonoscopes, diagnostic cystoscopes, cystourethroscopes, enteroscopes, esophagogastroduodenoscopes, rigid esophagoscopes, fiberoptic illuminators for endoscopes, incandescent endoscope lamps, biliary pancreatoscopes, proctoscopes, resectoscopes, nephroscopes, sigmoidoscopes, ureteroscopes, urethroscopes, endomagnetic retrievers, cytology brushes for endoscopes, and lubricating jelly for transurethral surgical instruments. This section does not apply to endoscopes that have specialized uses in other medical specialty areas and that are covered by classification regulations in other parts of the device classification regulations.

Special Controls

*Classification* —(1)*Class II (special controls).* The device, when it is an endoscope disinfectant basin, which consists solely of a container that holds disinfectant and endoscopes and accessories; an endoscopic magnetic retriever intended for single use; sterile scissors for cystoscope intended for single use; a disposable, non-powered endoscopic grasping/cutting instrument intended for single use; a diagnostic incandescent light source; a fiberoptic photographic light source; a routine fiberoptic light source; an endoscopic sponge carrier; a xenon arc endoscope light source; an endoscope transformer; an LED light source; or a gastroenterology-urology endoscopic guidewire, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I for the photographic accessories for endoscope, miscellaneous bulb adapter for endoscope, binocular attachment for endoscope, eyepiece attachment for prescription lens, teaching attachment, inflation bulb, measuring device for panendoscope, photographic equipment for physiologic function monitor, special lens instrument for endoscope, smoke removal tube, rechargeable battery box, pocket battery box, bite block for endoscope, and cleaning brush for endoscope. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807of this chapter, subject to the limitations in § 876.9.

In combination with the general controls of the FD&C Act, the integrated operating table-electromechanical surgical system is subject to the following special controls: 1. (1) Premarket clinical performance testing, or a combination of premarket clinical performance testing and postmarket surveillance (in accordance with special control (2)), must include the following: 1. (i) Objective performance measures (e.g., rate and number of conversions to other surgical modalities, rate of device related adverse events (including tissue injury, hematoma, and increased blood loss), and their severity, cause, and outcomes) must be reported with relevant descriptive comparator performance measures. 2. (ii) The data must demonstrate the performance of the device for providing accurate and precise control of attached surgical instruments in range of clinical conditions relevant to the device's intended use. 3. (iii) The test dataset must include data collected from a patient population representative of the intended patient population under anticipated conditions of use. 2. (2) Data obtained from postmarket surveillance must demonstrate, in consideration of the premarket data obtained in accordance with special control (1), that the device performs in accordance with special control (1), unless FDA determines, based on the totality of the premarket data, that data from postmarket surveillance is not required to demonstrate that the device performs as intended. Such postmarket surveillance must be conducted per a protocol determined appropriate by FDA to demonstrate that the device performs as intended (in consideration of the premarket data obtained in accordance with special control (1)), and must include initiation, enrollment, and reporting requirements to ensure timely periodic updates to FDA on post-market surveillance progress and outcomes. 3. (3) Animal performance testing must evaluate the extent of port site trauma due to repositioning of table during surgical procedures when utilizing robotic minimally invasive and laparoscopic approaches 4. (4) The device manufacturer must develop, and update as necessary, a device-specific use training program that ensures proper device setup/use/shutdown, accurate control of instruments to perform the intended surgical procedures, troubleshooting and handling during unexpected events or emergencies, and safe practices to mitigate use error. 5. (5) The device manufacturer may only distribute the device to facilities that implement and maintain the device-specific use training program and ensure that users of the device have completed the device-specific use training program. (6) Human factors assessment must demonstrate that the user can correctly use the device system across all intended use environments with the provided instructions and training materials, including patient access during normal operating conditions and emergency situations, and effects arising from the integrated nature of the operating table and robotic surgical arms. (7) Labeling must include: (i) A detailed summary of clinical performance testing conducted with the device, including study population, results, adverse events, and comparisons to any comparator groups identified; (ii) A statement in the labeling that the safety and effectiveness for the representative specific procedures was based on evaluation of the device as a surgical tool and did not include evaluation of outcomes related to the treatment of the patient's underlying disease or condition, unless FDA determines that it can be removed or modified based on clinical performance data submitted to FDA; (iii) Identification of compatible devices; (iv) The list of surgical procedures for which the device has been determined to be safe with clinical justification; (v) Reprocessing instructions for reusable components; (vi) A shelf life for any sterile components; (vii) A description of the device-specific use training program; (viii) A statement that the device is only for distribution to facilities that implement and maintain the device-specific use training program and ensure that users of the device have completed the device-specific use training program; and (ix) A summary of any completed postmarket surveillance data collected as required by special control (2), including updated labeling to accurately reflect outcomes observed in postmarket surveillance. (8) Non-clinical performance testing must demonstrate that the device performs as intended under anticipated conditions of use and must include: (i) Device motion accuracy and repeatability; (ii) System testing; (iii) Instrument reliability; (iv) Crosstalk; (v) Table motion control; (vi) Thermal effects on tissue; (vii) User-device interface performance; (viii) Workspace access testing; and (ix) Performance testing with compatible devices. (9) Software verification, validation, and hazard analysis must be performed. (10) Electromagnetic compatibility and electrical, thermal, and mechanical safety testing must be performed. (11) Performance data must demonstrate the sterility of all patient-contacting device components. (12) Performance data must support the shelf life of the device components provided sterile by demonstrating continued sterility and package integrity over the labeled shelf life. (13) Performance data must validate the reprocessing instructions for the reusable components of the device. (14) Performance data must demonstrate that all patient-contacting components of the device are biocompatible. (15) Performance data must demonstrate that all patient-contacting components of the device are non-pyrogenic. (16) The device manufacturer must submit a report to the FDA annually on the anniversary of initial marketing authorization for the device, until such time as FDA may terminate such reporting, which comprises the following information: (i) Cumulative summary, by year, of complaints and adverse events since date of initial marketing authorization; and (ii) Identification and rationale for changes made to the device, labeling, or device specific use training program, which did not require submission of a premarket notification during the reporting period.

Predicate Devices

Submission Summary (Full Text)

{0}------------------------------------------------ K103509 Page 1 of 4 MAY 1 9 2011 Unimax Suction Irrigation Set # 510(k) Summary Type of Submission: 5.1 Traditional | 5.2 | <b>Submitter:</b> | Unimax Medical Systems Inc. | | |-----|-------------------------------------------|---------------------------------------------------------------------------|--| | | <b>Address:</b> | 8F-2, No. 127, Lane 235, Pao Chiao Rd., Hsin Tien City,<br>Taipei, Taiwan | | | | <b>Phone:</b> | 886-2-89191698 | | | | <b>Fax:</b> | 886-2-89191528 | | | | <b>Contact:</b> | Sophia Chiu | | | | <b>Establishment Registration Number:</b> | 3007791595 | | #### 5.3 Identification of the Device: | Proprietary/Trade name: | Unimax Suction Irrigation Set | |-------------------------|----------------------------------------| | Common Name: | Suction Irrigation | | Classification Name: | Laparoscope, General & Plastic Surgery | | Device Classification: | II | | Regulation Number: | 876.1500 | | Panel: | General & Plastic Surgery | | Product Code: | GCJ | ### 5.4 Identification of the Predicate Device: | Predicate Device Name: | GeniCon Laparoscopic Suction Irrigation | | |-----------------------------------------|-----------------------------------------|--| | Manufacturer: | Genicon | | | 510(k) Number or Clearance Information: | K041967 | | ## 5.5 Intended Use and Indications for Use of the subject device. The Unimax Suction Irrigation Set is available with an array of probe designs to facilitate lavage during laparoscopic surgery. This device has applications in laparoscopic gynecologic, general, thoracic and urology procedures to provide suction and irrigation functions to help flush blood and tissue debris from the operative site during laparoscopy to aid visualization. {1}------------------------------------------------ K103509 Page 2 of 4 #### Unimax Suction Irrigation Set #### 5.6 Device Description The Unimax Suction Irrigation Set is indicated for use in patients undergoing a laparoscopic surgical procedure. It is designed to deliver-sterile irrigation fluids to surgical sites during laparoscopic procedures and to evacuate blood, tissue debris, and smoke from the surgical site. The suction irrigation set consists of a hand piece equipped with two trumpet style valves, a probe, and connecting lines of tubing, one set designed to a supply of irrigation fluid, and the other designed to attach to an aspiration pump. The valves allow controlled irrigation and aspiration during a surgical procedure. The hand piece of the suction irrigator is designed to allow instruments to be introduced through the suction irrigation probe to reach the operative site. The instrument adapter is adjustable to allow a variety of instruments and diameters. It is a single use, disposable device and is sold sterile. #### 5.7 Non-clinical Testing A series of in vitro and in vivo preclinical physical, mechanical and biocompatibility tests were performed to assess the safety and effectiveness of the Unimax Suction Irrication Set. The tests were conducted in accordance with IEC 60601-2-2 Medical electrical equipment -Part 2-2: Particular requirements for the safety of high frequency surgical equipment. All the test results demonstrate the performance of Unimax Suction Irrigation Set meets the requirements of its pre-defined acceptance criteria and intended uses. The results of the non-clinical testing demonstrate that the Unimax Suction Irrigation Set is as safe and effective as the predicate devices. #### 5.8 Safety and Effectiveness The result of bench testing indicates that the new device is as safe and effective as the predicate device. {2}------------------------------------------------ K103509 Page 3 of (4) Unimax Suction Irrigation Set ### 5.9 Substantial Equivalence Determination The Unimax Suction Irrigation Set submitted in this 510(k) file is substantially equivalent in intended use, design, technology/principles of operation, materials and performance to the cleared GeniCon Laparoscopic Suction Irrigation which is the subject of K041967. Differences between the devices cited in this section do not raise any new issues of safety or effectiveness. | Item | Predicate Device<br>(GeniCon Laparoscopic Suction<br>Irrigation) | Proposed Device<br>(Unimax Medical Systems<br>Inc. Suction Irrigation Set) | |---------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------| | Similarity | | | | Intended Use | The device is available with an array of<br>probe designs to facilitate lavage<br>during laparoscopic surgery. This<br>device has applications in laparoscopic<br>gynecologic, general, thoracic and<br>urology procedures to provide suction<br>and irrigation functions to help flush<br>blood and tissue debris from the<br>operative site during laparoscopy to aid<br>visualization. | Same | | Specification | The device consists of a hand piece<br>equipped with two trumpet style<br>valves, a probe, and connecting lines of<br>tubing, one set designed to attach to a<br>supply of irrigation fluid, and the other<br>designed to attach to an aspiration<br>pump. The valves allow controlled<br>irrigation and aspiration during a<br>surgical procedure.<br>Reusable Monopolar Probe:<br>Description Size | Same | {3}------------------------------------------------ K103509 Page 4 of (4)- Unimax Suction Irrigation Set 510(k) Notification | | Spatula Probe | 5mm x 33cm | |------------------|---------------------------------|------------| | | J-Hook Probe | 5mm x 33cm | | | L-Hook Probe | 5mm x 33cm | | Biocompatibility | Cytotoxicity test | Same | | | Intracutaneous test | | | | Maximization sensitization test | | # 5.10 Conclusion After analyzing bench tests, electrical safety testing data, it can be concluded that Unimax Suction Irrigation Set is as safe and effective as the predicate device. {4}------------------------------------------------ Image /page/4/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features a stylized eagle with three stripes representing the three branches of government. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle. Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002 MAY 1 9 2011 Unimax Medical Systems, Inc. % AcmeBiotechs Co., Ltd. Mr. Michael Lee No. 45, Minsheng Rd., Danshui Town Taipei County, 251 Taiwan Re: K103509 Trade/Device Name: Unimax Suction Irrigation Set Regulation Number: 21 CFR 876.1500 Regulation Name: Endoscope and accessories Regulatory Class: Class II Product Code: GCJ Dated: April 25, 2011 Received: April 25, 2011 Dear Mr. Lee: We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food. Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA), You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you; however, that device labeling must be truthful and not misleading. If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act {5}------------------------------------------------ Page 2 - Mr. Michael Lee or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050. If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance. You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Sincerely yours. Aiz B. n h Mark N. Melkerson Director Division of Surgical, Orthopedic And Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health Enclosure {6}------------------------------------------------ K103509 Unimax Suction Irrigation Set Indications.for Use #### 510(k) Number (if known): Device Name: Unimax Suction Irrigation Set #### Indications for Use: The Unimax Suction Irrigation Set is available with an array of probe designs to facilitate lavage during laparoscopic surgery. This device has applications in laparoscopic gynecologic, general, thoracic and urology procedures to provide suction and irrigation functions to help flush blood and tissue debris from the operative site during laparoscopy to aid visualization. Prescription Use ________________ (Part 21 CFR 801 Subpart D) . AND/OR Over-The-Counter Use_ (21 CFR 801 Subpart C) (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE) Neil RP. Ogden for mxm (Director Sign Off) Page 1 of _1 Division of Surgical, Orthopedic, and Restorative Devic 510(k) Number K103509 । ক
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