StealthStation FlexENT (9736242), StealthStation S8 ENT Software (9735762)
K200723 · Medtronic Navigation, Inc. · PGW · Jun 26, 2020 · Neurology
Device Facts
Record ID
K200723
Device Name
StealthStation FlexENT (9736242), StealthStation S8 ENT Software (9735762)
Applicant
Medtronic Navigation, Inc.
Product Code
PGW · Neurology
Decision Date
Jun 26, 2020
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 882.4560
Device Class
Class 2
Indications for Use
The StealthStation FlexENT™ System, with the StealthStation™ ENT Software, is intended as an aid for precisely locating anatomical structures in either open or percutaneous ENT procedures. Their use is indicated for any medical condition in which the use of stereotactic surgery may be appropriate, and where reference to a rigid anatomical structure, such as the skull, can be identified relative to images of the anatomy. This can include, but is not limited to, the following procedures: Functional Endoscopic Sinus Surgery (FESS) Endoscopic Skull Base procedures Lateral Skull Base procedures
Device Story
Electromagnetic surgical guidance platform; tracks instrument position relative to patient anatomy using preoperative or intraoperative images. Inputs: patient imaging data (X-ray, MR, nuclear medicine), tracked instrument position via electromagnetic localization (AxiEM III). Operation: system registers patient anatomy to images; tracks instrument tip and trajectory in real-time; displays positional data on 2D/3D views. Used in OR by surgeons to guide instruments along pre-planned trajectories. Output: real-time visual feedback of instrument location relative to anatomy and surgical plan. Benefits: aids precise navigation during complex ENT procedures; validates surgeon judgment; supports surgical planning.
Clinical Evidence
No clinical data. Bench testing only. Accuracy validated using anatomically representative phantoms; mean positional error ≤ 0.93-1.04 mm and trajectory error ≤ 0.55-1.31 degrees across platforms.
Technological Characteristics
Electromagnetic localization (AxiEM III); Intel-based PC; Linux (Ubuntu) OS; Ethernet connectivity. Compatible with Medtronic navigated instruments. Standards: AAMI/ANSI ES 60601-1:2012, IEC 60601-1-2:2014. Software: C++ based, includes registration, planning, and 3D visualization modules.
Indications for Use
Indicated for patients undergoing open or percutaneous ENT procedures where stereotactic surgery is appropriate and rigid anatomical structures (e.g., skull) can be referenced to medical images. Includes FESS, endoscopic skull base, and lateral skull base procedures.
Regulatory Classification
Identification
A stereotaxic instrument is a device consisting of a rigid frame with a calibrated guide mechanism for precisely positioning probes or other devices within a patient's brain, spinal cord, or other part of the nervous system.
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June 26, 2020
Medtronic Navigation Inc. Carey Brenner Sr. Regulatory Affairs Specialist 826 Coal Creek Circle Louisville. Colorado 80027
Re: K200723
Trade/Device Name: StealthStation S8 ENT Software 1.3, StealthStation FlexENT Regulation Number: 21 CFR 882.4560 Regulation Name: Stereotaxic Instrument Regulatory Class: Class II Product Code: PGW Dated: March 18, 2020 Received: March 19, 2020
# Dear Carey Brenner:
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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, 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 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
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801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.
For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance)and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
for Michael J. Ryan Director DHT1C: Division of ENT. Sleep Disordered Breathing, Respiratory and Anesthesia Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health
Enclosure
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# Indications for Use
510(k) Number (if known) K200723
Device Name StealthStation™ S8 ENT Software 1.3
#### Indications for Use (Describe)
The StealthStation FlexENT™ System, with the StealthStation™ ENT Software, is intended as an aid for precisely locating anatomical structures in either open or percutaneous ENT procedures. Their use is indicated for any medical condition in which the use of stereotactic surgery may be appropriate, and where reference to a rigid anatomical structure, such as the skull, can be identified relative to images of the anatomy.
This can include, but is not limited to, the following procedures:
- · Functional Endoscopic Sinus Surgery (FESS)
- · Endoscopic Skull Base procedures
- · Lateral Skull Base procedures
Type of Use (Select one or both, as applicable)
X Prescription Use (Part 21 CFR 801 Subpart D)
| Over-The-Counter Use (21 CFR 801 Subpart C)
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# Indications for Use
510(k) Number (if known) K200723
Device Name StealthStation FlexENT™
### Indications for Use (Describe)
The Medtronic SteathStation FlexENT™ computer-assisted surgery system and its associated applications are intended as an aid for precisely locating anatomical structures in either open or percutaneous ENT procedures. Their use is indicated for any medical condition in which the use of stereotactic surgery may be appropriate, and where reference to a rigid anatomical structure, such as the skull, can be identified relative to images of the anatomy.
| Type of Use (Select one or both, as applicable) | |
|----------------------------------------------------------------------------|--|
| <div> <span>☑</span> Prescription Use (Part 21 CFR 801 Subpart D) </div> | |
| <div> <span>☐</span> Over-The-Counter Use (21 CFR 801 Subpart C) </div> | |
## CONTINUE ON A SEPARATE PAGE IF NEEDED.
This section applies only to requirements of the Paperwork Reduction Act of 1995.
## *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.*
The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:
> Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov
"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."
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# 510(k) Summary
### l. Company Medtronic Navigation, Inc. 826 Coal Creek Circle Louisville, Colorado 80027 USA Telephone Number: 720-890-3200 Fax Number: 720-890-3500
# Contact
Carev Brenner Senior Regulatory Affairs Specialist 720-352-1146 carey.j.brenner@medtronic.com
K. Elizabeth Waite Requlatory Affairs Manager 720-890-2182 elizabeth.waite@medtronic.com
- II. Proprietary Trade Name: StealthStation™ S8 ENT Software 1.3 StealthStation FlexENT™
- III. Common Name: Stereotaxic Instrument
- IV. Classification Name: Stereotaxic Instrument (21 CFR 882.4560)
- V. Classification: Class II (21 CFR 882.4560)
- VI. Product Code: PGW
#### VII. Product Description
The StealthStation FlexENT™ is an electromagnetic based surgical guidance platform that supports use of special application software (StealthStation™ S8 ENT Software 1.3 and associated instruments.
The StealthStation™ S8 ENT Software 1.3 helps guide surgeons during ENT procedures such as functional endoscopic sinus surgery (FESS), endoscopic skull base procedures, and lateral skull base procedures. StealthStation™ S8 ENT Software 1.3 functionality is described in terms of its feature sets which are categorized as imaging modalities, registration, planning, and views. Feature sets include functionality that contributes to clinical decision making and are necessary to achieve system performance.
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Patient images can be displayed by the StealthStation™ S8 ENT Software 1.3 from a variety of perspectives (axial, sagittal, coronal, oblique) and 3dimensional (3D) renderings of anatomical structures can also be displayed. During navigation, the system identifies the tip location and traiectory of the tracked instrument on images and models the user has selected to display. The surgeon may also create and store one or more surgical plan trajectories before surgery and simulate progression along these trajectories. During surgery, the software can display how the actual instrument tip position and trajectory relate to the plan, helping to guide the surgeon along the planned trajectory. While the surgeon's judgment remains the ultimate authority, realtime positional information obtained through the StealthStation™ System can serve to validate this judgment as well as guide. The StealthStation™ S8 ENT v1.3 Software can be run on both the StealthStation FlexENT™ and StealthStation™ S8 Platforms.
The StealthStation™ System is an Image Guided System (IGS), comprised of a platform (StealthStation FlexENT™ or StealthStation™ S8), clinical software, surgical instruments, and a referencing system (which includes patient and instrument trackers). The IGS tracks the position of instruments in relation to the surgical anatomy, known as localization, and then identifies this position on preoperative or intraoperative images of a patient.
#### VIII. Indications for Use
## StealthStation™ S8 ENT Software 1.3
The StealthStation FlexENT™ system with the StealthStation™ ENT software, is intended as an aid for precisely locating anatomical structures in either open or percutaneous ENT procedures. Their use is indicated for any medical condition in which the use of stereotactic surgery may be appropriate, and where reference to a rigid anatomical structure, such as the skull, can be identified relative to images of the anatomy.
This can include, but is not limited to, the following procedures:
- Functional Endoscopic Sinus Surgery (FESS) .
- Endoscopic Skull Base procedures .
- . Lateral Skull Base procedures
### StealthStation FlexENT™
The StealthStation FlexENT™ computer-assisted surgery system and its associated applications are intended as an aid for precisely locating anatomical structures in either open or percutaneous ENT procedures. Their use is indicated for any medical condition in which the use of stereotactic surgery may be appropriate, and where reference to a rigid anatomical structure, such as the skull, can be identified relative to images of the anatomy.
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- IX. Identification of Legally Marketed Devices (Predicate Devices) Primary Predicate: K170018 - StealthStation™ S8 ENT Software 1.0 Predicate: K153247 - FUSION™ Compact
#### X. Comparison of the Technological Characteristics
Refer to the tables within this section for a comparison of the technological features of the subject devices compared to the predicate devices. The S8 Software 1.3 has been updated to enable compatibility with the StealthStation FlexENT™ platform. The StealthStation™ S8 ENT software 1.3 running on the StealthStation™ S8 Platforms, including FlexENT™ is equivalent to the predicate devices in technological characteristics and indications for use.
The StealthStation FlexENT™ is a new platform that utilizes the latest Medtronic localization system (AxiEM III). The EM mounting apparatus has been updated from the Fusion™ Compact version in order to be compatible with the Medtronic AxiEM III localization system. The instruments that are compatible with the StealthStation FlexENT™ system are the same Medtronic instruments as those compatible with the Fusion™ Compact. The StealthStation FlexENT™ platform is equivalent to the predicate device in technological characteristics and indications for use.
Bench testing has shown that as navigation devices, the subject devices are as functional as the predicate. As such, there are no different questions of safety and effectiveness.
# StealthStation™ S8 ENT Software Version 1.3 as Compared to Primary Predicate Device
| Feature/<br>Attribute | Subject Device<br>StealthStation™ S8 ENT<br>Software v1.3 | Primary Predicate<br>K170018, StealthStation™ S8<br>ENT Software v1.0 Running on<br>StealthStation™ S8 Platform |
|-----------------------|-----------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|
| Classification | Same | Class II |
| Product Code | Same | PGW |
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| Feature/<br>Attribute | Subject Device | Primary Predicate |
|---------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| | StealthStationTM S8 ENT<br>Software v1.3 | K170018, StealthStationTM S8<br>ENT Software v1.0 Running on<br>StealthStationTM S8 Platform |
| Intended/<br>Indications for<br>Use | StealthStationTM ENT Software<br>v1.3, Running on StealthStation<br>FlexENTTM<br>The StealthStation FlexENTTM<br>System, with the StealthStationTM<br>ENT software, is intended as an<br>aid for precisely locating<br>anatomical structures in either<br>open or percutaneous ENT<br>procedures. Their use is indicated<br>for any medical condition in which<br>the use of stereotactic surgery<br>may be appropriate, and where<br>reference to a rigid anatomical<br>structure, such as the skull, can<br>be identified relative to images of<br>the anatomy.<br>This can include, but is not limited<br>to, the following procedures:<br>Functional Endoscopic Sinus<br>Surgery (FESS)Endoscopic Skull Base<br>proceduresLateral Skull Base procedures<br>StealthStationTM S8 ENT<br>Software v1.3, Running on<br>StealthStationTM S8 Platform<br>Same | The StealthStationTM S8<br>System, with the<br>StealthStationTM ENT software,<br>is intended as an aid for<br>precisely locating anatomical<br>structures in either open or<br>percutaneous ENT procedures.<br>Their use is indicated for any<br>medical condition in which the<br>use of stereotactic surgery may<br>be appropriate, and where<br>reference to a rigid anatomical<br>structure, such as the skull, can<br>be identified relative to images<br>of the anatomy.<br>This can include, but is not<br>limited to, the following<br>procedures:<br>Functional Endoscopic<br>Sinus Surgery (FESS)Endoscopic Skull Base<br>proceduresLateral Skull Base<br>procedures |
| Feature/<br>Attribute | Subject Device | Primary Predicate |
| | StealthStation™ S8 ENT<br>Software v1.3 | K170018, StealthStation™ S8<br>ENT Software v1.0 Running on<br>StealthStation™ S8 Platform |
| Accuracy Testing | Under representative worst-case configuration, the StealthStation<br>FlexENT™ and S8 Systems with<br>StealthStation™ S8 ENT v1.3<br>Software, has demonstrated<br>performance in 3D positional<br>accuracy with a mean error ≤ 2.0<br>mm and in trajectory angle<br>accuracy with a mean error ≤ 2.0<br>degrees.<br>Specific Mean Accuracy Values<br>Results of Software running on<br>StealthStation FlexENT™:<br>Positional Error – 0.93mm<br>Trajectory Error – 0.55°<br>Results of Software running on<br>StealthStation™ S8:<br>Positional Error – 1.04mm<br>Trajectory Error – 1.31° | Under representative<br>worst-case configuration, the<br>StealthStation™ S8 System with<br>StealthStation™ ENT v1.0<br>Software, has demonstrated<br>performance in 3D positional<br>accuracy with a mean error ≤<br>2.0 mm and in trajectory angle<br>accuracy with a mean error ≤<br>2.0 degrees.<br>Specific Mean Accuracy Values<br>Results:<br>Positional Error – 0.88mm<br>Trajectory Error – 0.73° |
| Compatible<br>instrumentation | Same | Medtronic instruments tracked<br>via electromagnetic localization<br>technology located within the<br>instrument and patient trackers. |
| Imaging<br>Modalities | Same | X-Ray based MR based Nuclear<br>Medicine based |
| View (Display)<br>Features | Same | 3D, 2D Anatomic Orthogonal<br>(Coronal, Sagittal, Axial), Video<br>Input, Virtual Endoscopic,<br>Trajectory 1 and 2, Target<br>Guidance, Trajectory Guidance,<br>Probe's Eye, Look Ahead |
| Exam-to-Exam<br>Registration<br>Features | Same | Identity Merge Registration,<br>Manual Merge Registration and<br>Automatic Merge Registration |
| Patient<br>Registration<br>Features | Same | PointMerge® registration,<br>Tracer™ registration, Touch<br>registration (previously Touch-n-<br>Go™) |
| Feature/<br>Attribute | Subject Device | Primary Predicate |
| | StealthStation™ S8 ENT<br>Software v1.3 | K170018, StealthStation™ S8<br>ENT Software v1.0 Running on<br>StealthStation™ S8 Platform |
| Planning<br>Features | Same | Plan Entry and Target Selection,<br>3D Model Building, Advanced<br>Visualization |
| Scanner Interface<br>Technology (to<br>imaging devices) | Same | Network Connectivity<br>CD, DVD, USB<br>DICOM Import<br>DICOM Export |
| Software<br>Interface (GUI) | Same | Black and gray style with<br>procedure task overview in left<br>menu option and next/back task<br>flow at bottom of the screen.<br>Software controls for images,<br>planning and instrument<br>management<br>are contained in a right side bar. |
| Programming<br>Language | Same | C++ |
| Compatible<br>Platforms | StealthStation™ Platforms<br>including S8, Planning Station,<br>FlexENT™ | StealthStation™ S8 Platforms |
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# StealthStation FlexENT™ Platform as compared to Predicate Device
| Item | Subject Device<br>StealthStation FlexENT™<br>Platform | Predicate<br>K153247, FUSION™ Compact<br>Platform |
|--------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Classification | Same | Class II |
| Product Code | Same | PGW |
| Item | Subject Device<br>StealthStation FlexENT™<br>Platform | Predicate<br>K153247, FUSION™ Compact<br>Platform |
| Intended/ Indications<br>for Use | Same | The Medtronic FUSION™<br>Compact computer-assisted<br>surgery system and its<br>associated applications are<br>intended as an aid for precisely<br>locating anatomical structures<br>in either open or percutaneous<br>ENT procedures. Their use is<br>indicated for any medical<br>condition in which the use of<br>stereotactic surgery may be<br>appropriate, and where<br>reference to a rigid anatomical<br>structure, such as the skull, can<br>be identified relative to images<br>of the anatomy. |
| Operating Principle | Electromagnetic | Electromagnetic |
| (Tracking Method)<br>Electromagnetic | Manufacturer: Same<br>Localizer: AxiEM III | Manufacturer: Medtronic<br>Navigation, Inc. |
| Technology | Emitter Types: Side, Flat | Localizer: AxiEM II |
| including<br>Localization System | | Emitter Types: Side |
| Computer | Same | Intel-Based PC<br>Computer/Monitor all-in-one,<br>touch screen technology, video<br>capture |
| Operating System | Same | Linux-based: Ubuntu |
| Network<br>Connectivity | Same | Standard Ethernet |
| Instrument Tracking | Same | Receive Coils |
| Instrument ports | 4-coils per port, 6 ports in total | 4-coils per port, 8 ports in total |
| EM Mounting<br>apparatus | FlexENT Articulating Arm<br>mounted to FlexENT Cart,<br>FlexENT Floor Stand, or surgical<br>bed rail. | Emitter Stand and Emitter<br>Clamp |
| Compatible<br>instrumentation | Medtronic instruments tracked<br>via electromagnetic localization<br>technology located within the<br>instrument and patient trackers. | General instruments for ENT<br>procedures, navigated sinus<br>dilation instrumentation,<br>trackers, powered blades,<br>suctioning devices |
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#### XI. Discussion of the Performance Testing
Testing conducted demonstrates the product will perform as intended according to the outlined design requirements. The following testing was conducted on the StealthStation FlexENT™ Platform to establish substantial equivalence of the system and verify that the device will perform as intended meeting all the design inputs. The subject devices met all the performance testing requirements:
- . Electrical Emissions and Immunity 4th edition testing provided confirmation that the StealthStation FlexENT™ platform conforms to AAMI/ANSI ES 60601-1:2012 - Medical Electrical Equipment - Part 1: General Requirements for Basic Safety and Essential Performance (IEC 60601-1:2005, MOD).
- . Electrical, Mechanical, Thermal Safety testing confirmed that the StealthStation FlexENT™ platform conforms to IEC 60601-1-2:2014 -Medical Electrical Equipment - Part 1-2: General requirements for safety; Electromagnetic Compatibility - Requirements and Tests.
- ' Software Verification and Validation testing verified the operating system software requirements are met and software performs as intended
- l Hardware Verification testing ensuring the hardware requirements identified for the system are met and hardware performs as intended
- . The StealthStation FlexENT™ platform and product labeling was tested for the intended user profiles, uses, and use environments in accordance to FDA quidance "Applying Human Factors and Usability Engineering to Medical Devices" demonstrating that the usability and human factors requirements were adequately met. The StealthStation FlexENT has been found to be adequately safe and effective for the intended users, uses and use environments.
For the software, Integration tests are executed as part of development tasks for every code change. These tests are executed and must pass prior to merging into the production code branch for formal testing. Verification & validation tests are then executed, and evidence of final passing execution is documented in the Verification & Validation Plan-Summary
The following table summarizes the testing conducted on the StealthStation FlexENT™ and the StealthStation™ S8 platforms with StealthStation™ ENT v1.3 Software.
Description
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Testing was performed under the representative worst-case configuration, for the StealthStation™ S8 ENT 1.3 Software running on the StealthStation FlexENT™ and the StealthStation™ S8 platforms. Results demonstrated performance in 3D positional accuracy with a mean error ≤ 2.0 mm and in trajectory angle accuracy with a mean error ≤ 2.0 degrees. This performance was determined using anatomically representative phantoms and utilizing a subset of system components and features that represent the worst-case combinations of all potential system components. The results show that the update to the StealthStation™ S8 ENT 1.3 Software running on the StealthStation FlexENT™ and the StealthStation™ S8 platforms do not impact overall system accuracy performance.
| | Subject<br>(StealthStation™ S8 ENT v1.3) | | Predicate<br>(StealthStation™<br>S8 ENT v1.0) |
|----------------------------|------------------------------------------|-----------------------|-----------------------------------------------|
| platform | StealthStation<br>FlexENT™ | StealthStation™<br>S8 | StealthStation™<br>S8 |
| | Positional Error (mm) | | |
| Mean | 0.93 | 1.04 | 0.88 |
| Standard<br>Deviation | 0.47 | 0.51 | 0.48 |
| 99% Confidence<br>Interval | 2.02 | 2.23 | 2.39 |
| | Trajectory Error (degree) | | |
| Mean | 0.55 | 1.31 | 0.73 |
| Standard<br>Deviation | 0.29 | 0.44 | 0.45 |
| 99% Confidence<br>Interval | 1.22 | 2.34 | 2.52 |
The following table summarizes the quality assurance measures that were applied during development of the software component of the system:
| Description |
|-------------------------------------------------------|
| Software Development Life Cycle |
| Software Risk Assessment |
| Software Configuration Management and Version Control |
The results of testing support the safety and effectiveness of the StealthStation ENT v1.3 software running on the StealthStation FlexENT and StealthStation S8 platforms and demonstrate that the software should perform as intended in the specified use conditions.
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Bench testing has shown that as navigation devices, the subject devices are as functional as the predicate. As such, there are no different questions of safety and effectiveness.
Clinical testing was not considered necessary prior to release as this is not new technology.
#### XII. Conclusions
The StealthStation FlexENT™ Platform and StealthStation™ S8 ENT Software v1.3 have been shown through comparison and testing to be substantially equivalent to the identified predicate devices.
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.