LFRE INDIRECT LARYNGOSCOPE

K023004 · Astralite Corp. · EOB · Jan 28, 2003 · Ear, Nose, Throat

Device Facts

• Record ID: K023004
• Device Name: LFRE INDIRECT LARYNGOSCOPE
• Applicant: Astralite Corp.
• Product Code: EOB · Ear, Nose, Throat
• Decision Date: Jan 28, 2003
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 874.4760
• Device Class: Class 2

Indications for Use

The LFRE Indirect Laryngoscope may be used for examinations of the larynx and nasopharynx 1. while conducting normal, routine physical examinations. 2. while inspecting for causes of abnormal conditions (e.g., hoarseness, pain) presented by the patient. 3. while inspecting for causes of abnormal conditions indicated by referring facilities.

Device Story

LFRE Indirect Laryngoscope is a manual visualization tool used by clinicians for direct or indirect inspection of the larynx and nasopharynx. Device facilitates routine physical examinations and diagnostic assessment of symptoms like hoarseness or pain. Operates as a non-powered or simple optical instrument; provides visual access to upper airway structures. Used in clinical settings by physicians or qualified healthcare providers to aid in clinical decision-making regarding patient airway health.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Indirect laryngoscope for visualization of larynx and nasopharynx. Manual, non-powered optical device. Class II, Product Code EOB (Nasopharyngoscope).

Indications for Use

Indicated for patients requiring examination of the larynx and nasopharynx during routine physical exams or investigation of abnormal conditions such as hoarseness or pain.

Regulatory Classification

Identification

A nasopharyngoscope (flexible or rigid) and accessories is a tubular endoscopic device with any of a group of accessory devices which attach to the nasopharyngoscope and is intended to examine or treat the nasal cavity and nasal pharynx. It is typically used with a fiberoptic light source and carrier to provide illumination. The device is made of materials such as stainless steel and flexible plastic. This generic type of device includes the antroscope, nasopharyngolaryngoscope, nasosinuscope, nasoscope, postrhinoscope, rhinoscope, salpingoscope, flexible foreign body claw, flexible biopsy forceps, rigid biopsy curette, flexible biospy brush, rigid biopsy forceps and flexible biopsy curette, but excludes the fiberoptic light source and carrier.

Submission Summary (Full Text)

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/0/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with three lines representing its body and wings. The eagle is facing right. Encircling the eagle is the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement.

## Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 2 8 2003

Astralite Corporation c/o Dorian Swartz, President 7701 Woodley Avenue Van Nuys, CA 91406

Re: K023004

Trade/Device Name: LFRE Indirect Laryngoscope Regulation Number: 21 CFR 874.4760 Regulation Name: Nasopharyngoscope (flexible or rigid) and accessories Regulatory Class: Class II Product Code: EOB Dated: December 7, 2002 Received: December 10, 2002

Dear Mr. Swartz:

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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such 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 801); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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Page 2 - Dorian Swartz, President

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). 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 [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours.

A helyi korenthal

A. Ralph Rosenthal, M.D. Director Division of Ophthalmic and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Astralite/LFRE/Indications for Use Statement

Page I of 1

## INDICATIONS FOR USE STATEMENT

## LFRE Indirect Laryngoscope K023004

## INDICATIONS FOR USE:

The LFRE Indirect Laryngoscope may be used for examinations of the larynx and nasopharynx

- 1. while conducting normal, routine physical examinations.
- 2. while inspecting for causes of abnormal conditions (e.g., hoarseness, pain) presented by the patient.
- 3. while inspecting for causes of abnormal conditions indicated by referring facilities.

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription for use (Per 21 CFR 801.109)

Keren Baker

(Division Sian-Off Division of Ophthalmic Ea Nose and Throat Devis

510(k) Number k023004