Veloxion Controller Kit, Veloxion Fluid Control Kit, Veloxion Resectoscope, Veloxion Video Control Unit, Veloxion Roll Stand, Waste Management Tubing, Tissue Catch

K190099 · Corinth Medtech, Inc. · FJL · Mar 15, 2019 · Gastroenterology, Urology

Device Facts

• Record ID: K190099
• Device Name: Veloxion Controller Kit, Veloxion Fluid Control Kit, Veloxion Resectoscope, Veloxion Video Control Unit, Veloxion Roll Stand, Waste Management Tubing, Tissue Catch
• Applicant: Corinth Medtech, Inc.
• Product Code: FJL · Gastroenterology, Urology
• Decision Date: Mar 15, 2019
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 876.1500
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The Veloxion System is intended for use by trained urologists for endoscopically controlled tissue chip resection and coagulation, and removal of prostate adenomas via suction channel under continuous flow conditions following resection using a bipolar resecting device.

Device Story

Veloxion System is a bipolar resectoscope for prostate adenoma resection; used by urologists in clinical settings. System inputs include saline irrigation fluid and electrical power for RF resection/coagulation. Controller manages dual peristaltic pumps for irrigation/aspiration and monitors intracavitary pressure via dual independent sensors. Integrated sterile camera/light provides visualization; video control unit outputs to external monitor and allows media storage via USB. Device maintains continuous flow and cavity pressure; includes passive flow mechanism via roller clamp. Software monitors pressure limits, notifies user of over-pressure or clogs, and controls pump flow rates. Benefits include controlled tissue removal, improved visualization, and automated pressure management to enhance procedural safety and efficiency.

Clinical Evidence

No clinical data. Substantial equivalence supported by bench testing: software verification/validation (IEC 62304), functional testing (cut/coagulation, aspiration, pressure control), dimensional inspection, LED thermal evaluation, comparative visualization, electrode durability, biocompatibility (ISO 10993-1), sterility (ISO 11135/11137), packaging (ASTM D4169/ISO 11607), shelf-life (ASTM F1980), and electrical safety/EMC (IEC 60601 series).

Technological Characteristics

Bipolar RF energy source. Electrode: Tungsten (99.95% purity); Insulation: FEP. Dual peristaltic pumps for irrigation/aspiration. Integrated sterile 10-degree endoscope. Pressure control: Dual independent sensors. Connectivity: USB for media download. Sterilization: Sterile, single-use. Software: IEC 62304 compliant. Dimensions: 25Fr sheath OD, 220mm working length.

Indications for Use

Indicated for trained urologists performing endoscopically controlled tissue chip resection, coagulation, and removal of prostate adenomas via suction channel under continuous flow conditions.

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.

Predicate Devices

• Veloxion System (K162979)

Submission Summary (Full Text)

{0}------------------------------------------------

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo is in blue and includes the letters "FDA" and the words "U.S. FOOD & DRUG ADMINISTRATION".

March 15, 2019

Corinth MedTech, Inc. Sandeep Saboo Vice President, Quality Assurance and Regulatory Affairs 1601 S. De Anza Blvd, Suite 200 Cupertino, CA 95014

Re: K190099

Trade/Device Name: Veloxion System Regulation Number: 21 CFR§ 876.1500 Regulation Name: Endoscope and Accessories Regulatory Class: II Product Code: FJL, KQT, GEI Dated: January 18, 2019 Received: January 22, 2019

Dear Sandeep Saboo:

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, 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 or any Federal statutes and regulations administered by other Federal agencies.

{1}------------------------------------------------

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 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/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.html; 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 http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). 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 (http://www.fda.gov/DICE) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely,

# Mark R. Kreitz -S

for Benjamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

{2}------------------------------------------------

# Indications for Use

510(k) Number (if known) K190099

Device Name Veloxion System

Indications for Use (Describe)

The Veloxion System is intended for use by trained urologists for endoscopically controlled tissue chip resection and coagulation, and removal of prostate adenomas via suction channel under continuous flow conditions following resection using a bipolar resecting device.

Type of Use (Select one or both, as applicable)

| | Prescription Use (Part 21 CFR 801 Subpart D) |
|--|----------------------------------------------|
| | Over-The-Counter Use (21 CFR 801 Subpart C) |

## 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 [e-mail]

"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."

{3}------------------------------------------------

# K190099: 510(k) Summary

# I. Submitter Information

| Submitter name: | Corinth MedTech, Inc.<br>1601 S. De Anza Blvd, Suite 200<br>Cupertino, CA 95014 |
|-----------------|---------------------------------------------------------------------------------------------------------------------------|
| Contact person: | Sandeep Saboo<br>Vice President, Regulatory Affairs and Quality Assurance<br>Phone: [phone]<br>Fax: [phone] |
| Date Prepared: | 06 March 2019 |

#### II. Product Classification

| Device Name: | Veloxion System | |
|---------------------------|---------------------------|----------------|
| Common Name: | Resectoscope | Subject Device |
| Regulation: | 21 CFR 876.1500 | |
| Regulation Name: | Endoscope and accessories | |
| Class: | II | |
| Product Code: | FJL | |
| Additional Product Codes: | KQT, GEI | |

#### III. Predicate Devices

The predicate device is the system comprised of the following legally marketed devices as used in combination to which substantial equivalence is claimed: Primary Predicate: Veloxion System (cleared per K162979)

Predicate has not been a subject of a design related recall.

#### IV. Device Description

The Veloxion System consists of the following components:

- · Veloxion Controller (with Integrated Fluid Control)
- o Footswitch
- · Veloxion Resectoscope
- · Veloxion Fluid Control Set
- · Veloxion Video Control Unit
- · Veloxion Roll Stand

The Veloxion System also includes the following Class I accessories for handling of waste collected from the patient (these items only handle waste after it is already outside the patient), which includes:

- · Waste Management Tubing: To provide a conduit for transfer of aspirated fluids and tissue from the patient and from under the patient's buttocks drape
- · Tissue Catch: For collection of gross resected tissue pieces for pathology.

The Veloxion System provides bipolar resection and coagulation of prostate adenomas, it distends the cavity by filling with saline and it provides pressure control of the cavity to facilitate viewing

{4}------------------------------------------------

with the integrated Resectoscope. The components of Veloxion System perform the following functions:

- The Veloxion Controller provides bipolar radiofrequency outputs (for cut and coagulation) and fluid/pressure control through the use of two integrated peristaltic pumps, provides the user interface to establish the desired set pressure, monitors intracavitary pressure using dual independent pressure sensors mechanically connected to the Veloxion Fluid Control Set irrigation lumen. The software then monitors, controls and notifies the user when the limits are reached or when specific conditions are met.
- · The Veloxion Resectoscope is a sterile single use hand held bipolar radiofrequency device configured to provide camera and light for visualization of the anatomy for the resection of tissue and aspiration of resected chips. Fluid inflow and aspiration of the resected chips are controlled by the Controller's peristaltic pumps.
- · The Veloxion Fluid Control Set is a sterile single use device that provides conduits for fluid inflow, aspiration of resected tissue and fluids and a diaphragm (pressure membrane) that provides mechanism for the Controller to measure cavity pressure (through the irrigation lumen) during the procedure thereby facilitating the insufflation function.
- · The Veloxion Video Control Unit provide control of the camera, light, display image to a commercially available monitor, stores image and video selected by the user from a session, and provides a USB connection for a USB Stick download of stored media by the user.
- · The Veloxion Roll Stand enables monitoring of saline remaining in the saline bag.

# V. Indications for Use

There is no difference in the indications for use for the subject device when compared to the predicate device

| Device | Indications For Use |
|--------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Modified Veloxion<br>System<br>(Subject Device) | The Veloxion System is intended for use by trained urologists for<br>endoscopically controlled tissue chip resection and coagulation, and<br>removal of prostate adenomas via suction channel under continuous flow<br>conditions following resection using a bipolar resecting device. |
| Veloxion System<br>K162979<br>(Predicate Device) | The Veloxion System is intended for endoscopically controlled tissue chip<br>resection and coagulation and removal of prostate adenomas via suction<br>channel under continuous flow conditions following resection using a<br>bipolar resecting device. |

## Comparison of Indications for Use

## VI. Comparison of Technological Characteristics with the Predicate Device

The subject Veloxion System and the previously cleared Veloxion System (K162979) have the same or similar technological characteristics in terms of basic operating principle and basic design features with one key difference being that the subject Veloxion System includes a sterile, single use camera and light while the predicate Veloxion System uses a commercially available reusable Endoscope.

{5}------------------------------------------------

# Veloxion System Traditional 510(k) Premarket Notification

| Technological Characteristics | Modified VELOXION SYSTEM<br>(Subject) | VELOXION SYSTEM<br>(Predicate K162979) |
|---------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------|
| Monopolar or Bipolar | Bipolar | Bipolar |
| Energy Type: | Radiofrequency, Bipolar | Radiofrequency, Bipolar |
| Optics: | Integrated, Sterile, 10degree Endoscope | Compatible with reusable 30° marketed Endoscope |
| Able to Set Cavity Pressure on the Device? | YES | YES |
| Continuous Flow? : | YES | YES |
| Irrigation fluid: | Saline | Saline |
| Pump? | Dual Pump (Irrigation, Aspiration) | Dual Pump (Irrigation, Aspiration) |
| Able to Monitor saline remaining?: | YES | YES |
| Programmed Flow Rate: | Programmed flow rate constant for each mode:<br>Steady State = 50ml/min,<br>Cut = 380ml/min<br>Coag = 50ml/min<br>ASPIRATE = 400ml/min | Programmed flow rate constant for each mode:<br>Steady State = 100ml/min,<br>Cut = 380ml/min,<br>Coag = 100ml/min<br>ASPIRATE = 750ml/min |
| Passive Flow: | User adjustable flow rate using Roller Clamp installed during<br>manufacturing. The nominal passive flow rate when Roller Clamp<br>is fully open is:<br>• 360ml/min (at 20mmHg)<br>• 500ml/min (at 60mmHg) | No passive flow |
| Set Pressure Range: | 20 to 60mmHg | 10 to 60mmHg |
| Positive Action to Increase Above 40mmHg: | YES | YES |
| Pressure Sensor: | Dual, independent, direct sensing of cavity pressure | Dual, independent, direct sensing of cavity pressure |
| Over-pressure condition detection: | YES | YES |
| Maximum Allowable Actual Cavity Pressure | 75mmHg | 75mmHg |
| Ultimate mitigation for risk of over-pressurization of<br>cavity if all designed mitigations are unsuccessful | • Non-defeatable, continuous notification tone<br>• Notification displayed:<br>"Remove device from cavity. Check for Clog." | • Notification tone<br>• Notification displayed:<br>"Remove device from cavity. Check for Clog." |
| Max. Shaft OD (Sheath): | With Sheath Assembled: 25Fr (8.3mm) | With Sheath Assembled: 26Fr (8.6mm) |
| Working Length: | Sheath Working Length: 220mm | Sheath Working Length: 193mm |
| Materials (Electrode/ Insulation): | Electrode: Tungsten (99.95% purity)<br>Insulation: FEP | Electrode: Tungsten (99.95% purity)<br>Insulation: FEP |
| How Supplied (Sterility): | Sterile, Single Use<br>(Veloxion Resectoscope) | Sterile, Single Use<br>(Veloxion Resecting Device Kit) |

{6}------------------------------------------------

K190099

The main technological differences between the subject Veloxion System and the predicate Veloxion System are the following:

- The subject Veloxion System includes a sterile, single-use camera and light system while the predicate Veloxion System uses a commercially available reusable Endoscope.
- The subject Veloxion System includes programmed flow rates that are slightly different than the predicate Veloxion System as a result of an integrated passive flow mechanism.

The differences outlined were evaluated through performance testing to demonstrate safety and effectiveness of the subject Veloxion System.

## VII. Non-Clinical Testing Data

The following performance data have been provided in support of the substantial equivalence determination.

- Software Verification and Validation Testing performed per IEC 62304 and . documentation provided per FDA's Guidance for Industry and FDA Staff, "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices."
- Other Tests were performed per approved test protocols which included: ●
- o Integrity: System withstands operating pressures
- Functional Testing: Cut and coagulation, aspiration, irrigation, pressure control O
- Dimensional Inspection and Testing O
- Functional Testing for all components of the system O
- Maximum LED Tip Temperature O
- Comparative visualization testing in a simulated model O
- Simulated Use: Tissue resection and spot coagulation of cavity pressure, O imaging
- Durability Testing: Electrode durability testing for tissue resection and coagulation. O
- Comparative testing to predicate for electrode durability, pressure control and fluid O control.
- Thermal effects evaluation. O
- Biocompatibility Testing: In accordance with ISO 10993-1 O
- Sterility: In accordance with ISO 11135:2014, ISO 11137-1:2006, ISO 11137-2:2013 O
- Packaging: In accordance with ASTM D4169:14 and ISO 11607-1:2006. O
- Shelf-life: In accordance with ASTM F1980:2007. O
- Electrical Safety & EMC: In accordance with IEC 60601-1:2005, IEC 60601-1-O 2:2014, IEC 60601-2-18:2009 and IEC 60601-2-2:2009.
- Usability Testing: Use related risk evaluation o

#### VIII. Conclusions

Based on the results of performance tests, the subject Veloxion System is considered to be substantially equivalent and as safe and effective as the predicate Veloxion System (K162979).