Cleared Traditional

K091962 - POLYSCOPE FLEXIBLE ENDOSCOPY CATHETER (FDA 510(k) Clearance)

Also includes:
10,000 PIXEL FIBER OPTIC XENON LIGHT SOURCE, MODEL LS-200
Sep 2009
Decision
91d
Days
Class 2
Risk

K091962 is an FDA 510(k) clearance for the POLYSCOPE FLEXIBLE ENDOSCOPY CATHETER. This device is classified as a Mini Endoscope, Gastroenterology-urology (Class II - Special Controls, product code ODF).

Submitted by Lumenis, Inc. (Santa Clara, US). The FDA issued a Cleared decision on September 30, 2009, 91 days after receiving the submission on July 1, 2009.

This device falls under the Gastroenterology & Urology FDA review panel. Regulated under 21 CFR 876.1500. To Examine And Perform Procedures In Body Cavities Of The Gi And Gu Tract. If The Device Is Reusable, Validated Reprocessing Instructions And Reprocessing Validation Data For This Device Type Must Be Included In A 510(k) Submission (82 Fr 26807, Available At Https://www.gpo.gov/fdsys/pkg/fr-2017-06-09/pdf/2017-12007.pdf)..

Submission Details

510(k) Number K091962 FDA.gov
FDA Decision Cleared Substantially Equivalent - Traditional 510(k) (SESE)
Date Received July 01, 2009
Decision Date September 30, 2009
Days to Decision 91 days
Submission Type Traditional
Review Panel Gastroenterology & Urology (GU)
Summary Summary PDF

Device Classification

Product Code ODF - Mini Endoscope, Gastroenterology-urology
Device Class Class II - Special Controls
CFR Regulation 21 CFR 876.1500
Definition To Examine And Perform Procedures In Body Cavities Of The Gi And Gu Tract. If The Device Is Reusable, Validated Reprocessing Instructions And Reprocessing Validation Data For This Device Type Must Be Included In A 510(k) Submission (82 Fr 26807, Available At Https://www.gpo.gov/fdsys/pkg/fr-2017-06-09/pdf/2017-12007.pdf).