Cleared Special

K111165 - KARL STORZ SCB / COVIDIEN FORCETRIAD INTERFACE MODULE

K111165 is an FDA 510(k) clearance for KARL STORZ SCB / COVIDIEN FORCETRIAD IN..., manufactured by KARL STORZ Endoscopy-America, Inc.. The device is a Class 2 Gastroenterology & Urology device with product code ODA cleared through the Special 510(k) pathway after a 255-day FDA review.

K111165 · KARL STORZ Endoscopy-America, Inc. · Gastroenterology & Urology device
Download Printable Device Report (PDF) Official FDA 510(k) Summary (PDF)
Optimized for regulatory review, auditing and printing
Jan 2012
Decision
255d
Days
Class 2
Risk

K111165 is an FDA 510(k) clearance for the KARL STORZ SCB / COVIDIEN FORCETRIAD INTERFACE MODULE. Classified as Endoscopic Central Control Unit (product code ODA), Class II - Special Controls.

Submitted by KARL STORZ Endoscopy-America, Inc. (El Segundo, US). The FDA issued a Cleared decision on January 6, 2012 after a review of 255 days - an extended review cycle.

This device falls under the Gastroenterology & Urology FDA review panel, regulated under 21 CFR 876.1500 - the FDA gastroenterology and urology device framework. As a Special 510(k), this submission covers a manufacturer modification to an existing cleared device rather than a new device introduction.

Device pattern: Iterative device modification. Standard predicate reliance. This Special 510(k) clearance confirms that the manufacturer's modifications remained within the established regulatory envelope of the original cleared device.

FDA 510(k) Submission Details - K111165

510(k) Number K111165 FDA.gov
FDA Decision Cleared Substantially Equivalent - Traditional 510(k) (SESE)
Date Received April 26, 2011
Decision Date January 06, 2012
Days to Decision 255 days
Submission Type Special
Review Panel Gastroenterology & Urology (GU)
Summary Summary PDF
Third-party Review No - reviewed directly by FDA
Combination Product No
PCCP Authorized No
Regulatory Context
Review time vs. panel average
124d slower than avg
Panel avg: 131d · This submission: 255d
Pathway characteristics
Modification to existing cleared device.

ODA Device Classification - Class 2, Special Controls

Product Code ODA Endoscopic Central Control Unit
Device Class Class 2 - Special Controls
CFR Regulation 21 CFR 876.1500
Definition To Control Endoscopic And Other Ancillary Surgical Equipment In One Central Location, Either By Remote Control, Touch Screen, Or Voice Command.
What this classification means

Class II devices require demonstration of substantial equivalence to a legally marketed predicate device. This pathway does not require clinical trials - it relies on engineering equivalence and performance data. Most Gastroenterology & Urology devices follow this clearance model.

Regulatory Peers - ODA Endoscopic Central Control Unit

All 17
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SYSTEMS INTEGRATION
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SYSTEMS INTEGRATION MODEL: ENDOALPHA
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K083598 · KARL STORZ Endoscopy-America, Inc. · May 2009
K111165 · KARL STORZ SCB / COVIDIEN FORCETRIAD INTERFACE MODULE
Download PDF FDA Summary KARL STORZ Endoscopy-…