(53 days)
The Cook® Formula™ 418™ Biliary Stent is indicated for use in palliation of malignant neoplasms in the biliary tree.
The Formula 418 Biliary Stent is a balloon-expandable, stainless steel stent which is premounted on the delivery system. The stent will be available in diameters of 3, 4, 5, 6, 7, and 8 mm and lengths of 12, 16, 20, 24 and 30 mm. This device will be supplied sterile and is intended for one-time use.
The provided text describes the 510(k) submission for the Cook® Formula 418™ Biliary Stent System. While it details various tests performed, it does not explicitly define acceptance criteria with numerical thresholds for each test, nor does it present the "reported device performance" in a manner suitable for a comparative table against such criteria. The document states that the tests provide "reasonable assurance that the device has been designed and tested to assure conformance to the requirements for its use as a biliary stent," implying that the device met some internal or industry-standard acceptance criteria, but these are not explicitly listed or quantified.
Therefore, many of the requested sections regarding the study that proves the device meets acceptance criteria cannot be extracted directly from the provided text.
Here is the information that can be extracted, with notes on what is missing:
1. Table of Acceptance Criteria and Reported Device Performance:
| Test | Acceptance Criteria (Not Explicitly Stated) | Reported Device Performance (Not Explicitly Stated) |
|---|---|---|
| Deployment Testing | Implied successful deployment | Implied successful deployment |
| Compression Force Testing | Implied resistance to compression | Implied resistance to compression |
| Expansion Force Testing | Implied adequate expansion | Implied adequate expansion |
| Dimensional Testing | Implied within specified dimensions | Implied within specified dimensions |
| Corrosion Testing | Implied negligible corrosion | Implied negligible corrosion |
| Balloon Performance Testing | Implied suitable balloon function | Implied suitable balloon function |
| Stent Deformation Testing | Implied maintains structural integrity | Implied maintains structural integrity |
| Tensile Strength Testing | Implied adequate tensile strength | Implied adequate tensile strength |
| Magnetic Resonance Imaging (MRI) Testing | Implied MRI compatibility/safety | Implied MRI compatibility/safety |
| Shelf Life Testing | Implied stable over specified shelf life | Implied stable over specified shelf life |
| Biocompatibility Testing | Implied biocompatible | Implied biocompatible |
Missing Information: The document states that "The results of these tests provide reasonable assurance that the device has been designed and tested to assure conformance to the requirements for its use as a biliary stent." However, it does not provide specific numerical acceptance criteria or the quantitative results of these tests.
2. Sample size used for the test set and the data provenance:
- Sample size for test set: Not specified in the provided text. The tests are listed, but no number of samples per test is given.
- Data provenance: Not specified (e.g., country of origin, retrospective or prospective). The text only mentions "Test Data" without details on its origin.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:
- Not applicable. The tests listed (e.g., mechanical, material, imaging compatibility) are physical/engineering tests, not clinical evaluations requiring expert interpretation of medical images or patient outcomes to establish ground truth in the context of diagnostic accuracy.
4. Adjudication method (e.g. 2+1, 3+1, none) for the test set:
- Not applicable. This concept typically applies to clinical studies involving expert review of medical data. The tests described are laboratory/bench tests.
5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:
- No. This is a premarket notification for a medical device (stent), not an AI-assisted diagnostic tool. Therefore, an MRMC study related to AI assistance is not applicable.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:
- No. This is a physical medical device (stent), not an algorithm.
7. The type of ground truth used:
- For the listed tests (Deployment, Compression, Expansion, Dimensional, Corrosion, Balloon Performance, Stent Deformation, Tensile Strength, MRI, Shelf Life, Biocompatibility), the "ground truth" would be established by engineering specifications, material standards, and validated testing protocols. For example, for dimensional testing, the ground truth would be the specified dimensions of the stent according to its design. For biocompatibility, it would be compliance with ISO standards for biological evaluation of medical devices.
8. The sample size for the training set:
- Not applicable. This device is a physical stent, not an AI model that requires a training set.
9. How the ground truth for the training set was established:
- Not applicable. (See point 8).
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Cook® Formula 418™ Biliary Stent System D.C.#K051785
Page 1 of 2
510(k) Summary of Safety and Effectiveness Information
Submitted By:
Karen Bradburn, RAC Senior Regulatory Affairs Specialist Cook Incorporated 750 Daniels Way, PO Box 489 Bloominaton, IN 47402 812-339-2235 August 16. 2005
Device:
| Trade Name: | Formula 418 Biliary Stent |
|---|---|
| Proposed Classification: | Biliary Catheter and Accessories |
Indications for Use
Indicated for use in palliation of malignant neoplasms in the biliary tree.
Predicate Devices:
The Formula 418 Biliary Stent is similar in terms of intended use, principles of operation, materials of construction and technological characteristics to predicate devices reviewed as devices for palliation of malignant neoplasms in the biliary tree.
Device Description:
The Formula 418 Biliary Stent is a balloon-expandable, stainless steel stent which is premounted on the delivery system. The stent will be available in diameters of 3, 4, 5, 6, 7, and 8 mm and lengths of 12, 16, 20, 24 and 30 mm. This device will be supplied sterile and is intended for one-time use.
Substantial Equivalence:
The Formula 418 Biliary Stent is similar to many devices in commercial distribution for palliation of malignant neoplasms in the Biliary tree. These devices include the Bridge FX (Bridge Assurant) Stent Delivery System (D.C. #K011817) stent, the Palmaz Genesis Transhepatic Biliary Stent (D.C. #K021345) and the Lifestent LP SDS Biliary Endoprosthesis (D.C.#K023248).
The similar indications for use, principles of operation, technological characteristics and performance testing results of the Formula 418 Biliary Stent
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KC51785
Page 2 of 2
as compared to the predicate devices support a determination of substantial equivalency.
Test Data:
The Formula 418 Biliary Stent was subjected to the following tests to assure reliable design and performance under the specified testing parameters. These tests were comprised of:
- Deployment Testing 1.
- Compression force Testing 2.
- Expansion Force Testing 3.
- Dimensional Testing 4.
-
- Corrosion Testing
- Balloon Performance Testing 6.
- Stent Deformation Testing 7.
- Tensile Strength Testing 8.
- ்ல Magnetic Resonance Imaging (MRI) Testing
- Shelf Life Testing 10.
-
- Biocompatibility Testing
The results of these tests provide reasonable assurance that the device has been designed and tested to assure conformance to the requirements for its use as a biliary stent.
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DEPARTMENT OF HEALTH & HUMAN SERVICES
Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of an eagle with three curved lines representing its wings and tail feathers.
Public Health Service
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
AUG 2 3 2005
Ms. Karen Bradburn, RAC Senior Regulatory Affairs Specialist Cook Incorporated P.O. Box 489 BLOOMINGTON IN 47402-0489
Re: K051785
K031783
Trade/Device Name: Cook® Formula™ 418TM Biliary Stent System Regulation Number: 21 CFR §876.5010 Regulation Name: Biliary catheter and accessories Regulatory Class: II Product Code: FGE Dated: August 5, 2005 Received: August 8, 2005
Dear Ms. Bradburn:
We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your becamed the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for use stated in the encreativent of the enactment date of the Medical Device Amendments, or to conninered pror to may 2011-11-11 in accordance with the provisions of the Federal Food, Drug, devices that have boon roomst therefore, market the device, subject to the general controls and Cosmete her (rec) - 1 or imitations described below. The general controls provisions of the provisions of the rice and for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.
The Office of Device Evaluation has determined that there is a reasonable likelihood that this The Office of Doriet intended use not identified in the proposed labeling and that such use could cause harm. Therefore, in accordance with Section 513(i)(1)(E) of the Act, the following limitation must appear in the Warnings section of the device's labeling:
The safety and effectiveness of this device for use in the vascular system have not been established.
Furthermore, the indication for biliary use must be prominently displayed in all labeling, i untilermore, the marcarton labels, instructions for use, and other promotional materials, in close proximity to the trade name, of a similar point size, and in bold print.
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Page 2 - Ms. Karen Bradburn, RAC
Please note that the above labeling limitations are required by Section 513(i)(1)(E) of the Act. Therefore, a new 510(k) is required before these limitations are modified in any way or removed from the device's labeling.
The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and permits your device to proceed to the market. This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification if the limitation statement described above is added to your labeling.
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 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
If you desire specific information about the application of other labeling requirements to your device (21 CFR Part 801), please contact the Office of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.
Sincerely yours,
onna-Bea Tillman, Ph.D. Director Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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Indications for Use
510(k) Number (if known): K051785
Device Name: Cook® Formula™ 418TM Biliary Stent System
Indications For Use:
The Cook® Formula™ 418™ Biliary Stent is indicated for use in palliation of malignant neoplasms in the biliary tree.
Prescription Use _____________________________________________________________________________________________________________________________________________________________
AND/OR
Over-The-Counter Use
(Part 21 CFR 801 Subpart D)
(21 CFR 807 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Nancy C. Brogdon
ive. Abdominal. nd Radiological D S10(k) Number
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§ 876.5010 Biliary catheter and accessories.
(a)
Identification. A biliary catheter and accessories is a tubular flexible device used for temporary or prolonged drainage of the biliary tract, for splinting of the bile duct during healing, or for preventing stricture of the bile duct. This generic type of device may include a bile collecting bag that is attached to the biliary catheter by a connector and fastened to the patient with a strap.(b)
Classification. Class II (special controls). The device, when it is a bile collecting bag or a surgical biliary catheter that does not include a balloon component, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.