K Number
K102540

Validate with FDA (Live)

Manufacturer
Date Cleared
2010-11-16

(74 days)

Product Code
Regulation Number
870.1340
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The PTFE Introducer is intended for use in the percutaneous insertion of pacing leads or catheters in the venous system.

Device Description

The Greatbatch Medical PTFE Peelable Introducer Kit consists of a disposable needle, a disposable syringe, a guidewire, and a peelable introducer set consisting of a dilator and sheath with integrated proximal handles. The introducer is available in various lengths in 3.5F through 16.5F. The dilator is designed to be delivered over a guidewire. The PTFE Peelable Introducer sheath has a "peel-away" feature which allows the user to remove the sheath without removing the inserted catheter or pacing lead. The PTFE Peelable Introducer is provided sterile and is intended for single use. The device is not intended for sterilization by the user.

AI/ML Overview

The Greatbatch Medical PTFE Peelable Introducer underwent performance testing to establish substantial equivalence to a predicate device (K093023).

1. Acceptance Criteria and Reported Device Performance

The acceptance criteria are not explicitly stated in numerical or percentage terms in the provided document. Instead, the document indicates that the device must "Pass" a series of functional and dimensional tests to verify that it "continues to function in a safe and effective manner" and "performs per specification requirements." The reported device performance for all tested parameters was "Pass."

TestAcceptance Criteria (Implicit)Reported Device Performance
Sheath Compatibility with DilatorConforms to specificationsPass
Initial Handle Break Force, SheathConforms to specificationsPass
Peel ForceConforms to specificationsPass
PeelabilityConforms to specificationsPass
Sheath/Tube Handle IntegrityConforms to specificationsPass
Dilator Hub/Tube Tensile ForceConforms to specificationsPass
Handle ID (min)Conforms to specificationsPass
Dilator Hub IDConforms to specificationsPass
Tip IDConforms to specificationsPass
Flat on TipConforms to specificationsPass
Tip AngleConforms to specificationsPass
LengthConforms to specificationsPass

2. Sample Size and Data Provenance

The document does not specify the exact sample size used for each test. It mentions that "Testing for this device was performed," but provides no details on the number of units tested. The data provenance (e.g., country of origin, retrospective/prospective) is not provided.

3. Number and Qualifications of Experts for Ground Truth

Not applicable. This is a medical device (introducer) and the study involved performance testing against engineering specifications, not clinical assessment or interpretation. Therefore, no experts were used to establish ground truth in the context of clinical accuracy or interpretation.

4. Adjudication Method

Not applicable. As noted above, this study involved performance testing against engineering specifications, not expert review of clinical cases.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No, a multi-reader multi-case (MRMC) comparative effectiveness study was not conducted. This device is not an AI-assisted diagnostic tool, but rather a physical medical introducer. The study focused on its functional and dimensional characteristics.

6. Standalone Performance (Algorithm Only)

No, standalone performance was not assessed in the context of an algorithm. This device is a physical medical device. The tests performed are described as "functional and dimensional testing" to ensure the device performs "per specification requirements."

7. Type of Ground Truth Used

The ground truth used was engineering specifications and established performance requirements for medical introducers, based on the predicate device. The tests were designed to verify that the device meets these pre-defined standards for functionality and dimensions.

8. Sample Size for the Training Set

Not applicable. This device is a physical medical device and does not involve a training set as would be used for an AI/ML algorithm. The performance testing was to demonstrate substantial equivalence to a predicate device, not to train a model.

9. How Ground Truth for the Training Set was Established

Not applicable, as there was no training set. The "ground truth" equivalent for the testing was the established performance standards and specifications derived from the predicate device and general medical device requirements, which were used to evaluate the manufactured PTFE Peelable Introducer.

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Greatbatch Medical Special Premarket Notification 510(k)

PTFE Peelable Introducer

Image /page/0/Picture/2 description: The image contains the word "Greatbatch". The text is in black and the background is white. The font is bold and sans-serif.

NOV 1 6 2010

1102540

510(k) Summary

5.1 Applicant Information

Submitter's Name:
Address:

Greatbatch Medical 2300 Berkshire Lane North Minneapolis, MN 55441

Establishment Registration No. 2183787

Kristi Fox Contact Person: Regulator Affairs Specialist kfox@greatbatchmedical.com 763-951-8205 (phone) (763) 559-0148 (fax) Steris, Inc. Sterilization Facility: 380 90th Avenue Northwest Minneapolis, MN 55433 (763) 786-2929 (phone) (763) 786-8199 (fax) Establishment Registration No. 2183744

5.2 Device Information

Trade Name: PTFE Peelable Introducer Classification Name: Introducer, Catheter Product Code: DYB Regulation: Class II 21 CFR 870.1340 Panel: Cardiovascular

Device Description 5.3

The Greatbatch Medical PTFE Peelable Introducer Kit consists of a disposable needle, a disposable syringe, a guidewire, and a peelable introducer set consisting of a dilator and sheath with integrated proximal handles. The introducer is available in various lengths in 3.5F through 16.5F. The dilator is designed to be delivered over a guidewire.

The PTFE Peelable Introducer sheath has a "peel-away" feature which allows the user to remove the sheath without removing the inserted catheter or pacing lead. The PTFE Peelable Introducer is provided sterile and is intended for single use. The device is not intended for sterilization by the user.

5.4 Indications for Use

The PTFE Introducer is intended for use in the percutaneous insertion of pacing leads or catheters in the venous system.

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Predicate Device Comparison / Technological Characteristics 5.5

The PTFE Peelable Introducer Kit has the same indication for use, technological characteristics and principles of operation as the market cleared Greatbatch Medical PTFE Peelable Introducer Kit (K093023). In addition, functional characteristics of the PTFE Peelable Introducer are substantially equivalent to the currently marketed device (K093023) including materials and method of construction. Where dimensional differences exist between the proposed device and the predicate device, performance testing was performed to demonstrate that these differences do not raise questions of safety or efficacy.

5.6 Summary of Testing

Testing for this device was performed to verify that the device continues to function in a safe and effective manner. The performance testing included the device specifications, functional and dimensional testing of the PTFE Peelable Introducer and other testing as applicable to the device. Test results verify that the device performs per specification requirements and is equivalent to the predicate device without creating additional risk to the patient or user. The following tests were performed on the PTFE Peelable Introducer:

TestResult
Sheath Compatibility withDilatorPass
Initial Handle Break Force,SheathPass
Peel ForcePass
PeelabilityPass
Sheath/Tube Handle IntegrityPass
Dilator Hub/Tube Tensile ForcePass
Handle ID (min)Pass
Dilator Hub IDPass
Tip IDPass
Flat on TipPass
Tip AnglePass
LengthPass

5.7 Statement of Equivalence

The PTFE Peelable Introducer has the same indication for use, principles of operation, and technological and functional characteristics as the market cleared Greatbatch Medical PTFE Peelable Introducer (K093023). The testing performed confirms that the PTFE Peelable Introducer will perform as intended. Therefore the PTFE Peelable Introducer is substantially equivalent to the previously cleared Greatbatch Medical PTFE Peelable Introducer (K093023).

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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 stylized depiction of a bird or abstract human figure, with three curved lines representing wings or arms. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged in a circular pattern around the figure.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room W-O66-0609 Silver Spring, MD 20993-0002

Kristi Fox Regulatory Affairs Specialist Greatbatch Medical 2300 Berkshire Lane North Minneapolis, MN 55441

Re: K102540

Trade/Device Name: PTFE Peelable Introducer Kit Regulation Number: 21 CFR 870.1340 Regulation Name: Catheter introducer Regulatory Class: Class II Product Code: DYB Dated: October 15, 2010 Received: November 3, 2010

NOV 1 6 2010

Dear Ms. Fox:

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 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). You may, therefore, market the device, subject to the general controls provisions of the Act. However, you are responsible to determine that the medical devices you use as components in the kit have either been determined as substantially equivalent under the premarket notification process (Section 510(k) of the act), or were legally on the market prior to May 28, 1976, the enactment date of the Medical Device Amendments. Please note: If you purchase your device components in bulk (i.e., unfinished) and further process (e.g., sterilize) you must submit a new 510(k) before including these components in your kit. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, and 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 additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In

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Page 2 - Ms. Kristi Fox

addition, FDA may publish further announcements concerning your device in the Eederal 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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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 advice for your device on our labeling regulation (21 CFR Part 801), please go to

http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 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 the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours,

bana R. lahmer

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Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

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Greatbatch Medical Special Premarket Notification 510(k)

PTFE Peelable Introducer

Indications for Use Statement

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Device Name: PTFE Peelable Introducer

NOV 16 2010

Indications for Use:

The PTFE Peelable Introducer is intended for use in the percutaneous insertion of pacing leads or catheters in the venous system.

Prescription Use _____________________________________________________________________________________________________________________________________________________________

Over-The-Counter Use__________________________________________________________________________________________________________________________________________________________

(Part 21 CFR 801 Subpart D)

(21 CFR 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED)

AND/OR

Concurrence of CDRH, Office of Device Evaluation (ODE)

uma R. Vachner

(Division Sign-Off) Division of Cardiovascular Devices

510(k) Number_k102540

§ 870.1340 Catheter introducer.

(a)
Identification. A catheter introducer is a sheath used to facilitate placing a catheter through the skin into a vein or artery.(b)
Classification. Class II (performance standards).