K Number
K150088
Date Cleared
2015-07-20

(185 days)

Product Code
Regulation Number
876.1075
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

To obtain percutaneous core biopsy samples from soft tissue and tumors of such organs as the liver, spleen, kidney, prostate, lung, breast, and lymph nodes. When used for breast biopsy, the product is for diagnosis only.

The extent histological abnormality in breast tissue cannot be reliably determined from mammographic appearance. Therefore, the extent of removal of the imaged evidence of an abnormality does not guarantee the complete removal of the affected tissue. When the sampled abnormality is not benign, it is necessary that the tissue margins be examined to ensure that the area of suspicion (e.g., malignancy) has been completely removed using standard surgical procedures.

Device Description

The Evacore Fully Disposable Vacuum Assist Biopsy Device is a gamma sterilized, single-use percutaneous biopsy device. The working end of the device consist of a stainless steel outer needle with a lateral aperture for sample acquisition (sample aperture), a stainless steel inner cutting cannula with a sharp edge, and a solid stainless steel stylet located inside the cutting cannula. The handle of the device contains (2) release buttons, a reset handle for the vacuum generator (thumb), a reset handle for the cutting cannula (two fingers), and a needle hub to adjust the needle aperture orientation based on the location of the lesion. When the release buttons are depressed (consecutively or concurrently) a vacuum is generated at the needle sample aperture drawing tissue into the needle, then the cutting cannula is activated automatically, traversing across the sample aperture dissevering the tissue sample. The solid stainless steel stylet prevents the tissue sample from migrating towards the handle once it has been separated from the patient. The device is then removed from the patient and reset via the reset handles allowing the tissue sample to be removed.

AI/ML Overview

The provided text describes a 510(k) premarket notification for the "Evacore Fully Disposable Vacuum Assist Biopsy Device." This document focuses on demonstrating substantial equivalence to a predicate device, rather than providing a detailed study report of the device's performance against specific clinical acceptance criteria.

The acceptance criteria and reported device performance are related to the physical characteristics of the biopsy samples obtained, specifically their volume or mass.

Here's an analysis of the provided information:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance CriteriaReported Device Performance
7 gauge 115mm & 145mm needle: Average volume of a sample > 0.105 cm³PASS
11 gauge 115mm & 145mm needle: Average volume of a samples > 0.033 cm³PASS
14 gauge 115mm & 145mm needle: Average mass of 8 samples > 0.018 cm³PASS

2. Sample Size Used for the Test Set and Data Provenance

The document states that the testing was "Simulated and supported with bench testing." It does not specify the sample size (number of tests or tissues) used for the bench testing or the origin/provenance of the data (e.g., country, retrospective/prospective).

3. Number of Experts Used to Establish Ground Truth for the Test Set and Their Qualifications

The document does not mention the use of experts to establish a ground truth for the bench testing. The "ground truth" in this context appears to be the quantitative measurement of sample volume/mass from the bench tests.

4. Adjudication Method for the Test Set

No adjudication method is mentioned, as the testing described is direct mechanical/physical measurement rather than subjective interpretation requiring adjudication.

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

No MRMC study was done. This device is a biopsy instrument, not an diagnostic imaging or interpretation device that would typically involve human readers.

6. Standalone Performance Study

Yes, a standalone performance assessment was conducted through "empirical testing" and "bench testing" focusing on the physical characteristics of the biopsy samples (volume/mass).

7. Type of Ground Truth Used

The ground truth used was based on quantitative physical measurements (average volume or mass) of samples obtained during simulated bench testing.

8. Sample Size for the Training Set

The document does not mention a training set. The descriptions of performance testing relate to a physical device, not an algorithm that would typically require a training set.

9. How the Ground Truth for the Training Set Was Established

Not applicable, as no training set is discussed for this type of device and testing.

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Image /page/0/Picture/1 description: The image is the logo for the Department of Health and Human Services (HHS). The logo features the words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" arranged in a circular fashion. Inside the circle is a stylized image of three human profiles facing right, with flowing lines extending from the first profile.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

Pin-Point Care Corporation Mr. Jeff M. Hathaway President N1723 Center Street Lebanon, Wisconsin 53047

July 20, 2015

Re: K150088

Trade/Device Name: Evacore Fully Disposable Vacuum Assist Biopsy Device Regulation Number: 21 CFR 876.1075 Regulation Name: Gastroenterology-urology biopsy instrument Regulatory Class: Class II Product Code: KNW Dated: June 26, 2015 Received: June 26, 2015

Dear Mr. Hathaway:

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. 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. 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

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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 contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. 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 Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

For

Sincerely yours,

Joshua

Binita S. Ashar, M.D., M.B.A., F.A.C.S. Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Pin-Point Care

Form Approved: OMB No. 0910-0120

Expiration Date: January 31, 2017

See PRA Statement below.

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K150088

Device Name

Evacore Fully Disposable Vacuum Assist Biopsy Device

Indications for Use (Describe)

To obtain percutaneous core biopsy samples from soft tissue and tumors of such organs as the liver, spleen, kidney, prostate, lung, breast, and lymph nodes. When used for breast biopsy, the product is for diagnosis only.

The extent histological abnormality in breast tissue cannot be reliably determined from mammographic appearance. Therefore, the extent of removal of the imaged evidence of an abnormality does not guarantee the complete removal of the affected tissue. When the sampled abnormality is not benign, it is necessary that the tissue margins be examined to ensure that the area of suspicion (e.g., malignancy) has been completely removed using standard surgical procedures.

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)

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Pin-Point Care

Date Prepared:

30 December, 2014

510(k) Summary

(As required per 21 CFR: §807.92)

Evacore Fully Disposable Vacuum Assist Biopsy Device

I. Applicant Information:

Pin-Point Care Corporation N1723 Center Street Lebanon, WI 53047

II. Contact Person:

Jeff M. Hathaway
Phone Number........................(262)623-1149
Fax Number........................(262)806-7499
Email........................................jeff.hathaway@pin-pointcare.com

III. Device Information:

ClassificationClass II
Trade NameEvacore Fully Disposable VacuumAssist Biopsy Device
Common NameBiopsy Instrument
Classification NameGastroenterology-Urology BiopsyInstrument (21 CFR 876.1075)
Panel78 Gastroenterology/Urology
Product CodeKNW

Predicate Device Information: IV.

ManufacturerHologic - Suros Surgical Systems
DeviceCelero Vacuum Assisted Spring Loaded Core Biopsy Device
510(k) NumberK034021

V. Device Description:

The Evacore Fully Disposable Vacuum Assist Biopsy Device is a gamma sterilized, single-use percutaneous biopsy device. The working end of the device consist of a stainless steel outer needle with a lateral aperture for sample acquisition (sample aperture), a stainless steel inner cutting cannula with a sharp edge, and a solid stainless steel stylet located inside the cutting cannula. The handle of the device contains (2) release buttons, a reset handle for the vacuum generator (thumb), a reset handle for the cutting cannula (two fingers), and a needle hub to adjust the needle

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aperture orientation based on the location of the lesion. When the release buttons are depressed (consecutively or concurrently) a vacuum is generated at the needle sample aperture drawing tissue into the needle, then the cutting cannula is activated automatically, traversing across the sample aperture dissevering the tissue sample. The solid stainless steel stylet prevents the tissue sample from migrating towards the handle once it has been separated from the patient. The device is then removed from the patient and reset via the reset handles allowing the tissue sample to be removed.

VI. Indications for Use:

The Evacore Fully Disposable Vacuum Assist Biopsy Device is a Biopsy Instrument as described under the provisions of 21 CFR §876.1075 and is medically prescribed to obtain percutaneous core biopsy samples from soft tissue and tumors of such organs as the liver, spleen, kidney, prostate, lung, breast, and lymph nodes. When used for breast biopsy, the product is for diagnosis only.

The extent histological abnormality in breast tissue cannot be reliably determined from mammographic appearance. Therefore, the extent of removal of the imaged evidence of an abnormality does not guarantee the complete removal of the affected tissue. When the sampled abnormality is not benign, it is necessary that the tissue margins be examined to ensure that the area of suspicion (e.g., malignancy) has been completely removed using standard surgical procedures.

VII. Device Comparison:

Note: Unless otherwise stated, the Device Comparison for the Evacore Fully Disposable Vacuum Assist Biopsy Device is for all noted needle lengths and gauges.

ComparisonPredicate Device - (K034021)Vacuum Assisted SpringLoaded Core Biopsy DeviceEvacore Fully DisposableVacuum Assist Biopsy Device
Intended UseTo obtain percutaneous corebiopsy samples from soft tissueand tumors of such organs asthe liver, spleen, kidney,prostate, lung, breast, andlymph nodes. When used forbreast biopsy, the product isfor diagnosis only.Same
Target PopulationPatients with suspicious softtissue lesion(s)Same
Product CodeKNWSame
Outer Needle Diameter(s)12 Guage7, 11, and 14 Guage
Needle Length≈123mm115mm and 145mm
Number of samplesUnknown16 samples
Method of DeviceInsertionWorking end of the deviceintroduced without or withcoaxial introducerSame
Method of Tissue CollectionInsert the needle in the correct position, activate the device and wait for the device to finish cycling (automatic), remove the device from the patient, reset the device and manually extract the tissue sample.Same
Optimal Sample Notch Length22mm19mm
Core TypePartial DiameterFull Diameter
Weight135g95g, 84g, and 79g(145mm needle length)
Selectable Sample LengthNoYes (19mm or 11mm length)
Echogenic Needle Description: Used for enhancing ultrsound imaging.YesYes
Disposable DeviceFully disposable single patient useSame
Device SterilityGamma SterilizationSame
Sterile BarrierThermoformed tray with heat sealed Tyvek™ coverSame
Shelf Life3 yearsSame
Electrical SafetyThe device operates on mechanical principles only. Therefore, the device has no electrical componentsSame
Method of TissueDissectionCutting cannula advances across tissue apertureSame
Mechanics of actionAutomaticSame
Needle Advancement/Penetration Depth25mmN/A
Mode of ActionSingle puncture and sample, orsingle puncture and multiplesamples with introducerSame
Non-Contact MaterialsColored polymer housings withmetal springs as the energysourceSame
Patient Contact Materials300 Series Stainless SteelSame
Vacuum Energy SourceSpring operated vacuumgeneratorSame
Cutting Cannula EnergySourceSpring operated cuttingcannulaSame
Dual interlocks (manual)for vacuum generatorreleaseNoYes
Dual interlocks (automatic)for cutting cannula releaseNoYes
Rotating Cutting CannulaNoYes
Manual reset of the deviceYesYes
Hand-Held ProcedureYesYes
Location UsedPhysician's Office or O.R.Same
Prescription vs. O.T.C.PrescriptionSame
PerformanceEquivalency to white paperperformance dataBench test equivalency
Method of placementCT/Ultrasound/Fluoroscopy/ManualSame

Predicate Device Comparison Table

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Traditional 510(k) Evacore Fully Disposable Vaccum Assist Biopsy Device

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VIII. Non-Clinical Performance Data:

The Evacore Fully Disposable Vacuum Assist Biopsy Device was performance tested using empirical testing.

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RiskTest MethodAcceptance CriteriaResults
7 gauge 115mm & 145mmneedle length tissuesample size is inadequateSimulated andsupported withbench testingAverage volume of a sample > .105cm3PASS
11 gauge 115mm & 145mmneedle length tissuesample size is inadequateSimulated andsupported withbench testingAverage volume of a samples >.033cm3PASS
14 gauge 115mm & 145mmneedle length tissuesample size is inadequateSimulated andsupported withbench testingAverage mass of 8 samples > .018cm3PASS

Summary of Non-Clinical Performance Data

IX. Substantial Equivalency:

The flow chart shown below is a duplicate of the one that can be found in "The 510(k) Program: Evaluating Substantial Equivalence in Premarket Notifications" in "Appendix A. 510(k) Decision-Making Flowchart". The pathway illustrates how the Evacore Fully Disposable Vacuum Assist Biopsy Device is substantially equivalent to the legally marketed predicate device.

The Predicate Device Comparison Table demonstrates that the Evacore Fully Disposable Vacuum Assist Biopsy Device has the same technological characteristics as the predicate device in terms of but not limited to, intended use, energy source, operating principals, optimal sample notch length, target population, device sterility, and method of tissue collection.

Conclusion:

Based on the Non-Clinical Performance Data provided in this summary, the Evacore Fully Disposable Vacuum Assist Biopsy Device has been shown to be substantially equivalent to the predicate device.

Note: See following page for flow chart.

§ 876.1075 Gastroenterology-urology biopsy instrument.

(a)
Identification. A gastroenterology-urology biopsy instrument is a device used to remove, by cutting or aspiration, a specimen of tissue for microscopic examination. This generic type of device includes the biopsy punch, gastrointestinal mechanical biopsy instrument, suction biopsy instrument, gastro-urology biopsy needle and needle set, and nonelectric biopsy forceps. This section does not apply to biopsy instruments that have specialized uses in other medical specialty areas and that are covered by classification regulations in other parts of the device classification regulations.(b)
Classification. (1) Class II (performance standards).(2) Class I for the biopsy forceps cover and the non-electric biopsy forceps. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.