K Number
K161277
Date Cleared
2016-11-22

(200 days)

Product Code
Regulation Number
876.4620
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The ConvertX™ Nephroureteral Stent System with releasable drainage catheter is delivered percutaneously and is intended to establish internal drainage from the ureteropelvic junction to the bladder while maintaining external access to the stent, as well as providing external drainage.
For patients for whom external drainage is not, or no longer desirable, the releasable drainage catheter may be removed, leaving the stent to provide internal drainage from the ureteropelvic junction to the bladder.

Device Description

The ConvertX Nephroureteral Stent System is a sterile, single-use non-vascular intervention device inserted using percutaneous access techniques to re-establish internal drainage between the ureteropelvic junction and the bladder, and stent the ureter. The ConvertX System allows for external drainage and access as needed.
The ConvertX Nephroureteral Stent System is a single lumen device that has a detachable ureteral stent with proximal and distal pigtails. Both proximal and distal pigtails contain drainage holes. The proximal pigtail forms in the renal pelvis, while the distal pigtail forms in the bladder. The distal pigtail has a tapered, atraumatic tip. Drainage can occur internally (from the ureteropelvic junction to the bladder) or externally (from the ureteropelvic junction to the outside of the patient). A loop suture is attached to the proximal pigtail enabling the pigtail, straightened for delivery, to be closed in the renal pelvis.
The ConvertX Nephroureteral Stent System's Hub has three ports which are used for both ends of the loop suture, external drainage of urine and the ureteral stent release wire. One end of the loop suture and the release wire are connected to pull tabs. The releasable drainage catheter and loop suture may be detached from the ureteral stent when external drainage is no longer necessary, leaving the stent in place. While still attached, the releasable drainage catheter may be used to withdraw the ureteral stent. The ConvertX Nephroureteral Stent System is radiopaque throughout its length.
The ConvertX Nephroureteral Stent System is comprised of the following components:

  • Ureteral Stent
  • Releasable Drainage Catheter with Hub
    The following accessories are provided with the ConvertX Nephroureteral Stent System:
  • Metal Stiffening Cannula
  • Luer Cap
AI/ML Overview

The provided text describes the 510(k) premarket notification for the ConvertX™ Nephroureteral Stent System. The document focuses on establishing substantial equivalence to predicate devices through non-clinical performance testing. It does not include information about studies involving human subjects or AI algorithms.

Therefore, many of the requested criteria related to clinical studies, AI performance, ground truth establishment, expert involvement, and sample sizes for training/testing sets cannot be extracted from this document.

Here's an attempt to answer the applicable parts of your request based on the provided text:

1. A table of acceptance criteria and the reported device performance

The document states: "The ConvertX Nephroureteral Stent System, including its packaging, met the predetermined acceptance criteria. No new safety or performance issues were raised during testing." However, the specific numerical or descriptive acceptance criteria for each performance test are not detailed in this summary. Instead, it lists the types of tests performed.

Acceptance Criteria (General)Reported Device Performance
Met predetermined acceptance criteriaMet predetermined acceptance criteria. No new safety or performance issues were raised during testing.
Compliance with standardsComplied with ASTM F1828-97, ASTM F623-99, ISO 10555-1:2013, FDA Guidance for Ureteral Stents, ASTM F2182-11a, ASTM F2119-07, ASTM F2052-15, ASTM F2503-13, and ASTM F640-12.
Indications for UseIntended to establish internal drainage from the ureteropelvic junction to the bladder while maintaining external access and providing external drainage. For patients where external drainage is not desired, the releasable catheter can be removed, leaving the stent for internal drainage. (See full description in "Indications for Use" section).
Performance/Technological CharacteristicsSee the comparison table below

Comparison Table of ConvertX Nephroureteral Stent System vs. Predicate Devices (Contains performance characteristics, implicitly showing the ConvertX meets similar performance as predicates)

Performance / Technological CharacteristicConvertX Nephroureteral Stent SystemExpel Nephroureteral Stent System Twist Loc Hub (K141344)Expel Ureteral Stent System (K141344)
Indications for UseThe ConvertX Nephroureteral Stent System with releasable drainage catheter is delivered percutaneously and is intended to establish internal drainage from the ureteropelvic junction to the bladder while maintaining external access to the stent, as well as providing external drainage. For patients for whom external drainage is not, or no longer desirable, the releasable drainage catheter may be removed, leaving the stent to provide internal drainage from the ureteropelvic junction to the bladder.The Expel Nephroureteral Stents are delivered percutaneously and are intended to establish internal drainage from the ureteropelvic junction to the bladder while maintaining external access to the stent, as well as providing external drainage.The Expel Ureteral Stent System is delivered percutaneously and is intended to establish drainage from the ureteropelvic junction to the bladder and stenting of the ureter for all patients in whom it is desirable to place a drain which does not extend externally.
Common NameUreteral StentUreteral StentUreteral Stent
ClassificationClass II, Performance StandardsClass II, Performance StandardsClass II, Performance Standards
Regulation Number21 CFR 876.462021 CFR 876.462021 CFR 876.4620
Product CodeFADFADFAD
Single Use OnlyYesYesYes
Provided SterileYesYesYes
Sterilization MethodEtOEtOEtO
Diameters10.3 French8.3 and 10.3 French8.3 and 10.3 French
Stent Lengths20, 22, 24, 26, 28 cm22, 24, 26, 28 cm22, 24, 26, 28 cm
Guidewire Compatibility0.038"0.038"0.038"
Stent MaterialPolyurethanePolyurethanePolyurethane
Drainage Catheter MaterialPolyurethanePolyurethaneNA
Loop Suture MaterialPolyethyleneNylonNylon
Tapered Stent TipYesYesYes
RadiopaqueYesYesYes
MRI CompatibleYesYesYes
Urine CompatibleYesYesYes
Maximum Indwelling TimeNot to exceed 30-daysNot to exceed 30-daysNot to exceed 90-days
Delivery MethodPercutaneousPercutaneousPercutaneous
Method of conversion from nephroureteral stent to ureteral stentDisconnectRemoval / ExchangeNA
BiocompatibilityMeets requirements of 10993-1Meets requirements of 10993-1Meets requirements of 10993-1
Accessory DevicesStiffening Cannula, Luer CapCannulas, Plug/Cap, Stabilizer, Pigtail StraightenerCannulas, Stabilizer, Pigtail Straightener

2. Sample size used for the test set and the data provenance

The document describes non-clinical testing (e.g., mechanical, material, and compatibility tests), not a clinical study involving a "test set" of patient data. Therefore, this information is not applicable. The provenance of the data is from BrightWater Medical's internal testing.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable. This was non-clinical performance testing against engineering and material specifications, not a study requiring expert clinical ground truth.

4. Adjudication method for the test set

Not applicable. See point 3.

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

Not applicable. This device is a physical medical device (stent), not an AI algorithm, and the documentation describes non-clinical performance testing, not a comparative effectiveness study involving human readers.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

Not applicable. This documentation is for a physical medical device.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

For the non-clinical tests described, the "ground truth" would be the engineering specifications, material standards (e.g., ASTM, ISO), and regulatory requirements (e.g., FDA guidance documents). The device was tested to meet these predefined physical and performance characteristics.

8. The sample size for the training set

Not applicable. This is not a study involving a "training set" for an AI or machine learning model.

9. How the ground truth for the training set was established

Not applicable. See point 8.

{0}------------------------------------------------

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" written around it. Inside the circle is an abstract symbol that resembles three human profiles facing to the right, stacked on top of each other.

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

November 22, 2016

Brightwater Medical Bob Smouse CEO/ CMO 816 W. Bennett Ct. Dunlap. IL 61525

Re: K161277

Trade/Device Name: ConvertX™ Nephroureteral Stent System Regulation Number: 21 CFR 876.4620 Regulation Name: Ureteral Stent Regulatory Class: Class II Product Code: FAD Dated: October 13, 2016 Received: October 17, 2016

Dear Bob Smouse,

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 devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in

{1}------------------------------------------------

the quality systems (OS) 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" (21 CFR 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.

Sincerely yours,

For Division

Douglas Silverstein -S 2016.11.22 12:05:41 -05'00'

Benjamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

{2}------------------------------------------------

Indications for Use

510(k) Number (if known) K161277

Device Name

ConvertX Nephroureteral Stent System

Indications for Use (Describe)

The ConvertX Nephroureteral Stent System with releasable drainage catheter is delivered percutaneously and is intended to establish internal drainage from the ureteropelvic junction to the bladder while maintaining external access to the stent, as well as providing external drainage.

For patients for whom external drainage is not, or no longer desirable, the releasable drainage catheter may be removed, leaving the stent to provide internal drainage from the ureteropelvic junction to the bladder.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement below.

{3}------------------------------------------------

Image /page/3/Picture/0 description: The image contains the logo for BrightWater Medical. The logo consists of a stylized water droplet made up of three curved lines in different shades of blue and green. To the right of the droplet is the text "BrightWater" in a light blue sans-serif font, with the word "Medical" below it in a smaller font size.

510(K) SUMMARY OF SAFETY AND EFFECTIVENESS

In accordance with 21 CFR §807.92 the following summary of information is provided:

Submitted ByBrightWater Medical816 W. Bennett Ct.Dunlap, IL 61525U.S.A.
Contact PersonBob Smouse, M.D.Chief Executive Officer / Chief Medical OfficerPhone: 1-650-210-8100Email: bsmouse@brightwatermed.com
Date PreparedOctober 13, 2016
Proprietary NameConvertX™ Nephroureteral Stent System
Common NameUreteral Stent
ClassificationClass II
Regulation Number21 CFR 876.4620
Classification PanelGastroenterology/Urology
Product CodeFAD
Predicate DeviceK141344, Expel Nephroureteral Stent System with Twist-Loc Huband Expel Ureteral Stent System
Intended Use /Indications for UseThe ConvertX Nephroureteral Stent System with releasabledrainage catheter is delivered percutaneously and is intended toestablish internal drainage from the ureteropelvic junction to thebladder while maintaining external access to the stent, as well asproviding external drainage.For patients for whom external drainage is not, or no longerdesirable, the releasable drainage catheter may be removed, leavingthe stent to provide internal drainage from the ureteropelvicjunction to the bladder.

{4}------------------------------------------------

Image /page/4/Picture/0 description: The image contains the logo for BrightWater Medical. The logo consists of a stylized water droplet made up of three curved lines in different shades of blue and green. To the right of the droplet are the words "BrightWater" in a light blue sans-serif font, with the word "Medical" underneath in a smaller font.

DEVICE DESCRIPTION

The ConvertX Nephroureteral Stent System is a sterile, single-use non-vascular intervention device inserted using percutaneous access techniques to re-establish internal drainage between the ureteropelvic junction and the bladder, and stent the ureter. The ConvertX System allows for external drainage and access as needed.

The ConvertX Nephroureteral Stent System is a single lumen device that has a detachable ureteral stent with proximal and distal pigtails. Both proximal and distal pigtails contain drainage holes. The proximal pigtail forms in the renal pelvis, while the distal pigtail forms in the bladder. The distal pigtail has a tapered, atraumatic tip. Drainage can occur internally (from the ureteropelvic junction to the bladder) or externally (from the ureteropelvic junction to the outside of the patient). A loop suture is attached to the proximal pigtail enabling the pigtail, straightened for delivery, to be closed in the renal pelvis.

The ConvertX Nephroureteral Stent System's Hub has three ports which are used for both ends of the loop suture, external drainage of urine and the ureteral stent release wire. One end of the loop suture and the release wire are connected to pull tabs. The releasable drainage catheter and loop suture may be detached from the ureteral stent when external drainage is no longer necessary, leaving the stent in place. While still attached, the releasable drainage catheter may be used to withdraw the ureteral stent. The ConvertX Nephroureteral Stent System is radiopaque throughout its length.

The ConvertX Nephroureteral Stent System is comprised of the following components:

  • Ureteral Stent ●
  • Releasable Drainage Catheter with Hub

The following accessories are provided with the ConvertX Nephroureteral Stent System:

  • Metal Stiffening Cannula .
  • . Luer Cap

SUMMARY OF NON-CLINICAL TESTING

Design verification / performance testing for the ConvertX Nephroureteral Stent System was completed in accordance with applicable sections of ASTM F1828-97 - Standard Specification for Ureteral Stents, ASTM F623-99 - Standard Performance Specification for Foley Catheters, ISO 10555-1: 2013 - Intravascular catheters - Sterile and single-use catheters, Part 1: General requirements, and the FDA Guidance for the Content of Premarket Notifications for Ureteral Stents. MRI Compatibility was evaluated according to ASTM F2182-11a - Standard Test Method for Measurement of Radio Frequency Heating On or Near Passive Implants During Magnetic Resonance Imaging, ASTM F2119-07 - Standard Test Method for Evaluation of MR Image Artifacts from Passive Implants, ASTM F2052-15 - Standard Test Method for Measurement of Magnetically Induced Displacement Force on Medical Devices in the Magnetic Resonance Environment, and ASTM F2503-13 - Standard Practice for Marking Medical Devices and Other Items for Safety in Magnetic Resonance Environment. Radiopacity of the ConvertX

{5}------------------------------------------------

Image /page/5/Picture/0 description: The image contains the logo for BrightWater Medical. The logo consists of a stylized water droplet made up of three concentric lines in teal, light green, and teal again. To the right of the droplet is the text "BrightWater" in a teal sans-serif font, with the word "Medical" in a smaller font size directly below it.

Nephroureteral Stent System was evaluated in accordance with ASTM F640-12 - Standard Test Methods for Determining Radiopacity for Medical Use.

  • Stent / Catheter Dimensions
  • · Stiffener Dimensions
  • · Straightener to Stent Compatibility
  • · Guidewire Compatibility
  • · Loop Recovery
  • Flow Recovery Post Kinking
  • Stent-Catheter Interface Strength
  • Kink Resistance
  • Stent Shaft Tensile Strength
  • Hub to Shaft Tensile Strength
  • Hub to Stiffener Strength
  • · Stiffener Tip Strength
  • · Loop Retention / Removal Force
  • Pull wire to Pull Tab Tensile Strength
  • Loop Suture to Pull Tab Tensile strength
  • · Frictional Force
  • · Loop Suture Removal Force
  • Lock Suture to Hub Tensile Strength
  • · Decoupling Force
  • · Resistance to Deformation
  • · Urine Compatibility Stent
  • · Urine Compatibility -System
  • Resistance to Liquid Leakage Under Pressure and During Aspiration/ Vacuum
  • Flow Rate
  • · Shelf Life
  • MRI Compatibility Conditional
  • · Sterilization
  • · Non-pyrogenic LAL Kinetic Chromogenic
  • · Biocompatibility
  • · Radiopacity
  • · Pouch Seal Strength

The ConvertX Nephroureteral Stent System, including its packaging, met the predetermined acceptance criteria. No new safety or performance issues were raised during testing.

Performance /TechnologicalCharacteristicConvert XNephroureteral StentSystemExpel NephroureteralStent System Twist LocHub (K141344)Expel Ureteral StentSystem (K141344)
Indications for UseThe ConvertXNephroureteral StentSystem with releasabledrainage catheter isdelivered percutaneouslyand is intended toestablish internaldrainage from theureteropelvic junction tothe bladder whilemaintaining externalaccess to the stent, aswell as providingexternal drainage.The Expel NephroureteralStents are deliveredpercutaneously and areintended to establishinternal drainage from theureteropelvic junction tothe bladder whilemaintaining externalaccess to the stent, aswell as providing externaldrainage.The Expel Ureteral StentSystem is deliveredpercutaneously and isintended to establishdrainage from theureteropelvic junction tothe bladder and stentingof the ureter for allpatients in whom it isdesirable to place a drainwhich does not extendexternally.
Performance /TechnologicalCharacteristicConvert XNephroureteral StentSystemExpel NephroureteralStent System Twist LocHub (K141344)Expel Ureteral StentSystem (K141344)
For patients for whomexternal drainage is not,or no longer desirable,the releasable drainagecatheter may beremoved, leaving thestent to provide internaldrainage from theureteropelvic junction tothe bladder.
Common NameUreteral StentUreteral StentUreteral Stent
ClassificationClass II, PerformanceStandardsClass II, PerformanceStandardsClass II, PerformanceStandards
Regulation Number21 CFR 876.462021 CFR 876.462021 CFR 876.4620
Product CodeFADFADFAD
Single Use OnlyYesYesYes
Provided SterileYesYesYes
Sterilization MethodEtOEtOEtO
Diameters10.3 French8.3 and 10.3 French8.3 and 10.3 French
Stent Lengths20, 22, 24, 26, 28 cm22, 24, 26, 28 cm22, 24, 26, 28 cm
GuidewireCompatibility0.038"0.038"0.038"
Stent MaterialPolyurethanePolyurethanePolyurethane
Drainage CatheterMaterialPolyurethanePolyurethaneNA
Loop Suture MaterialPolyethelyneNylonNylon
Tapered Stent TipYesYesYes
RadiopaqueYesYesYes
MRI CompatibleYesYesYes
Urine CompatibleYesYesYes
Maximum IndwellingTimeNot to exceed 30-daysNot to exceed 30-daysNot to exceed 90-days
Delivery MethodPercutaneousPercutaneousPercutaneous
Method ofconversion fromnephroureteral stentto ureteral stentDisconnectRemoval / ExchangeNA
PerformanceTechnologicalCharacteristicConvert XNephroureteral StentSystemExpel NephroureteralStent System Twist LocHub (K141344)Expel Ureteral StentSystem (K141344)
BiocompatibilityMeets requirements of10993-1Meets requirements of10993-1Meets requirements of10993-1
Accessory DevicesStiffening CannulaLuer CapCannulas, Plug/Cap,Stabilizer, PigtailStraightenerCannulas, Stabilizer,Pigtail Straightener

PREDICATE DEVICE COMPARISON

{6}------------------------------------------------

Image /page/6/Picture/0 description: The image contains the logo for BrightWater Medical. The logo consists of a stylized water droplet made up of three curved lines in different shades of blue and green. To the right of the droplet is the text "BrightWater" in a sans-serif font, with the word "Medical" in a smaller font size below it.

{7}------------------------------------------------

Image /page/7/Picture/0 description: The image contains the logo for BrightWater Medical. The logo consists of a stylized water droplet symbol on the left, composed of three concentric lines in shades of blue and green. To the right of the symbol, the text "BrightWater" is displayed in a light blue sans-serif font, with the word "Medical" appearing below it in a smaller font size and the same color.

CONCLUSION

The ConvertX™ Nephroureteral Stent System has the same intended use and similar technological characteristics as the Expel Nephroureteral Stent System with Twist-Loc Hub and Expel Ureteral Stent System (K141344) marketed by Boston Scientific Corporation. Moreover, performance testing contained in this submission demonstrate that any differences in their technological characteristics do not raise any new questions of safety or effectiveness. Thus, the ConvertX Nephroureteral Stent System is substantially equivalent to the predicate devices.

§ 876.4620 Ureteral stent.

(a)
Identification. A ureteral stent is a tube-like implanted device that is inserted into the ureter to provide ureteral rigidity and allow the passage of urine. The device may have finger-like protrusions or hooked ends to keep the tube in place. It is used in the treatment of ureteral injuries and ureteral obstruction.(b)
Classification. Class II (performance standards).