K Number
K011621
Device Name
KOALA CLAMP, KOALA CLAMP AND CUTTER
Manufacturer
Date Cleared
2001-08-10

(77 days)

Product Code
Regulation Number
884.4530
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The indications for use of the Koala Clamp & Cutter are to simultaneously clamp and cut the umbilical cord.
Device Description
Not Found
More Information

Not Found

No
The summary provides no information suggesting the use of AI or ML. The device description is missing, and there are no mentions of AI, ML, image processing, or data sets typically associated with AI/ML development. The intended use is a simple mechanical action.

No
The device is used to clamp and cut the umbilical cord, which is a procedural tool rather than a therapeutic intervention for a disease or condition.

No
The device's intended use is to simultaneously clamp and cut the umbilical cord, which is a therapeutic or procedural action, not a diagnostic one. It does not gather information for disease or condition detection.

No

The device description is not found, but the intended use clearly describes a physical action (clamping and cutting) which requires hardware. The predicate device also appears to be a physical instrument.

Based on the provided information, the Koala Clamp & Cutter is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is to "simultaneously clamp and cut the umbilical cord." This is a physical action performed on a part of the body (the umbilical cord), not a test performed on a sample taken from the body to diagnose a condition or provide information about a physiological state.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing a biological sample (blood, urine, tissue, etc.)
    • Detecting or measuring substances in a sample
    • Providing diagnostic information
    • Using reagents or analytical methods

The device is a surgical/medical instrument used for a physical procedure during childbirth. The predicate device (ClampCut) also appears to be a similar type of instrument, further supporting that this is not an IVD.

N/A

Intended Use / Indications for Use

The indications for use of the Koala Clamp & Cutter are to simultaneously clamp and cut the umbilical cord.

Product codes (comma separated list FDA assigned to the subject device)

85 HFW

Device Description

Not Found

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Umbilical Cord

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Not Found

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K982464

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 884.4530 Obstetric-gynecologic specialized manual instrument.

(a)
Identification. An obstetric-gynecologic specialized manual instrument is one of a group of devices used during obstetric-gynecologic procedures to perform manipulative diagnostic and surgical functions (e.g., dilating, grasping, measuring, and scraping), where structural integrity is the chief criterion of device performance. This type of device consists of the following:(1) An amniotome is an instrument used to rupture the fetal membranes.
(2) A circumcision clamp is an instrument used to compress the foreskin of the penis during circumcision of a male infant.
(3) An umbilical clamp is an instrument used to compress the umbilical cord.
(4) A uterine curette is an instrument used to scrape and remove material from the uterus.
(5) A fixed-size cervical dilator is any of a series of bougies of various sizes used to dilate the cervical os by stretching the cervix.
(6) A uterine elevator is an instrument inserted into the uterus used to lift and manipulate the uterus.
(7) A gynecological surgical forceps is an instrument with two blades and handles used to pull, grasp, or compress during gynecological examination.
(8) A cervical cone knife is a cutting instrument used to excise and remove tissue from the cervix.
(9) A gynecological cerclage needle is a looplike instrument used to suture the cervix.
(10) A hook-type contraceptive intrauterine device (IUD) remover is an instrument used to remove an IUD from the uterus.
(11) A gynecological fibroid screw is an instrument used to hold onto a fibroid.
(12) A uterine sound is an instrument used to determine the depth of the uterus by inserting it into the uterine cavity.
(13) A cytological cervical spatula is a blunt instrument used to scrape and remove cytological material from the surface of the cervix or vagina.
(14) A gynecological biopsy forceps is an instrument with two blades and handles used for gynecological biopsy procedures.
(15) A uterine tenaculum is a hooklike instrument used to seize and hold the cervix or fundus.
(16) An internal pelvimeter is an instrument used within the vagina to measure the diameter and capacity of the pelvis.
(17) A nonmetal vaginal speculum is a nonmetal instrument used to expose the interior of the vagina.
(18) A fiberoptic nonmetal vaginal speculum is a nonmetal instrument, with fiberoptic light, used to expose and illuminate the interior of the vagina.
(b)
Classification. (1) Class II (special controls). The device, when it is an umbilical clamp with or without a cutter, a uterine tenaculum which is sterile and does not use suction and is intended for single use, a nonmetal vaginal speculum, or a fiberoptic nonmetal vaginal speculum, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 884.9.(2) Class I for the amniotome, uterine curette, cervical dilator (fixed-size bougies), cerclage needle, IUD remover, uterine sound, and gynecological 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 § 884.9.

0

KOII621

AUG 1 0 2001

510(k) Summary

Substantial Equivalence & Safety & Effectiveness Information

[May 18, 2001]

  • Koala Clamp & Cutter I. Proprietary Name:
  • Umbilical Cord Clamp & Cutter Device Common Name: II.
  • Umbilical Clamp (HFW), Umbilical Scissors (HDJ) Classification Name: III.
  • Cutter is substantially Clamp & Substantial Equivalence: The Koala IV. equivalent to the ClampCut by PriceInvena APS, a legally marketed device in the US. [510(k) No. 982464]
  • Statement of Intended Use: The indications for use of the Koala Clamp & are to V. simultaneously clamp and cut the umbilical cord.

Image /page/0/Picture/13 description: The image contains a handwritten number '30'. The number is written in a simple, slightly rounded style, with the '3' and '0' clearly distinguishable. The digit is written in black ink on a white background.

1

KO 11621

Comparison of Present Device & Predicate Device: VI.

| Comparison Chart of Koala Clamp & Cutter and

Predicate Device
Koala ClampClampCut (SCC-23)
Indications for UseThe indications for use are to
simultaneously clamp and cut the umbilical
cord.The indications for use are to
simultaneously clamp and cut the umbilical
cord. The device reduces the risk to
healthcare practitioners of unnecessary
exposure to infection by bloodborne
diseases.
Target PopulationAll birthsAll births
Materials: PlasticLexan 144R (alternate: Lexan
124R)Polyamid 6.6.
BiocompatibleYesYes
Materials: BladeStainless Steel Surgical BladeStainless Steel Knife
Shield (for Blade)YesNo
Dimensions: Open Unit74mm x 50.6mm x 32.9mm120mm x 70mm x 20mm
Dimensions: Closed Unit46.8mm x 50.6mm x 32.9mm85mm x 60mm x 20mm
Dimensions: Infant
Clamp43.5mm x 23.9mm x 6.5mm50mm x 9mm x 7mm
Weight of Total Unit1.316 oz0.811 oz (23 grammes)
Weight of Cutter Unit
alone0.53 oz0.713 oz (20.2 grammes)
Weight of Infant Clamp
alone0.086 oz0.099 oz (2.8 grammes)
SterilityGamma-Sterilized (alternate:
Ethylene Oxide Gas)Ethylene Oxide Gas
Anatomical SitesUmbilical CordUmbilical Cord

31

2

Image /page/2/Picture/1 description: The image is a circular seal for the Department of Health & Human Services - USA. The seal features an abstract image of an eagle in the center. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged around the top half of the circle.

AUG 1 0 2001

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Ronald B. Hicks Vice President and COO Maternus, Inc. P.O. Box 782089 SAN ANTONIO TX 78278-2089 Re: K011621 Koala Clamp & Cutter, Umbilical Cord Clamp and Cutter Dated: May 22, 2001 Received: May 25, 2001 Regulatory Class: II 21 CFR $884.4530/Procode: 85 HFW

Dear Mr. Hicks:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have been include devices We have reviewed your Section 310(x) noutications of mise enclosed to legally marketd predicate devices and device is substantially equivalent (10) the materials to tass and added Device Americal Device Amendmants, or to devices of to devices of to devices of to devices of tot Act marketed in intersate commerce provisions of the Federal Food, Drug, and Comments Act (Act.). You may, accorple provisions of the Ar that have been reclassified in accordance with the provisions of the every means a controls provisions of the Act. therefore, market the device, subject to the general controls of the Programment of the contributions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (Premater Approval), it may be subjections If your device is classinod (See above) nito elifecting your device can be in the Code of Federal Regulations, to such additional controls. Existing major regulation and the Current Good Manufacturing (11 CFR Parts Title 21, Parts 800 to 893. A substant decimination assame and called Devices: Central regulation (21 CFR Partice, coursely, could Practice requirements, as set form in the Food and Drug Administration (PDA) will be rify such assumptions. Failure 820) and that, through periodic QS inspections, the Pod and Drag From and the may publish further announcements.
The comply with the GMP regulation may result in regulatory a to comply with the GMP regulation in regulations and this resolution of theming world. Includion submission does not
concerning your device in the Federal Register. Please n concerning your device in the rederal Register. Trease noter and response of the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin marketing your device as described in your 510(k) premarks incification for your province and This letter will allow you to begally marketed predicated anyone of your of your device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally on the scameration on the scameration on the scameration on the sca If you desire specific advice tor your device of Compliance at (301) 594-4639. Additionally, for questions on the promotion diagnosite devices), please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 807.97). Other general information of your of the fire entitled, "Misbanding by relectice to picharker nothe Division of Small Manufactures Assistance at its toll-free number (800)
responsibilities under the Act may be obtained f responsibilities under the Act may be obtained internet address "http://www.fda.gov/cdrh/dsmala.html".

Sincerely yours.

Nancy C Brogdon

Nancy C. rogdon Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure (s)

3

Statement of Indications for Use

510(k) Number:K011621
Device Name:Koala Clamp & Cutter
Indications for Use:The indications for use of the Koala Clamp & Cutter are to simultaneously clamp and cut the umbilical cord.

Concurrence of CDRH, Office of Device Evaluation (ODE)

9

David C. Simpson

.............................................................................................................................................................................

(Division Sign-Off) Division of Reproductive, Abdominal, and Radiological Devices 510(k) Number _ 0/162

Prescription Use
(Per 21 CFR 801.109)

510(k) Premarket Notification Koala Clamp & Cutter