K Number
K011818
Date Cleared
2001-09-06

(87 days)

Product Code
Regulation Number
890.1385
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Concentric, Monopolar, Hook Wire and Hypodermic EMG Electrodes are intended for use with recording, monitoring and stimulation/recording equipment for the stimulation/recording of biopotential signals including electromyograph (EMG) and nerve potential signals.

Device Description

EMG electrodes are applied in the study of biopotentials such as electromyograph (EMG), nerve conduction and stimulation/response. Electrodes are invasive as they are placed in contact with nerve or muscle tissue.

The electrodes consist of a needle with a connector/lead wire attached. The connector/lead wires terminate in a safety connector that cannot be connected to an AC power outlet.

The electrodes provide the patient contact device. The electrodes connect to the user's recording, monitoring and stimulation/response equipment. The electrodes are used under the supervision of a physician.

The EMG electrodes consist of a needle with a connector or lead wire attached. The connector or lead wires terminate in a safety connector that cannot be connected to an AC power outlet. The EMG Electrodes are provided sterile and for single patient use.

AI/ML Overview

This document is a 510(k) summary for Sterile EMG Electrodes by Nicolet Biomedical Incorporated. It describes the device, its intended use, and its substantial equivalence to predicate devices. However, this document does not contain any information about acceptance criteria or a study proving device performance against such criteria.

Therefore, I cannot provide the requested information. The document focuses on demonstrating substantial equivalence to predicate devices, which is a regulatory pathway that typically does not involve new clinical performance studies or specific acceptance criteria for performance metrics like sensitivity, specificity, or accuracy.

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SEP - 6 2001

Image /page/0/Picture/1 description: The image shows the logo for Nicolet Biomedical. The word "Nicolet" is in a large, bold, sans-serif font. Below the word "Nicolet" is a thick black line. Below the line, the word "BIOMEDICAL" is in a smaller, sans-serif font.

K011818

Summary of Safety and Effectiveness

Company Name:Nicolet Biomedical Incorporated5225 Verona RoadMadison, WI 53711
Contact:Glen Hermanson, Manager of Standards and Compliance
Phone:608 441-2065
Fax:608 441-2007
Summary Date:June 7, 2001
Trade Name:Sterile EMG Electrodes
Common Name:EMG Electrodes
Classification Name:21 CFR 890.1385, EMG Needle Electrode
Predicate Device(s):
510(k) Number:K850107
Manufacture:Nicolet Biomedical Incorporated
Trade Name:Concentric EMG Electrodes (non-sterile)
Product Code:IKT
Classification:21 890.1385, Diagnostic Electromyograph Needle Electrode
510(k) Number:K912282, K924521, K955335, K982950
Manufacture:Chalgren, Incorporated
Trade Name:Disposable Monopolar EMG Electrode, Disposable ConcentricNeedle Electrode, Disposable Hypodermic Monopolar Needle,Fine Wire Electrode (Hook Wire)
Product Code:IKT
Classification:21 890.1385, Diagnostic Electromyograph Needle Electrode
510(k) Number:K912783
Manufacture:Class A Incorporated
Trade Name:Disposable Monopolar Needle Electrode
Product Code:GXZ
Classification:21 882.1350, Needle Electrode

Nicolet Biomedical Inc.

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5225 Verona Road Bldg. 2 Madison, Wisconsin USA 53711-4495 Tel: 608/273-5000 Fax: 608/273-5067 Toll free: 1-800/356-0007

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BIOMEDICA

Packaging and sterilization of the EMG electrodes is equivalent to the Subdermal Needle Electrodes, described in the following Nicolet Biomedical 510(k):

510(k) Number: K010019 Manufacture: Nicolet Biomedical Subdermal Needle Electrodes Trade Name:

1.0 Description of Electrodes

EMG electrodes are applied in the study of biopotentials such as electromyograph (EMG), nerve conduction and stimulation/response. Electrodes are invasive as they are placed in contact with nerve or muscle tissue.

The electrodes consist of a needle with a connector/lead wire attached. The connector/lead wires terminate in a safety connector that cannot be connected to an AC power outlet.

The electrodes provide the patient contact device. The electrodes connect to the user's recording, monitoring and stimulation/response equipment. The electrodes are used under the supervision of a physician.

2.0 Intended Use of Electrodes

EMG electrodes are intended for use with recording, monitoring and stimulation/recording equipment for the stimulation/recording of biopotential signals including electromyograph (EMG) and nerve potential signals.

3.0 Technological Characteristics

The EMG electrodes consist of a needle with a connector or lead wire attached. The connector or lead wires terminate in a safety connector that cannot be connected to an AC power outlet. The EMG Electrodes are provided sterile and for single patient use.

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Image /page/2/Picture/0 description: The image shows the logo for Nicolet Biomedical. The word "Nicolet" is in large, bold, sans-serif font. Below "Nicolet" is a thick black line, and below that is the word "BIOMEDICAL" in a smaller, sans-serif font.

4.0 Conclusions

The characteristics of the EMG Electrodes are substantially equivalent to the predicate devices. No new questions of safety or effectiveness are raised.

$\sigma$

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

SEP = 6 2001

Nicolet Biomedical, Inc. c/o Mr. Gary Syring Quality and Regulatory Associates, LLC 800 Levanger Lane Stoughton, Wisconsin 53589

Re: K011818

Trade/Device Name: Sterile EMG Electrodes Regulation Number: 890.1385, 882.1350 Regulation Name: Diagnostic electromyograph needle electrode Needle electrode Regulatory Class: II Product Code: IKT, GXZ Dated: June 8, 2001 Received: June 11, 2001

Dear Mr. Syring:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we 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). You may, therefore, market the device, subject to the general controls Costions 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.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations ( remailed in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to mopellish the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

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Page 2 - Mr. Gary Syring

This letter will allow you to begin marketing your device as described in your 510(k) premarket This lotter will and it your disubstantial equivalence of your device to a legally marketed predicate 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 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at additionally 607.10 for in 10 and stimestions on the promotion and advertising of your device, 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 on your responsibilities under the Act may be obtained from the Division of Small mountacturers 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,

Susa Walker, M.D

Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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510(k) Number (if known): K011818

Device Name: Sterile EMG Electrodes

Indications For Use:

Concentric, Monopolar, Hook Wire and Hypodermic EMG Electrodes are intended for use with recording, monitoring and stimulation/recording equipment for the stimulation/recording of biopotential signals including electromyograph (EMG) and nerve potential signals.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

SV
Division Sign-Off

(Division Sign-Of (Division Sign-On)
Division of General, Restorative Division of Sources

(Optional Format 3-10-98)

510(k) Number K011818

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§ 890.1385 Diagnostic electromyograph needle electrode.

(a)
Identification. A diagnostic electromyograph needle electrode is a monopolar or bipolar needle intended to be inserted into muscle or nerve tissue to sense bioelectrical signals. The device is intended for medical purposes for use in connection with electromyography (recording the intrinsic electrical properties of skeletal muscle).(b)
Classification. Class II (performance standards).