K Number
K012452
Device Name
MODEL 6500 UNIPOLAR TEMORARY MYOCARDIAL PACING LEAD
Manufacturer
Date Cleared
2001-08-14

(13 days)

Product Code
Regulation Number
870.3680
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Model 6500 Unipolar Temporary Myocardial Pacing Lead is designed for temporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.
Device Description
The Model 6500 Unipolar Temporary Myocardial Pacing Lead consists of an electrode and an insulated multi-filament conductor which are crimped together. A blue monofilament proximally attached to the conductor wire permits exiting the pacing lead through the chest wall. The electrode terminates distally in an atraumatic myocardial curved needle. The lead is implanted in myocardial tissue. An atraumatic chest needle at the proximal end of the conductor wire permits exiting the pacing lead through the chest wall. All components of the lead remain in the body, except the silicone rubber disc in case of atrial application.
More Information

Not Found

Not Found

No
The 510(k) summary describes a simple temporary pacing lead with no mention of AI or ML capabilities in its intended use, device description, or performance studies.

Yes
The device is designed for temporary atrial and ventricular pacing and sensing, which are therapeutic interventions for managing cardiac rhythm.

No

This device is a temporary myocardial pacing lead, designed for pacing and sensing, not for diagnosing a condition. It is a therapeutic device that delivers electrical impulses to the heart.

No

The device description clearly details physical components like an electrode, conductor, needles, and a silicone rubber disc, indicating it is a hardware device. The performance studies also focus on physical and electrical testing of these components.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is for temporary atrial and ventricular pacing and sensing, which is a direct intervention on the patient's heart.
  • Device Description: The device is a pacing lead designed to be implanted in myocardial tissue.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens derived from the human body (like blood, urine, tissue samples, etc.) to provide information for diagnosis, monitoring, or compatibility testing.

IVD devices are used in vitro (outside the body) to analyze biological samples. This device is used in vivo (inside the body) for therapeutic and diagnostic purposes related to heart function.

N/A

Intended Use / Indications for Use

The Model 6500 Unipolar Temporary Myocardial Pacing Lead is designed for temporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.

Product codes

74 LDF

Device Description

The Model 6500 Unipolar Temporary Myocardial Pacing Lead consists of an electrode and an insulated multi-filament conductor which are crimped together. A blue monofilament proximally attached to a curved needle terminating distally in an atraumatic myocardial electrode. The lead has an atraumatic chest needle at the proximal end of the conductor wire that permits exiting the pacing lead through the skin. All components of the lead (except the silicone rubber disc in case of atrial application) remain in the body once implanted.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

myocardial tissue, atrial and ventricular

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

Medtronic, Inc. performed system compatibility testing to support that the Model 6500 Unipolar Temporary Myocardial Pacing Lead is equivalent to the predicate device. Device testing included: Environmental Conditioning, Visual Verification, Dimensional Testing, Electrical Testing, Mechanical Testing. All system compatibility tests performed have demonstrated that the modified Model 6500 heartwire meets the specified requirements.

Key Metrics

Not Found

Predicate Device(s)

The predicate device for the Model 6500 Unipolar Temporary Myocardial Pacing Lead is the Medtronic Model 6500 Unipolar Temporary Myocardial Pacing Lead.

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.3680 Cardiovascular permanent or temporary pacemaker electrode.

(a)
Temporary pacemaker electrode —(1)Identification. A temporary pacemaker electrode is a device consisting of flexible insulated electrical conductors with one end connected to anexternal pacemaker pulse generator and the other end applied to the heart. The device is used to transmit a pacing electrical stimulus from the pulse generator to the heart and/or to transmit the electrical signal of the heart to the pulse generator.(2)
Classification. Class II (performance standards).(b)
Permanent pacemaker electrode —(1)Identification. A permanent pacemaker electrode is a device consisting of flexible insulated electrical conductors with one end connected to an implantable pacemaker pulse generator and the other end applied to the heart. The device is used to transmit a pacing electrical stimulus from the pulse generator to the heart and/or to transmit the electrical signal of the heart to the pulse generator.(2)
Classification. Class III (premarket approval).(c)
Date PMA or notice of completion of PDP is required. A PMA or notice of completion of a PDP is required to be filed with the Food and Drug Administration on or before October 4, 2012, for any permanent pacemaker electrode device that was in commercial distribution before May 28, 1976, or that has, on or before October 4, 2012, been found to be substantially equivalent to any permanent pacemaker electrode device that was in commercial distribution before May 28, 1976. Any other pacemaker repair or replacement material device shall have an approved PMA or declared completed PDP in effect before being placed in commercial distribution.

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MEDTRONIC CONFIDENTIAL AUG 1 4 2001

Special 510(k) Premarke Model 6500 Unipolar Temporary Myocardial Pacing Lead loder 6500 Unipolar Teliffordi y Myobatantial Equivalence

KOL2452

ATTACHMENT D 510(K) SUMMARY OF SUBSTANTIAL EQUIVALENCE

Submitter

Medtronic, Inc. 7000 Central Avenue N.E. Minneapolis, MN 55432

Contact: Tina Benoit, Associate Product Regulation Manager Telephone: (763) 514-4112 Fax: (763) 514-6424 E-Mail: tina.benoit@medtronic.com

Date Prepared: July 31, 2001

Name of Device

Trade Name: Temporary Pacemaker Electrode, 74 LDF Common Name: Temporary Pacing Lead Classification: Class II

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Predicate Devices

The predicate device for the Model 6500 Unipolar Temporary Myocardial Pacing
Parties of the Model 6500 Unicolar Temporary The predicate device for the Model 6500 Unipslar Temporary Myocardial Pacing Lead.

Device Description

The Model 6500 Unipolar Temporary Myocardial Pacing Lead consists of an The Model 0500 Unipolar Temperary They conductor which are crimped together. electrode and an insulated multi-inament concession of the lead is attached to the A blue monomanent proximally ocheardumatic myocardial curved needle. A
t electrode and terminates distally in an atraumatic myocardial in museum electrode and terminates distanty in an active the lead is implanted in myocardial tissue. An atraumatic chest needle at the proximal end of the conductor wire tissue. An alraumatic chest neceite at the probably of oremove the pacing lead, permits exiting the pacing icad through the enains in the body, except the silicone rubber disc in case of atrial application.

Packaging

The sterile packaging for the Model 6500 Unipolar Temporary Myocardial Pacing I he sterife packaging for the Model Coop Configuration. The inner pouch (or package liner) Lead consists of a dodoic pouch connigation. Tyvek - polyester/polyethylene laminate. The pouches are heat-sealed.

Intended Use

The is designed for temporary atrial and ventricular pacing and sensing for a The is designed for temporary attrails release. The device is supplied sterile and intended for single use only.

Technological Characteristics

The technology used with the Model 6500 Unipolar Temporary Myocardial The technology asoc with the Moderial characteristics as the predicate device.

Summary of Studies

Medtronic, Inc. performed system compatibility testing to support that the Model 6500 Unipolar Temporary Myocardial Pacing Lead is equivalent to the predicate device. Device testing included:

  • Environmental Conditioning

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Special 510 Model 6500 Unipolar Temporary Myocardia loder 6500 Umpolar Temporary ikyo ostantial Equivalence

  • Visual Verification .
  • Dimensional Testing .
  • Electrical Testing .
  • Mechanical Testing .

All system compatibility tests performed have demonstrated that the modified Model 6500 heartwire meets the specified requirements.

Sterilization Validation

The Model 6500 Unipolar Temporary Myocardial Pacing Lead is sterilized using a The Model 0300 Oxide (ETO) sterilization process. Processes appropriate for sterilizing the devices were validated.

Conclusion

Through data and information presented, numerous similarities support a I hrough data and micrination proseence, and show the device modifications do not affect the intended use of the device or alter the fundamental scientific technology of the device. Market clearance of the Model 6500 Unipolar Temporary Myocardial Pacing Lead is supported through this Special 510(k) Premarket Notification.

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract symbol that resembles an eagle or a stylized human figure with outstretched arms.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG 1 4 2001

Ms. Tina L. Benoit Medtronic, Inc. Cardiac Rhythm Management 7000 Central Avenue NE Minneapolis, MN 55432-3576

Re: K012452

Trade Name: Model 6500 Unipolar Temporary Myocardial Pacing Lead Regulation Number: 21 CFR 870.3680 Regulatory Class: Class II (two) Product Code: 74 LDF Dated: July 31, 2001 Received: August 1, 2001

Dear Ms. Benoit:

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 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.

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 affecting your device can be found 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 comply with 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

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Page 2 - Ms. Tina L. Benoit

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.

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial 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 (301) 594-4646. Additionally, for questions 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 Manufacturers 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,

Dore K. Miller

James E. Dillard II Director Division of Cardiovascular and Respiratory Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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INDICATIONS FOR USE

510(k) Number (if known):

KO12452 NA

Device Name:

Medtronic® Model 6500 Unipolar Temporary-Myocardial Pacing Lead

Indications For Use:

The Model 6500 Unipolar Temporary Myocardial Pacing I he Model 0500 Omporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. schsing for a concemplated in and intended for single use only.

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE) 1 Over-The-Counter Use__ OR Prescription Use (Per 21 CFR 801.109)

(Optional Format 1-2-96)

Deak Teth

Division of Cardiovascular & Respiratory Devices
510(k) Number K012452

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