(58 days)
The Wilson-Cook Modified Zilver Biliary Stent is indicated for use in palliation of malignant neoplasms in the biliary tree.
Used to maintain patency of malignant biliary strictures.
The Wilson-Cook Zilver Biliary Stent is indicated for use in the palliation of malignant neoplasms in the biliary tree.
The Wilson-Cook Modified Zilver Biliary Stent is indicated for use in palliation of malignant neoplasms in the biliary tree. This device and its introduction system are supplied sterile and intended for single use only.
The modification of the Zilver Biliary Stent includes a change to the introduction system only. The stent itself is identical to the predicate Cook Zilver Biliary Stent (K010242) in configuration and materials of construction, and the intended use for both the predicate and modified device are also the same. However, since the predicate introduction system is utilized for percutaneous biliary stent placement and the modified Wilson-Cook Metal Biliary Stent introduction system is used for endoscopic placement, the introduction system of the modified device is longer (200 cm) than that of the predicate device (80 cm).
These devices also operate in the same manner; the main difference being the method utilized in order to gain access to the placement site. The predicate device is used for percutaneous placement, while the modified Wilson-Cook Biliary Stent is placed endoscopically.
The document provided is a 510(k) summary for the Wilson-Cook Modified Zilver Biliary Stent. It describes the device, its intended use, and its substantial equivalence to a predicate device. However, this document does not contain the detailed information necessary to fully address all aspects of your request regarding acceptance criteria and the study that proves the device meets those criteria.
Specifically, the document states:
- "All results obtained during our Design Verification met our predetermined acceptance criteria for this product line." (Page 2, "Design Control/Risk Analysis/Design Verification" section).
- It also mentions "dimensional and functional testing to ensure the performance and design integrity of this product line."
However, the document DOES NOT provide:
- The actual acceptance criteria themselves (the specific numerical or qualitative targets).
- The detailed results of these tests.
- Information about sample sizes, data provenance, ground truth establishment, expert qualifications, or adjudication methods for these tests.
- Any information regarding a multi-reader multi-case (MRMC) comparative effectiveness study or a standalone algorithm performance study, as this is a medical device, not an AI/software device.
Given the information provided in the 510(k) summary:
1. A table of acceptance criteria and the reported device performance:
| Acceptance Criteria | Reported Device Performance |
|---|---|
| Not specified in document (e.g., specific dimensions, deployment force, patency duration, biocompatibility test results, etc.) | "All results obtained during our Design Verification met our predetermined acceptance criteria for this product line." (Successful performance in dimensional and functional testing, and biocompatibility has been established.) |
2. Sample size used for the test set and the data provenance:
- Sample Size for Test Set: Not specified in the document.
- Data Provenance: Not specified in the document. The tests seem to be internal design verification and functional testing conducted by the manufacturer, Wilson-Cook Medical Inc.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:
- This type of information is generally not applicable to a physical medical device's design verification and functional testing, which relies on engineering specifications and laboratory measurements, not expert review of images or data. Therefore, this information is not present in the document.
4. Adjudication method (e.g., 2+1, 3+1, none) for the test set:
- Not applicable as this is a physical medical device, not an AI/software device requiring human adjudication for test set ground truth.
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:
- No. This is a physical medical device (biliary stent and introducer), not an AI-powered diagnostic or assistive technology. Therefore, an MRMC study related to AI assistance is not applicable and was not performed.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:
- No. This is a physical medical device. This type of study is not applicable.
7. The type of ground truth used:
- For the device's design verification and functional testing, the "ground truth" would be established by the engineering specifications and performance requirements defined by the manufacturer based on regulatory standards, industry best practices, and the intended use of the device. Biocompatibility was established through "history of use in similar patient-contacting medical devices and as applicable biocompatibility test results."
8. The sample size for the training set:
- Not applicable. This is a physical medical device, not a machine learning algorithm.
9. How the ground truth for the training set was established:
- Not applicable. This is a physical medical device, not a machine learning algorithm.
In summary, the provided 510(k) indicates that design verification and functional testing were performed and met pre-determined acceptance criteria. However, it does not detail those criteria or the specifics of the testing as would be expected for an AI/software device. The questions related to experts, adjudication, MRMC studies, and training/test sets for AI are not applicable to this type of medical device submission.
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510(K) SUMMARY OF SAFETY AND EFFECTIVENESS
Submitted By:
Wilson-Cook Medical Inc. 4900 Bethania Station Road Winston-Salem, NC 27105
Device Description:
The Wilson-Cook Modified Zilver Biliary Stent is indicated for use in palliation of malignant neoplasms in the biliary tree. This device and its introduction system are supplied sterile and intended for single use only.
| Trade Name: | Wilson-Cook Zilver Biliary Stent | |
|---|---|---|
| Common/Usual Name: | Expandable Metal Biliary Stent | |
| Classification Name/Code: | Catheter, Biliary, GU/78 FGE | |
| Classification: | FDA has classified similar devices as Class II, as per21 CFR § 876.5010. This device falls within thepurview of the Gastroenterology and Urology DevicePanel. | |
| Performance Standards: | To the best of our knowledge, performance standardsfor this device do not exist. | |
| Intended Use: | Used to maintain patency of malignant biliarystrictures. |
Predicate Device:
| PREDICATE DEVICE | MANUFACTURER | DOCUMENT CONTROL NUMBER |
|---|---|---|
| Cook Zilver Biliary Stent | Cook Incorporated | K010242 |
Substantial Equivalence:
The Wilson-Cook Modified Zilver Biliary Stent is substantially equivalent to the referenced predicate device with respect to design, materials of construction and intended use.
The modification of the Zilver Biliary Stent includes a change to the introduction system only. The stent itself is identical to the predicate Cook Zilver Biliary Stent (K010242) in configuration and materials of construction, and the intended use for both the predicate and modified device are also the same. However, since the predicate introduction system is utilized for percutaneous biliary stent placement and the modified Wilson-Cook Metal Biliary Stent introduction system is used for endoscopic placement, the introduction system of the modified device is longer (200 cm) than that of the predicate device (80 cm).
These devices also operate in the same manner; the main difference being the method utilized in order to gain access to the placement site. The predicate device is used for percutaneous placement, while the modified Wilson-Cook Biliary Stent is placed endoscopically.
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Page 2 of 2
| DEVICE CHARACTERISTIC | Wilson-Cook Modified ZilverBiliary Stent& Introducer[Subject of Special 510(k)] | PredicateCook Zilver Biliary Stent& Introducer(K010242) |
|---|---|---|
| Intended Use | Indicated for use in palliation ofmalignant neoplasms in thebiliary tree. | Indicated for use in palliation ofmalignant neoplasms in thebiliary tree. |
| Sterility | Sterile, Disposable | Sterile, Disposable |
510(K) SUMMARY OF SAFETY AND EFFECTIVENESS (continued)
Biocompatibility:
Reasonable assurance of biocompatibility for the patient-contacting materials has been established through a history of use in similar patient-contacting medical devices and as applicable biocompatibility test results.
Design Control/Risk Analysis/Design Verification:
Design Control, Risk Analysis, Design Verification activities for the subject of this special 510(k) have been conducted in accordance with all applicable internal procedures. The design control process employed is inclusive of the elements as stipulated by 21 CFR Part 820.30, as applicable to the project. The risk analysis performed identified the risks relative to the performance requirements, as specified by our internal procedure for Risk Analysis. The failure mode, effect of failure, severity, potential cause, rate of occurrence, design control element/production controls to eliminate, the potential to detect and our recommended actions were also documented. During Design Verification, dimensional and functional testing to ensure the performance and design integrity of this product line were conducted. A l l results obtained during our Design Verification met our predetermined acceptance criteria for this product line.
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Image /page/2/Picture/1 description: The image is a black and white logo for the U.S. Department of Health and Human Services. The logo consists of a circle with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of an eagle with its wings spread.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
MAY - 8 2002
Ms. Margaret J. Posner Regulatory Affairs Specialist Wilson-Cook Medical GI Endoscopy 4900 Bethania Station Road WINSTON-SALEM NC 27105
Re: K020788
Trade/Device Name: Wilson-Cook Zilver Biliary Stent Regulation Number: 21 CFR § 876.5010 Regulation Name: Biliary catheter and accessories Regulatory Class: II Product Code: 78 FGE Dated: April 10, 2002 Received: April 11, 2002
Dear Ms. Posner:
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 and the limitations described below. 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.
The Office of Device Evaluation has determined that there is a reasonable likelihood that this device will be used for an intended use not identified in the proposed labeling and that such use could cause harm. Therefore, in accordance with Section 513(i)(1)(E) of the Act, the following limitation must appear in the Warnings section of the device's labeling:
The safety and effectiveness of this device for use in the vascular system have not been established.
Furthermore, the indication for biliary use must be prominently displayed in all labeling, including pouch, box, and carton labels, instructions for use, and other promotional materials, in close proximity to the trade name, of a similar point size, and in bold print.
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Page 2 - Ms. Margaret Posner
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 (1 remancer ripproval), 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 mspotation 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.
The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and permits your device to proceed to the market. This letter will allow you to begin marketing your device as described in your 510(k) premarket notification if the limitation statement above is added to your labeling, as described.
Please note that the above labeling limitations are required by Section 513(i)(1)(E) of the Act. Therefore, a new 510(k) is required before these limitations are modified in any way or removed from the device's labeling.
If you desire specific information about the application of other labeling requirements to your device (21 CFR Part 801 and additionally §809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4616. 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" (21 CFR §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,
Bert Ehrhart.
Bernard E. Statland, M.D., Ph.D. Director Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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510(k) Number (if known): K020788
Device Name: Wilson-Cook Zilver Biliary Stent
FDA's Statement of the Indications for Use for device:
The Wilson-Cook Zilver Biliary Stent is indicated for use in the palliation of malignant neoplasms in the biliary tree.
Prescription Use V OR (Per 21 CFR 801.109)
Over-The-Counter Use_
Nancy C. Brogdon
(Division Sign-Off)
Division of Reproductive, Abdominal,
and Radiological Devices
510(k) Number K020788
§ 876.5010 Biliary catheter and accessories.
(a)
Identification. A biliary catheter and accessories is a tubular flexible device used for temporary or prolonged drainage of the biliary tract, for splinting of the bile duct during healing, or for preventing stricture of the bile duct. This generic type of device may include a bile collecting bag that is attached to the biliary catheter by a connector and fastened to the patient with a strap.(b)
Classification. Class II (special controls). The device, when it is a bile collecting bag or a surgical biliary catheter that does not include a balloon component, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.