K Number
K023051
Device Name
INTRAUTERINE DELIVERY SYSTEM - INJECTOR
Manufacturer
Date Cleared
2002-12-12

(90 days)

Product Code
Regulation Number
884.4530
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Intrauterine delivery system is used to deliver and fill uterine cavity with sterile imaging agents or injection media for ultrasound imaging, diagnosis and treatment of uterine disorders. The injection media /agents can be saline, contrast agents, or other sonography media / agents in liquid, viscous gel or suspension form to conform the interior of the uterine cavity. The Uterine delivery catheter device is designed to facilitate the sealing of the cervical os during injection procedure.
Device Description
Intrauterine Delivery System - Injector
More Information

Not Found

Not Found

No
The summary describes a mechanical delivery system for imaging agents and explicitly states "Mentions AI, DNN, or ML: Not Found".

No
The device is described as a delivery system for imaging agents and media for "ultrasound imaging, diagnosis and treatment of uterine disorders." While it's used in the context of treatment, its primary function is delivery for imaging and diagnosis, not the treatment itself.

Yes
The device is used for the delivery of imaging agents for "ultrasound imaging, diagnosis and treatment of uterine disorders," indicating its role in the diagnostic process.

No

The device description explicitly refers to a "system" and a "catheter device," indicating physical components for delivery and sealing, not solely software.

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

Here's why:

  • IVDs are used to examine specimens from the human body. The intended use of this device is to deliver substances into the uterine cavity for imaging and treatment, not to analyze samples taken from the body.
  • The device facilitates imaging and treatment within the body. It's an instrument used in a medical procedure, not a test performed on a biological sample.

The device is a delivery system for imaging agents and treatment media used in conjunction with ultrasound imaging. This falls under the category of a medical device used for diagnosis and treatment, but not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Intrauterine delivery system is used to deliver and fill uterine cavity with sterile imaging agents or injection media for ultrasound imaging, diagnosis and treatment of uterine disorders. The injection media /agents can be saline, contrast agents, or other sonography media / agents in liquid, viscous gel or suspension form to conform the interior of the uterine cavity.

The Uterine delivery catheter device is designed to facilitate the sealing of the cervical os during injection procedure.

Product codes

85 LKF

Device Description

Intrauterine Delivery System- Injector

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

ultrasound imaging

Anatomical Site

uterine cavity, cervical os

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

Not Found

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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.

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Image /page/0/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the department's name around the perimeter. In the center is a stylized image of an eagle with three human profiles incorporated into its design. The text is in a sans-serif font and the eagle is depicted in black.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850.

Ashvin Desai Manager, Regulatory Affairs ProSurg, Inc. 2193 Trade Zone Blvd. SAN JOSE CA 95131

Re: K023051

Trade/Device Name: Intrauterine Delivery System- Injector Regulation Number: None Regulatory Class: Unclassified Product Code: 85 LKF Dated: September 14, 2002 Received: September 13, 2002

Dear Mr. Desai:

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.

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); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (sections 531-542 of the Act); 21 CFR 1000-1050.

1

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), please contact the Office of Compliance at one of the following numbers, based on the regulation number at the top of this letter:

8xx.1xxx(301) 594-4591
876.2xxx, 3xxx, 4xxx, 5xxx(301) 594-4616
884.2xxx, 3xxx, 4xxx, 5xxx, 6xxx(301) 594-4616
892.2xxx, 3xxx, 4xxx, 5xxx(301) 594-4654
Other(301) 594-4692

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 Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers. 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,

Nancy C. Snogdon

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

Enclosure

2

510(k) Number (if known):_

Device Name: Intrauterine Delivery System - Injector

Indications For Use:

Indications For Use:

The Intrauterine delivery system is used to deliver and fill uterine cavity with sterile imaging agents or injection media for ultrasound imaging, diagnosis and treatment of uterine disorders. The injection media /agents can be saline, contrast agents, or other sonography media / agents in liquid, viscous gel or suspension form to conform the interior of the uterine cavity.

The Uterine delivery catheter device is designed to facilitate the sealing of the cervical os during injection procedure.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Kamil G. Shamoon

(Division Sign-Off) Division of Reproductive, Abdoo and Radiological Devices 510(k) Number -

Prescription Use_ (Per 21 CFR 801.109)

OR

Over-The-Counter Use__________________________________________________________________________________________________________________________________________________________

(Optional Formal 1-2-9C