K Number
K023507
Device Name
MODIFICATION TO GELBFISH VASCULAR DILATORS
Manufacturer
Date Cleared
2002-11-08

(21 days)

Product Code
Regulation Number
870.1310
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The VascuMetrix Vascular Dilators are to be used over a guidewire to dilate or calibrate blood vessels.
Device Description
Not Found
More Information

K0012256

Not Found

No
The summary does not mention AI, ML, image processing, or any related concepts. The device description and intended use are purely mechanical.

Yes.
The device's intended use is to "dilate or calibrate blood vessels," which directly implies it is used for medical treatment or diagnosis, fitting the definition of a therapeutic device. Additionally, it is compared to a predicate device, "Gelbfish Vascular Dilators," further supporting its medical and potentially therapeutic nature.

No
The device is used to dilate or calibrate blood vessels, which is a therapeutic or procedural function, not a diagnostic one.

No

The device description and intended use clearly indicate a physical medical device (vascular dilators) used over a guidewire, not a software-only product.

Based on the provided information, the VascuMetrix Vascular Dilators are not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use is to "dilate or calibrate blood vessels over a guidewire." This is a direct intervention on the patient's body, not a test performed on a sample taken from the body.
  • Anatomical Site: The anatomical site is "blood vessels," which are within the living patient.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Testing of samples (blood, urine, tissue, etc.)
    • Detection or measurement of substances in samples
    • Diagnosis or monitoring of disease based on sample analysis

The device is clearly intended for a therapeutic or procedural purpose within the patient's vascular system.

N/A

Intended Use / Indications for Use

These devices are intended to be used over a guidewire to dilate or calibrate blood vessels.

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

DRE

Device Description

Not Found

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

blood vessels

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.

K0012256

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

§ 870.1310 Vessel dilator for percutaneous catheterization.

(a)
Identification. A vessel dilator for percutaneous catheterization is a device which is placed over the guide wire to enlarge the opening in the vessel, and which is then removed before sliding the catheter over the guide wire.(b)
Classification. Class II (performance standards).

0

NOV 8 2002

Summary of 510(k) Submission Section 11

11.1 Type of Submission

Special 510(k) Date of Submission: October 15, 2002

11.2 Manufacturer

VascuMetrix, LLC 2824 N. Power Rd. Suite 113-278 Mesa, AZ 85215 (480) 807-6300 Fax: (480) 807-6307

11.3 Contact Person

Nick Raible President

11.4 Device

510(k) Number:K023507
Proprietary Name:VascuMetrix Dilators
Generic Name:Dilator, Vessel, For Percuteneous Catheterization
Classification:Class II
Relevant Section:870.1310
Product Code:DRE
Intended Use:These devices are intended to be used over a guidewire to
dilate or calibrate blood vessels.

1

11/623507

11.5 Predicate Device

510(k) Number:K0012256
Proprietary Name:Gelbfish Vascular Dilators
Generic Name:Dilator, Vessel, For Percuteneous Catheterization
Classification:Class II
Relevant Section:870.1310
Product Code:DRE
Intended Use:These devices are intended to be used over a guidewire to
dilate or calibrate blood vessels.

11.6 Comparison to Predicate Device

    1. The original 510(k) on these dilators limited the shaft size to a shaft with "a lumen large enough to slide over an 0.035" guidewire." The modified devices will have shatts with smaller lumens. The modified devices will accommodate 0.018" and/or 0.014" guidewires.
    1. The original 510(k) on these dilators limited the tip size to an outer diameter size range of 2.0 mm to 7.0 mm. The modified devices will have tip sizes that range from 1.0 mm to 10.0 mm.
    1. The current device does not have any markings or etchings. The modified device will have the device size laser etched on the tip.

11.7 Conclusion

Comparison of the original device with the modified device for physical properties, performance characteristics and intended use, indicate that these devices are substantially equivalent and that there are no additional safety issues.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features the department's name in a circular arrangement around a stylized symbol. The symbol consists of three curved lines that resemble a human figure. The text is in all capital letters and reads "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA".

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV 8 2002

VascuMetrix, LCC Mr. Nick Raible President 2824 N. Power Rd., Suite 113-278 Mesa, AZ 85215

Re: K023507

Trade/Device Name: VascuMetrix Gelbfish Vascular Dilators Regulation Number: 21 CFR 870.1310 Regulation Name: Dilator, Vessel, For Percutaneous Catheterization Regulatory Class: Class II Product Code: DRE Dated: October 15, 2002 Received: October 18, 2002

Dear Mr. Raible:

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 such 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

3

Page 2 - Mr. Nick Raible

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. This letter will allow you to begin marketing your device as described in your Section 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 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4586. 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 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

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

K023507

Indications For Use Section 10

The VascuMetrix Vascular Dilators are to be used over a guidewire to dilate or calibrate blood vessels. .

Nick Raible

Nick Raible

Date: 11-6-02

Prescription Use
(Per 21 CFR 801.109) ✓

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

Ashley Barrant for DCD