K Number
K031003
Device Name
STIMULUS/DISSECTION INSTRUMENTS, BALL-TIP PROBES
Date Cleared
2003-04-11

(11 days)

Product Code
Regulation Number
874.1820
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Stimulus-Dissection Instruments are indicated for tissue dissection and stimulation of cranial and peripheral motor nerves for location and identification during surgery, including spinal nerve roots.
Device Description
The designs of the Stimulus - Dissection Instruments are similar to existing stainless steel manual surgical instruments. The instruments consist of scissors, retractors, awls, taps, needles, probes, and hooks with biocompatible electrical insulation applied to selected portions, and proximal connectors provided to attach the instruments to a monopolar stimulator. The distal surfaces of the instruments are non-insulated stainless steel to provide for mechanical, manual dissection / resection, and tissue stimulation. The Stimulus - Dissection Instruments are a protected pin design and meet the requirements of IEC 60601-1:1988 /A1:1991 /A2:1995 Clause 56.3(c) per 21 CFR 898.12. Accessories include monopolar cables available in lengths up to 3 M.
More Information

No
The device description focuses on manual surgical instruments with electrical stimulation capabilities, and there is no mention of AI, ML, or related concepts in the provided text.

No
The device is described as a surgical instrument for tissue dissection and nerve stimulation, which are diagnostic and procedural functions performed during surgery, not therapeutic interventions.

No

The device is indicated for "tissue dissection and stimulation of cranial and peripheral motor nerves for location and identification during surgery." While "identification" might seem diagnostic, the primary function of "location and identification" within the context of "stimulation" of nerves during surgery is to guide the surgeon's actions and prevent damage, rather than to provide a diagnosis of a disease or condition. It's an intraoperative tool for guidance, not for diagnosing a patient's medical state.

No

The device description clearly outlines physical instruments made of stainless steel with electrical insulation and connectors, indicating it is a hardware device, not software-only.

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

Here's why:

  • Intended Use: The intended use is for "tissue dissection and stimulation of cranial and peripheral motor nerves for location and identification during surgery." This describes a surgical tool used directly on the patient's body during a procedure.
  • Device Description: The description details surgical instruments (scissors, retractors, etc.) with electrical insulation and connectors for a stimulator. This aligns with surgical tools, not devices used to test samples outside the body.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue samples, etc.) or providing diagnostic information based on such analysis. IVDs are designed to perform tests in vitro (in glass, or outside the living organism).

The device is clearly intended for use in vivo (within the living organism) during surgery.

N/A

Intended Use / Indications for Use

The Stimulus-Dissection Instruments are indicated for tissue dissection and stimulation of cranial and peripheral motor nerves for location and identification during surgery, including spinal nerve roots.

Product codes

ETN, Various, Various

Device Description

The designs of the Stimulus - Dissection Instruments are similar to existing stainless steel manual surgical instruments. The instruments consist of scissors, retractors, awls, taps, needles, probes, and hooks with biocompatible electrical insulation applied to selected portions, and proximal connectors provided to attach the instruments to a monopolar stimulator. The distal surfaces of the instruments are non-insulated stainless steel to provide for mechanical, manual dissection / resection, and tissue stimulation. The Stimulus - Dissection Instruments are a protected pin design and meet the requirements of IEC 60601-1:1988 /A1:1991 /A2:1995 Clause 56.3(c) per 21 CFR 898.12. Accessories include monopolar cables available in lengths up to 3 M.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

cranial and peripheral motor nerves, spinal nerve roots

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)

K014165, K992869

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 874.1820 Surgical nerve stimulator/locator.

(a)
Identification. A surgical nerve stimulator/locator is a device that is intended to provide electrical stimulation to the body to locate and identify nerves and to test their excitability.(b)
Classification. Class II.

0

K031003

510(k) Summary

1.0 Date Prepared

APR 1 1 2003

March 28, 2003

2.0 Submitter (Contact)

Martin D. Sargent Regulatory Affairs Manager Medtronic Xomed Jacksonville, FL (904) 279-7586

3.0 Device Name

Proprietary Name:Stimulation / Dissection Instruments (Tradenames have not been finalized at this time)
Common Name(s):Nerve Stimulator / Locator
Classification Name(s):Surgical Nerve Stimulator / Locator

4.0 Device Classification

Classification Name: Surgical Nerve Stimulator / Locator and accessories
Procode 77ETNClass II21 CFR § 874.1820
Procode VariousClass I-21 CFR § 874.4420
Procode VariousClass I21 CFR § 878.4800

5.0 Device Description

The designs of the Stimulus - Dissection Instruments are similar to existing stainless steel manual surgical instruments. The instruments consist of scissors, retractors, awls, taps, needles, probes, and hooks with biocompatible electrical insulation applied to selected portions, and proximal connectors provided to attach the instruments to a monopolar stimulator. The distal surfaces of the instruments are non-insulated stainless steel to provide for mechanical, manual dissection / resection, and tissue stimulation. The Stimulus - Dissection Instruments are a protected pin design and meet the requirements of IEC 60601-1:1988 /A1:1991 /A2:1995 Clause 56.3(c) per 21 CFR 898.12. Accessories include monopolar cables available in lengths up to 3 M.

6.0 Indications for Use

The Stimulus-Dissection Instruments are indicated for tissue dissection and stimulation of cranial and peripheral motor nerves for location and identification during surgery, including spinal nerve roots.

1

510(k) Summary (continued)

7.0 Substantial Equivalence

The design, technology, features, function, and intended use of the Stimulus-Dissection Instrument is substantially equivalent to Medtronic Xomed Stimulus Dissection Instruments cleared via K014165 and Medtronic Xomed Monopolar Stimulator Probes originally described in K992869.

| Characteristic | Stimulus - Dissection
Instruments
[Proposed Device] | Stimulus / Dissection Instruments
[K014165] |
|------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Indications For
Use | Tissue dissection and stimulation
of cranial and peripheral motor
nerves for location and
identification during surgery,
including spinal nerve roots. | Tissue dissection and stimulation
of cranial and peripheral motor
nerves for location and
identification during surgery,
including spinal nerve roots. |
| Stainless steel
construction | Yes | Yes |
| Electrical
insulation | Electrical insulation on all surfaces
not intended to provide electrical
contact with the patient | Electrical insulation on all surfaces
not intended to provide electrical
contact with the patient |
| Distal stainless
steel patient
contact surface | Yes | Yes |
| Proximal
stimulator
connector | Yes | Yes |
| IEC 60601-1
Protected Pin
design | Yes | Yes |
| Biocompatible | Yes | Yes |
| Single Use,
Sterile | Yes | Yes
[K992869] |

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which is often associated with healthcare. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the symbol.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

APR 11 2003

Medtronic Xomed, Inc. c/o Mr. Martin D. Sargent Regulatory Affairs Manager 6743 Southpoint Drive North Jacksonville, FL 32216

Re: K031003

Trade/Device Name: Stimulus/Dissection Instruments, Ball-Tip Probes Regulation Number: 21 CFR 874.1820 Regulation Name: Surgical nerve stimulator/locator Regulatory Class: Class II Product Code: ETN Dated: March 28, 2003 Received: March 31, 2003

Dear Mr. Sargent:

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 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.

3

Page 2 - Mr. Martin D. Sargent

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), please contact the Office of Compliance at (301) 594-4613. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act 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 vours,

A. halpi Rosenthal

A. Ralph Rosenthal, M.D. Director Division of Ophthalmic and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

K031003 510(k) Number (if known): Stimulus - Dissection Instruments Device Name: Indications for Use:

The Stimulus - Dissection Instruments are indicated for tissue dissection and stimulation of cranial and peripheral motor nerves for location and identification during surgery, including spinal nerve roots.

(Please do not write below this line - continue on another page if needed) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use
(Per 21 CFR 801.109)

Or

Over-the-Counter Use

(Optional Format 1-2-96)

Karen H. Baker
(Division Sign-Off)

Division of Ophthalmic Ear, Nose and Throat Devises

510(k) Number_ K031003