K Number
K031360
Device Name
GI SUPPLY BILIARY STENT
Manufacturer
Date Cleared
2003-09-24

(147 days)

Product Code
Regulation Number
876.5010
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The GI Supply Biliary Stent is a disposable single-use device intended for use to temporarily by-pass obstructions in the biliary tree and allow drainage into the duodenum.
Device Description
The GI Supply Biliary Stent is a disposable single-use device.
More Information

Not Found

Not Found

No
The summary describes a physical, disposable stent and contains no mention of software, algorithms, image processing, AI, or ML.

Yes
The device is intended to temporarily by-pass obstructions in the biliary tree, which is a therapeutic intervention to allow drainage.

No

The device is described as a "biliary stent" intended to "temporarily by-pass obstructions in the biliary tree and allow drainage into the duodenum." This function is therapeutic (to create a bypass and allow drainage), not diagnostic (to identify or determine the nature of a condition).

No

The device description clearly states it is a "disposable single-use device," which is a physical object, not software.

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

Here's why:

  • Intended Use: The intended use is to "temporarily by-pass obstructions in the biliary tree and allow drainage into the duodenum." This describes a therapeutic or interventional procedure performed directly on the patient's body.
  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health. They are used for diagnosis, monitoring, or screening.
  • Device Description: The description of a "disposable single-use device" that is a "Biliary Stent" further confirms it's a physical device inserted into the body, not a diagnostic test performed on a sample.

The information provided clearly indicates a device used within the body for a therapeutic purpose, not a test performed outside the body on a sample for diagnostic purposes.

N/A

Intended Use / Indications for Use

The GI Supply Biliary Stent is a disposable single-use device intended for use to temporarily by-pass obstructions in the biliary tree and allow drainage into the duodenum.

Product codes

78 FGE

Device Description

The GI Supply Biliary Stent is a disposable single-use device.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

biliary tree

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.

Not Found

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

§ 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.

0

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized caduceus, which is a symbol of medicine, with three horizontal lines representing the branches of government. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the caduceus.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

SEP 2 4 2003

GI Supply c/o Mr. Rob Whalen Regulatory Consultant MYCOSCIENCE INC. 25 Village Hill Road WILLINGTON CT 06279

Re: K031360

Trade/Device Name: GI Supply Biliary Stent Regulation Number: 21 CFR §876.5010 Regulation Name: Biliary catheter and accessories Regulatory Class: II Product Code: 78 FGE Dated: July 31, 2003 Received: August 4, 2003

Dear Mr. Whalen:

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 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 one of the following numbers, based on the regulation number at the top of the letter:

8xx. Ixxx(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" (21CFR Part 807.97) you may obtain. 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. Brogdon

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

Enclosure

2

Section 8.2

Intended Use Statement

510k INDICATION FOR USE STATEMENT

510(k) Number (if known):

K03/1360

  • Device Name: GI Supply Biliary Stent
    Applicant Name: GI Supply division of Chek-Med Systems Inc.

The GI Supply Biliary Stent is a disposable single-use device Indication for Use: intended for use to temporarily by-pass obstructions in the biliary tree and allow drainage into the duodenum.

GI Supply/Chek-Med Signature:

Date: 4-28-03

Frank Carter - CEO

David G. Lygum.

(Division Sign-Off) Division of Reproductive, Abdominal, and Radiological Device 510(k) Number.

Prescription Use
(Per 21 CFR 801.109)