K Number
K032198
Manufacturer
Date Cleared
2003-08-20

(33 days)

Product Code
Regulation Number
882.5200
Reference & Predicate Devices
N/A
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Aesculap Yasargil Aneurysm Clip Booster Clip is intended to be used for increasing the closing force of standard permanent aneurysm clips to occlude cerebral aneurysms.

Device Description

The Aesculap Yasarqil Aneurysm Clip Booster Clip is designed to provide additional pressure for occlusion of cerebral aneurysms when used with a standard aneurysm clip during neurosurgical procedures. They are made from Phynox (cobalt alloy) per ISO 5832/7 and are for use with Phynox aneurysm clips only.

AI/ML Overview

This document describes the Aesculap Yasargil Aneurysm Clip Phynox Booster Clip. The device is intended to increase the closing force of standard permanent aneurysm clips to occlude cerebral aneurysms. The performance data for this device primarily relies on biomechanical testing to demonstrate substantial equivalence to a predicate device.

Here's the information requested, based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance Criteria (Inferred)Reported Device Performance
Effective clip force enhancementBiomechanical testing results demonstrate the Aesculap Yasargil Aneurysm Clip Phynox Booster Clip provides effective clip force enhancement.
Substantial equivalence to predicate device (Yasargil Aneurysm Clip Titanium Booster Clip) in clip force enhancement for occluding cerebral aneurysms.Biomechanical testing results demonstrate the Aesculap Yasargil Aneurysm Clip Phynox Booster Clip is substantially equivalent to Yasargil Aneurysm Clip Titanium Booster Clip currently on the market. The device is also made from Phynox (cobalt alloy) per ISO 5832/7 and is for use with Phynox aneurysm clips only, implying material and compatibility equivalence for its intended use with specific clips. The FDA's 510(k) clearance confirms substantial equivalence.
Compliance with "Draft Guidance for the Preparation of Premarket Notifications (510(k)s)"All required testing per "Draft Guidance for the Preparation of Premarket Notifications (510(k)s)" for the Aesculap Yasargil Aneurysm Clip Booster Clip was completed.

2. Sample Size Used for the Test Set and Data Provenance

The document does not specify the exact sample size used for the biomechanical testing (test set) or the data provenance (e.g., country of origin, retrospective/prospective). It just states "Biomechanical testing results."

3. Number of Experts Used to Establish Ground Truth for the Test Set and Their Qualifications

Not applicable. The ground truth for this device's performance is established through biomechanical testing, not expert interpretation of outputs like images.

4. Adjudication Method for the Test Set

Not applicable. This is not a study requiring adjudication of expert opinions.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done

No, a Multi-Reader Multi-Case (MRMC) comparative effectiveness study was not done, as this is a medical device for surgical intervention and not an AI/imaging diagnostic tool.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) was done

No, this is a physical medical device, not an algorithm. Therefore, a standalone algorithm-only performance study is not applicable. The performance described relates to the physical properties and function of the clip.

7. The Type of Ground Truth Used

The ground truth used for this device is based on biomechanical engineering principles and measurements of clip force enhancement, compared against a predicate device.

8. The Sample Size for the Training Set

Not applicable. This is a physical medical device, not a machine learning algorithm requiring a training set.

9. How the Ground Truth for the Training Set was Established

Not applicable, as there is no training set for this type of device.

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AUG 2 0 2003esculap Yasargil Aneurysm Clip Phynox Booster Clip

$\phi$32198

Page 1 of 1

C. 510(k) SUMMARY OF SAFETY AND EFFECTIVENESS (in Accordance with SMDA of 1990)

AESCULAP YASARGIL ANEURYSM CLIP BOOSTER CLIP

July 17, 2003

COMPANY:Aesculap®, Inc.3773 Corporate ParkwayCenter Valley, PA 18034Establishment Registration Number: 2916714
CONTACT:Matthew M. Hull800-258-1946 x 5072 (phone)610-791-6882 (fax)
TRADE NAME:Aesculap Yasargil Aneurysm Clip Phynox Booster Clip
COMMON NAME:Aneurysm Clip Booster or Reinforcement Clip
DEVICE CLASS:Class II
PRODUCT CODE:84 HCH
CLASSIFICATION:882.5200 - Clip, Aneurysm
REVIEW PANEL:Neurology

INDICATIONS FOR USE

The Aesculap Yasargil Aneurysm Clip Booster Clip is intended to be used for increasing the closing force of standard permanent aneurysm clips to occlude cerebral aneurysms.

DEVICE DESCRIPTION

The Aesculap Yasarqil Aneurysm Clip Booster Clip is designed to provide additional pressure for occlusion of cerebral aneurysms when used with a standard aneurysm clip during neurosurgical procedures. They are made from Phynox (cobalt alloy) per ISO 5832/7 and are for use with Phynox aneurysm clips only.

PERFORMANCE DATA

All required testing per "Draft Guidance for the Preparation of Premarket Notifications (510(k)s)" for the Aesculap Yasargil Aneurysm Clip Booster Clip was completed. Biomechanical testing results demonstrate the Aesculap Yasarqil Aneurysm Clip Phynox Booster Clip provides effective clip force enhancement and is substantially equivalent to Yasargil Aneurysm Clip Titanium Booster Clip currently on the market.

SUBSTANTIAL EQUIVALENCE

Aesculap®, Inc. believes that the Aesculap Yasarqil Aneurysm Clip Booster Clip are substantially equivalent to our currently marketed Yasargil Aneurysm Clip Titanium Booster Clip.

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Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" around the perimeter. Inside the circle is an image of an eagle with its wings spread.

AUG 2 0 2003

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Matthew M. Hull Senior Regulatory Affairs Associate Aesculap, Inc. 3773 Corporate Parkway Center Valley, Pennsylvania 18034

Re: K032198

Trade/Device Name: Aesculap Yasargil Aneurysm Clip Phynox Booster Clip Regulation Number: 21 CFR 882.5200 Regulation Name: Aneurysm Clip Regulatory Class: II Product Code: HCH Dated: July 17, 2003 Received: July 24, 2003

Dear Mr. Hull:

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. Iisting 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.

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Page 2 - Mr. Matthew M. Hull

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) 594-4659. 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 yours,

Sincerely yours,

for Mark A. Milhens

Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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INDICATIONS FOR USE STATEMENT B.

510(k) Number: K432198

Device Name: Aesculap Yasargil Aneurysm Clip Phynox Booster Clip

Indication for Use:

The Aesculap Yasargil Aneurysm Clip Booster Clip is intended to be used for increasing the rne hosodiap Tradard permanent aneurysm clips to occlude cerebral aneurysms.

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Concurrence of CDRH, Office of Device Evaluation (ODE)

(Division Sign-Off)
Division of General, Restorative and Neurological Devices
510(k) NumberK032198
Prescription Useor Over-the-Counter Use
(per 21 CFR 801.109)

§ 882.5200 Aneurysm clip.

(a)
Identification. An aneurysm clip is a device used to occlude an intracranial aneurysm (a balloonlike sac formed on a blood vessel) to prevent it from bleeding or bursting.(b)
Classification. Class II (performance standards).