K Number
K033736
Device Name
MERCI RETRIEVER, MODELS 90065, 90066
Date Cleared
2004-08-11

(257 days)

Product Code
Regulation Number
870.1250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Merci Retriever is intended to restore blood flow in the neurovasculature by removing thrombus in patients experiencing ischemic stroke. Patients who are ineligible for treatment with intravenous tissue plasminogen activator (IV t-PA) or who fail IV t-PA therapy are candidates for treatment. The Merci Retriever is also indicated for use in the retrieval of foreign bodies misplaced during interventional radiological procedures in the neuro, peripheral and coronary vasculature.
Device Description
The Merci Retriever consists of a Nitinol tapered wire with a helical shaped distal tip. A platinum coil is attached over the helical distal tip. A radiopaque distal coil facilitates fluoroscopic visualization.
More Information

K030476 Concentric Retriever

Not Found

No
The 510(k) summary describes a mechanical device for thrombus removal and foreign body retrieval, with no mention of AI or ML in the intended use, device description, or performance studies. The input imaging modality is fluoroscopy, which is used for visualization during the procedure, not for AI/ML processing.

Yes
The device is described as restoring blood flow and removing thrombus in stroke patients, and retrieving foreign bodies, which are direct therapeutic interventions.

No
Explanation: The device is intended to remove thrombus and foreign bodies, which are treatment interventions, not diagnostic functions.

No

The device description clearly states it is a physical device made of Nitinol and platinum, designed for mechanical thrombus removal. It is not software.

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

Here's why:

  • IVD devices are used to examine specimens taken from the human body. The intended use of the Merci Retriever is to restore blood flow by removing thrombus directly from the neurovasculature and to retrieve foreign bodies from within blood vessels. This is an interventional procedure performed in vivo (within the living body), not in vitro (in a test tube or laboratory setting).
  • The device description and intended use clearly describe a medical device used for a therapeutic procedure. It's a physical tool used to interact directly with the patient's anatomy.

Therefore, the Merci Retriever falls under the category of a therapeutic medical device, not an IVD.

N/A

Intended Use / Indications for Use

The Merci Retriever is intended to restore blood flow in the neurovasculature by removing thrombus in patients experiencing ischemic stroke. Patients who are ineligible for treatment with intravenous tissue plasminogen activator (IV t-PA) or who fail IV t-PA therapy are candidates for treatment. The Merci Retriever is also indicated for use in the retrieval of foreign bodies misplaced during interventional radiological procedures in the neuro, peripheral and coronary vasculature.

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

NRY

Device Description

The Merci Retriever consists of a Nitinol tapered wire with a helical shaped distal tip. A platinum coil is attached over the helical distal tip. A radiopaque distal coil facilitates fluoroscopic visualization.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

neurovasculature, neuro, peripheral and coronary vasculature

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)

The MERCI Clinical Study established that no new issues of safety and effectiveness exist when the Merci Retriever is used for thrombus removal versus foreign body removal from the neurovasculature.

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.

K030476 Concentric Retriever

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

§ 870.1250 Percutaneous catheter.

(a)
Identification. A percutaneous catheter is a device that is introduced into a vein or artery through the skin using a dilator and a sheath (introducer) or guide wire.(b)
Classification. Class II (performance standards).

0

Concentric Medical, Inc.

K033736 1/2

AUG 1 1 2004

510(k) Summary

General Information

ClassificationClass II, Percutaneous Catheter per 21 CFR § 870.1250
Trade NameConcentric Merci® Retriever
Models X5 and X6
SubmitterConcentric Medical, Inc.
1380 Shorebird Way
Mountain View, CA 94043
Tel: 650-938-2100
Fax: 650-938-2700
ContactKevin F. MacDonald
Vice President, Clinical and Regulatory Affairs

Intended Use

The Merci Retriever is intended to restore blood flow in the neurovasculature by removing thrombus in patients experiencing ischemic stroke. Patients who are ineligible for treatment with intravenous tissue plasminogen activator (IV t-PA) or who fail IV t-PA therapy are candidates for treatment. The Merci Retriever is also indicated for use in the retrieval of foreign bodies misplaced during interventional radiological procedures in the neuro, peripheral and coronary vasculature.

Predicate Devices K030476 Concentric Retriever Manufactured by Concentric Medical, Inc.

Device Description

The Merci Retriever consists of a Nitinol tapered wire with a helical shaped distal tip. A platinum coil is attached over the helical distal tip. A radiopaque distal coil facilitates fluoroscopic visualization.

Materials

All materials used in the manufacture of the Merci Retriever are suitable for this use and have been used in numerous previously cleared products.

Testing Summary

The Merci Retriever was tested in the same manner as the predicate Concentric Retriever (K030476). All components, subassemblies, and/or full devices met the required specifications for the completed tests. The Merci Retriever was designed under the Concentric Quality System that is in compliance with 21CFR§820.30.

1

KC 3373C

2/2

Summary of Clinical Testing

The MERCI Clinical Study established that no new issues of safety and effectiveness exist when the Merci Retriever is used for thrombus removal versus foreign body removal from the neurovasculature.

Summary of Substantial Equivalence

The Merci Retriever is equivalent to the predicate device, the Concentric Retriever. The indications for use, function, methods of manufacturing, and materials used are substantially equivalent. Concentric Medical, Inc. believes the Merci Retriever is substantially equivalent to existing legally marketed device.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular emblem with the department's name around the perimeter. Inside the circle is a stylized image of an eagle with three lines representing its wings and body. The eagle is facing to the right.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG 1 1 2004

Mr. Kevin 1 . MacDonald Vice President, Clinical and Regulatory Affairs Concentric Medical, Inc. 1380 Shorebird Way Mountain View, California 94043

Re: K033736

Trade/Device Name: Concentric Merci® Retriever Models X5 and X6 Regulation Number: 21 CFR 870.1250 Regulation Name: Catheter, thrombus retriever Regulatory Class: II Product Code: NR Y Dated: May 28, 2004 Received: June 2, 2004

Dear Mr. MacDonald:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your becaon 3 roxy premier is substantially equivalent (for the indications felcrenced above und nave actoring ally marketed predicate devices marketed in interstate for use stated in the encreativent of the enactment date of the Medical Device Amendments, or to commerce provided in accordance with the provisions of the Federal Food, Drug, de necs that have been receive approval of a premarket approval application (PMA). and Costicule Tec (110) that to neview subject to the general controls provisions of the Act. The Tournal controls provisions of the Act include requirements for annual registration, listing of general controls provisions of use ice, 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 If your device is classified (600 abovetrols. Existing major regulations affecting your device can may oc subject to such additions. 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 I lease of advised that I Drivision that your device complies with other requirements of the Act that I DT has made a wond regulations administered by other Federal agencies. You must or any it cactares and regulanents, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set CI It Fart 6077, lacemig (21 CFR Part 820); and if applicable, the electronic form in the quality Systems (Sections 531-542 of the Act); 21 CFR 1000-1050.

3

Page 2 - Mr. Kevin F. MacDonald

This letter will allow you to begin marketing your device as described in your Section 510(k) I ms letter will anow you to begin maneting of substantial equivalence of your device to a legally premaired 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 If you desire specific davice 101 Jour 2011) 594-4659. Also, please note the regulation entitled, Connact the Office of Company of Company (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small other general informational 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,

Celia M. Witt, Ph.D., M.D.

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

4

Indications for Use

510(k) Number (if known):K033736
Device Name:Concentric Merci® Retriever
Models X5 and X6
Indications for Use:The Merci Retriever is intended to restore blood flow in the
neurovasculature by removing thrombus in patients experiencing
ischemic stroke. Patients who are ineligible for treatment with
intravenous tissue plasminogen activator (IV t-PA) or who fail IV
t-PA therapy are candidates for treatment. The Merci Retriever is
also indicated for use in the retrieval of foreign bodies misplaced
during interventional radiological procedures in the neuro,
peripheral and coronary vasculature.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ (Per 21 CFR 801Subpart D) AND/OR

Over-The-Counter Use _________________________________________________________________________________________________________________________________________________________ (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

and the comments of the comments of the comments of the comments of the comments of the comments of the comments of the comments of the comments of the contribution of the co

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Division of General, Restorative, and Neurological Devices

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