K Number
K040565
Device Name
PHYSICIAN INDUSTRIES RADIOFREQUENCY ABLATION NEEDLE
Date Cleared
2004-07-22

(141 days)

Product Code
Regulation Number
882.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Physician Industries' Radiofrequency Ablation Needle is a single use RF (radiofrequency) needle with injection capabilities. It can be used for either 1) (Fadiofrequency) in the lesioning, or 2) percutaneous nerve blocks with a local anesthetic solution. The nerve is localized by using electrical stimulation through the needle. The nerve may then be blocked either by the generating an RF lesion, or by the injecting of a local anesthetic. It is to be used only under the direction of a licensed clinician.
Device Description
The Physician Industries Inc. needle shares major similarities with the predicate device(s), inasmuch as the configuration, material, use, labeling and safety issues remain basically unchanged. It consists of a plastic hub, insert molded over a PTFE-coated stainless steel cannula.
More Information

No
The 510(k) summary describes a standard radiofrequency ablation needle and does not mention any AI or ML components or functionalities.

Yes
The device is used for radiofrequency ablation and percutaneous nerve blocks, both of which are therapeutic procedures to treat medical conditions.

No

The device is used for treatment (radiofrequency lesioning or injecting an anesthetic), not for diagnosing a condition. It can be used to localize a nerve using electrical stimulation, but this is a step in the treatment process, not a diagnostic act in itself.

No

The device description explicitly states it consists of a plastic hub and a stainless steel cannula, which are physical hardware components. The intended use also describes a physical needle used for RF ablation and nerve blocks.

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

Here's why:

  • Intended Use: The intended use describes a device used in vivo (within the body) for procedures like radiofrequency ablation and nerve blocks. IVDs are used in vitro (outside the body) to examine specimens like blood, urine, or tissue to diagnose diseases or conditions.
  • Device Description: The description details a needle designed for insertion into the body.
  • Lack of IVD Characteristics: There is no mention of analyzing biological specimens, reagents, or any other typical components or processes associated with IVD devices.

Therefore, this device falls under the category of a therapeutic or surgical device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

"The Physician Industries' Radiofrequency Ablation Needle is a single use RF (radiofrequency) needle with injection capabilities. It can be used for either 1) (Fadiofrequency) in the lesioning, or 2) percutaneous nerve blocks with a local anesthetic solution. The nerve is localized by using electrical stimulation through the needle. The nerve may then be blocked either by the generating an RF lesion, or by the injecting of a local anesthetic. It is to be used only under the direction of a licensed clinician."

Product codes

GXI, GXD

Device Description

The Physician Industries Inc. needle shares major similarities with the predicate device(s), inasmuch as the configuration, material, use, labeling and safety issues remain basically unchanged. It consists of a plastic hub, insert molded over a PTFE-coated stainless steel cannula.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

licensed clinician

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)

K021942, K963577

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 882.4400 Radiofrequency lesion generator.

(a)
Identification. A radiofrequency lesion generator is a device used to produce lesions in the nervous system or other tissue by the direct application of radiofrequency currents to selected sites.(b)
Classification. Class II (performance standards).

0

510(k) PI RF Ablation Needle

Physician Industries

anufacturing M

SUMMARY OF SAFETY AND EFFECTIVENESS

KO40565

PHYSICIAN INDUSTRIES INC. SUBMITTED BY: 2203 W. Alexander Salt Lake City UT 84119 Phone: 801-886-9505, toll free 800-241-2210.

    1. DEVICE NAME (Trade/common, and classification): Physician Industries' Radiofrequency Ablation Needle
      Classification: GXI: GXD

Regulation Nos .: 882.4775; 882.4400

02. PREDICATE DEVICES:

  • Radionics' Pole Needle, K021942, found SE Sep 11, 2002); .
  • Radionics' Pole Needle, K963577, found SE Nov. 21, 1996 .
  • See also the FDA's 510(k) database of several other products under the same . classifications, also found SE, or pre-ammendment.
  • DESCRIPTION: The Physician Industries Inc. needle shares major similarities with the . predicate device(s), inasmuch as the configuration, material, use, labeling and safety issues remain basically unchanged. It consists of a plastic hub, insert molded over a PTFE-coated stainless steel cannula.
    1. INTENDED USE: The Physician Industries' radiofrequency ablation needle is a radiofrequency needle with injection capabilities. It can be used for either 1) radiofrequency (RF) lesioning, and / or 2) percutaneous nerve blocks with a local anesthetic solution. The nerve is localized by using electrical stimulation through the needle. The nerve may then be blocked by generating an RF lesion, or by the injecting of a local anesthetic. It is to be used only under the direction of a licensed clinician.
    1. SUBSTANTIAL EQUIVALENCE (SE) RATIONALE: The Physician Industries' RF Ablation Needle shares the same basic characteristics and features and, therefore, are SE to the Radionic's Pole Needles, K021942, and K963577. In addition:
    • No record of unexpected patient problems or adverse reactions were found in our o review of the FDA's MAUDE, Safety Alert ... , and MDR databases;
    • The device and its packaging will be tested by and independent lab for sterility, will 0 be subjected to inspection / testing by IQC, during / after manufacture QC, and

2203 West Alexander Street • West Valley, Utah 84119 • (801) 886-9505 • Fax (801) 886-9081

1

510(k) PI RF Ablation Needle

monitored in the field by means of our CAPA system.

    1. SAFETY AND EFFECIVENESS: There are no substantive differences between the device defined in this 510(k) submission and the predicate devices. It is similar to the material and manufacturing / sterilization technologies that are currently used in other similar medical devices. It was developed and documented under Physician Industries' mature Quality Management System, under the Quality System Regulation, 21 CFR Part 820, including design / change control, and is verified / validated to applicable standards / guidance documents, including vendor and our SOPs. It is designed and manufactured to be safe and effective when used as intended, under a licensed clinician's supervision.
    1. The Physician Industries' Radiofrequency Ablation Needle, share similar indication for use, and characteristics and functional features, and thus are substantially equivalent to the currently marketed predicate devices, cited above.
  • numm ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Signed:

/s - 21 - = ] Dated:

Brian Baker, President PHYSICIAN INDUSTRIES INC. 2203 W. Alexander Salt Lake City UT 84119 Phone: 801-886-9505, toll free 800-241-2210.

2

Image /page/2/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features a circular design with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized representation of a caduceus, a symbol often associated with healthcare, featuring a staff with two snakes entwined around it.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUL 222004

Mr. Brian Baker President Physician Industries, Inc. 3385 West 1820 South Salt Lake City, Utah 84104

Re: K040565

Trade/Device Name: Physician Industries' Radiofrequency Ablation Needle Regulation Number: 21 CFR 882.4725, 21 CFR 882.4400 Regulation Name: Radiofrequency lesion probe; Radiofrequency lesion generator Regulatory Class: II Product Code: GXI, GXD Dated: June 9, 2004 Received: June 15, 2004

Dear Mr. Baker:

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. Brian Baker

This letter will allow you to begin marketing your device as described in your Section 510(k) I mis tetter will and w yourse of substantial equivalence of your device to a legally prematice notification. " 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 spocitio acries 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 other general micromational 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,
Mark A. Melkerson

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: K040565

Device Name: Physician Industrics' Radiofrequency Ablation Needle

Indications for Use:

"The Physician Industries' Radiofrequency Ablation Needle is a single use RF (radiofrequency) needle with injection capabilities. It can be used for either 1) (Fadiofrequency) in the lesioning, or 2) percutaneous nerve blocks with a local anesthetic solution. The nerve is localized by using electrical stimulation through the needle. The nerve may then be blocked either by the generating an RF lesion, or by the injecting of a local anesthetic. It is to be used only under the direction of a licensed clinician."

Prescription Use X (Part 21 CFR 801 Subpart D)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)
Mark N Millman

Sign-Off Division of General, Restorative, and Neurological Devices

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510(k) Number K040563