K Number
K041604
Device Name
MACRO-MICRO DEPTH ELECTRODE
Date Cleared
2004-08-16

(63 days)

Product Code
Regulation Number
882.1330
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Macro-Micro Depth Electrodes are intended for use with recording, monitoring and stimulation equipment for the recording, monitoring and stimulation of electrical signals at the subsurface level of the brain.
Device Description
Depth electrodes described in this application are single patient use, disposable, sterile and non-sterile devices. The electrodes are invasive as they are placed in contact with nerve tissue. The electrodes provide the patient contact device. The electrodes connect to the user's recording, monitoring and stimulation/response equipment. The electrodes are used under the supervision of a physicians in the areas of biopotential recording, monitoring and stimulation/response studies understand the use of depth electrodes. The main components of the depth electrodes are: 1. Contract strip with macro depth electrode contacts and connector contacts; 2. Stylet; Inner lumen: 3. 4. Micro wire electrode(s) for insertion and placement through the macro electrode inner lumen. The lead wires terminate in a safety connector that cannot be connected to an AC power outlet. The materials are the same as used in the predicate devices and/or are common to depth electrodes.
More Information

Not Found

No
The device description focuses on the physical components and intended use of depth electrodes for recording, monitoring, and stimulation of electrical signals. There is no mention of AI or ML in the description, intended use, or any of the other sections provided. The device appears to be a passive component connecting to external equipment.

No
The device is used for recording, monitoring, and stimulation of electrical signals, which are diagnostic and monitoring functions, not therapeutic.

No

Explanation: The "Intended Use" states that the device is for "recording, monitoring and stimulation of electrical signals," which are functions typically associated with data acquisition and intervention, not diagnosis. While the data collected might inform a diagnosis, the device itself isn't described as determining a specific disease or condition.

No

The device description explicitly details physical components like electrodes, stylets, and lead wires, 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:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens (like blood, urine, tissue) taken from the human body to provide information about a patient's health. This testing is done outside of the body (in vitro).
  • Device Description: The description clearly states that the Macro-Micro Depth Electrodes are "invasive as they are placed in contact with nerve tissue." They are used for "recording, monitoring and stimulation of electrical signals at the subsurface level of the brain." This is a direct interaction with the patient's body, not the analysis of a specimen taken from the body.
  • Intended Use: The intended use is for recording, monitoring, and stimulation within the brain, not for analyzing samples.

Therefore, the device falls under the category of an invasive medical device used for physiological monitoring and stimulation, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Macro-Micro Depth Electrodes are intended for use with recording, monitoring and stimulation equipment for the recording, monitoring and stimulation of electrical signals at the subsurface level of the brain.

Product codes

GZL

Device Description

Depth electrodes described in this application are single patient use, disposable, sterile and non-sterile devices. The electrodes are invasive as they are placed in contact with nerve tissue.

The electrodes provide the patient contact device. The electrodes connect to the user's recording, monitoring and stimulation/response equipment. The electrodes are used under the supervision of a physicians in the areas of biopotential recording, monitoring and stimulation/response studies understand the use of depth electrodes.

The main components of the depth electrodes are:

    1. Contract strip with macro depth electrode contacts and connector contacts;
    1. Stylet;
  • Inner lumen: 3.
    1. Micro wire electrode(s) for insertion and placement through the macro electrode inner lumen.

The lead wires terminate in a safety connector that cannot be connected to an AC power outlet. The materials are the same as used in the predicate devices and/or are common to depth electrodes.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

subsurface level of the brain

Indicated Patient Age Range

Not Found

Intended User / Care Setting

physicians

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)

K891920, K964644, K033173

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 882.1330 Depth electrode.

(a)
Identification. A depth electrode is an electrode used for temporary stimulation of, or recording electrical signals at, subsurface levels of the brain.(b)
Classification. Class II (performance standards).

0

K041604

AUG 1 6 2004

Summary of Safety and Effectiveness

| Company Name: | AD-TECH Medical Instrument Corporation
1901 William Street
Racine, WI 53404 1876 | |
|----------------------------|----------------------------------------------------------------------------------------|----------------------------------------|
| Contact:
Phone:
Fax: | John Ziobro, Chief Operating Officer
262 367-9200, ext. 101
262 367-9149 | |
| Summary Date: | August 2, 2004 | |
| Trade Name: | Macro-Micro Depth Electrodes | |
| Common Name: | Depth Electrodes | |
| Classification Name: | 21 CFR 882.1330, Depth Electrode | |
| Predicate Device(s): | | |
| | 510(k) Number: | K891920, K964644 |
| | Manufacture: | AD-TECH Medical Instrument Corporation |
| | Trade Name: | Depth Electrode |
| | Product Code: | GZL |
| | 510(k) Number: | K033173 |
| | Manufacture: | Fhc, Inc. |
| | Trade Name: | Micro Targeting Electrode |
| | Product Code: | GZL |

1.0 Description of Electrodes

Depth electrodes described in this application are single patient use, disposable, sterile and non-sterile devices. The electrodes are invasive as they are placed in contact with nerve tissue.

The electrodes provide the patient contact device. The electrodes connect to the user's recording, monitoring and stimulation/response equipment. The electrodes are used under the supervision of a physicians in the areas of biopotential recording, monitoring and stimulation/response studies understand the use of depth electrodes.

1

K041604

2.0 Intended Use of Electrodes

The Macro-Micro Depth Electrodes are intended for use with recording, monitoring and stimulation equipment for the recording, monitoring and stimulation of electrical signals at the subsurface level of the brain.

3.0 Technological Characteristics

The main components of the depth electrodes are:

    1. Contract strip with macro depth electrode contacts and connector contacts;
    1. Stylet;
  • Inner lumen: 3.
    1. Micro wire electrode(s) for insertion and placement through the macro electrode inner lumen.

The lead wires terminate in a safety connector that cannot be connected to an AC power outlet. The materials are the same as used in the predicate devices and/or are common to depth electrodes.

4.0 Conclusions

The characteristics of the Macro-Micro Depth Electrodes are substantially equivalent to the predicate devices. No new questions of safety or effectiveness are raised.

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 consists of a stylized eagle or bird-like symbol with three curved lines representing its wings or body. The symbol is enclosed within a circular border. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged around the upper portion of the circle.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG 1 6 2004

Ad-Tech Medical Instrument Corporation c/o Mr. Gary Syring Quality and Regulatory Associates, LLC 800 Levanger Lane Stoughton, Wisconsin 53589

Re: K041604

Trade/Device Name: Macro-Micro Depth Electrodes Regulation Number: 21 CFR 882.1330 Regulation Name: Depth electrode Regulatory Class: II Product Code: GZL Dated: June 11, 2004 Received: June 15, 2004

Dear Mr. Syring:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your bection 9 re(x) presidentially equivalent (for the indications felerenced above and nave dotermined in marketed predicate devices marketed in interstate for use stated in the encreate) to the enactment date of the Medical Device Amendments, or to commence provision to May 20, 1978, the enaordance with the provisions of the Federal Food. Drug, devices that have been recuire approval of a premarket approval application (PMA).
and Cosmetic Act (Act) that do not require approval of a premarket approval application (PM You may, therefore, market the device, subject to the general controls provisions of the Act. The 1 ou may, mercrore, market the act include requirements for annual registration, listing of general controls provisions of use tice, 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 (soc aborto) als. Existing major regulations affecting your device can
may be subject to such additional controls. Existing major regulations may be subject to suen additions, Title 21, Parts 800 to 898. In addition, FDA may be found in the Our cements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not nean I rease oc advised that I Dri 3155aantes over device complies with other requirements of the Act that I Dri has made a determaniations administered by other Federal agencies. You must of any I edical statutes and regaranents ancluding, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set CFK Fart 807), labeling (21 CFR Part 820); and if applicable, the electronic north in the quality systems (Sections 531-542 of the Act); 21 CFR 1000-1050.

3

Page 2 - Mr. Gary Syring

This letter will allow you to begin marketing your device as described in your Section 5 10(k) I his letter will anow you to ocgin manceing your artial equivalence of your device to a legally premarket notification. The 127 imaing of sackanner sy.
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 If you desire specific advice for your are not 100 %. 4659. Also, please note the regulation entitled, contact the Office of Complance at (bet notification" (21CFR Part 807.97). You may obtain "Misoranuiling by Icierchee to premailer novilities under the Act from the Division of Small other general information on your responser Assistance at its toll-free number (800) 638-2041 or Manufacturers, International and Soless http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Miriam C. Provost

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): K041604

Device Name: Macro-Micro Depth Electrodes

Indications for Use:

The Macro-Micro Depth Electrodes are intended for use with recording, monitoring and stimulation equipment for the recording, monitoring and stimulation of electrical signals at the subsurface level of the brain.

× Prescription Use (Part 21 CFR 801 Subpart D)

... ... . . . . .

AND/OR

Over-The-Counter Use _ (21 CFR 807 Subpart C)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

・・・・・・・

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

Concurrence of CDRH. Office of Device Evaluation (ODE)

iriam C. Provost

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

Page 1 of 1

510(k) Number K0 41604