K Number
K043193
Device Name
BARD INLAYOPTIMA URETERAL STENT WITH SUTURE
Manufacturer
Date Cleared
2004-12-07

(19 days)

Product Code
Regulation Number
876.4620
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Bard® InlayOptima™ Ureteral Stent is indicated to relieve obstruction in a variety of benign, malignant and post-traumatic conditions in the ureter. These conditions include stones and/or stone fragments or other ureteral obstructions such as those associated with ureteral stricture, malignancy of abdominal organs, retroperitoneal fibrosis or ureteral trauma, or in association with Extracorporeal Shock Wave Lithotripsy (ESWL). The stent may be placed using endoscopic surgical techniques or percutaneously using standard radiographic technique. It is recommended that the indwelling time not exceed 365 days. The stent is not intended as a permanent indwelling device.
Device Description
The Bard® InLayOptima™ Ureteral Stent and Multi-Length Ureteral Stent is a coated, double pigtail ureteral stent with a monofilament suture loop attached to aid in stent removal. The stent is available in two forms: a single size or a customizable multi-length size. The following items are included with each stent: 1 Ureteral Stent with Suture 1 Push Catheter with Radiopaque Tip ー Pigtail Straightener Guidewire* (Optional) 1 *Note: a 4.7 Fr stent is compatible with a .035" guidewire and a 6.7 and 8 Fr stents are compatible with a .038" guidewire. In vitro testing conducted on the Bard® InLayOptima™ Ureteral Stents and Multi-Length Ureteral Stents indicate reduced accumulation of urine calcium salts as assayed by calcium when compared to a control. Correlation of in vitro data to clinical outcome has not been established.
More Information

Not Found

No
The document describes a physical medical device (ureteral stent) and its intended use, materials, and performance in vitro. There is no mention of software, algorithms, or data processing that would indicate the use of AI or ML.

Yes
The device is indicated to "relieve obstruction in a variety of benign, malignant and post-traumatic conditions in the ureter," which describes a therapeutic effect.

No
The device is a ureteral stent used to relieve obstruction, not to diagnose a condition.

No

The device description clearly outlines physical components like a ureteral stent, push catheter, pigtail straightener, and optional guidewire, indicating it is a hardware medical device.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices intended for use in vitro for the examination of specimens, including blood and tissue samples, derived from the human body, solely or principally for the purpose of providing information concerning a physiological or pathological state, or a congenital abnormality, or to determine the safety and compatibility with potential recipients, or to monitor therapeutic measures.
  • Device Function: The Bard® InlayOptima™ Ureteral Stent is a physical device that is implanted into the ureter to relieve obstruction. It is a therapeutic device, not a diagnostic one.
  • Intended Use: The intended use clearly states it is for relieving obstruction in the ureter due to various conditions. This is a treatment, not a diagnostic process.
  • Device Description: The description details the physical components of the stent and its accessories for insertion.
  • Performance Studies: The performance study mentioned is an in vitro test on the device itself (accumulation of calcium salts), not a diagnostic test on a patient sample.

While the device description mentions "In vitro testing," this refers to testing performed on the device in a lab setting, not a diagnostic test performed on a patient's sample to diagnose a condition.

N/A

Intended Use / Indications for Use

The Bard® InlayOptima™ Ureteral Stent is indicated to relieve obstruction in a variety of benign, malignant and post-traumatic conditions in the ureter. These conditions include stones and/or stone fragments or other ureteral obstructions such as those associated with ureteral stricture, malignancy of abdominal organs, retroperitoneal fibrosis or ureteral trauma, or in association with Extracorporeal Shock Wave Lithotripsy (ESWL). The stent may be placed using endoscopic surgical techniques or percutaneously using standard radiographic technique. It is recommended that the indwelling time not exceed 365 days. The stent is not intended as a permanent indwelling device.

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

78 FAD

Device Description

The Bard® InLayOptima™ Ureteral Stent and Multi-Length Ureteral Stent is a coated, double pigtail ureteral stent with a monofilament suture loop attached to aid in stent removal. The stent is available in two forms: a single size or a customizable multi-length size. The following items are included with each stent:

  • 1 Ureteral Stent with Suture
  • 1 Push Catheter with Radiopaque Tip
  • ー Pigtail Straightener
  • Guidewire* (Optional) 1
  • *Note: a 4.7 Fr stent is compatible with a .035" guidewire and a 6.7 and 8 Fr stents are compatible with a .038" guidewire.

In vitro testing conducted on the Bard® InLayOptima™ Ureteral Stents and Multi-Length Ureteral Stents indicate reduced accumulation of urine calcium salts as assayed by calcium when compared to a control. Correlation of in vitro data to clinical outcome has not been established.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Radiographic technique

Anatomical Site

ureter

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 document mentions "In vitro testing conducted on the Bard® InLayOptima™ Ureteral Stents and Multi-Length Ureteral Stents indicate reduced accumulation of urine calcium salts as assayed by calcium when compared to a control." It also states "Performance and functional testing standards are based on the FDA draft "Guidance for the Content of Premarket Notifications for Ureteral Stents" dated February 10, 1993 and the draft ASTM F.04.70.01, "Standard Test Method for Ureteral Stents" dated July 9, 1997." No specific study types, sample sizes, AUC, MRMC, standalone performance, or key results are provided beyond the general statement about in vitro testing.

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.

K022447

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

§ 876.4620 Ureteral stent.

(a)
Identification. A ureteral stent is a tube-like implanted device that is inserted into the ureter to provide ureteral rigidity and allow the passage of urine. The device may have finger-like protrusions or hooked ends to keep the tube in place. It is used in the treatment of ureteral injuries and ureteral obstruction.(b)
Classification. Class II (performance standards).

0

DEC - 7 2004

K043193
Page 1 of 3

510 (k) SUMMARY OF SAFETY AND EFFECTIVENESS INFORMATION

This 510(k) summary of safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990.

  • A. Submitter's Information:
Submitter's Name:C. R. Bard, Inc., Urological Division
Address:8195 Industrial Blvd.
Covington, Georgia 30014
Contact Person:Frances E. Harrison, RAC
Contact Person's Phone:(770) 784-6257
Contact Person's Fax:(770) 784-6419
Date of Preparation:November 24, 2004
  • B Device Name:
Trade Name:Bard® InLayOptima™ Ureteral Stent with Suture
Common / Usual Name:Bard Ureteral Stent
Classification Name:Ureteral Stent
  • C. Predicate Device Name:
Trade Name:Bard ® InLayOptima™ Ureteral Stent with Suture
#K022447
  • D. Device Description: The Bard® InLayOptima™ Ureteral Stent and Multi-Length Ureteral Stent is a coated, double pigtail ureteral stent with a monofilament suture loop attached to aid in stent removal. The stent is available in two forms: a single size or a customizable multi-length size. The following items are included with each stent:
    • 1 Ureteral Stent with Suture
    • 1 Push Catheter with Radiopaque Tip
    • ー Pigtail Straightener
    • Guidewire* (Optional) 1
    • *Note: a 4.7 Fr stent is compatible with a .035" guidewire and a 6.7 and 8 Fr stents are compatible with a .038" guidewire.

In vitro testing conducted on the Bard® InLayOptima™ Ureteral Stents and Multi-Length Ureteral Stents indicate reduced accumulation of urine calcium salts as assayed by calcium when compared to a control. Correlation of in vitro data to clinical outcome has not been established.

Choong, SKS, Wood. S, Whitfield, HN. "A model to quantify encrustation on ureteric stents, urethral catheters, and polymers intended for urological use," BJU International (2000), 86, 414-421.

  • E. Intended Use: The Bard® InlayOptima™ Ureteral Stent is indicated to relieve obstruction in a variety of benign, malignant and post-traumatic conditions in the ureter. These conditions include stones and/or stone fragments or other ureteral obstructions such as those associated with ureteral stricture, malignancy of abdominal organs, retroperitoneal fibrosis or ureteral trauma, or in association with Extracorporeal Shock Wave Lithotripsy (ESWL). The stent may be placed using endoscopic surgical techniques or percutaneously using standard radiographic technique. It is recommended that the indwelling time not exceed 365 days. The stent is not intended as a permanent indwelling device.

1

K043193

Page 2 of 3

  • F. Technological Characteristics Summary:
    The table below provides a tabulated comparison summary of the technological characteristics of
    the Bard* InlayOptima™ Ureteral Stent with Suture versus the predicate device

| Product
Characteristics | Bard® Inlay Optima ™ Ureteral Stent
with Suture
(this 510(k)) | Bard® Inlay Optima™ Ureteral Stent
with Suture
(Predicate device - #K022447) | Difference |
|--------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------|
| Stent | | | |
| Indications or
Intended Use | The Bard® Inlay Optima ™ Ureteral Stent
is indicated to relieve obstruction in a
variety of benign, malignant and post-
traumatic conditions in the ureter. These
conditions include stones and/or stone
fragments or other ureteral obstructions
such as those associated with ureteral
stricture, malignancy of abdominal
organs, retroperitoneal fibrosis or
ureteral trauma, or in association with
Extracorporeal Shock Wave Lithotripsy
(ESWL). The stent may be placed using
endoscopic surgical techniques or
percutaneously using standard
radiographic technique. It is
recommended that the indwelling time
not exceed 365 days. The stent is not
intended as a permanent indwelling
device. | The Bard® Inlay Optima ™ Ureteral Stent
is indicated to relieve obstruction in a
variety of benign, malignant and post-
traumatic conditions in the ureter. These
conditions include stones and/or stone
fragments or other ureteral obstructions
such as those associated with ureteral
stricture, malignancy of abdominal
organs, retroperitoneal fibrosis or
ureteral trauma, or in association with
Extracorporeal Shock Wave Lithotripsy
(ESWL). The stent may be placed using
endoscopic surgical techniques or
percutaneously using standard
radiographic technique. It is
recommended that the indwelling time
not exceed 365 days. The stent is not
intended as a permanent indwelling
device. | None |
| Disposable | Yes | Yes | None |
| Sterile | Yes | Yes | None |
| Stent Base Material | Polycarbonate-based Polyurethane* | Polyether-based Polyurethane | Material
change |
| X-Ray Opaque | Yes | Yes | None |
| Coating | | | |
| Double Pigtail | Hydrophobic polymer | Hydrophobic polymer | None |
| Multilength | Hydrophobic polymer | Hydrophobic polymer | None |
| Models and Sizes | | | |
| Fr. Sizes Available | 4.7 Fr., 6 Fr., 7 Fr., and 8 Fr. | 4.7 Fr., 6 Fr., 7 Fr., and 8 Fr. | None |
| Double Pigtail
Lengths | 14. 20-30 cm | 14. 20-30 cm | None |
| Multilength Lengths | 23-32cm (one overall adjustable length) | 23-32cm (one overall adjustable length) | None |
| Pigtail Geometry | | | |
| Double Pigtail | 360° curvature + 45° overlap (both ends) | 360° curvature + 45° overlap (both ends) | None |
| Multilength | 2 ½ Turns | 2 ½ Turns | None |
| Suture Loop | Yes - USP Medical Grade black nylon
monofilament: 3-0 | Yes - USP Medical Grade black
monofilament; 3-0 | None |
| Guidewire Interface | 4.7 Fr. = 0.035" diameter
6. 7. 8 Fr. = 0.038" diameter | 4.7 Fr. = 0.035" diameter
6. 7. 8 Fr. = 0.038" diameter | None |
| Accessories | | | |
| Stent Clamp | No | No | Clamp
Removed |
| Push Catheter | | | |
| Color | Orange | Orange | None |
| Material | High Density Polyethylene (HDPE) | High Density Polyethylene (HDPE) | None |
| Guidewire Interface | 4.7 Fr. = 0.035" diameter
6. 7. 8 Fr. = 0.038" diameter | 4.7 Fr. = 0.035" diameter
6. 7. 8 Fr. = 0.038" diameter | None |
| Radiopacity | Radiopaque marker band near distal end | Radiopaque marker band near distal end | None |

Comparison Summary of Technological Characteristics

. New feature(s) or change this 510(k)

2

X043193
Page 3 of 3

The Bard" InlayOpima" Ureteral Stent with Suture referenced in this submission is held to
the same design, manufacture, and performance specifications as those stents current manufactured by Bard. Performance and functional testing standards are based on the FDA draft "Guidance for the Content of Premarket Notifications for Ureteral Stents" dated February 10, 1993 and the draft ASTM F.04.70.01, "Standard Test Method for Ureteral Stents" dated July 9, 1997.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized symbol featuring three abstract human figures or forms, often interpreted as representing people or the provision of services.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

DEC - 7 2004

Frances E. Harrison, RAC Director, Regulatory Affairs C. R. Bard, Inc. 8195 Industrial Blvd. COVINGTON GA 30014

Re: K043193

Trade/Device Name: Bard® InlayOptima™ Ureteral Stent with Suture Regulation Number: 21 CFR §876.4620 Regulation Name: Ureteral stent Regulatory Class: II Product Code: 78 FAD Dated: November 10, 2004 Received: November 18, 2004

Dear Ms. Harrison:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced we have reviewed your becalled by equivalent (for the indications for use stated in above and nave determined the als at redicate devices marketed in interstate commerce prior to the enclosure) to regary manusical Device Amendments, or to devices that have been May 20, 1770, the clademisine acto 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 do not require approval of a promance approvisions of the Act. The general controls provisions of the Act device, subject to the general connois prove, 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 (Premarket If your device is classified (600 above).
Approval), it may be subject to such additional controls. Existing major regulations affecting your Apploval), It they of sabject to antiFederal Regulations, Title 21, Parts 800 to 898. In addition, FDA acvice can be round in the cements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that Ficast be advised mar PDT o isoual your device complies with other requirements of the Act or any FDA liade a actemination adaministered by other Federal agencies. You must comply with all the Federal statues and regulations administer to registration and listing (21 CFR Part 807); labeling ACL STEQuirements, metading but noing practice requirements as set forth in the quality systems (QS) (21 CFR Part 801); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

4

This letter will allow you to begin marketing your device as described in your Section 510(k) I mis lotter notification. The FDA finding of substantial equivalence of your device to a legally promation notificate 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 11 you atter of Compliance at one of the following numbers, based on the regulation number at the top of this letter:

21 CFR 876.xxxx(Gastroenterology/Renal/Urology)240-276-0115
21 CFR 884.xxxx(Obstetrics/Gynecology)240-276-0115
21 CFR 892.xxxx(Radiology)240-276-0120
Other240-276-0100

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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,

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

5

INDICATIONS FOR USE STATEMENT

510(k) Number (if known): _K043193

Device Name: Bard® InlayOptima™ Ureteral Stent

Indications for Use:

The Bard® InlayOptima™ Ureteral Stent is indicated to relieve obstruction in a variety of benign, malignant and post-traumatic conditions in the ureter. These conditions include stones and/or stone fragments or other ureteral obstructions such as those associated with ureteral stricture, malignancy of abdominal organs, retroperitoneal fibrosis or ureteral trauma, or in association with Extracorporeal Shock Wave Lithotripsy (ESWL). The stent may be placed using endoscopic surgical techniques or percutaneously using standard radiographic technique. It is recommended that the indwelling time not exceed 365 days. The stent is not intended as a permanent indwelling device.

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

CONCURRENCE OF CDRH, OFFICE OF DEVICE EVALUATION (ODE)

Prescription Use 1 (Per 21 CFR 801.109)

OR Over-The-Counter Use

(Optional Format 1/2/96)

Daniel A. Suggars

(Division Sign-Of Division of Reproductive, Abdominal. and Radiological Devic 510(k) Number