K Number
K043291
Device Name
CARDIOBLATE DISPERSIVE ELECTRODE ADAPTER (ACCESSORY), MODEL 60884
Manufacturer
Date Cleared
2004-12-21

(22 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Medtronic Cardioblate System is intended to ablate soft tissue during general surgery using radiofrequency energy.
Device Description
Cardioblate® Bipolar Radiofrequency Surgical Ablation System
More Information

Not Found

Not Found

No
The summary describes a radiofrequency ablation system for general surgery and does not mention AI, ML, or related concepts like image processing, training sets, or performance metrics typically associated with AI/ML devices.

Yes
The device is intended to ablate soft tissue, which is a therapeutic action aimed at treating or alleviating a condition.

No
The device description states its intended use is to "ablate soft tissue during general surgery using radiofrequency energy," which is a treatment, not a diagnostic function.

No

The device description clearly states "Cardioblate® Bipolar Radiofrequency Surgical Ablation System," indicating a hardware system that uses radiofrequency energy for ablation, not a software-only device.

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

Here's why:

  • Intended Use: The intended use is to "ablate soft tissue during general surgery using radiofrequency energy." This describes a surgical procedure performed on the patient's body, not a test performed on a sample taken from the patient's body.
  • Device Description: The description "Bipolar Radiofrequency Surgical Ablation System" further reinforces that it's a surgical tool.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), performing tests in vitro (outside the body), or providing diagnostic information based on sample analysis.

IVDs are devices used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device clearly falls outside that definition.

N/A

Intended Use / Indications for Use

The Medtronic Cardioblate System is intended to ablate soft tissue during general surgery using radiofrequency energy.

Product codes

GEI

Device Description

Not Found

Mentions image processing

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Mentions AI, DNN, or ML

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Input Imaging Modality

Not Found

Anatomical Site

Not Found

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

Not Found

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4400 Electrosurgical cutting and coagulation device and accessories.

(a)
Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.(b)
Classification. Class II.

0

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized depiction of an eagle or bird-like figure with three curved lines representing its wings or body. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the bird-like figure. The logo is black and white.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

DEC 2 1 2004

David D. Cox, Ph.D. Senior Principle Regulatory Affairs Specialist Medtronic, Inc. Medtronic Cardiac Surgery Technologies 7601 Northland Drive Minneapolis, Minnesota 55428

Re: K043291

R049271
Trade/Device Name: Cardioblate® Bipolar Radiofrequency Surgical Ablation System Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical cutting and coagulation device and accessories Regulatory Class: II Product Code: GEI Dated: November 22, 2004 Received: December 1, 2004

Dear Dr. Cox:

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 carı 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.

1

Page 2 - David D. Cox, Ph.D.

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 (240) 276-0115. 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,

Miriam C. Provost
65

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

2

Attachment 2

Indications for Use Statement

510(k) Number

ું 29 વા KO4

(if known)

Cardioblate® Bipolar Radiofrequency Surgical Ablation Device Name System

The Medtronic Cardioblate System is intended to ablate soft Indications tissue during general surgery using radiofrequency energy. for Use

Over-The-Counter Use OR Prescription Use_ V (Per 21 CFR 801. 109) PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER

PAGE IF NEEDED

Concurrence of CDRH, Office of Device Evaluation (ODE)

Miriam C. Provost

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

510(k) Number K043291