K Number
K053524
Device Name
C-PORT DISTAL ANASTOMOSIS SYSTEM
Manufacturer
Date Cleared
2006-11-16

(332 days)

Product Code
Regulation Number
878.4300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Cardica® C-Port® xA Anastomosis System is intended for the creation of anastomoses in blood vessels and grafts, including use in coronary artery bypass grafting procedures.
Device Description
The Cardica® C-Port® Anastomosis System is a sterile, single use device for creation of a reliably patent end-to-side anastomosis between a conduit and a small vessel. The product consists of accessories to assist in the conduit loading and a device that completes the anastomosis with stainless steel clips. Once the conduit has been loaded onto the device and the device positioned against the target vessel, the anastomosis is created by pushing the actuation button.
More Information

Not Found

No
The summary describes a mechanical device for creating anastomoses and does not mention any software, algorithms, or data processing that would indicate the use of AI/ML.

Yes
The device is used for creating anastomoses in blood vessels and grafts, including use in coronary artery bypass grafting procedures, which are therapeutic medical interventions.

No
The device is described as an "Anastomosis System" intended for the "creation of anastomoses in blood vessels and grafts." This describes a surgical tool used to join physiological lumens, not to diagnose a condition.

No

The device description clearly states it is a sterile, single-use device consisting of accessories and a device that completes the anastomosis with stainless steel clips, indicating it is a physical medical device, not software only.

Based on the provided information, the Cardica® C-Port® xA Anastomosis System is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use is for the creation of anastomoses (surgical connections) in blood vessels and grafts, specifically mentioning coronary artery bypass grafting procedures. This is a surgical procedure performed directly on the patient's body.
  • Device Description: The device is described as a sterile, single-use device that creates an anastomosis using stainless steel clips. This is a surgical tool used during a procedure.
  • Lack of IVD Characteristics: IVD devices are used to examine specimens (like blood, urine, tissue) outside of the body to provide information for diagnosis, monitoring, or screening. The description of the C-Port® xA Anastomosis System does not involve the analysis of any biological specimens.

Therefore, the Cardica® C-Port® xA Anastomosis System is a surgical device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Cardica® C-Port® xA Anastomosis System is intended for the creation of anastomoses in blood vessels and grafts, including use in coronary artery bypass grafting procedures.

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

FZP

Device Description

The Cardica® C-Port® Anastomosis System is a sterile, single use device for creation of a reliably patent end-to-side anastomosis between a conduit and a small vessel. The product consists of accessories to assist in the conduit loading and a device that completes the anastomosis with stainless steel clips. Once the conduit has been loaded onto the device and the device positioned against the target vessel, the anastomosis is created by pushing the actuation button.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Blood vessels and grafts, including in coronary artery bypass grafting procedures.

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)

All necessary in vitro and in vivo testing has been performed on the C-Port® xA Anastomosis System and packaging to ensure substantial equivalence to the predicate device and to ensure the safety and effectiveness of the device.

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.

Cardica® C-Port® Anastomosis System (K040832)

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

§ 878.4300 Implantable clip.

(a)
Identification. An implantable clip is a clip-like device intended to connect internal tissues to aid healing. It is not absorbable.(b)
Classification. Class II.

0

Attachment 4

NOV 16 2006

510(k) Summary

This summary of 510(k) safety and effectiveness information is submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

510(k) Number
Date Prepared15 December 2005
Applicant InformationCardica, Inc.
900 Saginaw
Redwood City, California 94063
Main: 650-364-9975
Fax: 650-364-3134
Contact PersonDavid Casal, PhD
Office: 650-331-7145
Fax: 650-364-3134
e-mail: casal@cardica.com
Establishment
Registration Number3004114958
Device InformationClassification Name: Clip, Implantable
Regulation Number: 21 CFR §878.4300
Trade Name: Cardica® C-Port® Anastomosis System
Common Name: Cardiovascular Surgical Instruments
Predicate Device(s)Cardica® C-Port® Anastomosis System (K040832)
Device DescriptionThe Cardica® C-Port® Anastomosis System is a sterile, single use device
for creation of a reliably patent end-to-side anastomosis between a
conduit and a small vessel. The product consists of accessories to assist
in the conduit loading and a device that completes the anastomosis with
stainless steel clips. Once the conduit has been loaded onto the device
and the device positioned against the target vessel, the anastomosis is
created by pushing the actuation button.

1

Intended UseThe Cardica® C-Port® xA Anastomosis System is intended for the creation of anastomoses in blood vessels and grafts, including use in coronary artery bypass grafting procedures.
Comparison to Predicate DeviceThe Cardica® C-Port® xA Anastomosis System is substantially equivalent to the Cardica® C-Port® Anastomosis System (K040832, 21 CFR §878.4300). The subject device is substantially equivalent to the predicate device with regard to indications, device characteristics, method of use, labeling and materials.
Device Testing Results and ConclusionAll necessary in vitro and in vivo testing has been performed on the C-Port® xA Anastomosis System and packaging to ensure substantial equivalence to the predicate device and to ensure the safety and effectiveness of the device.
SummaryBased upon the product technical information provided, intended use, and performance information provided in this pre-market notification, the Cardica® C-Port® Anastomosis System has been shown to be substantially equivalent to the currently marketed predicate device.

Cardica® and C-Port® are registered trademarks of Cardica, Inc.

:

.

.

2

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV 16 2006

Tiffini Lalude Director of Regulatory Affairs Cardica, Inc. 900 Saginaw Drive Redwood City, CA 94063

Re: K053524

C-Port™ xA Distal Anastomosis System Regulation Number: 21 CFR 878.4300 Regulatory Class: Class II Product Code: FZP Dated: October 1, 2006 Received: October 4, 2006

Dear: Ms. Lalude:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and have determined the device is substantially equivalent to 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). 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 (Premarket Approval), 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 895. A substantially equivalent determination assumes compliance with the Good Manufacturing Practice for Medical Devices: General (GMP) regulation (21 CFR Part 820) and that, through periodic GMP inspections, FDA will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, the Food and Drug Administration (FDA) may publish further announcements concerning your device in the Federal Register. Please note:

Image /page/2/Picture/10 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized caduceus symbol, which is a staff with two snakes coiled around it. The logo also includes the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged in a circular pattern around the caduceus.

3

Pagc 2 - Tiffini Lalude

this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. An 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, but it does not mean that FDA approves your device. Therefore, you may not promote or in any way represent your device or its labeling as being approved by FDA.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (240) 276-0120. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or at (240) 276-3150.

Sincerely yours.

Duna R. Vahner

Image /page/3/Picture/6 description: The image contains a handwritten symbol or character. It appears to be a cursive letter, possibly an 'S' or a stylized initial. The character is drawn with a single, continuous stroke, featuring a loop at the top and a curved line extending downwards.

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

4

Attachment 2

Indications for Use Statement

| 510(k) Number:

(if known)K053524
Device Name:Cardica® C-Port® xA Anastomosis System
Indications for Use:The Cardica® C-Port® xA Anastomosis System is intended for the creation of anastomoses in blood vessels and grafts, including use in coronary artery bypass grafting procedures.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription UseOROver-the Counter Use
(per 21 CFR §801.109(Optional Format 1-2-96)
Donna R. Lehner (Division Sign-Off) Division of Cardiovascular Devices
Cardica
16 December 2005
510(k) NumberK23053524
Special 510(k) C-Port xA System