K Number
K061231
Device Name
WELLFLEX BILIARY RX STENT SYSTEM
Date Cleared
2006-09-01

(122 days)

Product Code
Regulation Number
876.5010
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The WallFlex Biliary RX Uncovered Stent system is indicated for use in the palliative treatment of biliary strictures produced by malignant neoplasms.
Device Description
The proposed WallFlex™ Biliary RX Uncovered Stent System consists of a selfexpanding metal stent and a delivery catheter. The proposed stent consists of Platinum cored Nitinol wires wound together to form a cylinder with both proximal and distal flares. The proposed stent is mounted onto a sheath delivery system. The groposed delivery system is a coaxial tubing assembly that constrains the stent onto the delivery catheter shaft until the stent is released by retracting the exterior tube.
More Information

Not Found

No
The summary describes a mechanical stent and delivery system with no mention of AI/ML components or related performance metrics.

Yes
The device is indicated for palliative treatment of biliary strictures, which is a therapeutic purpose.

No
The device is a stent system used for palliative treatment of biliary strictures, which is a therapeutic rather than a diagnostic function.

No

The device description clearly states it consists of a self-expanding metal stent and a delivery catheter, which are hardware components.

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

Here's why:

  • Intended Use: The intended use is the "palliative treatment of biliary strictures produced by malignant neoplasms." This describes a therapeutic intervention performed within the body, not a test performed on a sample taken from the body to diagnose or monitor a condition.
  • Device Description: The device is a "self-expanding metal stent and a delivery catheter." This is a medical device designed to be implanted in the body to open up a blocked passage.
  • Lack of IVD Characteristics: The description does not mention any components or processes related to analyzing biological samples (blood, urine, tissue, etc.) or providing diagnostic information based on such analysis.

IVD devices are used to examine specimens derived from the human body to provide information for the diagnosis, monitoring, or treatment of a disease or condition. This device is a therapeutic device used to treat a condition directly.

N/A

Intended Use / Indications for Use

The WallFlex Biliary RX Uncovered Stent system is indicated for use in the palliative treatment of biliary strictures produced by malignant neoplasms.

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

FGE

Device Description

The proposed WallFlex™ Biliary RX Uncovered Stent System consists of a selfexpanding metal stent and a delivery catheter. The proposed stent consists of Platinum cored Nitinol wires wound together to form a cylinder with both proximal and distal flares. The proposed stent is mounted onto a sheath delivery system. The groposed delivery system is a coaxial tubing assembly that constrains the stent onto the delivery catheter shaft until the stent is released by retracting the exterior tube.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

biliary

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)

Comparative performance testing was completed to establish substantial equivalence between the proposed WallFlex™ Biliary RX Uncovered Stent System and the predicate devices. This testing included but was not limited to dimensional evaluation, radial force, deployment and reconstrainment force and bond integrity.

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.

K000308, K993232, K982184, K964119, K925406, K012752, K030107

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

§ 876.5010 Biliary catheter and accessories.

(a)
Identification. A biliary catheter and accessories is a tubular flexible device used for temporary or prolonged drainage of the biliary tract, for splinting of the bile duct during healing, or for preventing stricture of the bile duct. This generic type of device may include a bile collecting bag that is attached to the biliary catheter by a connector and fastened to the patient with a strap.(b)
Classification. Class II (special controls). The device, when it is a bile collecting bag or a surgical biliary catheter that does not include a balloon component, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.

0

Boston Scientific Corporation August 7, 2006

KD61231
21 of 2

SECTION 5 510(K) SUMMARY

510(K) SUMMARY

1. Submitter:

Boston Scientific Corporation 100 Boston Scientific Way Marlborough, MA 01760 Telephone: 508-683-4356 Fax: 508-683-5939

Contact: Allyson Barford, RAC Regulatory Affairs Specialist Date Prepared: August 7, 2006

2. Device:

Trade Name: WallFlex™ Biliary RX Uncovered Stent System Common Name: Biliary Stent Classification Name: Biliary Catheter and Accessories Regulation Number: 876.5010 Product Code: FGE Classification: Class II

3. Predicate Device:

Boston Scientific Corporation's Wallstent Biliary Endoprosthesis, K000308, K993232, K982184, K964119 and K925406

Boston Scientific Corporation's Wallstent RX Biliary Endoprosthesis, K012752 and K030107

The predicate devices are class II devices per 21 CFR 876.5010

4. Device Description:

The proposed WallFlex™ Biliary RX Uncovered Stent System consists of a selfexpanding metal stent and a delivery catheter. The proposed stent consists of Platinum cored Nitinol wires wound together to form a cylinder with both proximal and distal flares. The proposed stent is mounted onto a sheath delivery system. The groposed delivery system is a coaxial tubing assembly that constrains the stent onto the delivery catheter shaft until the stent is released by retracting the exterior tube.

1

5. Intended Use:

The proposed WallFlex Biliary RX Uncovered Stent System is indicated for use in the palliative treatment of biliary strictures produced by malignant neoplated 1.

6. Technological Characteristics:

The proposed WallFlex Biliary RX Uncovered Stent System has similar technological characteristics to the currently marketed Wallstent Biliary Endoprosthesis (K000308, K993232, K982184, K964119 and K925406) and Wallstent RX Biliary Endoprosthesis (K012752 and K030107).

7. Performance Data:

Comparative performance testing was completed to establish substantial equivalence between the proposed WallFlex™ Biliary RX Uncovered Stent System and the predicate devices. This testing included but was not limited to dimensional evaluation, radial force, deployment and reconstrainment force and bond integrity.

8. Conclusion:

Boston Scientific Corporation has demonstrated that the proposed WallFlex Biliary RX Uncovered Stent System is substantially equivalent to Boston Scientific Corporation's currently marketed Wallstent RX Biliary Endoprosthesis and Wallstent Boildy Endoprosthesis.

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized eagle with three lines representing its body and wings. The eagle is facing right. The text "DEPARTMENT OF HEALTH AND HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Ms. Allyson Barford, R.A.C. Regulatory Affairs Specialist Boston Scientific Corporation Endoscopy 100 Boston Scientific Way MARLBOROUGH MA 01752

SEP - 1 2006

Re: K061231

Trade/Device Name: WallFlexTM Biliary RX Uncovered Stent System Regulation Number: 21 CFR §876.5010 Regulation Name: Biliary catheter and accessories Regulatory Class: II Product Code: FGE Dated: August 7, 2006 Received: August 8, 2006

Dear Ms. Barford:

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). You may, therefore, market the device, subject to the general controls provisions of the Act and the limitations described below. 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.

The Office of Device Evaluation has determined that there is a reasonable likelihood that this device will be used for an intended use not identified in the proposed labeling and that such use could cause harm. Therefore, in accordance with Section 513(i)(1)(E) of the Act, the following limitation must appear in the Warnings section of the device's labeling:

The safety and effectiveness of this device for use in the vascular system have not been established.

Furthermore, the indication for biliary use must be prominently displayed in all labeling. including pouch, box, and carton labels, instructions for use, and other promotional materials, in close proximity to the trade name, of a similar point size, and in bold print.

3

Page 2 - Ms. Allyson Barford

Please note that the above labeling limitations are required by Section 513(i)(1)(E) of the Act. Therefore, a new 510(k) is required before these limitations are modified in any way or removed from the device's labeling.

The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and permits your device to proceed to the market. This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification if the limitation statement described above is added to your labeling.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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.

If you desire specific information about the application of other labeling requirements to your device (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" (21 CFR 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 (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html. .

Sincerely yours,

Donna-Bea Tillman, Ph.D., M.P.A. Director Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

Indications for Use

510(k) Number: K061231

Device Name: WallFlex™ Biliary RX Uncovered Stent System

FDA's Statement of the Indications for Use for the device:

The WallFlex Biliary RX Uncovered Stent system is indicated for use in the palliative treatment of biliary strictures produced by malignant neoplasms.

Prescription Use X (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)

David Ch. Loymm

(Division Sign-Off) Division of Reproductive, Abdominal, and Radiological Devices 510(k) Number.

Page 1 of 1