(104 days)
The Alexis Wound Retractor (large and extra large size only) is indicated for use to provide abdominal access during routine non-urgent cesarean deliveries.
The Alexis Wound Retractor was previously cleared for the following general indications for use (K041711) :
- l Access the abdominal cavity during surgery through an atraumatically retracted incision.
- 피 Delivery maximum exposure of the abdominal cavity with minimum incision size.
- 트 Protect against wound contamination during laparoscopic and open surgery.
- . Seal off the incision opening to permit insufflating the peritoneum.
- 트 Convert the incision wound to an additional trocar port site.
- 트 Access the thoracic cavity or other soft tissue retraction during cardiac and general surgical procedures through an atraumatically-retracted incision.
The Applied Wound Retractor consists of a flexible polymer membrane formed into the shape of a cylinder. Attached to each open end of the cylinder are two semi-rigid polymer rings.
To perform these functions, Alexis Wound Retractors are constructed as a cylindrical membrane sheath that has two rings attached to each open end. The rings are molded in a plastic material The Wound Retractor package also includes an incision template.
The Wound Retractor is simple to set up and easy to use. A sterile skin marker is used to mark an incision line at the surgery site and the incision is made. The Wound Protecting theath is placed in position through the incision with one ring inside the abdomen. The external ing is placed in traction and folded over itself until it contacts the abdomen. Once securely in place, the Alexis Wound Refractor keeps the incision open during the procedure. The wound protective sheath lines the incision and protects against wound contamination during the procedure.
The Applied Wound Retractor is a disposable, single-use device and is packaged inside a Tyvek/Mylar peel pouch, which is standard packaging material for Applied's products. The packaged product is then placed in an outer product shelf pack.
The provided text is a 510(k) summary for the Alexis® Wound Retractor, a device used for surgical retraction and wound protection. It does not contain a study demonstrating that the device meets specific acceptance criteria in the way typically found for diagnostic algorithms or devices with quantifiable performance metrics (e.g., sensitivity, specificity, accuracy).
Instead, the submission focuses on substantial equivalence to a predicate device, and the "acceptance criteria" are related to biocompatibility, material properties, and sterility, which are standard for a medical device of this type.
Here's an analysis based on the provided text, addressing the requested points:
1. Table of Acceptance Criteria and Reported Device Performance
| Acceptance Criteria Category | Specific Criteria/Test | Reported Device Performance |
|---|---|---|
| Biocompatibility | Non-irritant status (ISO 10993, Part I) | Found "non-irritant" when tested in accordance with ISO 10993, Part I: Biological Evaluation of Medical Devices. |
| Material Properties | Tensile Strength (ASTM D 412) | Determined to "pass" tensile strength testing. |
| Elongation (ASTM D 412) | Determined to "pass" elongation testing. | |
| Tear Strength (ASTM D 624) | Determined to "pass" tear strength testing. | |
| Functional Performance | Device function for surgical retraction and protection | "Functional performance testing has been completed and has passed the required testing." (Specific metrics not detailed, but imply it functions as intended for its stated use.) |
| Sterility | Sterility Assurance Level (SAL) | 10⁻⁶ SAL provided by 100% EO sterilization cycle. |
| Sterilant Residue Levels | In compliance with ANSI/AAMI/ISO 10993-7:1995 for limited exposure devices (20 mg ethylene oxide, 12 mg ethylene chlorohydrin). | |
| Substantial Equivalence | Equivalence to predicate device | "The Alexis Wound Retractor is substantially equivalent to predicate devices in design methodology, principle of operation and clinical utility. The device introduces no new safety or effectiveness issues when used as instructed." |
2. Sample size used for the test set and the data provenance
- For the material and biocompatibility testing, specific sample sizes are not mentioned in the document. These tests are typically performed on a statistically relevant number of samples to demonstrate compliance with standards.
- Data provenance is not explicitly stated, but it can be inferred that these tests were conducted internally by Applied Medical Resources Corporation or by a qualified third-party testing facility under their direction, as part of the device development and regulatory submission process. These are laboratory-based tests of the device itself.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
- Not applicable in the context of this device and submission. The "ground truth" here is compliance with established physical, chemical, and biological safety standards (e.g., ISO, ASTM). These standards define the test methods and acceptance criteria, rather than requiring expert consensus on a diagnostic outcome. Experts involved would be those qualified to execute and interpret these standard tests (e.g., toxicologists for biocompatibility, materials scientists for mechanical properties, microbiologists for sterility validation).
4. Adjudication method for the test set
- Not applicable. Adjudication methods like 2+1 or 3+1 are typically used for clinical studies comparing diagnostic interpretations, not for physical device property testing. Compliance is determined by whether the test results meet the predefined numerical or qualitative criteria of the respective standards.
5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance
- No. This is a physical surgical device, not a diagnostic AI or imaging interpretation tool. Therefore, an MRMC study is not relevant.
6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done
- No. This is a physical surgical device. The concept of an "algorithm only" or "standalone" performance without human-in-the-loop is not applicable here. Its function is to be used by a human surgeon.
7. The type of ground truth used
- The "ground truth" for this device's acceptance is based on compliance with recognized international and national standards for:
- Biocompatibility: ISO 10993 (biological safety).
- Material Properties: ASTM D 412 (tensile strength, elongation) and ASTM D 624 (tear strength).
- Sterility Validation: ANSI/AAMI/ISO 10993-7 (sterilant residues) and principles for achieving a 10⁻⁶ SAL (e.g., "three half-cycle validation runs").
- Functional Adequacy: Demonstrated by "functional performance testing" (details not provided, but implies it mechanically performs its intended role).
- Ultimately, the overarching "ground truth" for regulatory clearance is substantial equivalence to an already legally marketed predicate device, demonstrating that it is as safe and effective.
8. The sample size for the training set
- Not applicable. This is a physical medical device, not an AI or machine learning algorithm that requires a "training set."
9. How the ground truth for the training set was established
- Not applicable. No training set is involved.
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510(k) SUMMARY
| 510(k) NUMBER: | K062907 |
|---|---|
| SUBMITTED BY: | Applied Medical Resources Corporation22872 Avenida EmpresaRancho Santa Margarita, CA-92688(949) 713-8000 |
| CONTACT PERSON: | Cheryl BlakeVice President, Regulatory Affairs and Quality Systems |
| DATE OF PREPARATION: | December 27, 2006 |
| NAME OF DEVICE: | Wound Retractor |
| CLASSIFICATION NAME: | Drape, Surgical, General & Plastic Surgery.(Regulation Number 21CFR 878.4370, Surgical drape and drapeaccessories).Retractor, Manual Surgical(Regulation number 878.4800 Manual surgical instruments forgeneral surgical use (retractor), and 884.4520 Obstetric-gynecological general manual instruments. |
| TRADE NAME: | Alexis® Wound Retractors |
| PREDICATE DEVICE: | OB/MobiusApple Medical Corp.28 Lord Road, Unit 135Marlboro, MA 01752 |
| DESCRIPTION: | The Applied Wound Retractor consists of a flexible polymermembrane formed into the shape of a cylinder. Attached to eachopen end of the cylinder are two semi-rigid polymer rings. |
JAN 190 2007SUMMARY STATEMENT: The Applied Alexis Wound Retractor (large and extra large size only) is indicated for use to assist in non-urgent cesarean deliveries that are nutine procedures . It is intended to provide incision retraction and to protect against open wound contamination during a cesarean section. It is indicated for use as a surgical retractor for both vertical and transverse incisions.
To perform these functions, Alexis Wound Retractors are constructed as a cylindrical membrane sheath that has two rings attached to each open end. The rings are molded in a plastic material The Wound Retractor package also includes an incision template,
The Wound Retractor is simple to set up and easy to use. A sterile skin marker is used to mark an incision line at the surgery site and the incision is made. The Wound Protecting theath is placed in position through the incision with one ring inside the abdomen. The external ing is placed in traction and folded over itself until it contacts the abdomen. Once securely in place, the Alexis Wound Refractor keeps the incision open during the procedure. The wound protective sheath lines the incision and protects against wound contamination during the procedure,
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The Alexis Wound Retractor has been found non-irritant when tested in accordance with ISO 10993, Part I: Biological Evaluation of Medical Devices. The materials used in the manufacturing of the Alexis Wound Retractor have been tested in accordance with applicable standards and was determined to pass tensile strength, elongation, (ASTM D 412) and Tear Strength (ASTM D 624). Functional performance testing has been completed and has passed the required testing.
The Applied Wound Retractor is a disposable, single-use device and is packaged inside a Tyvek/Mylar peel pouch, which is standard packaging material for Applied's products. The packaged product is then placed in an outer product shelf pack.
The Applied Wound Retractor is sterilized using 100% EO. Applied's 100% EO sterilization cycle provides a sterility assurance level of 10°. Sterilization for Applied Medical's EO cycle uses three half-cycle validation runs, which incorporate biological indicators and temperature monitors distributed throughout the load to verify gas penetration and profile temperature distribution. Spore strip biological indicators of Bacillus Airophaeus with a population of 10 are used to monitor routine finished product sterilization loads. Sterilant residue levels will be in compliance with ANSI/AAMI/ISO 10993-7:1995 for limited exposure devices which is 20 mg ethylene oxide and 12 mg ethylene chlorohydrin.
The Alexis Wound Retractor is substantially equivalent to predicate devices in design methodology, principle of operation and clinical utility. The device introduces no new safety or effectiveness issues when used as instructed.
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Image /page/2/Picture/1 description: The image shows a circular seal with the Department of Health & Human Services logo. The logo features a stylized eagle with three lines representing its wings. The text "DEPARTMENT OF HEALTH & HUM." is arranged around the left side of the seal.
2007 JAN 9
Food and Drug Administration 9200 Corporate Blvd. Rockville MD 20850
Ms. Cheryl Blake Vice President Regulatory Affairs Applied Medical Resources 22872 Avenida Empresa RANCHO SANTA MARGARITA CA 92688
Re: K062907
Trade/Device Name: Alexis Wound Retractor Regulation Number: 21 CFR 884.4530 Regulation Name: Obstetric-gynecologic specialized manual instrument Regulation Number: 21 CFR 878.4800 Regulation Name: Manual surgical instrument for general use Regulatory Class: II Product Code: KNA and GAD Dated: December 29, 2006 Received: January 3, 2006
Dear Ms. Blake:
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 (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 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
Image /page/2/Picture/10 description: The image is a black and white circular seal. The seal contains the letters "DA" in a bold, sans-serif font in the center. Above the letters, the numbers "1906-1996" are printed. Below the letters, the word "Centennial" is printed in a cursive font. The seal is surrounded by a dotted border and some text that is difficult to read.
ationa Public .
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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.
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 one of the following numbers, based on the regulation number at the top of this letter:
| 21 CFR 876.xxx | (Gastroenterology/Renal/Urology) | 240-276-0115 |
|---|---|---|
| 21 CFR 884.xxx | (Obstetrics/Gynecology) | 240-276-0115 |
| 21 CFR 894.xxx | (Radiology) | 240-276-0120 |
| Other | 240-276-0100 |
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 (240) 276-3150
or at its Internet address http://www.fda.gov/cdrl/industry/support/index.html.
Sincerely yours,
Nancy C. Hogdon
Nancy C. Brogdon Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health
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Indications for Use
510(k) Number: K062907
Device Name: Alexis Wound Retractor
Indication For Use:
The Alexis Wound Retractor (large and extra large size only) is indicated for use to provide abdominal access during routine non-urgent cesarean deliveries.
The Alexis Wound Retractor was previously cleared for the following general indications for use (K041711) :
- l Access the abdominal cavity during surgery through an atraumatically retracted incision.
- 피 Delivery maximum exposure of the abdominal cavity with minimum incision size.
- 트 Protect against wound contamination during laparoscopic and open surgery.
- . Seal off the incision opening to permit insufflating the peritoneum.
- 트 Convert the incision wound to an additional trocar port site.
- 트 Access the thoracic cavity or other soft tissue retraction during cardiac and general surgical procedures through an atraumatically-retracted incision.
Concurrence of CDRH, Office of Device Evaluation (ODE)
Prescription Use (Part 21 CFR 801 Subpart D)
AND / OR
Over-The-Counter Use (21 CFR 807 Subpart C)
Nancy C. Brogdon
uctive. Abdominal, and 510(k) Numbe
§ 878.4370 Surgical drape and drape accessories.
(a)
Identification. A surgical drape and drape accessories is a device made of natural or synthetic materials intended to be used as a protective patient covering, such as to isolate a site of surgical incision from microbial and other contamination. The device includes a plastic wound protector that may adhere to the skin around a surgical incision or be placed in a wound to cover its exposed edges, and a latex drape with a self-retaining finger cot that is intended to allow repeated insertion of the surgeon's finger into the rectum during performance of a transurethral prostatectomy.(b)
Classification. Class II (special controls). The device, when it is an ear, nose, and throat surgical drape, a latex sheet drape with self-retaining finger cot, a disposable urological drape, a Kelly pad, an ophthalmic patient drape, an ophthalmic microscope drape, an internal drape retention ring (wound protector), or a surgical drape that does not include an antimicrobial agent, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 878.9.