K Number
K080791
Device Name
CONTURA MULTI-LUMEN BALLOON SOURCE APPLICATOR FOR BRACHYTHERAPY, MODELS B001-45 AND B011-45
Manufacturer
Date Cleared
2008-04-30

(41 days)

Product Code
Regulation Number
892.5700
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Contura Multi-Lumen Balloon Source Applicator for Brachytherapy is intended to provide brachytherapy when the physician chooses to deliver intracavitary radiation to the surgical margins following lumpectomy for breast cancer.
Device Description
The Contura MLB applicator consists of a multi-lumen catheter connected to an inflatable spherical balloon that can be attached to commercially available High Dose Rate remote afterloader equipment for passage of the radiation source delivery wire. Five radiation source wire lumens are provided; one central lumen located along the long axis of the applicator and four curved lumens symmetrically offset from the central lumen. The balloon is inflated to a 4 or 5 cm spherical shape by a controlled volume injection of physiological saline to approximately 33 or 58 ml, respectively.
More Information

Not Found

No
The summary describes a physical medical device (a balloon applicator) and its mechanical function. There is no mention of software, algorithms, or data processing that would indicate the presence of AI or ML.

Yes
The device is described as an "Applicator for Brachytherapy" and is "intended to provide brachytherapy" which is a form of radiation therapy used for treatment, indicating it is a therapeutic device.

No

This device is used for delivering radiation therapy (brachytherapy), not for diagnosing a condition. It is an applicator for a radiation source.

No

The device description clearly outlines physical components like a multi-lumen catheter, inflatable balloon, and lumens for radiation source delivery, indicating it is a hardware device.

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

Here's why:

  • Intended Use: The intended use clearly states that the device is used to "deliver intracavitary radiation to the surgical margins following lumpectomy for breast cancer." This is a therapeutic procedure performed in vivo (within the body), not a diagnostic test performed in vitro (outside the body) on biological samples.
  • Device Description: The description details a physical applicator used to deliver radiation, not a test kit or instrument for analyzing biological samples.
  • Lack of IVD Characteristics: There is no mention of analyzing blood, tissue, or other biological samples, nor is there any indication of providing diagnostic information about a patient's condition.

Therefore, the Contura Multi-Lumen Balloon Source Applicator for Brachytherapy is a therapeutic medical device, not an IVD.

N/A

Intended Use / Indications for Use

The Contura Multi-Lumen Balloon Source Applicator for Brachytherapy is intended to provide brachytherapy when the physician chooses to deliver intracavitary radiation to the surgical margins following lumpectomy for breast cancer.

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

JAQ

Device Description

The Contura MLB applicator consists of a multi-lumen catheter connected to an inflatable spherical balloon that can be attached to commercially available High Dose Rate remote afterloader equipment for passage of the radiation source delivery wire. Five radiation source wire lumens are provided; one central lumen located along the long axis of the applicator and four curved lumens symmetrically offset from the central lumen. The balloon is inflated to a 4 or 5 cm spherical shape by a controlled volume injection of physiological saline to approximately 33 or 58 ml, respectively.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

breast

Indicated Patient Age Range

Not Found

Intended User / Care Setting

physician

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)

Not Found

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.

K071229

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

§ 892.5700 Remote controlled radionuclide applicator system.

(a)
Identification. A remote controlled radionuclide applicator system is an electromechanical or pneumatic device intended to enable an operator to apply, by remote control, a radionuclide source into the body or to the surface of the body for radiation therapy. This generic type of device may include patient and equipment supports, component parts, treatment planning computer programs, and accessories.(b)
Classification. Class II.

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K080791

APR 30 2008 . . .

SENORX

7.

Date preparedMarch 14, 2008
NameSenoRx, Inc.
11 Columbia
Aliso Viejo, CA 92656
T. 949.362.4800; F. 949.362.0300
Contact personEben Gordon
Vice President, RA/QA
SenoRx, Inc.
T. 949.362.4800; F. 949.362.0300
Device nameContura MLB Source Applicator for Brachytherapy
Common nameMulti-lumen balloon source applicator
Classification nameRemote controlled radionuclide source applicator
Classification regulation21 CFR 892.5700;
90 JAQ
Predicate deviceSenoRad Multi-Lumen Balloon Source Applicator for Brachytherapy
(K071229)
DescriptionThe Contura MLB applicator consists of a multi-lumen catheter connected to an
inflatable spherical balloon that can be attached to commercially available High
Dose Rate remote afterloader equipment for passage of the radiation source
delivery wire. Five radiation source wire lumens are provided; one central
Iumen located along the long axis of the applicator and four curved lumens
symmetrically offset from the central lumen. The balloon is inflated to a 4 or 5
cm spherical shape by a controlled volume injection of physiological saline to
approximately 33 or 58 ml, respectively.
Indications for useThe Contura Multi-Lumen Balloon Source Applicator for Brachytherapy is
intended to provide brachytherapy when the physician chooses to deliver
intracavitary radiation to the surgical margins following lumpectomy for breast
cancer.
Summary of substantial
equivalenceThe device design, materials, processes, etc. have not been changed with this
application. The modification is to a warning only, therefore, the Contura
Multi-Lumen Balloon Source Applicator as described in this submission is
substantially equivalent to the predicate device.

.

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Third Party Review Quality Assessment

Section 1 - Submission Information
510(k) No.:K080791
Third Party Organization:REGULATORY TECHNOLOGIES Services
Third Party's Primary Reviewer(s):MARK JOB
ODE/OIVD Division:ORAO
Branch/Team:RAOB
Section 2 - 510(k) Decision
Third party recommendation:SE ✓ NSE Other (specify):
ODE/OIVD final decision:SE ✓ NSE Other (specify):

Section 3 - Assessment of Third Party Review

Review ElementRating (check one)
AdequateMinorMajor
Issue(s)Issue(s)
a. Determination of device eligibility for third party review
b. Extent of pre-submission consultation with ODE/OIVD division
c. Organization and format of review documentation
d. Determination of 510(k) administrative completeness (screening
review)
e. Summary of device characteristics, intended use, and performance
(including accessories, if applicable) and reason for 510(k) submission
f. Comparison to legally marketed devices-identification and analysis of
key similarities and differences
g. Rationale for conclusions and recommendation
h. Use of guidance documents and standardsN/A
i. Resolution of 510(k) deficiencies and FDA requests for additional
information
j. Scope of reviewer expertise and use of consulting reviewers
k. Other (specify):

Comments (explanation of ratings/issues): ____________________________________________________________________________________________________________________________________

Section 4 - ODE/OIVD Assessor Information R. PHILLIPS Date: 4/20/08 Tel. No.: 240-276-366

Assessed by:


Routing: Division -- Clip completed assessment (this page only) to inside front cover of 510(k). DMC-Forward this page only to Eric Rechen, POS/ODE, Rm. 120J, Corp. Blvd. (HFZ-402).

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Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized symbol that resembles a caduceus, a traditional symbol of medicine, but with a more abstract and modern design.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

APR 3 0 2008

SenoRx, Inc. % Mr. Mark Job Responsible Third Party Official Regulatory Technology Services, LLC 1393 25th Street NW BUFFALO MN 55313

Re: K080791

Trade/Device Name: Contura Multi-Lumen Balloon Source Applicator for Brachytherapy Regulation Number: 21 CFR 892.5700 Regulation Name: Remote controlled radionuclide applicator system Regulatory Class: II Product Code: JAQ Dated: April 14, 2008 Received: April 15, 2008

Dear Mr. Job:

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 the Contura Multi-Lumen Balloon Source Applicator for Brachytherapy as a replacement for whole breast irradiation in the treatment of breast cancer has not been established.

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The Warning must be presented within a black box, and the font should be bold and the same size as any surrounding text. The Warning should be the first item in your list of warnings.

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) 276-0100. Also, 1 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/industry/support/index.html.

Sincerely yours.

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

Enclosure

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6. INDICATIONS FOR USE

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Device Name: _________________________________________________________________________________________________________________________________________________________________

Indications for Use:

The Contura Multi-Lumen Balloon Source Applicator for Brachytherapy is intended to provide brachytherapy when the physician chooses to deliver intracavitary radiation to the surgical margins following lumpectomy for breast cancer.

Prescription UseX
(Part 21 CFR 801 Subpart D)

AND/OR

Over the Counter Use _________________________________________________________________________________________________________________________________________________________

(21 CFR 801 Subpart C)

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


Concurrence of CDRH, Office of Device Evaluation (ODE)

Aopi Nha

Page __ of ___________________________________________________________________________________________________________________________________________________________________

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

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