K Number
K090217
Manufacturer
Date Cleared
2009-04-23

(84 days)

Product Code
Regulation Number
876.1500
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Bonee Needle for Bladder Injections is used to deliver injectable materials into the urinary bladder wall during the transurethral endoscopic procedures.

Device Description

The needle for bladder injections is designed for a working endoscope channel inner diameter of 5 French or larger. This product is 35 cm (ref: NBI035) or 70 cm (ref: NBI070) length and is made of thermoplastic tubing polyamide (PA) marked by ink, a stainless steel cystoscopic needle, a polyamide Luer Lock connector and a Tuohy Borst adapter to allow connection with the cystoscope. The assembly of the different components is being insured by gluing (UV process). A blue protective cap in Neoplex® is also supplied to prevent cystoscope channel degradation during needle insertion. Shelf life of the full range of the needle for bladder injections is 2 years. The needle for bladder injections is provided sterile and is intended for single use.

AI/ML Overview

The provided text describes a 510(k) premarket notification for a medical device called the "Bonee Needle for Bladder Injections." A 510(k) submission primarily demonstrates substantial equivalence to a predicate device, rather than explicit acceptance criteria and performance studies in the way you might find for novel device approvals (PMA) or algorithm-based AI/ML devices.

Therefore, many of the requested points cannot be answered from the provided document as it focuses on demonstrating equivalence through bench testing and material comparisons, not extensive clinical or performance studies with ground truth, expert adjudication, or large sample sizes for AI/ML.

Here's an analysis based on the available information:

1. A table of acceptance criteria and the reported device performance:

The document does not specify formal "acceptance criteria" for the Bonee Needle in the sense of performance metrics (e.g., accuracy, sensitivity, specificity, or specific mechanical thresholds beyond general safety and effectiveness). Instead, the device's performance is demonstrated through comparison to a predicate device.

Acceptance Criterion (Implied)Reported Device Performance
Substantial equivalence to predicate in performance, indication, design, and materials."Substantial equivalence is supported by bench testing comparing Bonee Injection needle to the predicate devices and biocompatibility testing performed on the Bonne Needle."
- (Specific performance metrics are not detailed)- (Specific performance metrics are not detailed)

2. Sample size used for the test set and the data provenance:

  • Sample Size: Not explicitly stated. The studies mentioned are "bench testing" and "biocompatibility testing." These generally involve a limited number of devices or material samples for specific tests (e.g., tensile strength, flow rate).
  • Data Provenance: Not specified. "Bench testing" typically refers to in-vitro laboratory testing, not human or animal studies with provenance like country of origin.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

This information is not applicable to the provided document. Ground truth as typically understood for AI/ML performance evaluation (e.g., expert consensus on image annotations, pathology reports) is not relevant for bench testing of a mechanical device.

4. Adjudication method for the test set:

Not applicable. There's no mention of a test set requiring adjudication in the context of human expert review.

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 not an AI/ML device, and no MRMC study with human readers is mentioned.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

No. This is not an AI/ML device.

7. The type of ground truth used:

The concept of "ground truth" as it applies to clinical outcomes or expert labels for diagnostic AI is not used here. Instead, the "ground truth" for this device's performance validation would be established by:

  • Engineering specifications and validated test methods (for bench testing).
  • Recognized standards for biocompatibility (e.g., ISO standards).
  • The performance characteristics of the predicate device.

8. The sample size for the training set:

Not applicable. This is not an AI/ML device that requires a training set.

9. How the ground truth for the training set was established:

Not applicable.

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K090217

Page 1 of 2

5

510(k) SUMMARY

(as required by section 807.92(c)

APR 2 3 2009

510(K) Owner's Name:

Address:

Holtedam 1 3050 Humlebaek, Denmark

Coloplast A/S

Office:

Phone/Fax/Email:

(612) 226-3040 Mobile: Fax: (612) 287-4138 Email: usskg@coloplast.com

(612) 287-4174

Name of Contact Person:

Trade Or Proprietary Name:

Common Or Usual Name:

Classification Name:

Suresh Ghai Regulatory Affairs Manager

Date Prepared:

January 29th, 2009

Bonee Needle for Bladder Injections

Endoscopic Injection Needle

Endoscope and accessories (21CFR section 876.1500) (Product Code: FBK) Device Class: 2

Legally Marketed Device To Which Your Firm Is Claiming Equivalence:

The Bonee Needle for Bladder Injections is substantially equivalent in performance, indication, design and materials to Cook Injection Needles from Cook Urological, Inc., cleared under Premarket notification # K022484.

Device Description:

The needle for bladder injections is designed for a working endoscope channel inner diameter of 5 French or larger.

This product is 35 cm (ref: NBI035) or 70 cm (ref: NBI070) length and is made of thermoplastic tubing polyamide (PA) marked by ink, a stainless steel cystoscopic needle, a polyamide Luer Lock connector and a Tuohy Borst adapter to allow connection with the cystoscope.

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K090217
page 2 of 2

The assembly of the different components is being insured by gluing (UV process).

A blue protective cap in Neoplex® is also supplied to prevent cystoscope channel degradation during needle insertion.

Shelf life of the full range of the needle for bladder injections is 2 years. The needle for bladder injections is provided sterile and is intended for single use.

Image /page/1/Figure/4 description: The image shows a long, thin object that is curved in an arc. The object appears to be made of a dark material. The object is positioned horizontally across the frame, with the left end of the object being higher than the right end. The right end of the object is partially obscured by some dark shapes.

Figure 1: Bonee Needle for Bladder Injections

Product variants available:

ReferenceLength (cm)UseBody diameter (mm)Needle tip
NBI03535With rigid cystoscope1.7 mm (= 5 CH/FR)Chiba tip (22G)
NBI07070With flexible cystoscope4 mm in length

Table 2. Sizes and codes of the needle for bladder injections

Intended Use Of The Device:

: _ǐ

The Bonee Needle for Bladder Injections is used to deliver injectable materials into the urinary bladder wall during the transurethral endoscopic procedures.

Technological Characteristics Compared To Predicate Device:

The Bonee Needle for Bladder Injections is substantially equivalent in performance, indication, design and materials to Cook Injection Needles from Cook Urological, Inc., cleared under Premarket notification # K022484.

Summary and Conclusions from the Nonclinical Tests Submitted:

Substantial equivalence is supported by bench testing comparing Bonee Injection needle to the predicate devices and biocompatibility testing performed on the Bonne Needle.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

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 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 fashion around the bird-like figure.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

APR 2 3 2009

Mr. Suresh Ghai Regulatory Affairs Manager Coloplast A/S 1601 West River Road N MINNEAPOLIS MN 55411

Re: K090217

Trade/Device Name: Bonee Needle for Bladder Injections Regulation Number: 21 CFR 876.1500 Regulation Name: Endoscope and accessories Regulatory Class: II Product Code: FBK Dated: April 2, 2009 Received: April 3, 2009

Dear Mr. Ghai: .

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.

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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.

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If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Center for Devices and Radiological Health's (CDRH's) Office of Compliance at one of the following numbers, based on the regulation number at the top of this letter.

21 CFR 876.xxx 21 CFR 884.xxx 21 CFR 892.xxx Other

(Gastroenterology/Renal/Urology) (Obstetrics/Gynecology) (Radiology)

(240) 276-0115 (240) 276-0115 (240) 276-0120 (240) 276-0100

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please contact the CDRH/Office of Surveillance and Biometrics/Division of Postmarket Surveillance at 240-276-3464. For more information regarding the reporting of adverse events, please go to http://www.fda.gov/cdrh/mdr/.

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,

Janine M. Morris Acting Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

Page 2

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4 INDICATIONS FOR USE STATEMENT

Indications for Use

510(k) Number (if known): K090217

Device Name: Bonee Needle for Bladder Injections

Indications for Use:

The Bonee Needle for Bladder Injections is used to deliver injectable materials into the urinary bladder wall during the transurethral endoscopic procedures.

Prescription Use X (Part 21 CFR 801 Subpart D) Over-The-Counter Use (21 CFR 801 Subpart C)

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

AND/OR

Concurrence of CDRH, Office of Device Evaluation (ODE)

luzi Whting

(Division Sigh-Off) Division of Reproductive, Abdominal, and Radiological Devic 510(k) Number

§ 876.1500 Endoscope and accessories.

(a)
Identification. An endoscope and accessories is a device used to provide access, illumination, and allow observation or manipulation of body cavities, hollow organs, and canals. The device consists of various rigid or flexible instruments that are inserted into body spaces and may include an optical system for conveying an image to the user's eye and their accessories may assist in gaining access or increase the versatility and augment the capabilities of the devices. Examples of devices that are within this generic type of device include cleaning accessories for endoscopes, photographic accessories for endoscopes, nonpowered anoscopes, binolcular attachments for endoscopes, pocket battery boxes, flexible or rigid choledochoscopes, colonoscopes, diagnostic cystoscopes, cystourethroscopes, enteroscopes, esophagogastroduodenoscopes, rigid esophagoscopes, fiberoptic illuminators for endoscopes, incandescent endoscope lamps, biliary pancreatoscopes, proctoscopes, resectoscopes, nephroscopes, sigmoidoscopes, ureteroscopes, urethroscopes, endomagnetic retrievers, cytology brushes for endoscopes, and lubricating jelly for transurethral surgical instruments. This section does not apply to endoscopes that have specialized uses in other medical specialty areas and that are covered by classification regulations in other parts of the device classification regulations.(b)
Classification —(1)Class II (special controls). The device, when it is an endoscope disinfectant basin, which consists solely of a container that holds disinfectant and endoscopes and accessories; an endoscopic magnetic retriever intended for single use; sterile scissors for cystoscope intended for single use; a disposable, non-powered endoscopic grasping/cutting instrument intended for single use; a diagnostic incandescent light source; a fiberoptic photographic light source; a routine fiberoptic light source; an endoscopic sponge carrier; a xenon arc endoscope light source; an endoscope transformer; an LED light source; or a gastroenterology-urology endoscopic guidewire, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I for the photographic accessories for endoscope, miscellaneous bulb adapter for endoscope, binocular attachment for endoscope, eyepiece attachment for prescription lens, teaching attachment, inflation bulb, measuring device for panendoscope, photographic equipment for physiologic function monitor, special lens instrument for endoscope, smoke removal tube, rechargeable battery box, pocket battery box, bite block for endoscope, and cleaning brush for endoscope. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807of this chapter, subject to the limitations in § 876.9.