K Number
K090938
Device Name
FLOW CONTROLLER
Date Cleared
2009-06-04

(62 days)

Product Code
Regulation Number
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Punctal Occluders (plugs) are indicated for the treatment of "dry eye" syndrome.
Device Description
This device, made of medical grade silicone, titanium dioxide as a colorant and utilizing a proprietary surface treatment made under current good manufacturing practices, is a small, generally "plug" shaped design. Punctal Occluders are intended for the treatment of "dry eve" conditions through partial occlusion of individual punctual openings.
More Information

No
The summary describes a physical medical device (punctual occluder) and does not mention any software, algorithms, or data processing that would indicate the use of AI or ML.

Yes
The device is indicated for the "treatment" of "dry eye" syndrome, which describes a therapeutic purpose.

No
The device, Punctal Occluders, is indicated for treatment of "dry eye" syndrome by physically occluding punctal openings, not for diagnosing the condition.

No

The device description explicitly states it is made of medical grade silicone and titanium dioxide, indicating it is a physical, hardware device.

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

Here's why:

  • Intended Use: The intended use is for the treatment of "dry eye" syndrome by physically occluding punctal openings. This is a therapeutic intervention, not a diagnostic test performed on samples taken from the body.
  • Device Description: The description details a physical device (a plug) made of silicone, designed to be inserted into the punctal openings. This is a medical device, but not one used for in vitro diagnostic purposes.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in samples
    • Providing information for diagnosis, monitoring, or screening of diseases or conditions

Therefore, this device falls under the category of a medical device used for treatment, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

Punctal Occluders (plugs) are indicated for the treatment of "dry eye" syndrome.

Product codes

LZU

Device Description

This device, made of medical grade silicone, titanium dioxide as a colorant and utilizing a proprietary surface treatment made under current good manufacturing practices, is a small, generally "plug" shaped design. Punctal Occluders are intended for the treatment of "dry eve" conditions through partial occlusion of individual punctual openings. By material, design and intended use, Micro Flow is substantially equivalent to the previous Odyssey Punctal Occluder (K970631).

Differences between the two devices may be described as follows:

The original Odyssey plug under 510 K970631 has a larger angle nose, no through hole and shorter in length.

The new design "Micro-Flow" is similar to the original plug with the exceptions of the following:

  • A through hole which allows for partial occlusion of individual punctual openings. .
  • A .002 ridge on nose to help support the designed through hole. .
  • Angle on nose (tip) is smaller. ●

Alternative methods of punctual occlusion are either permanent or difficult to reverse. In contrast, the submitted method is both functionally safe and fully reversible. Unlike some other methods, this device does not require the breach of intact tissue surfaces or the risk of damaging said surface should reversal become desirable.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

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)

Not Found

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K970631

Reference Device(s)

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

N/A

0

K090938

Image /page/0/Picture/1 description: The image shows the word "ODYSSEY" in a stylized font. To the left of the word is a graphic of an arrow piercing through three concentric circles. The arrow is pointing towards the right, and the circles are arranged around the arrow's shaft. The word "ODYSSEY" is written in all capital letters, with each letter outlined in black.

Odyssey Medical, Ir 2975 Brother Blvd. Bartlett, TN 38133 Ph 901-383-777 Fax 901-382-2712

JUN - 4 2009

510K Summary

Submitted: 03/12/2009 By: Terry Green Registration Number: 1060840 Trade Name: Punctal Occluder Common Name: Plug, Punctum Product Name: Micro Flow Classification Name: LZU Classification Panel: Ophthalmic Device Class: Unclassified Performance Standards: None Established

Summary:

This device, made of medical grade silicone, titanium dioxide as a colorant and utilizing a proprietary surface treatment made under current good manufacturing practices, is a small, generally "plug" shaped design. Punctal Occluders are intended for the treatment of "dry eve" conditions through partial occlusion of individual punctual openings. By material, design and intended use, Micro Flow is substantially equivalent to the previous Odyssey Punctal Occluder (K970631).

Differences between the two devices may be described as follows:

The original Odyssey plug under 510 K970631 has a larger angle nose, no through hole and shorter in length.

The new design "Micro-Flow" is similar to the original plug with the exceptions of the following:

  • A through hole which allows for partial occlusion of individual punctual openings. .
  • A .002 ridge on nose to help support the designed through hole. .
  • Angle on nose (tip) is smaller. ●

Alternative methods of punctual occlusion are either permanent or difficult to reverse. In contrast, the submitted method is both functionally safe and fully reversible. Unlike some other methods, this device does not require the breach of intact tissue surfaces or the risk of damaging said surface should reversal become desirable.

Kim Finch for Jerry Green Kim Finch
(Signature) (Typed Name)

6/2/09

(Date)

(Premarket Notification [510(k)] Number)

1

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/1/Picture/1 description: The image shows the seal of the U.S. Department of Health & Human Services. The seal is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is an abstract symbol that resembles three stylized human figures.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Oddyssey Medical. Inc. c/o Terry R. Green 2975 Brother Blvd. Bartlett, Tennessee 38133

Re: K090938

Trade/Device Name: Micro Flow Punctal Occluder Regulatory Class: Unclassified Product Code: LZU Dated: March 26, 2009 Received: April 3, 2009

Dear Mr. Green:

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 (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); 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.

2

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 (240) 276-0115. 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.

Malvina B. Eplehnus, m.d.

Malvina B. Eydelman, M.D. Director Division of Ophthalmic and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

3

Indications for Use

510(k) K090938 Number:

Name: Micro Flow Device

Indications for Use:

Punctal Occluders (plugs) are indicated for the treatment of "dry eye" syndrome.

Prescription Use

Over-The-Counter Use

(Part 21 CFR 801 Subpart D)

AND/OR

(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)

510(k) Number_109

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Division of Ophthalmic and Ear, Nose and Throat Devices