K Number
K092310
Device Name
SEGUIN ANNULOPLASTY RING
Manufacturer
Date Cleared
2009-08-27

(29 days)

Product Code
Regulation Number
870.3800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The SJM™ Seguin annuloplasty ring is indicated for use in the repair of mitral valves that are diseased or damaged due to acquired or congenital processes.
Device Description
The SJM Seguin Ring is a semi-rigid ring fabricated from an ultra-high molecular weight polyethylene core surrounded by a polyester sewing cuff, which provides a means for attaching the ring to the mitral annulus as well as a suitable surface for tissue ingrowth.
More Information

Not Found

No
The device description and performance studies focus on the physical properties and mechanical performance of an annuloplasty ring, with no mention of software, algorithms, or data processing that would indicate AI/ML.

Yes
The device is indicated for use in the repair of diseased or damaged mitral valves, which is a therapeutic intervention aimed at restoring or improving physiological function.

No.
The device is an annuloplasty ring used to repair mitral valves, not to diagnose a disease or condition.

No

The device description clearly states it is a physical ring fabricated from polyethylene and polyester, indicating it is a hardware device, not software.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is for the repair of mitral valves within the body. This is a surgical implant, not a test performed on samples taken from the body.
  • Device Description: The description details a physical ring designed to be implanted.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.) or providing diagnostic information based on such analysis.

IVD devices are used to examine specimens from the human body to provide information for diagnosis, monitoring, or screening. This device is a therapeutic implant.

N/A

Intended Use / Indications for Use

The SJM™ Seguin annuloplasty ring is indicated for use in the repair of mitral valves that are diseased or damaged due to acquired or congenital processes.

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

KRH

Device Description

The SJM Seguin Ring is a semi-rigid ring fabricated from an ultra-high molecular weight polyethylene core surrounded by a polyester sewing cuff, which provides a means for attaching the ring to the mitral annulus as well as a suitable surface for tissue ingrowth.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Mitral annulus

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)

The following performance characteristics were evaluated:

  • Ring Tensile Strength .
  • Ring Compression Strength .
  • Suture Pullout Test .
  • . MR Safety Evaluation
  • Manufacturing Process validation .
  • Biological Evaluation
  • Sterilization Parameter Evaluation .

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.

K014037

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

§ 870.3800 Annuloplasty ring.

(a)
Identification. An annuloplasty ring is a rigid or flexible ring implanted around the mitral or tricuspid heart valve for reconstructive treatment of valvular insufficiency.(b)
Classification. Class II (special controls). The special control for this device is the FDA guidance document entitled “Guidance for Annuloplasty Rings 510(k) Submissions.”

0

16092310

SECTION 7 - 510(K) SUMMARY

Applicant Information

Submitter's Name and Address:

Contact Name

Submission Prepared

Device Information

Proprietary Name:

Common or Usual Name:

Classification:

Predicate Device:

SJM Seguin Ring model SARP-(size)

510(k) No. K014037 - cleared January 4, 2002

Device Description:

The SJM Seguin Ring is a semi-rigid ring fabricated from an ultra-high molecular weight polyethylene core surrounded by a polyester sewing cuff, which provides a means for attaching the ring to the mitral annulus as well as a suitable surface for tissue ingrowth.

Intended Use:

The SJMM Seguin annuloplasty ring is intended to be used for repair of diseased or damaged mitral heart valves that are determined by the physician to be repairable and do not require replacement.

St. Jude Medical Seguin Ring - Special 510(k)

AUG 2 7 2009

St. Jude Medical 177 County Road B. East St. Paul, MN 55117

Thomas Rademacher Regulatory Affairs Specialist St. Jude Medical 177 County Road B, East St. Paul, MN 55117 Bus: (651) 756-6473 Fax: (651) 766-3049 Email: trademacher@sjm.com

July 24, 2009

SJM Seguin Annuloplasty Ring

Semi-rigid annuloplasty ring Mitral repair ring

Class II per 21 CFR 870.3800, Annuloplasty rings

Confidential

1

Comparison of Required Technological Characteristics

SJM considers the SJM Seguin Annuloplasty ring to be substantially equivalent in technological characteristics (e.g. design and materials) and intended use to the predicate device. The table below is a comparison of the equivalency characteristics between the SJM Seguin Annuloplasty Ring and the predicate device.

ItemEquivalency
Principles of OperationIdentical
Product LabelingSubstantially Equivalent
Indications for UseIdentical
Physical CharacteristicsSubstantially Equivalent
Anatomical SitesIdentical
Target PopulationIdentical
Performance TestingSubstantially Equivalent
Safety CharacteristicsSubstantially Equivalent
PackagingIdentical
SterilizationIdentical
Shelf-LifeIdentical

Summary of Non-Clinical Tests

The following performance characteristics were evaluated:

  • Ring Tensile Strength .
  • Ring Compression Strength .
  • Suture Pullout Test .
  • . MR Safety Evaluation
  • Manufacturing Process validation .
  • Biological Evaluation
  • Sterilization Parameter Evaluation .

Conclusion

St. Jude Medical has demonstrated that the SJM Seguin Annuloplasty ring is safe and effective for the The Seguin Ring is, with respect to intended use and technological characteristics, intended use. substantially equivalent to the predicate device.

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains an image of an eagle. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are written around the edge of the circle.

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-0609 Silver Spring, MD 20993-0002

AUG 2 7 2009

St. Jude Medical c/o Mr. Thomas Rademacher Regulatory Affairs Specialist 177 County Road B, East St. Paul, MN 55117

Re: K092310

Seguin Annuloplasty Ring Model SARP-(size), Sizes 24 mm-40 mm (even sizes) Regulation Number: 21 CFR 870.3800 Regulation Name: Annuloplasty ring Regulatory Class: Class II (two) Product Code: KRH Dated: July 24, 2009 Received: July 29, 2009

Dear Mr. Rademacher:

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 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. However, you are responsible to determine that the medical devices you use as components in the [kit/tray] have either been determined as substantially equivalent under the premarket notification process (Section 510(k) of the act), or were legally on the market prior to May 28, 1976, the enactment date of the Medical Device Amendments. Please note: If you purchase your device components in bulk (i.e., unfinished) and further process (e.g., sterilize) you must submit a new 510(k) before including these components in your kit/tray. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, and 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.

3

Page 2 - Mr. Thomas Rademacher

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 (OS) 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 advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. 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 go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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 (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely vours.

Duna R. Vorhmer

Bram D. Zuckerman, M.D.

Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

Attachment 2

Indications for Use Statement

Indications for Use

510(k) Number (if known): K092310 Device Name: SJM Seguin Annuloplasty Ring Indications For Use:

The SJM™ Seguin annuloplasty ring is indicated for use in the repair of mitral valves that are diseased or damaged due to acquired or congenital processes.

Prescription Use (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 IFNEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Anna R. de Sinner

(Division Sign-Off) Division of Cardiovascular Devices

510(k) Number_K092310

Page 1 of