K Number
K094048
Date Cleared
2011-07-14

(560 days)

Product Code
Regulation Number
870.1240
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Percu-Pro™ Messenger Balloon Catheter is intended to facilitate the placement of interventional devices during diagnostic and interventional cardiovascular procedures. The device is not intended for coronary or neurovascular use.

Device Description

The Cardiosolutions Percu-Pro™ Messenger Balloon Catheter is a 5Fr catheter with a bifurcated proximal hub. The catheter shaft and connection ends are made from Pebax and the distal tip balloon is made from latex.

AI/ML Overview

This document does not contain information about a study proving that a device meets acceptance criteria, an AI/ML device, or a standalone algorithm.

The document is a 510(k) summary for the Percu-Pro™ Messenger Balloon Catheter, which is a physical medical device (a catheter). The summary details its design, intended use, and comparison to predicate devices to establish substantial equivalence, rather than providing performance metrics like accuracy, sensitivity, or specificity that would be typical for an AI system.

Therefore, I cannot provide the requested information.

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K094048

510(k) Summary

JUL 1 4 2011

As required by section 807.92(c)

Company NameCardiosolutions Inc.
Address75 Mill St.Stoughton, MA 02072Phone: 781-344-0801Fax: 781-344-0803
Contact PersonMichele Lucey
Date PreparedMay 10, 2011
Trade NamePercu-Pro™ Messenger Balloon Catheter
Common NameIntravascular Guiding Catheter
Classification NameFlow-Directed Catheter
Product CodeDYG
Regulation #21 CFR 870.1240
Class2
PanelCirculatory System Devices Panel
Predicate DevicesTechDevice Percutaneous Occlusion Balloon Catheter K051137
Boston Scientific Schneider Guider™ Softip™ Guiding Catheter K961999, K010853
Biosensors International Flow Directed Thermodilution Catheter K083384
Device DescriptionThe Cardiosolutions Percu-Pro™ Messenger Balloon Catheter is a 5Fr catheter with abifurcated proximal hub. The catheter shaft and connection ends are made from Pebaxand the distal tip balloon is made from latex.
Intended UseThe Percu-Pro™ Messenger Balloon Catheter is intended to facilitate the placement ofinterventional devices during diagnostic and interventional cardiovascular procedures.The device is not intended for coronary or neurovascular use.
Safety andPerformanceTestingNo performance standards have been established under Section 514 of the Food, Drugand Cosmetic Act for these devices, However, testing was conducted in accordancewith protocols based on the requirements of industry standards and FDA Guidancedocuments. Non-clinical testing included: biocompatibility, catheter tensile strength;balloon bond tensile strength; multiple inflation to burst; marker band adherence; andInsertion and withdrawal force testing.
SubstantialEquivalenceThe Percu-Pro™ Messenger Balloon Catheter is identical in design to the TechDeviceOcclusion Balloon Catheter K051137 with the exception of the platinum-iridiummarker bands that are contained in the Percu-Pro Device but not in the TechDevice. Byidentical we mean that the Percu-Pro device is made from the same materials, isspecified by the same design, and is manufactured by the same processes used for theTechDevice Occlusion Balloon Catheter. These marker bands have been addedbecause they are radiopaque and are useful for viewing the position of the catheterduring insertion and manipulation.
The Percu-Pro™ Messenger Balloon Catheter has the same intended use as the BostonScientific Schneider™ Softip™ Guiding Catheter( K961999), is made from similarmaterials, and is similar in length and diameter. Both devices have multi-lumen toallow for insertion of a guide wire to permit access for other devices. The BostonScientific device is provided with multiple distal tip designs with varying stiffnesses toaccommodate different uses, the Percu-Pro™ device is offered in only oneconfiguration. Based upon a significant history of use for the same purpose in thesame area of the body new questions regarding safety are not raised.
The Percu-Pro™ Messenger Balloon Catheter incorporates an inflatable balloon tip toallow for flow direction for catheter tip positioning. This intended use and designfeature are substantially equivalent to the Biosensors Thermodilution Catheter(K083384) which defines a balloon tip to allow for flow direction for catheter tippositioning in their intended use statement by means of an inflatable balloon tip.
The Percu-Pro™ Messenger Balloon Catheter is substantially equivalent to thepredicate devices in terms of intended use, design, materials, technology, andperformance.

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Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized eagle with three lines representing its body and wings. The eagle is enclosed in a circle with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter of the circle. The text is written in all capital letters.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

Cardiosolutions. Inc. c/o Michele Lucey 75 Mill Street Stoughton, MA 02072

JUL 1 4 2011

Re: K094048

Trade/Device Name: Percu-Pro™ Messenger Balloon Catheter Regulation Number: 21 CFR 870.1240 Regulation Name: Flow-directed catheter Regulatory Class: Class II Product Code: DYG Dated: May 10, 2011 Received: May 12, 2011

Dear Ms. Lucey:

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, l'isting of devices, good manufacturing practice, labeling, and prohibitions against misbanding and adulteration. Please note: CDRH does not evaluate information related to contractly and warranties. We remind you, however, that device labeling must be truthful and not misleading.

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.

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Page 2 - Ms. Michele Lucey

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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.goy/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/ReportalProblem/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/Resourcesfor You/Industry/default.htm.

Sincerely yours,

jll

Bram D. Zuckerm

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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12/23/2009

INDICATIONS FOR USE

510(k) Number (if known):

:

Device Name: Percu-Pro™ Messenger Balloon Catheter

Indications for Use:

The Percu-Pro™ Messenger Balloon Catheter is intended to facilitate the placement of interventional devices during diagnostic and interventional cardiovascular procedures. The device is not intended for coronary or neurovascular use.

Prescription Use

AND/OR Over-The_Counter Use _________________________________________________________________________________________________________________________________________________________

(PLEASE DO NOTR WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)
(Division Sign-Off) Division of Cardiovascular Devices
510(k) NumberK094048

§ 870.1240 Flow-directed catheter.

(a)
Identification. A flow-directed catheter is a device that incorporates a gas-filled balloon to help direct the catheter to the desired position.(b)
Classification. Class II (performance standards).