K Number
K100807
Device Name
MINIARC PRECISE SINGLE-INCISION SLING SYSTEM MODEL: 720181, 720191
Date Cleared
2010-06-07

(77 days)

Product Code
Regulation Number
878.3300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The MiniArc Precise™ Single-Incision Sling System is intended for the placement of a sub-urethral sling for the treatment of female stress urinary incontinence (SUI) resulting from urethral hypermobility and/or intrinsic sphincter deficiency (ISD).
Device Description
The MiniArc Precise Single-Incision Sling System (MiniArc Precise) is a modification of the currently commercialized device, MiniArc Single-Incision Sling System (MiniArc), which consist of one sterile mesh sling and one sterile surgical instrument · used for sub-urethral sling placement. The minor modifications to MiniArc for the development of the MiniArc Precise are as follows: Self-fixating tips on the mesh sling are for a "secure connection" (snap-fit) to 0 the delivery tool needle tip. Delivery tool has an actuating needle tip release mechanism for the mesh sling. ● Mesh slings center-length dimensions are modified and the mesh sling arms 0 are knit with reinforcement fibers. The MiniArc Precise is available in two configurations; each configuration contains one sterile mesh sling and one sterile delivery tool. The identical delivery tool is used with both configurations. The configurations are identified by the mesh sling option, either the short center-length mesh or the long center-length mesh. The mesh sling and mesh arms material for MiniAre Precise is the same knitted polypropylene monofilament material used in the predicate, MiniArc. MiniArc Precise uses the same surgical approach and the same mesh placement procedures as the predicate device. MiniArc. The MiniArc Precise device is for the treatment of female stress urinary incontinence (SUI) resulting from urethral hypermobility and/or intrinsic sphincter deficiency (ISD). MiniArc Precise device is for single use only and is not to be re-sterilized.
More Information

Not Found

No
The description focuses on mechanical components and materials, with no mention of AI or ML.

Yes

The device is intended for the treatment of female stress urinary incontinence, which is a medical condition, making it a therapeutic device.

No

Explanation: The device is a surgical sling system used for the treatment of female stress urinary incontinence, not for diagnosing conditions.

No

The device description explicitly states it consists of a sterile mesh sling and a sterile surgical instrument, which are physical hardware components.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are devices intended for use in the collection, preparation, and examination of specimens taken from the human body (such as blood, urine, or tissue) to provide information for the diagnosis, treatment, or prevention of disease.
  • Device Description: The MiniArc Precise Single-Incision Sling System is a surgical implant used to treat stress urinary incontinence by providing support to the urethra. It is a physical device placed within the body, not a tool for analyzing biological samples.
  • Intended Use: The intended use is the treatment of female stress urinary incontinence, not the diagnosis of a condition through the analysis of specimens.

Therefore, based on the provided information, the MiniArc Precise Single-Incision Sling System falls under the category of a surgical device or implant, not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The MiniArc Precise™ Single-Incision Sling System is intended for the placement of a sub-urethral sling for the treatment of female stress urinary incontinence (SUI) resulting from urethral hypermobility and/or intrinsic sphincter deficiency (ISD).

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

PAH

Device Description

The MiniArc Precise Single-Incision Sling System (MiniArc Precise) is a modification of the currently commercialized device, MiniArc Single-Incision Sling System (MiniArc), which consist of one sterile mesh sling and one sterile surgical instrument · used for sub-urethral sling placement.

The minor modifications to MiniArc for the development of the MiniArc Precise are as follows:

  • Self-fixating tips on the mesh sling are for a "secure connection" (snap-fit) to 0 the delivery tool needle tip.
  • Delivery tool has an actuating needle tip release mechanism for the mesh sling. ●
  • Mesh slings center-length dimensions are modified and the mesh sling arms 0 are knit with reinforcement fibers.

The MiniArc Precise is available in two configurations; each configuration contains one sterile mesh sling and one sterile delivery tool. The identical delivery tool is used with both configurations. The configurations are identified by the mesh sling option, either the short center-length mesh or the long center-length mesh. The mesh sling and mesh arms material for MiniAre Precise is the same knitted polypropylene monofilament material used in the predicate, MiniArc.

MiniArc Precise uses the same surgical approach and the same mesh placement procedures as the predicate device. MiniArc. The MiniArc Precise device is for the treatment of female stress urinary incontinence (SUI) resulting from urethral hypermobility and/or intrinsic sphincter deficiency (ISD). MiniArc Precise device is for single use only and is not to be re-sterilized.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

sub-urethral

Indicated Patient Age Range

female

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 non-clinical testing included the assessment of the MiniArc Precise physical properties; ability to achieve its intended use; and substantial equivalence to the MiniArc predicate device.

  • Bench testing confirmed the product performance of the MiniArc Precise to be . suitable for its intended use: the same intended use as the predicate device.
  • Animal testing confirmed the tissue fixation and tissue response is equivalent ● to the predicate device.
  • Cadaver lab testing confirmed the surgical procedure, using the "secure ● connection" self-fixating tips to the delivery tool needle, is the equivalent to the predicate device.
  • Biocompatibility assessment ensured the MiniArc Precise materials are ● biocompatible based on the similarity of the materials to the predicate device.

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.

K070065, K071902, K073703

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

§ 878.3300 Surgical mesh.

(a)
Identification. Surgical mesh is a metallic or polymeric screen intended to be implanted to reinforce soft tissue or bone where weakness exists. Examples of surgical mesh are metallic and polymeric mesh for hernia repair, and acetabular and cement restrictor mesh used during orthopedic surgery.(b)
Classification. Class II.

0

p. 1 of 4

510(k) Summary As required by 21 CFR 807.92 (b)

510(k) Number: K100807

Date Revised:June 2, 2010JUN - 7 2010
Submitter Information:
Submitter's Name/
AddressAmerican Medical Systems, Inc.
10700 Bren Road West
Minnetonka, MN 55434-USA
Owner/Operator:American Medical Systems, Inc.
10700 Bren Road West
Minnetonka, MN 55434-USA
Manufacturing Sites:American Medical Systems, Inc.
10700 Bren Road West
Minnetonka, MN 55434-USA
FDA Establishment Registration Number: 2183959
Sterigenics US, Inc.
7775 South Quincy Street
Willowbrook, IL 60527
FDA Establishment Registration Number: 1450293

Submission Contact Information:

| Primary Contact: | Donna M. Semlak
Senior Regulatory Affairs Specialist
Telephone: 952-939-7082
Fax: 952-939-5785
Donna.Semlak@AmericanMedicalSystems.com |
|----------------------|----------------------------------------------------------------------------------------------------------------------------------------------------|
| Alternative Contact: | Melanie Hess
Senior Manager Regulatory Affairs
Telephone: 952-930-6490
Fax: 952-939-5785
Melanie.Hess@AmericanMedicalSystems.com |

1

Device(s) Information:

Trade Name:MiniArc Precise™ Single-Incision Sling
Common Name:Surgical Mesh
Classification Name:Surgical Mesh, Polymeric
Class:Class II / 21 CFR § 878.3300
Product Code:PAH

Predicate Device:

Device NameSubmission NumberClearance Date
MiniArc® Sling SystemK070065March 1, 2007
MiniArc® Sling SystemK071902August 24, 2007
MiniArc® Sling SystemK073703January 20, 2008

Device Description:

The MiniArc Precise Single-Incision Sling System (MiniArc Precise) is a modification of the currently commercialized device, MiniArc Single-Incision Sling System (MiniArc), which consist of one sterile mesh sling and one sterile surgical instrument · used for sub-urethral sling placement.

The minor modifications to MiniArc for the development of the MiniArc Precise are as follows:

  • Self-fixating tips on the mesh sling are for a "secure connection" (snap-fit) to 0 the delivery tool needle tip.
  • Delivery tool has an actuating needle tip release mechanism for the mesh sling. ●
  • Mesh slings center-length dimensions are modified and the mesh sling arms 0 are knit with reinforcement fibers.

The MiniArc Precise is available in two configurations; each configuration contains one sterile mesh sling and one sterile delivery tool. The identical delivery tool is used with both configurations. The configurations are identified by the mesh sling option, either the short center-length mesh or the long center-length mesh. The mesh sling and mesh arms material for MiniAre Precise is the same knitted polypropylene monofilament material used in the predicate, MiniArc.

MiniArc Precise uses the same surgical approach and the same mesh placement procedures as the predicate device. MiniArc. The MiniArc Precise device is for the treatment of female stress urinary incontinence (SUI) resulting from urethral hypermobility and/or intrinsic sphincter deficiency (ISD). MiniArc Precise device is for single use only and is not to be re-sterilized.

2

Indications for Use:

Existing Indications for Use:

The MiniArc Sling System (MiniArc) is intended for the placement of a suburethral sling for the treatment of female stress urinary incontinence (SUI) resulting from urethral hypermobility and/or intrinsic sphincter deficiency (ISD).

Proposed Indications for Use:

There are no changes to the existing indications for use with the exception of the device name, as shown below:

The MiniArc Precise™ Single-Incision Sling System is intended for the placement of a suburethral sling for the treatment of female stress urinary incontinence (SUI) resulting from urethral hypermobility and/or intrinsic sphincter deficiency(ISD).

Comparison to Predicate Device:

The proposed MiniArc Precise and the predicate device, MiniArc, consist of one sterile mesh sling and one sterile surgical instrument (needle passer or deliver tool).

The MiniArc Precise and MiniArc devices are intended for the placement of a suburethral mesh sling under the female urethra, with self-fixating tips in the right and left obturator. The mesh sling is placed with the use of a surgical instrument. The surgical instrument is a stainless steel curved needle with an attached plastic handle. The tip portion of surgical instrument is configured to allow for secure connection and placement of the mesh sling. The mesh sling is a piece of knitted polypropylene mesh with self-fixating tips at each end. The mesh sling is intended to remain in the body as a permanent implant and is not absorbed or degraded by the action of tissue in-growth or tissue enzymes.

These device systems are for the treatment of female stress urinary incontinence (SUI) resulting from urethral hypermobility and/or intrinsic sphincter deficiency (1SD). These devices are for single use and are not to be re-sterilized.

  • The MiniArc Precise has the same intended use, same implant materials, and same . • sterilization methods. The MiniArc Precise also uses similar manufacturing processes and similar delivery tool materials/characteristics to the predicate device, MiniArc.

Summary of Non-Clinical Testing / Statement of Substantial Equivalence

The non-clinical testing included the assessment of the MiniArc Precise physical properties; ability to achieve its intended use; and substantial equivalence to the MiniArc predicate device.

3

  • Bench testing confirmed the product performance of the MiniArc Precise to be . suitable for its intended use: the same intended use as the predicate device.
  • Animal testing confirmed the tissue fixation and tissue response is equivalent ● to the predicate device.
  • Cadaver lab testing confirmed the surgical procedure, using the "secure ● connection" self-fixating tips to the delivery tool needle, is the equivalent to the predicate device.
  • Biocompatibility assessment ensured the MiniArc Precise materials are ● biocompatible based on the similarity of the materials to the predicate device.

The following table is a summary of non-clinical testing conducted in accordance to industry standards/regulations:

TestIndustry Standards
Design VerificationQuality System Requirements FDA 21 CFR Part 820.20 EN ISO
13485: 2003; Design Controls FDA 21 CFR Part 820.30
Device PerformanceQuality System Requirements FDA 21 CFR Part 820.20 EN ISO
13485: 2003; Design Controls FDA 21 CFR Part 820.30
Animal ModelFDA 21 CRR: Part 58 Good Laboratory Practice Regulations
PackagingISO 11607: 2006 Part 1 and Part 2: Packaging for Terminal
Sterilized Medical Devices
Shelf LifeISO 11607: 2006 Part 1, 6.4 Stability Testing
BiocompatibilityISO 10993-1: 2009 Biological Evaluation of Medical Devices.
SterilizationISO 11135: Medical Devices - Validation and Routine Control of
Ethylene Oxide Sterilization and EN ISO 13485.

The proposed MiniArc Precise device performance, intended use and fundamental scientific technology remain unchanged from the predicate device. The proposed modifications do not change the mesh fixation mechanism found in the predicate device, MiniArc. The tissue fixation element fixates the mesh until tissue in-growth occurs through the pores of the mesh. The mesh sling will still be used as a supporting framework in areas where the connective tissue has weakened or ruptured. The mesh sling, with self-fixating tips, is intended to remain in the body as a permanent implant.

American Medical Systems considers the MiniArc Precise product performance to be significantly equivalent to the predicate device, MiniArc, because there are no changes to the product performance specifications; device intended use; or device functional scientific technology.

Conclusion

The above non-clinical testing for the MiniArc Precise demonstrates product performance to be substantially equivalent and demonstrates that it is as safe and effective as the predicate device. MiniArc.

4

Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three stripes forming its body and wing. The eagle is encircled by the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" in a circular arrangement.

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

American Medical Systems, Inc. % Ms. Donna Semlak Senior Regulatory Affairs Specialist 10700 Bren Road West MINNETONKA MN 55434

SEP 2 8 2012

Re: K100807

Trade/Device Name: MiniArc Precise™ Single-Incision Sling System Regulation Number: 21 CFR 878.3300 Regulation Name: Surgical mesh Regulatory Class: II Product Code: PAH Dated: April 23, 2010 Received: April 26, 2010

Dear Ms. Semlak:

This letter corrects our substantially equivalent letter of June 7, 2010.

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 (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

5

Page 2 -

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.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" (21 CFR 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/Resourcesfor You/Industry/default.htm.

Sincerely yours,

Benjamin R. Perkins

Benjamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

6

K100807
p. 1. f 1

Indications for Use Statement

INDICATIONS FOR USE STATEMENT

510(k) Number (if known):

Name of Devices:

Indications for Use:

MiniArc Precise™ Single-Incision Sling System

The MiniArc Precise™ Single-Incision Sling System is intended for the placement of a sub-urethral sling for the treatment of female stress urinary incontinence (SUI) resulting from urethral hypermobility and/or intrinsic sphincter deficiency (ISD).

Prescription Use X (Part 21 CFR 801 Subpart D)

AND/OR

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

Daniel Kione for MKCM

(Division Slyn-Off) Division of Surgical, Orthopedic. and Restorative Devices

510(k) Number K100807

Trade Secret/Confidential

American Medical Systems