K Number
K110055
Date Cleared
2011-04-05

(85 days)

Product Code
Regulation Number
870.1250
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Reverse Medical ReFlex™ Guide Catheter is indicated for the introduction of interventional devices into the peripheral, and neuro vasculature.

Device Description

The ReFlex™ Guide Catheter is a single lumen, flexible, variable stiffness composite catheter. The catheter shaft has a hydrophilic coating to reduce friction during use. The ReFlex™ Guide Catheter shaft is visible under fluoroscopy. The ReFlex™ Guide Catheter dimensions are included on the individual device label. The ReFlex™ Guide Catheter inner lumen can accommodate guidewires up to 0.038 inches in diameter to aid in placement of the catheter system. The proximal end of the ReFlex™ Guide Catheter has a luer fitting to allow attachment of accessories and infusion of liquids through the system. The ReFlex™ Guide Catheter is offered in various sizes to accommodate physician preferences and anatomical variations. The catheter is provided sterile, nonpyrogenic, and is intended for single use only.

AI/ML Overview

The ReFlex™ Guide Catheter's acceptance criteria and the study proving it meets these criteria are described below:

1. Table of Acceptance Criteria and Reported Device Performance

In vitro TestsAcceptance CriteriaReported Performance
Dimensional and Visual InspectionMet established criteriaMet established criteria
Guidewire CompatibilityMet established criteriaMet established criteria
Torque ResponseMet established criteriaMet established criteria
Torque StrengthMet established criteriaMet established criteria
Kink ResistanceMet established criteriaMet established criteria
Flexibility TestMet established criteriaMet established criteria
Tensile StrengthMet established criteriaMet established criteria
Catheter Leak Test (Liquid Leakage)Met established criteriaMet established criteria
Catheter Leak Test (Air Leakage)Met established criteriaMet established criteria
Dynamic Pressure TestMet established criteriaMet established criteria
Static Burst TestMet established criteriaMet established criteria
Aspiration TestMet established criteriaMet established criteria
Hub GaugingMet established criteriaMet established criteria
Corrosion ResistanceMet established criteriaMet established criteria
USP Particulate TestMet established criteriaMet established criteria
Navigation and Accessibility Capabilities in vitroMet established criteriaMet established criteria
In vivo Tests
System Deliverability, Compatibility, Visibility and Aspiration PerformanceMet established criteriaMet established criteria
Acute histopathology of treated vesselsMet established criteriaMet established criteria
Biocompatibility testingMet established criteriaMet established criteria

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

The document does not explicitly state the specific sample size for each individual test. However, it mentions that "All testing was performed on units which were sterilized and met all inspection criteria."

The data provenance is from bench-top (in vitro) and in vivo testing conducted by Reverse Medical Corporation, the device sponsor. The document does not specify the country of origin for the in vivo testing, but considering the sponsor is based in Irvine, CA, USA, it's likely conducted in the US. The studies are prospective in nature, as they involve testing of newly manufactured devices under controlled conditions to evaluate their performance.

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

This information is not provided in the document. The tests performed are primarily engineering and biological performance tests, not diagnostic tests requiring human expert interpretation in the context of ground truth establishment for a test set. The "ground truth" for these tests is based on established engineering standards, biological compatibility requirements, and functional specifications, not expert consensus on medical images or patient outcomes.

4. Adjudication method for the test set:

This information is not applicable as the tests are objective measurements and evaluations against established criteria, not subjective interpretations requiring adjudication.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done:

No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. This type of study is typically used for diagnostic devices that rely on human interpretation of images or data, often with AI assistance, to measure the impact of the AI on human performance. The ReFlex™ Guide Catheter is an interventional device, and its evaluation focuses on its physical, mechanical, and biological performance.

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

Yes, the testing described is primarily focused on the standalone performance of the device itself. The "Design Verification (Bench-Top Testing)" and "In vivo Tests" assess the intrinsic characteristics and functionality of the ReFlex™ Guide Catheter without human interaction being a variable in the performance evaluation.

7. The type of ground truth used:

The "ground truth" for the tests is based on:

  • Established engineering standards and specifications: For dimensional, mechanical (torque, kink resistance, tensile strength, leak, burst, aspiration), and material (corrosion, particulate) tests.
  • Biological compatibility standards: For biocompatibility tests (cytotoxicity, sensitization, intracutaneous reactivity, systemic toxicity, hemocompatibility, pyrogenicity) in accordance with ISO 10993-1 guidelines.
  • Functional performance criteria: For guidewire compatibility, navigation and accessibility capabilities, and system deliverability/compatibility/visibility/aspiration.
  • Histopathological evaluation: For acute histopathology of treated vessels, likely performed by a qualified pathologist, to assess tissue reaction.

8. The sample size for the training set:

There is no mention of a training set as this product is a physical medical device, not an AI/machine learning algorithm that requires training data.

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

Not applicable, as there is no training set for this device.

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4. 510(k) Summary according to 807.92

Pursuant to Section 12, Part (a)(i)(3A) of the Safe Medical Devices Act of 1990, Reverse Medical Corporation is providing the summary of Substantial Equivalence for the ReFlex™ Guide Catheter,

4.1 Sponsor /Applicant Name and Address

Reverse Medical Corporation 13900 Alton Parkway Suite 123 Irvine, CA 92618

4.2 Sponsor Contact Information

Jeff Valko President/CEO Phone: 949-215-0660 949-215-0661 Fax: email: jvalko@reversemed.com

4.3 Date of Preparation of 510(k) Summary

March 10, 2011

4.4 Device Trade or Proprietary Name

ReFlex™ Guide Catheter

4.5 Device Common/Usual or Classification Name

Catheter, Percutaneous (Product Code: DQY)

4.6 Identification of the Legally Marketed Devices to which Equivalence is Being Claimed:

Name of Predicate DeviceName of Manufacturer(Town, State)510(k) Number
Penumbra Neuron™Intracranial Access SystemPenumbra, Inc.Alameda, CAK070970
HD Guide CatheterConcentric Medical, Inc.Mountain View, CAK090335

APR - 5 2011

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510(k) Summary according to 807.92 (continued)

4.7 Device Description

The ReFlex™ Guide Catheter is a single lumen, flexible, variable stiffness composite catheter. The catheter shaft has a hydrophilic coating to reduce friction during use. The ReFlex™ Guide Catheter shaft is visible under fluoroscopy. The ReFlex™ Guide Catheter dimensions are included on the individual device label. The ReFlex™ Guide Catheter inner lumen can accommodate guidewires up to 0.038 inches in diameter to aid in placement of the catheter system.

The proximal end of the ReFlex™ Guide Catheter has a luer fitting to allow attachment of accessories and infusion of liquids through the system. The ReFlex™ Guide Catheter is offered in various sizes to accommodate physician preferences and anatomical variations. The catheter is provided sterile, nonpyrogenic, and is intended for single use only.

4.8 Intended Use

The Reverse Medical ReFlex™ Guide Catheter is indicated for the introduction of interventional devices into the peripheral, and neuro vasculature.

4.9 Comparison to Predicate Devices
-------------------------------------------
Penumbra Neuron™Intracranial AccessSystemHD Guide CatheterReFlex™ GuideCatheter
510(k) NumberK070970K090335TBD
ClassificationClass II, DQYClass II, DQYClass II, DQY
IndicationThe ... is indicated forthe introduction ofinterventional devicesinto the peripheral,coronary, and neurovasculature.The ... is indicated foruse in facilitating theinsertion and guidanceof an occlusioncatheter, infusioncatheter or otherappropriatemicrocatheter into aselected blood vesselin the peripheral,coronary and neurovascular systems.The ... is indicated forthe introduction ofinterventional devicesinto the peripheral, ,and neuro vasculature.
Materials
- Shaft MaterialsPTFE linednylon/polyurethanecatheter,with hydrophilic coatingPTFE linedpolymericcatheterwith hydrophilic coatingPTFE linedpolymericcatheter,with hydrophilic coating
- Catheter shaft supportStainless SteelStainless SteelNitinol
- Proximal EndConfigurationLuer HubLuer HubLuer Hub
- Radiographic markers /Radiopacity• Radiopaque markerat distal tip• Radiopaquemarker at distal tip• Radiopaque markerat distal tip

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510(k) Summary according to 807.92 (continued) 4.9 Comparison to Predicate Devices (continued)

Penumbra Neuron™Intracranial AccessSystemHD Guide CatheterReFlex™ GuideCatheter
-PackagingCatheterattached topackaging cardinsidePET/PE/Tyvek pouchinside SBS cartonCatheterin polyethylene hoopinsidePET/PE/Tyvek pouchinside SBS cartonCatheterin polyethylene hoopattached topackaging cardinsidePET/PE/Tyvek pouchinside SBS carton
Packaged AccessoryDevicesPackaged with anrotating hemostaticvalve (RHV)Packaged with anrotating hemostaticvalve (RHV)Not Applicable
SterilizationEtOEtOEtO

4.10 Summary of Non-clinical Data

4.10.1 Biocompatibility and Sterilization

The ReFlex™ Guide Catheter is classified as Externally Communicating Devices, Circulating Blood, Limited Contact (≤ 24 hours). Results of the testing demonstrate that the blood contacting materials are biocompatible.

Blood contacting materials were tested in accordance with the tests recommended in the FDA General Program Memorandum #G95-1 (5/1/95): Use of International Standard ISO 10993-1 guidelines "Biological Evaluation of Medical Devices Part 1: Evaluation and Testing". The ReFlex™ Guide Catheter successfully passed all of the following biocompatibility tests:

TestMethod
CytotoxicityL929 MEM Elution Test
SensitizationKligman Maximization
Intracutaneous Reactivity (Irritation)Intracutaneous Injection Test
Systemic Toxicity (Acute)ISO Acute Systemic Injection Test
HemocompatibilityComplement Activation
Hemolysis
Inactivated Partial Thromboplastin Time Test
In vivo thrombogenicity
PyrogenicityUSP Material Mediated Rabbit Pyrogen Test
EtO ResidualsEthylene oxide and Ethylene chlorohydrinsresiduals

Sterilization conditions have been validated according to ANSI / AAMI / ISO 11135, Sterilization of Health Care Products-Part 1: Requirement, validation and routine control of a sterilization process for medical devices to provide a Sterility Assurance Level (SAL) of 10 °.

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510(k) Summary according to 807.92 (continued) 4.10.2 Design Verification (Bench-Top Testing)

The physical, mechanical and performance testing of the ReFlex™ Guide Catheter demonstrates that the product is substantially equivalent to the currently marketed predicate devices. Design Verification testing was conducted to evaluate the physical and mechanical properties of the ReFlex™ Guide Catheter. All studies were conducted in accordance with Reverse Medical Design Control procedures. All testing was performed on units which were sterilized and met all inspection criteria. Tests on the ReFlex™ Guide Catheter included:

Verification and Test Summary

In vitro TestsResult
Dimensional and Visual InspectionMet established criteria
Guidewire CompatibilityMet established criteria
Torque ResponseMet established criteria
Torque StrengthMet established criteria
Kink ResistanceMet established criteria
Flexibility TestMet established criteria
Tensile StrengthMet established criteria
Catheter Leak Test (Liquid Leakage)Met established criteria
Catheter Leak Test (Air Leakage)Met established criteria
Dynamic Pressure TestMet established criteria
Static Burst TestMet established criteria
Aspiration TestMet established criteria
Hub GaugingMet established criteria
Corrosion ResistanceMet established criteria
USP Particulate TestMet established criteria
Navigation and Accessibility Capabilities in vitroMet established criteria
In vivo TestsResult
SystemDeliverability, Compatibility,Visibility and Aspiration PerformanceMet established criteria
Acute histopathology of treated vesselsMet established criteria
Biocompatibility testingMet established criteria

The physical, mechanical and performance testing of the subject ReFlex™ Guide Catheter demonstrate that the product is safe and effective for its labeled indications and is Substantially Equivalent to the currently marketed predicate devices.

4.11 Substantial Equivalence

The performance of the ReFlex™ Guide Catheter in this submission demonstrates that the product is substantially equivalent to the performance of the predicate devices. The equivalence was shown through comparison of component materials and specification, performance and biocompatibility testing and sterilization validation.

The ReFlex™ Guide Catheter is substantially equivalent in intended use, design, technology/principles of operation, materials and performance to the predicate devices. Differences between the devices do not raise any significant issues of safety or effectiveness.

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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 or bird-like figure with three wing-like shapes extending upwards. The bird is positioned within a circular border that contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in capital letters. The text is arranged around the circumference of the circle.

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

Reverse Medical Corporation c/o Mr. Mark Job Regulatory Technology Services LLC 1394 25° St. NW Buffalo, MN 55313

APR - 5 2011

Re: K110055

Trade/Device Name: ReFlex™ Guide Catheter Regulation Number: 21 CFR 870.1250 Regulation Name: Percutaneous Catheter Regulatory Class: Class II Product Code: DOY Dated: March 18, 2011 Received: March 21, 2011

Dear Mr. Job

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.

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Page 2 - Mr. Mark Job

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.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 (240) 276-3150 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours.

Duna R. Vahner

Image /page/5/Picture/7 description: The image shows a handwritten symbol or character. It appears to be a stylized letter or a combination of lines and curves. The symbol is drawn with thick strokes, and it has a somewhat angular appearance.

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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3. Indications for Use

510(k) Number (if known):_K 110055

Device Name: Reverse Medical ReFlex™ Guide Catheter

Indications for Use:

The Reverse Medical ReFlex™ Guide Catheter is indicated for the introduction of interventional devices into the peripheral, and neuro vasculature.

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 IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Dana R. Vahine

on of Cardiovascular Devices

510(k) Number_K 110055

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§ 870.1250 Percutaneous catheter.

(a)
Identification. A percutaneous catheter is a device that is introduced into a vein or artery through the skin using a dilator and a sheath (introducer) or guide wire.(b)
Classification. Class II (performance standards).