K Number
K110407
Device Name
INVISIPORT
Date Cleared
2011-10-13

(241 days)

Product Code
Regulation Number
880.5965
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Invisiport™ is indicated for any patient requiring repeated access of the vascular system for delivery of medications, nutritional supplementation, fluids, blood, blood products, or the sampling of blood, or for power injection of contrast media when used with a power-injectable Huber needle or infusion set.
Device Description
The Invisiport™ consists of an injection port made from material evaluated for hiocompatibility. The Invisiport has a self-sealing silicone septum. An open ended radiopaque catheter is pre-attached to the port. The silicone septum covers a reservoir that can be accessed with a non-coring Huber type needle. Power injection of contrast for imaging examinations can be performed when the port is accessed with a power-injectable Huber needle or infusion set.
More Information

Not Found

No
The device description and intended use focus on the physical components and function of an implantable port, with no mention of AI or ML capabilities.

Yes

The device repeatedly accesses the vascular system for the delivery of medications, nutritional supplementation, fluids, blood, and blood products, which are all therapeutic interventions.

No

The Invisiport™ is used for vascular access for the delivery of substances or sampling of blood, and for power injection of contrast media for imaging. It is a device for therapeutic/interventional use or to facilitate diagnostic imaging, but not a diagnostic device itself as it does not analyze or interpret patient data to make a diagnosis.

No

The device description clearly states that the Invisiport™ consists of physical components like an injection port, septum, catheter, and reservoir, indicating it is a hardware device, not software-only.

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

Here's why:

  • Intended Use: The intended use clearly describes a device for accessing the vascular system for delivering substances (medications, fluids, blood, etc.) and sampling blood from the patient. This is an in-vivo (within the living body) application.
  • Device Description: The description details a port and catheter system designed for implantation and direct access to the bloodstream.
  • No mention of testing biological samples outside the body: IVD devices are used to examine specimens (like blood, urine, tissue) that have been taken from the human body to provide information about a physiological state, health, or disease. The Invisiport™ facilitates the collection of blood, but it doesn't perform any diagnostic testing on that blood.
  • Mentions image processing/contrast media: While it mentions power injection of contrast for imaging, this is a therapeutic/diagnostic imaging procedure performed on the patient, not an in-vitro test of a sample.

Therefore, the Invisiport™ is a medical device used for vascular access, not an IVD.

N/A

Intended Use / Indications for Use

The Invisiport™ is indicated for any patient requiring repeated access of the vascular system for delivery of medications, nutritional supplementation, fluids, blood, blood products, or the sampling of blood, or for power injection of contrast media when used with a power-injectable Huber needle or infusion set.

Product codes

LJT

Device Description

The Invisiport™ consists of an injection port made from material evaluated for hiocompatibility. The Invisiport has a self-sealing silicone septum. An open ended radiopaque catheter is pre-attached to the port. The silicone septum covers a reservoir that can be accessed with a non-coring Huber type needle. Power injection of contrast for imaging examinations can be performed when the port is accessed with a power-injectable Huber needle or infusion set.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Peripheral or thoracic (for implantation)

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Hospital/clinic licensed health care provider

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

To establish the technical equivalency of the Invisiport tests were conducted according to methods presented in FDA Guidance: Guidance on 510(k) Submissions for Implanted Infusion Ports, October 1990, Submission and Review of Sterility Information in Premarket Notification 510(k) Submissions for Devices Labeled as Sterile, December 12, 2008 and provided by FDA in review and discussion. The device passed all testing.

Key Metrics

Not Found

Predicate Device(s)

K043178, K060812, K060036, K934518

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 880.5965 Subcutaneous, implanted, intravascular infusion port and catheter.

(a)
Identification. A subcutaneous, implanted, intravascular infusion port and catheter is a device that consists of a subcutaneous, implanted reservoir that connects to a long-term intravascular catheter. The device allows for repeated access to the vascular system for the infusion of fluids and medications and the sampling of blood. The device consists of a portal body with a resealable septum and outlet made of metal, plastic, or combination of these materials and a long-term intravascular catheter is either preattached to the port or attached to the port at the time of device placement. The device is available in various profiles and sizes and can be of a single or multiple lumen design.(b)
Classification. Class II (special controls) Guidance Document: “Guidance on 510(k) Submissions for Implanted Infusion Ports,” FDA October 1990.

0

OCT 1 3 2011

5.0 510(k) Summary

This sunmary is provided to support the 510(k) notification for the Invisiport™ manufactured for Stealth Therapenties, Inc.

Company Name:Stealth Therapeutics, Inc.
Address:5520 Nobel Drive, Suite 150
Fitchburg, Wisconsin 53711
Phone:(608) 577-4484
Date Summary Prepared:February 8, 2011
Trade Name:Invisiport™
Common Name:Implantable Infusion Port
Classification Name:Subcutaneous, Implanted, Intravascular Infusion Port and Catheter
21 CFR 880.5965, Product Code LJT
Predicate Devices:K043178, Rhapsody Access Port manufactured by GrantAdler Corporation
K060812, PowerPort™ Implantable Titanium Port manufactured by C.R.
Bard, Inc.
K060036, PORT-A-CATH manufactured by Smiths Medical
K934518, PeriPort manufactured by Strato Medical Corp.

Product Description 5. I

The Invisiport™ consists of an injection port made from material evaluated for hiocompatibility. The Invisiport has a self-sealing silicone septum. An open ended radiopaque catheter is pre-attached to the port. The silicone septum covers a reservoir that can be accessed with a non-coring Huber type needle. Power injection of contrast for imaging examinations can be performed when the port is accessed with a power-injectable Huber needle or infusion set.

5.2 Intended Use of the Device

The intended use of the Invisiport is the same as predicate devices:

The Invisiport™ is indicated for any patient requiring repeated access of the vascular system for delivery of medications, nutritional supplementation, fluids, blood, blood products, or the

54

1

sampling of blood, or for power injection of contrast media when used with a powerinjectable Huber needle or infusion set.

Summary of Technological Characteristics 5.3

The following table provides a side-by-side comparison the Invisiport™ to the predicate devices being used to support this notification.

Table 5.3-1: Substantial Equivalence Technical Characteristics
FeatureInvisiport™
(Under Review)PeriPort
K934518GrantAdler
Rhapsody
Access Port
K043178,
K082126Bard Power
Port
K060812Smiths Medical
PORT-A-
CATH
K060036Comment
Indications
for UseThe Invisiport™
is indicated for
any patient
requiring
repeated access
of the vascular
system for
delivery of
medications,
nutritional
supplementation,
fluids, blood,
blood products,
or the sampling
of blood, or for
power injection
of contrast when
used with a
power-injectable
Huber needle or
infusion set.The PeriPort is a
totally
implantable drug
delivery system
designed to give
repeated access
to the venous
system for
infusions,
nutritional
solutions,
medications,
fluids, and for
the sampling of
venous blood.The GrantAdler
Rhapsody
Access Port and
Catheter is
indicated for any
patient requiring
reliable
repeated access
of the vascular
system for
delivery of
medications,
nutritional
supplementation,
fluids, blood,
blood products
or the sampling
of blood.The PowerPort
implanted port is
indicated for
patient therapies
requiring
repeated access
to the vascular
system. The port
system can be
used for infusion
of medications,
I.V. fluids,
parenteral
nutrition
solutions, blood
products, and for
the withdrawal
of blood
samples. When
used with the
PowerLoc
Safety Infusion
Set, the
PowerPort
device is
indicated for
power injection
of contrast
media. For
power injection
of contrast
media, the
maximum
recommended
infusion rate is
5 ml/s.PORT-A-CATH
-Systems with
Dual Layer
Catheter are
indicated when
patient therapy
requires repeated
vascular access
for injection or
infusion therapy
and/or venous
blood
sampling.The indication for use of
the Invisiport is the same
as the predicate devices,
including power
injection compatibility.
The 5 ml/sec power
injection of contrast
media limit is the same
as the Bard Power Port.
Port AccessHospital/clinic
licensed health
care providerHospital/clinic
licensed health
care providerHospital/clinic
licensed health
care providerHospital/clinic
licensed health
care providerHospital/clinic
licensed health
care providerSame
Location of
implantPeripheral or
thoracicPeripheral
(medial mid arm
or upper arm
above the elbow
or antecubital
space and well
below the
subaxillary area)Peripheral or
thoracicThoracicPeripheral
(upper arm) or
ThoracicSame
The PeriPort, GrantAdler
Rhapsody and Port-A-
Cath have a
recommended peripheral
implantation site (upper
arm); the same as the
Invisiport.
DesignSeptum/port
with integrated
catheterSeptum/port
with an
attachableSeptum/port
with an
attachableSeptum/port
with an
attachableSeptum/port
with an
attachableAs a convenience to the
user, the catheter is
integrated with the port.

2

| Feature | Invisiport™
(Under Review) | PeriPort
K934518 | GrantAdler
Rhapsody
Access Port
K043178,
K082126 | Bard Power
Port
K060812 | Smiths Medical
PORT-A-
CATH
K060036 | Comment |
|--------------------|-------------------------------|---------------------|--------------------------------------------------------------|-------------------------------|----------------------------------------------|----------------------------------------|
| | | catheter | catheter | catheter | catheter | reservoir. |
| Catheter
Length | 53.3 cm | 76 cm | Up to 52 cm | Up to 45 cm | 76 cm | Within the range of the
predicates. |
| Catheter ID | 1.3 mm | 1.0 mm | 2 mm | Unknown | 1.0 mm | Within the range of the
predicates. |
| Catheter OD | 2.0 mm | 1.7 mm | 2.33 mm (7 Fr) | 2.7 mm (8 Fr) | 1.9 mm | Within the range of the
predicates. |

Performance tests to demonstrate substantial equivalency: 5.4

To establish the technical equivalency of the Invisiport tests were conducted according to methods presented in FDA Guidance: Guidance on 510(k) Submissions for Implanted Infusion Ports, October 1990, Submission and Review of Sterility Information in Premarket Notification 510(k) Submissions for Devices Labeled as Sterile, December 12, 2008 and provided by FDA in review and discussion. The device passed all testing.

5.5 Conclusion

The Invisiport™ met all established acceptance criteria for performance testing. The intended use and technology of the Invisiport are equivalent to the predicate devices. No new questions of safety or effectiveness are raised.

3

Image /page/3/Picture/0 description: The image shows a partial view of the Department of Health & Human Services logo. The left side of the logo shows the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged in a circular pattern. To the right of the text is a symbol consisting of three stylized lines, which are thicker at the top and taper towards the bottom.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

Stealth Therapeutics, Incorporated C/O Mr. Gary J. Syring Principal Consultant Quality & Regulatory Associates, LLC 800 Levanger Lane Stoughton, Wisconsin 53589

OCT. 13 2011

Re: K110407

Trade/Device Name: Invisiport™ Regulation Number: 21 CFR 880.5965 Regulation Name: Subcutaneous, Implanted, Intravascular Infusion Port and Catheter Regulatory Class: II Product Code: LJT Dated: October 6, 2011 Received: October 7, 2011

Dear Mr. Syring:

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. Please note: CDRH does not evaluate information related to contract liability 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.

4

Page 2 - Mr. Syring

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/Resourcesfor You/Industry/default.htm.

Sincerely yours.

Anthony O. m

Anthony D. Watson, B.S., M.S., M.B.A. Director Division of Anesthesiology, General Hospital', Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

Indications for Use

510(k) Number (if known): K110 407

Device Name: Invisiport™

Indications for Use:

The Invisiport™ is indicated for any patient requiring repeated access of the vascular system for delivery of medications, nutritional supplementation, fluids, blood, blood products, or the sampling of blood, or for power injection of contrast media when used with a power-injectable Huber needle or infusion set.

Prescription Use X (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

:

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Rily C. Chyn 10/14/14
(Division Sign Off)

(Division Sign-Off) Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number: K110407

Page 1 of 1