K Number
K110529
Manufacturer
Date Cleared
2011-07-22

(148 days)

Product Code
Regulation Number
876.5980
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The EndoFLIP® EF-900 Gastric Tube is intended for use in bariatric surgical procedures to provide a sized support bougie, and to permit stomach decompression, gastric fluid drainage and removal. It is also intended for use to aid deployment of EndoFLIP® EF-620, EF-325, and BF-325 catheters.

Device Description

The EndoFLIP® Gastric Tube is a simple single lumen tube which acts as a support bougie for a 43 Fr lumen and may be used to aid in the EndoFLIP® catheter, K092850 and K 102214, deployment. It may also be used for drainage, suction or irrigation as it is open at both ends and features a number of side-holes at the distal end. A connector is supplied to push-on the proximal end to aid attachment to a suction system. The tube is 75 cm long and markings are provided at 20 cm and 70 cm from the distal end. The EndoFLIP® Gastric Tube is supplied non-sterile and is single patient use, disposable. An alcohol swab is provided to wipe down the tube exterior prior to use.

AI/ML Overview

The Crospon Ltd. EndoFLIP® Gastric Tube EF-900 is a single-lumen tube intended for use in bariatric surgical procedures as a support bougie, for stomach decompression, gastric fluid drainage and removal, and to aid deployment of other EndoFLIP® catheters.

Here's an analysis of the acceptance criteria and study information:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance CriteriaReported Device Performance
Mechanical Performance
Age TestingMeets performance specifications, does not raise safety/efficacy issues.
Kink TestMeets performance specifications, does not raise safety/efficacy issues.
Biocompatibility
ISO 10993-1 TestingMeets ISO 10993-1 standards for materials in contact with the patient.

2. Sample Size Used for the Test Set and Data Provenance

The provided document does not specify a separate test set or sample size for the performance testing mentioned (age testing, kink test, biocompatibility). The testing appears to be conducted on the device itself as part of product validation.

Data provenance (e.g., country of origin, retrospective/prospective) is not applicable or provided for these types of engineering/material tests.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications

This information is not applicable to the type of performance testing described. The acceptance criteria relate to physical and material properties, not clinical diagnostic accuracy or similar evaluations that would require expert-established ground truth.

4. Adjudication Method for the Test Set

This information is not applicable as there is no mention of a human expert review process for the performance criteria. The testing involves objective measurements against established engineering and biocompatibility standards.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No MRMC comparative effectiveness study was mentioned. The device is a surgical tool, not an imaging or diagnostic device that would typically undergo such a study.

6. Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study

No standalone or algorithm-only performance study was conducted. The device is a physical instrument, not an AI or software-based system.

7. Type of Ground Truth Used

The "ground truth" for the performance criteria appears to be established by engineering specifications, international standards (e.g., ISO 10993-1), and internal performance specifications. For example, the biocompatibility ground truth is conformity to ISO 10993-1. For age and kink testing, the ground truth is likely predefined thresholds for durability and functionality under specified conditions.

8. Sample Size for the Training Set

This information is not applicable. The device is a medical instrument and does not involve AI or machine learning that would require a "training set."

9. How the Ground Truth for the Training Set Was Established

This information is not applicable for the same reason as above.

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K110529
PAGE 1 OF 3

510(k) Summary Page 1 of 3 17-Jun-11

JUL 222 2011

CompanyCrospon Ltd.Galway Business ParkDanganGalway, IrelandTel - 011 [353] (91) 519882Fax - 011 [353] (91) 519873
Official Contact:John O'Dea, Ph.D.
Proprietary or Trade Name:EndoFLIP® Gastric Tube EF-900
Common/Usual Name:Gastrointestinal motility monitoring system
Classification / CFR:KNT - CFR 876.1500
Device:EndoFLIP® Gastric Tube EF-900
Predicate Devices:K002838 - BioEnterics® Gastric Balloon SuctionCatheter

Device Description:

The EndoFLIP® Gastric Tube is a simple single lumen tube which acts as a support bougie for a 43 Fr lumen and may be used to aid in the EndoFLIP® catheter, K092850 and K 102214, deployment. It may also be used for drainage, suction or irrigation as it is open at both ends and features a number of side-holes at the distal end. A connector is supplied to push-on the proximal end to aid attachment to a suction system. The tube is 75 cm long and markings are provided at 20 cm and 70 cm from the distal end. The EndoFLIP® Gastric Tube is supplied non-sterile and is single patient use, disposable. An alcohol swab is provided to wipe down the tube exterior prior to use.

Indications for Use:

The EndoFLIP® EF-900 Gastric Tube is intended for use in bariatric surgical procedures to provide a sized support bougie, and to permit stomach decompression, gastric fluid drainage and removal. It is also intended for use to aid deployment of EndoFLIP® EF-620, EF-325, and BF-325 catheters.

Patient Population:Patients undergoing gastric and bariatric surgery where a bougieor suctioning capabilities are needed.
Environment of Use:Hospitals and Surgery Centers
Contraindications:None

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KIIO529

PAGE 2 OF 3

.

510(k) Summary

EndoFLIP® Gastric TubeEF-900BioEnterics® Gastric BalloonSuction CatheterK002838
Attributes
Indications for UseThe EndoFLIP® EF-900 GastricTube is intended for use in bariatricsurgical procedures to provide a sizedsupport bougie, and to permitstomach decompression, gastric fluiddrainage and removal. It is alsointended for use to aid deployment ofEndoFLIP® EF-620, EF-325, andBF-325 catheters.Indicated for use in gastric andbariatric surgical procedures toprovide visible and tactile delineationof the antrum of the stomach alongwith the ability to decompress andremove gastric fluid and size a gastricpouch.
Typical UseUse in gastric and bariatricsurgical proceduresUse in gastric and bariatricsurgical procedures
Environments of useHospital and surgery centersHospital and surgery centers
Patient PopulationAll individuals undergoing gastricand bariatric proceduresAll individuals undergoing gastricand bariatric procedures
ContraindicationsNoneNone
PrescriptionPrescription usePrescription use
FunctionsSuctionDrainageSuctionDrainage
Intraoperative useYesYes
French Size43 Fr40 - 56 Fr
Design
TubeLength -750 mm14.3 mm ODLength - 685 mm13.3 mm OD
Side holes at distal endfor suctioningYesYes
Depth markingsYesYes
Connector for suctionYesYes
SterilitySupplied non-sterile, and aresingle patient use, disposableSupplied non-sterile, and aresingle patient use, disposable
PerformanceAge testingN/A
Materials usedTube -- PVC withDuraglide/PTFE coatingNot identified
BiocompatibilityTested according to ISO 10993-1ISO 10993-1

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510(k) Summary Page 3 of 3 17-Jun-11

Substantial Equivalence:

The EndoFLIP® Gastric Tube is viewed as substantially equivalent to the predicate device because:

Indications -

Similar to predicate - K002838 - BioEnterics® Gastric Balloon Suction Catheter - Indicated for use in bariatric surgical procedures to provide a sized support bougie, and to permit stomach decompression, gastric fluid drainage and removal. In both cases the intended use is to assist the clinician in gastric and bariatric procedures.

It is also intended for use to aid deployment of EndoFLIP® EF-620, EF-325, and BF-325 catheters.

Technology -

Similar to predicate - K002838 - BioEnterics® Gastric Balloon Suction Catheter except the proposed device does not have a balloon which is unnecessary for the intended use i.e. the balloon is specifically purposed for sizing the pouch created during a gastric band placement, whereas the EF-900 is not used for the creation of such pouches.

Materials -

The materials in contact with the patient have been tested per ISO 10993.

Environment of Use -

Identical to predicate -K002838 - BioEnterics® Gastric Balloon Suction Catheter.

Patient Population -

Identical to predicate - K002838 - BioEnterics® Gastric Balloon Suction Catheter.

Performance Testing -

We did perform age testing, ISO 10993 testing for material biocompatibility, and a kink test. The proposed device meets its performance specifications and does not raise any new safety or efficacy issues.

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" arranged around the top half of the circle. Inside the circle is an abstract symbol resembling an eagle or bird-like figure with three stylized wings or feathers.

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

Crospon, Ltd. % Mr. Paul Dryden President ProMedic, Inc. 24301 Woodsage Drive BONITA SPRINGS FL .34134-2958

JUL 2 2 2011

Re: K110529

Trade/Device Name: EndoFLIP® EF-900 Gastric Tube Regulation Number: 21 CFR §876.5980 Regulation Name: Gastrointestinal tube and accessories Regulatory Class: II Product Code: KNT Dated: June 17, 2011 Received: June 20, 2011

Dear Mr. Dryden:

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.

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 of medical device-related

{4}------------------------------------------------

Page 2

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 (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default:htm.

Sincerely yours,

Hubert Lenoir MD

Herbert P. Lerner, M.D., Director (Acting) Division of Reproductive. Gastro-Renal and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health.

Enclosure

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Indications for Use Statement

Page 1 of 1

510(k) Number:

Device Name:

K110529

EndoFLIP® EF-900 Gastric Tube

Indications for Use:

The EndoFLIP® EF-900 Gastric Tube is intended for use in bariatric surgical procedures to provide a sized support bougie, and to permit stomach decompression, gastric fluid drainage and removal. It is also intended for use to aid deployment of EndoFLIP® EF-620, EF-325, and BF-325 catheters.

Prescription Use (Part 21 CFR 801 Subpart D)

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)

ision Sigh-Off of Reproductive, Gastro-Rena 10(k) Numbe

17

§ 876.5980 Gastrointestinal tube and accessories.

(a)
Identification. A gastrointestinal tube and accessories is a device that consists of flexible or semi-rigid tubing used for instilling fluids into, withdrawing fluids from, splinting, or suppressing bleeding of the alimentary tract. This device may incorporate an integral inflatable balloon for retention or hemostasis. This generic type of device includes the hemostatic bag, irrigation and aspiration catheter (gastric, colonic, etc.), rectal catheter, sterile infant gavage set, gastrointestinal string and tubes to locate internal bleeding, double lumen tube for intestinal decompression or intubation, feeding tube, gastroenterostomy tube, Levine tube, nasogastric tube, single lumen tube with mercury weight balloon for intestinal intubation or decompression, and gastro-urological irrigation tray (for gastrological use).(b)
Classification. (1) Class II (special controls). The barium enema retention catheter and tip with or without a bag that is a gastrointestinal tube and accessory or a gastronomy tube holder accessory is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I (general controls) for the dissolvable nasogastric feed tube guide for the nasogastric tube. The class I device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 876.9.