K Number
K111295
Device Name
.014 MONORAIL AND OTW PTA BALLOON DILATATION CATHETERS
Date Cleared
2011-05-31

(21 days)

Product Code
Regulation Number
870.1250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
.014 PTA Balloon Dilatation Catheter is indicated for Percutaneous Transluminal Angioplasty (PTA) in the peripheral vasculature, including iliac, femoral, infrapopliteal, popliteal, renal arteries, and for the treatment of obstructive lesions of native or synthetic arteriovenous dialysis fistulae.
Device Description
The .014 PTA Balloon Dilatation Catheters have a coaxial shaft design. The outer lumen is used for inflation of the balloon, and the wire lumen permits the use of guidewires 0.014 in (0.36 mm) to facilitate advancement of the catheter to and through the stenosis to be dilated. The balloon is designed to provide an inflatable segment of known diameter and length at recommended pressures. The catheter includes a tapered tip to facilitate advancement of the catheter. The working lengths of the balloon catheter are 90 cm and 150 cm.
More Information

Not Found

No
The device description and performance studies focus on the physical characteristics and mechanical performance of a balloon catheter, with no mention of AI or ML.

Yes
The device is a PTP Balloon Dilatation Catheter indicated for Percutaneous Transluminal Angioplasty (PTA) to treat obstructive lesions in various arteries and arteriovenous fistulae, which is a therapeutic intervention.

No

The device is a PTA Balloon Dilatation Catheter, indicated for Percutaneous Transluminal Angioplasty (PTA) to treat obstructive lesions. Its purpose is therapeutic (dilating vessels), not diagnostic (identifying or characterizing disease).

No

The device description clearly describes a physical catheter with a balloon, lumens, and a tip, indicating it is a hardware device, not software only.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health. These tests are performed outside of the body.
  • Device Description and Intended Use: The description clearly states that this is a balloon dilatation catheter used for Percutaneous Transluminal Angioplasty (PTA). This is a procedure performed inside the body to widen narrowed blood vessels.
  • Lack of Diagnostic Testing: The device is used for a therapeutic procedure (dilating vessels), not for analyzing samples to diagnose a condition.

Therefore, based on the provided information, this device is a therapeutic medical device, not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The .014 Balloon Dilatation Catheter is indicated for Percutaneous Transluminal Angioplasty (PTA) in the peripheral vasculature, including iliac, femoral, infrapopliteal, renal arteries, and for the treatment of obstructive lesions of native or synthetic arteriovenous dialysis fistulae.

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

LIT, DQY

Device Description

The .014 PTA Balloon Dilatation Catheters have a coaxial shaft design. The outer lumen is used for inflation of the balloon, and the wire lumen permits the use of guidewires 0.014 in (0.36 mm) to facilitate advancement of the catheter to and through the stenosis to be dilated. The balloon is designed to provide an inflatable segment of known diameter and length at recommended pressures. The catheter includes a tapered tip to facilitate advancement of the catheter. The working lengths of the balloon catheter are 90 cm and 150 cm.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

peripheral vasculature, including iliac, femoral, infrapopliteal, renal arteries, and obstructive lesions of native or synthetic arteriovenous dialysis fistulae.

Indicated Patient Age Range

Not Found

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)

Bench testing and biocompatibility testing were performed to support a determination of substantial equivalence. The results of these tests provide reasonable assurance that the proposed device has been designed and tested to assure conformance to the requirements for its intended use. No new safety or performance issues were raised during the testing.

The following biocompatibility tests were completed on the .014 PTA Balloon Dilatation Catheter:
MEM Elution / Cytotoxicity
Hemolysis / Direct Contact
Guinea Pig Maximization Sensitization
Complement Activation
Intracutaneous Reactivity
Partial Thromboplastin Time
Acute Systemic Toxicity
In Vitro Hemocompatibility
Materials Mediated Rabbit Pyrogen

The following in-vitro performance tests were completed for the .014 PTA Balloon Dilatation Catheter:
Balloon Multiple Inflation
Distal Shaft Profile
Balloon Compliance (Distension)
Flexibility and Kink Test
Balloon Diameter at Nominal Pressure
Folded Balloon Crossing Profile
Balloon Length Dimensions (mm)
Particulates Evaluation
Balloon Rated Burst Pressure
Proximal Shaft Profile MR
Bond Tensile
Proximal Shaft Profile OTW
Burst Mode
Radiopacity
Catheter Length Dimensions
Sheath Insertion and Withdrawal Force
Distal Inner Shaft ID

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.

K080982, K093636, K093720

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

§ 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).

0

K111295 page 1 of 4

MAY 3 1 2011

510(k) Summary

| Submitter: | Boston Scientific Corporation
One Scimed Place Maple Grove, MN 55311 |
|------------------------|-------------------------------------------------------------------------|
| Contact Person: | Mark Murphy |
| Phone Number: | 763-494-2377 |
| Fax Number: | 763-494-2222 |
| Date Prepared: | May 6, 2011 |
| Device Trade Name: | .014 Monorail and OTW PTA Balloon Dilatation Catheters |
| Common Name: | Percutaneous Transluminal Angioplasty Dilatation Catheter |
| Device Classification: | Class II, 21 CFR 870.1250 Product Code: LIT |

Predicate Devices

Sterling SL Monorail and OTW PTA Balloon Dilatation Catheters and Sterling ES Monorail and OTW PTA Catheters.

Device Description

The .014 PTA Balloon Dilatation Catheters have a coaxial shaft design. The outer lumen is used for inflation of the balloon, and the wire lumen permits the use of guidewires 0.014 in (0.36 mm) to facilitate advancement of the catheter to and through the stenosis to be dilated. The balloon is designed to provide an inflatable segment of known diameter and length at recommended pressures. The catheter includes a tapered tip to facilitate advancement of the catheter. The working lengths of the balloon catheter are 90 cm and 150 cm.

Indications for Use

The .014 Balloon Dilatation Catheter is indicated for Percutaneous Transluminal Angioplasty (PTA) in the peripheral vasculature, including iliac, femoral, infrapopliteal, renal arteries, and for the treatment of obstructive lesions of native or synthetic arteriovenous dialysis fistulae.

Substantial Equivalence

The .014 PTA Balloon Dilatation Catheters design, materials, manufacturing process and intended use are substantially equivalent to predicate devices Sterling ES (K080982 and K093636), and Sterling SL Monorail and OTW (K093720) PTA Catheters.

Comparison of Technological Characteristics

The .014 PTA Balloon Dilatation Catheter incorporates substantially equivalent device materials and design, packaging materials and design, fundamental technology, manufacturing processes, sterilization processes and intended use as those featured in the Boston Scientific predicate devices, Sterling ES PTA Balloon Dilatation Catheter (K080982 and K093636) and Sterling SL PTA Balloon Dilatation Catheter (K093720).

1

CharacteristicSterling ES (MR/OTW)Sterling SL (MR/OTW)
ManifoldSame material. Different colorant.
Same design with minor
dimensional differences but serving
same functionOTW Same material. MR different
material. Same design with minor
dimensional differences but
serving same function
Strain ReliefMR has different material. OTW has
same material. Similar designs with
serving same functionSame material, different colorant,
different designs but serving same
function
Catheter Proximal Shaft /
Distal OuterMR different material. OTW similar
material. Both designs serving
same functionSimilar material and design serving
same function
Catheter Inner ShaftSame material, different colorants
and serving same functionSimilar material, same colorants
and serving same function
Bumper TipDifferent material, same colorant
but serving same functionDifferent material, different
colorant but serving same function
BalloonDifference in balloon material and
design but serving same function
and fundamental technologyDifference in balloon material and
design but serving same function
and fundamental technology
Balloon Bonding MethodSame bonding method and
functionSame bonding method and
function
Balloon Forming
ProcessSame forming method and functionSame forming method and function
Marker BandsSimilar component serving same
functionDifferent component serving same
function
CoatingSame coating serving same
functionSame coating serving same
function
Balloon ProtectorSame material and similar design
both serving same function.Same material and similar design
both serving same function
Proximal Shaft Outer
DiameterSimilar shaft outer diametersSimilar shaft outer diameters

·

Comparison to Predicate Devices in Materials and Manufacturing

2

CharacteristicSterling ES (MR/OTW)Sterling SL (MR/OTW)
Balloon DiametersSimilar balloon diameter range
serving same functionSame balloon diameter range
serving same function
Balloon LengthsShorter balloon length ranges
serving same functionSimilar balloon length ranges
serving same function
Rated Burst Pressure
(RBP)Similar rated burst pressureSame rated burst pressure
Catheter LengthSimilar catheter length ranges
serving same functionSame catheter length ranges
serving same function
Recommended
Introducer Sheath
CompatibilitySimilar ranges and compatibilitiesSame ranges and compatibilities
Recommended
GuidewireSame compatibility.Same compatibility.
Sterilization MethodSame method.Same method.
SALSame level of assuranceSame level of assurance
Packaging Material
and ConfigurationSame design and functionSame design and function

Performance Data

Bench testing and biocompatibility testing were performed to support a determination of substantial equivalence. The results of these tests provide reasonable assurance that the proposed device has been designed and tested to assure conformance to the requirements for its intended use. No new safety or performance issues were raised during the testing.

The following biocompatibility tests were completed on the .014 PTA Balloon Dilatation Catheter:

MEM Elution / CytotoxicityHemolysis / Direct Contact
Guinea Pig Maximization SensitizationComplement Activation
Intracutaneous ReactivityPartial Thromboplastin Time
Acute Systemic ToxicityIn Vitro Hemocompatibility
Materials Mediated Rabbit Pyrogen

3

K111295 page 4 of 4

The following in-vitro performance tests were completed for the .014 PTA Balloon Dilatation Catheter:

Balloon Multiple InflationDistal Shaft Profile
Balloon Compliance (Distension)Flexibility and Kink Test
Balloon Diameter at Nominal PressureFolded Balloon Crossing Profile
Balloon Length Dimensions (mm)Particulates Evaluation
Balloon Rated Burst PressureProximal Shaft Profile MR
Bond TensileProximal Shaft Profile OTW
Burst ModeRadiopacity
Catheter Length DimensionsSheath Insertion and Withdrawal Force
Distal Inner Shaft ID

Conclusion

Based on the indications for use, technological characteristics, and safety and performance testing, the .014 PTA Balloon Dilatation Catheter has been shown to be appropriate for its intended use and is considered to be substantially equivalent to the Boston Scientific Sterling ES PTA Balloon Dilatation Catheter (K080982 and K0936336) and the Sterling SL PTA Balloon Dilatation Catheter (K093720).

4

Image /page/4/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features the department's name arranged in a circular fashion around a stylized emblem. The emblem consists of a caduceus-like symbol with three parallel lines that curve and converge, representing health and human services.

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

MAY 3 1 2011

Boston Scientific Corporation c/o Mr. Mark Murphy One Scimed Place Maple Grove, MN 55311-1566

Re: K111295

Trade/Device Name: .014 Monorail and Over-The-Wire PTA Balloon Dilatation Catheters Regulation Number: 21 CFR 870.1250 Regulation Name: Percutancous catheter Regulatory Class: Class II (two) Product Code: LIT, DQY Dated: May 6, 2011 Received: May 9, 2011

Dear Mr. Murphy:

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.

5

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/CDRH0ffices/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.

érely vou

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

Enclosure

6

Indications for Use Statement
510(k) Number
(if known)K111295
Device Name.014 MR & OTW PTA Balloon Dilatation Catheters
Indications for
Use.014 PTA Balloon Dilatation Catheter is indicated for Percutaneous
Transluminal Angioplasty (PTA) in the peripheral vasculature, including
iliac, femoral, infrapopliteal, popliteal, renal arteries, and for the treatment o
obstructive lesions of native or synthetic arteriovenous dialysis fistulae.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

signature

(Division Sign-Off) Division of Cardioyascular Devices 510(k) Nui ાંાણા 295

Prescription Use ___X (Per 21 CFR 801.109 OR

Over-The-Counter Use___________________________________________________________________________________________________________________________________________________________________________