K Number
K112849
Device Name
FIXATE TISSUE BAND
Date Cleared
2011-10-27

(28 days)

Product Code
Regulation Number
882.5880
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The fiXate Tissue Band is intended to be an accessory to the leads component of Spinal Cord Stimulator systems functioning to secure the lead to the fascia or inter-spinous/supra-spinous ligament.
Device Description
The fiXate Tissue Band consists of an adjustable loop of non-absorbable 2-0 suture with two (2) attached anchors. The construct is provided sterile and preloaded on a disposable delivery instrument. The instrument's needle facilitates placement of the suture by positioning the T-anchors in the sub-layer of tissue.
More Information

Not Found

No
The summary describes a mechanical device for securing leads and does not mention any computational or algorithmic functions, let alone AI/ML.

No
The device is described as an "accessory to the leads component of Spinal Cord Stimulator systems functioning to secure the lead to the fascia or inter-spinous/supra-spinous ligament." It does not directly provide therapy but rather secures another therapeutic device.

No

Explanation: The device description states its purpose is to secure parts of a Spinal Cord Stimulator system, which is a therapeutic function, not diagnostic. It does not mention any ability to detect, identify, or monitor medical conditions.

No

The device description clearly outlines a physical implantable device made of suture and anchors, delivered with a disposable instrument. It is not software.

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

Here's why:

  • Intended Use: The intended use is to secure a lead component of a Spinal Cord Stimulator system to tissue (fascia or ligament). This is a surgical accessory used in vivo (within the body) during a medical procedure.
  • Device Description: The device is a physical construct (suture and anchors) designed for mechanical fixation within the body.
  • Lack of IVD Characteristics: An IVD is a medical device used in vitro (outside the body) to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. The description of the fiXate Tissue Band does not involve any of these activities.

Therefore, the fiXate Tissue Band is a surgical accessory, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The fiXate Tissue Band is intended to be an accessory to the leads component of Spinal Cord Stimulator systems functioning to secure the lead to the fascia or inter-spinous/supra-spinous ligament.

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

GZB, GAT

Device Description

The fiXate Tissue Band consists of an adjustable loop of non-absorbable 2-0 suture with two (2) attached anchors. The construct is provided sterile and preloaded on a disposable delivery instrument. The instrument's needle facilitates placement of the suture by positioning the T-anchors in the sub-layer of tissue.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

fascia or inter-spinous/supra-spinous ligament

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)

Biocompatibility and bench testing were completed and support the safety and effectiveness of the fiXate Tissue Band.

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.

K111462

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

§ 882.5880 Implanted spinal cord stimulator for pain relief.

(a)
Identification. An implanted spinal cord stimulator for pain relief is a device that is used to stimulate electrically a patient's spinal cord to relieve severe intractable pain. The stimulator consists of an implanted receiver with electrodes that are placed on the patient's spinal cord and an external transmitter for transmitting the stimulating pulses across the patient's skin to the implanted receiver.(b)
Classification. Class II (performance standards).

0

K112849

OCT 2 7 2011

Section 5 - 510(k) Summary

As Required by 21 CFR 807.92

. .

| Submitter: | Anulex Technologies, Inc.
5600 Rowland Road, Suite 280
Minnetonka, MN 55343 |
|-----------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person: | Rachel Kennedy
Director, Regulatory Affairs and Quality Systems
Anulex Technologies, Inc.
Direct: 952.224.4034
Fax: 952.224.4040
E-Mail: rkennedy@anulex.com |
| Date Prepared: | September 27, 2011 |
| Trade Name: | fiXate Tissue Band |
| Classification: | II |
| Product Code: | GZB
21 CFR 882.5880 |
| Predicate Device(s): | The subject device is substantially equivalent to the following
predicate device: |
| | • Anulex Technologies fiXate Tissue Band
(K111462 cleared September 8, 2011) |
| Device Description: | The fiXate Tissue Band consists of an adjustable loop of non-
absorbable 2-0 suture with two (2) attached anchors. The
construct is provided sterile and preloaded on a disposable
delivery instrument. The instrument's needle facilitates
placement of the suture by positioning the T-anchors in the sub-
layer of tissue. |
| Indications for Use: | The fiXate Tissue Band is intended to be an accessory to the
leads component of Spinal Cord Stimulator systems functioning
to secure the lead to the fascia or inter-spinous/supra-spinous
ligament. |
| Functional and Safety
Testing: | Biocompatibility and bench testing were completed and support
the safety and effectiveness of the fiXate Tissue Band. |
| Conclusion: | The fiXate Tissue Band is similar in materials, design, and
performance characteristics and has the same intended use as the
original fiXate Tissue Band (K111462). Substantial equivalence
is demonstrated through the detailed device description,
performance testing and conformance with voluntary
performance standards. |

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Image /page/1/Picture/11 description: The image shows a logo for the Department of Health & Human Services. The logo features a stylized eagle with three wavy lines extending from its head. The text "DEPARTMENT OF HEALTH & HU" is arranged vertically along the left side of the logo.

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

OCT 27 2011

Ms. Rachel Kennedy Director of Regulatory Affairs & Ouality Systems Anulex Technologies, Inc. 5600 Rowland Road, Suite 280 Minnetonka, MN 55343

Re: K112849

Trade/Device Name: fiXate Tissue Band Regulation Number: 21 CFR 882.5880 Regulation Name: Implanted Spinal Cord Stimulator for Pain Relief Regulatory Class: Class II Product Codes: GZB and GAT Dated: September 28, 2011 Received: September 29, 2011

Dear Ms. Kennedy:

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.

2

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 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/ReportalProblem/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/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Eula Tenenbaum

Malvina B. Eydelman, M.D. Director Division of Ophthalmic, Neurological, and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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K112849

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Indications for Use Statement

Device Name: fiXate Tissue Band

Indications for Use:

The fiXate Tissue Band is intended to be an accessory to the leads component of Spinal Cord Stimulator systems functioning to secure the lead to the fascia or interspinous/supra-spinous ligament.

Prescription UseX
(Part 21 CFR 801 Subpart D C)

AND/OR

Over-The-Counter
(21 CFR 801 Subpart

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

Concurrence of CDRH. Office of Device Evaluation (ODE)


Kristen Bowsher

Division Sign-Off) Division of Ophthalmic, Neurological and Ear, Nose and Throat Devices

K 112849 SI((k) Number_