K Number
K120902
Device Name
GID 700
Date Cleared
2012-08-15

(142 days)

Product Code
Regulation Number
878.5040
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The GID 700 is used for aspiration, harvesting, filtering, and transferring of autologous adipose tissue for aesthetic body contouring. The system should be used with a legally marketed vacuum or aspirator apparatus as a source of suction. If harvested fat is to be reimplanted, the harvested fat is only to be used without any additional manipulation.

The GID 700 is intended for use in the following surgical specialties when aspiration of soft tissue is desired: plastic and reconstructive surgery, neurosurgery, gastrointestinal and affiliated organ surgery, urological surgery, general surgery, orthopedic surgery, gynecological surgery, thoracic surgery, and laparoscopic surgery.

Device Description

The GID Group's GID 700 device is a sterile, single use 700 ml canister and accessories used to receive and filter tissue from lipoplasty procedures. When the tissue is deposited into the canister, it is filtered through a mesh filter to capture the tissue. The vacuum source is user or institution supplied. Various ports on the canister provide access to the vacuum source, receives the harvested tissue, vent the canister during the wash process, and transfer the filtered tissue.

AI/ML Overview

The GID 700 Tissue Canister is a medical device used for aspirating, harvesting, filtering, and transferring autologous adipose tissue. The provided documents detail its performance and acceptance criteria for FDA 510(k) clearance, establishing substantial equivalence to a predicate device (Shippert Tissu-Trans Filtron 1000 canister).

Here's a breakdown of the requested information:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance Criteria (Test)Reported Device Performance (GID 700)
Canister vacuum Implosion TestPasses
Tubing connection, tensile strengthPasses
Mechanical plugging testingPasses
Biocompatibility (ISO 10993)Meets ISO 10993 requirements
Pyrogen TestNon-pyrogenic

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

The documents describe various physical and biological tests conducted on the GID 700 device itself, rather than a clinical study involving a "test set" of patient data in the typical sense for AI/ML devices. Therefore, a sample size for a "test set" or data provenance (country of origin, retrospective/prospective) is not applicable in this context. The tests performed are laboratory-based evaluations of the device's physical and material properties.

3. Number of Experts Used to Establish Ground Truth and Qualifications

This information is not applicable to the type of device and study described. The GID 700 is a physical medical device, not an AI/ML algorithm that requires expert consensus for ground truth establishment. The performance data is derived from direct measurements and laboratory tests.

4. Adjudication Method for the Test Set

This information is not applicable as there is no "test set" of patient cases requiring adjudication by experts. The performance is based on direct physical and biological testing of the device.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was Done

No, an MRMC comparative effectiveness study was not conducted. This type of study is typically performed for AI/ML diagnostic or prognostic tools to assess how human readers' performance (e.g., accuracy, efficiency) is improved with AI assistance. The GID 700 is a physical tissue collection and processing device, not an AI-powered diagnostic tool.

6. If a Standalone (Algorithm Only Without Human-in-the-Loop Performance) was Done

No, a standalone algorithm performance study was not done. The GID 700 is a physical device, and therefore this type of study, relevant to AI/ML algorithms, is not applicable.

7. The Type of Ground Truth Used

The "ground truth" for the GID 700's performance is established through direct physical and biological testing standards and requirements. For instance:

  • Physical Tests: "Passes" for implosion, tensile strength, and mechanical plugging indicate meeting pre-defined engineering specifications and safety thresholds.
  • Biocompatibility: Conformance to ISO 10993 standards serves as the ground truth for the device's biological safety when in contact with human tissue.
  • Pyrogen Test: A "non-pyrogenic" result confirms the absence of fever-inducing substances, which is a direct biological safety standard.

8. The Sample Size for the Training Set

This information is not applicable. The GID 700 is a physical medical device, not an AI/ML algorithm that undergoes a "training" process with a dataset. Its design and manufacturing are based on established engineering principles and material science.

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

This information is not applicable as there is no "training set" for a physical device. Its design is based on engineering specifications and regulatory requirements for predicate devices.

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K120902

1042

510(k) Summary

ﻬﺎ

AUG 1 5 2012

Submitted byThe GID Group Inc.578 W. Sagebrush Ct.Louisville, CO 80027303-952-4901
--------------------------------------------------------------------------------------------------
Contact PersonLewis Ward
L. W. Ward and Associates, Inc.
4655 Kirkwood Court
Boulder, CO 80301
303-530-3279
lwward@qwest.net
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Product NameGID 700 Tissue CanisterBut hand and see a first and to the comment of a ministration and to--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ClassificationSystem, Suction, Lipoplasty
Product Code: MUU
Regulation Number: 878.5040
Device Class 2
General Plastic Surgery Panel
Indication for Use Statement
The GID 700 is used for aspiration, harvesting, filtering, andtransferring of autologous adipose tissue for aesthetic bodycontouring. The system should be used with a legallymarketed vacuum or aspirator apparatus as a source ofsuction. If harvested fat is to be reimplanted, the harvestedfat is only to be used without any additional manipulation.
The GID 700 is intended for use in the following surgicalspecialties when aspiration of soft tissue is desired: plasticand reconstructive surgery, neurosurgery, gastrointestinaland affiliated organ surgery, urological surgery, generalsurgery, orthopedic surgery, gynecological surgery, thoracicsurgery, and laparoscopic surgery.
Technological CharacteristicsThe GID Group's GID 700 device is a sterile, single use700 ml canister and accessories used to receive and filtertissue from lipoplasty procedures. When the tissue isdeposited into the canister, it is filtered through a mesh filterto capture the tissue. The vacuum source is user orinstitution supplied.Various ports on the canister provide access to the vacuumsource, receives the harvested tissue, vent the canister duringthe wash process, and transfer the filtered tissue.
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Page 1 of 2

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V120902
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Test DataCanister vacuum Implosion Test - passes
Tubing connection, tensile strength - passes
Mechanical plugging testing - passes
Biocompatibility - meets ISO 10993 requirements
Pyrogen Test - non-pyrogenic

i

:

.

FeaturesGID 700Shippert Tissu-Trans Filtron1000
Indication for UseUsed in the aspiration, harvesting, filtering, and transferring of autologous tissue.Used in the aspiration, harvesting, filtering, and transferring of autologous tissue.
ManufacturerThe GID Group, USAShippert Medical Technologies Corp.
Product CodeMUU, Class 2General and Plastic Surgery PanelMUU, Class 2General and Plastic Surgery Panel
Regulation Number878.5040 Suction Lipoplasty System878.5040 Suction Lipoplasty System
Use ModeSingle use, disposable, sterile.Unit remains assembled throughout entire process.Single use, disposable, sterile.Unit remains assembled throughout entire process.
Sterilization MethodElectron Beam IrradiationISO 11137Radiation
Canister ConstructionPolymer materials, closed system filtration, and disposable tubing sets. Manual stir mechanism.Polymer materials, closed system filtration, and disposable tubing sets
Source of EnergyUser supplied vacuumUser supplied vacuum
Filtering200 micro mesh filter to retain tissue400 micron mesh filter to retain tissue
AccessoryNone. Institutions provide collection trap.None. Institutions provide collection trap.
Mechanical Testing- Implosion test: Passes- Tubing Connection, Tensile Strength: Passes- Mechanical Plugging: Passes- Implosion test: Passes- Tubing Connection, Tensile Strength: Passes- Mechanical Plugging: Passes
BiocompatibilityMeets ISO 10993 External Communicating Device, Contact < 24 hoursMeets ISO 10993 External Communicating Device, Contact < 24 hours
Canister Size700 ml1000 ml
Canister PortsSuction, vent, input, extractionSuction, vent, input, extraction
Substantial EquivalenceThe GID 700 is substantially equivalent to the Shippert Tissu-
Trans-Filtron 1000 canister (K092482) manufactured by
Shippert Medical based on design, materials, and testing.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/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 symbol with three curved lines representing its body and wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged in a circular fashion around the symbol.

Public Health Service

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

AUG 15 2012

The CID Group, Incorporated % L.W. Ward and Associates, Incorporated Mr. Lewis Ward Consultant 4655 Kirkwood Court Boulder, Colorado 80301

Re: K120902

Trade/Device Name: GID 700 Regulation Number: 21 CFR 878.5040 Regulation Name: Suction lipoplasty system Regulatory Class: II Product Code: MUU Dated: July 18, 2012 Received: July 19, 2012

Dear Mr Ward:

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 such 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); good manufacturing practice requirements as set

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Page 2 - Mr. Lewis Ward

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.

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at (240) 276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at (240) 276-3464. 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/cdrh/industry/support/index.html.

Sincerely vours.

yours,

of Peter
Melkerson

{

Mark N. Melkerson Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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INDICATIONS FOR USE

Device Name: GID 700

Indications for Use:

The GID 700 is used for aspiration, harvesting, filtering, and transferring of autologous adipose tissue for aesthetic body contouring. The system should be used with a legally marketed vacuum or aspirator apparatus as a source of suction. If harvested fat is to be reimplanted. the harvested fat is only to be used without any additional manipulation.

The GID 700 is intended for use in the following surgical specialties when aspiration of soft tissue is desired: plastic and reconstructive surgery, neurosurgery, gastrointestinal and affiliated organ surgery, urological surgery, general surgery, orthopedic surgery, gynecological surgery, thoracic surgery, and laparoscopic surgery.

Prescription Use X AND/OR (Part 21 CFR 801 Subpart D)

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)

Da.l. Kramer for MM
(Division Sign-Off)

Division of Surgical. Onhopedie. and Restorative Devices

510(k) Number K120902

§ 878.5040 Suction lipoplasty system.

(a)
Identification. A suction lipoplasty system is a device intended for aesthetic body contouring. The device consists of a powered suction pump (containing a microbial filter on the exhaust and a microbial in-line filter in the connecting tubing between the collection bottle and the safety trap), collection bottle, cannula, and connecting tube. The microbial filters, tubing, collection bottle, and cannula must be capable of being changed between patients. The powered suction pump has a motor with a minimum of1/3 horsepower, a variable vacuum range from 0 to 29.9 inches of mercury, vacuum control valves to regulate the vacuum with accompanying vacuum gauges, a single or double rotary vane (with or without oil), a single or double diaphragm, a single or double piston, and a safety trap.(b)
Classification. Class II (special controls). Consensus standards and labeling restrictions.