K Number
K121954
Device Name
NMI MICROCATHETER
Date Cleared
2012-07-17

(14 days)

Product Code
Regulation Number
870.1200
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The NMI Microcatheter is intended for use in small vessels and superselective anatomy during diagnostic and interventional procedures in the peripheral vasculature. Upon access of the desired region, the microcatheter can be used for the controlled and selective infusion of diagnostic, therapeutic and embolic materials. All products must be used in accordance with the original manufacturer's instructions for use. The catheter is not intended for use in coronary or neuro- vasculature.
Device Description
The NMI MCs has an outside diameter of 2.8F and 2.4F and has a nominal inside diameter of 0.027" and 0.021", respectively, along the entire catheter length. The MC has a braided reinforced shaft, which transitions from a stiffer proximal region to a flexible 30cm distal end. A radiopaque marker is located I mm from the distal end of the catheter to identify the location of the distal tip under fluoroscopic visualization. The MC has a hydrophilic coating applied to the outer surface of the distal end. The proximal end of the MC contains a Luer fitting and strain relief. The device is provided sterile and intended for single procedure use.
More Information

K 112124, K111368

Not Found

No
The description focuses on the physical characteristics and intended use of a microcatheter, with no mention of AI or ML capabilities.

No
The device is a microcatheter used for the controlled and selective infusion of various materials, including therapeutic materials, but it is not itself a therapeutic device. It is an instrument used to deliver therapy, not to provide therapy.

Yes

The "Intended Use / Indications for Use" section explicitly states that the device is intended for use "during diagnostic and interventional procedures" and "can be used for the controlled and selective infusion of diagnostic, therapeutic and embolic materials." This indicates its role in diagnostic procedures.

No

The device description clearly details a physical catheter with specific dimensions, materials (braided reinforced shaft, hydrophilic coating), and a radiopaque marker. It is a hardware device.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used outside of the body.
  • Device Function: The NMI Microcatheter is a device used inside the body during medical procedures. It is inserted into blood vessels to deliver substances or assist in interventions.
  • Intended Use: The intended use clearly describes its function within the peripheral vasculature for diagnostic and interventional procedures, involving the infusion of materials into the body.

Therefore, the NMI Microcatheter is a medical device used in vivo (within the living body), not an in vitro diagnostic.

N/A

Intended Use / Indications for Use

The NMI MC is intended for use in small vessels and supreselective anatomy during diagnostic and interventional procedures in the peripheral vasculature. Upon access of the desired region, the microcatheter can be used for the controlled and selective infusion of diagnostic, therapeutic and embolic materials. All products delivered through the microcatheter must be used in accordance with the original manufacturer's instruction for use. The catheter is not intended for use in coronary or neuro- vasculature.

Product codes

DQO

Device Description

The NMI MCs has an outside diameter of 2.8F and 2.4F and has a nominal inside diameter of 0.027" and 0.021", respectively, along the entire catheter length. The MC has a braided reinforced shaft, which transitions from a stiffer proximal region to a flexible 30cm distal end. A radiopaque marker is located I mm from the distal end of the catheter to identify the location of the distal tip under fluoroscopic visualization. The MC has a hydrophilic coating applied to the outer surface of the distal end. The proximal end of the MC contains a Luer fitting and strain relief. The device is provided sterile and intended for single procedure use.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

fluoroscopic visualization

Anatomical Site

small vessels and supreselective anatomy during diagnostic and interventional procedures in the peripheral vasculature.

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)

The results of infusate compatibility testing support the labeling change described in this submission and demonstrate substantial equivalence of the proposed device.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K 112124, K111368

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.1200 Diagnostic intravascular catheter.

(a)
Identification. An intravascular diagnostic catheter is a device used to record intracardiac pressures, to sample blood, and to introduce substances into the heart and vessels. Included in this generic device are right-heart catheters, left-heart catheters, and angiographic catheters, among others.(b)
Classification. Class II (performance standards).

0

K12 1954 page 1 of 1

JUL 1 7 2012

510(k) SUMMARY

Date Prepared: July 2, 2012

A. Sponsor

Navilyst Medical, Inc 26 Forest Street Marlborough, MA 01752

B. Contact

Wanda Carpinella Director, Global Regulatory Affairs 508-650-7929

C. Device Name

Trade Name: Common/Usual name: Classification Name:

Lorraine M. Hanley Vice President, Global Regulatory Affairs 508-608-7945

NMI MC Microcatheter Diagnostic Intravascular Catheter 21 CRF §870.1200, ProCode DQO Class II

Classification

D. Predicate Device(s)

The NMI MC described in this submission is identical in terms of intended use, materials, design, components and technological characteristics to the predicate NMI MC cleared under K 112124 and K111368. The change involves a labeling change only.

E. Device Description

The NMI MCs has an outside diameter of 2.8F and 2.4F and has a nominal inside diameter of 0.027" and 0.021", respectively, along the entire catheter length. The MC has a braided reinforced shaft, which transitions from a stiffer proximal region to a flexible 30cm distal end. A radiopaque marker is located I mm from the distal end of the catheter to identify the location of the distal tip under fluoroscopic visualization. The MC has a hydrophilic coating applied to the outer surface of the distal end. The proximal end of the MC contains a Luer fitting and strain relief. The device is provided sterile and intended for single procedure use.

F. Intended Use

The NMI MC is intended for use in small vessels and supreselective anatomy during diagnostic and interventional procedures in the peripheral vasculature. Upon access of the desired region, the microcatheter can be used for the controlled and selective infusion of diagnostic, therapeutic and embolic materials. All products delivered through the microcatheter must be used in accordance with the original manufacturer's instruction for use. The catheter is not intended for use in coronary or neuro- vasculature.

G. Technology Characteristics

The proposed device is identical in terms of materials, design, and technological characteristics as the currently marketed NMI MC.

H. Performance Data

The results of infusate compatibility testing support the labeling change described in this submission and demonstrate substantial equivalence of the proposed device.

。 Conclusion

The submission is for a labeling change only. No design, dimensional or material changes have been made to the predicate device. The results of the non-clinical testing support the labeling change described in this submission demonstrate substantial equivalence of the proposed device.

1

Image /page/1/Picture/1 description: The image shows the seal of the Department of Health & Human Services USA. The seal is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" around the perimeter. In the center of the seal is an abstract image of an eagle.

Public Health Service

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

JUL 1 7 2012

Navylist Medical, Inc. c/o Ms. Wanda Carpinella 26 Forest St. Marlborough, MA 01752

Re: K121954

Trade/Device Name: Embarc Microcatheter Regulation Number: 21 CFR 870.1200 Regulation Name: Diagnostic intravascular catheter Regulatory Class: Class II (two) Product Code: DQO Dated: July 2, 2012 Received: July 3, 2012

Dear Ms. Carpinella:

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

2

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/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.

Sincerely vours.

Cm. A. Holben

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

Enclosure

3

Indications for Use

510(k) Number (if known): K 121959

Device Name: NMI Microcatheter

Indication For Use:

The NMI Microcatheter is intended for use in small vessels and superselective anatomy during diagnostic and interventional procedures in the peripheral vasculature. Upon access of the desired region, the microcatheter can be used for the controlled and selective infusion of diagnostic, therapeutic and embolic materials. All products must be used in accordance with the original manufacturer's instructions for use. The catheter is not intended for use in coronary or neuro- vasculature.

Prescription Use X (21 CFR Part 801 Subpart D) And/Or

Over the Counter Use (21 CFR Part 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

M. G. Killian

(Division Sign-Off) Division of Cardiovascular Devices

510(k) Number 121954