K Number
K123109
Device Name
ABSORBATACK 5MM SINGLE USE ABSORBABLE FIXATION DEVICE
Manufacturer
Date Cleared
2012-10-23

(19 days)

Product Code
Regulation Number
878.4750
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The device is intended for fixation of prosthetic material to soft tissue in various minimally invasive and open surgical procedures such as hernia repair.
Device Description
AbsorbaTack™ Absorbable Fixation Devices are sterile single use devices for the fixation of prosthetic material such as hernia mesh to soft tissue. The Tack is constructed of an absorbable synthetic polyester copolymer derived from lactic and glycolic acid and is dyed with D&C violet #2. The device is offered with 5, 10, 15, 20, or 30 tacks. AbsorbaTack™ Absorbable Fixation device is similar to the predicate device except for the revised shaft design. The design modifications include adding a flex cable in the inner drive tube of the shaft to allow for continuous rotation if the outer tube is bent to ensure tack deployment, shortening an existing stiffener to reinforce the interface between the outer shaft tube and the body halves, and extending the spring up the entire length of the outer shaft tube that is outside of the body halves.
More Information

Not Found

No
The description focuses on mechanical design modifications and material composition, with no mention of AI or ML capabilities.

No
The device is used for fixation of prosthetic material and does not treat or cure a disease or condition.

No

The device is described as an "Absorbable Fixation Device" intended for "fixation of prosthetic material to soft tissue," which is a therapeutic rather than diagnostic function. It does not mention any diagnostic capabilities such as imaging, sensing, or analyzing biological data.

No

The device description clearly details a physical, absorbable tack made of synthetic material and a delivery mechanism with a shaft and internal components, indicating it is a hardware device, not software only.

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

Here's why:

  • Intended Use: The intended use is for the "fixation of prosthetic material to soft tissue in various minimally invasive and open surgical procedures such as hernia repair." This describes a surgical device used in vivo (within the body) to physically attach materials.
  • Device Description: The description details a physical device with tacks made of an absorbable material, designed for surgical use.
  • Lack of IVD Characteristics: An IVD device is used in vitro (outside the body) to examine specimens (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. This device does not perform any such analysis of biological specimens.

The information provided clearly indicates a surgical fixation device, not an in vitro diagnostic.

N/A

Intended Use / Indications for Use

The device is intended for fixation of prosthetic material to soft tissue in various minimally invasive and open surgical procedures such as hernia repair.

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

GDW

Device Description

AbsorbaTack™ Absorbable Fixation Devices are sterile single use devices for the fixation of prosthetic material such as hernia mesh to soft tissue. The Tack is constructed of an absorbable synthetic polyester copolymer derived from lactic and glycolic acid and is dyed with D&C violet #2. The device is offered with 5, 10, 15, 20, or 30 tacks.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

soft tissue (in procedures such as hernia repair)

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)

Performance data: There has been no change to the performance specifications of the AbsorbaTack™ Absorbable Fixation Device. The modified design does not change the performance of the device for its intended use.

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.

AbsorbaTack™ Absorbable Fixation Device (K090470)

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

§ 878.4750 Implantable staple.

(a)
Identification. An implantable staple is a staple-like device intended to connect internal tissues to aid healing. It is not absorbable.(b)
Classification. Class II.

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AbsorbaTack™ Absorbable Fixation Device

OCT 2 3 2012 Submitter Information: Name: Surgical Solutions, a global business unit of Covidien Address: 60 Middletown Avenue North Haven, CT 06473 Name of contact person: Renee Borgesano Manager, Regulatory Affairs Covidien Phone: (203) 492-5325 Fax: (203) 492-5029 1219930 Establishment Registration: Date prepared: September 27, 2012 Name of device: Trade or proprietary name: AbsorbaTack™ Absorbable Fixation Device Common or usual name: Absorbable Tack and Applicator Classification name: Implantable Staple Device Classification: Pursuant to 21 CFR 878.4750, this product is a Class II device. Classification panel: General and Plastic Surgery (79) Regulation: 21 CFR 878.4750 Product Code: GDW Reason for 510(k) submission: To obtain premarket clearance for the change in the design of the AbsorbaTack™ Absorbable Fixation Device with no changes in the indications or intended use of the device. Predicate Device(s): AbsorbaTack™ Absorbable Fixation Device (K090470) Device description: AbsorbaTack™ Absorbable Fixation Devices are sterile single use devices for the fixation of prosthetic material such as hernia mesh to soft tissue. The Tack is constructed of an absorbable synthetic polyester copolymer derived from lactic and glycolic acid and is dyed with D&C violet #2. The device is offered with 5, 10, 15, 20, or 30 tacks. Intended use of the device: AbsorbaTack™ Absorbable Fixation Devices are intended for fixation of prosthetic material to soft tissue in various minimally. invasive and open general surgical procedures such as hernia repair. Technological characteristics: AbsorbaTack™ Absorbable Fixation device is similar to the predicate device except for the revised shaft design. The design modifications include adding a flex cable in the inner drive tube of the shaft to allow for continuous rotation if the outer tube is bent to ensure tack deployment, shortening an existing stiffener to reinforce the interface between the outer shaft tube and the body

510(k) Summary of Safety and Effectiveness

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K123109 page 2/2

AbsorbaTack™ Absorbable Fixation Device

halves, and extending the spring up the entire length of the outer shaft tube that is outside of the body halves.

Material characteristics: Devices are comprised of materials which have been evaluated in accordance with ISO 10993-1: 2003, Biological Evaluation of medical devices – Part 1, Evaluation and Testing and is identical to the predicate device. No new materials are introduced in the proposed device.

Performance data: There has been no change to the performance specifications of the AbsorbaTack™ Absorbable Fixation Device. The modified design does not change the performance of the device for its intended use.

2

Image /page/2/Picture/1 description: The image shows the seal of the Department of Health & Human Services - USA. The seal is circular and contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is an abstract symbol that resembles a stylized caduceus or a representation of human figures.

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

OCT 23 2012

Covidien % Ms. Renee Borgesano Manager, Regulatory Affairs 60 Middletown Avenue North Haven, Connecticut 06473

Re: K123109

Trade/Device Name: ABSORBATACK™ Absorbable Fixation Device Regulation Number: 21 CFR 878.4750 Regulation Name: Implantable staple Regulatory Class: Class II Product Code: GDW Dated: October 03, 2012 Received: October 04, 2012

Dear Ms. Borgesano:

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 (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set

3

Page 2 - Ms. Renee Borgesano

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/Resourcesfor You/Industry/default.htm.

Sincerely yours,

cerely yours,

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

Enclosure

4

Indications for Use

510(k) Number (if known): K123109

ABSORBATACK™ Absorbable Fixation Device Device Name:

Indications For Use:

The device is intended for fixation of prosthetic material to soft tissue in various minimally invasive and open surgical procedures such as hernia repair.

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

(Division Sign-Off)
Division of Surgical, Orthopedic,
and Restorative Devices

510(k) Number K123109
: