K Number
K130611
Device Name
ENTUIT THRIVE BALLOON RETENTION GASTROSTOMY FEEDING TUBE
Date Cleared
2013-12-19

(287 days)

Product Code
Regulation Number
876.5980
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube is intended to provide gastric access for enteral feeding, medication and decompression through an established gastrointestinal stoma tract. The Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube is indicated for use in percutaneous placement of an enteral feeding tube in adult and pediatric patients that require enteral feeding, medication administration or decompression through an established gastrointestinal stoma tract.
Device Description
The Entuit The Thrive Balloon Retention Gastrostony Feeding Tube is constructed primarily of silicone. The device consists of a tri-port funnel which is overmolded onto a previously extruded bi-lumen shaft. A retention bolster is molded separately and placed over the shall. At the proximal end, a silicone balloon is bonded to the shaft using silicone RTV. The tip of the shaft is filled with radiopaque barium RTV. In use, the balloon end of the catheter is inserted through a gastrointestinal stoma tract and into the stomach lumen. The balloon is then inflated to the rated volume using sterile or distilled water and the bolster adjusted down to the skin to secure the device in place.
More Information

Not Found

No
The device description and performance studies focus on the physical properties and mechanical performance of a silicone feeding tube, with no mention of AI or ML.

No
The device is a feeding tube used for administering enteral feeding, medication, or decompression; it does not directly treat a disease or condition.

No

This device is described as a feeding tube, used for enteral feeding, medication administration, and decompression through an established stoma tract. Its function is to provide access and deliver substances, not to diagnose medical conditions.

No

The device description clearly states it is constructed primarily of silicone and includes physical components like a tri-port funnel, shaft, retention bolster, and balloon. This indicates it is a physical medical device, not software-only.

Based on the provided information, 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 the body (in vitro).
  • Device Function: The Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube is a device that is inserted into the body to provide a pathway for feeding, medication, or decompression. It is a therapeutic or supportive device, not a diagnostic one.
  • Intended Use: The intended use clearly states it's for providing gastric access for enteral feeding, medication, and decompression. This is a functional purpose within the body, not a diagnostic test on a sample.
  • Device Description: The description details the physical components and how it's used for insertion and securing within the stomach. There is no mention of analyzing samples or performing diagnostic tests.

Therefore, the Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube falls under the category of a medical device but not specifically an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube is intended to provide gastric access for enteral feeding, medication and decompression through an established gastrointestinal stoma traci.

The Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube is indicated for use in perculaneous placement of an enteral feeding tube in adult and pediatric patients that require enteral feeding, medication administration or decompression through an established gastrointestinal stoma tract.

Product codes

KNT

Device Description

The Entuit The Thrive Balloon Retention Gastrostony Feeding Tube is constructed primarily of silicone. The device consists of a tri-port funnel which is overmolded onto a previously extruded bi-lumen shaft. A retention bolster is molded separately and placed over the shall. At the proximal end, a silicone balloon is bonded to the shaft using silicone RTV. The tip of the shaft is filled with radiopaque barium RTV. In use, the balloon end of the catheter is inserted through a gastrointestinal stoma tract and into the stomach lumen. The balloon is then inflated to the rated volume using sterile or distilled water and the bolster adjusted down to the skin to secure the device in place.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

gastric, gastrointestinal stoma tract

Indicated Patient Age Range

adult and pediatric patients

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 following performance testing was conducted for the Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube: Flow rate, Balloon Burst Volume, Balloon Volume Maintenance, Balloon Concentricity, Balloon Over Shaft Size, Balloon Integrity, and Balloon Integrity in simulated gastric fluid. All tests were performed in accordance to ASTM F2528-06 (Procedures A through G). The candidate device met all performance requirements. Where acceptance criteria were not defined in the standard, the candidate device performed equivalent to or better than the predicate device. In all instances the Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube performed as intended.

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

Not Found

Predicate Device(s)

K083684

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.5980 Gastrointestinal tube and accessories.

(a)
Identification. A gastrointestinal tube and accessories is a device that consists of flexible or semi-rigid tubing used for instilling fluids into, withdrawing fluids from, splinting, or suppressing bleeding of the alimentary tract. This device may incorporate an integral inflatable balloon for retention or hemostasis. This generic type of device includes the hemostatic bag, irrigation and aspiration catheter (gastric, colonic, etc.), rectal catheter, sterile infant gavage set, gastrointestinal string and tubes to locate internal bleeding, double lumen tube for intestinal decompression or intubation, feeding tube, gastroenterostomy tube, Levine tube, nasogastric tube, single lumen tube with mercury weight balloon for intestinal intubation or decompression, and gastro-urological irrigation tray (for gastrological use).(b)
Classification. (1) Class II (special controls). The barium enema retention catheter and tip with or without a bag that is a gastrointestinal tube and accessory or a gastronomy tube holder accessory is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I (general controls) for the dissolvable nasogastric feed tube guide for the nasogastric tube. The class I device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 876.9.

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K130611 pg 1 of 3

Image /page/0/Picture/1 description: The image shows the word "xeridiem" with a circular logo to the left of the word. The logo is a circle with two arrows pointing in opposite directions. The word "xeridiem" is in a bold, sans-serif font. There is a registered trademark symbol to the right of the word.

DEC 1 9 2013

510(k) Summary

As required by 21 CFR 807.92, this "510(k) Summary" provides a basis for the substantial equivalence determination of the device listed below.

General Information

Date Prepared:April 5, 2013
Submitter Name:Xeridiem Medical Devices
[formerly Manufacturing and Research, Inc.]
Submitter Address:4700 S. Overland Dr.
Tucson, Az 85714
Contact Person:Michelle Lott, RAC
Phone Number:(520) 882-7794
Fax Number:(520) 882-6894

Device Information

Trade Name:Entuit TM Thrive Balloon Retention Gastrostomy Feeding Tube
Common Name:Gastrostomy Tube
Classification Name:Tubes, gastrointestinal (and accessories)
[21 CFR 876.5980, Product Code KNT]
Classification Panel:Gastroenterology/Urology

Predicate Device Information

Trade Name:EndoVive™ Standard Replacement Gastrostomy Tube (K083684)
Common Name:Gastrostomy Tube
Classification Name:Tubes, gastrointestinal (and accessories)
[21 CFR 876.5980, Product Code KNT]
Classification Panel:Gastroenterology/Urology

Device Description

The Entuit The Thrive Balloon Retention Gastrostony Feeding Tube is constructed primarily of silicone. The device consists of a tri-port funnel which is overmolded onto a previously extruded bi-lumen shaft. A retention bolster is molded separately and placed over the shall. At the proximal end, a silicone balloon is bonded to the shaft using silicone RTV. The tip of the shaft is filled with radiopaque barium RTV. In use, the balloon end of the catheter is inserted through a gastrointestinal stoma tract and into the stomach lumen. The balloon is then inflated to the rated volume using sterile or distilled water and the bolster adjusted down to the skin to secure the device in place.

Entuit Thrive Balloon Retention Gastrostomy Feeding Tube Xeridiem 510(k) Application - K130611 Appendix B Page 1 of 3

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K130611 pg 2 of 3

Image /page/1/Picture/1 description: The image contains the word "xeridiem" in a stylized font, with a circled R symbol next to the word. To the left of the word is a circular graphic with a white center and a black border. The text is in black and the background is white. The image appears to be a logo.

Intended Use/Indications for Use

The Entuil™ Thrive Balloon Retention Gastrostomy Feeding Tube is intended to provide gastric access for enteral feeding, medication and decompression through an established gastrointestinal stoma traci.

The Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube is indicated for use in perculaneous placement of an enteral feeding tube in adult and pediatric patients that require enteral feeding, medication administration or decompression through an established gastrointestinal stoma tract.

Technological Characteristics

The table below provides a general summary of the technological characteristics of the Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube compared to the predicate device.

Technological Characteristics
EntuitTM Thrive Balloon
Retention Gastrostomy Feeding
Tube (Submitted device)EndoViveTM Standard
Replacement Gastrostomy Tube
(Predicate Device)
K083684
Product Range
(FR size)12 - 24 FR12 - 28 FR
Product Range
(Length)10 cm10 cm
Product Range
(Balloon Size)5 cc for 12 - 18 FR devices
20cc for 20 - 24 FR devices4 cc for 12 FR device
6 cc for 14 - 28 FR devices
FunnelSimilar - Silicone with 3 ports: one for feeding, one for medication and the other for balloon inflation. Adapter added to medication port plug.Silicone with 3 ports: one for feeding, one for medication and the other for balloon inflation
BolsterSilicone 40 durometer in straight configuration - different bolster profileSilicone 60 durometer in two configurations: one straight and one right angle
Inflation valveSimilar - Thermoplastic housing with silicone valve (low profile valve)Thermoplastic housing with silicone valve
BalloonSame materials as K083684, different balloon profileSilicone pancake shaped balloon
ShaftSame as K083684Silicone 65 durometer
Barium stripeBarium sulfate without colorantBarium sulfate with blue colorant
Kit ContentsNo accessory devices included with deviceInflation syringe, gauze and lubricating jelly
Packaging System/MaterialsSame as K083684Tyvek Pouch. Polybag. IFU, Corrugate Case & Shipper

Entuit TM Thrive Balloon Retention Gastrostomy Feeding Tube Xeridiem 510(k) Application - K130611 Appendix B Page 2 of 3

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K130611

pg 3 of 3

Performance Characteristics

The table below provides a general summary of the performance testing that was conducted for the Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube.

TestMethodConclusion
-Flow rate
-Balloon Burst Volume
-Balloon Volume Maintenance
-Balloon Concentricity
-Balloon Over Shaft Size
-Balloon Integrity
-Balloon Integrity in simulated gastric fluidAll in accordance to ASTM
F2528-06
(Procedures A through G)Candidate device met all
performance requirements.
Where acceptance criteria
were not defined in the
standard, the candidate device
performed equivalent to or
better than the predicate
device.

Test Method Conclusion

In all instances the Entuit ™ Thrive Balloon Retention Gastrostomy Feeding Tube performed as intended.

Substantial Equivalence - Comparison to Predicate Device

Among the information and summary tables presented in the 510(k) submission to support substantial equivalence of the Entuit ™ Thrive Balloon Retention Gastrostomy Feeding Tube to the legally marketed predicate device are: 1.) device description, 2.) indications for use, 3.) device comparison tables, 4.} material information, 5.) bench test results, and 6.) labeling. In particular, bench testing demonstrates that there was no difference in the performance, safety, or effectiveness between the Fintuit 11 Thrive Balloon Retention Gastrostomy Feeding Tube and the EndoVive " Standard Replacement Gastrostomy Tube.

The Entuit "M Thrive Balloon Relention Gastrostomy Feeding Tube is substantially equivalent to the EndoVive™ Standard Replacement Gastrostomy Tube (K083684).

The subject device and predicate device have the same intended use and similar indications. (echnological characteristics and principles of operation. The minor differences in technological characteristics have been identified and do not present any new issues of safety or effectiveness. Thus, the Entuit ™ Thrive Balloon Retention Gastrostomy Feeding Tube is substantially equivalent to the Endo Vive " Standard Replacement Gastrostomy Tube (K083684).

Entuit 7M Thrive Balloon Retention Gastrostomy Feeding Tube Xeridiem 510(k) Application - K130611 Appendix B Page 3 of 3

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with its wings spread, and the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle. The logo is black and white.

Public Health Service

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

December 19, 2013

Xeridiem Medical Devices . Michelle Lott RA/QA Director, RAC 4700 S. Overland Drive Tucson, AZ 85714

Re: K130611

Trade/Device Name: Entuit™ Thrive Balloon Retention Gastronomy Feeding Tube Regulation Number: 21 CFR& 876.5980 Regulation Name: Gastrointestinal tube and accessories Regulatory Class: II Product Code: KNT Dated: November 27, 2013 Received: November 29, 2013

Dear Michelle Lott,

. .

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

4

Page 2 - Michelle Lott

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/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,

Glenn Bell-S

for

Benjamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure


5

Image /page/5/Picture/0 description: The image shows the logo for Xeridiem Medical Devices. The logo consists of a circular symbol with arrows pointing inward, followed by the company name "xeridiem" in a bold font, with the words "MEDICAL DEVICES" underneath in a smaller font. Below the logo is the company's address, which is 4700 South Overland Drive, Tucson, Arizona 85714, along with their phone number 520-882-7794 and website www.xeridiem.com.

Indications for Use

510(k) Number (if known): K130611

Device Name: Entuit TM Thrive Balloon Retention Gastrostomy Feeding Tube

Indications For Use:

The Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube is intended to provide gastric access for enteral feeding; medication and decompression through an established gastrointestinal stoma tract.

The Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube is indicated for use in percutaneous placement of an enteral feeding tube in adult and pediatric patients that require enteral feeding, medication administration or decompression through an established gastrointestinal stoma tract.

Prescription Use AND/OR Over-The-Counter Use X = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = (21 CFR 801 Subpart C) (Part 21 CFR 801 Subpart D)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Glenn B. Bell -S

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