K Number
K130674
Device Name
ENTUIT THRIVE LP BALLOON RETENTION GASTROSTOMY FEEDING TUBE
Date Cleared
2014-01-13

(306 days)

Product Code
Regulation Number
876.5980
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Entuit The Thrive Balloon Retention Gastrostomy Feeding Tube is indicated in adult and pediations for use in percutaneous placement of an Enteral feeding tube for feeding tube feeding and/or administration of medication in conjunction with an established GI stoma to act The replacement tube may also be used for gastric decompression.
Device Description
The Entuit™ Thrive I.P Balloon Retention Gastrostomy Feeding Tube is constructed primarily of silicone. The low profile device consists of a hub which is overmolded onto a previously extruded bilumen shaft. At the proximal end, a silicone balloon is bonded to the shaft using a 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 with 5mL sterile or distilled water to secure the device in place. Accessories for the Low Profile device include two extension set configurations, an inflation syringe, a catheter tip syringe, gauzes and a stoma measuring device to facilitate device placement and use.
More Information

Not Found

No
The document describes a mechanical feeding tube and its accessories, with no mention of AI or ML technology.

Yes

The device is a feeding tube used for administering nutrition and medication, which directly aligns with the definition of a therapeutic device as it provides treatment or management for a medical condition.

No

This device is a feeding tube designed for administering nutrition and medication, and for gastric decompression. It does not perform any diagnostic functions.

No

The device description explicitly states it is constructed primarily of silicone and includes physical components like a hub, shaft, balloon, and accessories. It also details bench testing of physical properties.

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

Here's why:

  • Intended Use: The intended use is for "percutaneous placement of an Enteral feeding tube for feeding tube feeding and/or administration of medication in conjunction with an established GI stoma" and "gastric decompression." This describes a device used in vivo (within the body) for delivering substances or removing contents from the stomach.
  • Device Description: The description details a physical tube inserted into the body, not a reagent, instrument, or system intended for use in vitro (outside the body) for the examination of specimens derived from the human body.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, detecting analytes, or providing diagnostic information based on laboratory testing.

Therefore, the Entuit The Thrive Balloon Retention Gastrostomy Feeding Tube is a medical device used for therapeutic and supportive purposes, not for in vitro diagnosis.

N/A

Intended Use / Indications for Use

Entuit ™ Thrive LP Balloon Retention Gastrostomy Feeding Tube is indicated in adult and pediatric populations for use in percutaneous placement of an enteral feeding and/or administration of medication in conjunction with an established gastrointestinal stoma tract. The replacement tube may also be used for gastric decompression.

Product codes

KNT

Device Description

The Entuit™ Thrive I.P Balloon Retention Gastrostomy Feeding Tube is constructed primarily of silicone. The low profile device consists of a hub which is overmolded onto a previously extruded bilumen shaft. At the proximal end, a silicone balloon is bonded to the shaft using a 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 with 5mL sterile or distilled water to secure the device in place. Accessories for the Low Profile device include two extension set configurations, an inflation syringe, a catheter tip syringe, gauzes and a stoma measuring device to facilitate device placement and use.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

gastrointestinal stoma tract

Indicated Patient Age Range

adult and pediatric populations

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

Test:
-Flow rate
-Balloon Burst Volume
-Balloon Volume Maintenance
-Balloon Concentricity
-Balloon Over Shaft Size
-Balloon Integrity
-Balloon Integrity in simulated gastric fluid

Method: All in accordance to ASTM F2528-06 (Procedures A through G)

Conclusion: 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 LP Balloon Retention Gastrostomy Feeding Tube performed as intended.

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

Not Found

Predicate Device(s)

K083685

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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Image /page/0/Picture/1 description: The image shows the word "xeridiem" in a bold, serif font. To the left of the word is a circular logo with four curved shapes pointing inward. A small registered trademark symbol is located to the right of the word.

JAN 13 2014

:

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:February 26, 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™ Thrive LP Balloon Retention Gastrostomy Feeding Tube
Common Name:Gastrostomy Tube Kit (low profile)
Classification Name:Tubes, gastrointestinal (and accessories) [21 CFR 876.5980, Product Code KNT]
Classification Panel:Gastroenterology/Urology

Predicate Device Information

Trade Name:EndoVive™ Low Profile Replacement Gastrostomy Tube (K083685)
Common Name:Gastrostomy Tube Kit (low profile)
Classification Name:Tubes, gastrointestinal (and accessories)
[21 CFR 876.5980, Product Code KNT]
Classification Panel:Gastroenterology/Urology

Device Description

The Entuit™ Thrive I.P Balloon Retention Gastrostomy Feeding Tube is constructed primarily of silicone. The low profile device consists of a hub which is overmolded onto a previously extruded bilumen shaft. At the proximal end, a silicone balloon is bonded to the shaft using a 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 with 5mL sterile or distilled water to secure the device in place. Accessories for the Low Profile device include two extension set configurations, an inflation syringe, a catheter tip syringe, gauzes and a stoma measuring device to facilitate device placement and use.

============================================================================================================================================================================== Entuit ™ Thrive LP Balloon Retention Gastrostomy Feeding Tube Xeridiem Special 510(k) Application Appendix B Page 1 of 3

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Image /page/1/Picture/1 description: The image shows the word "xeridiem" with a circled R symbol next to it. To the left of the word is a circular symbol with arrows pointing in a circular direction. The text is in a bold, sans-serif font.

Intended Use/Indications for Use

Entuit ™ Thrive LP Balloon Retention Gastrostomy Feeding Tube is indicated in adult and pediatric populations for use in percutaneous placement of an enteral feeding and/or administration of medication in conjunction with an established gastrointestinal stoma tract. The replacement tube may also be used for gastric decompression.

Technological Characteristics

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

Technological Characteristics
EntuitTM Thrive LP Balloon
Retention Gastrostomy Feeding
Tube (Submitted device)EndoViveTM Low Profile
Replacement Gastrostomy Tube
(Predicate Device)
K083685
Product Range
(FR size)12 - 24 FR12 - 28 FR
Product Range
(Length)0.8 - 5.0 cm1.0 - 5.5 cm
Product Range
(Balloon Size)5 cc for all FR sizes4 cc for 12 FR device
6 cc for 14 - 28 FR devices
HubSame as K083685Silicone with 2 ports: one for
feeding and the other for balloon
inflation
Inflation valveSame as K083685Thermoplastic housing with
silicone valve
BalloonSame materials as K083685,
different balloon profileSilicone balloon
Reflux (feeding)
valveThermoplastic housing with
silicone valve - different profile as
K083685Thermoplastic housing with
silicone valve
ShaftSilicone 65 duroSilicone 60 duro
Barium stripeBarium sulfateBarium sulfate with blue colorant
Kit ContentsInflation syringe, feeding syringe,
gauze, Bolus Extension Set,
Continuous Extension SetInflation syringe, feeding syringe,
gauze, lubricating jelly, Bolus
Feeding Set, Continuous Feeding
Set
Packaging
System/MaterialsSame as K083685Tyvek Pouch, Polybag, IFU,
Corrugate Case & Shipper

2

Performance Characteristics

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

Test Method Conclusion

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.

In all instances the Entuit ™ Thrive LP 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 LP Balloon Retention Gastrostomy Feeding Tube to the legally marketed predicate device are: 1.) device description, 2.) indications for use, 3.) device compaging tables, 4.) material information, 5.) bench test results, and 6.) labeling. In particular, bench testing democrates that there was no difference in the performance, safety, or effectiveness between the Entuisitation Balloon Retention Gastrostomy Feeding Tube and the Endo Vive™ Low Profile Replacement Gastrostomy Tube.

The Entuit ™ Thrive LP Balloon Retention Gastrostomy Feeding Tube is substantially equivalent to the EndoVive™ Low Profile Replacement Gastrostomy Tube (K083685)

The subject device and predicate device have the same intended use and similar indications, technological characteristics and principles of operation. The minor differences in technological characteritics have been identified and do not present any new issues of safety or effectiveness. Thus, the ve LP Balloon Retention Gastrostomy Feeding Tube is substantially equivalent to the EndoVive™ Low Profile Replacement Gastrostomy Tube (K083685).

Entuit "M Thrive LP Balloon Retention Gastrostomy Feeding Tube Xeridiem Special 510(k) Application Appendix B Page 3 of 3

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

January 13, 2014

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

K130674 Re:

Trade/Device Name: Entuit™ Thrive Balloon Retention Gastrostomy Feeding Tube Regulation Number: 21 CFR§ 876.5980 Regulation Name: Gastrointestinal tube and accessories Regulatory Class: II Product Code: KNT Dated: December 3, 2013 Received: December 6, 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.

4

Page 2 - Michelle Lott

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 (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/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/ResourcesforYou/Industry/default.htm.

Sincerely yours.

Image /page/4/Picture/7 description: The image shows the name "Benjamin Fisher-S" in a bold, sans-serif font. The letters are black against a white background. The letters "FDA" are in the middle of the name, with a logo around them.

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

Indications for Use

510(k) Number (if known): K130674

Device Name: Entuit ™ Thrive Balloon Retention Gastrostomy Feeding Tube

Indications For Use:

The Entuit The Thrive Balloon Retention Gastrostomy Feeding Tube is indicated in adult and pediations for use in percutaneous placement of an Enteral feeding tube for feeding tube feeding and/or administration of medication in conjunction with an established GI stoma to act The replacement tube may also be used for gastric decompression.

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

Benjamin R. Fisher -S
2014.01.13 15:29:18 -05'00'

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