K Number
K131282
Device Name
NEXUS HEMORRHOID LIGATOR
Manufacturer
Date Cleared
2013-07-11

(66 days)

Product Code
Regulation Number
876.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The inx Medical Nexus™ Hemorrhoid Ligator includes suction and ligation capabilities. The ligator is used to cut off the blood flow to hemorrhoidal tissue by means of a ligature or ring placed around the hemorrhoid base. It is for use only by trained medical personnel in hospitals, clinics, and doctors' offices.
Device Description
The inx Medical Nexus™ Hemorrhoid Ligator is a simple handheld device which allows the user to hold the hemorrhoid tissue with an applied suction while slipping a ligation band around the tissue. The inx Medical Nexus™ Hemorrhoid Ligator is a disposable device for the rubber band ligation of hemorrhoids. It is for single use only and is supplied with preloaded non-latex rubber bands.
More Information

No
The device description and performance studies focus on mechanical function and material properties, with no mention of AI or ML.

Yes.
The device is used to cut off the blood flow to hemorrhoidal tissue, which is a treatment for hemorrhoids.

No

The device is described as a "Hemorrhoid Ligator" used with "suction and ligation capabilities" to "cut off the blood flow to hemorrhoidal tissue by means of a ligature or ring placed around the hemorrhoid base." This indicates it is a therapeutic device, not a diagnostic one.

No

The device is described as a "simple handheld device" and a "disposable device" with "suction and ligation capabilities" and "preloaded non-latex rubber bands." This clearly indicates a physical hardware device, not software.

Based on the provided information, the inx Medical Nexus™ Hemorrhoid Ligator 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 (like blood, urine, or tissue) to detect diseases, conditions, or infections.
  • Device Function: The inx Medical Nexus™ Hemorrhoid Ligator is a surgical device used to physically ligate (tie off) hemorrhoidal tissue. It directly interacts with the patient's body to perform a procedure, rather than analyzing a sample taken from the body.
  • Intended Use: The intended use clearly states it's used to "cut off the blood flow to hemorrhoidal tissue by means of a ligature or ring placed around the hemorrhoid base." This is a therapeutic procedure, not a diagnostic test.
  • Device Description: The description reinforces that it's a "simple handheld device which allows the user to hold the hemorrhoid tissue with an applied suction while slipping a ligation band around the tissue." This describes a surgical tool.

The device is a medical device, but it falls under the category of surgical or therapeutic devices, not in vitro diagnostics.

N/A

Intended Use / Indications for Use

The inx Medical Nexus™ Hemorrhoid Ligator includes suction and ligation capabilities. The ligator is used to cut off the blood flow to hemorrhoidal tissue by means of a ligature or ring placed around the hemorrhoid base.

It is for use only by trained medical personnel in hospitals, clinics, and doctors' offices.

Patient Population: Individuals with hemorrhoids

Product codes

FHN

Device Description

The inx Medical Nexus™ Hemorrhoid Ligator is a simple handheld device which allows the user to hold the hemorrhoid tissue with an applied suction while slipping a ligation band around the tissue.

The inx Medical Nexus™ Hemorrhoid Ligator is a disposable device for the rubber band ligation of hemorrhoids. It is for single use only and is supplied with preloaded non-latex rubber bands.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

hemorrhoidal tissue

Indicated Patient Age Range

Not Found

Intended User / Care Setting

trained medical personnel in hospitals, clinics, and doctors' offices.

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)

Non-clinical Testing Summary -
Drop

  • Standard test method of free fall per ISO 60068-2-32 .
  • Pass / fail criteria is that the device works
  • Discussion The proposed device passed the free fall testing. .

Environmental (Hot / Cold / Humidity Exposure)

  • Standard test methods for exposure followed the listed procedures
  • MIL-STD-810G Method 501.5, Procedure 1 (60℃ High Temperature Test 0 Storage)
  • MIL-STD-810G Method 502.5, Procedure I (-20℃ Cold Temperature Test o Storage)
  • MIL-STD-810G Method 506.5, Procedure 1 (Humidity Test Storage) o
  • Pass / fail criteria was that they would meet the performance specifications.
  • Discussion - The proposed device met the performance specifications after being exposed to the various conditions.

Biocompatibility of Materials -

  • Materials are identical to the predicate Haemoband Multi-Ligator (K091519). .
  • Parts which are Surface communicating, Mucosal contact, limited duration which o would be Ligator components.
  • Parts which are Surface communicating, Mucosal contact, and prolonged duration o would be the ligator bands.
  • Discussion All materials which are in patient contact are identical to the predicate . ● Haemoband Multi-Ligator (K091519).

Suction Applied -

  • Bench testing was performed to measure the applied vacuum generated by the device . which was compared to the predicate O'Regan device.
  • Discussion The vacuum generated was determined to be equivalent to the predicate ● O'Regan - O'Regan Ligator (K963166).

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

Not Found

Predicate Device(s)

K091519, K963166

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.4400 Hemorrhoidal ligator.

(a)
Identification. A hemorrhoidal ligator is a device used to cut off the blood flow to hemorrhoidal tissue by means of a ligature or band placed around the hemorrhoid.(b)
Classification. Class II (special controls). Except for a hemostatic metal clip intended for use in the gastrointestinal tract, the device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.

0

JUL 1 1 2013

Premarket Notification 510(k) Section 5 - 510(k) Summary

inx Medical

510(k) Summary Page I of 5

Date prepared:3-May-13
inx Medical
1819 Clarkson Rd., Suite #206
Chesterfield, MO 63017Tel - 636-333-1010
Fax - 636-333-1011
Official Contact:James L. Vermeersch - President & CEO
Proprietary or Trade Name:Nexus™ Hemorrhoid Ligator
Common/Usual Name:Hemorrhoidal ligators
Classification Name/Code:78 FHN - hemorrhoidal ligators
CFR 876.4400, Class II
Device:Multi-Ligator
Predicate Devices:K091519 - Haemoband - Multi-Ligator
K963166 - O'Regan - O'Regan Ligator

Device Description:

The inx Medical Nexus™ Hemorrhoid Ligator is a simple handheld device which allows the user to hold the hemorrhoid tissue with an applied suction while slipping a ligation band around the tissue.

The inx Medical Nexus™ Hemorrhoid Ligator is a disposable device for the rubber band ligation of hemorrhoids. It is for single use only and is supplied with preloaded non-latex rubber bands.

Indications for Use:

The inx Medical Nexus™ Hemorrhoid Ligator includes suction capabilities. The ligator is used to cut off the blood flow to hemorrhoidal tissue by means of a ligature or ring placed around the hemorrhoid base.

It is for use only by trained medical personnel located in hospitals, clinics, and doctors' offices.

Patient Population: Individuals with hemorrhoids

Environment of Use: Hospitals, clinics, and doctors' offices.

Contraindications

Do not use to treat:

  • . Anal polyps
  • Grade IV hemorrhoids ●
  • Patients with perineal infection .

1

inx Medical

510(k) Summary Page 2 of 5 3-May-13

  • Patients with perineal Crohn's Dz .
  • Patients with portal hypertension .
  • Use with caution when treating patients on anticoagulants i.e. Warfarin .

Predicate Device Comparison:

The inx Medical Nexus Hemorrhoid Ligator is viewed as substantially equivalent to the predicate devices because:

Indications -

  • The ligator is used to cut off the blood flow to hemorrhoidal tissue by means of a ligature or ring placed around the hemorrhoid base.
  • . Discussion - The indications for use are identical to the predicates Haemoband Multi-Ligator (K091519) and O'Regan - O'Regan Ligator (K963166)

Technology and Mode of Operation -

  • The internal mechanism for holding and banding the ligator bands is identical to the ♥ predicate Haemoband Multi-Ligator (K091519)
  • The incorporation of an internal suction / vacuum source is equivalent to the predicate . O'Regan - O'Regan Ligator (K963166)
  • Mode of operation that is banding hemorrhoidal tissue is identical to the predicates -. Haemoband Multi-Ligator (K091519) and O'Regan - O'Regan Ligator (K963166)
  • Discussion The technology and mode operation are identical to the combined predicates. .

Materials -

  • The materials in patient contact are identical to predicate device Haemoband Multi-Ligator . (K091519)
  • Discussion The materials are identical to the predicate. ♥

Environment of Use -

  • Identical to predicate Haemoband Multi-Ligator (K091519) and O'Regan O'Regan . Ligator (K963166)
  • . Discussion - The environments of use are identical to the predicates.

Differences -

There are no differences between the predicates and the proposed device which would raise any new safety or risks and thus can be found to be substantially equivalent,

2

K131282
Page 3 of 5

.

inx Medical

remarket Notification 510(

510(k) Summary

510(k) ManufacturerProposed DevicePredicate Device
Device NameNexus™ Hemorrhoid LigatorHaemoband
Multi-LigatorO'Regan Ligator
O'Regan
Product CodeFHNK091519K963166
CFR876.4400876.4400876.4400
Indications for UseThe inx Medical Nexus™ Hemorrhoid Ligator includes suction and ligation capabilities. The ligator is used to cut off the blood flow to hemorrhoidal tissue by means of a ligature or ring placed around the hemorrhoid base.The Haemoband Multi-Ligator includes suction and ligation capabilities. The ligator is used to cut off the blood flow to hemorrhoidal tissue by means of a ligature or ring placed around the hemorrhoid base.Hemorrhoidal ligators are used to cut off the blood flow to hemorrhoidal tissue by means of a ligature or ring placed around the hemorrhoid base.
Environment of UseHospitals, clinics, and doctors' offices.Hospitals, clinics, and doctors' offices.Hospitals, clinics, and doctors' offices.
PrescriptiveYes, for use by trained medical personnelYes, for use by trained medical personnelYes, for use by trained medical personnel
Principle of OperationApply a ligature or elastic ring around the base of the hemorrhoidal nodule in order to cut off the blood flow to the hemorrhoidal tissue. Has an internal means to apply suction to hold the hemorrhoidal tissue prior to and during the ligature procedure. Pre-loaded bands in a pistol handgrip with trigger to apply suction and release the banding ringApply a ligature or elastic ring around the base of the hemorrhoidal nodule in order to cut off the blood flow to the hemorrhoidal tissue. Has a means to apply suction to hold the hemorrhoidal tissue prior to and during the ligature procedure. Pre-loaded bands in a pistol handgrip with trigger to apply suction and release the banding ringApply a ligature or elastic ring around the base of the hemorrhoidal nodule in order to cut off the blood flow to the hemorrhoidal tissue. Has a manual means to apply suction to hold the hemorrhoidal tissue prior to and during the ligature procedure.
Method of suctionManually via an internal syringe type method to generate suctionConnected to an external vacuum sourceManually via a syringe type method to generate suction
510(k) Manufacturer
Device NameProposed DevicePredicate Device
Procedure optionsNexus™ Hemorrhoid Ligator
With or without the use of a proctoscopeK091519
Haemoband
Multi-Ligator
With or without the use of a proctoscopeK963166
O'Regan
O'Regan Ligator
With or without the use of a proctoscope
Number of ligation bands pre-loaded3-43-4Not specified
DisposableSingle patient use, disposableSingle patient use, disposableSingle patient use, disposable
Material biocompatibilityMaterials identical to K091519Identified and cleared in K091519N/A
Auto reloadYesYesNo
Non-clinical Performance TestingEnvironmental conditions
Mechanical Drop test
Ligator release and reload
Vacuum / suction generatedEnvironmental conditions
Mechanical Drop test
Ligator release and reloadVacuum / suction generated
StandardsNone under section 514None under section 514None under section 514

PDF Page 29 of 114

Page 5.3

3

K131282
Page 4 of 5

inx Medical

Premarket Notification 510(k)
Section 5 - 510(k) Summary

510(k) Summary

Page 5.4 PDF Page 30 of 114

4

510(k) Summary

Page 5 of 5 3-May-13

Non-clinical Testing Summary -

We have performed a number of tests appropriate for the proposed device. These tests include:

Drop

.

.

  • Standard test method of free fall per ISO 60068-2-32 .
  • . Pass / fail criteria is that the device works
  • Discussion The proposed device passed the free fall testing. .

Environmental (Hot / Cold / Humidity Exposure)

  • Standard test methods for exposure followed the listed procedures
    • MIL-STD-810G Method 501.5, Procedure 1 (60℃ High Temperature Test 0 Storage)
      • MIL-STD-810G Method 502.5, Procedure I (-20℃ Cold Temperature Test o Storage)
    • MIL-STD-810G Method 506.5, Procedure 1 (Humidity Test Storage) o
  • Pass / fail criteria was that they would meet the performance specifications.
  • . Discussion - The proposed device met the performance specifications after being exposed to the various conditions.

Biocompatibility of Materials -

  • Materials are identical to the predicate Haemoband Multi-Ligator (K091519). .
    • Parts which are Surface communicating, Mucosal contact, limited duration which o would be Ligator components.
    • Parts which are Surface communicating, Mucosal contact, and prolonged duration o would be the ligator bands.
  • Discussion All materials which are in patient contact are identical to the predicate . ● Haemoband Multi-Ligator (K091519).

Suction Applied -

  • Bench testing was performed to measure the applied vacuum generated by the device . which was compared to the predicate O'Regan device.
  • Discussion The vacuum generated was determined to be equivalent to the predicate ● O'Regan - O'Regan Ligator (K963166).

Substantial Equivalence Conclusion -

The sponsor has demonstrated through performance testing, design and features, and non-clinical testing that the proposed device and predicate have been found to substantially equivalent.

5

Public Health Service

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

July 11, 2013

inx Medical % Paul E. Dryden President ProMedic. Inc. 1819 Clarkson Rd., Suite #206 Chesterfield, MO 63017

Re: K131282

Trade/Device Name: Nexus™ Hemorrhoid Ligator Regulation Number: 21 CFR§ 876.4400 Regulation Name: Hemorrhoidal ligator Regulatory Class: II Product Code: FHN Dated: May 15, 2013 Received: May 16, 2013

Dear Paul E. Dryden:

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.

6

Page 2 - Paul E. Dryden

You must comply with all the Act's requirements, including, but not limited to: registration and I va mact och pr . mart 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements model. ab its 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 115809.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 yours,

Benjamin Fisher -S

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

Enclosure

7

Indications for Use Statement

Page 1 of 1

510(k) Number:

K131282 (To be assigned)

Nexus™ Hemorrhoid Ligator Device Name:

Indications for Use:

The inx Medical Nexus™ Hemorthoid Ligator includes suction and ligation capabilities. The ligator is used to cut off the blood flow to hemorrhoidal tissue by means of a ligature or ring placed around the hemorrhoid base.

It is for use only by trained medical personnel in hospitals, clinics, and doctors' offices.

Prescription Use XXorOver-the-counter use
(Part 21 CFR 801 Subpart D)(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)

Beniamin 2013.07.

(Division Sign-Off) Division of Reproductive, Gastro-Renal, and Urological Devices K131282 510(k) Number

PDF Page 26 of 114

Page 4.2