K Number
K140972
Device Name
UNIPOLAR PEDIATRIC TEMPORARY PACING LEAD, UNIPOLAR TEMPORARY ATRIAL PACING LEAD, UNIPOLAR TEMPORARY MYOCARDIAL PACING
Manufacturer
Date Cleared
2014-06-06

(51 days)

Product Code
Regulation Number
870.3680
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Streamline 1 Temporary Pacing Leads are indicated for temporary atrial, or atrial and ventricular pacing and sensing for a contemplated implant duration of 7 day or less. The devices are supplied sterile and intended for single use only. Model 6491 Unipolar Pediatric Temporary Pacing Lead: The Model 6491 Unipolar Pediatric Temporary Pacing Lead is designed for temporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only. Model 6492 Unipolar Temporary Atrial Pacing Lead: The Model 6492 Unipolar Temporary Atrial Pacing Lead is designed for temporary atrial pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only. Model 6494 Unipolar Temporary Myocardial Pacing Wire: The Model 6494 Unipolar Temporary Myocardial Pacing Wire is designed for temporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only. Model 6495 Bipolar Temporary Myocardial Pacing Lead: The Model 6495 Bipolar Temporary Myocardial Pacing Lead is designed for temporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only. Model 6500 Unipolar Temporary Myocardial Pacing Lead: The Model 6500 Unipolar Temporary Myocardial Pacing Lead is designed for temporary pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.
Device Description
Model 6491: The Model 6491 Unipolar Pediatric Temporary Pacing Lead consists of an electrode (1) and an insulated multi-filament conductor (2) which are crimped together (see Figure 1). A blue monofilament (3) proximally coiled for fixation of the lead is attached to the electrode and terminates distally in an atraumatic myocardial curved needle (4). A blue monofilament coil provides fixation while the lead is implanted in myocardial tissue. An atraumatic chest needle (5) at the proximal end of the conductor wire permits exiting the pacing lead through the chest wall. To remove the pacing lead, gentle traction should be applied. No part of the lead remains in the body. Model 6492: The Model 6492 Unipolar Temporary Atrial Pacing Lead consists of an electrode (1) and an insulated multi-filament conductor (2) which are crimped together (see Figure 2). A blue monofilament (3) proximally coiled for fixation of the lead is attached to the electrode and terminates distally in an atraumatic myocardial curved needle (4). A blue monofilament coil provides fixation while the lead is implanted in myocardial tissue. An atraumatic chest needle (5) at the proximal end of the conductor wire permits exiting the pacing lead through the chest wall. To remove the pacing lead, gentle traction should be applied. No part of the lead remains in the body. Model 6494: The Model 6494 Unipolar Temporary Myocardial Pacing Wire consists of an insulated multi- filament wire (1) (see Figure 3). One end of this wire has been stripped to have an electrode surface (2). This surface area can partly or completely be used as an electrode. The stripped end terminates distally in an atraumatic myocardial curved needle (3). An atraumatic chest needle (4) at the proximal end of the conductor wire permits running the pacing wire to exit through the chest wall. To remove the pacing wire, gentle traction should be applied. No part of the wire remains in the body. Model 6495: The Model 6495 Bipolar Temporary Myocardial Pacing Lead consists of an insulated multi- filament lead (see Figure 4) which contains a distal, discrete, ring electrode (1), a discrete, tip electrode (2); and a coaxial conductor lead body (3). Each discrete electrode is crimped onto a conductor and terminates in an atraumatic, myocardial curved needle (4). A blue monofilament coil provides fixation while the lead is implanted in myocardial tissue. An atraumatic chest needle (5) at the proximal end of the conductor wire permits exiting the pacing lead through the chest wall. Terminated on the back of the chest needle are two breakaway connector pins (6). To remove the pacing lead, gentle traction should be applied. No part of the lead remains in the body. Model 6500: The Model 6500 Unipolar Temporary Myocardial Pacing Lead consists of an electrode (1) and an insulated multi-filament conductor (2) which are crimped together (see Figure 5). A blue monofilament (3) proximally coiled for fixation of the lead is attached to the electrode and terminates distally in an atraumatic myocardial curved needle (4). A blue monofilament coil provides fixation while the lead is implanted in myocardial tissue. An atraumatic chest needle (5) at the proximal end of the conductor wire permits exiting the pacing lead through the chest wall. To remove the pacing lead, gentle traction should be applied. No part of the lead remains in the body, except the silicone rubber disc (6) in case of atrial application.
More Information

Not Found

No
The device description focuses on the physical components and mechanical function of temporary pacing leads. There is no mention of software, algorithms, or data processing that would suggest the use of AI or ML.

Yes.
The device is indicated for "temporary atrial, or atrial and ventricular pacing and sensing," which directly relates to treating a medical condition by providing electrical stimulation to the heart.

No

The device is described as "Temporary Pacing Leads" used for "temporary atrial, or atrial and ventricular pacing and sensing," which implies delivering therapy (pacing) rather than diagnosing a condition. While it also mentions "sensing," this is typically for monitoring the effectiveness of the pacing or for physiological regulation in conjunction with pacing, not for a primary diagnostic purpose to identify a disease state.

No

The device description clearly details physical components such as electrodes, conductors, needles, and monofilaments, indicating it is a hardware 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 Diagnostic devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. This testing is performed outside of the living body (in vitro).
  • Device Function: The Streamline 1 Temporary Pacing Leads are designed for in vivo (within the living body) pacing and sensing of the heart. They are implanted directly into the atrial or ventricular myocardial tissue to deliver electrical impulses and sense cardiac activity.
  • Intended Use: The intended use clearly states "temporary atrial, or atrial and ventricular pacing and sensing". This is a therapeutic and monitoring function performed directly on the patient, not a diagnostic test performed on a sample.

The device description further reinforces this by detailing the physical components designed for implantation and connection to a pacing system.

Therefore, the Streamline 1 Temporary Pacing Leads are medical devices, but they fall under the category of implantable or invasive therapeutic/monitoring devices, not In Vitro Diagnostics.

N/A

Intended Use / Indications for Use

The Streamline 1 Temporary Pacing Leads are indicated for temporary atrial, or atrial and ventricular pacing and sensing for a contemplated implant duration of 7 day or less. The devices are supplied sterile and intended for single use only.

The Model 6491 Unipolar Pediatric Temporary Pacing Lead is designed for temporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.

The Model 6492 Unipolar Temporary Atrial Pacing Lead is designed for temporary atrial pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.

The Model 6494 Unipolar Temporary Myocardial Pacing Wire is designed for temporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.

The Model 6495 Bipolar Temporary Myocardial Pacing Lead is designed for temporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.

The Model 6500 Unipolar Temporary Myocardial Pacing Lead is designed for temporary pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.

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

LDF

Device Description

The Streamline™ Temporary Pacing Leads are comprised of five models: 6491, 6492, 6494, 6495, and 6500.

Model 6491: The Model 6491 Unipolar Pediatric Temporary Pacing Lead consists of an electrode and an insulated multi-filament conductor which are crimped together. A blue monofilament proximally coiled for fixation of the lead is attached to the electrode and terminates distally in an atraumatic myocardial curved needle. A blue monofilament coil provides fixation while the lead is implanted in myocardial tissue. An atraumatic chest needle at the proximal end of the conductor wire permits exiting the pacing lead through the chest wall. To remove the pacing lead, gentle traction should be applied. No part of the lead remains in the body.

Model 6492: The Model 6492 Unipolar Temporary Atrial Pacing Lead consists of an electrode and an insulated multi-filament conductor which are crimped together. A blue monofilament proximally coiled for fixation of the lead is attached to the electrode and terminates distally in an atraumatic myocardial curved needle. A blue monofilament coil provides fixation while the lead is implanted in myocardial tissue. An atraumatic chest needle at the proximal end of the conductor wire permits exiting the pacing lead through the chest wall. To remove the pacing lead, gentle traction should be applied. No part of the lead remains in the body.

Model 6494: The Model 6494 Unipolar Temporary Myocardial Pacing Wire consists of an insulated multi-filament wire. One end of this wire has been stripped to have an electrode surface. This surface area can partly or completely be used as an electrode. The stripped end terminates distally in an atraumatic myocardial curved needle. An atraumatic chest needle at the proximal end of the conductor wire permits running the pacing wire to exit through the chest wall. To remove the pacing wire, gentle traction should be applied. No part of the wire remains in the body.

Model 6495: The Model 6495 Bipolar Temporary Myocardial Pacing Lead consists of an insulated multi-filament lead which contains a distal, discrete, ring electrode, a discrete, tip electrode; and a coaxial conductor lead body. Each discrete electrode is crimped onto a conductor and terminates in an atraumatic, myocardial curved needle. A blue monofilament coil provides fixation while the lead is implanted in myocardial tissue. An atraumatic chest needle at the proximal end of the conductor wire permits exiting the pacing lead through the chest wall. Terminated on the back of the chest needle are two breakaway connector pins. To remove the pacing lead, gentle traction should be applied. No part of the lead remains in the body.

Model 6500: The Model 6500 Unipolar Temporary Myocardial Pacing Lead consists of an electrode and an insulated multi-filament conductor which are crimped together. A blue monofilament proximally coiled for fixation of the lead is attached to the electrode and terminates distally in an atraumatic myocardial curved needle. A blue monofilament coil provides fixation while the lead is implanted in myocardial tissue. An atraumatic chest needle at the proximal end of the conductor wire permits exiting the pacing lead through the chest wall. To remove the pacing lead, gentle traction should be applied. No part of the lead remains in the body, except the silicone rubber disc in case of atrial application.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Myocardial tissue, atrial.

Indicated Patient Age Range

The Model 6491 Unipolar Pediatric Temporary Pacing Lead is designed for temporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. This implies a pediatric age range for this specific model, while the others do not specify age.

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)

Not Found

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.

K012454, K012458, K012459, K012460, K012452

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

§ 870.3680 Cardiovascular permanent or temporary pacemaker electrode.

(a)
Temporary pacemaker electrode —(1)Identification. A temporary pacemaker electrode is a device consisting of flexible insulated electrical conductors with one end connected to anexternal pacemaker pulse generator and the other end applied to the heart. The device is used to transmit a pacing electrical stimulus from the pulse generator to the heart and/or to transmit the electrical signal of the heart to the pulse generator.(2)
Classification. Class II (performance standards).(b)
Permanent pacemaker electrode —(1)Identification. A permanent pacemaker electrode is a device consisting of flexible insulated electrical conductors with one end connected to an implantable pacemaker pulse generator and the other end applied to the heart. The device is used to transmit a pacing electrical stimulus from the pulse generator to the heart and/or to transmit the electrical signal of the heart to the pulse generator.(2)
Classification. Class III (premarket approval).(c)
Date PMA or notice of completion of PDP is required. A PMA or notice of completion of a PDP is required to be filed with the Food and Drug Administration on or before October 4, 2012, for any permanent pacemaker electrode device that was in commercial distribution before May 28, 1976, or that has, on or before October 4, 2012, been found to be substantially equivalent to any permanent pacemaker electrode device that was in commercial distribution before May 28, 1976. Any other pacemaker repair or replacement material device shall have an approved PMA or declared completed PDP in effect before being placed in commercial distribution.

0

JUN 0 6 2014

510(k) Summary 2

l. Applicant Information

Date Prepared:June 05, 2014
Submitter:Medtronic, Inc.
Address:710 Medtronic Parkway, NE
Minneapolis, MN 55432
Contact Person:Debra Taitague
Regulatory Affairs Specialist
Medtronic, Inc.
Phone: (234) 248 4186
Fax: (949) 553 8983
Email: debra.a.taitague@medtronic.com
Alternate ContactDonna Saito
Sr. Regulatory Affairs Manager
Medtronic, Inc.
Phone: (949) -399-1675
Fax: (949) 553 8983
Email: donna.y.saito@medtronic.com

ll. Device Name and Classification

Trade Name:Temporary Pacemaker Electrode
Common Name:Temporary Pacing Lead
Establishment
Registration Number2025587
Product
Classification:Class II 21 CFR 870.3680(a)
Product Code:LDF

1

Predicate DevicesModelProduct Name
K0124546491Unipolar Pediatric Temporary Pacing Lead
K0124586492Unipolar Temporary Atrial Pacing Lead
K0124596494Unipolar Temporary Myocardial Pacing Wire
K0124606495Bipolar Temporary Myocardial Pacing Lead
K0124526500Unipolar Temporary Myocardial Pacing Lead

111. Indications for Use and Device Description

The Streamline 1 Temporary Pacing Leads are indicated for temporary atrial, or atrial and ventricular pacing and sensing for a contemplated implant duration of 7 day or less. The devices are supplied sterile and intended for single use only. The following are the specific device descriptions for each Streamline™ Temporary Pacing Lead model.

ModelDevice Description
6491The Model 6491 Unipolar Pediatric Temporary Pacing Lead consists of an electrode (1) and an
insulated multi-filament conductor (2) which are crimped together (see Figure 1). A blue
monofilament (3) proximally coiled for fixation of the lead is attached to the electrode and
terminates distally in an atraumatic myocardial curved needle (4). A blue monofilament coil
provides fixation while the lead is implanted in myocardial tissue. An atraumatic chest needle
(5) at the proximal end of the conductor wire permits exiting the pacing lead through the chest
wall. To remove the pacing lead, gentle traction should be applied. No part of the lead remains
in the body.
6492The Model 6492 Unipolar Temporary Atrial Pacing Lead consists of an electrode (1) and an
insulated multi-filament conductor (2) which are crimped together (see Figure 2). A blue
monofilament (3) proximally coiled for fixation of the lead is attached to the electrode and
terminates distally in an atraumatic myocardial curved needle (4). A blue monofilament coil
provides fixation while the lead is implanted in myocardial tissue. An atraumatic chest needle
(5) at the proximal end of the conductor wire permits exiting the pacing lead through the chest
wall. To remove the pacing lead, gentle traction should be applied. No part of the lead remains
in the body.
6494The Model 6494 Unipolar Temporary Myocardial Pacing Wire consists of an insulated multi-
filament wire (1) (see Figure 3). One end of this wire has been stripped to have an electrode
surface (2). This surface area can partly or completely be used as an electrode. The stripped
end terminates distally in an atraumatic myocardial curved needle (3). An atraumatic chest
needle (4) at the proximal end of the conductor wire permits running the pacing wire to exit
through the chest wall. To remove the pacing wire, gentle traction should be applied. No part of
the wire remains in the body.
6495The Model 6495 Bipolar Temporary Myocardial Pacing Lead consists of an insulated multi-
filament lead (see Figure 4) which contains a distal, discrete, ring electrode (1), a discrete, tip

1 The trademark name Streamline™ mentioned throughout the document represents the heartwire product family Models; 6491, 6492, 6494, 6495, and 6500.

2

ModelDevice Description
electrode (2); and a coaxial conductor lead body (3). Each discrete electrode is crimped onto a
conductor and terminates in an atraumatic, myocardial curved needle (4). A blue monofilament
coil provides fixation while the lead is implanted in myocardial tissue. An atraumatic chest
needle (5) at the proximal end of the conductor wire permits exiting the pacing lead through the
chest wall. Terminated on the back of the chest needle are two breakaway connector pins (6).
To remove the pacing lead, gentle traction should be applied. No part of the lead remains in
the body.
6500The Model 6500 Unipolar Temporary Myocardial Pacing Lead consists of an electrode (1) and
an insulated multi-filament conductor (2) which are crimped together (see Figure 5). A blue
monofilament (3) proximally coiled for fixation of the lead is attached to the electrode and
terminates distally in an atraumatic myocardial curved needle (4). A blue monofilament coil
provides fixation while the lead is implanted in myocardial tissue. An atraumatic chest needle
(5) at the proximal end of the conductor wire permits exiting the pacing lead through the chest
wall. To remove the pacing lead, gentle traction should be applied. No part of the lead remains
in the body, except the silicone rubber disc (6) in case of atrial application.

Comparison to Predicate Devices IV.

A comparison of the modified product to the current marketed predicate products indicates the following similarities:

  • Same intended use .
  • Same technological characteristics .
  • . Same operating principle
  • Same design features .
  • Same base materials .

The differences between the modified products to the current marketed predicate devices are as follows:

  • The pin protector is visually different and manufactured with a ridged material
  • Aseptic presentation of the device; instead of a double pouch sterile barrier there . is only a single pouch sterile barrier

  • Shrink wrap will be removed and the shelf carton opening mechanism was . changed
  • Shelf Life reduction from 4 years to 2 years .

V. Conclusion

Based upon the available testing, the modifications to the Streamline™ Temporary Pacing Leads do not affect the intended use of the devices or alter the fundamental scientific technology of the devices.

3

Image /page/3/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS). The seal is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" around the perimeter. Inside the circle is a stylized image of an eagle with its wings spread.

Public Health Service

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

June 6, 2014

Medtronic, Inc. % Debra Taitague Regulatory Affairs Specialist 1851 East Deere Ave. Santa Ana, California 92705

Re: K140972

Trade/Device Name: Streamline 11 Heartwires Temporary Pacing Leads Regulation Number: 21 CFR 870.3680(a) Regulation Name: Temporary Pacemaker Electrode Regulatory Class: Class II Product Code: LDF Dated: May 6, 2014 Received: May 8, 2014

Dear Ms. Taitague,

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 devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in

4

Page 2 - Debra Taitague

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 contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResqurcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 Industry and Consumer Education 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/8 description: The image shows a logo with the letters FDA. The letters are stylized and overlapping. The logo is black and white and appears to be a vectorized image.

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

Enclosure

5

The following are the Indications for Use for each model of Streamline™ Temporary Pacing Leads:

  • 6491
  • · 6492
  • 6494
  • 6495
  • · 6500

6

510(k) Number (if known): K140972

Device Name: Model 6491 Unipolar Pediatric Temporary Pacing Lead

Indications for Use:

The Model 6491 Unipolar Pediatric Temporary Pacing Lead is designed for temporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.

Prescription Use _ × (Part 21 CFR 801 Subpart D) 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)

AND/OR

Image /page/6/Picture/9 description: The image shows a signature and a date stamp. The date on the stamp reads "2014.06.06" and the time is "12:56:36 -04'00'". The signature is illegible, but appears to be written in cursive. The stamp is circular and has a decorative border.

Page __ of __

7

510(k) Number (if known): K140972

Device Name: Model 6492 Unipolar Temporary Atrial Pacing Lead

Indications for Use:

The Model 6492 Unipolar Temporary Atrial Pacing Lead is designed for temporary atrial pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.

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)

Image /page/7/Picture/11 description: The image shows a date and time stamp. The date is June 6, 2014, and the time is 14:13:48. The time zone is -04'00. There is also a signature to the left of the date and time stamp.

8

510(k) Number (if known): K140972

Device Name: Model 6494 Unipolar Temporary Myocardial Pacing Wire

Indications for Use:

The Model 6494 Unipolar Temporary Myocardial Pacing Wire is designed for temporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.

Prescription Use _ × (Part 21 CFR 801 Subpart D) Over-The-Counter Use 21 CFR 807 Subpart C)

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

AND/OR

Concurrence of CDRH, Office of Device Evaluation (ODE)

Page of of

Date:
2014.06.06
14:14:13+04'00'

9

510(k) Number (if known): K140972

Device Name: Model 6495 Bipolar Temporary Myocardial Pacing Lead

Indications for Use:

The Model 6495 Bipolar Temporary Myocardial Pacing Lead is designed for temporary atrial and ventricular pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.

Prescription Use × (Part 21 CFR 801 Subpart D) Over-The-Counter Use (21 CFR 807 Subpart C)

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

AND/OR

Image /page/9/Picture/9 description: The image shows the text "Concurrence of CDRH, Office of Device Evaluation (ODE)" at the top. Below this text is a stamp that includes the word "Date:" and the date "2014.06.06". The stamp also includes the time "14:14:36".

Page of of

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510(k) Number (if known): K140972

Device Name: Model 6500 Unipolar Temporary Myocardial Pacing Lead

Indications for Use:

The Model 6500 Unipolar Temporary Myocardial Pacing Lead is designed for temporary pacing and sensing for a contemplated implant duration of 7 days or less. The device is supplied sterile and intended for single use only.

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)

Image /page/10/Picture/11 description: The image shows a stamp with the letters "FDA" in a circular pattern. Next to the stamp, the word "Date:" is written, followed by the date "2014.06.06" and the time "14:15:00". The time zone "-04'00" is written below the time.