K Number
K141134
Device Name
POD SYSTEM
Manufacturer
Date Cleared
2014-07-03

(63 days)

Product Code
Regulation Number
882.5950
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The POD System is indicated for the embolization of:
Intracranial aneurysms
Other neurovascular abnormalities such as arteriovenous malformations and arteriovenous fistulae
Arterial and venous embolizations in the peripheral vasculature

Device Description

The POD System functions to selectively embolize targeted segments of the vasculature by packing a sufficient quantity of soft platinum coils to achieve occlusion in an equivalent fashion to existing bare-platinum embolization coils. The POD System consists of three components: a Coil Implant attached to a Detachment Pusher and a Detachment Handle.

AI/ML Overview

The provided text describes the acceptance criteria and study results for the Penumbra POD™ System, a neurovascular embolization device.

1. Table of Acceptance Criteria and Reported Device Performance:

AttributeAcceptance CriteriaReported Device Performance
BiocompatibilityMeet EN ISO 10993 requirements for: In Vitro Cytotoxicity, Sensitization, Irritation, Systemic Toxicity (Acute, Sub-acute/Sub-chronic, IV Toxicity, Pyrogenicity), Genotoxicity (Mouse Lymphoma, Ames, Micronucleus), Implantation, Hemocompatibility (Hemolysis, Complement Activation, Thrombogenicity)All tests Passed
Dimensional / Visual InspectionUnits meet all inspection criteria for release of finished goods (clinically acceptable) product.100% Pass
Fatigue TestingCoil Implant retains its secondary shape after being cycled into/out of introducer sheath 5 times.100% Pass
Friction TestingPush/pull friction acceptable through an 0.025in ID microcatheter.100% Pass
Stiffness TestingAppropriate stiffness per coil specifications.100% Pass
Simulated Use Flow Model TestingUnits meet all inspection criteria for release of finished goods (clinically acceptable) product after simulated use.100% Pass
Coil Dimensional Inspection (after simulated use)Units withstood the simulated use testing.100% Pass
Distal System Tensile TestCoil Implant and Detachment Pusher joints have sufficient tensile strength.100% Pass
MRI CompatibilityMinor design changes will have no impact on RF heating; same MRI conditions as predicate device are safe.Concluded as safe
GLP Animal Testing (Design Validation)Characterize the POD System's interaction with the vasculature.Fully characterized by predicate device study

2. Sample Sizes Used for the Test Set and Data Provenance:

  • Bench-top Testing: The document states that testing was performed "using units which were 2x sterilized and met finished goods release requirements." It also mentions "statistical sampling methods as required by the Penumbra Design Control procedures." However, specific sample sizes for each bench-top test are not provided.
  • Biocompatibility Testing: The document states "Studies, were selected in accordance with EN ISO 10993 -1 guidelines" and "All studies were conducted pursuant to 21 CFR, Part 58, Good Laboratory Practices." Specific sample sizes for each biological test are not provided. For the "Implantation GLP Study - Penumbra Coil System in Swine Venous Pouch Aneurysm Model" and "Intramuscular Implant Test 13 Week Duration," it mentions "Swine" and "13 Week Duration," implying animal models, but no specific animal count is given.
  • Data Provenance: The studies are described as "Non-clinical testing" and conducted under "Good Laboratory Practices (GLP)," indicating they are laboratory-based studies rather than human clinical data. The "Implantation GLP Study" mentions a "Swine Venous Pouch Aneurysm Model," indicating animal data. The document does not specify the country of origin for the data, but Penumbra, Inc. is located in Alameda, CA, USA. The studies are prospective in nature as they are conducted for device verification and validation.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications:

  • Not applicable to this device submission. This submission focuses on engineering, biocompatibility, and animal (GLP) testing for substantial equivalence to a predicate device, not on diagnostic accuracy requiring expert interpretation of images or clinical outcomes.

4. Adjudication Method for the Test Set:

  • Not applicable. See point 3.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done:

  • No. An MRMC comparative effectiveness study was not performed as this is a device submission for an embolization system, not an AI-powered diagnostic tool requiring human-in-the-loop performance evaluation. The focus is on the device's physical, mechanical, and biological properties, and its substantial equivalence to predicate devices.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Study Was Done:

  • Not applicable. The POD System is a medical device (coil implant, detachment pusher, handle) for physical embolization, not a software algorithm.

7. The Type of Ground Truth Used:

  • Bench-top Testing: Engineering specifications and objective measurements (e.g., dimensional measurements, force measurements for friction/tensile tests, visual inspection criteria, retention of shape).
  • Biocompatibility Testing: Established international standards and guidelines (EN ISO 10993) and Good Laboratory Practices (GLP) for biological responses.
  • Design Validation (GLP Animal Testing): Biological responses in animal models, evaluated against expected physiological interactions and safety profiles.

8. The Sample Size for the Training Set:

  • Not applicable. This submission describes a medical device, not an AI/ML algorithm that requires a training set. The "training set" concept does not apply here.

9. How the Ground Truth for the Training Set Was Established:

  • Not applicable. See point 8.

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510(k) Summary

(as required by 21 CFR 807.92)

Pursuant to Section 12, Part (a)(i)(3A) of the Safe Medical Devices Act of 1990, Penumbra Inc. is providing the summary of Substantial Equivalence for the POD™ System.

Sponsor/Applicant Name and Address

Penumbra, Inc. 1351 Harbor Bay Parkway Alameda, CA 94502, USA

Sponsor Contact Information

Charles DeNault Regulatory Affairs Specialist . Phone: (510) 748-3302 Fax: (510) 217-6414 Email: cdenault@penumbrainc.com

Date of Preparation of 510(k) Summary

April 30, 2014

Device Trade or Proprietary Name

POD™ System

Device Classification

II Regulatory Class: Classification Panel: Neurology Neurovascular/vascular embolization device Classification Name: 21 CFR 882.5950, 21 CFR 870.3300 Regulation Number: Product Code: HCG, KRD

Predicate Devices

510(k) Number /Clearance DateName of Predicate DeviceName ofManufacturer
K103305 / 26-Jan-2011Penumbra Coil SystemPenumbra, Inc.
K120330 / 02-Apr-2012Penumbra Coil SystemPenumbra, Inc.

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Predicate Comparison

Penumbra Coil SystemPOD System
510(k) No.K103305 & K120330To be determined
ClassificationClass II, HCG, KRDSame
IndicationIndicated for the endovascularembolization of:• Intracranial aneurysms• Other neurovascular abnormalities suchas arteriovenous malformations andarteriovenous fistulae•Arterial and venous embolizations in theperipheral vasculatureSame
Materials
CoilPlatinum/Tungsten, NitinolSame
Detachment PusherStainless steel, Polymer,Platinum/Iridium, NitinolSame
Detachment Handle Shell/FunnelPlastic
Dimensions/Shape
Coil Secondary Length1-60 cmSame
Coil Secondary Diameter2-32 mm4-8 mm*
Coil Secondary ShapeComplex (Standard, Soft, Extra Soft),Helical (Curve), JComplex
Accessories
Introducer SheathPolypropylene (color: orange)Same
Packaging Materials
Coil HoopPolyethyleneSame
PouchPolyester/Polyethylene/TyvekSame
Display CartonSBS PaperboardSame
Sterilization/Shelf Life
Sterilization MethodEtOSame
Shelf Life8 yearsSame

*The proximal segment of the coil will have a reduced secondary diameter

Device Description

The POD System functions to selectively embolize targeted segments of the vasculature by packing a sufficient quantity of soft platinum coils to achieve occlusion in an equivalent fashion to existing bare-platinum embolization coils. The POD System

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consists of three components: a Coil Implant attached to a Detachment Pusher and a Detachment Handle.

Intended Use

The POD System is indicated for the embolization of:

  • Intracranial aneurysms .
  • Other neurovascular abnormalities such as arteriovenous malformations and . arteriovenous fistulae
  • . Arterial and venous embolizations in the peripheral vasculature

Summary of Non-Clinical Data

As required under Section 12, Part (a)(i)(3A) of the Safe Medical Devices Act of 1990, a summary of any information regarding safety and effectiveness of the device follows.

Included in this section are descriptions of the testing's, which substantiates the safe and effective performance of the POD System as well as its substantial equivalence to the predicate devices:

  • . Biocompatibility
  • Design Verification (Bench-Top Testing) .
  • MRI Compatibility .
  • . Design Validation (GLP Animal Testing)

The subject POD System met all established requirements.

Biocompatibility Testing

Non-clinical testing found POD to be biocompatible according to the requirements of EN ISO 10993 requirements. Biocompatibility for POD was derived from studies on the predicate device. Studies, were selected in accordance with EN ISO 10993 -1 guidelines (Biological Evaluation of Medical Devices). All studies were conducted pursuant to 21 CFR, Part 58, Good Laboratory Practices. The following tests were performed:

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TestPass/Fail
In Vitro Cytotoxicity (MEM Elution)Pass
Sensitization (Kligman Maximization)Pass
Irritation (Intracutaneous Reactivity)Pass
Systemic Toxicity
Acute Toxicity (ISO Systemic Injection)Pass
In Vivo Sub-acute / Sub-chronic ToxicityPass
Sub-chronic Toxicity Subchronic (30-Day)Pass
Intravenous Toxicity Study - MicePass
Materials Mediated Pyrogen - RabbitPass
Genotoxicity
Mouse LymphomaPass
Ames MutagenicityPass
In Vivo Mouse MicronucleusPass
Implantation GLP Study - Penumbra CoilSystem in Swine Venous Pouch AneurysmModelPass
Intramuscular Implant Test 13 Week DurationPass
Hemocompatibility
HemolysisPass
Complement ActivationPass
Dog ThrombogenicityPass

Bench-top Testing

The physical, mechanical and performance testing of the POD System components demonstrate that the devices are substantially equivalent to the currently marketed predicate devices.

Design Verification testing was conducted to evaluate the physical and mechanical properties of POD System components. All studies were conducted using good scientific practices and statistical sampling methods as required by the Penumbra Design Control procedures. All testing was performed using units which were 2x sterilized and met finished goods release requirements. The tests performed on the POD System components included:

AttributeSpecificationResults
Dimensional / VisualInspectionThese evaluations confirm that the units used in this DesignVerification testing meet all inspection criteria for release offinished goods (clinically acceptable) product.100% Pass
Fatigue TestingThe Coil Implant shall retain its secondary shape after beingcycled into/out of introducer sheath 5 times100% Pass
Friction TestingPush/pull friction acceptable through an 0.025in IDmicrocatheter100% Pass
Stiffness TestingAppropriate stiffness per coil specifications100% Pass
Simulated Use Flow ModelTestingThese evaluations confirm that the units used in this DesignVerification testing meet all inspection criteria for release of100% Pass

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AttributeSpecificationResults
finished goods (clinically acceptable) product.
Coil Dimensional Inspection(after simulated use testing)These evaluations confirm that the units used in this DesignVerification testing withstood the simulated use testing100% Pass
Distal System Tensile TestCoil Implant and Detachment Pusher joints has sufficienttensile strength'100% Pass

All testing met specification. The results of the tests appropriately address the physical and mechanical performance expectations of the device. Based on these overall results, the physical and mechanical properties of the POD System are acceptable for the intended use and substantially equivalent to the predicate devices.

MRI Compatibility

Penumbra consulted with an MR scanning expert and concluded minor design changes will have no impact on RF heating, and the same MRI conditions that are safe for the Penumbra Coil System Coil Implants arrays will also be safe for the POD Coil Implants.

Design Validation (GLP Animal Testing)

The existing Penumbra Coil System GLP animal study fully characterizes the POD System's interaction with the vasculature. No additional animal testing is required for the POD System.

Summary of Substantial Equivalence

The POD System is substantially equivalent to the predicate devices with regard to intended use, operating principle, design concept, materials, shelf-life, packaging and sterilization processes.

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Image /page/5/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized human figure with outstretched arms, enclosed within a circle. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged around the upper portion of the circle.

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

July 3, 2014

Penumbra, Inc. Mr. Charles Denault Regulatory Affairs Specialist 1351 Harbor Bay Parkway Alameda, California 94502

Re: K141134

Trade/Device Name: POD system Regulation Number: 21 CFR 882.5950 Regulation Name: Neurovascular Embolization Device Regulatory Class: Class II Product Code: HCG and KRD Dated: June 4, 2014 Received: June 6, 2014

Dear Mr. Denault:

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

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Page 2 - Mr. Charles Denault

the quality systems (OS) 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/ResourcesforYou/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/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 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,

Felipe Aquel -S

Carlos L. Peña, PhD, MS for Director Division of Neurological

and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K141134

Device Name POD (Penumbra Occlusion Device) System

Indications for Use (Describe) The POD System is indicated for the embolization of:

Intracranial aneurysms

Other neurovascular abnormalities such as arteriovenous malformations and arteriovenous fistulae

Arterial and venous embolizations in the peripheral vasculature

Type of Use (Select one or both, as applicable)

2 Prescription Use (Part 21 CFR 801 Subpart D)

_ Over-The-Counter Use (21 CFR 801 Subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

pe Aguel -S Date: 2014.07.03 12:31:39

04'00'

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*DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW."

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

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EF

Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement below.

§ 882.5950 Neurovascular embolization device.

(a)
Identification. A neurovascular embolization device is an intravascular implant intended to permanently occlude blood flow to cerebral aneurysms and cerebral ateriovenous malformations. This does not include cyanoacrylates and other embolic agents, which act by polymerization or precipitation. Embolization devices used in other vascular applications are also not included in this classification, see § 870.3300.(b)
Classification. Class II (special controls.) The special control for this device is the FDA guidance document entitled “Class II Special Controls Guidance Document: Vascular and Neurovascular Embolization Devices.” For availability of this guidance document, see § 882.1(e).