K Number
K142971
Device Name
AMT Bridle - Nasal Tube Retention System
Date Cleared
2015-05-26

(224 days)

Product Code
Regulation Number
876.5980
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The AMT Bridle - Nasal Tube Retention System is indicated to prevent inadvertent displacement or removal of Nasogastric/Nasointestinal (NG/NI) tubes.
Device Description
The AMT Bridle™ – Nasal Tube Retention System is placed around the vomer bone of the nasal septum and attached to a nasogastric/nasointestinal (NG/NI) tube to prevent inadvertent displacement or removal of the tube. The AMT Bridle™ – Nasal Tube Retention System consists of a retrieval probe, catheter with stylet guide, a nasal tube clip, and removal pick. The AMT Bridle™ retrieval probe and catheter are the device components inserted through the patient's nares with the probe magnetically retrieving the catheter and creating a loop around the vomer bone. The nasal tube clip is the component directly attached to both the nasal tube and bridle catheter loop to hold the tube in place.
More Information

Not Found

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

No.
The device's intended use is to prevent the inadvertent displacement or removal of Nasogastric/Nasointestinal (NG/NI) tubes, which is a retention or securing function, not a direct therapeutic intervention.

No

The device is indicated to prevent inadvertent displacement or removal of Nasogastric/Nasointestinal (NG/NI) tubes. It is a retention system, not a diagnostic device.

No

The device description clearly outlines physical components (retrieval probe, catheter, nasal tube clip, removal pick) that are inserted into the patient and physically interact with the nasal tube and anatomy. This is a hardware-based medical device.

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

Here's why:

  • Intended Use: The intended use is to "prevent inadvertent displacement or removal of Nasogastric/Nasointestinal (NG/NI) tubes." This is a mechanical function related to securing a medical device within the body.
  • Device Description: The description details a system of physical components (probe, catheter, clip, pick) used to physically secure a tube. There is no mention of analyzing biological samples or providing diagnostic information.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological specimens (blood, urine, tissue, etc.)
    • Detecting or measuring substances in biological samples
    • Providing information for diagnosis, monitoring, or screening of diseases or conditions

The device's function is purely mechanical and related to the physical retention of a medical tube.

N/A

Intended Use / Indications for Use

The AMT Bridle - Nasal Tube Retention System is indicated to prevent inadvertent displacement or removal of Nasogastric/Nasointestinal (NG/NI) tubes.

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

KNT

Device Description

The AMT Bridle™ – Nasal Tube Retention System is placed around the vomer bone of the nasal septum and attached to a nasogastric/nasointestinal (NG/NI) tube to prevent inadvertent displacement or removal of the tube. The AMT Bridle™ – Nasal Tube Retention System consists of a retrieval probe, catheter with stylet guide, a nasal tube clip, and removal pick. The AMT Bridle™ retrieval probe and catheter are the device components inserted through the patient's nares with the probe magnetically retrieving the catheter and creating a loop around the vomer bone. The nasal tube clip is the component directly attached to both the nasal tube and bridle catheter loop to hold the tube in place.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Nasal septum (vomer bone)

Indicated Patient Age Range

Not Found

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)

AMT conducted various performance tests on all components contained within the AMT Bridle® - Nasal Tube Retention System. Testing found that all components and materials met or exceeded design specifications established and cleared under K030784. The following tests were used to show substantial equivalence:
• Clip hinge and teeth integrity
• Retention force
• Bond strength of material joints
• Tape pullout force
• Usability testing
• Shelf life testing

Bridle catheter, stylet guide, and probe designs remain very similar or the same as the predicate device cleared under K030784, so performance testing remains ultimately unchanged. Several performance tests were conducted for the new clip sizes to ensure that molded parts maintained the required performance specifications. Bridle clips passed all performance testing for hinge integrity, clamp integrity, and grip strength. Based on the test results, design and assembly integrity remain substantially equivalent to the predicate device.

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.

K030784

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

§ 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 logo for the U.S. Department of Health & Human Services. The logo is circular and contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the circle is an abstract symbol that resembles a stylized human figure in profile, with three overlapping heads.

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

May 26, 2015

Applied Medical Technology, Inc. Joshua D. Meinke OA/Regulatory Supervisor 8006 Katherine Blvd. Brecksville, OH 44141

Re: K142971

Trade/Device Name: AMT Bridle - Nasal Tube Retention System Regulation Number: 21 CFR§ 876.5980 Regulation Name: Gastrointestinal tube and accessories Regulatory Class: II Product Code: KNT Dated: April 23, 2015 Received: April 24, 2015

Dear Joshua D. Meinke,

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.

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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 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,

Herbert P. Lerner -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

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Indications for Use

510(k) Number (if known) K142971

Device Name AMT Bridle - Nasal Tube Retention System

Indications for Use (Describe)

The AMT Bridle - Nasal Tube Retention System is indicated to prevent inadvertent displacement or removal of Nasogastric/Nasointestinal (NG/NI) tubes.

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

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

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

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SECTION - 5

510(K) Summary

AMT Bridle™ – Nasal Tube Retention System

Date Prepared:May 26, 2015
Submitter:Joshua D. Meinke
QA/Regulatory Supervisor
Applied Medical Technology, Inc.
8006 Katherine Boulevard
Brecksville, OH 44141
Phone: 440-717-4252
Fax: 440-717-4200
Email: Joshua.Meinke@appliedmedical.net
Contact Person: Joshua Meinke
Device
Information:Trade Name: AMT Bridle™ - Nasal Tube Retention System
Common Name: Nasal Tube Fixation Device
Classification Name: Gastroenterology and Urology (21 CFR 876.5980)
Regulatory Class: II
Product Code: KNT
Predicate
Device:AMT Nasogastric Bridle™ System with Magnet Retrieval
(cleared under K030784)
Intended Use:The AMT Bridle™ – Nasal Tube Retention System is a device placed around the
vomer bone of the nasal septum and attached to a Nasogastric/Nasointestinal
(NG/NI) tube to prevent inadvertent displacement or removal of the nasal tube.
Device
Description:The AMT Bridle™ – Nasal Tube Retention System is placed around the vomer bone
of the nasal septum and attached to a nasogastric/nasointestinal (NG/NI) tube to
prevent inadvertent displacement or removal of the tube. The AMT Bridle™ – Nasal
Tube Retention System consists of a retrieval probe, catheter with stylet guide, a
nasal tube clip, and removal pick. The AMT Bridle™ retrieval probe and catheter
are the device components inserted through the patient's nares with the probe
magnetically retrieving the catheter and creating a loop around the vomer bone. The
nasal tube clip is the component directly attached to both the nasal tube and bridle
catheter loop to hold the tube in place.
Technological
Characteristics:The AMT Bridle™ – Nasal Tube Retention System is provided non-sterile for single
use only in a healthcare facility or unit. The AMT Bridle™ is provided in two
different configurations, a standard size and a smaller Micro sized design.
Description of each device type is described below:

AMT Bridle™:
Probe size: Larger diameter and longer length compared to AMT Micro Bridle™
Catheter Size: Same diameter as AMT Micro Bridle™, longer length
Clip Sizes(FR): 08 - 18 FR
Clip Thickness: Double thickness of AMT Micro Bridle™
Part Number Scheme: 4-41XX (where XX = French size of clip)

AMT Micro Bridle™:
Probe size: Smaller diameter and shorter length compared to AMT Bridle™
Catheter Size: Same diameter as AMT Bridle™, shorter length
Clip Sizes: 05 - 08 FR
Clip Thickness: Half thickness of AMT Bridle™
Part Number Scheme: 4-41XXM (where XX = French size of clip)

The standard and Micro designs maintain the same materials, manufacturing
methods, and instructions for use. Both devices are made from DEHP and Latex free
materials. Both designs incorporate the same components inside of a kit, including
the retrieval probe, catheter with stylet guide, nasal tube clip, and removal pick.
Placement of both devices is identical with the nasal clip attaching the Bridle loop to
the Nasal tube, securing the tube in place by connection to the vomer bone. |
| Biocompatibility
Testing: | The AMT Bridle – Nasal Tube Retention System has been tested for prolonged
contact (less than or equal to 30 days) to the applicable sections of the following
standards:
ISO 10993-1: 2009 Biological Evaluation of Medical Devices – Part 1:
Evaluation and testing within a risk management process ISO 10993-5: 2009 Biological Evaluation of Medical Devices – Part 5: Tests
for in vitro cytotoxicity ISO 10993-6: 2007 Biological Evaluation of Medical Devices – Part 6: Tests
for local effects after implantation ISO 10993-10: 2010 Biological Evaluation of Medical Devices – Part 10:
Tests for irritation and skin sensitization ISO 10993-11:2006 Biological Evaluation of Medical Devices – Part 11:
Tests for systemic toxicity ISO 10993-12:2007 Biological Evaluation of Medical Devices – Part 12:
Sample preparation and reference materials An independent risk assessment was completed for the above biocompatibility testing
and it was determined that the biocompatibility results for the AMT Bridle – Nasal
Tube Retention System met the acceptance criteria for prolonged contact (less than or
equal to 30 days). |
| Performance
Testing: | AMT conducted various performance tests on all components contained within the
AMT Bridle® - Nasal Tube Retention System. Testing found that all components
and materials met or exceeded design specifications established and cleared under
K030784. The following tests were used to show substantial equivalence:
• Clip hinge and teeth integrity
• Retention force
• Bond strength of material joints
• Tape pullout force
• Usability testing
• Shelf life testing

Bridle catheter, stylet guide, and probe designs remain very similar or the same as the
predicate device cleared under K030784, so performance testing remains ultimately
unchanged. Several performance tests were conducted for the new clip sizes to
ensure that molded parts maintained the required performance specifications. Bridle
clips passed all performance testing for hinge integrity, clamp integrity, and grip
strength. Based on the test results, design and assembly integrity remain
substantially equivalent to the predicate device. |
| Conclusions: | The AMT Bridle™ - Nasal Tube Retention System is substantially equivalent to the
predicate device cleared under K030784 in intended use, patient population, design,
biocompatibility and testing criteria, and method of operation. |

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