K Number
K150280
Device Name
PulmoVia Working Channel
Manufacturer
Date Cleared
2015-06-11

(126 days)

Product Code
Regulation Number
874.4680
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Pulmo Via Working Channel is intended to be used as an access channel through which a bronchoscope and other endoscopic tools may be introduced to treat targeted tissue of the airways. The Pulmo Via Working Chamel can also provide means for bronchoalveolar lavage. The PulmoVia Working Channel is indicated for adult patients.
Device Description
The PulmoVia Working Channel is a single-use disposable, terminally-sterilized device for transtracheal access to bronchi of the lungs, and consists of a hollow tube with an angled flexible tip to assist in anatomical navigation. A radiopaque marker is located 4 mm from the distal tip to aid in localization under fluoroscopy/CT. Printed markings are positioned at 370 mm from the distal tip, and every 50 mm proximally from that point. The distal tip of the device has a pliable leading edge. The device also contains a disposable Tuohy-Borst adaptor to allow use of third-party devices such as ultrathin bronchoscopes. The full assembly will be packaged in a polyethylene and Tyvek pouch, sterilized via ethylene oxide (EO).
More Information

No
The device description and performance studies focus on mechanical and usability aspects of a physical access channel, with no mention of software, algorithms, or data processing that would indicate AI/ML.

No
The device is described as an "access channel" for introducing tools and a "means for bronchoalveolar lavage," not as directly treating or curing a condition itself.

No

The device is an access channel for endoscopic tools and allows for bronchoalveolar lavage, which are procedures for treatment and fluid collection, respectively, not diagnosis. It facilitates other diagnostic tools but is not diagnostic itself.

No

The device description clearly outlines a physical, single-use disposable device consisting of a hollow tube, flexible tip, radiopaque marker, and adaptor. It undergoes sterilization and mechanical testing, indicating it is a hardware device.

Based on the provided information, the Pulmo Via Working Channel is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostics are devices intended for use in the collection, preparation, and examination of specimens taken from the human body (such as blood, urine, tissue) to provide information for diagnostic purposes.
  • Pulmo Via Working Channel's Intended Use: The intended use of the Pulmo Via Working Channel is to provide an access channel for introducing bronchoscopes and other tools to treat targeted tissue in the airways, and for bronchoalveolar lavage. This is a therapeutic and procedural access device, not a device for analyzing specimens for diagnostic information.
  • Device Description: The device description focuses on its physical characteristics as a hollow tube for access and navigation, not on any components or functions related to analyzing biological samples.
  • Lack of IVD-related information: The document does not mention any aspects related to specimen collection, preparation, analysis, or diagnostic interpretation, which are hallmarks of IVD devices.

Therefore, the Pulmo Via Working Channel is a medical device used for procedural access and treatment within the airways, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The PulmoVia Working Channel is intended to be used as an access channel through which a bronchoscope and other endoscopic tools may be introduced to treat targeted tissue of the airways. The PulmoVia Working Chamel can also provide means for bronchoalveolar lavage. The PulmoVia Working Channel is indicated for adult patients.

Product codes

EOO, EOQ

Device Description

The PulmoVia Working Channel is a single-use disposable, terminally-sterilized device for transtracheal access to bronchi of the lungs, and consists of a hollow tube with an angled flexible tip to assist in anatomical navigation. A radiopaque marker is located 4 mm from the distal tip to aid in localization under fluoroscopy/CT. Printed markings are positioned at 370 mm from the distal tip, and every 50 mm proximally from that point. The distal tip of the device has a pliable leading edge.

The device also contains a disposable Tuohy-Borst adaptor to allow use of third-party devices such as ultrathin bronchoscopes. The full assembly will be packaged in a polyethylene and Tyvek pouch, sterilized via ethylene oxide (EO).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

airways, bronchi of the lungs

Indicated Patient Age Range

adult patients

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

Usability assessments were conducted in a simulated use environment to optimize the safety of the device design and validate the usability of the device.

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Non-clinical performance testing consisted of sterility, shelf-life, packaging validation, transport, biocompatibility and mechanical bench testing which demonstrated that the device met all mechanical design and safety requirements.

The biocompatibility testing included:

  • Cytotoxicity (ISO 10993-5:2009, Biological Evaluation Of Medical Devices - Part 5: Tests For In Vitro Cytotoxicity)
  • Irritation/ Intracutaneous (ISO 10993-10:2010, Biological Evaluation Of Medical Devices - Part 10: Tests For Irritation And Skin Sensitization)
  • Sensitization (ISO 10993-10:2010, Biological Evaluation Of Medical Devices Part. 10: Tests For Irritation And Skin Sensitization)
  • Acute systemic toxicity (ISO 10993-11:2006, Biological Evaluation Of Medical. Devices - Part 11: Tests For Systemic Toxicity)
  • Pyrogenicity (ISO 10993-11:2006 Biological Evaluation of Medical Devices - Part 11: Tests for Systemic Toxicity)

The mechanical testing included: (Side by side testing indicated by an asterisk *)

  • Pull test*
  • Torque test*
  • Kink test*
  • Bend test*
  • Leak test*
  • Vacuum test*
  • Operating temperature/humidity test*
  • Radiopaque test
  • Gravity fed hydrostatic flow test*

No clinical studies were performed using the PulmoVia Working Channel. Usability assessments were conducted in a simulated use environment to optimize the safety of the device design and validate the usability of the device. The results demonstrated that users can operate the PulmoVia Working Channel safely and effectively.

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

Not Found

Predicate Device(s)

K131234, K112562, K060243

Reference Device(s)

K060243, K112562

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 874.4680 Bronchoscope (flexible or rigid) and accessories.

(a)
Identification. A bronchoscope (flexible or rigid) and accessories is a tubular endoscopic device with any of a group of accessory devices which attach to the bronchoscope and is intended to examine or treat the larynx and tracheobronchial tree. It is typically used with a fiberoptic light source and carrier to provide illumination. The device is made of materials such as stainless steel or flexible plastic. This generic type of device includes the rigid ventilating bronchoscope, rigid nonventilating bronchoscope, nonrigid bronchoscope, laryngeal-bronchial telescope, flexible foreign body claw, bronchoscope tubing, flexible biopsy forceps, rigid biopsy curette, flexible biopsy brush, rigid biopsy forceps, flexible biopsy curette, and rigid bronchoscope aspirating tube, but excludes the fiberoptic light source and carrier.(b)
Classification. Class II.

0

Image /page/0/Picture/1 description: The image contains the logo for the U.S. Department of Health and Human Services. The logo consists of two main elements: a circular seal on the left and a stylized symbol on the right. The circular seal contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. The symbol on the right is a graphic representation of a human figure, with three profiles layered on top of each other to create a sense of depth and dimension.

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

June 11, 2015

Sanovas, Inc. c/o Cynthia Nolte, Ph.D., RAC Senior Director of Regulatory Affairs ICON Clinical Research LLC 62 Forest Street, Suite 300 Marlborough, MA 01752

Re: K150280

Trade/Device Name: PulmoVia Working Channel Regulation Number: 21 CFR 874.4680 Regulation Name: Bronchoscope (Flexible or Rigid) Regulatory Class: Class II Product Code: EOO Dated: April 22, 2015 Received: April 22, 2015

Dear Dr. Nolte:

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.

1

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 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,

Tejashri Purohit-Sheth, M.D.

Tejashri Purohit-Sheth, M.D. Clinical Deputy Director DAGRID/ODE/CDRH FOR

Erin I. Keith, M.S. Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control, and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K150280

Device Name

PulmoVia Working Channel

Indications for Use (Describe)

The Pulmo Via Working Channel is intended to be used as an access channel through which a bronchoscope and other endoscopic tools may be introduced to treat targeted tissue of the airways. The Pulmo Via Working Chamel can also provide means for bronchoalveolar lavage. The PulmoVia Working Channel is indicated for adult patients.

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)

Form Approved: OMB No. 0910-0120

Expiration Date: January 31, 2017

See PRA Statement below

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FORM FDA 3881 (8/14)

Page 1 of 1

PSC Publishing Services (301)-443-6740 B

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ട്. 510(K) SUMMARY

Sanovas, Inc. PulmoVia Working Channel

(per 21CFR 807.92 and http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/default.htm)

1. SUBMITTER/510(K) HOLDER

Sanovas, Inc.
2597 Kerner Blvd
San Rafael, CA 94901
Phone: 415-729-9391
Contact: Roy Morgan, VP of Research and Development
Contact's Phone: 415-729-9391
Contact's Email: regulatory@sanovas.com
Date Prepared: June 10, 2015

2. DEVICE NAME

Trade Name:PulmoVia Working Channel
Classification Name:Bronchoscope (flexible or rigid) and accessories
Classification Panel:Ear, Nose, and Throat Devices Panel
Classification Regulation:21 CFR 874.4680
Device Classification:Class II
Product Code:EOQ

3. PREDICATE DEVICES

  • LungPoint™ Tools (LungPoint Sheath and LungPoint Dilation Balloon), K131234
  • KimVent BAL Cath Bronchial Aspirate Sampling Catheter, K112562
  • Olympus Guide Sheath, K060243

DEVICE DESCRIPTION 4.

The PulmoVia Working Channel is a single-use disposable, terminally-sterilized device for transtracheal access to bronchi of the lungs, and consists of a hollow tube with an angled flexible tip to assist in anatomical navigation. A radiopaque marker is located 4 mm from the distal tip to aid in localization under fluoroscopy/CT. Printed markings are positioned at 370 mm from the distal tip, and every 50 mm proximally from that point. The distal tip of the device has a pliable leading edge.

The device also contains a disposable Tuohy-Borst adaptor to allow use of third-party devices such as ultrathin bronchoscopes. The full assembly will be packaged in a polyethylene and Tyvek pouch, sterilized via ethylene oxide (EO).

4

5. INDICATION FOR USE/INTENDED USE

The PulmoVia Working Channel is intended to be used as an access channel through which a bronchoscope and other endoscopic tools may be introduced to treat targeted tissue of the airways. The PulmoVia Working Channel can also provide means for bronchoalyeolar lavage. The PulmoVia Working Channel is indicated for adult patients.

SUMMARY OF TECHNOLOGICAL CHARACTERISTICS COMPARED TO THE PREDICATE 6. DEVICES

Both the proposed PulmoVia Working Channel and the predicate Lung Point Sheath are catheters designed for use with a bronchoscope to reach a targeted area of the bronchial tree. The working length of the PulmoVia Working Channel (485 mm) is less than that of the predicate Lung Point Sheath and reference devices. The inner diameter of the catheter (5.25 mm) is greater than that of the Lung Point and Olympus Guide Sheath. The inner diameter was established in order to be compatible with bronchoscopes with an OD of 4.0 mm.

The predicate Lung Point Sheath is supplied with a stylet. Neither the proposed PulmoVia Working Channel nor the reference device Olympus Guide Sheath are supplied with a stylet.

The proposed PulmoVia Working Channel has an angled, flexible tip to aid in navigation of the PulmoVia Working Channel within the lung. The BAL Cath tip is also designed with a flexible tip.

The materials used for the proposed device are provided in the side-by-side comparison table. Like the predicate devices, the PulmoVia Working Channel sheath and connector are composed of polymers. As will be discussed in Section 7, the PulmoVia Working Channel meets the biocompatibility requirements of ISO 10993-1:2009 for the nature and duration of contact.

SUMMARY OF NON-CLINICAL PERFORMANCE TESTING AS BASIS FOR SUBSTANTIAL 7. EQUIVALENCE

Non-clinical performance testing consisted of sterility, shelf-life, packaging validation, transport, biocompatibility and mechanical bench testing which demonstrated that the device met all mechanical design and safety requirements.

The biocompatibility testing included:

  • . Cytotoxicity (ISO 10993-5:2009, Biological Evaluation Of Medical Devices - Part 5: Tests For In Vitro Cytotoxicity)

5

  • Irritation/ Intracutaneous (ISO 10993-10:2010, Biological Evaluation Of Medical ● Devices - Part 10: Tests For Irritation And Skin Sensitization)
  • Sensitization (ISO 10993-10:2010, Biological Evaluation Of Medical Devices Part . 10: Tests For Irritation And Skin Sensitization)
  • Acute systemic toxicity (ISO 10993-11:2006, Biological Evaluation Of Medical . Devices - Part 11: Tests For Systemic Toxicity)
  • . Pyrogenicity (ISO 10993-11:2006 Biological Evaluation of Medical Devices - Part 11: Tests for Systemic Toxicity)

The mechanical testing included: (Side by side testing indicated by an asterisk *)

  • . Pull test*
  • Torque test*
  • Kink test* ●
  • . Bend test*
  • . Leak test*
  • Vacuum test*
  • Operating temperature/humidity test* ●
  • Radiopaque test ●
  • Gravity fed hydrostatic flow test* ●

SUMMARY OF CLINICAL TESTING AS BASIS FOR SUBSTANTIAL EQUIVALENCE 8.

No clinical studies were performed using the PulmoVia Working Channel. Usability assessments were conducted in a simulated use environment to optimize the safety of the device design and validate the usability of the device. The results demonstrated that users can operate the PulmoVia Working Channel safely and effectively.

SUMMARY OF OTHER INFORMATION 9.

No other information is available.

10. CONCLUSIONS DRAWN FROM NON-CLINICAL AND CLINICAL TESTS

Non-clinical testing confirms that the PulmoVia Working Channel is sterile, has a packaging system adequate to maintain sterility and transportation hazards, and a validated shelf life. The PulmoVia Working Channel is biocompatible and side by side testing confirms that the proposed device has equivalent physical and mechanical characteristics to the identified predicates. Human factors testing confirms that users can operate the PulmoVia Working Channel safely and effectively.

6

The similarities in intended use, operational characteristics, functional technological characteristics and conclusions drawn from nonclinical testing between the proposed PulmoVia Working Channel and the predicate LungPoint Sheath and KimVent BAL Cath lead to a conclusion of substantial equivalence between the proposed and predicate devices. A side-by-side comparison of the predicate devices and the proposed device is provided in the table at the end of this section.

| | PulmoVia™ | LungPoint™ Tools | Olympus Guide
Sheath | BAL Cath* |
|--------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Feature | Working Channel
(Proposed) | K131234
(Predicate) | K060243
(Reference) | K112562
(Reference) |
| Indication for Use | The PulmoVia
Working Channel is
intended to be used
as an access channel
through which a
bronchoscope and
other endoscopic
tools may be
introduced to treat
targeted tissue of
the airways. The
PulmoVia Working
Channel can also
provide means for
bronchoalveolar
lavage. The
PulmoVia Working
Channel is indicated
for adult patients. | The LungPoint
Sheath is intended
to be used as a
working channel
through which
endoscopic tools
may be introduced
to targeted tissue.
Not for pediatric
use. | The instrument has
been designed to be
used with Olympus
bronchoscopes,
endo-therapy
accessories or
ultrasound probe to
the targeted area
within the
respiratory organs. | The BAL Cath is
used in the
diagnosis of diffuse
lung disease by
allowing collection
of bronchoalveolar
lavage (BAL)
specimens from
deep within the
lung. The use of a
bronchoscope is not
necessary. This
catheter is used in
adult intubated
patients. |
| Single Use | Single use | Single use | Single use | Single use |
| Sterile | Yes (Ethylene
oxide) | Yes (E-beam) | Yes | Yes |
| Catheter Working
Length | 485 mm | 900 mm | 1050 mm | Not known |
| Catheter Internal
Diameter (ID) | 5.25 mm | 2.0 mm | 2.1 mm | 4 mm |
| Maximum Catheter
Outer Diameter
(OD) | 6.0 mm | 2.65 mm | 2.7 mm | 5.2 mm |
| Bronchoscope
Compatibility | Max OD: 4.0 mm
Min Working
Length: 600 mm | Not known | Not known | Not used with a
bronchoscope |
| Catheter Length | 495 mm | 975 mm | 900 mm | Not known |
| Tuohy-Borst
Adaptor | Yes | No | Not known | Not known |
| Stylet | No | Yes | No | No |
| Distal Tip | Angled, flexible | Not known | Not pliable | Flexible, directional |
| Radiopaque | Yes | Yes | Yes | Yes |
| Feature
Markers | PulmoViaTM
Working Channel
(Proposed) | LungPointTM Tools
K131234
(Predicate) | Olympus Guide
Sheath
K060243
(Reference) | BAL Cath*
K112562
(Reference) |
| Materials | Extrusion:
Tecothane and
Pebax
Marker Band:
Platinum-Iridium
Hub: Polycarbonate
Tuohy Borst
Connector:
Polycarbonate with
silicone gasket | Extrusion: Not
known^
Marker band: Not
known^ | Extrusion:
Polymer^
Marker band:
Radio-opaque metal
Accessory Port:
Polymer^
Tri-Channel
Connector:
Polymer^ | Extrusion:
Polymer^
Marker band: Not
known^
Collar: Polymer^ |

Side-by-Side Comparison of the PulmoVia™ Working Channel with the LungPoint™ Tools and Reference Devices

7

*BAL Cath: Kimberly-Clark KimVent BAL Cath Bronchial Aspirate Sampling Catheter ^Material composition is not known