K Number
K150350
Device Name
Flexi-Seal Signal Fecal Management System
Manufacturer
Date Cleared
2015-07-21

(160 days)

Product Code
Regulation Number
876.5980
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For use to manage fecal incontinence through the collection of liquid to semi-liquid stool and to provide access to administer medications.
Device Description
The Flexi-Seal® SIGNAL™ Fecal Management System is comprised of a soft catheter tube assembly, a Luer-lock syringe, a collection bag with cap and a cinch clamp to pinch off flow in the catheter when required for medication retention or to stop waste flow. The components are contained in a rigid thermoformed plastic clamshell. The catheter main drain tube is fabricated from collapsible silicone rubber with the addition of an odor adsorber, which is added in order to help contain the fecal odor which often permeates through the wall of the catheter. The drain tube has a low-pressure silicone retention balloon at the distal end and a connector for attaching a collection bag (provided with the device and also available separately) at the proximal end. There is a recess (pocket) under the balloon for the clinician's finger, which allows the device to be positioned digitally. Two ports are attached to the side of the catheter. One port is used to inflate the retention balloon with water or saline after the device has been inserted into the patient's rectum. This port also provides a visual and tactile signal of when the low pressure retention balloon is filled to its optimal volume. The other port is used to flush the device if needed and administer medication if prescribed. An additional sampling port is located on the side of the catheter, which allows access to clinicians for stool sample collection. A syringe (provided with the device) is used to fill and evacuate the retention balloon for insertion and removal. The device, collection bag and syringe are intended for single us, are provided non-sterile and contain no components made with animal products, natural rubber latex or DEHP.
More Information

Not Found

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

No.
The device's intended use is for managing fecal incontinence by collecting stool and for administering medications. While it manages a condition, it does not treat or cure a disease or directly restore function, which are characteristic of a therapeutic device. It's primarily a fecal management system.

No

The device is intended for the collection of liquid to semi-liquid stool and to administer medications, which are treatment and management functions rather than diagnostic ones. While it includes an "additional sampling port... which allows access to clinicians for stool sample collection," the primary indicated use is not for diagnosis, but for management of fecal incontinence and medication administration.

No

The device description clearly outlines multiple physical components including a catheter tube assembly, syringe, collection bag, cinch clamp, and a retention balloon. This indicates it is a hardware-based medical device, not software-only.

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

Here's why:

  • Intended Use: The intended use is to "manage fecal incontinence through the collection of liquid to semi-liquid stool and to provide access to administer medications." This describes a device used on the patient for management and access, not for testing samples in vitro (outside the body) to diagnose or monitor a condition.
  • Device Description: The description details a system for collecting stool and administering medication directly to the patient's rectum. While it mentions a sampling port for stool collection, the primary function is not diagnostic testing of that sample.
  • Lack of Diagnostic Function: There is no mention of the device performing any tests, analyses, or measurements on the collected stool sample to provide diagnostic information. The sampling port is for access to collect a sample, which would then be sent to a lab for in vitro testing if needed.
  • Performance Studies: The performance studies focus on functional and structural parameters and biocompatibility, not on the accuracy or reliability of any diagnostic measurements.

In summary, the Flexi-Seal® SIGNAL™ Fecal Management System is a medical device used for managing fecal incontinence and providing access for medication administration and sample collection, but it does not perform any diagnostic testing itself.

N/A

Intended Use / Indications for Use

For use to manage fecal incontinence through the collection of liquid to semi-liquid stool and to provide access to administer medications.

Product codes

KNT

Device Description

The Flexi-Seal® SIGNAL™ Fecal Management System is comprised of a soft catheter tube assembly, a Luer-lock syringe, a collection bag with cap and a cinch clamp to pinch off flow in the catheter when required for medication retention or to stop waste flow. The components are contained in a rigid thermoformed plastic clamshell.

The catheter main drain tube is fabricated from collapsible silicone rubber with the addition of an odor adsorber, which is added in order to help contain the fecal odor which often permeates through the wall of the catheter.

The drain tube has a low-pressure silicone retention balloon at the distal end and a connector for attaching a collection bag (provided with the device and also available separately) at the proximal end. There is a recess (pocket) under the balloon for the clinician's finger, which allows the device to be positioned digitally.

Two ports are attached to the side of the catheter. One port is used to inflate the retention balloon with water or saline after the device has been inserted into the patient's rectum. This port also provides a visual and tactile signal of when the low pressure retention balloon is filled to its optimal volume. The other port is used to flush the device if needed and administer medication if prescribed.

An additional sampling port is located on the side of the catheter, which allows access to clinicians for stool sample collection.

A syringe (provided with the device) is used to fill and evacuate the retention balloon for insertion and removal.

The device, collection bag and syringe are intended for single us, are provided non-sterile and contain no components made with animal products, natural rubber latex or DEHP.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

rectum

Indicated Patient Age Range

The device is not intended for use on pediatric patients.

Intended User / Care Setting

clinicians

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 of the subject device for functional and structural parameters has been performed. In this testing, the device's performance has been found to be substantially equivalent to the aforementioned predicate device both functionally and structurally (material strength, catheter size, balloon size, etc.). The device has also been evaluated for biocompatibility in accordance with the US Food and Drug Administration's guidance entitled Use of International Standard ISO-10993, 'Biological Evaluation of Medical Devices Part 1: Evaluation and Testing', issued May 1, 1995, and has been found safe in such respect for its intended use. In conclusion, the subject device has been demonstrated as safe and effective and substantially equivalent to the predicate device.

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

Not Found

Predicate Device(s)

K112342

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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

July 21, 2015

ConvaTec, Ltd. Clare Williamson Regulatory Affairs Documentation Compliance Manager Unit 20, First Avenue, Deeside Industrial Park Deeside, Flintshire CH5 2NU UK

Re: K150350 Trade/Device Name: Flexi-Seal® Signal™ Fecal Management System Regulation Number: 21 CFR§ 876.5980 Regulation Name: Gastrointestinal tube and accessories Regulatory Class: II Product Code: KNT Dated: June 18, 2015 Received: June 24, 2015

Dear Clare Williamson,

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.

1

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,

Benjamin R. Fisher -S

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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

Indications for Use

510(k) Number (if known)K150350
Device NameFlexi-Seal® Signal™ Fecal Management System
Indications for Use (Describe)For use to manage fecal incontinence through the collection of liquid to semi-liquid stool and to provide access to administer medications.
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)

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

FOR FDA USE ONLY

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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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FORM FDA 3881 (1/14)Page 1 of 1PSC Publishing Services (301) 443-6740 EF
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Image /page/3/Picture/0 description: The image shows the logo for ConvaTec. The logo consists of the word "ConvaTec" in blue, followed by a blue circle with a stylized image of a building with three columns inside. The logo is simple and modern, and the blue color gives it a sense of trustworthiness and reliability.

Unit 20, First Avenue Deeside Industrial Park Deeside Flintshire CH5 2NU Telephone: 01244 584000 Facsimile: 01244 584011

510(k) Summary

Subject Device: Flexi-Seal® SIGNAL™ Fecal Management System

Date Prepared: February 06, 2015

Applicant: ConvaTec Ltd.

First Avenue Deeside Industrial Park Deeside Flintshire CH5 2NU UK

Contact: Clare Williamson

Regulatory Affairs Documentation Compliance Manager Tel: +44 (0)1244 584155 Fax: +44 (0)1244 584311 Email: clare.williamson@convatec.com

Device Trade Name: Flexi-Seal® SIGNAL™ Fecal Management System

Common Name: Fecal Management System

Classification Name: Gastrointestinal Tube and Accessories (21 CFR §876.5980, Product Code: KNT)

Device Class: Class II

Predicate Device:

Device Trade Name: Flexi-Seal® SIGNAL™ Fecal Management System -ConvaTec Inc.

Common Name: Fecal Management System

Classification Name: Gastrointestinal Tube and Accessories (21 CFR §876.5980, Product Code: KNT)

Device Class: Class II

510(k) Substantial Equivalence: K112342 - determined substantially equivalent on April 26, 2012

Device Description:

4

The Flexi-Seal® SIGNAL™ Fecal Management System is comprised of a soft catheter tube assembly, a Luer-lock syringe, a collection bag with cap and a cinch clamp to pinch off flow in the catheter when required for medication retention or to stop waste flow. The components are contained in a rigid thermoformed plastic clamshell.

The catheter main drain tube is fabricated from collapsible silicone rubber with the addition of an odor adsorber, which is added in order to help contain the fecal odor which often permeates through the wall of the catheter.

The drain tube has a low-pressure silicone retention balloon at the distal end and a connector for attaching a collection bag (provided with the device and also available separately) at the proximal end. There is a recess (pocket) under the balloon for the clinician's finger, which allows the device to be positioned digitally.

Two ports are attached to the side of the catheter. One port is used to inflate the retention balloon with water or saline after the device has been inserted into the patient's rectum. This port also provides a visual and tactile signal of when the low pressure retention balloon is filled to its optimal volume. The other port is used to flush the device if needed and administer medication if prescribed.

An additional sampling port is located on the side of the catheter, which allows access to clinicians for stool sample collection.

A syringe (provided with the device) is used to fill and evacuate the retention balloon for insertion and removal.

The device, collection bag and syringe are intended for single us, are provided non-sterile and contain no components made with animal products, natural rubber latex or DEHP.

This Traditional 510(k) concerns modifications which do not alter the indications for use of the predicate device, the Flexi-Seal® SIGNAL™ Fecal Management System (ref. K112342).

Intended use:

The Flexi-Seal® SIGNAL™ Fecal Management System is an indwelling fecal management catheter intended for use to manage fecal incontinence through the collection of liquid to semi-liquid stool and to provide access to administer medications. The device is not intended for use on pediatric patients.

Summary of Technological Characteristics:

The Flexi-Seal® SIGNAL™ Fecal Management System has the same intended use and indications for use as the predicate device, however the tubing now incorporates odor adsorbing properties. The adsorber reduces the odor which often permeates through the wall of the catheter. These unpleasant odors during catheter use can cause major discomfort to the patients, caregivers and visitors. Therefore, the reduction of odor is advantageous to overall patient wellbeing.

The device specifications are essentially identical to those of the predicate device, although minor adjustments have been made to the catheter tubing to

5

ensure that the material softness remains. Catheter tube diameter, catheter tube hardness, catheter tube tensile strength, and balloon-catheter bonding were evaluated via bench testing and are substantially equivalent to the predicate device. There are no differences in operation between the Flexi-Seal® SIGNAL ™ Fecal Management System and the predicate device.

Summary of Performance (Non-Clinical Testing) Data:

Non-clinical testing of the subject device for functional and structural parameters has been performed. In this testing, the device's performance has been found to be substantially equivalent to the aforementioned predicate device both functionally and structurally (material strength, catheter size, balloon size, etc.). The device has also been evaluated for biocompatibility in accordance with the US Food and Drug Administration's guidance entitled Use of International Standard ISO-10993, 'Biological Evaluation of Medical Devices Part 1: Evaluation and Testing', issued May 1, 1995, and has been found safe in such respect for its intended use.

In conclusion, the subject device has been demonstrated as safe and effective and substantially equivalent to the predicate device.

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Summary of Technological Characteristics

The following table summarises the technological characteristics of the subject and predicate devices (ref. K112342, determined substantially equivalent on April 26, 2012) and outlines the product characteristics and specifications which form the basis of the substantial equivalence discussion.

The intended use, technological characteristics and principles of operation of the Flexi-Seal® SIGNAL™ Fecal Management System remains the same as those of the predicate device.

Subject DevicePredicateComparison
ParameterFlexi-Seal® SIGNAL™ Fecal Management
SystemFlexi-Seal® SIGNAL™ Fecal Management
System
(K112342)SimilaritiesDifferences
FDA Product
CodeKNTKNTBoth devices are the sameNone
FDA
Classification
Regulation21 CFR 876.598021 CFR 876.5980Both devices are the sameNone
Regulatory
ClassClass IIClass IIBoth devices are the sameNone
Intended UseTo manage fecal incontinence through the
collection of liquid to semi-liquid stool and to
provide access to administer medicationsTo manage fecal incontinence through the
collection of liquid to semi-liquid stool and to
provide access to administer medicationsBoth devices are the sameNone
Functional
configurationCollapsible catheter with distal end secured in
the rectum and proximal end connected to a
collection bagCollapsible catheter with distal end secured in
the rectum and proximal end connected to a
collection bagBoth devices are the sameNone
Retention
featureSoft annular balloonSoft annular balloonBoth devices are the sameNone
Balloon materialSilicone rubberSilicone rubberBoth devices are the sameNone
Inflation
managementSealed water filled balloonSealed water filled balloonBoth devices are the sameNone
Retention
balloon inflation
materialWater/saline (45ml)Water/saline (45ml)Both devices are the sameNone
Catheter tube
length1,550mm - 1,670mm1,550mm - 1,670mmBoth devices are the sameNone
Length of
sphincter section>10cm>10cmBoth devices are the sameNone

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ParameterSubject DevicePredicateComparison
Flexi-Seal® SIGNAL™ Fecal Management
SystemFlexi-Seal® SIGNAL™ Fecal Management
System
(K112342)SimilaritiesDifferences
Drain channelLarge main drain tubeLarge main drain tubeBoth devices are the sameNone
Inflation and
irrigation port
connectionsLuerLuerBoth devices are the sameNone
Inflation lumen
diameterTwo lumens at 1.45 mmTwo lumens at 1.45 mmBoth devices are the sameNone
Inflation lines22Both devices are the sameNone
Irrigation lines11Both devices are the sameNone
Sampling portClosable snap seal for catheter syringe accessClosable snap seal for catheter syringe accessBoth devices are the sameNone
Collection bag
configurationDisposable with gas filterDisposable with gas filterBoth devices are the sameNone
Collection bag
size1 litre disposable1 litre disposableBoth devices are the sameNone
Method of bed
connectionHanging strap on bag connectorHanging strap on bag connectorBoth devices are the sameNone
Accessory
componentsSyringe and cinch clampSyringe and cinch clampBoth devices are the sameNone
Flow stop
mechanismExternal cinch clampExternal cinch clampBoth devices are the sameNone
Sterility status
(how provided)Non-sterileNon-sterileBoth devices are the sameNone
PackagingThermoformed plastic clamshellThermoformed plastic clamshellBoth devices are the sameNone