K Number
K152161
Date Cleared
2015-09-18

(46 days)

Product Code
Regulation Number
870.4210
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The CentriMag Return (Arterial) Cannula is indicated for use as an arterial return cannula with an extracorporeal bypass circuit for extracorporeal circulatory support for periods up to six hours.

Device Description

The Thoratec CentriMag Return (Arterial) Cannula Kit consists of the return (arterial) cannula and several accessories used in the surgical placement procedure. The cannula and all kit accessories are sterile, single-use, disposable devices. The cannula kit is designed for use with the Thoratec CentriMag® Extracorporeal Blood Pumping System (K020271).

The Cannula Kit includes the following accessories:

QTYKit Component
1Return (Arterial) Cannula Body
1Connector, 3/8-inch, barbed
1Introducer
1Hemostasis Seal
1Cap (with Umbilical tape)
1Porous Plug
1Guidewire Assembly
1Introducer Needle
4Suture Rings (small)
4Suture Rings (medium)
4Tip Rings
AI/ML Overview

This document describes a 510(k) premarket notification for the "Thoratec CentriMag Return (Arterial) Cannula Kit." This is a medical device and not an AI/ML algorithm, so many of the requested fields are not applicable. I will provide information relevant to device testing as presented in the document.

1. Table of Acceptance Criteria and Reported Device Performance

TestAcceptance Criteria (Implied)Reported Device Performance
Flex TestDevice integrity maintainedSuccessful results
Tensile Strength TestDevice integrity maintained under tensile stressSuccessful results
Chemical Resistance TestDevice integrity maintained after exposure to chemicalsSuccessful results
Pressure TestDevice integrity maintained under pressureSuccessful results
Suture and Tip Ring Security and Deformation TestRings remain secure and do not deform beyond acceptable limitsSuccessful results
Dimensional Verification ExaminationDimensions meet specificationsSuccessful results
Cannula Body Material ExaminationMaterial properties meet specificationsSuccessful results
Material Evaluation (Chemical Characterization)New materials are chemically suitableSuccessful results
BiocompatibilityNew materials are biocompatibleSuccessful results
Microbiological Performance (Reduced Confirmatory Revalidation)Device maintains sterilitySuccessful results

2. Sample Size Used for the Test Set and Data Provenance

The document does not explicitly state the sample size for each performance test. It only mentions that "All testing employed devices that were exposed to 2x sterilized, accelerated-aging to simulate a real-time equivalent of 1-year, and heated saline soak for 30 days."

Data Provenance: Not specified, but generally, device performance testing data comes from the manufacturer's internal testing labs. It is a prospective study in the sense that the tests were designed and executed to evaluate the new device.

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

Not applicable. This device is evaluated through engineering and biocompatibility testing, not expert interpretation of outputs.

4. Adjudication Method for the Test Set

Not applicable. This is not an AI/ML algorithm or a diagnostic test requiring human adjudication. Device performance is determined by meeting physical and chemical specifications.

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

No, an MRMC comparative effectiveness study was not done. This is a medical device, not an AI/ML diagnostic tool.

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

Not applicable. This is a physical medical device, not an algorithm. The performance tests are inherently "standalone" in that they assess the device itself.

7. The Type of Ground Truth Used

The "ground truth" for this device's performance testing is based on:

  • Engineering specifications and design requirements (e.g., specific tensile strength values, pressure limits, dimensional tolerances).
  • Material science standards (e.g., chemical composition analysis, biocompatibility standards).
  • Sterility standards (microbiological performance).

8. The Sample Size for the Training Set

Not applicable. This is a physical medical device undergoing performance and material testing, not an AI/ML model that requires a training set.

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

Not applicable, as there is no training set for a physical medical device.

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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 features the department's name encircling a stylized symbol. The symbol consists of three overlapping profiles facing right, with flowing lines suggesting movement or connection. The profiles are rendered in black against a white background.

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

Thoratec Corporation Lori DonDiego Senior Manager, Regulatory Affairs 6035 Stoneridge Drive Pleasanton, VA 94588

Re: K152161

Trade/Device Name: Thoratec CentriMag Return (Arterial) Cannula Kit Regulation Number: 21 CFR 870.4210 Regulation Name: Cardiopulmonary Vascular Catheter, Cannula, or Tubing Regulatory Class: Class II Product Code: DWF Dated: August 31, 2015 Received: September 2, 2015

Dear Ms. DonDiego:

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 device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set

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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" (21CFR 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.

M.A. Hillebrand

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

Enclosure

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4.0 Indications for Use Statement

Applicant:Thoratec Corporation
510(k) Number (if known):K152161
Device Name:Thoratec CentriMag® Return (Arterial) Cannula Kit

Indications for Use:

The CentriMag Return (Arterial) Cannula is indicated for use as an arterial return cannula with an extracorporeal bypass circuit for extracorporeal circulatory support for periods up to six hours.

Prescription Use X (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)

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5.0 510(k) Summary

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the Safe Medical Devices Act (SMDA) of 1990 and Title 21 of the Code of Federal Regulations, Part 807, and in particular §807.92.

A. Application Information

Date Prepared:July 31, 2015
Submitter's Name & Address:Thoratec Corporation6035 Stoneridge DrivePleasanton, CA 94588Establishment Registration No.: 2916596Owner / Operator No.: 9045196
Contact Person:Lori DonDiegoSr. Manager, Regulatory AffairsPh: 925-734-6921Fax: (925) 847-8628

B. Device Information

Trade or Proprietary Name:CentriMag Return (Arterial) Cannula Kit
Common or Usual Name:Cardiopulmonary bypass cannula
Classification Name:Cardiovascular bypass vascular catheter,cannula, or tubing (DWF, 21 CFR -870.4210), Class II
Performance Standard:Performance standards do not currentlyexist for these devices. None establishedunder section 514 of the Food, Drug andCosmetic Act.

C. Legally Marketed Predicate Device

Thoratec CentriMag Return Cannula Kit (K110980)

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Device Description D.

The Thoratec CentriMag Return (Arterial) Cannula Kit consists of the return (arterial) cannula and several accessories used in the surgical placement procedure. The cannula and all kit accessories are sterile, single-use, disposable devices. The cannula kit is designed for use with the Thoratec CentriMag® Extracorporeal Blood Pumping System (K020271).

The Cannula Kit includes the following accessories:

QTYKit Component
1Return (Arterial) Cannula Body
1Connector, 3/8-inch, barbed
1Introducer
1Hemostasis Seal
1Cap (with Umbilical tape)
1Porous Plug
1Guidewire Assembly
1Introducer Needle
4Suture Rings (small)
4Suture Rings (medium)
4Tip Rings

E. Intended Use

The CentriMag Cannulae are designed to serve as conduits to transport blood between the heart and the extracorporeal blood pump. The Cannulae are intended for use for circulatory support during cardiac surgery for cardiopulmonary surgical procedures for up to six hours.

ட Technological Characteristics

The technological characteristics of the modified CentriMag Return (Arterial) Cannula Kit are the same as the predicate device.

G. Comparison to Predicate Device

The modified CentriMag Return (Arterial) Cannula Kit has the same indication for use, technological characteristics, and performance attributes which essentially renders the modified device equivalent to the predicate device. Moreover, the new device raises no new questions concerning safety or effectiveness. The modification improves upon the reliability of the connection between the connector and the cannula body.

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Summary of Performance Data H.

The modified CentriMag Return (Arterial) Cannula Kit has successfully undergone performance testing to demonstrate substantial equivalence to the predicate device.

The following performance and dimensional verification tests have been conducted on the redesigned cannula with successful results:

  • . Flex Test
  • . Tensile Strength Test
  • . Chemical Resistance Test
  • . Pressure Test
  • Suture and Tip Ring Security and Deformation Test
  • . Dimensional Verification Examination
  • Cannula Body Material Examination

All testing employed devices that were exposed to 2x sterilized, acceleratedaging to simulate a real-time equivalent of 1-year, and heated saline soak for 30days.

Additional verification involved materials evaluation for chemical characterization and biocompatibility to address raw material supplier changes. Lastly, a reduced confirmatory microbiological performance qualification revalidation) was conducted.

The risk management methods used to assess the design modifications to the CentriMag Return (Arterial) Cannula were a Risk Analysis and a Failure Modes and Effects Analysis (FMEA).

l. Clinical Performance

Clinical testing was not performed.

J. Conclusion

The redesigned CentriMag Return (Arterial) Cannula Kit is substantially equivalent to the current CentriMag Return Cannula Kit (K110980).

§ 870.4210 Cardiopulmonary bypass vascular catheter, cannula, or tubing.

(a)
Identification. A cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to cannulate the vessels, perfuse the coronary arteries, and to interconnect the catheters and cannulas with an oxygenator. The device includes accessory bypass equipment.(b)
Classification. Class II (performance standards).