K Number
K162906
Manufacturer
Date Cleared
2017-03-07

(141 days)

Product Code
Regulation Number
876.5980
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

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

Device Description

The new device is called Flexi-Seal® PROTECT™ Fecal Management System which is an upqrade to the predicate device K150350. Flexi-Seal® Signal™ Fecal Management System (also known as Flexi-Seal® Signal™ Fecal Management System with Odor Barrier), launched in October 2015. The new device uses the same design and components except

  • (1) the change from the 1-dome fill indicator to a new 2-dome fill indicator to provide visual cue by using
    • (a) a green color dome to indicate an optimal fill status of retention balloon which is similar to the existing fill indicator except the color, and
    • (b) a red color dome to indicate the over inflation status of retention balloon,
  • (2) adding a white cap that can close off the inflation port,
  • (3) adding a dark blue color in the sample port, and
  • (4) Privacy bag (one bag instead of 3).

The device is comprised of the following components (in a clamshell pack with label card, IFU and 5 date labels): see diagram

AI/ML Overview

The provided document is a 510(k) premarket notification for a medical device called the Flexi-Seal® PROTECT™ Fecal Management System. It primarily focuses on demonstrating substantial equivalence to a predicate device (Flexi-Seal® SIGNAL™ Fecal Management System) rather than presenting a study to prove acceptance criteria for a new, AI-powered device.

Therefore, the information required to answer your specific questions about acceptance criteria and a study proving device performance (especially in the context of AI, multi-reader multi-case studies, or standalone algorithm performance) is not present in the provided text.

The document discusses non-clinical testing for functional and structural parameters to demonstrate that modifications to the predicate device do not affect safety and effectiveness. These are not acceptance criteria for an AI algorithm's performance.

Here's an analysis based on the information that is available, highlighting the absence of the requested details:


1. A table of acceptance criteria and the reported device performance

The document provides a comparison table (pages 7 and 8) outlining similarities and differences between the subject device (Flexi-Seal® PROTECT™) and the predicate device (Flexi-Seal® SIGNAL™). This table details parameters and their values for both devices, mainly focusing on physical characteristics and some functional aspects.

This is NOT a table of acceptance criteria for an AI study. It describes product specifications and how the new device compares to the old one. For example:

ParameterAcceptance Criteria (from document, interpreted as "same as predicate")Reported Device Performance (from document, interpreted as "new device value")
Fill indication for optimal inflation volumeGreen dome inflated at 35 - 45 ml (Predicate was White dome inflated at 35-45ml)Green dome inflated at 35 - 45 ml
Fill Indicator for overfilling statusRed dome inflated beyond 45 ml and above ("A new feature in the subject device")Red dome inflated beyond 45 ml and above
Cap for inflation portRemovable silicone cap ("A new feature in the subject device")Removable silicone cap with sufficient removal force and joint strength
Sampling port colorDark blue color (Predicate was natural color)Dark blue color
Collection bag configurationOne bag (Predicate was three bags)One bag with gas filter
Collection bag - front panel colorWhite with a clear window (Predicate was Clear)White with a clear window
Other parameters (e.g., Catheter tube material, tensile strength, balloon size)Generally "Both devices are the same" as the predicate device (e.g., Silicone rubber, 245N, 56.82mm)Match the predicate device's specifications

The "Performance Testing - Bench" section (page 5-6) lists tests conducted (e.g., fill indicator testing, cap testing, sampling port testing, privacy bag testing, journey hazard testing) but does not provide specific numerical acceptance criteria or performance results within the provided text. It only states that "Based on non-clinical testing of the subject device for functional and structural parameters, the modifications in the subject device do not affect the safety and effectiveness of the predicate device."

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

This information is not provided in the document. The document refers to "non-clinical testing" (bench testing) and does not involve patient data or clinical studies with test sets in the context of an AI device.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

This information is not provided in the document. No expert review or ground truth establishment relevant to an AI model is mentioned, as this is not an AI device submission.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

This information is not provided in the document.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

This information is not provided in the document. No MRMC study is mentioned, as this is not an AI device.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

This information is not provided in the document. No standalone algorithm performance is mentioned.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

This information is not provided in the document. The "ground truth" for the non-clinical tests would be reference measurements or engineering specifications, not clinical outcomes or expert consensus for diagnoses.

8. The sample size for the training set

This information is not provided in the document. No training set is involved as this is not an AI/ML device.

9. How the ground truth for the training set was established

This information is not provided in the document. No training set or associated ground truth establishment is mentioned.


In summary: The provided FDA 510(k) submission pertains to a conventional medical device (Fecal Management System) and its modifications. It details bench testing to show equivalence to a predicate device. None of the questions related to AI-specific acceptance criteria, study designs (test/training sets, experts, MRMC, standalone performance), or ground truth establishment for AI models are applicable or answerable using this document.

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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 consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is an abstract symbol that resembles a stylized human figure or a series of interconnected profiles.

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

March 7, 2017

ConvaTec Karen Howes Regulatory Affairs Manager GDC, First Avenue, Deeside Industrial Park Deeside, Flintshire CH5 2NU United Kingdom

Re: K162906

Trade/Device Name: Flexi-Seal® PROTECT™ Fecal Management System Regulation Number: 21 CFR§ 876.5980 Regulation Name: Gastrointestinal Tube and Accessories Regulatory Class: II Product Code: KNT Dated: February 2, 2017 Received: February 6, 2017

Dear Karen Howes:

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,

Joyce M. Whang -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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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) Unknown K162906

Device Name

Flexi-Seal® PROTECT TM Fecal Management System

Indications for Use (Describe)

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

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

"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:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

FORM FDA 3881 (8/14)

Page 1 of 1

PSC Publishing Services (301) 243-1741 EF

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Image /page/3/Picture/0 description: The image features the logo of ConvaTec, a global medical products and technologies company. The logo consists of two distinct elements: a circular icon on the left and the company name "ConvaTec" on the right. The circular icon is a blue circle with a white graphic inside, resembling a building with columns. The text "ConvaTec" is written in a bold, sans-serif font, also in blue, matching the color of the circular icon.

Section 5 510(k) Summary

Applicant: ConvaTec Limited.

Applicant Address: GDC, First Avenue Deeside Industrial Park Deeside Flintshire CH5 2NU UK The Establishment Registration number is 1000317571

Contact: Karen Howes Regulatory Affairs Manager ConvaTec Ltd. GDC, First Avenue, Deeside industrial Park Deeside Flintshire, CH5 2NU UK Tel: +44(0) 1244832195

Date Prepared: 1 December 2016

Device Identification:

Trade Name: Flexi-Seal® PROTECT™ Fecal Management System Common Name: Fecal Management System

Regulation Number: 21 CFR §876.5980

Classification Panel: Gastroenterology and Urology

Classification Name: Gastrointestinal tube and accessories

Regulatory Class: II

Product Code: KNT

Predicate Devices: 510(K) number: K150350 Flexi-Seal® SIGNAL™ Fecal Management System

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Device Description

The new device is called Flexi-Seal® PROTECT™ Fecal Management System which is an upqrade to the predicate device K150350. Flexi-Seal® Signal™ Fecal Management System (also known as Flexi-Seal® Signal™ Fecal Management System with Odor Barrier), launched in October 2015. The new device uses the same design and components except

  • (1) the change from the 1-dome fill indicator to a new 2-dome fill indicator to provide visual cue by using
    • (a) a green color dome to indicate an optimal fill status of retention balloon which is similar to the existing fill indicator except the color, and
    • (b) a red color dome to indicate the over inflation status of retention balloon,
  • (2) adding a white cap that can close off the inflation port,
  • (3) adding a dark blue color in the sample port, and
  • (4) Privacy bag (one bag instead of 3).

The device is comprised of the following components (in a clamshell pack with label card, IFU and 5 date labels): see diagram

Image /page/4/Figure/9 description: The image shows a medical catheter with different parts labeled with numbers 1-11. The parts include the catheter irrigation and medication port, balloon inflation port, sampling port, catheter, position indicator line, low-pressure retention balloon, connector, hanging strap, luer-lock syringe, collection bag, and cinch clamp. The catheter is a long, flexible tube that is inserted into the body to drain fluids or deliver medications.

New device Flexi-Seal® PROTECT™ Fecal Management System

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Predicate device: Flexi-Seal® SIGNAL™ Fecal Management System

Image /page/5/Figure/1 description: This image shows a diagram of a catheter system with different parts labeled with numbers 1-11. The numbers correspond to the following parts: Catheter Irrigation and Medication Port, Balloon Inflation Port with Fill Indicator, Sampling Port, Catheter, Position Indicator Line, Low-Pressure Retention Balloon with Finger Pocket, Connector, Hanging Strap, Luer-lock Syringe, Collection Bag with Integrated Cap, and Cinch Clamp. The diagram shows the different parts of the catheter system and how they are connected.

Intended Use

The Flexi-Seal PROTECT FMS 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.

Performance Testing - Bench

There are no differences in the intended use or performance of the subject and the predicate device. Non clinical testing has been conducted on the predicate and subject devices. The list of non-clinical testing for which the results are detailed in Sec. 18 includes:

    1. Fill indicator testing:
    • a. Fill indication for optimal inflation volume of retention balloon
    • b. Fill Indictor for overfilling status of retention balloon
    • c. Fill Indicator joint strength to catheter
    • d. Luer valve joint strength to Inflation Port
    • e. Green ink adhesion
    • Red ink adhesion f.
    1. Inflation port cap testing:
    • a. Cap joint strength to the fill indicator
    • b. Cap removal force
    • c. Cap repeated removal 5 times
    1. Sampling port testing:
    • a. Sampling port seal against air
    • b. Sampling port seal against water
    1. Privacy bag testing:

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  • a. Width of clear window at 10 25 mm
  • b. Graduation at 500 ml is within ± 15%
  • c. Graduation at 1000 ml is within ± 15%
  • d. Pouch has 1 Liter capacity
  • e. Ink Adhesion
    1. Journey hazard testing:
    • a. Journey hazard testing
    • b. Post-JHT Product Release Testing Visual, Color, and Cap
    • c. Post-JHT Product Release Testing Fill indication for optimal inflation volume of retention balloon
    • d. Post-JHT Product Release Testing Fill Indictor for overfilling status of retention balloon

Based on non-clinical testing of the subject device for functional and structural parameters, the modifications in the subject device do not affect the safety and effectiveness of the predicate device. Flexi-Seal® PROTECT™ Fecal Management System described in this submission is, in our opinion, substantially equivalent to the predicate device, Flexi-Seal® SIGNAL™ Fecal Management System per K150350.

Substantial Equivalence Conclusion

It has been demonstrated through comparison of design features and performance testing, that the proposed device and its predicate have been found to be substantially equivalent; see following pages.

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Substantial Equivalence Discussion

The following table compares the similarities and differences between the subject device: Flexi-Seal® PROTECT™ Fecal Management System and the predicate device: Flexi-Seal® SIGNAL™ Fecal Management System (ref; K150350) 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 fecal management system remains the same as those of the predicate device.

Subject DevicePredicateComparison
ParameterFlexi-Seal® PROTECT™ Fecal ManagementSystemFlexi-Seal® SIGNAL™ Fecal Management System(K150350)SimilaritiesDifferences
FDA Product CodeKNTKNTBoth devices are the sameNone
FDA ClassificationRegulation21 CFR 876.598021 CFR 876.5980Both devices are the sameNone
Regulatory ClassClass IIClass IIBoth devices are the sameNone
Intended UseTo manage fecal incontinence through thecollection of liquid to semi-liquid stool and toprovide access to administer medicationsTo manage fecal incontinence through the collectionof liquid to semi-liquid stool and to provide access toadminister medicationsBoth devices are the sameNone
FunctionalconfigurationCollapsible catheter with distal end securedin the rectum and proximal end connected toa collection bagCollapsible catheter with distal end secured in therectum and proximal end connected to a collectionbagBoth devices are the sameNone
Retention featureSoft annular balloonSoft annular balloonBoth devices are the sameNone
Balloon materialSilicone rubberSilicone rubberBoth devices are the sameNone
InflationmanagementSealed water filled balloonSealed water filled balloonBoth devices are the sameNone
Retention balloonWater/saline (45ml)Water/saline (45ml)Both devices are the sameNone
inflation materialsame
Retention ballooninflated diameter56.82mm56.82mmBoth devices are thesameNone
Retention ballooninflated height25.96mm25.96mmBoth devices are thesameNone
Catheter tubematerialSilicone rubber plus 3% zeolite, by weightSilicone rubber plus 3% zeolite, by weightBoth devices are thesameNone
Catheter tubesurface roughness<15µm<15µmBoth devices are thesameNone
Fill indication foroptimal inflationvolume ofretention balloonGreen dome inflated at 35 - 45 mlWhite dome inflated at 35 - 45 mlExcept color, bothdevices provided thesame visual indicationfor optimal ballooninflation volume. Thedimension of the fillindicator is similar.Color
Fill Indictor foroverfilling status ofretention balloonRed dome inflated beyond 45 ml and aboveNoneA new feature in thesubject device using asimilar fill indicatordesignA new feature in thesubject device
Cap for inflationportA removable silicone cap to close off theinflation port with sufficient removal forceand joint strengthNoneA new feature in thesubject device todifferentiate theinflation port from theirrigation portA new feature in thesubject device
Catheter tubehardnessShore A 38.5 - 51Shore A 38.5 - 51Both devices are thesameNone
Catheter tube wallthickness0.40 - 0.65mm0.40 - 0.65mmBoth devices are thesameNone
Catheter tubetensile strength245N245NBoth devices are thesameNone
Balloon-to-tubebonding strength25.4N25.4NBoth devices are thesameNone
Catheter tubelength1,550mm - 1,670mm1,550mm - 1,670mmBoth devices are thesameNone
Length ofsphincter section>10cm>10cmBoth devices are thesameNone
Drain channelLarge main drain tubeLarge main drain tubeBoth devices are thesameNone
Inflation andirrigation portconnectionsLuerLuerBoth devices are thesameNone
Inflation lumendiameterTwo lumens at 1.45 mmTwo lumens at 1.45 mmBoth devices are thesameNone
Inflation lines22Both devices are thesameNone
Irrigation lines11Both devices are thesameNone
Irrigation lumensize8mm x 1.6mm (collapsible)8mm x 1.6mm (collapsible)Both devices are thesameNone
Sampling portClosable snap seal for catheter syringeaccess - dark blue colorClosable snap seal for catheter syringe access -natural colorExcept color, bothdevices provided thesame seal againstwater and air.Color
Waste lumendiameter collapsed10mm10mmBoth devices are thesameNone
Collection bagconfigurationDisposable with gas filterDisposable with gas filterBoth devices use thesame filter, flange,and film panels in thecollection bag.One bag in the subjectdevice vs. three bags inthe predicate device
Collection bag size1 litre disposable1 litre disposableBoth devices are thesameNone
Collection bagmaterialEthyl vinyl acetateEthyl vinyl acetateBoth devices are thesameNone
Collection bag -front panel colorWhite with a clear windowClearExcept color in thefront panel, both bagsperform the sameColor
Method of bedconnectionHanging strap on bag connectorHanging strap on bag connectorBoth devices are thesameNone
AccessorycomponentsSyringe and cinch clampSyringe and cinch clampBoth devices are thesameNone
Flow stopmechanismExternal cinch clampExternal cinch clampBoth devices are thesameNone
Sterility status(how provided)Non-sterileNon-sterileBoth devices are thesameNone
PackagingThermoformed plastic clamshell PETG(POLYETHYLENE TEREPHTHALATEGLYCOL-MODIFIED) or APET(AMORPHOUS POLYETHYLENETEREPHTHALATE), both sides coated with2% silicone.Thermoformed plastic clamshell PETG(POLYETHYLENE TEREPHTHALATE GLYCOL-MODIFIED) or APET (AMORPHOUSPOLYETHYLENE TEREPHTHALATE), both sidescoated with 2% silicone.Both devices use thesame packagingmaterialNone

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§ 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.