K Number
K170247
Device Name
Lacriflow CL
Date Cleared
2017-04-18

(81 days)

Product Code
Regulation Number
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Lacriflow CL is indicated in treatments of epiphora in patients 12 months and older, in cases of: - Canalicular pathologies (stenosis, obstruction, lacerations), - During Dacryocystorhinostomy (conventional or laser), - Congenital nasolacrimal duct obstruction.
Device Description
The LACRIFLOW CL is intended for the treatment of epiphora due to conditions including the obstructions of lacrimal punctum, lacrimal canaliculus, or nasolacrimal duct. The LACRIFLOW CL consists of the Lacrimal duct tube and the Bougie. The Lacrimal duct tube is intended to be inserted and placed inside the lacrimal canaliculus or other sites to dilate the lacrimal duct, and the Bougie is intended to be used for the Lacrimal duct tube and removed after insertion of Lacrimal duct tube. Lacrimal duct is dilated by insertion of the Lacrimal duct tube into the obstructed site.
More Information

Not Found

No
The device description and performance studies focus on mechanical properties and physical insertion, with no mention of AI/ML terms or data-driven analysis.

Yes
The device is intended for "treatments of epiphora" and to "dilate the lacrimal duct," which are therapeutic actions to alleviate a medical condition.

No

The device description clearly states it is "intended for the treatment of epiphora" and "to dilate the lacrimal duct," indicating a therapeutic rather than diagnostic purpose.

No

The device description explicitly states the device consists of a "Lacrimal duct tube and the Bougie," which are physical components, not software. The performance studies also describe physical tests like penetration, insertion, and bending tests.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health.
  • Device Function: The Lacriflow CL is a device designed to be inserted into the lacrimal system to treat obstructions. It is a therapeutic device used directly on the patient's anatomy, not a device used to analyze samples outside the body.
  • Intended Use: The intended use clearly describes treatment of epiphora due to lacrimal system pathologies, not diagnostic testing.
  • Device Description: The description details a physical device (tube and bougie) for insertion and dilation, not equipment for analyzing biological samples.

Therefore, the Lacriflow CL falls under the category of a therapeutic medical device, not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The Lacriflow CL is indicated in treatments of epiphora in patients 12 months and older, in cases of:

  • Canalicular pathologies (stenosis, obstruction, lacerations),
  • During Dacryocystorhinostomy (conventional or laser),
  • Congenital nasolacrimal duct obstruction.

Product codes

OKS

Device Description

The LACRIFLOW CL is intended for the treatment of epiphora due to conditions including the obstructions of lacrimal punctum, lacrimal canaliculus, or nasolacrimal duct. The LACRIFLOW CL consists of the Lacrimal duct tube and the Bougie. The Lacrimal duct tube is intended to be inserted and placed inside the lacrimal canaliculus or other sites to dilate the lacrimal duct, and the Bougie is intended to be used for the Lacrimal duct tube and removed after insertion of Lacrimal duct tube. Lacrimal duct is dilated by insertion of the Lacrimal duct tube into the obstructed site.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Lacrimal duct, lacrimal punctum, lacrimal canaliculus, nasolacrimal duct

Indicated Patient Age Range

12 months and older

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)

A risk analysis was conducted to assess the impact of the modifications on the subject device in accordance with our design control and ISO 14971. The design verification tests completed as follows:

ModificationPerformance test
Elimination of stainless steel rings on both sides of the tube partsPenetration test of the tip with the Bougie was performed.
Change in the shape of the tips of the lacrimal duct tubeSimulated insertion test was performed. Bending test for the tip was performed.
Change in the hydrophilic coating areaInserting load was measured. Visual inspection regarding extraneous matter, abnormality which prevents use, coating droplet was performed.

In accordance with design control requirements in 21 CFR 820.30, the subject device met all verification tests listed above.

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

Not Found

Predicate Device(s)

K120886

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

N/A

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April 18, 2017

Kaneka Pharma America LLC % Izumi Maruo Senior Consultant MIC International 4-1-17 Hongo Bunkyo-ku, Tokyo 113-0033, Japan

Re: K170247

Trade/Device Name: Lacriflow CL Regulatory Class: Unclassified Regulatory Name: Unclassified Product Code: OKS Dated: March 21, 2017 Received: March 22, 2017

Dear Izumi Maruo:

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

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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 forth in the quality systems (OS) 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.

Denise L. Hampton -S

for Malvina B. Eydelman, M.D. Director Division of Ophthalmic and Ear, Nose, and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K170247

Device Name Lacriflow CL

Indications for Use (Describe)

The Lacriflow CL is indicated in treatments of epiphora in patients 12 months and older, in cases of.

  • Canalicular pathologies (stenosis, obstruction, lacerations),
  • During Dacryocystorhinostomy (conventional or laser),
  • Congenital nasolacrimal duct obstruction.

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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Kaneka Pharma America LLC 546 Fifth Avenue, 21st Floor New York, NY 10036

TEL:(212)705-4343 FAX:(212)705-4395

510(k) Summary

a. Owner/Company name, address KANEKA PHARMA AMERICA LLC 546 Fifth Avenue, 21st Floor New York, NY 10036 USA

b. Contact

Masaaki Fukunishi Director KANEKA PHARMA AMERICA LLC 546 Fifth Avenue, 21st Floor New York, NY 10036 USA

Phone: 1- 212-705-4343 Fax: 1- 212-705-4395 Email: masaaki.fukunishi @kaneka.com

c. Application Correspondent

Izumi Maruo Senior Consultant MIC International 4-1-17 Hongo, Bunkyo-ku Tokyo, 113-0033, Japan

Phone:011-81-3-3818-8577
Fax:011-81-3-3818-8573
Email:maruo@mici.co.jp

d. Date prepared

January 23, 2017

e. Name of device

Trade Name:LACRIFLOW CL
Common Name:Lacrimal stent
Classification Name:Lacrimal Stents and Intubation Sets
Classification Regulation:Unclassified
Product Code:OKS

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Image /page/4/Picture/1 description: The image shows the word "Kaneka" in a sans-serif font. The word is written in all lowercase letters and is a dark blue color. The letters are bold and have rounded edges. The background is white.

Kaneka Pharma America LLC 546 Fifth Avenue, 21st Floor New York, NY 10036

TEL:(212)705-4343 FAX:(212)705-4395

f. Predicate devices

The LACRIFLOW CL is substantially equivalent to the following legally marketed device:

510(k):K120886
Trade name:LACRIFLOW
Product code:OKS

g. Description of the device

The LACRIFLOW CL is intended for the treatment of epiphora due to conditions including the obstructions of lacrimal punctum, lacrimal canaliculus, or nasolacrimal duct. The LACRIFLOW CL consists of the Lacrimal duct tube and the Bougie. The Lacrimal duct tube is intended to be inserted and placed inside the lacrimal canaliculus or other sites to dilate the lacrimal duct, and the Bougie is intended to be used for the Lacrimal duct tube and removed after insertion of Lacrimal duct tube. Lacrimal duct is dilated by insertion of the Lacrimal duct tube into the obstructed site.

h. Indications for Use

Indications for Use

The LACRIFLOW CL is indicated in treatments of epiphora in-patients 12 months and older. in cases of:

  • Canalicular pathologies (stenosis, obstruction, lacerations),
  • During Dacryocystorhinostomy (conventional or laser),
  • Congenital nasolacrimal duct obstruction.

i. Statement of substantial equivalence

The LACRIFLOW CL was modified from the LACRIFLOW (K120886).

The Indications for Use of the LACRIFLOW CL is unchanged from the LACRIFLOW (K120886).

The LACRIFLOW CL contains the following modifications as compared to the LACRIFLOW (K120886);

  • O Elimination of stainless steel rings on both sides of the tube part
  • O Change in the shape of the tips of the lacrimal duct tube
  • No openings on both ends of the lacrimal duct tube
  • Change in the hydrophilic coating area
  • O The LACRIFLOW CL does not contain the "Mini" model

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Kaneka Pharma America LLC 546 Fifth Avenue, 21st Floor New York, NY 10036

TEL:(212)705-4343 FAX:(212)705-4395

Following comparison table provides technological characteristic between the subject and the predicate device;

Table 1. Comparison table between LACRIFLOW CL and the LACRIFLOW (K120886).
-------------------------------------------------------------------------------
SUBJECT DEVICEPREDICATE DEVICE
LACRIFLOW CLLACRIFLOW (K120886)
Indications for UseSame as the predicateThe LACRIFLOW is indicated in
treatments of epiphora in patients
12 months and older, in cases of:
-Canalicular pathologies
(stenosis, obstruction,
lacerations),
-During Dacryocystorhinostomy
(conventional or laser),
-Congenital nasolacrimal duct
obstruction.
Prescription useYesYes
Product CodeSame as the predicateOKS
Tube ShapeSame as the predicateTwo tubes are
connected by a rod
part
Tip ShapePointed and no openingRounded and opening in both
ends
Hydrophilic coatingSurface of the device except the
tip part is coatedEntire surface of the device is
coated
Size of the Tube
- LengthStandard type: 105 mm
Short type: 90 mmStandard type: 105 mm
Short type: 90 mm
Mini type: 50 mm
-Outer DiameterSame as the predicateTube part: 1.0 mm
Rod part: 0.7 mm
Tensile Strength of the TubeSame as the predicate14.2 N (Average of 9 samples)
Insertion MethodSame as the predicateThe LACRIFLOW consists of the
tube and the Bougie, and thus the
Bougie is used for insertion.
Insertion Assist PartsSame as the predicateThe Bougie
-LengthSame as the predicate55 mm
-Outer DiameterSame as the predicate0.5 mm
-Tip ShapeSame as the predicateStraight, helically grooved
-Tip DiameterSame as the predicateThe same as the outer diameter
-MaterialSame as the predicateStainless steel
SterilizationSame as the predicateYes
(Ethylene Oxide)
Single-Use OnlySame as the predicateYes

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TEL:(212)705-4343 FAX:(212)705-4395

The modification from the LACRIFLOW (K120886) includes material change. However, this change is caused by elimination of stainless steel ring and the LACRIFLOW (K120886) contains all materials used for the LACRIFLOW CL. Therefore, this modification does not alter the fundamental scientific technology of the device.

A risk analysis was conducted to assess the impact of the modifications on the subject device in accordance with our design control and ISO 14971. The design verification tests completed as follows:

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Table 2. Summary of design verification tests

ModificationPerformance test
Elimination of stainless steel rings on both
sides of the tube partsPenetration test of the tip with the Bougie was
performed.
Change in the shape of the tips of the lacrimal
duct tubeSimulated insertion test was performed.
Bending test for the tip was performed.
Change in the hydrophilic coating areaInserting load was measured.
Visual inspection regarding extraneous matter,
abnormality which prevents use, coating
droplet was performed.

In accordance with design control requirements in 21 CFR 820.30, the subject device met all verification tests listed above.

We determined that following modifications would not cause harm;

  • O The LACRIFLOW CL does not contain the "Mini" model
  • No openings on both ends of the lacrimal duct tube

In conclusion, the LACRIFLOW CL is substantially equivalent to the LACRIFLOW (K120886).

a. Conclusion

The LACRIFLOW CL has the identical indications for use to the LACRIFLOW (K120886). The results of design verification tests based on the risk analysis demonstrate that the LACRIFLOW CL is substantially equivalent to the predicate devices.