K Number
K170740
Device Name
GORE VIABIL Short Wire Biliary Endoprosthesis
Date Cleared
2017-05-08

(59 days)

Product Code
Regulation Number
876.5010
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The GORE® VIABIL® Short Wire Biliary Endoprosthesis is intended for palliation of malignant strictures in the biliary tree.
Device Description
The GORE® VIABIL® Short Wire Biliary Endoprosthesis is a flexible endoprosthesis (stent) that is radially compressed and secured onto the distal end of a delivery catheter. The catheter provides a means for implanting the GORE® VIABIL® Short Wire Biliary Endoprosthesis at the target site in the biliary tract. The subject of this 510(k) pre-market notification is a modification to the catheter component of the endoscopic (GI) delivery system to include a guidewire exit port located near the distal end of the catheter which will allow use of a shorter length (minimum 260cm) guidewire enabling single user control of the guidewire during use. No changes have been made to the implanted endoprosthesis of the predicate GORE® VIABIL® Biliary Endoprosthesis device.
More Information

Not Found

No
The device description focuses on mechanical modifications to a delivery catheter for a stent, with no mention of AI/ML or related concepts.

Yes.
The device is an endoprosthesis (stent) intended for the "palliation of malignant strictures in the biliary tree," which is a form of treatment to alleviate symptoms, thus qualifying it as a therapeutic device.

No

This device is an endoprosthesis (stent) intended for the palliation of malignant strictures, which is a treatment rather than a diagnostic function.

No

The device description clearly states it is a flexible endoprosthesis (stent) and a delivery catheter, which are physical hardware components. The 510(k) is for a modification to the catheter.

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

Here's why:

  • Intended Use: The intended use is "palliation of malignant strictures in the biliary tree." This describes a therapeutic intervention performed within the body, not a test performed on a sample taken from the body.
  • Device Description: The device is a "flexible endoprosthesis (stent)" and a "delivery catheter." These are instruments used for implantation and delivery within the body.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting analytes, or providing diagnostic information based on laboratory testing.

IVD devices are used to examine specimens derived from the human body to provide information for the diagnosis, prevention, monitoring, treatment, or alleviation of disease. This device is a therapeutic implant and delivery system.

N/A

Intended Use / Indications for Use

The GORE® VIABIL® Short Wire Biliary Endoprosthesis is intended for palliation of malignant strictures in the biliary tree.

Product codes (comma separated list FDA assigned to the subject device)

FGE

Device Description

The GORE® VIABIL® Short Wire Biliary Endoprosthesis is a flexible endoprosthesis (stent) that is radially compressed and secured onto the distal end of a delivery catheter. The catheter provides a means for implanting the GORE® VIABIL® Short Wire Biliary Endoprosthesis at the target site in the biliary tract. The subject of this 510(k) pre-market notification is a modification to the catheter component of the endoscopic (GI) delivery system to include a guidewire exit port located near the distal end of the catheter which will allow use of a shorter length (minimum 260cm) guidewire enabling single user control of the guidewire during use. No changes have been made to the implanted endoprosthesis of the predicate GORE® VIABIL® Biliary Endoprosthesis device.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

biliary tree, biliary tract

Indicated Patient Age Range

Not Found

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)

Non-Clinical: The device specific guidance document, FDA's Guidance for the Content of Premarket Notifications for Metal Expandable Biliary Stents, was consulted in determining the appropriate testing for the subject catheter modification. Testing was conducted on representative sterile, aged samples. The test samples were subjected to simulated use deployment testing, dimensional testing, tensile/bond strength testing, deployment force, accessory component compatibility, deployment accuracy, and deployment reliability. Testing demonstrated the subject Viabil device met the established acceptance criteria for up to the intended device shelf life, consistent with the predicate Viabil device. Biocompatibility testing was conducted per ISO10993-1 and confirmed the subject device, like the predicate device, is biocompatible for its intended use. Packaging testing of the subject Viabil device in the predicate Viabil device packaging system confirmed that the packaging system was acceptable for the GORE® VIABIL® Short Wire Biliary Endoprosthesis device. MR Safety testing was conducted in recognition of FDA's guidance, Establishing Safety and Compatibility of Passive Implants in the Magnetic Resonance (MR) Environment and the results included in the device labeling.
Animal study: No animal studies were required to support this submission.
Clinical: No clinical evaluations were required to support this submission.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K081184

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 876.5010 Biliary catheter and accessories.

(a)
Identification. A biliary catheter and accessories is a tubular flexible device used for temporary or prolonged drainage of the biliary tract, for splinting of the bile duct during healing, or for preventing stricture of the bile duct. This generic type of device may include a bile collecting bag that is attached to the biliary catheter by a connector and fastened to the patient with a strap.(b)
Classification. Class II (special controls). The device, when it is a bile collecting bag or a surgical biliary catheter that does not include a balloon component, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.

0

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Image /page/0/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract image of three human profiles facing to the right. The profiles are stacked on top of each other, with the top profile being the most complete and the bottom profile being the least complete.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - W O66-G609 Silver Spring, MD 20993-0002

May 8, 2017

W.L. Gore & Associates, Inc. Barbara L. Smith, RAC Regulatory Associate 301 Airport Road Elkton, MD 21921

Re: K170740

Trade/Device Name: GORE® VIABIL® Short Wire Biliary Endoprosthesis Regulation Number: 21 CFR§ 876.5010 Regulation Name: Biliary Catheter and Accessories Regulatory Class: II Product Code: FGE Dated: March 9, 2017 Received: March 10, 2017

Dear Barbara L. Smith:

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 and the limitations described below. 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.

The Office of Device Evaluation has determined that there is a reasonable likelihood that this device will be used for an intended use not identified in the proposed labeling and that such use could cause harm. Therefore, in accordance with Section 513(i)(E) of the Act, the following limitation must appear in the Warnings section of the device's labeling:

The safety and effectiveness of this device for use in the vascular system have not been established

1

Furthermore, the indication for biliary use must be prominently displayed in all labeline. including pouch box, and carton labels, instructions for use, and other promotional materials, in close proximity to the trade name, of a similar point size, and in bold print.

Please note that the above labeling limitations are required by Section 513(i)(1)(E) of the Act. Therefore, a new 510(k) is required before these limitations are modified in any way or removed from the device's labeling.

The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and permits your device to proceed to the market. This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification if the limitation statement described above is added to your labeling.

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 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.

2

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,

William H. Maisel -S

William H. Maisel, MD, MPH Director, Office of Device Evaluation (Acting) Deputy Center Director for Science Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known)

K170740

Device Name

GORE® VIABIL® Short Wire Biliary Endoprosthesis

Indications for Use (Describe)

The GORE® VIABIL® Short Wire Biliary Endoprosthesis is intended for palliation of malignant strictures in the biliary tree.

Type of Use (Select one or both, as applicable)
X Prescription Use (Part 21 CFR 801 Subpart D)Over-The-Counter Use (21 CFR 801 Subpart C)

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7 510(K) SUMMARY [21 CFR 807.92]

510(k) Submitter

W. L. Gore & Associates, Inc. 301 Airport Road Elkton, Maryland 21921 Regulatory contact: Barbara L. Smith, RAC

Date Prepared

May 1, 2017

Device Names/Classification

Device Name:GORE® VIABIL® Short Wire Biliary Endoprosthesis
Common Name:Biliary Stent
Classification Name:Catheter, biliary, diagnostic
Classification:21CFR876.5010 – Class II
Product Code:FGE

Predicate Devices

  • . K081184 GORE® VIABIL® Biliary Endoprosthesis

Device Description

The GORE® VIABIL® Short Wire Biliary Endoprosthesis is a flexible endoprosthesis (stent) that is radially compressed and secured onto the distal end of a delivery catheter. The catheter provides a means for implanting the GORE® VIABIL® Short Wire Biliary Endoprosthesis at the target site in the biliary tract. The subject of this 510(k) pre-market notification is a modification to the catheter component of the endoscopic (GI) delivery system to include a guidewire exit port located near the distal end of the catheter which will allow use of a shorter length (minimum 260cm) guidewire enabling single user control of the guidewire during use. No changes have been made to the implanted endoprosthesis of the predicate GORE® VIABIL® Biliary Endoprosthesis device.

5

The sizes of the GORE® VIABIL® Short Wire Biliary Endoprosthesis device are the same as the predicate GORE® VIABIL® Biliary Endoprosthesis as noted in the following table.

| Endoprosthesis -
Diameter (mm) x Length
(cm) | Drainage Holes
Located at the
Hilar Region |
|----------------------------------------------------|--------------------------------------------------|
| 8 × 4 | No holes |
| 8 x 6 | No holes |
| 8 × 8 | No holes |
| 8 x 10 | No holes |
| 10 x 4 | No holes |
| 10 x 6 | No holes |
| 10 x 8 | No holes |
| 10 x 10 | No holes |
| 8 × 6 | Holes |
| 8 × 8 | Holes |
| 8 x 10 | Holes |
| 10 x 6 | Holes |
| 10 x 8 | Holes |
| 10 x 10 | Holes |

Indications for Use

The GORE® VIABIL® Short Wire Biliary Endoprosthesis is intended for palliation of malignant strictures in the biliary tree.

6

Comparison of Technological Characteristics

The table below describes the similarities/differences between the catheter component of the subiect GORE® VIABIL® Short Wire Biliary Endoprosthesis and the catheter component of the predicate GORE® VIABIL® Biliary Endoprosthesis (K081184).

Modified DevicePredicate Device
GORE® VIABIL® Short Wire BiliaryGORE® VIABIL® Biliary
EndoprosthesisEndoprosthesis
K081184
Indications for useNo change - Same as predicateIntended for palliation of malignant
strictures in the biliary tree.
Endoprosthesis
(Stent device)No change - Same as predicateePTFE/FEP film tube supported by
an FEP coated Nitinol stent.
Deployment
SystemNo change - Same as predicatePull-line style deployment using an
ePTFE zipper
Single port hubY-arm (dual port) catheter hub
GI Delivery
Catheter
Component -
Modified for use
with shorter
guidewireDual lumen catheter tubing
-Added guidewire exit port on catheter
shaft; 2nd catheter hub port eliminated.
Catheter material formulation change
to different durometer of same
material typeDual lumen catheter tubing
-Guidewire exits from 2nd catheter
hub port
BiocompatibilitySame as predicateBiocompatible per ISO10993-1.
Device Packaging• HDPE coil with modified connector
• No change to sterile barrier• HDPE coil and connector for
physical protection of device
within sterile barrier
Sterilization
method/SALSame as predicateEthylene Oxide/SAL of 10-6
LabelingSame as predicate
MR safety information
Update to warning statementsComplies with applicable regulations &
FDA guidance on MR safety

Summary of Performance Testing

Non-Clinical

The device specific guidance document, FDA's Guidance for the Content of Premarket Notifications for Metal Expandable Biliary Stents, was consulted in determining the appropriate testing for the subject catheter modification. Testing was conducted on representative sterile, aged samples. The test samples were subjected to simulated use deployment testing, dimensional testing, tensile/bond strength testing, deployment force, accessory component compatibility, deployment accuracy, and deployment reliability. Testing demonstrated the subject Viabil device met the established acceptance criteria for up to the intended device shelf life, consistent with the predicate Viabil device. Biocompatibility testing was conducted per ISO10993-1 and confirmed the subject device, like the predicate device, is biocompatible for its intended use. Packaging testing of the subject Viabil device in the predicate Viabil device packaging system confirmed that the packaging system

7

was acceptable for the GORE® VIABIL® Short Wire Biliary Endoprosthesis device. MR Safety testing was conducted in recognition of FDA's guidance, Establishing Safety and Compatibility of Passive Implants in the Magnetic Resonance (MR) Environment and the results included in the device labeling.

Animal study: No animal studies were required to support this submission.

Clinical

No clinical evaluations were required to support this submission.

Conclusion

Based on the information contained within this 510(k) premarket notification, W. L. Gore & Associates concludes that the subject GORE® VIABIL® Short Wire Biliary Endoprosthesis device is substantially equivalent to the predicate GORE® VIABIL® Biliary Endoprosthesis device in terms of indications for use, materials, biocompatibility, sterilization, packaging, labeling and performance.