K Number
K181431
Device Name
Laser Ureteral Catheter
Manufacturer
Date Cleared
2018-07-30

(59 days)

Product Code
Regulation Number
878.4810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Laser Ureteral Catheter is intended for protection and delivery of a laser fiber in the urinary tract.
Device Description
The Laser Ureteral Catheter is a single lumen catheter available in a diameter of 7.1 French and a length of 40 centimeters. The Laser Ureteral Catheter is manufactured from polyethylene tubing, with a proximal female Luer lock adapter and connector cap, and male Luer lock adapter and connector cap with a cap seal. The device is provided sterile and intended for one-time use.
More Information

No
The summary describes a physical catheter for laser fiber delivery and protection, with no mention of software, algorithms, or data processing that would indicate AI/ML.

No.
The device is a catheter intended for protection and delivery of a laser fiber; it does not directly treat a disease or condition itself.

No
The description states the device is intended for "protection and delivery of a laser fiber in the urinary tract," which is a therapeutic or interventional function, not diagnostic. There are no mentions of image processing, AI, or diagnostic performance metrics.

No

The device description clearly outlines physical components made of polyethylene tubing, Luer lock adapters, and connector caps, indicating it is a hardware device.

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

Here's why:

  • Intended Use: The intended use is "for protection and delivery of a laser fiber in the urinary tract." This describes a device used within the body for a therapeutic or procedural purpose, not for testing samples outside the body to diagnose a condition.
  • Device Description: The description details a physical catheter designed for insertion into the urinary tract. This aligns with an in vivo medical device, not an in vitro diagnostic.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), reagents, or any process related to diagnosing a disease or condition based on in vitro testing.

IVD devices are specifically designed to examine specimens derived from the human body to provide information for the diagnosis, monitoring, or treatment of a disease or condition. This device does not fit that description.

N/A

Intended Use / Indications for Use

The Laser Ureteral Catheter is intended for protection and delivery of a laser fiber in the urinary tract.

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

GEX

Device Description

The Laser Ureteral Catheter is a single lumen catheter available in a diameter of 7.1 French and a length of 40 centimeters. The Laser Ureteral Catheter is manufactured from polyethylene tubing, with a proximal female Luer lock adapter and connector cap, and male Luer lock adapter and connector cap with a cap seal. The device is provided sterile and intended for one-time use.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

urinary 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)

Performance - Testing shows that the subject device conforms to the performance testing requirements based on intended use. All predetermined acceptance criteria were met.
Tests Performed:

  • Compatibility and Dimensional Testing
  • Tensile Strength
  • Radiopacity
  • Kink Radius

Biocompatibility - Testing shows that the subject device conforms to the biocompatibility requirements based on its intended use. All predetermined acceptance criteria were met.
Tests Performed:

  • Cytotoxicity – ISO MEM Elution
  • Sensitization – Guinea Pig Maximization
  • Irritation/Intracutaneous Reactivity - Intracutaneous Study

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.

K960768

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.

K171662

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

§ 878.4810 Laser surgical instrument for use in general and plastic surgery and in dermatology.

(a)
Identification. (1) A carbon dioxide laser for use in general surgery and in dermatology is a laser device intended to cut, destroy, or remove tissue by light energy emitted by carbon dioxide.(2) An argon laser for use in dermatology is a laser device intended to destroy or coagulate tissue by light energy emitted by argon.
(b)
Classification. (1) Class II.(2) Class I for special laser gas mixtures used as a lasing medium for this class of lasers. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 878.9.

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July 30, 2018

Cook Incorporated Carly Powell Regulatory Affairs Specialist 750 Daniels Way Bloomington, IN 47404

Re: K181431

Trade/Device Name: Laser Ureteral Catheter Regulation Number: 21 CFR§ 878.4810 Regulation Name: Laser Surgical Instrument for use in General and Plastic Surgery and in Dermatology Regulatory Class: II Product Code: GEX Dated: May 31, 2018 Received: June 1, 2018

Dear Carly Powell:

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 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.

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 comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Glenn B. Bell -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

2

Indications for Use

510(k) Number (if known) K181431

Device Name Laser Ureteral Catheter

Indications for Use (Describe)

The Laser Ureteral Catheter is intended for protection and delivery of a laser fiber in the urinary tract.

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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2.0 510(k) Summary

750 DANIELS WAY, I

K181431 Page 1 of 5

Laser Ureteral Catheter 21 CFR 878.4810 Date Prepared: July 30, 2017

Cook Incorporated

Cook Incorporated

Carly Powell Karthik Pillai

Submitted By:

Submission: Applicant: Contact:

Applicant Address:

Contact Phone Number: Contact Fax Number:

Device Information:

750 Daniels Way Bloomington, IN 47404 (812) 335-3575 x104913 (812) 332-0281

Traditional 510(k) Premarket Notification

Trade Name:Laser Ureteral Catheter
Common Name:Powered Laser Surgical Instrument
Classification Name:Laser surgical instrument for use in general and plastic
surgery and in dermatology
Classification Regulation:21 CFR 878.4810, Product Code GEX
Device Class/Classification Panel:Class II, General & Plastic Surgery

Predicate Device:

The Laser Ureteral Catheter is substantially equivalent to the following device:

  • K960768 Laser Fiber Delivery/Cleaning Catheter (Cook Urological Inc.). The Laser Fiber Delivery/Cleaning Catheter is used to protect the delivery of a laser ablation fiber for periodic, intraoperative cleaning of charred, thermally degraded tissue from the laser fiber and for irrigation of the surgical site.

Reference Device:

  • . K171662 Ureteral catheters are indicated for access and catheterization of the urinary tract, including the following applications:
    • Delivery of contrast media
    • I Drainage of fluids from the urinary tract
    • Delivery of irrigation fluids to the urinary tract
    • Navigation of a tortuous ureter

4

2

  • . Access, advancement, or exchange of wire guides (open-ended catheters only)
  • The Pediatric Ureteral Catheter is indicated for access and catheterization of the o urinary tract in pediatric patients, including the following applications:
    • . Delivery of contrast media
    • I Drainage of fluids from the urinary tract
    • I Delivery of irrigation fluids to the urinary tract
    • I Navigation of a tortuous ureter

Device Description:

The Laser Ureteral Catheter is a single lumen catheter available in a diameter of 7.1 French and a length of 40 centimeters. The Laser Ureteral Catheter is manufactured from polyethylene tubing, with a proximal female Luer lock adapter and connector cap, and male Luer lock adapter and connector cap with a cap seal. The device is provided sterile and intended for one-time use.

Indications for Use:

The Laser Ureteral Catheter is intended for protection and delivery of a laser fiber in the urinary tract.

Comparison to Predicate:

The Laser Ureteral Catheter and the predicate device, Laser Fiber Delivery/Cleaning Catheter (K960768), are substantially equivalent in indications for use; these devices have similar design, technological characteristics, construction and function. Both are catheters intended to protect the delivery of a laser fiber. The Laser Ureteral Catheter and the reference device Ureteral Catheter (K171662) are similar in dimension, material, and these devices are both used in the ureter.

The intended uses for the Laser Fiber Delivery/Cleaning Catheter (K960768), and the subject device Laser Ureteral Catheter are fundamentally identical; "intended to be used to protect and deliver a laser fiber". The predicate has a broader indication for general surgery, whereas the subject device is specifically indicated for the urinary tract. The addition of this specific indication for the use in urinary tract does not raise any new questions of safety and effectiveness, since predicate is indicated for general surgery. Additionally, the access and catheterization of the urinary tract using a ureteral catheter is supported by the reference device Ureteral Catheter (K171662). The subject device and the reference device, Ureteral Catheters (K171662), are both indicated to access and catheterize the urinary tract.

5

Cook Incorporated - Traditional 510(k) Laser Ureteral Catheter July 17, 2018

The subject and predicate device have similar intended uses, and therefore, no new questions of safety or effectiveness are raised. A comparison of the intended uses and technological characteristics of the subject, reference and predicate devices is provided in Table 2.0-1.

PREDICATE DEVICEREFERENCE DEVICESUBJECT DEVICE
Laser Fiber Delivery/Cleaning
CatheterUreteral CathetersLaser Ureteral Catheter
ManufacturerCook Urological, IncCook IncorporatedCook Incorporated
510(k)K960768K171662Subject of this submission
Regulation21 CFR §878.4810
Laser surgical instrument for use
in general and plastic surgery
and in dermatology.21 CFR §876.5130
Catheter, Ureteral, General & Plastic
Surgery21 CFR §878.4810
Laser surgical instrument for use in
general and plastic surgery and in
dermatology.
Product CodeGEXKODGEX
ClassificationIIIIIdentical
Indications for
UseThe Laser Fiber
Delivery/Cleaning Catheter is
intended to be used to protect the
delivery of a laser ablation fiber
for periodic, intraoperative
cleaning of charred, thermally
degraded tissue from the laser
fiber and for irrigation of the
surgical site. The 5.7 Fr Laser
Fiber Delivery/Cleaning
Catheter will accept laser fibers
up to 1250 microns (0.050 inch).
The 8.0 Fr Laser Fiber
Delivery/Cleaning Catheter will
accept fibers up to 1500 microns
(0.060 inch).Ureteral catheters are indicated for
access and catheterization of the
urinary tract, including the following
applications:
• Delivery of contrast media
· Drainage of fluids from the urinary
tract
• Delivery of irrigation fluids to the
urinary tract
• Navigation of a tortuous ureter
• Access, advancement, or exchange of
wire guides (open-ended catheters
only)
The Pediatric Ureteral Catheter is
indicated for access and catheterization
of the urinary tract in pediatric patients,
including the following applications:
• Delivery of contrast media
• Drainage of fluids from the urinary
tract
• Delivery of irrigation fluids to the
urinary tract
· Navigation of a tortuous ureterThe Laser Ureteral Catheter is
intended for protection and
delivery of a laser fiber in the
urinary tract.

Table 2.0-1 Comparison Table

6

PREDICATE DEVICEREFERENCE DEVICESUBJECT DEVICE
Laser Fiber
Delivery/Cleaning CatheterUreteral CathetersLaser Ureteral Catheter
Catheter
Diameter (Fr)5.7-accept fibers up to 1250
microns (0.05 inch),
8.0-accept fibers up to 1500
microns (0.06 inch)3-97.1
Catheter
Length (cm)25-4010, 15, 70, 85, 12040
Catheter
MaterialPolyethyleneRadiopaque Polyvinyl chloride or
Polyurethane Radiopaque tubing or
PolytetrafluoroethylenePolyethylene Radiopaque Tubing
Maximum
shelf-life
(years)Unknown33
Sterilization
MethodEtOEtOIdentical
PackagingTyvek-Poly pouchTyvek polyethylene peel-open pouchTyvek-PET/ LDPE

Performance Data:

The subject device underwent the applicable testing listed below to ensure reliable design and performance under the testing parameters. Performance and biocompatibility testing were conducted in accordance with the following applicable FDA guidance documents to confirm the reliable performance of critical device characteristics.

  • . Performance - Testing shows that the subject device conforms to the performance testing requirements based on intended use. All predetermined acceptance criteria were met.
Test PerformedGuidance Document
Compatibility and Dimensional Testing – Testing ensures dimensional and
compatibility requirements were met.N/A
Tensile Strength – Testing shows that there should be no fracture of catheter shaft and
hub-to-shaft.
Radiopacity – Testing shows that the mean radiopacity met the acceptance criteria and
evaluated radiopacity by subjecting the ureteral catheters to a comparative
fluoroscopic evaluation.
Kink Radius – Testing determined the kink radius of the ureteral catheter tubing.
  • . Biocompatibility - Testing shows that the subject device conforms to the biocompatibility requirements based on its intended use. All predetermined acceptance criteria were met.
    4

7

5

Testing PerformedGuidance Document
Cytotoxicity – ISO MEM ElutionUse of International Standard
ISO 10993-1, "Biological
evaluation of medical devices -
Part 1: Evaluation and testing
within a risk management
process"
Sensitization – Guinea Pig Maximization
Irritation/Intracutaneous Reactivity - Intracutaneous Study

All predetermined acceptance criteria were met.

Conclusion:

The data included in this submission indicate that the subject device does not raise new questions of safety or effectiveness compared to the predicate device, Laser Fiber Delivery/Cleaning Catheter (K960768), which supports a determination of substantial equivalence.