K Number
K182217
Device Name
Linear Cutter Staplers and Loading Units for Single Use, Circular Staplers for Single Use
Date Cleared
2019-04-16

(244 days)

Product Code
Regulation Number
878.4750
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Linear Cutter Staplers and Loading Units for Single Use have application in gastrointestinal for transection, resection, and/or creation of anastomoses. The Circular Staplers for Single Use has applications throughout the alimentary for end-to-end, end-to-side and side-to-side anastomoses.
Device Description
The Linear Cutter Staplers and Loading Units for Single Use place two double staggered rows of titanium staples and simultaneously cut and divides tissue between the two double rows. The device is available in 60mm, 80mm and 100mm length with reload in 2.5mm and 4.5mm staple size to accommodate various tissue thicknesses. The device may be reloaded and fired up to 8 times in a single procedure. The Circular Staplers for Single Use places a double staggered, circular row of titanium staples upon activation, which was achieved by squeezing the handles firmly as far as they could go. Immediately after formation of the staples, the excess tissue will be resect by the circular knife, and then a circular anastomosis is created. The stapler is available in 33mm, 29mm, 25mm and 21mm five specifications. Two staple sizes (3.5mm and 4.8mm) are available to accommodate various tissue thicknesses.
More Information

Not Found

No
The summary describes mechanical surgical staplers and does not mention any AI/ML components or capabilities.

Yes
The device is described as a surgical stapler used for "transection, resection, and/or creation of anastomoses" in the gastrointestinal and alimentary systems, which are therapeutic medical procedures.

No

Explanation: The device is described as a surgical stapler used for cutting tissue and creating anastomoses. Its function is to perform a surgical procedure, not to diagnose a condition.

No

The device description clearly details physical hardware components (staplers, loading units, titanium staples, circular knife) and performance tests related to mechanical properties (firing force, staple formation, tensile strength, etc.), indicating it is a physical medical device, not software-only.

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

Here's why:

  • Intended Use: The intended use clearly describes the device's application in surgical procedures for transection, resection, and creation of anastomoses within the gastrointestinal and alimentary tracts. This is a direct surgical intervention on the body.
  • Device Description: The description details a mechanical device that physically manipulates tissue by placing staples and cutting. This is a surgical instrument.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens derived from the human body (like blood, urine, tissue samples) to provide information for diagnosis, monitoring, or treatment. The device itself is performing a surgical action, not analyzing biological samples.
  • Performance Studies: The performance studies focus on the mechanical and biological compatibility of the device itself (firing force, staple formation, biocompatibility, etc.), not on the accuracy or reliability of diagnostic information derived from biological samples.

In summary, the device is a surgical stapler used for physical manipulation of tissue during surgery, which falls under the category of a surgical instrument, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Linear Cutter Staplers and Loading Units for Single Use have application in gastrointestinal for transection, resection, and/or creation of anastomoses.

The Circular Staplers for Single Use has applications throughout the alimentary for end-to-end, end-to-side and side-to-side anastomoses.

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

GDW, GAG

Device Description

The Linear Cutter Staplers and Loading Units for Single Use place two double staggered rows of titanium staples and simultaneously cut and divides tissue between the two double rows. The device is available in 60mm, 80mm and 100mm length with reload in 2.5mm and 4.5mm staple size to accommodate various tissue thicknesses. The device may be reloaded and fired up to 8 times in a single procedure.

The Circular Staplers for Single Use places a double staggered, circular row of titanium staples upon activation, which was achieved by squeezing the handles firmly as far as they could go. Immediately after formation of the staples, the excess tissue will be resect by the circular knife, and then a circular anastomosis is created. The stapler is available in 33mm, 29mm, 25mm and 21mm five specifications. Two staple sizes (3.5mm and 4.8mm) are available to accommodate various tissue thicknesses.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Gastrointestinal, alimentary

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 tests were conducted to verify that the proposed device met all design specifications as was Substantially Equivalent (SE) to the predicate device. The test provided in this submission include package integrity test, bacteria endotoxin test, biocompatibility tests. The shelf life test and performance tests were performed on both proposed device and predicate device to determine substantial equivalence, the performance test include following items:

  • Firing Force Test
  • Staple Formation Test
  • Staple Line Pressure Test
  • Staple Line Tensile Test
  • Closed Staple Height Test

Biocompatibility tests included cytotoxicity, sensitization, intracutaneous irritation and pyrogenicity.

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.

K020779, K983536, K100723

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

§ 878.4750 Implantable staple.

(a)
Identification. An implantable staple is a staple-like device intended to connect internal tissues to aid healing. It is not absorbable.(b)
Classification. Class II.

0

S001

Exhibit 2 510(k) Summary

This 510(k) Summary is being submitted in accordance with requirements of Title 21, CFR Section 807.92.

The assigned 510(k) Number: K182217

    1. Date of Preparation: 2/25/2019
    1. Sponsor Identification

Ezisurg (Suzhou) Medical Co., Ltd.

Building 16, No.8 Jinfeng Rd., Suzhou National Hi-Tech District, Suzhou 215163 Jiangsu, China.

Establishment Registration Number: Not yet registered.

Contact Person: Jingtian Ren Position: Regulatory Affairs Engineer Tel: +86-21-50456176-8026 Fax: +86-21-50676156 Email: renjingtian@ezisurg.com

    1. Designated Submission Correspondent
      Ms. Diana Hong (Primary Contact Person) Ms. Ying Xu (Alternative Contact Person)

Mid-Link Consulting Co., Ltd P.O. Box 120-119, Shanghai, 200120, China

Tel: +86-21-22815850, Fax: 3609253199 Email: info@mid-link.net

1

4. Identification of Proposed Device

Trade Name: Linear Cutter Staplers and Loading Units for Single Use Circular Staplers for Single Use Common Name: Stapler and Reload

Regulatory Information

Classification Name: Staple, Implantable Classification: II Product Code: GDW Regulation Number: 21 CFR 878.4750 Review Panel: General & Plastic Surgery

Classification Name: Stapler, Surgical; Classification: I Subsequent Product Code: GAG; Regulation Number: 21CFR 878.4800 Review Panel: General & Plastic Surgery

Intended Use Statement:

The Linear Cutter Staplers and Loading Units for Single Use have application in gastrointestinal for transection, resection, and/or creation of anastomoses.

The Circular Staplers for Single Use has applications throughout the alimentary for end-to-end, end-to-side and side-to-side anastomoses.

Device Description

The Linear Cutter Staplers and Loading Units for Single Use place two double staggered rows of titanium staples and simultaneously cut and divides tissue between the two double rows. The device is available in 60mm, 80mm and 100mm length with reload in 2.5mm and 4.5mm staple size to accommodate various tissue thicknesses. The device may be reloaded and fired up to 8 times in a single procedure.

The Circular Staplers for Single Use places a double staggered, circular row of titanium staples upon activation, which was achieved by squeezing the handles firmly as far as they could go. Immediately after formation of the staples, the excess tissue will be resect by the circular knife, and then a circular anastomosis is created. The stapler is available in 33mm, 29mm, 25mm and 21mm five

2

specifications. Two staple sizes (3.5mm and 4.8mm) are available to accommodate various tissue thicknesses.

ર . Identification of Predicate Devices

Predicate Device 1 510(k) Number: K020779 Product Name: ENDOPATH™ and PROXIMATE™ Linear Cutters and Staplers

Predicate Device 2 510(k) Number: K983536 Device Name: PROXIMATE Curved and Straight Intraluminal Staplers

Predicate Device 3 510(k) Number: K100723 Device Name: PROXIMATE Curved and Straight Intraluminal Staplers

Non-Clinical Test Conclusion 6.

Non clinical tests were conducted to verify that the proposed device met all design specifications as was Substantially Equivalent (SE) to the predicate device. The test provided in this submission include package integrity test, bacteria endotoxin test, biocompatibility tests. The shelf life test and performance tests were performed on both proposed device and predicate device to determine substantial equivalence, the performance test include following items.

  • . Firing Force Test
  • . Staple Formation Test
  • . Staple Line Pressure Test
  • . Staple Line Tensile Test
  • . Closed Staple Height Test

Biocompatibility tests included cytotoxicity, sensitization, intracutaneous irritation and pyrogenicity.

The test results demonstrated that the proposed device complies with the following standards:

  • A ISO 10993-1:2009 Biological evaluation of medical devices- Part 1: Evaluation and testing within a risk management process.
  • ISO 10993-5:2009 Biological evaluation of medical devices-Part 5: Tests for in vitro cytotoxicity.

  • ISO 10993-10:2010 Biological evaluation of medical devices- Part 10: Test for irritation and delayed-type hypersensitivity

  • USP 38-NF 33 Bacterial Endotoxins Tests

3

K182217S001E2 510(k) Summary
----------------------------------
  • ASTM F 88/F88M-09 Standard test method for seal strength of flexible barrier materials;

  • ISO 11137-2:2013 Sterilization of health care products -Radiation- Part 2: Establishing the sterilization dose

  • USP 39-NF 34 Pyrogen

    1. Clinical Test Conclusion

No clinical study is included in this submission.

4

K182217
---------

Substantially Equivalent (SE) Comparison 8.

ItemProposed DevicePredicate Device 1
K020779
Product CodeGDWGDW
Regulation Number21 CFR 878.475021 CFR 878.4750
Intended UseThe Linear Cutter Staplers and Loading Units for Single Use have application in gastrointestinal for transection, resection, and/or creation of anastomoses.The PROXIMATE Linear and Vascular Linear Cutters with Safety Lockout have application in gastrointestinal, gynecologic, thoracic and pediatric surgery for transection, resection, and/or creation of anastomoses and can be used with staple line or tissue buttressing materials, such as bovine pericardium
Cutting MechanismLinearLinear
Operation PrincipleManualManual
Safety MechanismSafety release for prevent from mis-firingSafety release for prevent from mis-firing
Suture Length60mm, 80mm, 100mm55, 75mm
Closed Staple Height1.0mm, 1.5mm, 2.0mm1.0mm, 1.5mm, 1.8mm, 2.0mm
Closed staple formImage: staple formImage: staple form
Endotoxin Limit20 EUSame
LabelingConforms with 21 CFR 801Conforms with 21 CFR 801

Table 1 Comparison for Linear Cutter Staplers and Loading Units for Single Use

5

ItemProposed DevicePredicate Device 2Predicate Device 3
K983536K100723
Product CodeGDWGDWGDW
Regulation Number21 CFR 878.475021 CFR 878.475021 CFR 878.4750
Intended UseThe Circular Staplers for Single Use has
applications throughout the alimentary
for end-to-end, end-to-side and
side-to-side anastomoses.The PROXIMATER Curved and
Straight Intraluminal Staplers have
application throughout the alimentary
for end to end, end to side and side to
side anastomoses.The Disposable Circular Stapler has
application throughout the alimentary
tract for end-to-end, end-to-side and
side-to-side anastomoses.
Cutting MechanismCircular KnifeCircular KnifeCircular Knife
Operation PrincipleManualManualManual
Safety MechanismSafety Release is used for preventing
from mis-firing.Safety Release is used for preventing
from mis-firing.Safety Release is used for preventing
from mis-firing.
Diameter21mm, 25mm, 29mm, 31mm, 33mm21mm, 25mm, 29mm, 33mm25.5mm, 29.5mm
Closed Staple Height1.0~2.5mm1.0~2.5mm1.5~2.0mm
Closed staple formImage: staple formImage: staple formImage: staple form
Endotoxin Limit20 EU20EU20EU
LabelingConforms with 21 CFR 801Conforms with 21 CFR 801Conforms with 21 CFR 801

Table 2 Comparison for Circular Staplers for Single Use

S001

6

K182217
    1. Substantially Equivalent (SE) Conclusion
      Based on the comparison and analysis above, the proposed devices are determined to be Substantially Equivalent (SE) to the predicate devices.

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Image /page/8/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo is a blue square with the letters "FDA" in white, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue.

April 16. 2019

Ezisurg (Suzhou) Medical Co., Ltd. % Diana Hong General Manager Mid-Link Consulting Co., Ltd P.O. box 120-119 Shanghai, 200120 Cn

Re: K182217

Trade/Device Name: Linear Cutter Staplers and Loading Units for Single Use. Circular Staplers for Single Use

Regulation Number: 21 CFR 878.4750 Regulation Name: Implantable Staple Regulatory Class: Class II Product Code: GDW, GAG Dated: August 6, 2018 Received: August 15, 2018

Dear Ms. Hong:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

9

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) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.htm); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; 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 mediation-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.

  • for Binita S. Ashar, M.D., M.B.A., F.A.C.S. Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health
    Enclosure