K Number
K182233
Device Name
FlowTriever Retrieval/Aspiration System
Manufacturer
Date Cleared
2018-10-15

(59 days)

Product Code
Regulation Number
870.5150
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The FlowTriever Retrieval/Aspiration System is indicated for: - The non-surgical removal of emboli and thrombi from blood vessels. - Injection, infusion, and/or aspiration of contrast media and other fluids into or from a blood vessel. The FlowTriever Retrieval/Aspiration System is intended for use in the peripheral vasculature and for the treatment of pulmonary embolism.
Device Description
The FlowTriever Retrieval/Aspiration System is a single-use over-the-wire catheter-based system for the minimally invasive treatment of thromboemboli in the peripheral vasculature. The system is comprised of two main components packaged separately: Aspiration Guide Catheter FlowTriever Catheters (available in 4 sizes: 6-10 mm, 11-14 mm, 15-18 mm, and 19-25 mm) The FlowTriever Catheter is inserted through the Aspiration Guide Catheter and advanced to the thrombus. Self-expanding wireform disks are deployed to engage thrombus by retracting the outer delivery catheter. The FlowTriever Catheter is retracted into the Aspiration Guide Catheter to capture the targeted thrombus. Additional clot may also be removed by aspiration with the provided 60 cc syringe. After the procedure is complete, the Aspiration Guide Catheter and FlowTriever Catheter are removed from the patient.
More Information

No
The description focuses on the mechanical components and function of a catheter-based system for thrombus removal. There is no mention of AI or ML in the intended use, device description, or performance studies.

Yes
This device is designed for the non-surgical removal of emboli and thrombi from blood vessels and for the treatment of pulmonary embolism, which are direct therapeutic interventions.

No

The device is a system for the non-surgical removal of emboli and thrombi (treatment), not for diagnosing conditions.

No

The device description clearly outlines physical components (catheters, syringe, wireform disks) and procedures involving their manipulation within the body, indicating it is a hardware-based medical device.

Based on the provided information, the FlowTriever Retrieval/Aspiration System is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used outside of the body.
  • FlowTriever Function: The FlowTriever system is a medical device used inside the body (in vivo) to physically remove blood clots from blood vessels. It is a surgical/interventional tool, not a diagnostic test performed on a sample.
  • Intended Use: The intended use clearly states "non-surgical removal of emboli and thrombi from blood vessels" and "Injection, infusion, and/or aspiration of contrast media and other fluids into or from a blood vessel." These are therapeutic and procedural actions, not diagnostic testing.
  • Device Description: The description details a catheter-based system for minimally invasive treatment, involving physical manipulation within the vasculature.

Therefore, the FlowTriever Retrieval/Aspiration System falls under the category of a therapeutic or interventional medical device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The FlowTriever Retrieval/Aspiration System is indicated for:

  • The non-surgical removal of emboli and thrombi from blood vessels.
  • Injection, infusion, and/or aspiration of contrast media and other fluids into or from a blood vessel.

The FlowTriever Retrieval/Aspiration System is intended for use in the peripheral vasculature and for the treatment of pulmonary embolism.

Product codes

DXE

Device Description

The FlowTriever Retrieval/Aspiration System is a single-use over-the-wire catheter-based system for the minimally invasive treatment of thromboemboli in the peripheral vasculature. The system is comprised of two main components packaged separately:
Aspiration Guide Catheter FlowTriever Catheters (available in 4 sizes: 6-10 mm, 11-14 mm, 15-18 mm, and 19-25 mm) The FlowTriever Catheter is inserted through the Aspiration Guide Catheter and advanced to the thrombus. Self-expanding wireform disks are deployed to engage thrombus by retracting the outer delivery catheter. The FlowTriever Catheter is retracted into the Aspiration Guide Catheter to capture the targeted thrombus. Additional clot may also be removed by aspiration with the provided 60 cc syringe. After the procedure is complete, the Aspiration Guide Catheter and FlowTriever Catheter are removed from the patient.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

peripheral vasculature and for the treatment of pulmonary embolism.

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 Testing

In accordance with the Design Failure Modes and Effects Analysis, verification and validation testing were identified to support the substantial equivalence of the modified FlowTriever Retrieval/Aspiration System. This testing demonstrated compliance with relevant product specifications. These tests included:

  • Packaging Testing
  • Leak Testing
  • Vacuum Testing
  • Tensile Testing
  • Simulated Use Testing

Accelerated 2-year shelf-life testing was conducted for the modification to the 60 cc syringe to support the existing 2-year shelf-life.

Clinical testing was not required for the determination of substantial equivalence.

Test results demonstrated that all acceptance criteria were met; therefore, the device conforms to established product specifications.

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

Not Found

Predicate Device(s)

Inari FlowTriever Retrieval/Aspiration System (K181694)

Reference Device(s)

Inari FlowTriever Retrieval/Aspiration System (K162970)

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.5150 Embolectomy catheter.

(a)
Identification. An embolectomy catheter is a balloon-tipped catheter that is used to remove thromboemboli, i.e., blood clots which have migrated in blood vessels from one site in the vascular tree to another.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

October 15, 2018

Inari Medical, Inc. Mr. Eben Gordon Vice President, Regulatory Affairs and Quality Assurance 9272 Jeronimo Rd., Suite 124 Irvine, California 92618

Re: K182233

Trade/Device Name: FlowTriever Retrieval/Aspiration System Regulation Number: 21 CFR 870.5150 Regulation Name: Embolectomy catheter Regulatory Class: Class II Product Code: DXE Dated: August 16, 2018 Received: August 17, 2018

Dear Mr. Gordon:

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 requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part

1

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 (QS) 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 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, 2018.10.15 08:45:43 Eleni Whatley -04'00' For Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K182233

Device Name FlowTriever Retrieval/Aspiration System

Indications for Use (Describe)

The FlowTriever Retrieval/Aspiration System is indicated for:

  • · The non-surgical removal of emboli and thrombi from blood vessels.
  • · Injection, infusion, and/or aspiration of contrast media and other fluids into or from a blood vessel.

The FlowTriever Retrieval/Aspiration System is intended for use in the peripheral vasculature and for the treatment of pulmonary embolism.

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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K182233

PAGE 1 OF 2

510(K) SUMMARY

Date preparedAugust 17, 2018
NameInari Medical, Inc.
9272 Jeronimo Road, Suite 124
Irvine, CA 92618
949.600.8433 x114
Contact personEben Gordon
Vice President, Regulatory Affairs & Quality Assurance
Trade nameFlowTriever Retrieval/Aspiration System
Common nameEmbolectomy catheter
Regulation nameEmbolectomy catheter
Classification number21 CFR 870.5150
Product codeDXE
Regulatory classII
Predicate deviceInari FlowTriever Retrieval/Aspiration System (K181694)
Reference deviceInari FlowTriever Retrieval/Aspiration System (K162970)
DescriptionThe FlowTriever Retrieval/Aspiration System is a single-use over-the-wire
catheter-based system for the minimally invasive treatment of thromboemboli in
the peripheral vasculature. The system is comprised of two main components
packaged separately:
Aspiration Guide Catheter FlowTriever Catheters (available in 4 sizes: 6-10 mm, 11-14 mm, 15-18 mm, and 19-25 mm) The FlowTriever Catheter is inserted through the Aspiration Guide Catheter and
advanced to the thrombus. Self-expanding wireform disks are deployed to engage
thrombus by retracting the outer delivery catheter. The FlowTriever Catheter is
retracted into the Aspiration Guide Catheter to capture the targeted thrombus.
Additional clot may also be removed by aspiration with the provided 60 cc
syringe. After the procedure is complete, the Aspiration Guide Catheter and
FlowTriever Catheter are removed from the patient.
Indications for UseThe FlowTriever Retrieval/Aspiration System is indicated for:
The non-surgical removal of emboli and thrombi from blood vessels. Injection, infusion, and/or aspiration of contrast media and other fluids into or from a blood vessel. The FlowTriever Retrieval/Aspiration System is intended for use in the peripheral
vasculature and for the treatment of pulmonary embolism.

4

K182233

PAGE 2 OF 2

  • The change to the FlowTriever Retrieval/Aspiration System from the version Device modifications cleared under K181694 is to replace the Retraction Aspirator with the manual retraction of the FlowTriever Catheter into the Aspiration Guide Catheter and the aspiration of thrombus using a 60 cc VacLok syringe. The tip of the syringe has been modified to connect to the Aspiration Guide Catheter's side port tubing connector. Alternatively, an Aspiration Adapter is provided that allows a physician to connect an off-the-shelf syringe directly to the side port tubing connector of the Aspiration Guide Catheter for aspiration.
    There is no change of intended use or fundamental scientific technology between Summary of substantial equivalence the proposed and predicate devices.

The FlowTriever Retrieval/Aspiration System has the same indication for use as the predicate, K181694.

Non-Clinical Testing

In accordance with the Design Failure Modes and Effects Analysis, verification and validation testing were identified to support the substantial equivalence of the modified FlowTriever Retrieval/Aspiration System. This testing demonstrated compliance with relevant product specifications. These tests included:

  • Packaging Testing ●
  • . Leak Testing
  • Vacuum Testing
  • Tensile Testing
  • . Simulated Use Testing

Accelerated 2-year shelf-life testing was conducted for the modification to the 60 cc syringe to support the existing 2-year shelf-life.

Clinical testing was not required for the determination of substantial equivalence.

Test results demonstrated that all acceptance criteria were met; therefore, the device conforms to established product specifications.

Conclusion

The proposed device modifications to the FlowTriever Retrieval/Aspiration System do not change its intended use. With consideration of the results of the testing leveraged from K181694 and K162970, it can be concluded that the proposed FlowTriever Retrieval/Aspiration System is substantially equivalent to the predicate devices.