K Number
K182662
Device Name
NAV PAK Needle, NIM NAV PAK Needle
Date Cleared
2019-04-10

(197 days)

Product Code
Regulation Number
874.1820
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The BE-ST NAV PAK is indicated for navigated pedicle pilot hole preparation. The BE-ST NAV PAK should only be used with a compatible Medtronic StealthStation® System. The BE-ST NAV NIM® PAK is indicated for navigated pedicle pilot hole preparation, locating, and identifying nerves during surgery, including spinal nerve roots. The BE-ST NAV NIM® PAK should only be used with compatible Medtronic StealthStation® and Medtronic NIM® Systems.
Device Description
The BE-ST Navigated PAK Needles are single use surgical instruments composed of stainless steel and plastic. They are sterile packaged. The devices are comprised of three main components: the cannula, stylet assembly, and tracker subassembly. There are two devices in the family: the BE-ST Navigated NIM® PAK Needle and the BE-ST Navigated PAK Needle. The BE-ST Navigated NIM® PAK Needle is an accessory to the Medtronic StealthStation® System and is intended for use as a stimulating accessory to the Medtronic NIM® System. The BE-ST Navigated PAK Needle is an accessory to the Medtronic StealthStation® System. The only significant differences between the two subject devices are the electrical insulation on the cannula and the connection to the NIM® System. The BE-ST Navigated PAK device has the same basic function and navigational capabilities as the BE-ST Navigated NIM® PAK device but is not an accessory to the Medtronic NIM® system and therefore cannot be used for nerve monitoring.
More Information

Not Found

No
The summary describes a navigated surgical instrument and its compatibility with existing navigation and nerve monitoring systems. There is no mention of AI or ML in the intended use, device description, or performance studies.

No.
A therapeutic device is one that treats or cures a disease or condition. This device is indicated for "navigated pedicle pilot hole preparation" and "locating and identifying nerves during surgery," which are diagnostic and procedural aids, not direct treatments.

No

The device is intended for "navigated pedicle pilot hole preparation" and "locating, and identifying nerves during surgery," which are surgical guidance and monitoring functions, not diagnostic determination of a medical condition.

No

The device description explicitly states that the devices are "single use surgical instruments composed of stainless steel and plastic" and are comprised of "the cannula, stylet assembly, and tracker subassembly," indicating they are physical hardware devices.

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

Here's why:

  • Intended Use: The intended use is for "navigated pedicle pilot hole preparation" and "locating, and identifying nerves during surgery." This describes a surgical procedure performed directly on the patient's body, not a test performed on a sample taken from the body.
  • Device Description: The device is described as "single use surgical instruments composed of stainless steel and plastic." This aligns with surgical tools, not diagnostic reagents or equipment used to analyze biological samples.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (like blood, urine, tissue, etc.), detecting specific analytes, or providing diagnostic information based on in vitro testing.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information for diagnosis, monitoring, or screening. This device's function is entirely focused on guiding surgical procedures.

N/A

Intended Use / Indications for Use

The BE-ST NAV PAK is indicated for navigated pedicle pilot hole preparation. The BE- ST NAV PAK should only be used with a compatible Medtronic StealthStation® System.

The BE-ST NAV NIM® PAK is indicated for navigated pedicle pilot hole preparation, locating, and identifying nerves during surgery, including spinal nerve roots. The BE-ST NAV NIM® PAK should only be used with compatible Medtronic StealthStation® and Medtronic NIM® Systems.

Product codes

OLO, PDQ, HAW

Device Description

The BE-ST Navigated PAK Needles are single use surgical instruments composed of stainless steel and plastic. They are sterile packaged. The devices are comprised of three main components: the cannula, stylet assembly, and tracker subassembly.

There are two devices in the family: the BE-ST Navigated NIM® PAK Needle and the BE-ST Navigated PAK Needle. The BE-ST Navigated NIM® PAK Needle is an accessory to the Medtronic StealthStation® System and is intended for use as a stimulating accessory to the Medtronic NIM® System. The BE-ST Navigated PAK Needle is an accessory to the Medtronic StealthStation® System.

The only significant differences between the two subject devices are the electrical insulation on the cannula and the connection to the NIM® System. The BE-ST Navigated PAK device has the same basic function and navigational capabilities as the BE-ST Navigated NIM® PAK device but is not an accessory to the Medtronic NIM® system and therefore cannot be used for nerve monitoring.

The Medtronic StealthStation® System and Medtronic NIM® System are not included in the scope of this premarket notification.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

pedicle, spinal nerve roots

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Intraoperative

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)

Functional use and reliability testing:
The following functional use tests were performed on the subject devices and the predicate devices. For all tests, the results were compared to verify substantial equivalence.

  • Impact testing into simulated bone with snap lock testing of cannula and stylet handles
  • Hipot testing, continuity testing, and visual analysis following impact testing
  • Instron insertion and removal testing in simulated bone
    Results: Devices passed all functional use and reliability testing.

Biocompatibility testing:
Biocompatibility testing conducted on ETO sterilized, finished devices per ISO 10993.

  • Cytotoxicity: MEM Elution testing
  • Sensitization: Magnusson-Kligman Method
  • Irritation: Intracutaneous Toxicity
  • Systemic Toxicity: Systemic Injection Test
  • Material Mediated Pyrogen test: Rabbit Pyrogen Test
  • Hemolysis: Extract method test
    Results: Devices passed biocompatibility testing.

ETO sterilization validation:
ETO sterilization validation per ISO 11135. Validation achieved a SAL of 10-6. The residual ETO limit for the devices is

§ 874.1820 Surgical nerve stimulator/locator.

(a)
Identification. A surgical nerve stimulator/locator is a device that is intended to provide electrical stimulation to the body to locate and identify nerves and to test their excitability.(b)
Classification. Class II.

0

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April 10, 2019

Boston Endo Surgical Tech Mr. James Rogers Director, Regulatory Affairs, Safety and Environment Division of Lacey Manufacturing Co., LLC 1146 Barnum Ave Bridgeport, Connecticut 06610

Re: K182662

Trade/Device Name: NAV PAK Needle, NIM NAV PAK Needle Regulation Number: 21 CFR 882.4560 Regulation Name: Stereotaxic Instrument Regulatory Class: Class II Product Code: OLO, PDQ, HAW Dated: Undated Received: March 11, 2019

Dear Mr. Rogers:

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

1

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 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.html; 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 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,

Matthew C. Krueger -S

Carlos L. Peña. PhD, MS Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K182662

Device Name BE-ST Navigated PAK and Navigated NIM® PAK

Indications for Use (Describe)

The BE-ST NAV PAK is indicated for navigated pedicle pilot hole preparation. The BE-ST NAV PAK should only be used with a compatible Medtronic StealthStation® System.

The BE-ST NAV NIM® PAK is indicated for navigated pedicle pilot hole preparation, locating, and identifying nerves during surgery, including spinal nerve roots. The BE-ST NAV NIM® PAK should only be used with compatible Medtronic StealthStation® and Medtronic NIM® Systems.

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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510(k) Summary

I. SUBMITTER

Boston-Endo Surgical Technologies, Division of Lacey Manufacturing Company, LLC 1146 Barnum Avenue Bridgeport, CT 06610 (203) 336-7453

Prepared by: James Rogers Director of Regulatory Affairs, Environment and Safety Email: jim.rogers@nninc.com Phone: (203)336-7453

Date Prepared: September 18, 2018

II. DEVICE

Name of Device:BE-ST Navigated PAK Needles
510(k) Number:K182662
Common Name:Nerve Stimulator/Locator
Classification Name:21 CFR 882.4560, Stereotaxic instrument
21 CFR 874.1820, Surgical nerve, stimulator/locator
Review PanelNeurology
Regulatory Class:II
Product Code:OLO, PDO

III. IDENTIFICATION OF LEGALLY MARKETED DEVICES (PREDICATE DEVICES)

Predicate Device

K180542BE-ST NIM PAK Needle, Blunt, and Pedicle Probe
K170011Medtronic StealthStation® S8 Spine Software v1.0.0
K050438Medtronic StealthStation® System Update

IV. DEVICE DESCRIPTION

The BE-ST Navigated PAK Needles are single use surgical instruments composed of stainless steel and plastic. They are sterile packaged. The devices are comprised of three main components: the cannula, stylet assembly, and tracker subassembly.

There are two devices in the family: the BE-ST Navigated NIM® PAK Needle and the BE-ST Navigated PAK Needle. The BE-ST Navigated NIM® PAK Needle is an accessory to the Medtronic StealthStation® System and is intended for use as a stimulating accessory to the Medtronic NIM® System. The BE-ST Navigated PAK Needle is an accessory to the Medtronic StealthStation® System.

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The only significant differences between the two subject devices are the electrical insulation on the cannula and the connection to the NIM® System. The BE-ST Navigated PAK device has the same basic function and navigational capabilities as the BE-ST Navigated NIM® PAK device but is not an accessory to the Medtronic NIM® system and therefore cannot be used for nerve monitoring.

The Medtronic StealthStation® System and Medtronic NIM® System are not included in the scope of this premarket notification.

V. INDICATIONS FOR USE

The BE-ST NAV PAK is indicated for navigated pedicle pilot hole preparation. The BE-ST NAV PAK should only be used with a compatible Medtronic StealthStation® System.

The BE-ST NAV NIM® PAK is indicated for navigated pedicle pilot hole preparation, locating, and identifying nerves during surgery, including spinal nerve roots. The BE-ST NAV NIM® PAK should only be used with compatible Medtronic StealthStation® and Medtronic NIM® Systems.

VI. COMPARISON OF TECHNOLOGICAL CHARACTERISTICS WITH THE PREDICATE DEVICE

The BE-ST Navigated NIM® PAK device is based on the predicate Medtronic Navigated NIM-SPINE® PAK Needle. The BE-ST Navigated NIM® PAK device is similar to the BE-ST NIM® PAK device with the addition of a tracker assembly which allows the device to be used with the Medtronic StealthStation® System. The subject device and the BE-ST NIM® PAK device have the same technological features, the same basic geometry, and are manufactured from the same materials, with the exception that the subject device has a tracker assembly which is substantially equivalent to the tracker assembly on the Medtronic predicate device.

The BE-ST Navigated PAK device has the same basic function and navigational capabilities as the BE-ST Navigated NIM® PAK device but does not have neural integrity monitoring capabilities.

Comparison of Subject and Predicate Devices
CharacteristicSubject DevicePredicate DevicePredicateReference Predicate
BE-ST Navigated NIM® PAK
NeedleStealthStation System
UpdateBE-ST NIM® PAK
NeedleStealthStation S8
Spine Software v1.0.0
ManufacturerBoston-Endo Surgical
TechnologiesMedtronic NavigationBoston-Endo Surgical
TechnologiesMedtronic Navigation
510(k)K182662K050438K180542K170011
Indications for
UseThe BE-ST NAV PAK is
indicated for navigated pedicle
pilot hole preparation. The BE-
ST NAV PAK should only be
used with a compatible[...] is indicated for any
medical condition in
which the use of
stereotactic surgery
may be appropriate,[...] is indicated for
pedicle pilot hole
preparation, locating,
and identifying cranial
and peripheral motor[...] is indicated for
any medical condition
in which the use of
stereotactic surgery
may be appropriate,

The tables below compare the subject and predicate devices.

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Medtronic StealthStation® System.and where reference to a rigid anatomical structure, such as the skull, a long bone, or vertebra, can be identified relative to a CT or MR based model, fluoroscopy images, or digitized landmarks of the anatomy.nerves during surgery, including spinal nerve roots.and where reference to a rigid anatomical structure, such as the spine or pelvis, can be identified relative to images of the anatomy.
The BE-ST NAV NIM® PAK is indicated for navigated pedicle pilot hole preparation, locating, and identifying nerves during surgery, including spinal nerve roots. The BE-ST NAV NIM® PAK should only be used with compatible Medtronic StealthStation® and Medtronic NIM® Systems
Technological Comparison of Subject and Predicate Devices
CharacteristicBE-ST Navigated NIM® PAK NeedleMedtronic Navigated NIM-SPINE® PAK NeedleBE-ST NIM® PAK Needle
ManufacturerBoston-Endo Surgical TechnologiesMedtronic NavigationBoston-Endo Surgical Technologies
Accessory to Medtronic StealthStation® SystemYesYesNo
Accessory to Medtronic NIM® SystemYesYesYes
Technological featuresSame as predicateSame as subjectSame as subject with exception of tracker assembly used for navigation
Construction MaterialsStainless steel - stylet, cannula, self-tapping screws, and posts
Polymer - stylet handle, cannula hub, and tracker assembly
Polyester – cannula electrical insulationStainless steel – stylet, cannula, self-tapping screw, and posts
Polymer - stylet handle, locking ring, cannula hub, and tracker assembly
Nylon - cannula electrical insulationStainless steel – stylet and cannula
Polymer - stylet handle, cannula hub
Polyester - cannula electrical insulation
Electrical insulationOn all cannula surfaces not intended to provide electrical contact with the patient.On all cannula surfaces not intended to provide electrical contact with the patient.On all cannula surfaces not intended to provide electrical contact with the patient.
Distal tipSame as predicateSame as subjectSame as subject
Stylet handle/cannula Hub connectionOvermolded stylet handle that locks to overmolded cannula hubRemovable handle with a locking ring the locks the handle to the cannula and/or stylet.Overmolded stylet handle that locks to overmolded cannula hub
BiocompatibleYesYesYes

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Single UseYesYesYes
Sterilization Method(s)Sterile (ETO)Sterile (ETO)Sterile (gamma)
Environment of UseIntraoperativeIntraoperativeIntraoperative
Duration of Use, Bacterial Endotoxins Test.
  • · USP , Rabbit Pyrogen Test
  • · USP , Medical Devices: Bacterial Endotoxin and Pyrogen Tests

The table below summarizes the testing which was performed on the subject devices to show substantial equivalence to the predicate devices.

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TestTest Method SummaryResults
Functional use and
reliability testingThe following functional use tests were performed on the
subject devices and the predicate devices. For all tests, the
results were compared to verify substantial equivalence.
• Impact testing into simulated bone with snap lock testing of
cannula and stylet handles
• Hipot testing, continuity testing, and visual analysis following
impact testing
• Instron insertion and removal testing in simulated boneDevices passed all
functional use and
reliability testing
Biocompatibility
testingBiocompatibility testing conducted on ETO sterilized, finished
devices per ISO 10993.
• Cytotoxicity: MEM Elution testing
• Sensitization: Magnusson-Kligman Method
• Irritation: Intracutaneous Toxicity
• Systemic Toxicity: Systemic Injection Test
• Material Mediated Pyrogen test: Rabbit Pyrogen Test
• Hemolysis: Extract method testDevices passed
biocompatibility testing
ETO sterilization
validationETO sterilization validation per ISO 11135. Validation achieved
a SAL of 10-6. The residual ETO limit for the devices is