K Number
K183361
Date Cleared
2019-04-05

(122 days)

Product Code
Regulation Number
870.5150
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The EkoSonic Endovascular Device with Control Unit 4.0 is indicated for the:

  • Ultrasound facilitated, controlled and selective infusion of physician-specified fluids, including thrombolytics, into the vasculature for the treatment of pulmonary embolism.
  • Infusion of solutions into the pulmonary arteries.
  • Controlled and selective infusion of physician-specified fluids, including thrombolytics, into the peripheral vasculature.
Device Description

The EkoSonic Endovascular Device with CU 4.0 consists of an EkoSonic Endovascular Device and the Control System 4.0 (Control Unit 4.0 and Connector Interface Cables). The EkoSonic Endovascular Device consists of a disposable infusion catheter with removable ultrasound core. The infusion catheter contains multiple side holes distributed over the length of the treatment zone. The ultrasound core contains up to 30 ultrasound elements, evenly spaced over the treatment zone. Thermal sensors in the treatment zone monitor catheter temperature. The Control System 4.0 generates and controls the delivery of radiofrequency energy to the ultrasound core while monitoring and controlling the temperature of the treatment zone.

It is the modifications to the Control System 4.0 that are the subject of this submission.

AI/ML Overview

The EkoSonic Endovascular Device with Control Unit 4.0 is indicated for ultrasound-facilitated infusion of fluids, including thrombolytics, into the vasculature for pulmonary embolism treatment, infusion into pulmonary arteries, and controlled infusion into the peripheral vasculature.

The device's substantial equivalence to its predicate (EKOS EkoSonic Endovascular Device with CU 4.0, K162771) was established based on performance data provided in the submission. The modifications in this submission specifically relate to the Control System 4.0.

1. A table of acceptance criteria and the reported device performance

The document does not explicitly state "acceptance criteria" with numerical thresholds for performance. Instead, it lists various hardware and software tests conducted, with the reported performance being "Pass" for all of them, indicating compliance with internal standards for the modifications made to the Control System 4.0.

Test CategorySpecific TestReported Performance
HardwareSecondary Cell Battery TestsPass
Reliability PredictionPass
Battery Hardware Design VerificationPass
Electrical SafetyPass
Hardware InspectionPass
EMC/EMIPass
RF Board Hardware TestsPass
System IntegrationPass
CIC Hardware TestsPass
Shipping Package TestsPass
Design Verification Hardware TestsPass
UI Board Hardware TestsPass
Environmental TestsPass
Power Management Module TestsPass
Short Circuit ResponsePass
Patched Fastener Design VerificationPass
EkoSonic Device ReliabilityPass
SoftwarePeriodic Self-TestPass
User InterfacePass
Firmware UpgradePass
Event LoggingPass
System Connect ValidationPass
Single Channel RFPass
GraphingPass
Device CompatibilityPass
Dual Channel RFPass
Therapy SupportPass
System StartupPass
Processor CommunicationPass
Constant ParameterPass
Source Code InspectionPass
AC and Battery PowerPass

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

The document does not specify the sample sizes used for the various hardware and software tests, nor does it provide details on data provenance (e.g., country of origin, retrospective/prospective). The tests were likely conducted internally by the manufacturer, EKOS Corporation, Inc.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

The document does not mention the use of experts to establish a "ground truth" for the test set in the context typically seen for diagnostic or AI-based devices. The performance data here pertains to engineering and software validation of device functionality, not clinical outcome or diagnostic accuracy. Therefore, the concept of expert-established ground truth as a comparison point is not applicable to the type of testing described.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

Not applicable. The reported tests are engineering and software verification and validation, not clinical studies requiring adjudications by experts for a test set.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

Not applicable. This device is an endovascular catheter system with a control unit, not an AI-assisted diagnostic or imaging device that would typically undergo MRMC studies with human readers.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

The device itself is a physical medical device (catheter and control unit) that requires physician involvement. The "standalone" performance in this context refers to the functionality of the device components as tested in isolation or in simulated environments, as reflected in the hardware and software tests. The document confirms that "Testing has confirmed that the EkoSonic Endovascular Device with CU 4.0 functions as intended."

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

The concept of "ground truth" in the context of clinical outcomes or pathology is not directly applicable to the performance data presented. The "ground truth" for these engineering and software tests would be the established design specifications, functional requirements, and recognized industry standards for safety and performance of such medical devices. The predicate device (K162771) serves as the basis for demonstrating substantial equivalence based on technological characteristics and intended use.

8. The sample size for the training set

Not applicable. This device is not an AI/ML device that requires a training set in the conventional sense. The "training" for the device, if any, would be its design and manufacturing processes, which are verified through the listed tests.

9. How the ground truth for the training set was established

Not applicable, as there is no mention of a training set for an AI/ML algorithm.

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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, with the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text. The text is stacked, with "U.S. FOOD & DRUG" on top and "ADMINISTRATION" on the bottom.

November 22, 2021

BTG International, Inc. Benjamin Hornsey Regulatory Affairs Manager 11911 N Creek Pkwy S Bothell, Washington 98011

Re: K183361

Trade/Device Name: EkoSonic Endovascular Device with Control Unit 4.0 Regulation Number: 21 CFR 870.5150 Regulation Name: Embolectomy catheter Regulatory Class: Class II Product Code: QEY, KRA

Dear Benjamin Hornsey:

The Food and Drug Administration (FDA) is sending this letter to notify you of an administrative change related to your previous substantial equivalence (SE) determination letter dated April 5, 2019. Specifically. FDA is updating this SE Letter as an administrative correction because FDA has created a new product code to better categorize your device technology.

Please note that the 510(k) submission was not re-reviewed. For questions regarding this letter please contact Gregory O'Connell, OHT2: Office of Cardiovascular Devices, (301) 796-6075, Gregory.Oconnell(@FDA.HHS.gov.

Sincerely,

Gregory W - Digitally signed by Gregory W. O'connell -S O'connell -S Date: 2021.11.22

Gregory O'Connell Assistant Director DHT2C: Division of Coronary and Peripheral Intervention Devices OHT2: Office of Cardiovascular Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

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Image /page/1/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health and Human Services logo on the left and the FDA logo on the right. The FDA logo is in blue and includes the letters "FDA" followed by the words "U.S. Food & Drug Administration".

April 5, 2019

BTG International, Inc. Benjamin Hornsey Regulatory Affairs Manager 11911 N Creek Pkwy S Bothell, Washington 98011

Re: K183361

Trade/Device Name: EkoSonic Endovascular Device with Control Unit 4.0 Regulation Number: 21 CFR 870.1210 Regulation Name: Continuous Flush Catheter Regulatory Class: Class II Product Code: KRA Dated: March 5, 2019 Received: March 6, 2019

Dear Mr. Hornsey:

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 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for

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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 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,

For

Digitally signed by Haiira F. Hajira F. Ahmad -S Date: 2019.04.05 Ahmad -S 14:01:06 -04'00'

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K183361

Device Name

EkoSonic Endovascular Device with Control Unit 4.0

Indications for Use (Describe)

The EkoSonic Endovascular Device with Control Unit 4.0 is indicated for the:

  • · Ultrasound facilitated, controlled and selective infusion of physician-specified fluids, including thrombolytics, into the vasculature for the treatment of pulmonary embolism.
  • · Infusion of solutions into the pulmonary arteries.
  • · Controlled and selective infusion of physician-specified fluids, including thrombolytics, into the peripheral vasculature.

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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l. Submitter

EKOS Corporation, Inc. 11911 North Creek Parkway S Bothell, WA 98011

Phone: 425-415-3143 Fax: 425-415-3105

Contact Person: Benjamin Hornsey Date Prepared: December 3, 2018

II. Device

Proprietary Name:EkoSonic™ Endovascular Device with Control Unit 4.0
Common or Usual Name:Continuous Flush Catheter
Classification Name:Catheter, Continuous Flush (21 CFR §870.1210)
Product Code:KRA

Continuous Flush Catheters have been classified by the FDA Cardiovascular Panel as Class II.

lll. Predicate Devices

The EkoSonic Endovascular Device with CU 4.0 (CU 4.0) is substantially equivalent to another legally marketed device. This predicate device is the EKOS EkoSonic Endovascular Device with CU 4.0 (K162771).

No reference devices were used in this submission.

IV. Device Description

The EkoSonic Endovascular Device with CU 4.0 consists of an EkoSonic Endovascular Device and the Control System 4.0 (Control Unit 4.0 and Connector Interface Cables). The EkoSonic Endovascular Device consists of a disposable infusion catheter with removable ultrasound core. The infusion catheter contains multiple side holes distributed over the length of the treatment zone. The ultrasound core contains up to 30 ultrasound elements, evenly spaced over the treatment zone. Thermal sensors in the treatment zone monitor catheter temperature. The Control System 4.0 generates and controls the delivery of radiofrequency energy to the ultrasound core while monitoring and controlling the temperature of the treatment zone.

It is the modifications to the Control System 4.0 that are the subject of this submission.

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V. Intended Use/Indications for use

The EkoSonic Endovascular Device with Control Unit 4.0 is indicated for the:

  • Ultrasound facilitated, controlled and selective infusion of physician-specified fluids, including thrombolytics, into the vasculature for the treatment of pulmonary embolism.
  • Infusion of solutions into the pulmonary arteries.
  • Controlled and selective infusion of physician-specified fluids, including thrombolytics, into the peripheral vasculature.
EkoSonic Endovascular Device withEkoSonic Endovascular Device with
CU 4.0CU 4.0
(Subject Device)(Predicate Device)
510(k) NumberK183361K162771
Product CodeKRAKRA
Indications forUseThe EkoSonic Endovascular Device with CU 4.0is indicated for the:• Ultrasound facilitated, controlled andselective infusion of physician-specifiedfluids, including thrombolytics, into thevasculature for the treatment of pulmonaryembolism.• Infusion of solutions into the pulmonaryarteries.• Controlled and selective infusion ofphysician-specified fluids, includingthrombolytics, into the peripheralvasculature.The EkoSonic Endovascular Device with CU 4.0is indicated for the:• Ultrasound facilitated, controlled andselective infusion of physician-specifiedfluids, including thrombolytics, into thevasculature for the treatment of pulmonaryembolism.• Infusion of solutions into the pulmonaryarteries.• Controlled and selective infusion ofphysician-specified fluids, includingthrombolytics, into the peripheralvasculature.
Principle ofOperationThe EkoSonic Endovascular Device with CU 4.0employs ultrasound to facilitate the delivery ofthrombolytic agents into vascular blood clots.The EkoSonic Endovascular Device with CU 4.0employs ultrasound to facilitate the delivery ofthrombolytic agents into vascular blood clots.
Software Version01.02.0201.00.05
Battery Version8742-0036841-002
Infusion HolePatternMultiple side-holesMultiple side-holes
Catheter WorkingLength106 cm or 135 cm106 cm or 135 cm
Treatment ZoneLength6 cm - 50 cm6 cm - 50 cm
EkoSonic Endovascular Device withCU 4.0(Subject Device)EkoSonic Endovascular Device withCU 4.0(Predicate Device)
CompatibleGuide Wire0.035"0.035"
Outer Diameter5.4 Fr5.4 Fr
Placement ModePercutaneous/endovascularPercutaneous/endovascular
Packaged SterileYes - EkoSonic DeviceYes - EkoSonic Device
Single-UseDisposableYes - EkoSonic DeviceYes - EkoSonic Device
MaterialsBiocompatibleYes - EkoSonic DeviceYes - EkoSonic Device
RadiopaqueMarkersYes on IDDCMSD ultrasound elements are radiopaqueYes on IDDCMSD ultrasound elements are radiopaque
Mechanism ofActionUltrasoundUltrasound
Energy SourceR/F electrical from CU 4.0 converted toultrasoundR/F electrical from CU 4.0 converted toultrasound
UltrasoundTransducer(s) inCatheter6 to 306 to 30
AcousticCharacteristicsFrequency = 2.0 - 2.5 MHzFrequency = 2.0 - 2.5 MHz
Battery BackupInternal, lithium-ion backup batteryInternal, lithium-ion backup battery
MaximumOutput PowerLimitPower is available for ~100W Pulses. Thepower output is limited by software to ~50W.Power is available for ~100W Pulses. Thepower output is limited by software to ~50W.
MaximumEkoSonic DeviceTemperatureTemperature monitoring, feedback and controlsystem limits the surface temperature of theIDDC to 43°C during operation.Temperature monitoring, feedback and controlsystem limits the surface temperature of theIDDC to 43°C during operation.

VI. Comparison of Technological Characteristics with the Predicate Device

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The device modifications described in the submission do not affect the intended use,

indications for use or the technological characteristics for the EkoSonic Endovascular System.

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VII. Performance Data

Testing has confirmed that the EkoSonic Endovascular Device with CU 4.0 functions as intended and is substantially equivalent to the predicate device.

Hardware Testing Performed
Secondary Cell Battery TestsPass
Reliability PredictionPass
Battery Hardware Design VerificationPass
Electrical SafetyPass
Hardware InspectionPass
EMC/EMIPass
RF Board Hardware TestsPass
System IntegrationPass
CIC Hardware TestsPass
Shipping Package TestsPass
Design Verification Hardware TestsPass
UI Board Hardware TestsPass
Environmental TestsPass
Power Management Module TestsPass
Short Circuit ResponsePass
Patched Fastener Design VerificationPass
EkoSonic Device ReliabilityPass
Software Testing Performed
Periodic Self-TestPass
User InterfacePass
Firmware UpgradePass
Event LoggingPass
System Connect ValidationPass
Single Channel RFPass
GraphingPass
Device CompatibilityPass
Dual Channel RFPass
Therapy SupportPass
System StartupPass
Processor CommunicationPass
Constant ParameterPass
Source Code InspectionPass
AC and Battery PowerPass

Performance standards have not been promulgated for Continuous Flush Catheters.

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VIII. Conclusions

The EkoSonic Endovascular Device with CU 4.0 is substantially equivalent to the predicate device. The modifications to the Control System 4.0 do not affect the intended use or the technological characteristics for the system and do not raise new questions of safety or effectiveness.

§ 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).