(276 days)
The Dornier CASCADE Ureteral Stent is indicated to relieve obstruction in a variety of benign, malignant and post-traumatic conditions in the ureter such as presence of stones and/or stone fragments, or other ureteral obstructions such as those associated with ureteral stricture, carcinoma of abdominal organs, retroperitoneal fibrosis or ureteral trauma, or in association with Extracorporeal Shock Wave Lithotripsy (ESWL). The stent may be placed using endoscopic surgical techniques or percutaneously using standard radiographic technique.
The Dornier CASCADE Ureteral Stents are sterile, single-use devices. The stents are available in 4.9 to 8.0 French (Fr) diameter, with lengths ranging from 14.0 to 32.0 centimeters (cm). The stents are constructed of a thermoplastic polyurethane elastomer. The base polyurethane material is compounded with BaSO4 to render the stent radiopaque under x-ray fluoroscopy.
Drainage holes extend along the body of the stent as well as on the pigtails to provide drainage. The stents are secured in the urinary tract with pigtail loops on the proximal and distal ends. A monofilament tether for repositioning and removal of the device is located on the proximal pigtail (bladder end) of the stent. Along the stent are graduation marks to provide visualization during stent advancement and placement. The CASCADE Ureteral Stent includes a pigtail straightener, a small polymer tube to aid in placement over a wire guide. The pigtail straightener is removed prior to use. The CASCADE Ureteral Stents are labeled for a maximum 30day indwell time.
The stents are packaged into a pre-formed tray and sealed within a Tyvek pouch. The individually sealed Tyvek pouches are labeled with identification labeling and then packaged into a corrugated shipping box. The packaged stents are sterilized by a contract sterilizer using ethylene oxide.
The provided text is a 510(k) summary for the Dornier CASCADE Ureteral Stent. It describes the device, its indications for use, and the studies conducted to demonstrate its substantial equivalence to a predicate device. However, it does not contain specific acceptance criteria or detailed results of a study designed to prove the device meets those criteria in a format applicable to evaluating AI/ML models.
The document states: "All testing was found to be acceptable and bench performance testing comparable to the predicate device." This is a general statement of compliance, not a detailed report of acceptance criteria and performance data for a particular device function.
Therefore, many of the requested details about acceptance criteria, specific device performance, sample sizes for test and training sets, expert qualifications, adjudication methods, or MRMC studies are not present in this regulatory document.
However, I can extract the information that is available from the document:
1. A table of acceptance criteria and the reported device performance
The document does not provide a table of specific numerical acceptance criteria or reported device performance values. It generally states that "All testing was found to be acceptable and bench performance testing comparable to the predicate device." The types of tests performed are listed, implying that the device met the requirements of these tests.
Summary of available information for Section 1:
| Acceptance Criteria (General) | Reported Device Performance (General) |
|---|---|
| Sterilization validation requirements | Found to be acceptable |
| Shelf life, including packaging validation and functional performance testing requirements | Found to be acceptable |
| Biocompatibility requirements (cytotoxicity, skin sensitization, skin irritation, acute systemic toxicity, material-mediated pyrogenicity, genotoxicity, implantation studies, chemical characterization) | Found to be acceptable for stent and pusher |
| Bench Performance Testing requirements (visual inspection, dimensional analysis, pigtail retention, suture retention, coefficient of friction, tensile strength, elongation, radiopacity, and flow rate) | Found to be acceptable and comparable to the predicate device |
2. Sample size used for the test set and the data provenance
Not applicable/Not provided in this document. This document pertains to a physical medical device (ureteral stent), not a software or AI/ML device that operates on a "test set" of data in the common sense of the term for AI/ML. The "testing" refers to physical and biological evaluations of the stent itself.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
Not applicable/Not provided in this document. Ground truth as typically defined for AI/ML models (e.g., expert consensus on medical images) is not relevant for the types of physical and biological tests described for this ureteral stent.
4. Adjudication method for the test set
Not applicable/Not provided in this document. Adjudication methods are typically for evaluating discrepancies in human or AI interpretations of data, which is not what this document describes.
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
No. This document does not mention any MRMC study or AI assistance, as it concerns a physical medical device.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done
No. This document does not describe an algorithm or AI performance.
7. The type of ground truth used
Not applicable/Not provided in this document in the context of expert consensus or pathology for data interpretation. The "ground truth" for the physical device would be the validated standards and specifications against which the stent's physical properties and biological interactions were measured (e.g., ISO standards, ASTM standards for material properties, specified biocompatibility limits).
8. The sample size for the training set
Not applicable/Not provided. This concept is for AI/ML models, not for physical device testing.
9. How the ground truth for the training set was established
Not applicable/Not provided. This concept is for AI/ML models, not for physical device testing.
In summary, the provided document is a 510(k) summary for a physical medical device, not an AI/ML device. Therefore, most of the requested information regarding AI/ML model evaluation, such as sample sizes for test/training sets, data provenance, expert ground truth, adjudication methods, and MRMC studies, is not present or applicable. The document confirms that the Dornier CASCADE Ureteral Stent underwent standard sterilization, shelf-life, biocompatibility, and bench performance testing, and was found to be acceptable and comparable to its predicate device.
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November 15, 2019
Dornier MedTech America Inc. John Hoffer Vice President Quality, Regulatory, Clinical 1155 Roberts Blvd, Suite 100 Kennesaw, GA 30144
Re: K190312
Trade/Device Name: Dornier CASCADE Ureteral Stent Regulation Number: 21 CFR 876.4620 Regulation Name: Ureteral stent Regulatory Class: II Product Code: FAD Dated: October 7, 2019 Received: October 7, 2019
Dear John Hoffer:
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
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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/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.
For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
Sharon M. Andrews Assistant Director DHT3B: Division of Reproductive. Gynecology and Urology Devices OHT3: Office of GastroRenal, ObGyn, General Hospital and Urology Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health
Enclosure
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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Indications for Use
Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement on last page
510(k) Number (if known)
Device Name
Dornier CASCADE Ureteral Stent
Indications for Use (Describe)
The Dornier CASCADE Ureteral Stent is indicated to relieve obstruction in a variety of benign, malignant and post-traumatic conditions in the ureter such as presence of stones and/or stone fragments, or other ureteral obstructions such as those associated with ureteral stricture, carcinoma of abdominal organs, retroperitoneal fibrosis or ureteral trauma, or in association with Extracorporeal Shock Wave Lithotripsy (ESWL). The stent may be placed using endoscopic surgical techniques or percutaneously using standard radiographic technique.
Type of Use (Select one or both, as applicable)
区 Prescription Use (Part 21 CFR 801 Subpart D) Subpart C)
□ Over-The-Counter Use (21 CFR 801
PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.
FOR FDA USE ONLY
Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)
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510(k) SUMMARY - K190321
Dornier CASCADE Ureteral Stent
Submitter Name and Address Dornier MedTech America. Inc. 1155 Roberts Blvd. Kennesaw. GA 30144
Date Prepared October 7, 2019
Contact Person John Hoffer Phone: 770-514-6163
Name/Address of Sponsor Dornier MedTech America,
Inc. 1155 Roberts Blvd. Kennesaw, GA 30144
Device Information
Name of Device: Dornier CASCADE Ureteral Stent Common or Usual Name: Ureteral stent Classification Name: Class = Product Code: FAD
Predicate Device Bard Inlay Stent (K983498) The predicate device has not been subject to a design related recall.
Device Description
The Dornier CASCADE Ureteral Stents are sterile, single-use devices. The stents are available in 4.9 to 8.0 French (Fr) diameter, with lengths ranging from 14.0 to 32.0 centimeters (cm). The stents are constructed of a thermoplastic polyurethane elastomer. The base polyurethane material is compounded with BaSO4 to render the stent radiopaque under x-ray fluoroscopy.
Drainage holes extend along the body of the stent as well as on the pigtails to provide drainage. The stents are secured in the urinary tract with pigtail loops on the proximal and distal ends. A monofilament tether for repositioning and removal of the device is located on the proximal pigtail (bladder end) of the stent. Along the stent are graduation marks to provide visualization during stent advancement and placement. The CASCADE Ureteral Stent includes a pigtail straightener, a small polymer tube to aid in placement over a wire guide. The pigtail straightener is removed prior to use. The CASCADE Ureteral Stents are labeled for a maximum 30day indwell time.
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The stents are packaged into a pre-formed tray and sealed within a Tyvek pouch. The individually sealed Tyvek pouches are labeled with identification labeling and then packaged into a corrugated shipping box. The packaged stents are sterilized by a contract sterilizer using ethylene oxide.
Indications for Use Statement
The Dornier CASCADE Ureteral Stent is indicated to relieve obstruction in a variety of benign, malignant and post-traumatic conditions in the ureter such as presence of stones and/or stone fragments, or other ureteral obstructions such as those associated with ureteral stricture, carcinoma of abdominal organs, retroperitoneal fibrosis or ureteral trauma, or in association with Extracorporeal Shock Wave Lithotripsy (ESWL). The stent may be placed using endoscopic surgical techniques or percutaneously using standard radiographic technique.
Substantial Equivalence
The subject and predicate device have the same indications for use statement.
The subject and predicate device have different technological characteristics including minor differences in design and a change in indwelling time (maximum of 30 days for the subject device vs maximum of 365 days for the predicate device. These differences in technological characteristics do not raise different questions of safety or effectiveness.
Performance Data
The CASCADE Ureteral Stent was subjected to the following tests to assure design and performance under the specified testing parameters:
- Sterilization validation
- Shelf life, including packaging validation and functional performance testing
- Biocompatibility
- o Stent: cytotoxicity, skin sensitization, skin irritation, acute systemic toxicity, material-mediated pyrogenicity, genotoxicity (Ames bacterial reverse mutation, in vitro mouse lymphoma assay), and implantation studies (2week, muscular), 13-weeks subcutaneous implantation, and chemical characterization followed by the risk assessment of extractables with the stent
- Pusher: cytotoxicity, skin sensitization, skin irritation, acute systemic toxicity o and material-mediated pyrogenicity
- Bench Performance Testing, including visual inspection, dimensional analysis, ● pigtail retention, suture retention, coefficient of friction, tensile strength, elongation, radiopacity, and flow rate.
The performance and functional testing are based on the FDA guidance "Guidance for the Content of Premarket Notifications for Ureteral Stents" and the ASTM F1828-17, "Standard Specifications for Ureteral Stents." All testing was found to be acceptable and bench performance testing comparable to the
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predicate device.
Conclusion
The Dornier CASCADE Ureteral Stent is substantially equivalent to its predicate device.
§ 876.4620 Ureteral stent.
(a)
Identification. A ureteral stent is a tube-like implanted device that is inserted into the ureter to provide ureteral rigidity and allow the passage of urine. The device may have finger-like protrusions or hooked ends to keep the tube in place. It is used in the treatment of ureteral injuries and ureteral obstruction.(b)
Classification. Class II (performance standards).