K Number
K191290
Device Name
Ancora Nerve Block Catheter Set
Date Cleared
2020-02-06

(269 days)

Product Code
Regulation Number
868.5150
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Ancora Nerve Block Catheter Set is indicated for surgical pain management during the pre-operative, perioperative and post-operative periods associated with general and orthopedic surgery. The device allows physicians to locate peripheral nerves by transferring electrical impulses from a nerve stimulator and/or through ultrasound visualization of the device. The catheter may remain in dwelling for up to 72 hours.
Device Description
The Ancora Nerve Block Catheter Set is a sterile, single-use, disposable device, intended for delivery of local anesthetic for continuous peripheral nerve blocks, in adult patients. The Ancora Nerve Block Catheter Set is intended to be placed with the use of nerve stimulation and/or ultrasound guidance. The device has a catheter-over-needle design, which consists of a 21-gauge needle and 18-gauge catheter with a twist lock connection between them. The device design includes an anchor and decoupler to help maintain the catheter position. Both the needle and catheter have NRFit connection for infusion. The device set includes two sizes of dressings.
More Information

Not Found

No
The summary describes a physical medical device (catheter set) used for nerve blocks with guidance from nerve stimulation and/or ultrasound. There is no mention of any software component or algorithm that would utilize AI or ML for tasks like image analysis, prediction, or automated control. The performance studies focus on the physical and functional characteristics of the device itself.

Yes.
The device is used for surgical pain management and delivery of local anesthetic to alleviate pain, which are therapeutic applications.

No

Explanation: The primary stated purpose of the device is for surgical pain management and delivery of local anesthetic, not for diagnosing a condition or disease. While it aids in locating nerves (which involves some information gathering), its ultimate function is therapeutic (delivery of anesthetic).

No

The device description clearly outlines physical components (catheter, needle, anchor, decoupler, dressings) and performance testing related to these physical components (electrical performance, flow rate, occlusion, kink resistance, etc.), indicating it is a hardware device. While it mentions ultrasound guidance, this is an input modality for the user, not the device itself being software-only.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, tissue) to provide information about a person's health. This testing is done outside of the body (in vitro).
  • Device Function: The Ancora Nerve Block Catheter Set is a device used within the body (in vivo) to deliver local anesthetic for pain management. It is used to locate nerves and facilitate the delivery of medication, not to analyze biological samples.

The description clearly outlines a device used for a surgical procedure and drug delivery, which falls outside the scope of IVD devices.

N/A

Intended Use / Indications for Use

The Ancora Nerve Block Catheter Set is indicated for surgical pain management during the pre-operative, perioperative and post-operative periods associated with general and orthopedic surgery. The device allows physicians to locate peripheral nerves by transferring electrical impulses from a nerve stimulator and/or through ultrasound visualization of the device. The catheter may remain in dwelling for up to 72 hours.

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

BSP

Device Description

The Ancora Nerve Block Catheter Set is a sterile, single-use, disposable device, intended for delivery of local anesthetic for continuous peripheral nerve blocks, in adult patients.
The Ancora Nerve Block Catheter Set is intended to be placed with the use of nerve stimulation and/or ultrasound guidance. The device has a catheter-over-needle design, which consists of a 21-gauge needle and 18-gauge catheter with a twist lock connection between them. The device design includes an anchor and decoupler to help maintain the catheter position. Both the needle and catheter have NRFit connection for infusion. The device set includes two sizes of dressings.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Ultrasound

Anatomical Site

Peripheral nerves

Indicated Patient Age Range

Adult patients

Intended User / Care Setting

Physicians

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)

Testing was performed with the Ancora Nerve Block Catheter Set to support substantial equivalence to the predicate device. Testing included performance testing, biocompatibility, sterilization, and shelf-life testing.

Performance testing completed included the following functional tests: electrical performance (continuity, current transfer), flow rate, occlusion, kink resistance, resistance to breakage, joint bond strength, leakage, penetration force, echogenicity, corrosion resistance.

Results of performance testing indicate that the needle and catheter, in the Ancora Nerve Block Catheter Set meet applicable sections of the standards referenced and are safe and effective for their intended use. Based upon the results of this testing, it was determined the Ancora Nerve Block Catheter Set performance was substantially equivalent to the predicate device.
Biocompatibility testing was performed based on the nature and duration of patient contact outlined in ISO 10993-1: "Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process" and the FDA guidance document: "Use of International Standard ISO 10993-1, "Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process"". The needle assembly was tested per the ISO 10993-1 requirements for an externally communicating device with tissue contact for a limited duration (24 hours to 30 days). The dressing was tested per the requirements of ISO 10993-1 as a skin contacting device with skin contact for a prolonged duration (>24 hours to 30 days). Results of testing demonstrates that the materials used in the construction of the needle and catheter in the proposed Ancora Nerve Block Catheter Set are safe for their intended use.

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.

K121846

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

§ 868.5150 Anesthesia conduction needle.

(a)
Identification. An anesthesia conduction needle is a device used to inject local anesthetics into a patient to provide regional anesthesia.(b)
Classification. Class II (performance standards).

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Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the seal of the Department of Health & Human Services. To the right of the seal is the FDA logo, which consists of the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG" in blue, and the word "ADMINISTRATION" in a smaller font size below.

Ancora Medical Technology % Terri Bogucki Consultant Decus Biomedical Inc 2342 Shattuck Ave #333 Berkeley, California 94704

Re: K191290

Trade/Device Name: Ancora Nerve Block Catheter Set Regulation Number: 21 CFR 868.5150 Regulation Name: Anesthesia Conduction Needle Regulatory Class: Class II Product Code: BSP Dated: January 6, 2020 Received: January 8, 2020

Dear Terri Bogucki:

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/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); 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 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,

Todd Courtney Assistant Director DHT1C: Division of ENT, Sleep Disordered Breathing, Respiratory and Anesthesia Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K191290

Device Name Ancora Nerve Block Catheter Set

Indications for Use (Describe)

The Ancora Nerve Block Catheter Set is indicated for surgical pain management during the pre-operative, perioperative and post-operative periods associated with general and orthopedic surgery. The device allows physicians to locate peripheral nerves by transferring electrical impulses from a nerve stimulator and/or through ultrasound visualization of the device. The catheter may remain in dwelling for up to 72 hours.

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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5 510(k) Summary

Submitter's Name:Ancora Medical Technology
Address:333 Ravenswood Ave
Menlo Park, CA 94025
Contact Person:Terese Bogucki
Title:Regulatory Consultant
Telephone Number:650-488-7799
Fax Number:650-227-2264
Email:terri@decusbiomedical.com
Date Summary Prepared:9 May 2019
Device Proprietary Name:Ancora Nerve Block Catheter Set
Model Number:10-04-SET1
Common Name:Peripheral Nerve Block Needle
Regulation Number:21 CFR 868.5150
Product Code:BSP
Device Class:II
Predicate DeviceTrade name: Braun Contiplex® C
Manufacturer: B Braun Medical Inc.
Address: 901 Marcon Boulevard
Allentown, PA 18109-9341
Regulation Number: 21 CFR 868.5150
Regulation Name: Needles, Conduction, Anesthetic, W/Wo introducer
Device Class: Class II
Product Code: BSP
510(k) Number: K121846
510(k) Clearance Date: November 20, 2012

5.1 Description of the Device

The Ancora Nerve Block Catheter Set is a sterile, single-use, disposable device, intended for delivery of local anesthetic for continuous peripheral nerve blocks, in adult patients.

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The Ancora Nerve Block Catheter Set is intended to be placed with the use of nerve stimulation and/or ultrasound guidance. The device has a catheter-over-needle design, which consists of a 21-gauge needle and 18-gauge catheter with a twist lock connection between them. The device design includes an anchor and decoupler to help maintain the catheter position. Both the needle and catheter have NRFit connection for infusion. The device set includes two sizes of dressings.

5.2 Intended Use

The Ancora Nerve Block Catheter Set, consisting of the peripheral nerve block needle, catheter, and related dressing accessory, is intended to provide, via percutaneous administration, continuous and/or intermittent infusion of local anesthetics and analgesics for peripheral plexus anesthesia and pain management.

Indications for Use 5.3

The Ancora Nerve Block Catheter Set is indicated for surgical pain management during the pre-operative, perioperative and post-operative periods associated with general and orthopedic surgery. The device allows physicians to locate peripheral nerves by transferring electrical impulses from a nerve stimulator or through ultrasound visualization of the device. The catheter may remain in dwelling for up to 72 hours.

5.4 Summary of Technological Characteristics Comparison

The Ancora Nerve Block Catheter Set has the same intended use as the Contiplex C Continuous Peripheral Nerve Block Needle (K121846). The proposed device and predicate device both incorporate insulated needles to locate targeted nerve bundles by stimulation or ultrasound guidance in order to perform peripheral nerve block procedures. Both devices are used to place an indwelling catheter in position local to the target nerve and are intended to remain indwelling up to 72 hours. Both devices include a catheter over needle design.

Table 5-1 shows the similarities and differences between the two products. The differences in the technological characteristics of the devices result from the Ancora Nerve Block Catheter Set's features that enable the catheter to remain in position so that the anesthetics or analgesics are delivered to the targeted nerve. The Continuous Peripheral Nerve Block Needle secures the catheter to the patient's skin using the Perifix Pinpad. In the subject device, the decoupler assembly, anchor, and dressing work together to stabilize the catheter and catheter tip. While these characteristics are different, the testing demonstrates that they do not raise new questions of safety or effectiveness.

| Technological

CharacteristicPredicateSubject DeviceDifferences
DesignCatheter over needleSameNone
Technological
CharacteristicPredicateSubject DeviceDifferences
EchogenicYes (catheter)Yes (needle and
catheter)None - ultrasound can be
used with the both devices
to determine and confirm
the correct catheter
placement
Needle Gauge25G21GThe subject device has a
larger diameter needle,
which makes it easier to
control but does not impact
clinical use (other similar
devices on the market have
needles as large as 18G);
needle testing has
demonstrated it meets
standards
Needle Length190 mm100 mmMinimal - the subject
device's shorter needle is
easier to manage
Needle TypeStraightSameNone
Needle Bevel30 degreeSameNone
Needle
MaterialStainless steelSameNone
Compatible
with Nerve
StimulatorsYes -Stimuplex®
HNS 12 SENSe
nerve stimulatorsYes - used with
stimulators with a
2 mm touchproof
electromedical
connector and
delivering a
maximum current
of 5 mANone – the subject device
uses a standard connector
(that can be used with the
HNS 12 stimulator);
subject device testing has
demonstrated the needle
can tolerate a much higher
current than would be
applied clinically
Stimulation
Wire
Conduction
MaterialUnknownCopperConduction materials do
not contact the patient; any
material differences would
not impact safety or
effectiveness
Technological
CharacteristicPredicateSubject DeviceDifferences
Needle
Electrically
Insulated?Yes - parylene
coating insulates the
needle (except for
the bevel tip)Yes - catheter
construction
(effectively 5
layers) insulates
the needle (except
for the tip)The predicate device used
a coating on the needle, but
the subject device has no
insulation attached to the
body of the needle. While
the catheter provides
insulation, it isn't adhered
to the needle.
Catheter Gauge19G18GSize difference is minimal
Catheter
ConstructionPolyamide and
polyeurethanePolyimide inner
sheath with inner
spring coil, Pebax
outer sheathBoth devices are
echogenic; subject device
construction with a coil
and air gap between
sheaths enhances the
catheter's echogenicity
Catheter
Effective
Length187 mm95 mmMinimal - shorter catheters
are said to make
securement easier, reduce
the likelihood of catheter
knotting, and reduce the
potential for the catheter to
accidentally leave the
sterile field during
placement
Catheter TipOpen tapered tipOpen smooth,
rounded, tapered
tipMinimal - the shapes of
the tips do not impact
safety or effectiveness
Infusion Set
Connector
TypeCatheter clamp with
yellow connector
(likely NRFit)NRFitSubject device does not
require extra step of
attaching clamp to the end
of the catheter; NRFit is
designed to meet ISO
80369-6, an FDA-
recognized consensus
standard related to small
bore connectors for
neuraxial applications. The
yellow connector on the
predicate implies it is also
NRFit.
Technological
CharacteristicPredicateSubject DeviceDifferences
Catheter
FixationPerifix PinPad is a
skin fixation device
for the Perifix EF
filter (which
attaches to and
stabilizes the
catheter)Decoupler
assembly, anchor
and dressingTesting demonstrates the
decoupler and anchor do
not impact safety and
effectiveness.
Infusion FilterIncludes Perifix EF
filter (0.2µm)Not includedFilters are used to address
concerns the anesthetic is
non-sterile or
contaminated, for example,
as result of disconnection.
However, the two
additional connection
points have raised clinical
concerns that filters
actually increase the risk
for disconnection and
infection. Separate filters
are widely available and
could be attached to the
subject catheter.
Compatible
Infusion PumpLuer connector,
flow rate maximum
35mL/hrNRFit connector,
flow rate
maximum 33
ml/minMinimal - the subject
device's labeling indicates
the maximum flow rate
supported by the catheter,
as does the predicate.
Subject devices maximum
flow rate is higher than the
predicate, and therefore
matches or exceeds
compatibility.
External
DressingNot included or
specifiedSmall and large
dressing sizes
provided in setThe dressing serves to
protect the skin at the
catheter insertion point,
contain the decoupler and
secure the catheter;
standard practice is to
apply a dressing over the
insertion site.
Technological
CharacteristicPredicateSubject DeviceDifferences
Device
Insertion AidControl GripRidged edges on
the hubsThe moveable Control Grip
on the predicate device is
intended to facilitate
insertion of the needle and
catheter together at 2 cm
intervals. This is needed
because of the predicate's
thinner and longer needle.
The ridged edges on the
subject device's hubs help
stabilize the two
components during
insertion. The subject
device's thicker needle
does not need additional
support for insertion.
These differences have no
impact on safety and
effectiveness.
PackagingIndividually
packaged kits
provided in a case of
5 unitsIndividually
packaged kits
provided in
dispenser carton
of 6 unitsMinimal difference in
number of units has no
impact on safety or
effectiveness

Table 5-1. Summary of Technological Characteristics Comparison

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Non-Clinical Performance Data 5.5

Testing was performed with the Ancora Nerve Block Catheter Set to support substantial equivalence to the predicate device. Testing included performance testing, biocompatibility, sterilization, and shelf-life testing.

Performance testing completed included the following functional tests: electrical performance (continuity, current transfer), flow rate, occlusion, kink resistance, resistance to breakage, joint bond strength, leakage, penetration force, echogenicity, corrosion resistance.

The following standards were utilized in the evaluation:

  • ISO 20698, Catheter systems for neuraxial application -- Sterile and singleuse catheters and accessories
  • EN 13868, Catheters - Test methods for kinking of single lumen catheters and medical tubing

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  • . ISO 7864, Sterile hypodermic needles for single use
  • ISO 10555-1, Intravascular catheters -- Sterile and single-use catheters -- Part 1: General requirements
  • ISO 10555-5. Intravascular catheters -- Sterile and single-use catheters -- Part . 5: Over-needle peripheral catheters
  • . ASTM D4169-16, Standard Practice for Performance Testing of Shipping Containers and Systems

In addition, Ancora Medical Technology conducted performance testing to demonstrate the subject device conforms with the following test standards:

  • . ISO 80369-6:2016, Small bore connectors for liquids and gases in healthcare applications -- Part 6: Connectors for neuraxial applications
  • . ANSI/AAMI/ISO 11135:2014, Sterilization of health-care products -Ethylene oxide - Requirements for the development, validation and routine control of a sterilization process for medical devices

Results of performance testing indicate that the needle and catheter, in the Ancora Nerve Block Catheter Set meet applicable sections of the standards referenced and are safe and effective for their intended use. Based upon the results of this testing, it was determined the Ancora Nerve Block Catheter Set performance was substantially equivalent to the predicate device.

5.5.1 Biocompatibility Testing

Biocompatibility testing was performed based on the nature and duration of patient contact outlined in ISO 10993-1: "Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process" and the FDA guidance document: "Use of International Standard ISO 10993-1, "Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process"". The needle assembly was tested per the ISO 10993-1 requirements for an externally communicating device with tissue contact for a limited duration (24 hours to 30 days). The dressing was tested per the requirements of ISO 10993-1 as a skin contacting device with skin contact for a prolonged duration (>24 hours to 30 days). Results of testing demonstrates that the materials used in the construction of the needle and catheter in the proposed Ancora Nerve Block Catheter Set are safe for their intended use.

5.6 Substantial Equivalence Conclusion

An analysis of the subject and predicate devices shows that the Intended Use and Indications for Use, principles of operation, and conditions of use are identical, and that differences in technical characteristics do not raise different questions of safety and

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effectiveness. Therefore, one can conclude that the Ancora Nerve Block Catheter Set is substantially equivalent to the predicate Contiplex C Continuous Peripheral Nerve Block Needle device.