K Number
K211691
Device Name
Ultrast Gel
Manufacturer
Date Cleared
2021-12-22

(203 days)

Product Code
Regulation Number
892.1570
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Ultrast Gel is an in vivo biocompatible sterile sterile couplant intended for use as a scanning gel in surgical procedures, biopsies and similar sterile applications.

Ultrast Gel is used to couple sound waves between the patient and medical imaging electronic transducers during intracavitary medical diagnostic ultraging procedures, transcutaneous ultrasound image guided biopsy and aspiration, intracavity ultrasound imaging, and gel infusion sonography.

Ultrast Gel is unit dose packaged, sterilized and intended for use in all diagnostic ultrasound procedures that currently use an ultrasound coupling gel or other fluid, alone or in combination with a transducer cover, where sterility, in vivo biocompatibility and bioelimination are required.

ULTRAST Gel is available by prescription only for use by healthcare providers trained in performing the indicated procedure.

Device Description

The Ultrast Gel device, manufactured for Ultrast, Inc. is a phase changing hydrogel ultrasound coupling agent comprised of hydroxy-propylcellulose, sodium chloride, sodium citrate, and water. HCl may be added to adjust pH if necessary. The gel is viscous at room temperature, but subsequently liquefies as its temperature rises and reaches body temperature. In addition to general lubricating/coupling properties, the gel may be instilled in the uterine cavity through a standard intrauterine insemination (IUI) catheter to provide excellent ultrasonographic visualizations, after which point it liquifies and passes out of the uterine cavity.

The gel is contained in a single use 5cc capped syringe enclosed in a peel pouch to maintain sterility.

AI/ML Overview

The provided text is a 510(k) Premarket Notification summary for Ultrast Gel, a medical device. It describes the device, its intended use, and its substantial equivalence to a predicate device. However, this document does not contain information about acceptance criteria or a study that proves the device meets specific performance criteria in the context of an AI/human-in-the-loop study.

The "Performance Data" section primarily addresses biocompatibility testing, electrical safety/EMC (not applicable, as it's not a software/electrical device), software verification/validation (not applicable), and bench testing related to the physical properties of the gel (appearance, pH, viscosity, syringe force, acoustic properties, and package integrity). There is no mention of a study involving human readers, AI assistance, ground truth establishment by experts, or MRMC studies.

Therefore, I cannot fulfill the request to describe acceptance criteria and a study that proves the device meets them in the context of AI/human-in-the-loop performance. The information required for your request (AI performance, human reader improvement, expert adjudication, ground truth type, sample sizes for training/test sets related to AI) is simply not present in this regulatory document, as the device is a physical gel, not an AI software.

{0}------------------------------------------------

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: a symbol on the left and the FDA name and title on the right. The symbol on the left is a stylized representation of a human figure, while the text on the right reads "FDA U.S. FOOD & DRUG ADMINISTRATION" in blue letters.

Ultrast, Inc. % Howard Levine President 3286 Balsam Street OCEANSIDE NY 11572

December 22, 2021

Re: K211691

Trade/Device Name: Ultrast Gel Regulation Number: 21 CFR 892.1570 Regulation Name: Diagnostic ultrasonic transducer Regulatory Class: Class II Product Code: MUI Dated: November 24, 2021 Received: November 24, 2021

Dear Howard Levine:

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/cfpmp/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 and Part 809); 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

{1}------------------------------------------------

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 medical devices and radiation-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,

For

Thalia T. Mills, Ph.D. Director Division of Radiological Health OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

{2}------------------------------------------------

Indications for Use

510(k) Number (if known)

K211691

Device Name

Ultrast Gel

Indications for Use (Describe)

Ultrast Gel is an in vivo biocompatible sterile sterile couplant intended for use as a scanning gel in surgical procedures, biopsies and similar sterile applications.

Ultrast Gel is used to couple sound waves between the patient and medical imaging electronic transducers during intracavitary medical diagnostic ultraging procedures, transcutaneous ultrasound image guided biopsy and aspiration, intracavity ultrasound imaging, and gel infusion sonography.

Ultrast Gel is unit dose packaged, sterilized and intended for use in all diagnostic ultrasound procedures that currently use an ultrasound coupling gel or other fluid, alone or in combination with a transducer cover, where sterility, in vivo biocompatibility and bioelimination are required.

ULTRAST Gel is available by prescription only for use by healthcare providers trained in performing the indicated procedure.

Type of Use (Select one or both, as applicable)

☑ Prescription Use (21 CFR 201.Subpart D)
☐ Over-The-Counter Use (21 CFR 201 Subpart C)

Prescription Use (Part 21 CFR 801 Subpart D)

| | Over-The-Counter Use (21 CFR 801 Subpart C)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

{3}------------------------------------------------

In accordance with 21 CFR 807.87(h) and (21 CFR 807.92) the 510(k) Summary for the Ultrast Gel is provided below.

SUBMITTER 1.

Applicant:Ultrast, Inc.Tel: 516-606-1754
Contact:Howard LevinePresidentTel. 516-606-1754Email. hll@well.com
Submission Correspondent:Howard LevinePresidentTel. 516-606-1754Email. hll@well.com

Date Prepared: June 1, 2021

2. DEVICE

Device Trade Name:Ultrast Gel
Device Common Name:Sterile ultrasound gel
Classification NameDiagnostic ultrasonic transducer (21 CFR 892.1570)
Regulatory Class:Class II
Product Code:MUI

3. PREDICATE DEVICE

Predicate Device: Farco-Pharma GmbH; Lubricano Sterile Gel (K083358)

DEVICE DESCRIPTION 4.

The Ultrast Gel device, manufactured for Ultrast, Inc. is a phase changing hydrogel ultrasound coupling agent comprised of hydroxy-propylcellulose, sodium chloride, sodium citrate, and water. HCl may be added to adjust pH if necessary. The gel is viscous at room temperature, but subsequently liquefies as its temperature rises and reaches body temperature. In addition to general lubricating/coupling properties, the gel may be instilled in the uterine cavity through a standard intrauterine insemination (IUI) catheter to provide excellent ultrasonographic visualizations, after which point it liquifies and passes out of the uterine cavity.

The gel is contained in a single use 5cc capped syringe enclosed in a peel pouch to maintain sterility.

{4}------------------------------------------------

5. INTENDED USE/INDICATIONS FOR USE

Ultrast Gel is an in vivo biocompatible and bioexcretable sterile couplant intended for use as a scanning gel in surgical procedures, biopsies and similar sterile applications.

Ultrast Gel is used to couple sound waves between the patient and medical imaging electronic transducers during intracavitary medical diagnostic ultrasound imaging procedures, transcutaneous ultrasound image guided biopsy and aspiration, intracavity ultrasound imaging, and gel infusion sonography.

Ultrast Gel is unit dose packaged, sterilized and intended for use in all diagnostic ultrasound procedures that currently use an ultrasound coupling gel or other fluid, alone or in combination with a transducer cover, where sterility, in vivo biocompatibility and bioelimination are required.

ULTRAST Gel is available by prescription only for use by healthcare providers trained in performing the indicated procedure.

SUBSTANTIAL EQUIVALENCE 6.

Comparison of Indications

The indications for use are nearly identical to the predicate.

Subject device Indication for Use:

Ultrast Gel is an in vivo biocompatible and bioexcretable sterile couplant intended for use as a scanning gel in surgical procedures, biopsies and similar sterile applications.

Ultrast Gel is used to couple sound waves between the patient and medical imaging electronic transducers during intracavitary medical diagnostic ultrasound imaging procedures, transcutaneous ultrasound image guided biopsy and aspiration, intracavity ultrasound imaging, and gel infusion sonography.

Ultrast Gel is unit dose packaged, sterilized and intended for use in all diagnostic ultrasound procedures that currently use an ultrasound coupling gel or other fluid, alone or in combination with a transducer cover, where sterility, in vivo biocompatibility and bioelimination are required.

Predicate device Indications for Use:

Lubricano is an in vivo biocompatible and bioexcretable sterile couplant intended for use as a scanning gel in surgical procedures, biopsies and similar sterile applications.

Lubricano is used to couple sound waves between the patient and medical imaging electronic transducers during intracavitary medical diagnostic ultrasound imaging procedures, such as transcutaneous ultrasound image guided biopsy and aspiration, intracavity ultrasound imaging, and gel infusion sonography.

Lubricano is unit dose packaged, sterilized and intended for use in all diagnostic ultrasound procedures that currently use an ultrasound coupling gel or other fluid, alone or in

{5}------------------------------------------------

combination with a transducer cover, where sterility, in vivo biocompatibility and bioelimination are required.

Technological Comparisons

The table below compares the key technological feature of the subject devices to the predicate device (Lubricano Sterile Gel, K083358).

Proposed DevicePredicate Device
510(k) NumberTBDK083358
ApplicantUltrast, Inc.Farco-Pharma GmbH
Device NameUltrast GelLubricano Sterile Gel
Classification Regulation21 CFR 892.157021 CFR 892.1570
Product CodeMUI - Media, Coupling, UltrasoundMUI – Media, Coupling, Ultrasound
Indications for UseUltrast Gel is an in vivobiocompatible and bioexcretablesterile couplant intended for use as ascanning gel in surgical procedures,biopsies and similar sterileapplications.Ultrast Gel is used to couple soundwaves between the patient andmedical imaging electronictransducers during intracavitarymedical diagnostic ultrasoundimaging procedures, transcutaneousultrasound image guided biopsyand aspiration, intracavityultrasound imaging, and gelinfusion sonography.Ultrast Gel is unit dose packaged,sterilized and intended for use in alldiagnostic ultrasound proceduresthat currently use an ultrasoundcoupling gel or other fluid, alone orin combination with a transducercover, where sterility, in vivobiocompatibility and bioeliminationare required.Lubricano is an in vivobiocompatible and bioexcretablesterile couplant intended for use as ascanning gel in surgical procedures,biopsies and similar sterileapplications.Lubricano is used to couple soundwaves between the patient andmedical imaging electronictransducers during intraoperativeand intracavitary medical diagnosticultrasound imaging procedures, suchas transcutaneous ultrasound imageguided biopsy and aspiration,intraoperative ultrasound imaging,intracavity ultrasound imaging, andgel infusion sonography.Lubricano is unit dose packaged,sterilized and intended for use in alldiagnostic ultrasound proceduresthat currently use an ultrasoundcoupling gel or other fluid, alone orin combination with a transducercover, where sterility, in vivobiocompatibility and bioeliminationare required.
Containing UnitSyringeSyringe
CompositionHydroxypropylcellulose, sodiumchloride, sodium citrate, and waterHydroxyethylcellulose, Glycerol,Purified Water
SterileYes - Moist HeatYes – Moist Heat
pH Range6.5-8.55.0-7.5
Viscosity90,000-140,000 cpsGreater than 1800 mPas
Proposed DevicePredicate Device
Density1.010 - 1.030 g/cm31.018 - 1.028 g/cm3
Acoustic Impedance1.574 @ 4 MHz1.579 @ 7 MHz1.579 @ 10 MHz1.61 Mrayl (estimated)
Speed of Sound1513 m/sec @4 MHZ (25.6 °C)1518 m/sec @7 MHZ (25.6 °C)1518 m/sec @10 MHZ (25.6 °C)1532 m/s
Sound Attenuation0.02 (dB/cm-MHz)0.0023 2.17 dB/cm-MHz
BiocompatibilityMeets ISO-10993 Requirements,addressed through testing or riskassessment:CytotoxicitySensitizationIrritationAcute Systemic ToxicityPyrogenicityMeets ISO-10993 RequirementsPassed testing for:CytotoxicitySensitizationIrritation
Labeled UsePrescription UsePrescription Use

Technological Comparison Table 1:

{6}------------------------------------------------

6.1. Comparison of Technological Characteristics and Substantial Equivalence Conclusion

The proposed device has identical an intended use and identical indications for use compared to the predicate, as such there are no issues of substantial equivalence based on the proposed use. When examining technological characteristics, the proposed device is very similar to the predicate. Its major difference is the phase-changing characteristics that allow for easier removal. This phase change takes place after the ultrasound procedure and therefore leads to no significant questions of safety and effectiveness compared to the predicate. That is, the feature is described in the instructions for use and is supported by performance testing to demonstrate it works as intended. The minor differences in formulation are supported by the acoustic testing and biocompatibility testing. Other performance testing substantial equivalence includes sterilization validation and shelf-life/stability evaluation.

Based on the detailed comparison between the predicate devices and the subject device, the Ultrast Gel can be found substantially equivalent to the predicate device.

7. PERFORAMNCE DATA

Biocompatibility Testing

Ultrast Gel is an Implant Device contacting Tissue/Bone for a Limited Contact Duration. As such, biocompatibility testing was carried out according to the requirements in the following standards:

{7}------------------------------------------------

  • | ISO 10993-1:2018, Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process
  • । ISO10993-5:2009, Biological evaluation of medical devices - Part 5: Tests for in vitro cytotoxicity
  • ISO 10993-10:2010, Biological Evaluation of Medical Devices Part 10: Tests for -Irritation and Skin Sensitization
  • । ISO 10993-11:2017, Biological evaluation of medical devices - Part 11: Tests for systemic toxicity

Test results support that the Ultrast Gel device is biocompatible for its intended use and contact duration.

Electrical safety and electromagnetic compatibility (EMC)

Not applicable. The subject device is a software-only device. It contains no electric components, generates no electrical emissions, and uses no electrical energy of any type.

Software Verification and Validation Testing

Not applicable. The device contains no software.

Bench Testing

To establish the substantial equivalence of Ultrast Gel, bench testing was conducted to validate the performance of the device. The following tests were conducted:

  • Appearance ●
  • pH Level Testing
  • Phase Change/Viscosity Testing ●
  • Syringe Force Testing
  • Acoustic Testing .

The following tests were also conducted:

  • Bubble Leak Testing
  • Package Peel Testing ●
  • Pouch Dye Penetration Testing

The results of the bench testing support that technological characteristics of the proposed device are substantially equivalent to the predicate device.

Animal Testing

Not applicable. Animal studies are not necessary to establish the substantial equivalence of this device.

{8}------------------------------------------------

Clinical Data

Not applicable. Clinical studies are not necessary to establish the substantial equivalence of this device.

8. CONCLUSION

Like the predicate device, performance testing supports that the Ultrast Gel device biocompatible and meets requirements for performance testing, acoustic properties, sterility, and shelf life. Based on the detailed comparison between the predicate device and the subject device, the performance testing and conformance with applicable standards, Ultrast Gel can be found substantially equivalent to the predicate device.

§ 892.1570 Diagnostic ultrasonic transducer.

(a)
Identification. A diagnostic ultrasonic transducer is a device made of a piezoelectric material that converts electrical signals into acoustic signals and acoustic signals into electrical signals and intended for use in diagnostic ultrasonic medical devices. Accessories of this generic type of device may include transmission media for acoustically coupling the transducer to the body surface, such as acoustic gel, paste, or a flexible fluid container.(b)
Classification. Class II.