K Number
K212444
Device Name
Qora Stool Management Kit
Date Cleared
2021-11-17

(104 days)

Product Code
Regulation Number
876.5980
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Qora® Stool Management Kit is indicated for fecal management by diverting liquid or semi-formed stool to minimize skin contact with bedridden patients. The device is for use in patients 18 years and older only. The uninterrupted use of this device, including replacement with other same devices, should not exceed 29 days.
Device Description
Similar to the predicate device, the modified device is a non-sterile, single-use device intended to use for the management of fecal incontinence in bedridden patients. The device consists of an indwelling diverter, an external transit sheath, and an external collection bag. The kit also includes a collection bag hanger and a transit sheath clamp. The self-conforming indwelling fecal diverter, which is provided pre-loaded into a hygienic applicator used to deploy inside the rectum, remains in place by apposition to the rectal wall when deployed. The transit sheath acts as a conduit to facilitate the transfer of fecal matter from the indwelling diverter to the collection bag. The device includes three ports attached to the transit sheath, to facilitate irrigating of the indwelling divery, sample collection, and to allow withdrawal in a trauma-free manner.
More Information

No
The 510(k) summary describes a mechanical device for fecal management and does not mention any AI or ML components or functionalities. The performance studies focus on physical properties and MRI compatibility.

No.
The device manages fecal incontinence, which is a supportive function and not a treatment for a disease or condition.

No.
The device is described as a fecal management system for diverting stool from bedridden patients, with no mention of diagnosing conditions or analyzing patient data for diagnostic purposes. Its function is purely for physical management of feces.

No

The device description clearly outlines physical components like an indwelling diverter, external transit sheath, and collection bag, indicating it is a hardware-based medical device.

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

Here's why:

  • Intended Use: The intended use is for "fecal management by diverting liquid or semi-formed stool to minimize skin contact with bedridden patients." This is a physical management of waste, not a diagnostic test performed on a sample in vitro (outside the body).
  • Device Description: The description details a physical device (indwelling diverter, transit sheath, collection bag) designed to collect and manage stool. While it mentions a port for "sample collection," the primary function is not diagnostic testing of that sample.
  • Lack of Diagnostic Elements: There is no mention of reagents, assays, or any other components typically associated with in vitro diagnostic testing.
  • Performance Studies: The performance studies focus on physical characteristics like dimensional force testing and MRI compatibility, not on the accuracy or reliability of a diagnostic test.

Therefore, the Qora® Stool Management Kit is a medical device for managing fecal incontinence, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Qora® Stool Management Kit is indicated for fecal management by diverting liquid or semi-formed stool to minimize skin contact with bedridden patients. The device is for use in patients 18 years and older only. The uninterrupted use of this device, including replacement with other same devices, should not exceed 29 days.

Product codes

KNT

Device Description

Similar to the predicate device, the modified device is a non-sterile, single-use device intended to use for the management of fecal incontinence in bedridden patients. The device consists of an indwelling diverter, an external transit sheath, and an external collection bag. The kit also includes a collection bag hanger and a transit sheath clamp.

The self-conforming indwelling fecal diverter, which is provided pre-loaded into a hygienic applicator used to deploy inside the rectum, remains in place by apposition to the rectal wall when deployed. The transit sheath acts as a conduit to facilitate the transfer of fecal matter from the indwelling diverter to the collection bag. The device includes three ports attached to the transit sheath, to facilitate irrigating of the indwelling divery, sample collection, and to allow withdrawal in a trauma-free manner.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Rectum

Indicated Patient Age Range

18 years and older

Intended User / Care Setting

Bedridden patients in Hospitals and Nursing Homes

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)

Validation and verification testing, primarily dimensional force testing, identical to that performed on the original device, were performed on the modified device/components to ensure that the performance of the modified device is equivalent to the performance of the predicate device met all previous device specifications for the predicate device.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K153506

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.5980 Gastrointestinal tube and accessories.

(a)
Identification. A gastrointestinal tube and accessories is a device that consists of flexible or semi-rigid tubing used for instilling fluids into, withdrawing fluids from, splinting, or suppressing bleeding of the alimentary tract. This device may incorporate an integral inflatable balloon for retention or hemostasis. This generic type of device includes the hemostatic bag, irrigation and aspiration catheter (gastric, colonic, etc.), rectal catheter, sterile infant gavage set, gastrointestinal string and tubes to locate internal bleeding, double lumen tube for intestinal decompression or intubation, feeding tube, gastroenterostomy tube, Levine tube, nasogastric tube, single lumen tube with mercury weight balloon for intestinal intubation or decompression, and gastro-urological irrigation tray (for gastrological use).(b)
Classification. (1) Class II (special controls). The barium enema retention catheter and tip with or without a bag that is a gastrointestinal tube and accessory or a gastronomy tube holder accessory is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I (general controls) for the dissolvable nasogastric feed tube guide for the nasogastric tube. The class I device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 876.9.

0

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November 17, 2021

CM Technologies, Inc. % Alan Donald President Matrix Medical Consulting, Inc. 8880 Rio San Diego Drive, Suite 800 San Diego, CA 92108

Re: K212444

Trade/Device Name: Qora® Stool Management Kit Regulation Number: 21 CFR§ 876.5980 Regulation Name: Gastrointestinal Tube and Accessories Regulatory Class: II Product Code: KNT Dated: October 11, 2021 Received: October 19, 2021

Dear Alan Donald:

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.

1

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 https://www.fda.gov/combination-products/guidance-regulatoryinformation/postmarketing-safety-reporting-combination-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,

Je Hi An, Ph.D. Assistant Director DHT3A: Division of Renal, Gastrointestinal, Obesity and Transplant 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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Indications for Use

510(k) Number (if known) K212444

Device Name Qora® Stool Management Kit

Indications for Use (Describe)

The Qora® Stool Management Kit is indicated for fecal management by diverting liquid or semi-formed stool to minimize skin contact with bedridden patients. The device is for use in patients 18 years and older only. The uninterrupted use of this device, including replacement with other same devices, should not exceed 29 days.

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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SECTION 5 Special 510(k) Summary

This summary of safety and effectiveness for the Qora® Stool Management Kit is being submitted in accordance with the requirements of 21 CFR 807.92.

510(k) Number:

Name: CM Technologies, Inc. Address: 2165 San Diego Avenue, San Diego, CA 92110 Owner Operator Number: 10049590 Establishment Registration: 3013524793 Phone: (858) 243-3582 Contact: Alan Donald

Date Prepared: July 20, 2021

Trade Name: Qora® Stool Management Kit Common Name: Rectal Catheter Classification: 21 CFR 876.5980; Gastrointestinal Tube and Accessories Product Code: KNT Regulatory Class: Class II

Identification of the legally marketed predicate device

The modifications described herein relate to the Oora AIM™ Stool Management Kit, the legally marketed predicate device, with further details below.

Table 1: Legally Marketed Predicate Device

| 510(K) Identifier: | K153506 | Regulation Name: | Gastrointestinal Tube
and Accessories |
|--------------------------|--------------------------------|-------------------|------------------------------------------|
| Trade/Device Name: | Qora AIM™ Stool Management Kit | Regulatory Class: | Class II |
| Device Type/Common Name: | Rectal Catheter | Product Code: | KNT |
| Regulation Number: | 21 CFR 876.5980 | Clearance Date: | May 6, 2016 |

For this submission, the modified device, the Qora® Stool Management Kit, is compared with the Qora AIM™ Stool Management Kit, which was cleared in the company's 510(k) (ref. K153506).

Description of the modified device

Similar to the predicate device, the modified device is a non-sterile, single-use device intended to use for the management of fecal incontinence in bedridden patients. The device consists of an indwelling diverter, an external transit sheath, and an external collection bag. The kit also includes a collection bag hanger and a transit sheath clamp.

The self-conforming indwelling fecal diverter, which is provided pre-loaded into a hygienic applicator used to deploy inside the rectum, remains in place by apposition to the rectal wall when deployed. The transit sheath acts as a conduit to facilitate the transfer of fecal matter from the indwelling diverter to the collection bag. The device includes three ports attached to the transit sheath, to facilitate irrigating of the indwelling divery, sample collection, and to allow withdrawal in a trauma-free manner.

Indications for Use

The Oora" Stool Management Kit is indicated for fecal management by diverting and collecting liquid or semi formed stool to mimize skin contact in bedridden patients. The device is for use in patients 18 years and older only. The uninterrupted use for this device, including replacement with other same devices, should not exceed 29 days.

Note: There has been no modifications for Use statement other than the product name which has been changed from Qora AIM™ Stool Management Kit to Qora® Stool Management Kit.

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Substantial Equivalence

DescriptionModified Qora® SMKPredicate Device (K153506)Result
Intended UseFecal managementFecal managementIdentical
Intended UsersBedridden patientsBedridden patientsIdentical
Indications for UseThe Qora® Stool Management Kit is
indicated for fecal management by
diverting and collecting liquid or
semi-formed stool to minimize skin
contact with bedridden patients. The
device is for use in patients 18 years
and older only. The uninterrupted
use of this device, including
replacement with other same
devices, should not exceed 29 days.The Qora® AIM Stool Management
Kit is indicated for fecal
management by diverting and
collecting liquid or semi-formed
stool to minimize skin contact in
bedridden patients. The device is for
use in patients 18 years and older
only. The uninterrupted use for this
device, including replacement with
other same devices, should not
exceed 29 days.Identical
Patient Population18 years and older18 years and olderIdentical
Environment of UseHospitals and Nursing HomesHospitals and Nursing HomesIdentical
Condition of UseSingle-useSingle-useIdentical
Period of Usage29 days29 daysIdentical
Insertion MethodHygienic ApplicatorHygienic ApplicatorIdentical
Diverter OD55mm ± 10mm55mm ± 10mmIdentical
DetachableYesYesIdentical
Collection BagYesYesIdentical
Irrigation PortYesYesIdentical
Sampling PortYesYesIdentical
Retrieval ByCollapsing DiameterCollapsing DiameterIdentical
Interface PortSide catheter connector portSide catheter connector portIdentical
Odor ProtectionYesYesIdentical
SterilitySupplied non-sterile, disposable,
single patient useSupplied non-sterile, disposable,
single patient useIdentical
Shelf Life12 months12 monthsIdentical
MR SafetyNon-clinical testing demonstrated
that the Qora® SMK is MR
Conditional.
Conditions for MRI Testing were
revised based on the updates to the
indwelling diverterNon-clinical testing demonstrated
that the Qora AIMTM SMK is MR
Conditional.Reconfirmed
/Identical
See Note 1

Table 2: A summary of equivalence between the modified and the predicate device is given below:

Note 1: MR testing of the modified device was performed by the same independent laboratory, following the same applicable ASTM standards and US FDA guidance document, (Testing and Labeling Medical Devices for Safety in the MR environment, May 2021), as those for the predicate device. The test results of the modified device were found to be within the same acceptable range for Conditional usage as those cleared for Qora AIM™ SMK under K153506.

Description of Change

No design change has been made that would alter the technology used in the modified device. However, to improve manufacturability, and due to raw material availability, the stainless-steel wire in the indwelling diverter has been modified. This new wire allows the diameter to be increased by a small amount (0.09mm) without impacting the patient safety or device functionality, as demonstrated from the non-clinical tests performed.

The name of the product has been changed to Qora Stool Management Kit for marketing purposes. Corresponding label changes have been made to the Instructions For Use to reflect the name change and updated MR conditions. The labeling is in compliance with the US FDA guidance document, Testing and Labeling Medical Devices for Safety in the MR environment, May 2021.

5

Summary of Non-clinical Testing

Validation and verification testing, primarily dimensional force testing, identical to that performed on the original device, were performed on the modified device/components to ensure that the performance of the modified device is equivalent to the performance of the predicate device met all previous device specifications for the predicate device.

No additional biocompatibility testing was required by the modification of the diverter wire. Other minor changes did not involve patient contact materials.

Conclusions from Nonclinical Testing

The Qora® Stool Management Kit is fundamentally equivalent in design and function to the predicate device, the Qora AIM™ Stool Management Kit.

Qora® Stool Management Kit incorporates the similarities with the predicate device, the Qora AIM™ Stool Management Kit as shown in the above comparison table. The few differences, including this described modification, do not new issues of safety or effectiveness.

In summary, Qora® Stool Management Kit described in this substantially equivalent to the predicate Qora AIMTM Stool Management Kit.