K Number
K214009
Device Name
D·Kaptain PTA High Pressure Balloon Dilatation Catheter
Date Cleared
2023-04-05

(516 days)

Product Code
Regulation Number
870.1250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The D.Kaptain™ PTA High Pressure Balloon Dilatation Catheter is indicated for Percutaneous Transluminal Angioplasty (PTA) in the peripheral vasculature, including iliac, femoral, popliteal, tibial, peroneal, subclavian, and renal arteries and for the treatment of obstructive lesions of native or synthetic arteriovenous dialysis fistulae. This catheter is not for use in the coronary vasculature.
Device Description
The D·Kaptain™ PTA High Pressure Balloon Dilatation Catheter is an over-the-wire balloon catheter with a dual lumen shaft design. One lumen is used to pass the catheter over 0.035" guidewires. The second lumen communicates with the balloon and is used to inflate and deflate the balloon during the procedure. The guidewire lumen and the balloon lumen terminate at the proximal end of the catheter in a Y-connector manifold with luer lock fillings. There are radiopaque marker bands located under the balloon to aid in positioning the system during the procedure. A PVP coating is applied to the tip to enhance insertion and withdrawal performance. The D.Kaptain™ PTA High Pressure Balloon Dilatation Catheter will be available with balloon diameters 3.0 mm to 12.0 mm, balloon lengths 20 mm to 150 mm and with shaft lengths of 50 cm, 75 cm, and 130 cm.
More Information

No reference devices were used in this submission

No
The summary describes a standard balloon catheter with no mention of AI or ML capabilities. The performance studies are focused on physical and mechanical properties, not algorithmic performance.

Yes
The device is indicated for Percutaneous Transluminal Angioplasty (PTA) in the peripheral vasculature and for the treatment of obstructive lesions, which are therapeutic procedures aimed at treating medical conditions.

No

The device is a balloon dilatation catheter used for angioplasty, which is a therapeutic procedure to open narrowed or obstructed arteries, not a diagnostic procedure to identify a condition.

No

The device description clearly details a physical catheter with a balloon, lumens, guidewire compatibility, radiopaque markers, and a coating, indicating it is a hardware device.

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, or tissue) to provide information about a person's health. This testing is done outside of the body.
  • Device Description and Intended Use: The D.Kaptain™ PTA High Pressure Balloon Dilatation Catheter is a device used inside the body (in the peripheral vasculature) to physically dilate blood vessels. It is a therapeutic device, not a diagnostic one. It does not analyze samples taken from the body.

The information provided clearly describes a medical device used for a therapeutic procedure within the body, not for in vitro diagnostic testing.

N/A

Intended Use / Indications for Use

The D Kaptain™ PTA High Pressure Balloon Dilatation Catheter is indicated for Percutaneous Transluminal Angioplasty (PTA) in the peripheral vasculature, including iliac, femoral, popliteal, tibial, peroneal, subclavian, and renal arteries and for the treatment of obstructive lesions of native or synthetic arteriovenous dialysis fistulae. This catheter is not for use in the coronary vasculature.

Product codes

LIT, DOY

Device Description

The D·Kaptain™ PTA High Pressure Balloon Dilatation Catheter is an over-the-wire balloon catheter with a dual lumen shaft design. One lumen is used to pass the catheter over 0.035" guidewires. The second lumen communicates with the balloon and is used to inflate and deflate the balloon during the procedure. The guidewire lumen and the balloon lumen terminate at the proximal end of the catheter in a Y-connector manifold with luer lock fillings. There are radiopaque marker bands located under the balloon to aid in positioning the system during the procedure. A PVP coating is applied to the tip to enhance insertion and withdrawal performance. The D.Kaptain™ PTA High Pressure Balloon Dilatation Catheter will be available with balloon diameters 3.0 mm to 12.0 mm, balloon lengths 20 mm to 150 mm and with shaft lengths of 50 cm, 75 cm, and 130 cm.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

peripheral vasculature, including iliac, femoral, popliteal, tibial, peroneal, subclavian, and renal arteries; native or synthetic arteriovenous dialysis fistulae.

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Physicians with adequate training in performance of percutaneous transluminal angioplasty
Hospitals and physician offices

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)

In vitro performance tests, including visual inspection, dimensional verification, crossing profile, guidewire compatibility, simulated use, air/liquid leak, flexibility and kink, torque strength, particulate release, coating integrity, lubricity, balloon rated burst pressure, balloon fatigue, balloon compliance, balloon inflation and deflation time, catheter bond strength, tip pull strength, trackability, and radiopacity were conducted. The test results met all acceptance criteria and ensure the design and construction are suitable for its intended use as recommended by the Class II Peripheral Percutaneous Transluminal Angioplasty (PTA) and Specialty Catheters - Premarket Notification (510(k)) Submission (FDA; January 13, 2020).
Biocompatibility testing: Cytotoxicity, Sensitization test, Intracutaneous reactivity test, Systemic Toxicity test (Acute), Material-mediated pyrogenicity, hemocompatibility (hemolysis, complement activation, PTT, and in vivo thrombo resistance). The results of the testing show that the subject device included in this submission met all acceptance criteria and the subject device is biocompatible.
Sterility: Ethylene oxide sterilization according to the EN ISO 11135:2014.
Packaging/Shelf life: Simulated shipping testing, accelerated aging testing, and sterility package validation were carried out to decide the shelf life of the D·Kaptain™ PTA High Pressure Balloon Dilatation Catheter. Testing results demonstrated that the shelf life of the D.Kaptain™ PTA High Pressure Balloon Dilatation Catheter was 2 years.

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

Not Found

Predicate Device(s)

K103751

Reference Device(s)

No reference devices were used in this submission

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.1250 Percutaneous catheter.

(a)
Identification. A percutaneous catheter is a device that is introduced into a vein or artery through the skin using a dilator and a sheath (introducer) or guide wire.(b)
Classification. Class II (performance standards).

0

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April 5, 2023

DK Medical Technology Co., Ltd. % Yuling Chen Consultant Microkn Business Consulting (Shanghai) Co., Ltd Room 1219, Block A, No 3699, Gonghexin Road, Jingan District Shanghai. 200435 China

Re: K214009

Trade/Device Name: D.Kaptain™ PTA High Pressure Balloon Dilatation Catheter Regulation Number: 21 CFR 870.1250 Regulation Name: Percutaneous Catheter Regulatory Class: Class II Product Code: LIT, DOY Dated: February 26, 2023 Received: March 2, 2023

Dear Yuling Chen:

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

1

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 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 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,

Digitally signed by Gregory W. Gregory W. O'connell O'connell -S Date: 2023.04.05 12:23:00 -04'00

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

Enclosure

2

Indications for Use

510(k) Number (if known) K214009

Device Name

D.Kaptain™ PTA High Pressure Balloon Dilatation Catheter

Indications for Use (Describe)

The D Kaptain™ PTA High Pressure Balloon Dilatation Catheter is indicated for Percutaneous Transluminal Angioplasty (PTA) in the peripheral vasculature, including iliac, femoral, popliteal, tibial, peroneal, subclavian, and renal arteries and for the treatment of obstructive lesions of native or synthetic arteriovenous dialysis fistulae. This catheter is not for use in the coronary vasculature.

This catheter is not for use in the coronary 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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510K summary

According to the requirements Per 21 CFR §807.92, the following information is provided sufficient detail to understand the basis for a determination of substantial equivalence.

Company:DK Medical Technology CO., Ltd.(DK)
Address:301 unit, bioBAY B1, 218 Xinghu Str., Suzhou Industrial Park
Proprietary NamePTA High Pressure Balloon Dilatation Catheter
Trade NameD-KaptainTM PTA High Pressure Balloon Dilatation Catheter
Classification NamePeripheral Transluminal Angioplasty Catheter
Regulation product
codesLIT, DQY
ClassificationClass 11, 21 CFR Part 870.1250
Legal
Manufacturer:DK Medical Technology CO., Ltd.(DK)
Predicate DeviceMustang™ Balloon Dilatation Catheter
510(k) of
the
predicate deviceK103751
Consultant
CompanyMicrokn Business Consulting (Shanghai) Co., Ltd.
AddressRoom 1219, Block A, No 3699, Gonghexin Road, Jingan District,
Shanghai, China
Contact PersonYuling Chen
Telephone+86 15021397762
Emailyuling.chen@microkn.com

This predicate has not been subject to a design-related recall.

No reference devices were used in this submission

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1.Indications for use

The D.Kaptain™ PTA High Pressure Balloon Dilatation Catheter is indicated for Percutaneous Transluminal Angioplasty (PTA) in the peripheral vasculature, including iliac, femoral, popliteal, tibial, peroneal, subclavian, and renal arteries and for the treatment of obstructive lesions of native or synthetic arteriovenous dialysis fistulae.

This catheter is not for use in the coronary vasculature.

2. Description of the Device

The D·Kaptain™ PTA High Pressure Balloon Dilatation Catheter is an over-the-wire balloon catheter with a dual lumen shaft design. One lumen is used to pass the catheter over 0.035" guidewires. The second lumen communicates with the balloon and is used to inflate and deflate the balloon during the procedure. The guidewire lumen and the balloon lumen terminate at the proximal end of the catheter in a Y-connector manifold with luer lock fillings. There are radiopaque marker bands located under the balloon to aid in positioning the system during the procedure. A PVP coating is applied to the tip to enhance insertion and withdrawal performance. The D.Kaptain™ PTA High Pressure Balloon Dilatation Catheter will be available with balloon diameters 3.0 mm to 12.0 mm, balloon lengths 20 mm to 150 mm and with shaft lengths of 50 cm, 75 cm, and 130 cm.

3. Comparison to Predicate Device

To verify the Proposed device equivalent with the predicate device, the tab.1 listed the comparison results of clinical characteristics, technical characteristics, biological characteristics.

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Tab.1 Descriptive Comparison
Serial
NumberITEM
Product Code
510(k) numberProposed device
LIT, DQY
K214009Predicate device
LIT, DQY
K103751Discussion
01Intended useThe D·KaptainTM PTA High Pressure Balloon
Dilatation Catheter is a device that is introduced
into a vein or artery through the skin using a
dilator and a sheath (introducer) or guide wire
for Percutaneous Transluminal Angioplasty in
the peripheral vasculature and for the treatment
of obstructive lesions of native or synthetic
arteriovenous dialysis fistulae.The Mustang TM Balloon Dilatation Catheter is
intended for dilatation of Device stenosis in the
peripheral vascular, for the treatment of
obstructive lesions of native or synthetic
arteriovenous dialysis fistulae and
post-deployed stent expansion of self-expanding
and balloon expandable peripheral vascular
stents.SE
02Indication for useThe D·KaptainTM PTA High Pressure Balloon
Dilatation Catheter is indicated for Percutaneous
Transluminal Angioplasty (PTA) in the
peripheral vasculature, including iliac, femoral,
popliteal, tibial, peroneal, subclavian, and renal
arteries and for the treatment of obstructive
lesions of native or synthetic arteriovenous
dialysis fistulae.
This catheter is not for use in the coronaryThe MustangTM Balloon Dilatation Catheter is
indicated for percutaneous transluminal
angioplasty (PTA) in the peripheral vasculature
including iliac, femoral, popliteal, tibial,
peroneal, subclavian, and renal arteries, and for
the treatment of obstructive lesions of native or
synthetic arteriovenous dialysis fistulae.
The MustangTM Balloon Dilatation Catheter is
also indicated for post-dilatation of balloon
expandable and self-expanding stents in theSE
Tab.1 Descriptive Comparison
SerialITEMProposed devicePredicate deviceDiscussion
NumberProduct CodeLIT, DQYLIT, DQY
510(k) numberK214009K103751
vasculature.peripheral vasculature.
This catheter is not for use in coronary arteries.
03LocationPeripheral vasculature, including iliac, femoral,Peripheral vasculature, including iliac, femoral,SE
popliteal, tibial, peroneal, subclavian, and renalpopliteal, infra-popliteal and renal arteries, and
arteries and for the treatment of obstructivefor the treatment of obstructive lesions of native
lesions of native or synthetic arteriovenousor synthetic arteriovenous dialysis fistulae.
dialysis fistulae.
04ProcedurePercutaneous Transluminal Angioplasty (PTA)Percutaneous Transluminal Angioplasty (PTA)SE
05ContraindicationsThis catheter is not for use in the coronary.
vasculature.This catheter is not for use in coronary arteries.SE
06Site of useHospitals and physician officesHospitals and physician officesSE
Tab.1 Descriptive Comparison
SerialITEMProposed devicePredicate deviceDiscussion
NumberProduct CodeLIT, DQYLIT, DQY
510(k) numberK214009K103751
07Intended userPhysicians with adequate training in performance of percutaneous transluminal angioplastyPhysicians with adequate training in performance of percutaneous transluminal angioplastySE
08ComponentsIntegral exchange balloon expandable catheters with components : tip, balloon, marker bands, inner lumen, strain relief, shaft tubing and hub.Integral exchange balloon expandable catheters with components : tip, balloon, marker bands, inner lumen, strain relief, shaft tubing and hub.SE
09Catheter TypeOTWOTWSE
10MaterialsNylon 12 , polyether block amidePebax7033, nylon 12Difference 1
11Device Coating(s)No coating.No coating.SE
12Models189 models; balloon diameter: 3mm12mm; balloon length: 20mm150mm.203 models; diameter: 3mm~12mm; balloon length: 20-200 mm.Difference 2
13Useable Catheter Length75-130 cm80-150 cmSE
14Guidewire Compatibility0.035"0.035"SE
15Nominal Pressure (atm)88SE
16RBP (atm)14-2616-24SE
17Marker BandsYESYESSE
Tab.1 Descriptive Comparison
Serial
NumberITEMProposed devicePredicate deviceDiscussion
Product CodeLIT, DQYLIT, DQY
510(k) numberK214009K103751
18Can Infuse ContrastYESYESSE
19PackagingPouch in Pressboard cartonPouch in Pressboard cartonSE
20SterilizationEO, the SAL is 10-6EO, the SAL is 10-6SE

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Difference 1

The material is different. The biocompatibility testing and evaluation result of the subject device is biocompatible.

The difference does not raise new questions of safety or effectiveness.

Difference 2

The balloon length size of the subject device. The verification and validation testing of all sizes demonstrate the

difference does not raise new questions of safety or effectiveness.

9

4. Performance data in support of the substantial equivalence

The following performance data were provided in support of the substantial equivalence.

4.1 Performance

In vitro performance tests, including visual inspection, dimensional verification, crossing profile, guidewire compatibility, simulated use, air/liquid leak, flexibility and kink, torque strength, particulate release, coating integrity, lubricity, balloon rated burst pressure, balloon fatigue, balloon compliance, balloon inflation and deflation time, catheter bond strength, tip pull strength, trackability, and radiopacity were conducted. The test results met all acceptance criteria and ensure the design and construction are suitable for its intended use as recommended by the Class II Peripheral Percutaneous Transluminal Angioplasty (PTA) and Specialty Catheters - Premarket Notification (510(k)) Submission (FDA; January 13, 2020).

4.2 Biocompatibility testing

Biocompatibility testing for the D.Kaptain™ PTA High Pressure Balloon Dilatation Catheter was performed in accordance with the recommendations of ISO 10993-1, Biological Evaluation of Medical Device - Part 1: Evaluation and Testing. Tab.2 listing the testing results. The results of the testing show that the subject device included in this submission met all acceptance criteria and the subject device is biocompatible.

Tab.2 Biocompatibility testing
Cytotoxicity
Sensitization test
Intracutaneous reactivity test
Systemic Toxicity test (Acute)
Material-mediated pyrogenicity

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Tab.2 Biocompatibility testing

hemocompatibility (hemolysis, complement activation, PTT, and in vivo thrombo resistance)

4.3 STERILITY

The D.Kaptain™ PTA High Pressure Balloon Dilatation Catheter is sterile. The method employed for the sterilization of the D·Kaptain™ PTA High Pressure Balloon Dilatation Catheter is Ethylene oxide sterilization according to the EN 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.

4.4 Clinical Evidence

N/A

4.5 Animal Study

NA

4.6 PACKAGING/SHELF LIFE

Simulated shipping testing, accelerated aging testing, and sterility package validation were carried out to decide the shelf life of the D·Kaptain™ PTA High Pressure Balloon Dilatation Catheter. Testing results demonstrated that the shelf life of the D.Kaptain™ PTA High Pressure Balloon Dilatation Catheter was 2 years.

5. Conclusion

Based on the verification and validation testing, the D·Kaptain™ PTA High Pressure Balloon Dilatation Catheter does not raise new questions of safety and effectiveness compared to the

11

predicate device.

DK Medical Technology CO., Ltd.(DK) believes that the information and data provided clearly describes the D·Kaptain™ PTA High Pressure Balloon Dilatation Catheter and demonstrates that the device is substantially equivalent to the predicate device.