K Number
K221482
Device Name
Esophageal TTS Stent
Date Cleared
2022-06-22

(30 days)

Product Code
Regulation Number
878.3610
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Esophageal TTS Stent is intended for use in esophageal strictures caused by intrinsic and/or extrinsic malignant tumors and occlusion of concurrent esophageal fistulas.
Device Description
The Esophageal TTS Stents consists of an implantable metallic stent and a disposable, flexible introducer system for placement of the stent is a flexible and expandable tubular device made of Nitinol wire that is intended to be implanted to restore the structure and/or function of the esophagus. The introducer is a disposable system for delivery and deployment of the stent at the target position. Upon deployment, the stent imparts an outward radial force on the luminal surface of the esophagus to establish patency.
More Information

No
The device description and performance studies focus on the mechanical properties and deployment of a metallic stent, with no mention of AI or ML technologies.

Yes
The device is implanted to restore the structure and/or function of the esophagus, which is a therapeutic action for strictures and fistulas.

No

The device is an implantable metallic stent used to restore the structure and/or function of the esophagus in cases of strictures or fistulas, which is a therapeutic rather than a diagnostic function.

No

The device description clearly states it consists of an implantable metallic stent and a disposable, flexible introducer system, which are physical hardware components.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections.
  • Device Description: The description clearly states that the Esophageal TTS Stent is an implantable metallic stent and a disposable, flexible introducer system for placing the stent within the esophagus.
  • Intended Use: The intended use is to treat esophageal strictures and occlude fistulas by physically expanding the esophagus. This is a therapeutic intervention performed directly on the patient's body, not a diagnostic test performed on a sample outside the body.

The device is a medical device used for treatment, not for diagnosing a condition using in vitro methods.

N/A

Intended Use / Indications for Use

The Esophageal TTS Stent is intended for use in esophageal strictures caused by intrinsic and/or extrinsic malignant tumors and occlusion of concurrent esophageal fistulas.

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

ESW

Device Description

The Esophageal TTS Stents that are the subject of this 510(k) are identical to the devices cleared in K211706, K123205, and K113551, with the exception of a modification to the Indications for Use statement. The Esophageal TTS Stents consists of an implantable metallic stent and a disposable, flexible introducer system for placement of the stent is a flexible and expandable tubular device made of Nitinol wire that is intended to be implanted to restore the structure and/or function of the esophagus. The introducer is a disposable system for delivery and deployment of the stent at the target position. Upon deployment, the stent imparts an outward radial force on the luminal surface of the esophagus to establish patency.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Esophagus

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

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)

Biocompatibility Testing: The subject device is identical to previously cleared devices in formulation, processing, sterilization, and geometry, so no additional biocompatibility information is required.
Electrical safety and electromagnetic compatibility (EMC): Not applicable, as the device contains no electrical components.
Software Verification and Validation Testing: Not applicable, as the device contains no software.
Bench Testing: No design modifications were made. The only change is to the Indications for Use, which was assessed and determined not to introduce new risks. Testing previously performed on the Esophageal TTS Stent is considered appropriate and sufficient. No additional performance data is required.
Animal Testing: Not applicable.
Clinical Data: Not applicable.

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.

K211706, K123205, K113551

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.

K200860

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

§ 878.3610 Esophageal prosthesis.

(a)
Identification. An esophageal prosthesis is a rigid, flexible, or expandable tubular device made of a plastic, metal, or polymeric material that is intended to be implanted to restore the structure and/or function of the esophagus. The metal esophageal prosthesis may be uncovered or covered with a polymeric material. This device may also include a device delivery system.(b)
Classification. Class II. The special control for this device is FDA's “Guidance for the Content of Premarket Notification Submissions for Esophageal and Tracheal Prostheses.”

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June 22, 2022

Taewoong Medical Co., Ltd. % Matthew Krueger Senior Consultant, Medical Devices Biologics Consulting Group, Inc. 1555 King Street, Suite 300 Alexandria, VA 22314

Re: K221482

Trade/Device Name: Esophageal TTS Stent Regulation Number: 21 CFR 878.3610 Regulation Name: Esophageal Prosthesis Regulatory Class: Class II Product Code: ESW Dated: May 19, 2022 Received: May 23, 2022

Dear Matthew Krueger:

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

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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 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,

for

Shanil P. Haugen, 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) K221482

Device Name Esophageal TTS Stent

Indications for Use (Describe)

The Esophageal TTS Stent is intended for use in esophageal strictures caused by intrinsic and/or extrinsic malignant tumors and occlusion of concurrent esophageal fistulas.

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

1. SUBMITTER

| Applicant: | Taewoong Medical Co., Ltd.
14 Gojeong-ro, Wolgot-myeon, Gimpo-si, Gyeonggi
do, Korea, 10022
TEL: +82-31-996-0641 |
|---------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact: | Yongjin Jeff Kim
International Regulatory Affairs Manager
Phone: +82 70 4649 1543
E-mail: jinjeff@stent.net |
| Submission Correspondent: | Matthew Krueger
Senior Consultant, Medical Devices
Biologics Consulting Group, Inc.
Phone: (667) 352-2578
Email: mkrueger@biologicsconsulting.com |
| Date Prepared: | June 22, 2022 |

2. DEVICE

Device Trade Name:Esophageal TTS Stent
Device Common Name:Esophageal Stent
Classification Name878.3610, Prosthesis, Esophageal
Regulatory Class:Class II
Product Code:ESW

3. PREDICATE DEVICE AND REFERENCE DEVICES

Predicate Devices 3.1.

K211706: Taewoong Esophageal TTS Stent

K123205: Taewoong Esophageal TTS Stent

K113551: Taewoong Esophageal TTS Stent

3.2. Reference Device

K200860: HANAROSTENT Esophagus TTS (CCC) and HANAROSTENT Esophagus TTS (NCN)

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DEVICE DESCRIPTION 4.

The Esophageal TTS Stents that are the subject of this 510(k) are identical to the devices cleared in K211706, K123205, and K113551, with the exception of a modification to the Indications for Use statement. The Esophageal TTS Stents consists of an implantable metallic stent and a disposable, flexible introducer system for placement of the stent is a flexible and expandable tubular device made of Nitinol wire that is intended to be implanted to restore the structure and/or function of the esophagus. The introducer is a disposable system for delivery and deployment of the stent at the target position. Upon deployment, the stent imparts an outward radial force on the luminal surface of the esophagus to establish patency.

5. INTENDED USE/INDICATIONS FOR USE

The Esophageal TTS Stent is intended for use in esophageal strictures caused by intrinsic and/or extrinsic malignant tumors and occlusion of concurrent esophageal fistulas.

SUBSTANTIAL EQUIVALENCE 6.

Comparison of Indications

Table 1:Indications for Use Comparison
Subject DevicePredicate Device (K21170)
Subject DevicePredicate Device (K211706)Explanation of Differences
The Esophageal TTS Stent is
intended for use in esophageal
strictures caused by intrinsic
and/or extrinsic malignant
tumors and occlusion of
concurrent esophageal fistulas.The Esophageal TTS Stent is
intended for use in esophageal
strictures caused by intrinsic
and/or extrinsic malignant
tumors.Similar to predicate and is
nearly identical to the reference
device K200860 which used the
Taewoong TTS Stent
(K123205) as its predicate.
This addition to the Indications
for Use does not affect the
safety and efficacy of the
device because the device
design and intended use is
identical to the predicate.
Subject DevicePredicate
K211706
(K123205 and K113551)
Device NameEsophageal TTS StentEsophageal TTS Stent
Common
NameEsophageal StentEsophageal Stent
ManufacturerTaewoong Medical Co., LtdTaewoong Medical Co., Ltd
Classification
Regulation878.3610878.3610
Product CodeESWESW
Indications
for useFor use in esophageal strictures caused by
intrinsic and/or extrinsic malignant tumors
and occlusion of concurrent esophageal
fistulas.For use in esophageal strictures caused by
intrinsic and/or extrinsic malignant tumors.
Design
(Stents)
Image: Full Covered StentImage: Full Covered Stent
Image: Both Bare StentImage: Both Bare Stent
Nitinol wire in diamond shapeNitinol wire in diamond shape
Lengths; 60, 80, 100, 120, 140, 150mmLengths; 60, 80, 100, 120, 140, 150mm
Body Diameter/Head Diameter:Body Diameter/Head Diameter:
・ 18mm/26mm・ 18mm/26mm
・20mm/26mm・ 20mm/26mm
・ 22mm/28mm・ 22mm/28mm
Coverage:Coverage:
· Silicone Full Covered· Silicone Full Covered
• Silicone Both Bare• Silicone Both Bare
Radiopaque Markers: 8 Pt/Ir, 2 STS 316LRadiopaque Markers: 8 Pt/Ir, 2 STS 316L
Subject DevicePredicate
K211706
(K123205 and K113551)
Design
(Introducer)Image: Subject DeviceImage: Predicate K211706
Co-axial tube typeCo-axial tube type
Usable Length:Usable Length;
· 180cm (for diameter 22mm stent)· 180cm (for diameter 22mm stent)
· 220cm (for diameter 18, 20 & 22 mm stent)· 220cm (for diameter 18, 20 & 22 mm stent)
Diameter; 10.5 Fr (3.5mm)Diameter; 10.5 Fr (3.5mm)
Single UseYesYes
SterileEO SterilizationEO Sterilization
Method of
PlacementEndoscopicEndoscopic
Method of
DeploymentRelease by pulling outer sheathRelease by pulling outer sheath
MaterialsStent - Nitinol, Pt/Ir, STS316LStent - Nitinol, Pt/Ir, STS316L
Cover – SiliconeCover – Silicone
Introducer – Teflon, PE, ABSIntroducer – Teflon, PE, ABS

Technological Comparisons

The table below compares the key technological feature of the subject devices to the predicate device (Taewoong Esophageal TTS Stent, K211706).

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Table 2: Technological Comparison

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7. PERFORMANCE DATA

Biocompatibility Testing

The subject device in its final finished form is identical to the Esophageal TTS Stent cleared in K211706, K123205, and K113551, in formulation, processing, sterilization, and geometry and no other chemicals have been added (e.g., plasticizers, fillers, additives, cleaning agents, mold release agents).

Therefore, no additional biocompatibility information is required to establish substantial equivalence.

Electrical safety and electromagnetic compatibility (EMC)

Not applicable. The device 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.

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Bench Testing

No design modifications have been made to the cleared Esophageal TTS Stent. The only change is to the Indications for Use. An assessment of the change was performed, and it was determined that the modified Indications for Use do not introduce any new risks. Thus, testing previously performed for the Esophageal TTS Stent is appropriate and sufficient for the modified Indications for Use. The testing on the Esophageal TTS Stent is consistent with the testing performed on the reference device which uses this identical Indications for Use statement. Therefore, no additional performance data is required.

Animal Testing

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

Clinical Data

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

CONCLUSION 8.

Based on the modified Indications for Use, the technological characteristics and materials of construction, the Esophageal TTS Stent can be found substantially equivalent to the identified predicate device.