K Number
K221843
Device Name
GEM Biover Microvascular Clamps
Date Cleared
2022-09-14

(82 days)

Product Code
Regulation Number
870.4450
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
GEM™ BIOVER disposable microvascular clamps are instruments which are used for all microsurgical procedures. They are used to occlude vessels during anastomosis, which is necessary as a result of vessel damage or thrombosis.
Device Description
The GEM™ Biover Microvascular Clamps (Clamps) are arterial and venous clamps in both single and double clamp configurations, available in varying sizes. The clamps are sterile, disposable clamps for single use. The clamps are used in microsurgery, plastic surgery, and hand surgery for the temporary occlusion of blood vessels during an anastomosis. The clamps are available for arteries and veins. The clamping force is higher for the arterial clamps than for the veinous clamps. The clamps are identified by a product reference code and by the color of the clamp. The clamps for veins are green, and the clamps for arteries are yellow. The clamps are packaged individually in two Tyvek pouches (double pouched). The devices in the Tyvek pouches are gamma sterilized and are placed in cartons of 10. The clamps are used once and are disposed of after use.
More Information

Not Found

No
The device description and intended use are purely mechanical, describing disposable clamps for temporary vessel occlusion. There is no mention of any computational or analytical capabilities that would suggest the use of AI or ML.

No.
The device is used to temporarily occlude blood vessels during microsurgical procedures, which is a surgical tool rather than a therapeutic treatment for disease or injury.

No

Explanation: The device is used to occlude vessels during surgical procedures (anastomosis) and does not gather or analyze data for diagnosis.

No

The device description clearly describes physical, disposable microvascular clamps used for occluding blood vessels during surgery. There is no mention of software components.

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 information is used for diagnosis, monitoring, or screening.
  • Device Function: The GEM™ BIOVER disposable microvascular clamps are surgical instruments used to physically occlude blood vessels during surgery. They are used on the patient's body during a procedure, not to analyze samples taken from the body.
  • Intended Use: The intended use clearly states they are "instruments which are used for all microsurgical procedures" to "occlude vessels during anastomosis." This is a surgical function, not a diagnostic one.
  • Device Description: The description reinforces that they are "arterial and venous clamps" used "for the temporary occlusion of blood vessels during an anastomosis."

The device's purpose is to facilitate a surgical procedure, not to provide diagnostic information based on in vitro analysis.

N/A

Intended Use / Indications for Use

GEM™ BIOVER disposable microvascular clamps are instruments which are used for all microsurgical procedures. They are used to occlude vessels during anastomosis, which is necessary as a result of vessel damage or thrombosis.

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

DXC

Device Description

The GEM™ Biover Microvascular Clamps (Clamps) are arterial and venous clamps in both single and double clamp configurations, available in varying sizes. The clamps are sterile, disposable clamps for single use. The clamps are used in microsurgery, plastic surgery, and hand surgery for the temporary occlusion of blood vessels during an anastomosis.

The clamps are available for arteries and veins. The clamping force is higher for the arterial clamps than for the veinous clamps. The clamps are identified by a product reference code and by the color of the clamp. The clamps for veins are green, and the clamps for arteries are yellow.

The clamps are packaged individually in two Tyvek pouches (double pouched). The devices in the Tyvek pouches are gamma sterilized and are placed in cartons of 10. The clamps are used once and are disposed of after use.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

vessels

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Surgeons, scrubbed persons, and nurses in Hospital setting.

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)

The label design change and the outer carton sales unit design change were assessed and validated in a Packaging Summative Human Factors/Usability Study. Historical complaint data were reviewed and indicate no use-related concerns, thus, there are no use-related risks or complaints that trigger a need for further Human Factors validation.

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.

K011208

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

§ 870.4450 Vascular clamp.

(a)
Identification. A vascular clamp is a surgical instrument used to occlude a blood vessel temporarily.(b)
Classification. Class II (performance standards).

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: the Department of Health and Human Services logo on the left and the FDA logo on the right. The FDA logo features the letters "FDA" in a blue square, followed by the words "U.S. Food & Drug Administration" in blue text.

September 14, 2022

Synovis Micro Companies Alliance, Inc. (a subsidiary of Baxter International. Inc.) Julie Carlston Senior Manager, Regulatory Affairs 439 Industrial Lane Birmingham, Alabama 35211

Re: K221843

Trade/Device Name: GEM™ Biover Microvascular Clamps Regulation Number: 21 CFR 870.4450 Regulation Name: Vascular clamp Regulatory Class: Class II Product Code: DXC Dated: August 12, 2022 Received: August 15, 2022

Dear Julie Carlston:

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.

1

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); 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.

Rachel Neubrander Assistant Director DHT2B: Division of Circulatory Support, Structural and Vascular 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) K221843

Device Name GEMTM BIOVER Microvascular Clamps

Indications for Use (Describe)

GEM™ BIOVER disposable microvascular clamps are instruments which are used for all microsurgical procedures. They are used to occlude vessels during anastomosis, which is necessary as a result of vessel damage or thrombosis.

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

X 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

510(k) Summary K221843

l. Submitter Synovis Micro Companies Alliance, Inc. A Subsidiary of Baxter International Inc. 439 Industrial Lane Birmingham, AL 35211-4464 Establishment Registration Number: 1062741

Julie Carlston Synovis Micro Companies Alliance, Inc. A Subsidiary of Baxter International Inc. 2575 University Avenue West St. Paul, MN 55114-1024 Tel: 651-796-7511 Fax: 651-642-9018 julie_carlston@baxter.com

Date Prepared: September 13, 2022

II. Subject Device K221843

Device Trade NameGEM™ Biover Microvascular Clamps
Common NameMicrovascular Clamps
Classification NameClamp, Vascular
Regulation Number: 21 CFR 870.4450
Classification: Class II
Product CodeDXC

III. Predicate Device K011208

Device Trade NameBiover Microvascular Clamps
Common NameMicrovascular Clamps
Classification NameClamp, Vascular
Regulation Number: 21 CFR 870.4450
Classification: Class II
Product CodeDXC

IV. Device Description

The GEM™ Biover Microvascular Clamps (Clamps) are arterial and venous clamps in both single and double clamp configurations, available in varying sizes. The clamps are sterile, disposable clamps for single use. The clamps are used in microsurgery, plastic surgery, and hand surgery for the temporary occlusion of blood vessels during an anastomosis.

The clamps are available for arteries and veins. The clamping force is higher for the arterial clamps than for the veinous clamps. The clamps are identified by a product reference code and by the color of the clamp. The clamps for veins are green, and the clamps for arteries are yellow.

4

The clamps are packaged individually in two Tyvek pouches (double pouched). The devices in the Tyvek pouches are gamma sterilized and are placed in cartons of 10. The clamps are used once and are disposed of after use.

V. Intended Use and Indications for Use

The Intended Use remains the same as the predicate device (K011208).

Indication for Use

GEM BIOVER disposable microvascular clamps are instruments which are used for all microsurgical procedures. They are used to occlude vessels during anastomosis, which is necessary as a result of vessel damage or thrombosis.

The wording of the Indication for Use was modified slightly from the predicate to improve the clarity of the statement while maintaining the same intended use and scope. The indications for use statements are the same in intended clinical use and therefore there is no substantial change to the indication for use of the microvascular clamps. The similarity in the indication for use statements supports substantial equivalence.

VI. Comparison of Technological Characteristics with the Predicate Device

The device and primary packaging of the double pouch configuration (sterile packaging) remain unchanged and are identical to the predicate device. There are no engineering or performance changes to the device or its packaging. The only technology change is a minor modification to the sales unit carton (box of 10 individual pouches) which was made to ease removal of the packaged (pouched) clamps. There is no change in sterilization.

In addition to the minor change to the carton, updates were made to the Instruction Manual and package labeling to reflect the new tradename of the device.

AttributeSubject of this submissionPredicate DeviceComparison
510(k) #GEM BIOVER Microvascular
ClampsBIOVER Microvascular Clamps-
Manufacturer
(Specification
Developer)SYNOVIS MICRO COMPANIES
ALLIANCE, INC. (A Subsidiary Of
Baxter International Inc.)
439 Industrial Ln
BIRMINGHAM, AL 35211Biover AG
Muliweg 2
Hergiswil Nidwalden, CH 114-002Change due to
acquisition of
Biover AG
Contract
ManufacturerDIADEM CORPORATION
582-7, Ubaga-Cho
Hitachiomiya-Shi
Ibaraki, JP 319-2251DIADEM CORPORATION
582-7, Ubaga-Cho
Hitachiomiya-Shi
Ibaraki, JP 319-2251Same
AttributeSubject of this submission
GEM BIOVER Microvascular
ClampsPredicate Device
BIOVER Microvascular ClampsComparison
Intended UseGEM BIOVER disposable
microvascular clamps are used
in microsurgical procedures to
occlude blood vessels during
anastomosis.BIOVER disposable
microvascular clamps are used
in microsurgical procedures to
occlude blood vessels during
anastomosis.Same
Indications for UseDisposable microvascular
clamps are instruments which
are used for all microsurgical
procedures. They are used to
occlude vessels during
anastomosis, which is
necessary as a result of vessel
damage or thrombosis.BIOVER disposable
microvascular clamps are
used for end to end
anastomotic procedures for
arteries and veins. The
single version is placed to
stop blood flow for a certain
time (less than 16 hours).
The double version is used
for the repair of ruptured
arteries and veins.Equivalent. Update
of tradename. The
differences in
wording are
clarifying the
intended use of the
device and do not
constitute a
change in their
clinical use
General Description
Product Use
EnvironmentHospitalHospitalSame
End Users of
ProductSurgeons, scrubbed persons,
and nursesSurgeons, scrubbed persons,
and nursesSame
Clamp Design2 Types of Clamps are available
  1. Clamps for arteries are
    yellow (single (1) and
    double (2))
  2. Clamps for veins are
    green (single (1) and
    double (2)) | 2 Types of Clamps are available
  3. Clamps for arteries are
    yellow (single (1) and
    double (2))
  4. Clamps for veins are green
    (single (1) and double (2)) | Same |
    | Vessel Diameter | Artery Clamps (yellow):