K Number
K231579
Device Name
MOLLI 2
Date Cleared
2023-10-26

(148 days)

Product Code
Regulation Number
878.4300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The MOLLI Marker is intended to be placed percutaneously in soft tissue to temporarily mark a surgical site intended for surgical removal. The MOLLI Marker can only be implanted for less than 30 days. Using imaging guidance (such as ultrasound or radiography) or aided by non-imaging guidance (MOLLI 2 System), the MOLLI Marker is located and surgically removed with the target tissue. The MOLLI 2 System is intended only for the non-imaging detection of the MOLLI Marker that has been implanted in a site intended for surgical removal.
Device Description
MOLLI 2 is a precision surgical marking and guidance system for locating non-palpable lesions during surgery. MOLLI 2 consists of a temporary marker (MOLLI Marker), a marker delivery system (MOLLI Introducer), a detection wand (MOLLI Wand 2), and a visualization tablet (MOLLI Tablet 2). The MOLLI 2 Wand and MOLLI 2 Tablet constitute the MOLLI 2 system. The MOLLI 2 is intended for the non-imaging detection and localization of the MOLLI Marker that has been implanted in a site intended for surgical removal.
More Information

Not Found

No
The summary describes a system for non-imaging detection and localization of a marker using a wand and tablet. There is no mention of AI, ML, or any algorithms that would suggest their use in processing data or making decisions. The system appears to be based on direct detection of the marker.

No
The device is described as a surgical marking and guidance system intended to locate non-palpable lesions for surgical removal, not to treat a disease or condition.

No
The device is described as a surgical marking and guidance system for locating non-palpable lesions during surgery, not for diagnosing a condition. Its purpose is to aid in the surgical removal of tissue that has already been identified as needing removal.

No

The device description explicitly lists hardware components: a temporary marker, a marker delivery system, a detection wand, and a visualization tablet.

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. They are used to provide information for diagnosis, monitoring, or screening.
  • Device Function: The MOLLI Marker and MOLLI 2 System are used for marking and locating a surgical site within the body. They are implanted and then detected externally to guide surgical removal of tissue. This is an in vivo procedure (occurring within a living organism), not an in vitro procedure (occurring outside of a living organism).
  • Intended Use: The intended use clearly states the device is for "temporarily mark a surgical site intended for surgical removal" and "non-imaging detection of the MOLLI Marker that has been implanted in a site intended for surgical removal." This describes a surgical guidance and localization tool, not a diagnostic test performed on a sample.

Therefore, the MOLLI Marker and MOLLI 2 System fall under the category of surgical devices or localization systems, not in vitro diagnostics.

N/A

Intended Use / Indications for Use

The MOLLI Marker is intended to be placed percutaneously in soft tissue to temporarily mark a surgical site intended for surgical removal. The MOLLI Marker can only be implanted for less than 30 days. Using imaging guidance (such as ultrasound or radiography) or aided by non-imaging guidance (MOLLI 2 System), the MOLLI Marker is located and surgically removed with the target tissue.

The MOLLI 2 System is intended only for the non-imaging detection of the MOLLI Marker that has been implanted in a site intended for surgical removal.

Product codes

NEU

Device Description

MOLLI 2 is a precision surgical marking and guidance system for locating non-palpable lesions during surgery. MOLLI 2 consists of a temporary marker (MOLLI Marker), a marker delivery system (MOLLI Introducer), a detection wand (MOLLI Wand 2), and a visualization tablet (MOLLI Tablet 2). The MOLLI 2 Wand and MOLLI 2 Tablet constitute the MOLLI 2 system. The MOLLI 2 is intended for the non-imaging detection and localization of the MOLLI Marker that has been implanted in a site intended for surgical removal.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Using imaging guidance (such as ultrasound or radiography)

Anatomical Site

soft tissue

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)

Due to the changes in the processing of the patient-contacting components of the MOLLI 2 (i.e., the MOLLI Introducer) and the updates to the MOLLI Marker & Introducer user guide, additional non-clinical testing was performed.

The following reports are included in this submission demonstrate safety and effectiveness based on current industry standards:

  • . Biocompatibility testing to demonstrate safety of MOLLI Introducer
  • . Bench testing to demonstrate effectiveness of MOLLI Introducer
  • . Justification for updating cardiac device contraindication to a warning

The results of these reports indicate that the subject device is substantially equivalent to the predicate device.

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

Not Found

Predicate Device(s)

K223107

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4300 Implantable clip.

(a)
Identification. An implantable clip is a clip-like device intended to connect internal tissues to aid healing. It is not absorbable.(b)
Classification. Class II.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo is in blue and includes the letters "FDA" followed by the words "U.S. FOOD & DRUG ADMINISTRATION" stacked on top of each other.

October 26, 2023

MOLLI Surgical, Inc. Joseph De Croos Director. Ouality Assurance & Regulatory Affairs 50 Wellington Street East Suite 400 Toronto, ON M5E 1C8 Canada

Re: K231579

Trade/Device Name: Molli 2 Regulation Number: 21 CFR 878.4300 Regulation Name: Implantable Clip Regulatory Class: Class II Product Code: NEU Dated: September 29, 2023 Received: September 29, 2023

Dear Joseph De Croos:

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 (the 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 available 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

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device" (https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30. Design controls; 21 CFR 820.90. Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review, the QS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 Part 803) for devices or postmarketing safety reporting (21 CFR Part 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 Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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).

2

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-devices/deviceadvice-comprehensive-regulatory-assistance/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 Tek Tek N. N. Lamichhane -S Lamichhane -S Pate: 2023.10.26 16:08:14 -04'00' Tek N. Lamichhane, Ph.D. Assistant Director DHT4B: Division of Infection Control and Plastic and Reconstructive Surgery Devices OHT4: Office of Surgical and Infection Control 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) K231579

Device Name MOLLI 2

Indications for Use (Describe)

The MOLLI Marker is intended to be placed percutaneously in soft tissue to temporarily mark a surgical site intended for surgical removal. The MOLLI Marker can only be implanted for less than 30 days. Using imaging guidance (such as ultrasound or radiography) or aided by non-imaging guidance (MOLLI 2 System), the MOLLI Marker is located and surgically removed with the target tissue.

The MOLLI 2 System is intended only for the non-imaging detection of the MOLLI Marker that has been implanted in a site intended for surgical removal.

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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Image /page/4/Picture/1 description: The image shows the logo for Molli. The word "molli" is written in a dark blue font, with a light blue dot above the second "i". Below the word "molli" is the phrase "precision surgery made simpler" in a smaller font, with the word "simpler" in light blue and the rest of the phrase in dark blue.

K231579 - 510(k) Summary

DATE PREPARED

October 25, 2023

MANUFACTURER AND 510(k) OWNER

MOLLI Surgical, Inc. 50 Wellington Street East Suite 400 Toronto ON M5E 1C8 Canada Telephone: +1-833-665-5463 Dr. Joseph De Croos, Director of Quality Assurance and Regulatory Affairs Official Contact: Email: jdecroos@mollisurgical.com

DEVICE INFORMATION

Proprietary Name/Trade Name:MOLLI 2
Common Name:Implantable radiographic marker
Regulation Number:21 CFR 878.4300
Class:II
Product Code:NEU
Premarket Review:OPEQ/OHT4/Infection Control and Plastic Surgery Devices
(DHT4B)
Review Panel:General & Plastic Surgery

PREDICATE DEVICE IDENTIFICATION

MOLLI 2 is substantially equivalent to the following predicate:

510(k) NumberPredicate Device Name / ManufacturerPrimary Predicate
K223107MOLLI 2 / MOLLI Surgical, Inc.

The predicate device has not been subject to a design related recall.

DEVICE DESCRIPTION

MOLLI 2 is a precision surgical marking and guidance system for locating non-palpable lesions during surgery. MOLLI 2 consists of a temporary marker (MOLLI Marker), a marker delivery system (MOLLI Introducer), a detection wand (MOLLI Wand 2), and a visualization tablet (MOLLI Tablet 2). The MOLLI 2 Wand and MOLLI 2 Tablet constitute the MOLLI 2 system. The MOLLI 2 is intended for the non-imaging detection and localization of the MOLLI Marker that has been implanted in a site intended for surgical removal.

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Image /page/5/Picture/1 description: The image shows the logo for Molli, a company that specializes in precision surgery. The logo consists of the word "molli" in a dark blue sans-serif font, with a small light blue circle above the "i". Below the word "molli" is the tagline "precision surgery made simpler" in a smaller font, with the word "simpler" in light blue and the rest of the tagline in dark blue.

The purpose of this 510(k) premarket notification is to introduce the following changes to the previously cleared MOLLI device:

  • . Modification to the MOLLI Introducer
  • Update to contraindications and warning in the MOLLI Marker & Introducer user guide

INDICATIONS FOR USE

The MOLLI Marker is intended to be placed percutaneously in soft tissue to temporarily mark a surgical site intended for surgical removal. The MOLLI Marker can only be implanted for less than 30 days. Using imaging guidance (such as ultrasound or radiography) or aided by nonimaging guidance (MOLLI 2 System), the MOLLI Marker is located and surgically removed with the target tissue.

The MOLLI 2 System is intended only for the non-imaging detection and localization of the MOLLI Marker that has been implanted in a site intended for surgical removal.

COMPARISON OF TECHNOLOGICAL CHARACTERISTICS

MOLLI Surgical, Inc. believes that the subject device is substantially equivalent to the predicate device based on the information summarized here:

The subject device has the same intended use, design, and technological characteristics as the predicate device cleared in K223107. Minor modifications to the subject device as compared to the predicate device include:

  • MOLLI Introducer needle cannula is siliconized
  • . Update to contraindication and warning in the MOLLI Marker & Introducer user guide
    • o Current Contraindication: "The MOLLI Marker must not be placed in the same breast as an implanted cardiac device. If placing the MOLLI Marker in the contralateral breast, it must be a minimum of 20 mm away from an implanted cardiac device".
    • Change cardiac device contraindication to a warning: "Caution should be o exercised when using the MOLLI Marker on patients with magnetically susceptible implanted devices, including active implantable and wearable medical devices, and devices using a permanent maqnet (e.q., pacemakers, implantable defibrillators, cochlear implants, nerve stimulators, deep brain stimulators, infusion pumps, or any implantable or body worn permanent magnet). The MOLLI Marker must be implanted at a minimum of 40 mm away from magnetically susceptible implanted devices."

790 Estate Drive · 2nd Floor Deerfield · Illinois · 60015 United States

50 Wellington Street E. · Suite 400 Toronto · Ontario · M5E 1C8 Canada

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Image /page/6/Picture/0 description: The image shows the logo for Molli, a company that specializes in precision surgery. The word "molli" is written in a bold, sans-serif font, with a small blue circle above the "i". Below the word "molli" is the tagline "precision surgery made simpler®", with the word "simpler" in a lighter shade of blue. The logo is clean and modern, and the tagline suggests that Molli's products and services are designed to make surgery more efficient and effective.

SUMMARY OF NON-CLINICAL TESTING

Due to the changes in the processing of the patient-contacting components of the MOLLI 2 (i.e., the MOLLI Introducer) and the updates to the MOLLI Marker & Introducer user guide, additional non-clinical testing was performed.

The following reports are included in this submission demonstrate safety and effectiveness based on current industry standards:

  • . Biocompatibility testing to demonstrate safety of MOLLI Introducer
  • . Bench testing to demonstrate effectiveness of MOLLI Introducer
  • . Justification for updating cardiac device contraindication to a warning

The results of these reports indicate that the subject device is substantially equivalent to the predicate device.

CONCLUSION

Based on the testing performed, it can be concluded that the subject device does not raise new issues of safety or effectiveness compared to the predicate device. The same indications for use, technological characteristics, and performance characteristics for the proposed MOLLI 2 are assessed to be substantially equivalent to the predicate device.