K Number
K242086
Device Name
MagDI System (MAG-01, DS-01)
Date Cleared
2024-10-24

(99 days)

Product Code
Regulation Number
878.4816
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The GT Metabolic MagDI System is intended for use in the creation of side duodeno-ileal anastomoses in minimally invasive and laparoscopic surgery. Once wound strength is sufficient to maintain the anastomosis, the device is passed from the body. The effects of this device on weight loss were not studied. The GT Metabolic MagDI System is intended for use in adult patients > 21years.
Device Description
The set of two (2) Magnets is a sterile single-use device. The device provides a simple method for the creation of a round (oval/circular) compression anastomosis. After a period of 7-21 days, a compression-induced necrosis of the tissue between the Magnets occurs and the whole device, together with the necrosed tissue that was compressed by the Magnets, detaches, and is naturally expelled with the stool.
More Information

No
The summary describes a mechanical device (magnets) for creating an anastomosis. There is no mention of AI, ML, image processing, or data analysis that would indicate the use of such technologies.

Yes

The device aids in creating duodeno-ileal anastomoses, a surgical procedure performed to treat medical conditions, thus providing a therapeutic benefit to the patient.

No

Explanation: The device, the GT Metabolic MagDI System, is intended for use in the creation of side duodeno-ileal anastomoses. It is a surgical tool used to join two parts of the intestine, not to diagnose a condition.

No

The device description clearly states it is a set of two physical magnets, which are hardware components. The summary also details preclinical testing related to the physical properties of the magnets (field strength, separation forces, connection/disconnection) and biocompatibility, further indicating it is a hardware 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 the creation of surgical anastomoses (connections between two parts of the intestine) in minimally invasive and laparoscopic surgery. This is a surgical procedure performed on the body, not a test performed on a sample taken from the body.
  • Device Description: The device is a set of magnets used to create a compression anastomosis. This is a physical device used during surgery.
  • Lack of IVD Characteristics: There is no mention of the device being used to test a biological sample (blood, urine, tissue, etc.) to provide information about a patient's health status, disease, or condition.

IVD devices are used to perform tests in vitro (in glass, or outside the body) on samples to diagnose, monitor, or screen for diseases or conditions. This device is used in vivo (in the body) during a surgical procedure.

N/A

Intended Use / Indications for Use

The GT Metabolic MagDI System is intended for use in the creation of side duodeno-ileal anastomoses in minimally invasive and laparoscopic surgery. Once wound strength is sufficient to maintain the anastomosis, the device is passed from the body. The effects of this device on weight loss were not studied.

The GT Metabolic MagDI System is intended for use in adult patients > 21years.

The GT Metabolic MagDI™ System is intended for use in the creation of side-to-side duodeno-ileal anastomoses in minimally invasive and laparoscopic surgery. Once wound strength is sufficient to maintain the anastomosis, the device is passed from the body. The effects of this device on weight loss were not studied.

The GT Metabolic MagDI System is intended for use in adult patients >21 years.

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

SAH

Device Description

The set of two (2) Magnets is a sterile single-use device. The device provides a simple method for the creation of a round (oval/circular) compression anastomosis. After a period of 7-21 days, a compression-induced necrosis of the tissue between the Magnets occurs and the whole device, together with the necrosed tissue that was compressed by the Magnets, detaches, and is naturally expelled with the stool.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

duodeno-ileal anastomoses

Indicated Patient Age Range

adult patients > 21years.

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)

Preclinical Testing

  • Biocompatibility testing demonstrated the device is biocompatible according to . ISO 10993-1.
  • . Magnet field strength testing characterized the distances from the magnets are safe for patients and users with ferromagnetic implants, devices, or objects.
  • The Magnets maintain adequate separation forces over the use life. .
  • The Magnets connect and disconnect to the Delivery System over the use life. ●
  • Patient-contacting materials conform to ISO 10993-1 and FDA Guidance Use of ● International Standard ISO 10993-1, "Biological evaluation of medical devices -Part 1: Evaluation and testing within a risk management process" issued September 8, 2023.
  • The MagDI System demonstrates a SAL of 10-6, a continued sterility through the . labeled shelf life of the device, and conforms to ISO 11137-1, ISO 11137-2, and ISO 11137-3.
  • Chronic porcine animal testing was conducted over a 6-week period. ●

Clinical Testing

  • Clinical testing was conducted in obese patients with or without type 2 diabetes ● mellitus using the MagDI System for creation of a side-to-side duodeno-ileal anastomosis. The Magnets were sequentially delivered orogastrically either by swallow (first, distal Magnet only) or endoscopically using the Delivery System. The Magnets were successfully placed in all cases with alignment, and for all subjects reaching the one-month study visit, the device passed naturally as a set of connected Magnets with none requiring invasive re-intervention. Most adverse events were of low grade, Clavien-Dindo Classification I-II and those that met the criteria as a serious adverse event (SAE), were resolved without sequelae. No cases of internal hernia or bowel obstruction were reported. There were no cases of anastomotic bleeding, leakage, infection, or obstruction and no deaths. The MagDI System (K242086) performed safely and as intended to create patent duodeno-ileal side-to-side anastomoses with a profile as least as the predicate compression anastomosis device (MagDI System, DEN240013).
  • The subject device will be subject to and incorporated into the same postmarket ● surveillance study as the predicate device (DEN240013) to assess and characterize incidence and severity of internal hernia and bowel obstruction in U.S. patients representative of the U.S. intended use population who are treated with the MagDI System for duodenal-ileal side-to-side anastomosis.

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.

DEN240013

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.

K881484, K913411, K931056

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

N/A

0

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

October 24, 2024

GT Metabolic Solutions, Inc. Lisa Griffin Vincent Chief Regulatory/Quality Officer and General Manager 5450 Quam Ave NE, Suite 100 St. Michael. Minnesota 55376

Re: K242086

Trade/Device Name: MagDI System (MAG-01, DS-01) Regulation Number: 21 CFR 878.4816 Regulation Name: Magnetic Compression Anastomosis System Regulatory Class: Class II Product Code: SAH Dated: September 24, 2024 Received: September 24, 2024

Dear Lisa Griffin Vincent:

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.

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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.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rule"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

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 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-regulatory

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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 Date: 2024.10.24 13:22:47 -04'00' Tek N. Lamichhane, Ph.D. Assistant Director DHT4B: Division of 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

Submission Number (if known)

K242086

Device Name

MagDI System (MAG-01, DS-01)

Indications for Use (Describe)

The GT Metabolic MagDI System is intended for use in the creation of side duodeno-ileal anastomoses in minimally invasive and laparoscopic surgery. Once wound strength is sufficient to maintain the anastomosis, the device is passed from the body. The effects of this device on weight loss were not studied.

The GT Metabolic MagDI System is intended for use in adult patients > 21years.

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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510(k) Summary (K242086)

Submitter:

GT Metabolic Solutions, Inc. 3050 Three Springs Court, San Jose, CA 95140 Phone: 612-222-4200

Contact Person: Lisa Griffin Vincent, PhD, MA Date Prepared: September 23, 2024

Name of Device:

Proprietary/Trade Name:GT Metabolic MagDI™ System
Device Common Name:Magnet System
Model Numbers:MAG-01
DS-01
Product Code Name:Magnetic compression anastomosis system
Product Code:SAH
Regulation Number:878.4816
Review Panel:General & Plastic Surgery
Device Classification:Class II

Predicate Device:

Proprietary/Trade Name:GT Metabolic MagDI™ System
Device Common Name:Magnet System
Model Numbers:MAG-00(US) DS-
00(US)
Submission Number:DEN240013
Product Code Name:Magnetic compression anastomosis system
Product Code:SAH
Regulation Number:878.4816
Review Panel:General & Plastic Surgery
Device Classification:Class II

Reference Device:

| Proprietary/Trade Name: | Davis & Geck Valtrac® Biofrag
Anastomosis Ring (BAR) |

----------------------------------------------------------------------------------

Submission Number(s):

qmentable Anastomosis Ring (BAR) K881484, K913411, K931056

5

Product Code Name:Staple, implantable
Product Code:GDW
Regulation Number:878.4750
Review Panel:General & Plastic Surgery
Device Classification:Class II

Device Description:

The set of two (2) Magnets is a sterile single-use device. The device provides a simple method for the creation of a round (oval/circular) compression anastomosis.

After a period of 7-21 days, a compression-induced necrosis of the tissue between the Magnets occurs and the whole device, together with the necrosed tissue that was compressed by the Magnets, detaches, and is naturally expelled with the stool.

Intended Use / Indications for Use:

The GT Metabolic MagDI™ System is intended for use in the creation of side-to-side duodeno-ileal anastomoses in minimally invasive and laparoscopic surgery. Once wound strength is sufficient to maintain the anastomosis, the device is passed from the body. The effects of this device on weight loss were not studied.

The GT Metabolic MagDI System is intended for use in adult patients >21 years.

Technological Characteristics:

The subject device, GT Metabolic MaqDI™ System does not change the fundamental magnetic compression anastomosis technology employed in the predicate device and has the same intended use and same Indications for Use. The subject device is changing the device dimensions (a planned variant) while maintaining similar compression strength and changing the flange from titanium to a biofragmentable PGLA (+ 12% barium sulfate).

Performance Testing:

Preclinical Testing

  • Biocompatibility testing demonstrated the device is biocompatible according to . ISO 10993-1.
  • . Magnet field strength testing characterized the distances from the magnets are safe for patients and users with ferromagnetic implants, devices, or objects.
  • The Magnets maintain adequate separation forces over the use life. .
  • The Magnets connect and disconnect to the Delivery System over the use life. ●

6

  • Patient-contacting materials conform to ISO 10993-1 and FDA Guidance Use of ● International Standard ISO 10993-1, "Biological evaluation of medical devices -Part 1: Evaluation and testing within a risk management process" issued September 8, 2023.
  • The MagDI System demonstrates a SAL of 10-6, a continued sterility through the . labeled shelf life of the device, and conforms to ISO 11137-1, ISO 11137-2, and ISO 11137-3.
  • Chronic porcine animal testing was conducted over a 6-week period. ●

Clinical Testing

  • Clinical testing was conducted in obese patients with or without type 2 diabetes ● mellitus using the MagDI System for creation of a side-to-side duodeno-ileal anastomosis. The Magnets were sequentially delivered orogastrically either by swallow (first, distal Magnet only) or endoscopically using the Delivery System. The Magnets were successfully placed in all cases with alignment, and for all subjects reaching the one-month study visit, the device passed naturally as a set of connected Magnets with none requiring invasive re-intervention. Most adverse events were of low grade, Clavien-Dindo Classification I-II and those that met the criteria as a serious adverse event (SAE), were resolved without sequelae. No cases of internal hernia or bowel obstruction were reported. There were no cases of anastomotic bleeding, leakage, infection, or obstruction and no deaths. The MagDI System (K242086) performed safely and as intended to create patent duodeno-ileal side-to-side anastomoses with a profile as least as the predicate compression anastomosis device (MagDI System, DEN240013).
  • The subject device will be subject to and incorporated into the same postmarket ● surveillance study as the predicate device (DEN240013) to assess and characterize incidence and severity of internal hernia and bowel obstruction in U.S. patients representative of the U.S. intended use population who are treated with the MagDI System for duodenal-ileal side-to-side anastomosis.

Labeling conforms to 21 CFR 801 and ISO 15223.

Substantial Equivalence Conclusion:

The proposed subject device, GT Metabolic Solutions MagDI™ System (MAG-01, DS-01), is a modification and planned variant to the first MagDI System (MAG-00(US), DS-00(US); DEN240013). The subject device has demonstrated to be substantially equivalent to the predicate device (DEN240013) based on the same intended use and same Indications for Use, same or similar technological characteristics, and on performance testing.