AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The ETHICON™ 4000 and ETHICON™ 3D Reloads are intended for transection, resection and/or creation of anastomoses. The instruments have applications in multiple open or minimally invasive general, urologic, thoracic, and pediatric surgical procedures. They can be used with staple line or tissue reinforcement materials. The instruments may also be used for transection and resection of liver parenchyma (hepatic vasculature and biliary structures), pancreas, kidney, and spleen.

Device Description

The ETHICON™ 4000 Stapler and ETHICON™ 3D Reloads are sterile, single-patient-use instruments that simultaneously cut and staple tissue. There are six staggered rows of staples, three on either side of the cut line. Together, the ETHICON™ 4000 Staplers and ETHICON™ 3D Reloads deliver 3D staples in the first, second, fifth and sixth rows of staples. The third and fourth rows (nearest the knife) maintain the traditional 2D B-formed staples.

ETHICON™ 4000 60mm Staplers have a staple line that is approximately 60 mm long and a cut line that is approximately 57 mm long. The Subject stapler device is available in three different shaft lengths - Compact, Standard and Long. The shaft can rotate freely in both directions and an articulation mechanism enables the distal portion of the shaft to pivot to facilitate lateral access to the operative site. The device is packaged with a primary lithium Battery Pack that must be installed prior to use. There is embedded software to articulate and initiate firing of the device.

The instruments are packaged without a reload and must be loaded prior to use. The instrument may be reloaded for a maximum of 12 firings during a single procedure. A Staple Retaining Cap on the reload protects the staple leg points during shipping and transportation. The instruments' lockout feature is designed to prevent a used or improperly installed reload from being re-fired or an instrument from being fired without a reload.

The staples are permanent implants that provide tissue closure and apposition from the time of implant through the critical phases of healing. The staples remain in place for the patient's lifetime, unless in the opinion of the treating physician, they require removal.

AI/ML Overview

Based on the provided FDA 510(k) clearance letter for the ETHICON™ 4000 Stapler and ETHICON™ 3D Reloads (K250835), here's an analysis of the acceptance criteria and the study proving the device meets them:

Important Note: The provided document is a 510(k) clearance letter, which summarizes the FDA's decision based on the applicant's submission. It does not contain the full details of the studies conducted. Therefore, some information requested (e.g., specific acceptance criteria values, sample sizes for training sets, adjudication methods, details of expert qualifications, and MRMC study effect sizes) is not explicitly stated in this public document. The answers below are derived directly from the content provided and identify where information is not present.


Acceptance Criteria and Study to Prove Device Meets Acceptance Criteria

The primary purpose of this 510(k) submission was to expand the indications for use of an already cleared device to include transection and resection of liver parenchyma (hepatic vasculature and biliary structures), pancreas, kidney, and spleen. The acceptance criteria would therefore revolve around demonstrating safe and effective performance of the stapling system in these specific organ tissues.

Based on the document, the general "acceptance criteria" can be inferred from the types of performance tests conducted and the conclusion statement that the "subject devices passed the functional requirements of the device features" and "have been demonstrated to be safe and effective for the expanded indications for use."

1. Table of Acceptance Criteria and Reported Device Performance

As specific quantitative acceptance criteria (e.g., minimum burst pressure, maximum staple height deviation) are not provided in this summary document, we can only infer the categories of performance that were evaluated and determined to be acceptable.

Acceptance Criteria Category (Inferred)Reported Device Performance (Summary)
Mechanical PerformancePassed: Subject devices passed the functional requirements of the device features. This implies that the stated mechanical specifications related to staple formation, staple line length, and instrument operation were met.
Staple Line IntegrityPassed: Nonclinical (bench) tests included "staple line integrity in solid organs." The conclusion states the device passed functional requirements, indicating adequate staple line integrity.
Staple Form QualityPassed: Nonclinical (bench) tests included "formed staple height" and "staple form quality." The conclusion indicates these were met. The device delivers 3D staples in certain rows and 2D B-formed staples in others; the quality of these forms was assessed.
Hemostasis Performance (in Solid Organs & Vessels)Passed: Pre-clinical (animal) testing included "hemostasis performance in solid organs and vessels." The conclusion states the device is "safe and effective," implying successful hemostasis in the tested tissues.
Vessel SealingPassed: Nonclinical (bench) tests included "vessel sealing." The conclusion indicates this was met.
BiocompatibilityMeets ISO 10993-1: Stated as explicitly met.
Sterilization & Shelf LifeMet: Stated as EO Sterilization (Stapler) and Gamma Irradiation (Reload) with a 3-year shelf life. These inherently serve as acceptance criteria that were met.
Safety and Effectiveness for Expanded IUDemonstrated: "The ETHICON™ 4000 and ETHICON™ 3D Reloads have been demonstrated to be safe and effective for the expanded indications for use." This is the overarching acceptance criterion confirmed by the submission.
Substantial EquivalenceDemonstrated: "performance testing demonstrates that the Subject device performs substantially equivalent to the Predicate device and does not raise any new questions of safety and effectiveness." This is the ultimate acceptance criterion for 510(k).

2. Sample Size Used for the Test Set and Data Provenance

  • Sample Size for Test Set: Not explicitly stated in the document. The general descriptions refer to "nonclinical (bench) tests" and "pre-clinical (animal) testing," implying a test set was used, but no specific numbers of samples, instances, or animal subjects are provided.
  • Data Provenance:
    • Country of Origin: Not specified. Standard practice for such studies would likely involve labs in the US or collaborating international facilities, but the document does not state this.
    • Retrospective or Prospective: These were prospective studies, as they were conducted specifically to gather data for this 510(k) submission to support the expanded indications for use.

3. Number of Experts Used to Establish Ground Truth and Qualifications

This information is not applicable as this submission is for a mechanical surgical stapler and reload system, not an AI or image-based diagnostic device where "ground truth" would be established by human experts in image interpretation. The "truth" in this context is the physical performance and biological outcome (e.g., successful staple formation, hemostasis) confirmed through engineered testing and animal models.

4. Adjudication Method for the Test Set

This information is not applicable as this submission is for a mechanical device. Adjudication methods are typically used in studies involving human interpretation or clinical outcomes where there might be inter-reader variability. The "adjudication" in this context would be the rigorous adherence to testing protocols and criteria, verified by engineers and potentially DVMs for animal models.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and Effect Size

No, an MRMC comparative effectiveness study was not done. This type of study is relevant for AI or CAD (Computer-Aied Detection/Diagnosis) systems where the performance of human readers (e.g., radiologists) is compared with and without AI assistance. This submission is for a mechanical surgical stapler.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

This question is not applicable as this is not an AI/algorithm-based device. The "standalone performance" of the device is its mechanical function (stapling, cutting) which was assessed through bench and animal testing.

7. The Type of Ground Truth Used

The "ground truth" for this medical device's performance was established through:

  • Bench Test Results: Direct measurement and evaluation of physical characteristics and functional performance (e.g., formed staple height, staple form quality, vessel sealing, staple line integrity) under controlled laboratory conditions. These are objective engineering measurements.
  • Animal Model Outcomes: Direct observation and measurement of biological outcomes in live animal tissues (porcine model for liver, spleen, pancreas, isolated vessels, lung, uterine tissues). "Hemostasis performance" implies direct assessment of whether the stapling achieved effective cessation of bleeding. These are physiological and anatomical "truths."

8. The Sample Size for the Training Set

This information is not applicable as this is a mechanical device, not an AI/machine learning algorithm that requires a "training set."

9. How the Ground Truth for the Training Set Was Established

This information is not applicable for the same reason as above (not an AI/ML device).


In summary, the 510(k) clearance for the ETHICON™ 4000 Stapler and ETHICON™ 3D Reloads for expanded indications was based on a combination of rigorous nonclinical (bench) testing to verify mechanical performance and engineering specifications, and pre-clinical (animal) testing to demonstrate in vivo safety and effectiveness, particularly hemostasis performance in the newly indicated solid organs (liver, pancreas, kidney, spleen) and associated vasculature. The acceptance criteria were implicitly met by the successful completion and positive outcomes of these tests, demonstrating substantial equivalence to predicates and no new questions of safety and effectiveness for the expanded uses.

FDA 510(k) Clearance Letter - K250835

Page 1

U.S. Food & Drug Administration
10903 New Hampshire Avenue Doc ID # 04017.07.05
Silver Spring, MD 20993
www.fda.gov

May 14, 2025

Ethicon Endo-Surgery, LLC
Megan Westendorf
Senior Regulatory Affairs Specialist
475 Calle C
Guaynabo, PR 00969

Re: K250835

Trade/Device Name: ETHICON 4000 60mm Compact Stapler (EC3D60C); ETHICON 4000 60mm Standard Stapler (EC3D60S); ETHICON 4000 60mm Long Stapler (EC3D60L); ETHICON 3D 60mm White Reload (ER60W); ETHICON 3D 60mm Blue Reload (ER60B); ETHICON 3D 60mm Green Reload (ER60G); ETHICON 3D 60mm Black Reload (ER60T)

Regulation Number: 21 CFR 878.4750
Regulation Name: Implantable staple
Regulatory Class: Class II
Product Code: GDW, GAG
Dated: March 19, 2025
Received: March 20, 2025

Dear Megan Westendorf:

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

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K250835 - Megan Westendorf Page 2

Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

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 (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-reporting-combination-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-devices/device-advice-comprehensive-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-devices/medical-device-safety/medical-device-reporting-mdr-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/medical-devices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the

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K250835 - Megan Westendorf Page 3

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/device-advice-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,

TEK N. LAMICHHANE - S

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: K250835

Device Name:

  • ETHICON 4000 60mm Compact Stapler (EC3D60C)
  • ETHICON 4000 60mm Standard Stapler (EC3D60S)
  • ETHICON 4000 60mm Long Stapler (EC3D60L)
  • ETHICON 3D 60mm White Reload (ER60W)
  • ETHICON 3D 60mm Blue Reload (ER60B)
  • ETHICON 3D 60mm Green Reload (ER60G)
  • ETHICON 3D 60mm Black Reload (ER60T)

Indications for Use:

The ETHICON™ 4000 and ETHICON™ 3D Reloads are intended for transection, resection and/or creation of anastomoses. The instruments have applications in multiple open or minimally invasive general, urologic, thoracic, and pediatric surgical procedures. They can be used with staple line or tissue reinforcement materials. The instruments may also be used for transection and resection of liver parenchyma (hepatic vasculature and biliary structures), pancreas, kidney, and spleen.

Type of Use:
☑ Prescription Use (Part 21 CFR 801 Subpart D)
☐ Over-The-Counter Use (21 CFR 801 Subpart C)

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K250835

510(k) Summary

I. SUBMITTER

Submission: K250835

Company: Ethicon Endo-Surgery, LLC
475 Calle C
Guaynabo, PR 00969

Contact: Megan Westendorf
Senior Regulatory Affairs Specialist
Ethicon Endo-Surgery, Inc.
Phone: 513-479-6951
Email: mwestend@its.jnj.com

Date Prepared: May 14, 2025

II. Subject DEVICES

Trade NamesModels
ETHICON™ 4000 60mm Compact StaplerEC3D60C
ETHICON™ 4000 60mm Standard StaplerEC3D60S
ETHICON™ 4000 60mm Long StaplerEC3D60L
ETHICON™ 3D 60mm White ReloadER60W
ETHICON™ 3D 60mm Blue ReloadER60B
ETHICON™ 3D 60mm Green ReloadER60G
ETHICON™ 3D 60mm Black ReloadER60T

Classification Name: Surgical Stapler
Staple, Implantable

Classification Regulation: 21 CFR 878.4740
21 CFR 878.4750

Device Class: II

Product Code: GDW, GAG

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K250835

III. Predicate DEVICES

Predicate Device 510(k) NumberPredicate Device NamePredicate Device Models
K241629ECHELON™ 3000 60mm StaplerECH60C, ECH60S, ECH60L
K183435ECHELON Endoscopic Linear Cutter Reload (+Gripping Surface Technology) 60mmGST60W, GST60B, GST60G, GST60T

Reference DEVICES

Reference Device 510(k) NumberReference Device NameReference Device Models
K241630ETHICON™ 4000 60mm StaplerEC3D60C, EC3D60S, EC3D60L
K241630ETHICON™ 3D ReloadsER60B, ER60G, ER60T, ER60W

IV. Device Description

The ETHICON™ 4000 Stapler and ETHICON™ 3D Reloads are intended for transection, resection and/or creation of anastomoses.

The ETHICON™ 4000 Stapler and ETHICON™ 3D Reloads are sterile, single-patient-use instruments that simultaneously cut and staple tissue. There are six staggered rows of staples, three on either side of the cut line. Together, the ETHICON™ 4000 Staplers and ETHICON™ 3D Reloads deliver 3D staples in the first, second, fifth and sixth rows of staples. The third and fourth rows (nearest the knife) maintain the traditional 2D B-formed staples.

ETHICON™ 4000 60mm Staplers have a staple line that is approximately 60 mm long and a cut line that is approximately 57 mm long. The Subject stapler device is available in three different shaft lengths - Compact, Standard and Long. The shaft can rotate freely in both directions and an articulation mechanism enables the distal portion of the shaft to pivot to facilitate lateral access to the operative site. The device is packaged with a primary lithium Battery Pack that must be installed prior to use. There is embedded software to articulate and initiate firing of the device.

The instruments are packaged without a reload and must be loaded prior to use. The instrument may be reloaded for a maximum of 12 firings during a single procedure. A

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K250835

Staple Retaining Cap on the reload protects the staple leg points during shipping and transportation. The instruments' lockout feature is designed to prevent a used or improperly installed reload from being re-fired or an instrument from being fired without a reload.

The staples are permanent implants that provide tissue closure and apposition from the time of implant through the critical phases of healing. The staples remain in place for the patient's lifetime, unless in the opinion of the treating physician, they require removal.

V. Intended Use/Indications for Use

This submission is to expand the indications for use to include transection and resection of liver parenchyma (hepatic vasculature and biliary structures), pancreas, kidney, and spleen.

The ETHICON™ 4000 Staplers and ETHICON™ 3D Reloads are intended for transection, resection, and/or creation of anastomoses. The instruments have applications in multiple open or minimally invasive general, urologic, thoracic, and pediatric surgical procedures. They can be used with staple line or tissue reinforcement materials. The instruments may also be used for transection and resection of liver parenchyma (hepatic vasculature and biliary structures), pancreas, kidney, and spleen.

There is no change to the intended use: The ETHICON™ 4000 Stapler and ETHICON™ 3D Reloads are intended for transection, resection and/or creation of anastomoses.

VI. Technological Comparison

This table provides an overview of the characteristics of the subject device compared to the predicate device. The subject and predicate device share the same Indications for Use.

CharacteristicSubject DevicePredicate Device
Indication for UseThe ETHICON™ 4000 Staplers and ETHICON™ 3D Reloads are intended for transection, resection, and/or creation of anastomoses. The instruments have applications in multiple open or minimally invasive general, urologic, thoracic, and pediatric surgical procedures. They can be used with staple line or tissue reinforcement materials. The instruments may also be used for transection and resection of liver parenchyma (hepatic vasculature and biliary structures), pancreas, kidney, and spleen.The ECHELON FLEX™, ECHELON™ 3000, and ECHELON ENDOPATH™ families of staplers and reloads are intended for transection, resection, and/or creation of anastomoses. The instruments have application in multiple open or minimally invasive general, urologic, thoracic, and pediatric surgical procedures. They can be used with staple line or tissue reinforcement materials. The instruments may also be used for transection and resection of liver parenchyma (hepatic vasculature and biliary structures), pancreas, kidney, and spleen.

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K250835

CharacteristicSubject DevicePredicate Device
Intended UseTransection, resection, and/or creation of anastomoses.Same
Contraindications- Do not use the instruments on ischemic or necrotic tissue- Do not use the instruments on the aorta.- Do not use any endocutter on major vessels without making provision for proximal and distal control.- Tissue thickness should be carefully evaluated before firing any stapler.- Refer to the Reload Product Codes Table below for tissue compression requirement (closed staple height) for each staple size.- If tissue cannot comfortably compress to the closed staple height listed in the table, or easily compresses to less than the closed staple height listed in the table, the tissue is contraindicated as it may be too thick or too thin for the selected staple size.- These instruments are not intended for use when surgical stapling is contraindicated.Same
Sterile, Single Patient UseYesSame
Staple Rows6Same
Staple Form3D Staple form (first, second, fifth & sixth rows)2D Staple form (third & fourth rows)2D Staple form
Staple Line Length60 mmSame
Sterilization MethodStapler: EO SterilizationReload: Gamma IrradiationSame
Shelf Life3 YearsSame
Biocompatibility of MaterialsMeets ISO 10993-1Same
Packaging MaterialsStapler: PETG Tray with Tyvek LidReload: Flexible C-Film Blister with Tyvek LidSame

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K250835

This table provides an overview of the characteristics of the subject device compared to the reference device. The technological characteristics of the subject device are identical to that of the reference device; the only change is the expansion of the indications for use.

CharacteristicSubject DeviceReference Device
Indication for UseThe ETHICON™ 4000 Staplers and ETHICON™ 3D Reloads are intended for transection, resection, and/or creation of anastomoses. The instruments have applications in multiple open or minimally invasive general, urologic, thoracic, and pediatric surgical procedures. They can be used with staple line or tissue reinforcement materials. The instruments may also be used for transection and resection of liver parenchyma (hepatic vasculature and biliary structures), pancreas, kidney, and spleen.The ETHICON™ 4000 Staplers and ETHICON™ 3D Reloads are intended for transection, resection, and/or creation of anastomoses. The instruments have applications in multiple open or minimally invasive general, urologic, thoracic, and pediatric surgical procedures. They can be used with staple line or tissue reinforcement materials.
Intended UseTransection, resection, and/or creation of anastomoses.Same
Contraindications- Do not use the instruments on ischemic or necrotic tissue- Do not use the instruments on the aorta.- Do not use any endocutter on major vessels without making provision for proximal and distal control.- Tissue thickness should be carefully evaluated before firing any stapler.- Refer to the Reload Product Codes Table below for tissue compression requirement (closed staple height) for each staple size.- If tissue cannot comfortably compress to the closed staple height listed in the table, or easily compresses to less than the closed staple height listed in the table, the tissue is contraindicated as it may be too thick or too thin for the selected staple size.- These instruments are not intended for use when surgical stapling is contraindicated.Same
Sterile, Single Patient UseYesSame
Staple Rows6Same

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K250835

CharacteristicSubject DeviceReference Device
Staple Form3D Staple form (first, second, fifth & sixth rows)2D Staple form (third & fourth rows)Same
Staple Line Length60 mmSame
Sterilization MethodStapler: EO SterilizationReload: Gamma IrradiationSame
Shelf Life3 YearsSame
Biocompatibility of MaterialsMeets ISO 10993-1Same
Packaging MaterialsStapler: PETG Tray with Tyvek LidReload: Flexible C-Film Blister with Tyvek LidSame

VII. Non-Clinical and/or Clinical Tests

Performance test data (bench and animal) demonstrates that the subject device is substantially equivalent to the predicate device and that the device meets all requirements for the expanded indications for use to include solid organs.

The nonclinical (bench) tests that have been submitted include vessel sealing, formed staple height, staple form quality, and staple line integrity in solid organs. No additional bench testing was needed as the subject device is technologically identical to the reference device.

Pre-clinical (animal) testing includes hemostasis performance in solid organs and vessels. Hemostasis testing of liver, spleen and pancreas using porcine model was conducted to support the expansion of indications to include solid organs. Data was also collected from isolated arteries, veins and bundles/pedicles. Lung and uterine tissues along with their isolated vessels were also included in the testing.

Clinical Tests

This premarket submission did not rely on the assessment of clinical performance data to demonstrate device performance and equivalence.

VIII. Conclusion

In all cases the subject devices passed the functional requirements of the device features. The ETHICON™ 4000 and ETHICON™ 3D Reloads have been demonstrated to be safe and effective for the expanded indications for use.

In conclusion, the performance testing demonstrates that the Subject device performs substantially equivalent to the Predicate device and does not raise any new questions of safety and effectiveness.

§ 878.4750 Implantable staple.

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