K Number
K963750
Device Name
RETRIEVAL SNARE
Date Cleared
1996-11-22

(65 days)

Product Code
Regulation Number
876.4680
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Retrieval Snare is indicated for use in grasping and retrieval of foreign body within the alimentary tract. These foreign bodies may include guidewires, pullwires, or plastic stents.
Device Description
Not Found
More Information

Not Found

No
The summary describes a mechanical retrieval snare and provides no indication of AI/ML technology.

Yes
The device is indicated for grasping and retrieval of foreign bodies within the alimentary tract, which is a therapeutic intervention aimed at treating medical conditions or diseases.

No
The Retrieval Snare is described as a tool for grasping and retrieving foreign bodies, which is a therapeutic or interventional function, not a diagnostic one.

No

The device is described as a "Retrieval Snare" and is indicated for grasping and retrieval of foreign bodies. This description strongly suggests a physical, mechanical device, not software. The predicate devices listed are also physical snares.

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

Here's why:

  • Intended Use: The intended use is to grasp and retrieve foreign bodies within the alimentary tract. This is a direct intervention on a patient's body, not a test performed on a sample taken from the body.
  • Device Description: While the description is "Not Found," the intended use clearly describes a physical tool for retrieval.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Providing diagnostic information based on the analysis of samples
    • Using reagents or assays

The device described is a surgical or interventional device used for removing foreign objects from the body.

N/A

Intended Use / Indications for Use

The Retrieval Snare is indicated for use in grasping and retrieval of foreign body within the alimentary tract. These foreign bodies may include guidewires, pullwires, or plastic stents.

Product codes

78 FDI

Device Description

Not Found

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

alimentary tract

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)

Not Found

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

Not Found

Predicate Device(s)

K950496, K941750, K860269

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.4680 Ureteral stone dislodger.

(a)
Identification. A ureteral stone dislodger is a device that consists of a bougie or a catheter with an expandable wire basket near the tip, a special flexible tip, or other special construction. It is inserted through a cystoscope and used to entrap and remove stones from the ureter. This generic type of device includes the metal basket and the flexible ureteral stone dislodger.(b)
Classification. Class II (special controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 876.9.

0

NOV 22 1996

8112 SECTION 8 510(K) SUMMARY

1963750

FOLRELEASABLE

David San Daniel March 18 September 1

Pursuant to §513(i)(3)(A) of the Food, Drug, and Cosmetic Act, Boston Scientific Corporation is required to submit with this Premarket Notification " ... adequate summary of any information respecting safety and effectiveness or state that such information will be made available upon request of any person." Boston Scientific Corporation chooses to submit a summary of information respecting safety and effectiveness.

COMMON/USUAL NAMES:Snare, Flexible
TRADE/PROPRIETARY NAME:Retrieval Snare
CLASSIFICATION NAME &
DEVICE CLASSIFICATION:Class II
NameNumber21 CFR Ref.
Snare, Flexible78 FDI876.4300
DEVICE PANEL/BRANCH:Gastroenterology-Urology (GU)
Gastro Renal (GRDB)
OWNER/OPERATOR:Boston Scientific Corporation
One Boston Scientific Place
Natick, MA 01760
CONTACT PERSON:Lisa M. Quaglia, Regulatory Affairs Specialist

INDICATIONS FOR USE


エリ・スー

A UVO DOU 2000

The Retrieval Snare is indicated for use in grasping and retrieval of foreign body within the alimentary tract. These foreign bodies may include guidewires, pullwires, or plastic stents.

CONTRAINDICATIONS

There are no known contraindications for this device.

POTENTIAL COMPLICATIONS

Possible complications include, but may not be limited to: inadvertent perforation during retrieval.

Premarket Notifiontion, Retrieval Snare, November 20, 1906

Promarket Notification, Retrieval Snare, November 20, 1990

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T2:42

K963750
8292

Figure 8-1: Similarities and Differences retween Retrieval Snare, Boston Scientific's Snare, Profile Polypectomy Snare, and Retrieval Loop

| | Microvasive
Retrieval Snare | BSC's Snare | BSC's Profile
Polypectomy
Snare | BSC's Retrieval
Loop |
|-----------------------|-----------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------|--------------------------------------------------------------------|
| | (This 510(k)) | (K950496) | (K941750) | (K860269) |
| USE | | | | |
| Indication | Retrieval of
foreign body such
as guidewires,
pullwires, or
plastic stents. | Resection,
removal and
cauterization of
structures such as
polyps, tissue,
lesions or small
tumors. | Removal and
cauterization of
sessile,
diminutive, and
pedunculated
polyps. | Removal of foreign
bodies, stones,
PEG tubes, and
stents. |
| Catheter | | | | |
| Usable Length
(cm) | 180 | 40 to 240 | 240 | 190 |
| Sheath OD
(mm) | 1.9 or 2.3 | 1.9 or 2.3 | 1.9 | 1.7 |
| | | | | |
| Handle Type | Plastic Three-Ring | Plastic Three-Ring | Plastic Three-ring | Plastic Three-Ring |
| Loop Diameter | 11 - 33 mm | 11 - 33 mm | 11-33 mm | 3/8" |
| Loop Shapes | Oval, Crescent, or
Hexagonal | Oval, Crescent, or
Hexagonal | Oval, Crescent,
or Hexagonal | Oval |

BSC = Boston Scientific Corporation