K Number
K970099
Device Name
SIMON NITINOL FILTER/STRAIGHT LINE SYSTEM
Date Cleared
1997-04-16

(93 days)

Product Code
Regulation Number
870.3375
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The intended use of both Systems is to prevent embolisms from migrating to the pulmonary arteries.
Device Description
The cleared SNF/SL and SNF Systems and the proposed models of the SNF/SL and SNF Systems are composed of a SN Filter and a delivery system. The SN Filter component is made of a nitinol alloy which has thermal shape memory properties. These properties allow the nitinol alloy wires to be formed into the shape of a filter. When cooled, the wires can be straightened to allow delivery through a small diameter catheter. The SN Filter resumes its original shape, a dome with six legs, when warmed to body temperature in the vena cava. The SN Filters are delivered via the Seldinger technique, using a 7 French I.D. angiographic introducer sheath and a preliminary venacavogram. The sheath is introduced into the vein and positioned in the vena cava. When the sheath is positioned in the vena cava, the dilator is removed and the delivery system for the SN Filter is attached to the sheath. The SN Filter is then advanced through the sheath using the pusher wire until the SN Filter is at the tip of the sheath in the vena cava. The pusher wire has a stainless steel pusher cup or pad on the distal end of the pusher wire. The pusher wire is held in position while the sheath is withdrawn. This action releases the SN Filter into the vena cava; the SN Filter expands to its original shape which secures it against the vena cava. The sheath is then removed. NMT intends to modify the gold radiopaque marker band from one which is deposited onto the introducer sheath to one which is mechanically swaged onto the introducer sheath.
More Information

No
The device description focuses on the mechanical properties of the filter and the delivery system, with no mention of AI or ML.

Yes
The device is described as preventing embolisms from migrating to the pulmonary arteries, which is a therapeutic intervention aimed at treating or preventing a medical condition.

No

The device is described as an embolism prevention filter system, not a diagnostic tool. Its function is to physically entrap embolisms in the vena cava.

No

The device description clearly details a physical filter made of nitinol alloy and a delivery system, which are hardware components.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostics are devices intended for use in the collection, preparation, and examination of specimens taken from the human body (such as blood, urine, or tissue) to provide information for the diagnosis, treatment, or prevention of disease.
  • Device Description: The provided text describes a physical medical device (a vena cava filter) that is implanted into the body to prevent embolisms. It is a therapeutic device, not a diagnostic one.
  • Intended Use: The intended use is to "prevent embolisms from migrating to the pulmonary arteries," which is a therapeutic action, not a diagnostic test performed on a specimen.
  • Lack of IVD Characteristics: The description does not mention any analysis of biological samples, reagents, or laboratory procedures, which are characteristic of IVD devices.

This device is a therapeutic medical device used for intervention within the body.

N/A

Intended Use / Indications for Use

The intended use of both Systems is to prevent embolisms from migrating to the pulmonary arteries.

Product codes

DTK

Device Description

The cleared SNF/SL and SNF Systems and the proposed models of the SNF/SL and SNF Systems are composed of a SN Filter and a delivery system. The SN Filter component is made of a nitinol alloy which has thermal shape memory properties. These properties allow the nitinol alloy wires to be formed into the shape of a filter. When cooled, the wires can be straightened to allow delivery through a small diameter catheter. The SN Filter resumes its original shape, a dome with six legs, when warmed to body temperature in the vena cava.

The SN Filters are delivered via the Seldinger technique, using a 7 French I.D. angiographic introducer sheath and a preliminary venacavogram. The sheath is introduced into the vein and positioned in the vena cava. When the sheath is positioned in the vena cava, the dilator is removed and the delivery system for the SN Filter is attached to the sheath. The SN Filter is then advanced through the sheath using the pusher wire until the SN Filter is at the tip of the sheath in the vena cava. The pusher wire has a stainless steel pusher cup or pad on the distal end of the pusher wire. The pusher wire is held in position while the sheath is withdrawn. This action releases the SN Filter into the vena cava; the SN Filter expands to its original shape which secures it against the vena cava. The sheath is then removed.

NMT intends to modify the gold radiopaque marker band from one which is deposited onto the introducer sheath to one which is mechanically swaged onto the introducer sheath.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

vena cava, pulmonary arteries

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

K963014, K963016

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.3375 Cardiovascular intravascular filter.

(a)
Identification. A cardiovascular intravascular filter is an implant that is placed in the inferior vena cava for the purpose of preventing pulmonary thromboemboli (blood clots generated in the lower limbs and broken loose into the blood stream) from flowing into the right side of the heart and the pulmonary circulation.(b)
Classification. Class II. The special controls for this device are:(1) “Use of International Standards Organization's ISO 10993 ‘Biological Evaluation of Medical Devices Part I: Evaluation and Testing,’ ” and
(2) FDA's:
(i) “510(k) Sterility Review Guidance and Revision of 2/12/90 (K90-1)” and
(ii) “Guidance for Cardiovascular Intravascular Filter 510(k) Submissions.”

0

K970099

510(k) Summary Simon Nitinol Filter™ System and Simon Nitinol Filter/Straight Line™ System

APR 1 5 1997

Submitter's Name, Address, and Telephone Number

Nitinol Medical Technologies, Inc. 27 Wormwood St. 02210 Phone: (617) 737-0930 (617) 737-0932 Facsimile:

Contact Person

Sherrie Coval-Goldsmith V.P. Regulatory Affairs 27 Wormwood Street Boston, Mass 02210

Date Prepared

January 10, 1997

Name of Device

Simon Nitinol Filter™ System and Simon Nitinol Filter/Straight Line™ System

Classification Name

Cardiovascular Intravascular Filter

Common Name

Vena Cava Filter System

Product Code

DTK

0000172

1

Predicate Devices

Simon Nitinol Filter/StraightLine™ System ("SNF/SL System") 1. (K963014) and Simon Nitinol Filter™ System ("SNF System") (K963016).

Intended Use

The intended use of both Systems is to prevent embolisms from migrating to the pulmonary arteries.

Substantial Equivalence

The cleared SNF/SL and SNF Systems and the proposed models of the SNF/SL and SNF Systems are composed of a SN Filter and a delivery system. The SN Filter component is made of a nitinol alloy which has thermal shape memory properties. These properties allow the nitinol alloy wires to be formed into the shape of a filter. When cooled, the wires can be straightened to allow delivery through a small diameter catheter. The SN Filter resumes its original shape, a dome with six legs, when warmed to body temperature in the vena cava.

The SN Filters are delivered via the Seldinger technique, using a 7 French I.D. angiographic introducer sheath and a preliminary venacavogram. The sheath is introduced into the vein and positioned in the vena cava. When the sheath is positioned in the vena cava, the dilator is removed and the delivery system for the SN Filter is attached to the sheath. The SN Filter is then advanced through the sheath using the pusher wire until the SN Filter is at the tip of the sheath in the vena cava. The pusher wire has a stainless steel pusher cup or pad on the distal end of the pusher wire. The pusher wire is held in position while the sheath is withdrawn. This action releases the SN Filter into the vena cava; the SN Filter expands to its original shape which secures it against the vena cava. The sheath is then removed.

NMT intends to modify the gold radiopaque marker band from one which is deposited onto the introducer sheath to one which is mechanically swaged onto the introducer sheath.

The proposed models of SNF/SL and SNF Systems have the same intended use as both cleared systems. These devices are intended to prevent embolisms from migrating to the pulmonary arteries. They have equivalent principles of operation as they use a pusher wire to push the SN Filter through a sheath inserted into a vein in order to deliver the filter to the inferior vena cava. The minor technological difference between the proposed models of SNF/SL and SNF System and the cleared SNF/SL and SNF System, namely the method by which the gold radiopaque marker

0000173

2

band(s) are applied to the sheath, does not raise any new questions of safety or effectiveness. Thus, the proposed models of SNF/SL and SNF Systems are substantially equivalent to the cleared SNF/SL and SNF System respectively.