K Number
K972102
Device Name
RADIUS PUSH OVER THE GUIDE WIRE PERCUTANEOUS ENDOSCOPIC GASTROSTOMY KIT
Manufacturer
Date Cleared
1998-01-23

(233 days)

Product Code
Regulation Number
876.5980
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The device is indicated for percutaneous placement of a long term initial placement feeding and/or decompression gastrostomy device.
Device Description
The device is described as a Percutaneous Endoscopic Gastrostomy tube. The device may be life supporting in that it can be the primary source of nutrition for the patient. The indications, complications and contra-indications are identical to those of the predicate Bard device. The actual insertion and placement techniques are also identical. The bolster and connector systems perform the same functions as those performed by the Bard unit. The dilator portion of the over-the-guidewire peg is composed of the same medical grade polyethylene material that is used by Bard and is identical in design. The internal bolster system is comparable to the Bard system in both retention and removal characteristics.
More Information

Bard Guidewire System Peg Tray

Not Found

No
The summary describes a standard Percutaneous Endoscopic Gastrostomy tube and its components, with no mention of AI or ML technology.

Yes
The device is described as a Percutaneous Endoscopic Gastrostomy tube, which is used for feeding and/or decompression, directly supporting a bodily function and providing nutrition, making it a therapeutic device.

No
Explanation: The device is a Percutaneous Endoscopic Gastrostomy tube used for feeding and/or decompression. Its intended use is for placement of a feeding device, not for diagnosing a condition.

No

The device description explicitly describes a physical medical device (Percutaneous Endoscopic Gastrostomy tube) made of materials like medical grade polyethylene, with components like a bolster, connector systems, and a dilator. This is not a software-only 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 percutaneous placement of a feeding and/or decompression gastrostomy device. This is a surgical procedure performed directly on the patient's body.
  • Device Description: The device is described as a Percutaneous Endoscopic Gastrostomy tube. This is a medical device used for delivering nutrition or decompressing the stomach, not for testing samples in vitro (outside the body).
  • Lack of IVD Characteristics: There is no mention of the device being used to analyze biological samples (like blood, urine, tissue, etc.) to provide diagnostic information. The focus is entirely on the physical placement and function of the tube within the patient.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information about a person's health status. This device's function is entirely procedural and therapeutic/supportive.

N/A

Intended Use / Indications for Use

The device is indicated for percutaneous placement of a long term initial placement feeding and/or decompression gastrostomy device.

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

78 KNT

Device Description

The device is described as a Percutaneous Endoscopic Gastrostomy tube. The device may be life supporting in that it can be the primary source of nutrition for the patient. The indications, complications and contra-indications are identical to those of the predicate Bard device. The actual insertion and placement techniques are also identical. The bolster and connector systems perform the same functions as those performed by the Bard unit. The dilator portion of the over-the-guidewire peg is composed of the same medical grade polyethylene material that is used by Bard and is identical in design. The internal bolster system is comparable to the Bard system in both retention and removal characteristics.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

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): 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.

Bard Guidewire System Peg Tray

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.

Not Found

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

§ 876.5980 Gastrointestinal tube and accessories.

(a)
Identification. A gastrointestinal tube and accessories is a device that consists of flexible or semi-rigid tubing used for instilling fluids into, withdrawing fluids from, splinting, or suppressing bleeding of the alimentary tract. This device may incorporate an integral inflatable balloon for retention or hemostasis. This generic type of device includes the hemostatic bag, irrigation and aspiration catheter (gastric, colonic, etc.), rectal catheter, sterile infant gavage set, gastrointestinal string and tubes to locate internal bleeding, double lumen tube for intestinal decompression or intubation, feeding tube, gastroenterostomy tube, Levine tube, nasogastric tube, single lumen tube with mercury weight balloon for intestinal intubation or decompression, and gastro-urological irrigation tray (for gastrological use).(b)
Classification. (1) Class II (special controls). The barium enema retention catheter and tip with or without a bag that is a gastrointestinal tube and accessory or a gastronomy tube holder accessory is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I (general controls) for the dissolvable nasogastric feed tube guide for the nasogastric tube. The class I device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 876.9.

0

K97210Z するとす

JAN 2 3 1998

510(K) SUMMARY (as required by 807.92(c))

| Submitter of 510(k): | Regulatory & Marketing Services, Inc. (RMS)
40178 U.S. 19 North
Tarpon Springs, FL 34689 | |
|------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------|
| | Phone: | 813-942-3908 |
| | Fax: | 813-942-3828 |
| Contact Person: | Ed Ransom or Pat Lamb | |
| Date of Summary: | May 30, 1997 | |
| Trade Name: | Radius Push Over the Guide Wire Percutaneous
Endoscopic Gastrostomy Kit | |
| Classification Name: | Tube, Gastro-Intenstinal | |
| Predicate Device: | Bard Guidewire System Peg Tray | |
| Device Description/
Comparison: | The device is described as a Percutaneous Endoscopic
Gastrostomy tube. The device may be life supporting in that
it can be the primary source of nutrition for the patient. The
indications, complications and contra-indications are
identical to those of the predicate Bard device. The actual
insertion and placement techniques are also identical. The
bolster and connector systems perform the same functions
as those performed by the Bard unit. The dilator portion of
the over-the-guidewire peg is composed of the same
medical grade polyethylene material that is used by Bard
and is identical in design. The internal bolster system is
comparable to the Bard system in both retention and
removal characteristics. | |
| Intended Use: | The kit is a collection of medical devices that are assembled
for the purpose of creating a percutaneous gastrostomy
through which an enteral feeding tube is placed. | |

1

Image /page/1/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo is circular, with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter of the circle. Inside the circle is an abstract image of an eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 2 3 1998

Radius International, Inc. c/o Ed Ransom Consultant Regulatory and Marketing Services, Inc. P.O. Box 1108 Elfers, Florida 34680

Re: K972102 Radius Push PEG Tube Kit Requlatory Class: II Product Code: 78 KNT Dated: October 24, 1997 Received: October 27, 1997

Dear Mr. Ransom:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). You may, therefore, market the device, subject to the general controls provisions of Act. However, you are responsible to determine that the medical devices you use as components in the kit have either been determined as substantially equivalent under the premarket notification process (Section 510(k) of the act), or were on the market prior to May 28, 1976, the enactment date of the Medical Device Amendments. Please note: If you purchase your device components in bulk (i.e., unfinished) and further process (e.g., sterilize) you must submit a new 510(k) before including these components in your kit. 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.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval) 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 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, FDA will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, the Food and Drug Administration (FDA) may publish further announcements concerning your device in the Federal Register.

2

Page - 2 - Mr. Ed Ransom

Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or requlations.

In addition, we have determined that your device kit contains Lidocaine, Povidone-iodine swab, and Povidone - iodine ointment, which are subject to requlation as drugs.

Our substantially equivalent determination does not apply to the drug components of your device. We recommend you first contact the Center for Drug Evaluation and Research before marketing your device with the drug components. For information on applicable Agency requirements for marketing this these drugs, we suggest you contact:

Director, Division of Drug Labeling Compliance (HFD-310) Center for Drug Evaluation and Research Food and Drug Administration 5600 Fishers Lane Rockville, Maryland 20857 (301) 594-0101

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4613. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Other general information on your responsibilities under the Act, 807.97). may be obtained from the Division of Small Manufacturers Assistance at its toll free number (800) 638-2041 or (301) 443-6597, or at its Internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

Robert R. Stalling

Lillian Yin, Ph.D. Director, Division of Reproductive, Abdominal, Ear, Nose and Throat, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

3

510(k) Number (if known): Х 972/02

Device Name: Radius Push Over the Guide Wire Percutaneous Endoscopic Gastrostomy Kit

Indications For Use:

The device is indicated for percutaneous placement of a long term initial placement feeding and/or decompression gastrostomy device.

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Raber D Ratliff
(Division Sign-Off)

Division of Reproductive, Abdominal, ENT, and Radiological Devices 510(k) Number_1972102

Prescription Use_ OR Over-The-Counter Use -------Prescription OSe______________________________________________________________________________________________________________________________________________________________

(Optional Format 1-2-96)