K Number
K972871
Device Name
GENESIS
Date Cleared
1997-10-02

(59 days)

Product Code
Regulation Number
872.3660
Panel
Dental
Reference & Predicate Devices
N/A
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

For use by a dental professional in obtaining a reproduction of teeth and investing tissues, as needed.

Device Description

Not Found

AI/ML Overview

I am sorry, but the provided text from the FDA document does not contain information on the acceptance criteria, device performance, or study details such as sample sizes, ground truth establishment, or expert qualifications. The document is an FDA 510(k) clearance letter for a dental device called "Genesis Alginato," indicating its substantial equivalence to a legally marketed predicate device for obtaining reproductions of teeth and investing tissues. It outlines regulatory requirements and allows the manufacturer to market the device, but it does not include the technical performance evaluation data you are requesting.

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with three parallel lines forming its body and wings. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" are arranged in a circular pattern around the eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20856

Ms. Kathy L. Eppen Vice President Pacific Rim Dental, Incorporated 173 Shady Lane Stateline, Nevada 89449

K972871 Re: Trade Name: Genesis Regulatory Class: II Product Code: ELW Dated: July 29, 1997 Received: Auqust 4, 1997

Dear Ms. Eppen:

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 (Act). You may, therefore, market the device, subject to the general controls provisions The general controls provisions of the Act of the Act. include requirements for annual reqistration, listing of devices, qood 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 such additional controls. Existing major requlations affecting your device can be found in the Code of Federal Requlations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP requlation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531

OCT - 2 1997

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Page 2 - Ms. Eppen

through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or requlations.

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 leqally 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 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4618. 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 807.97). Other general information on your responsibilities under the Act 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.qov/cdrh/dsmamain.html".

Sincerely yours
K. Aultrux

Timothy A. Ulatowski Director Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health

. Enclosure ..................................................................................................................................................................

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Page 1_of 1

510(k) Number (if known): K972871

Device Name: Genesis Alginato

Indications For Use:

For use by a dental professional in obtaining a reproduction of teeth and investing tissues, as needed.

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

CONCURRENCE OF CDRH, OFFICE OF DEVICE EVALUATION(ODE)

(Division Sign-Off)
Division of Dental, Infection Control, and General Hospital Devices
(510(k) NumberKA72871
Prescription Use/OROver-The-Counter Use
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CONCURRENCE OF CDRH, OFFICE OF DEVICE EVALUATION(ODE)

(Option Formal 1-2-96)

§ 872.3660 Impression material.

(a)
Identification. Impression material is a device composed of materials such as alginate or polysulfide intended to be placed on a preformed impression tray and used to reproduce the structure of a patient's teeth and gums. The device is intended to provide models for study and for production of restorative prosthetic devices, such as gold inlays and dentures.(b)
Classification. Class II (Special Controls).