K Number
K984438
Device Name
MODIFIED AUTO SUTURE*VCS** ANASTOMOTIC**CLIP CARTRIDGE
Date Cleared
1999-01-07

(24 days)

Product Code
Regulation Number
878.4300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Modified Auto Suture* VCS** Anastomotic** clip cartridge is intended for use in the anastomosis of vascular structures and in the attachment of synthetic vascular prosthesis.
Device Description
The Modified Auto Suture* VCS** Anastomotic** clip cartridge uses titanium implantable clips to hold everted tissue edges together for the creation of vascular anastomosis.
More Information

Not Found

No
The summary describes a mechanical clip cartridge for vascular anastomosis and does not mention any software, algorithms, or AI/ML capabilities.

Yes
The device is used for anastomosis of vascular structures and attachment of synthetic vascular prostheses, which are therapeutic interventions.

No
The device is described as an anastomotic clip cartridge used to hold tissue edges together for the creation of vascular anastomosis, which is a surgical function, not a diagnostic one.

No

The device description clearly states it uses "titanium implantable clips" and is a "clip cartridge," indicating it is a physical hardware device.

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

Here's why:

  • Intended Use: The intended use clearly states the device is for "anastomosis of vascular structures and in the attachment of synthetic vascular prosthesis." This is a surgical procedure performed in vivo (within the living body).
  • Device Description: The description confirms the use of "titanium implantable clips to hold everted tissue edges together for the creation of vascular anastomosis." This is a mechanical device used during surgery.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens (like blood, urine, tissue samples) in vitro (outside the body) to provide information about a physiological state, health, or disease.

IVD devices are used to perform tests on samples taken from the body, while this device is used directly on the body during surgery.

N/A

Intended Use / Indications for Use

The Modified Auto Suture* VCS** Anastomotic** clip cartridge is intended for use in the anastomosis of vascular structures and in the attachment of synthetic vascular prosthesis.

The Modified Auto Suture* VCS** Anastomotic** clip cartridge has indications for use in the creation of vascular anastomoses and in the attachment of synthetic vascular prosthesis.

Product codes

FZP

Device Description

The Modified Auto Suture* VCS** Anastomotic** clip cartridge uses titanium implantable clips to hold everted tissue edges together for the creation of vascular anastomosis.

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.

Auto Suture* VCS* Clip Applier (K970793) and Sutures

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

§ 878.4300 Implantable clip.

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

0

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Modified Auto Suture* VCS** Anastomotic** Clip Cartridge K984438

IX. 510(k) Summary of Safety and Effectiveness

| SUBMITTER: | United States Surgical Corporation
150 Glover Avenue
Norwalk, CT 06856 |

------------------------------------------------------------------------------------------

CONTACT PERSON: Christopher A. Graham

DATE PREPARED: December 11, 1998

CLASSIFICATION NAME: Implantable Clip

COMMON NAME: Implantable Clip

PROPRIETARY NAME: Modified Auto Suture* VCS** Anastomotic** clip cartridge

Auto Suture* VCS* Clip Applier (K970793) and Sutures PREDICATE DEVICES:

The Modified Auto Suture* VCS** Anastomotic** clip DEVICE DESCRIPTION: cartridge uses titanium implantable clips to hold everted tissue edges together for the creation of vascular anastomosis.

INTENDED USE:

MATERIALS:

structures and in the attachment of synthetic vascular prosthesis. All component materials of the Modified Auto Suture* VCS**

The Modified Auto Suture* VCS** Anastomotic** clip cartridge is intended for use in the anastomosis of vascular

Anastomotic ** clip cartridge are comprised of materials which are in accordance with ISO Standard # 10993-1.

510(k) Premarket Notification

United States Surgical Corporation *Trademark of United States Surgical Corporation

12/11/98 Page 28

** Trademark name not you determined

1

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

7 1999 JAN

Mr. Christopher A. Graham Associate, Regulatory Affairs United States Surgical Corporation 150 Glover Avenue Norwalk, Connecticut 06856

Re: K984438

Trade Name: Modified Auto Suture VCS Anastomotic Clip Cartridge Regulatory Class: II Product Code: FZP Dated: December 11, 1998 Received: December 14, 1998

Dear Mr. Graham:

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

2

Page 2 - Mr. Christopher A. Graham

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 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4595. 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.gov/cdrh/dsmamain.html".

Sincerely yours,

Celia M. Witten, Ph.D., M.D.
Director
Division of General and

Division of General and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

3

Modified Auto Suture* VCS** Anastomotic** Clip Cartridge

IV. Indications For Use:

510(k) Number (if known): K984438

Name: Modified Auto Suture* VCS** Anastomotic** clip cartridge

Indications For Use:

The Modified Auto Suture* VCS** Anastomotic** clip cartridge has indications for use in the creation of vascular anastomoses and in the attachment of synthetic vascular prosthesis.

(Please do not write below this line - continue on another page if needed)

Concurrence of CDRH, Office of Evaluation (ODE)

Prescription Use:
OR Over-The-Counter Use:
(Per 21 CFR §801.109)

sion Sign-Off)

Division of General Restorati 510(k) Number

United States Surgical Corporation *Trademark of United States Surgical Corporation

** Trademark name not yet determined