K Number
K990104
Device Name
MEDTRONIC MODEL 7495 EXTENSION KIT
Manufacturer
Date Cleared
1999-02-09

(28 days)

Product Code
Regulation Number
882.5880
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Medtronic Model 7495 Extension Kit is intended for use with implanted spinal cord or peripheral nerve stimulation systems for the treatment of chronic, intractable pain.
Device Description
The Medtronic Model 7495 extension kit is used with spinal cord and peripheral nerve stimulation systems to connect stimulation leads to the implanted receiver of externally powered (RF) systems. The extension provides an electrical path to allow stimulation to be delivered to the target site.
More Information

Not Found

Not Found

No
The summary describes a passive electrical extension kit and does not mention any AI/ML capabilities or related terms.

Yes
The device is described as an "Extension Kit" intended for use with implanted spinal cord or peripheral nerve stimulation systems for the treatment of chronic, intractable pain. Its function is to connect stimulation leads to the implanted receiver, allowing stimulation to be delivered to the target site for pain treatment, which is a therapeutic purpose.

No

Explanation: The device description states it "connects stimulation leads to the implanted receiver" and "provides an electrical path to allow stimulation to be delivered to the target site." Its purpose is to facilitate the delivery of therapy, not to diagnose a condition.

No

The device description explicitly states it is an "extension kit" used to connect stimulation leads to an implanted receiver, providing an "electrical path." This indicates a physical hardware component, not software only.

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

Here's why:

  • Intended Use: The intended use is for connecting components of an implanted neurostimulation system for the treatment of chronic pain. This is a therapeutic application, not a diagnostic one.
  • Device Description: The device description clearly states its function is to provide an electrical path for stimulation, which is a treatment mechanism.
  • Lack of Diagnostic Activity: There is no mention of the device being used to analyze samples from the human body (like blood, urine, tissue, etc.) to provide information about a disease or condition.

IVD devices are specifically designed to perform tests on biological samples to diagnose, monitor, or screen for diseases or conditions. This device does not fit that description.

N/A

Intended Use / Indications for Use

The Medtronic Model 7495 Extension Kit is intended for use with implanted spinal cord or peripheral nerve stimulation systems for the treatment of chronic, intractable pain.

Product codes

GZB, GZF

Device Description

The Medtronic Model 7495 extension kit is used with spinal cord and peripheral nerve stimulation systems to connect stimulation leads to the implanted receiver of externally powered (RF) systems. The extension provides an electrical path to allow stimulation to be delivered to the target site.

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

Bench Testing: Because there is no significant change to the design of the accessory components, mechanical testing is not applicable. The material added to the connector boot has undergone extensive biocompatibility testing and has been determined to be biocompatible.

Key Metrics

Not Found

Predicate Device(s)

Medtronic Model 7495 extension kit

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 882.5880 Implanted spinal cord stimulator for pain relief.

(a)
Identification. An implanted spinal cord stimulator for pain relief is a device that is used to stimulate electrically a patient's spinal cord to relieve severe intractable pain. The stimulator consists of an implanted receiver with electrodes that are placed on the patient's spinal cord and an external transmitter for transmitting the stimulating pulses across the patient's skin to the implanted receiver.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image shows the date 2/9/99 at the top. Below the date is the Medtronic logo. The logo consists of the word "Medtronic" in bold, sans-serif font, followed by a square symbol containing a stylized image.

K 9940104

800 53rd Avenue Minneapolis, MN 55421-1200 nternet: www.medtronic.com elephone: (612) 514-5000 Toll-free: 1-800-328-0810 FAX: (612) 514-5078

510(k) SUMMARY

SUBMITTER I.

Name and Address:

Medtronic, Inc. Neurological Division 800 53rd Avenue NE Minneapolis, MN 55421

Lisa L. Pritchard Contact Person:

January 11, 1999 Date of Summary Preparation:

Establishment Registration Number: 2182207

II. DEVICE NAME

Extension for Spinal Cord and Device Common or Usual Name: Peripheral Nerve Stimulators Device Trade Name: Medtronic Model 7495 Extension Kit

III. PREDICATE DEVICE

Extensions for Implanted spinal Cord Stimulation (SCS) and/or Peripheral Nerve Stimulation (PNS) for the treatment of chronic intractable pain.

IV. DEVICE DESCRIPTION

The Medtronic Model 7495 extension kit is used with spinal cord and peripheral nerve stimulation systems to connect stimulation leads to the implanted receiver of externally powered (RF) systems. The extension provides an electrical path to allow stimulation to be delivered to the target site.

1

Medtronic &

Medtronic Neurological 800 53rd Avenue NE Minneapolis, MN 55440-9087 Internet: www.medtronic.com Telephone: (612) 514-5000 Toll Free: 1-800-328-0810 FAX: (612) 514-5078

V. INDICATION FOR USE

The Model 7495 extension kit with revised accessories has the same intended use as the current Model 7495 extension kit. These extensions are intended to be surgically implanted as part of a neurostimulation system to treat chronic, intractable pain.

VI. COMPARISON TO PREDICATE DEVICE

The Medtronic Model 7495 extension kit with revised accessories is substantially equivalent to the Medtronic Model 7495 extension kit that is currently in commercial distribution.

a. Intended Use

These extensions are intended to be surgically implanted as part of a neurostimulation system to treat chronic, intractable pain.

b. Principles of Operation

The design and principle of operation of the extension in the revised kit is identical to the currently available Model 7495 extension. The extension provides an electrical path between the neurostimulator and the lead to allow stimulation to be delivered to the target site.

Device Performance C.

Performance of the Model 7495 extension is not affected by the modifications in accessories provided with the extension kit. The design of the extension remains unchanged. Design of the large wedge tip and dual carrier tip tunneling accessories also remains unchanged (these accessories are currently packaged with the Model 7498 extension kit). Changes to the connector boots to add Roman Numeral identification and radiopaque material do not change the performance or use of the connector boot.

d. Bench Testing

Because there is no significant change to the design of the accessory components, mechanical testing is not applicable. The material added to the connector boot has undergone extensive biocompatibility testing and has been determined to be biocompatible.

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Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" around the perimeter. Inside the circle is a stylized image of three human profiles facing right, with flowing lines representing hair or clothing.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

FEB - 9 1999

Ms. Lisa L. Pritchard Principal Product Regulation Manager Medtronic Neurological 800 53rd Avenue NE Minneapolis, Minnesota 55440-9087

Re: K990104 Medtronic Model 7495 Extension Kit Trade Name: Regulatory Class: II Product Codes: GZB and GZF Dated: January 11, 1999 Received: January 12, 1999

Dear Ms. Pritchard:

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 able beach in the 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 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 Requlations, Title 21, Parts 800 to 895. ਜੋ substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical General requlation (21 CFR Part 820) and that, Devices: 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 In addition, FDA may publish further announcements action. Please note: concerning your device in the Federal Register. 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.

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Page 2 - Ms. Lisa L. Pritchard

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA acberroom in your tial equivalence of your device to a legally marketed predicate device results in a classification for your marketed produced or mits 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) 594-4659. Additionally, for questions on the promotion and advertising of your device, please contact che promocion and liance 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 Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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APPENDIX 2

INDICATIONS FOR USE STATEMENT

510(k) Number (if Known): ____________________________________________________________________________________________________________________________________________________

Device Name: Model 7495 Extension Kit

Indications For Use:

The Medtronic Model 7495 Extension Kit is intended for use with implanted spinal cord or peripheral nerve stimulation systems for the treatment of chronic, intractable pain.

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

Concurrence of CDRH, Office of Device Evaluation (ODE) Over-The Counter Use OR Prescription Use (Per 21 CFR 801.109)

Special 510(k) for Model 7495 Extension Kit Medtronic Neurological January 11, 1999

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