K Number
K990375
Device Name
DISPOSABLE MONOPOLAR NEEDLE ELECTRODE, DMF 25; DMN 25; DMF 37; DMN 37; DMN 50; DMN 75
Date Cleared
1999-03-09

(29 days)

Product Code
Regulation Number
890.1385
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Disposable Monopolar Needles Electrodes are used for recording unit potentials in skeletal muscles, spontaneous activity, interference patterns and conduction velocity studies. This process is known as electromyography (EMG).
Device Description
The disposable monopolar needle electrode is designed for single use only. The stainless steel needle electrode is insulated with a special PTFE coating to ensure minimal friction between the needle and the tissue. The tip of the conically sharpened needle is uninsulated and serves as recording area. The sterile electrode is individually sealed and delivered in sets of 48 pcs. In a hygienic and practical package ready for use package. The electrodes consists of a PTFE coated needle with an exposed area in the tip. The PTFE coating eases insertion into tissue and isolates the needle electrical. There are two diameters of the needles. In the non-invasive end of the device there is attached a connector, which enables the electrical signal to be transferred to the cable.
More Information

No
The description focuses on the physical characteristics and intended use of a disposable needle electrode for EMG, with no mention of AI or ML for signal processing or analysis.

No.
The device is used for recording electrical signals from skeletal muscles for diagnostic purposes (electromyography), not for treating a condition.

Yes
The device is used for electromyography (EMG), which is a diagnostic procedure used to assess the health of muscles and the nerve cells that control them.

No

The device description clearly details a physical, disposable needle electrode made of stainless steel with a PTFE coating and a connector. This is a hardware device, not software.

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

Here's why:

  • Intended Use: The intended use is for recording electrical activity in skeletal muscles (electromyography). This is a physiological measurement taken directly from the body, not a test performed on a sample of biological material in vitro (outside the body).
  • Device Description: The device is a needle electrode designed to be inserted into tissue to record electrical signals. This aligns with an in vivo (within the body) diagnostic procedure.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.) or performing tests on these samples outside of the body.

IVD devices are specifically designed to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device does not fit that description.

N/A

Intended Use / Indications for Use

The Disposable Monopolar Needles Electrodes are used for recording unit potentials in skeletal muscles, spontaneous activity, interference patterns and conduction velocity studies. This process is known as electromyography (EMG).

Product codes

IKT

Device Description

The disposable monopolar needle electrode is designed for single use only. The stainless steel needle electrode is insulated with a special PTFE coating to ensure minimal friction between the needle and the tissue. The tip of the conically sharpened needle is uninsulated and serves as recording area. The sterile electrode is individually sealed and delivered in sets of 48 pcs. In a hygienic and practical package ready for use package.

The electrodes consists of a PTFE coated needle with an exposed area in the tip. The PTFE coating eases insertion into tissue and isolates the needle electrical. There are two diameters of the needles. In the non-invasive end of the device there is attached a connector, which enables the electrical signal to be transferred to the cable.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

skeletal muscles

Indicated Patient Age Range

Pediatric to Adults

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)

K915741

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 890.1385 Diagnostic electromyograph needle electrode.

(a)
Identification. A diagnostic electromyograph needle electrode is a monopolar or bipolar needle intended to be inserted into muscle or nerve tissue to sense bioelectrical signals. The device is intended for medical purposes for use in connection with electromyography (recording the intrinsic electrical properties of skeletal muscle).(b)
Classification. Class II (performance standards).

0

K990375

510(k) SUMMARY

as required per 807.92(c)

1. Submitters Name, Address:

Medtronic Functional Diagnostics A/S Tonsbakken 16-18 DK - 2740 SKOVLUNDE DENMARK

Tel: (45 ) 44 57 95 02 Fax: (45) 44 57 90 10 Contact person for this submission: Ann-Christine Jönsson Date submission was prepared: 5th February, 1999

2. Trade Name, Common Name and Classification Name:

13 S Series Disposable Monopolar Needle Electrodes A. Trade Name:

B. Classification Name: Needle Electrode

C. Common name, Class and Regulation Number:

Common NameMedtronic CodeClassRegulation Number
Disposable Monopolar Needle Electrode, DMF259013S0611II21 CFR 882.1350
Disposable Monopolar Needle Electrode, DMN259013S0621II21 CFR 882.1350
Disposable Monopolar Needle Electrode, DMF379013S0631II21 CFR 882.1350
Disposable Monopolar Needle Electrode, DMN379013S0641II21 CFR 882.1350
Disposable Monopolar Needle Electrode, DMN509013S0651II21 CFR 882.1350
Disposable Monopolar Needle Electrode, DMN759013S0661II21 CFR 882.1350

3. Predicate Device Identification:

The new 13 S Series Disposable Monopolar Needle electrodes are substantially equivalent to previously marketed 13 R Series Disposable Monopolar Needles electrodes, which were previously determined by FDA to be substantially equivalent the 8th of December, 1992, K915741.

1(4)

COMPANY CONFIDENTIAL

Medtronic Functional Diagnostics A/S

Tonsbakken 16-18 DK-2740 SKOVLUNDE DENMARK

1

4. Device Description:

The disposable monopolar needle electrode is designed for single use only. The stainless steel needle electrode is insulated with a special PTFE coating to ensure minimal friction between the needle and the tissue. The tip of the conically sharpened needle is uninsulated and serves as recording area. The sterile electrode is individually sealed and delivered in sets of 48 pcs. In a hygienic and practical package ready for use package.

The electrodes consists of a PTFE coated needle with an exposed area in the tip. The PTFE coating eases insertion into tissue and isolates the needle electrical. There are two diameters of the needles. In the non-invasive end of the device there is attached a connector, which enables the electrical signal to be transferred to the cable.

5. Intended Use:

The Disposable Monopolar Needles Electrodes are used for recording unit potentials in skeletal muscles, spontaneous activity, interference patterns and conduction velocity studies. This process is known as electromyography (EMG).

6. Table of Device Similarities and differences to predicate device:

| Manufacturer | Dantec Medical A/S | Medtronic Functional
Diagnostics A/S | Comments to
differences |
|---------------|---------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------|----------------------------|
| 510(k) number | Predicate devices
13 R Series Disposable
Monopolar Electrodes
and
13P82 Disposable Electrode
Cable

  • K 915741 | Modified Device
    13 S Series Disposable
    Monopolar Electrode
  • K number to be decided
  • K 990375 | - |

| Intended Use /
Indication of Use | Records unit potentials in
skeletal muscles, spontaneous
activity, interference patterns
and conduction velocity studies. | Same | -- |
|-------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------|---------------|------------------------------------------------------------------------------------------------------|
| Intended
Populations | Pediatric to Adults | Same | -- |
| Sterilization | Gamma irradiation (originally)
but it was changed to Ethylene
Oxid via our change control
system and this was filed
internally. | Ethylene Oxid | Today it is the same, a
verification report of
the sterilization is
enclosed under flap PQ. |

2(4)

COMPANY CONFIDENTIAL

Medtronic Functional Diagnostics A/S

Tonsbakken 16-18 DK-2740 SKOVLUNDE DENMARK

2

Special 510(k) Notification 13 S Series of Disposable Monopolar Needle

SAL level10-6Same--
Packaging48 pieces individually blister
packed electrodes in each box.Same--
UsesSingle UseSame--
Offered Sizes0.35 x 20 mm
0.35 x 30 mm
0.45 x 30 mm
0.45 x 40 mm
0.45 x 50 mm
0.45 x 60 mm
0.45 x 80 mm0.35 x 25 mm
0.45 x 25 mm
0.35 x 37 mm
0.45 x 37 mm
0.45 x 50 mm
0.45 x 75 mmEnhanced assortiment
Shelf-life
(Expiring date)4 yearsSame--
Electrode cable13P82 Disposable Electrode
Cable9013C0031 shielded 1m with
DIN plug
9013C0041 unshielded 80cm
with 1,5mm connector.Class I device, the
cable is adjusted to fit
the 13 S series needles.
Materials –
Needle shaftStainless Steel ASTM 304Same--
Materials –
Needle head
(hub)Polyethylen needle headSame material, but the hub has
been enlarged.Enhanced ergonomic
design on grip
Materials –
coatingTeflon coated with Dupont
850.314 Teflon 2 Prog. Primer
Green and finished with Dupont
851-214 Teflon Topcoat Green.Wthitford PTFE coat, Xylan
8400/3349Easier to use and
improves work
environment when
producing the needles.
Protection tubeMounted on needle head,
polyethylene, medical gradeSame--
ConnectionSnap mounted in needle head.
Needle and connections are
crimped together. BrassSame--
Connector2 mm0.7 mmEnhanced changeability
Exposed length0.8 mmSame--
Mechanical pull
strength20 NSame--
Recording area0.3 mm sqSame--
Tip Exposure
processThe needle point was left
uninsulatedTip exposure process removes
the coat via an abrasive mediaEnhanced tip
performance

Medtronic Functional Diagnostics has reviewed its own files and is unaware of any safety or efficacy concerns that have resulted from the use of the predicate device 13 R Series of Disposable Monopolar Needle Electrode.

The changes in the new device doesn't effect any safety or efficacy concerns.

7. Assessment of non-clinical performance data for equivalence:

Verifications results shows that the enhanced device performs as its predicate device.

3(4) COMPANY CONFIDENTIAL

Medtronic Functional Diagnostics A/S Tonsbakken 16-18 DK-2740 SKOVLUNDE DENMARK

3

8. Assessment of clinical performance data for equivalence:

Clinical evaluation not performed.

9. Biocompatability:

The following biocompatibility tests have been performed on the Whitford PTFE coat, Xylan 8400/3349:

  • In Vitro Cytotoxicity Test (USP 23/ISO 10993-5 Elution Test) -
  • Intracutaneous Test performed according to the method described in International Standard -ISO 10993-10:1995
  • Test for Delayed Contact Hypersensitivity using the Guinea Pig Maximization Test -

The results of these tests shows that the material Whitford PTFE coat, xylan 8400/3349 have passed all tests.

10. Sterilization:

The needles are sterilized with ETO at a vendor sterilization plant, Maersk Medical A/S.

It is concluded that the process consistently with predetermined specifications. The specified requirements for sterility (EN 556) are met.

11. Standards and Guidances:

All the performed biocompatibility tests have been performed according to the following standards:

  • EN45001 -
  • ISO 10993-1 Biological evaluation of medical devices part 1: Guidance on selection of tests.
  • ISO 10993-10:1995 Biological evaluation of medical devices -
  • USP 23 / ISO 10 993 -5 -

The needle itself have been developed according to

  • EN 46001 -- Quality systems- Medical devices- Particular requirements for the application of -EN ISO 9001.
  • . . ISO/DIS 14971-1 - Medical Devices - Risk Management

This 510(k) content follow the Guidance document for the preparation of premarket notification 510(k), application for electromyograph needle electrodes.

4(4)

COMPANY CONFIDENTIAL

Medtronic Functional Diagnostics A/S Tonsbakken 16-18 DK-2740 SKOVLUNDE DENMARK

4

Image /page/4/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" arranged around the perimeter. Inside the circle is a stylized representation of a human figure, with three wavy lines forming the body and head.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR - 9 1999

Ms. Anne-Christine Jönsson Regulatory Affairs Specialist Medtronic Functional Diagnostics A/S Tonsbakken 16-18 DK-2740 Skovlunde Denmark

Re: K990375

Trade Name: 13 S Series Disposable Monopolar Needle Electrodes Regulatory Class: II Product Code: IKT Dated: February 5, 1999 Received: February 8, 1999

Dear Ms. Jönsson:

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 (OS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (OS) 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.

5

Page 2 - Ms. Ann-Christine Jönsson

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,

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

6

Special 510(k) Notification 13 Sx series of Disposable Monopolar Needle

Indication for Use Statement

Page_1_of_1__

510(k) Number (if known): K 990375

Device Name: 13 S Series Disposable Monopolar Needles Electrodes

Indications for Use:

The Disposable Monopolar Needles Electrodes are used for recording unit potentials in skeletal muscles, spontaneous activity, interference patterns and conduction velocity studies.

MRI Compatibility Statement:

Device is not claimed for use in MRI magnetic field.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)
------------------------------------------------------------
Prescription Use_ XOROver-The-Counter Use_
(Per 21 CFR 801.109)(Optional Format 1-2-96)

(Division Sign-Off)

Division of General Restorative Devices

510(k) Number 1499035

COMPANY CONFIDENTIAL

Medtronic Functional Diagnostics A/S

Tonsbakken 16-18 DK-2740 SKOVLUNDE DENMARK