K Number
K994262
Device Name
FRONTAL SINUS TREPHINATION CANNULA
Manufacturer
Date Cleared
2000-02-08

(53 days)

Product Code
Regulation Number
878.4800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Frontal Sinus Trephination Cannula is indicated for patients with sinus disease that require frontal sinus irrigation or repeated frontal sinus irrigation for up to thirty days.
Device Description
The device consists of a cannula and an occlusion plug.
More Information

No
The summary describes a simple mechanical device (cannula and occlusion plug) for irrigation and does not mention any computational or analytical capabilities, image processing, or terms related to AI/ML.

No.
The device is used for irrigation of the frontal sinus and is not described as providing treatment for a disease.

No
The device is described as a "Frontal Sinus Trephination Cannula" used for irrigation of the frontal sinus. Its function is to facilitate fluid delivery or drainage, not to diagnose a condition.

No

The device description explicitly states it consists of a cannula and an occlusion plug, which are physical hardware components.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used to provide information for diagnosis, monitoring, or screening.
  • Device Function: The Frontal Sinus Trephination Cannula is a surgical instrument used to access and irrigate the frontal sinus. It is used in vivo (within the body) for a therapeutic or diagnostic procedure, not for testing samples in vitro.
  • Intended Use: The intended use clearly states it's for "frontal sinus irrigation or repeated frontal sinus irrigation." This is a direct intervention on the patient's body.

The information provided describes a medical device used for a surgical procedure, not a diagnostic test performed on a sample outside the body.

N/A

Intended Use / Indications for Use

The Frontal Sinus Trephination Cannula is indicated for patients with sinus disease that require frontal sinus irrigation or repeated frontal sinus irrigation for up to thirty days.

Product codes

77KBF, 79GBX, 77KAM

Device Description

The device consists of a cannula and an occlusion plug.

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)

Medtronic Xomed Frontal Sinus Mini-Trephine Set irrigation cannula, K925176, Catheter Plug marketed by Bard Medical.

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4800 Manual surgical instrument for general use.

(a)
Identification. A manual surgical instrument for general use is a nonpowered, hand-held, or hand manipulated device, either reusable or disposable, intended to be used in various general surgical procedures. The device includes the applicator, clip applier, biopsy brush, manual dermabrasion brush, scrub brush, cannula, ligature carrier, chisel, clamp, contractor, curette, cutter, dissector, elevator, skin graft expander, file, forceps, gouge, instrument guide, needle guide, hammer, hemostat, amputation hook, ligature passing and knot-tying instrument, knife, mallet, disposable or reusable aspiration and injection needle, disposable or reusable suturing needle, osteotome, pliers, rasp, retainer, retractor, saw, scalpel blade, scalpel handle, one-piece scalpel, snare, spatula, stapler, disposable or reusable stripper, stylet, suturing apparatus for the stomach and intestine, measuring tape, and calipers. A surgical instrument that has specialized uses in a specific medical specialty is classified in separate regulations in parts 868 through 892 of this chapter.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 878.9.

0

510(k) Summary

1.0 Date Prepared

December 16, 1999

2.0 Submitter (Contact) Martin D. Sargent Medtronic Xomed, Inc Jacksonville, FL

(904) 279-7586

3.0 Device Name

Proprietary Name:Frontal Sinus Trephination Cannula
Common Name(s):Irrigation Cannula
Classification Name(s):Introduction/Drainage Catheter and Accessories

5.0 Device Classification

Sinus Trephine, Sinus Irrigation:
Procode 77KBFClass I21 CFR 874.4420
Irrigation Cannula:
Procode 79GBXClass I21 CFR 878.4200

6.0 Device Description

The device consists of a cannula and an occlusion plug.

7.0 Intended Use

The Frontal Sinus Trephination Cannula is indicated for patients with sinus disease that require frontal sinus irrigation or repeated for patients with sinus disease the

1

K994262

Substantial Equivalence 8.0

The Frontal Sinus Irrigation Cannula is substantially equivalent to the Medtronic Xomed Frontal Sinus Mini-Trephine Set irrigation cannula.

The short-term indwelling aspect of the device is substantially equivalent in intended use to introduction/drainage catheters as defined in 21 CFR 878.4200 which provide shortterm access to body cavities. Predicates include common peritoneal catheters and chest drainage tubes including the Vansonnenberg Chest Drainage Tubes as described in K925176.

The occlusion plug provided to close the cannula lumen between irrigation procedures is substantially equivalent in design and intended use to the Catheter Plug marketed by Bard Medical.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Image /page/2/Picture/2 description: The image shows the seal of the Department of Health & Human Services (HHS). The seal is circular and features the department's name around the perimeter. In the center of the seal is a stylized image of an eagle with its wings spread, symbolizing protection and service. The eagle is depicted in a simple, modern design with clean lines.

8 2000 FEB

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Martin D. Sargent Senior Regulatory Affairs Specialist Xomed, Inc. 6743 Southpoint Drive, North Jacksonville, FL 32216

Re: K994262

Trade Name: Frontal Sinus Trephination Cannula Regulatory Class: Unclassified Product Code: 77KAM Dated: December 16, 1999 Received: December 17, 1999

Dear Mr. Sargent:

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 legally marketed predicate 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 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, 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.

3

Page 2 - Martin D. Sargent

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, pormits 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) 594-4613. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594639. Also, please note the regulation entitled, "Misbranding by reference to premarket notificion" (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,

A. Ralph Rosenthal

A. Ralph Rosenthal, M.D. Director Division of Ophthalmic Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

510(k) Number (if known): Device Name: __ Frontal Sinus Trephination Cannula Indications for Use:

The Frontal Sinus Trephination Cannula is indicated for patients with sinus disease that require frontal sinus irrigation or repeated frontal sinus irrigation for up to thirty days.

(Please do not write below this line - continue on another page if needed) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use ← (Per 21 CFR 801.109)

Г

Or

Over-the-Counter Use _

Karen S. Bahr
(D:

(Optional Format 1-2-96)

510(k) Number K994462