K091240 · Alphamed, Inc. · HOZ · Oct 23, 2009 · Ophthalmic
Device Facts
Record ID
K091240
Device Name
ALPHAMED SURGICAL SPEAR, MODEL 70-5000
Applicant
Alphamed, Inc.
Product Code
HOZ · Ophthalmic
Decision Date
Oct 23, 2009
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 886.4790
Device Class
Class 2
Intended Use
AlphaMed Surgical Spears are intended to absorb fluids from the operative field during ophthalmic surgery
Device Story
AlphaMed Surgical Spear is a sterile, single-use ophthalmic sponge used during surgery. Device absorbs excess fluids from the operative field to maintain visibility and surgical site management. Operated by surgeons or surgical staff in an operating room setting. Device functions as a passive absorbent material; no active components, electronics, or software.
Clinical Evidence
Bench testing only.
Technological Characteristics
Absorbent sponge material; sterile; single-use; manual operation; no energy source; no software.
Indications for Use
Indicated for use in ophthalmic surgery to absorb fluids from the operative field. No specific patient population or contraindications provided.
Regulatory Classification
Identification
An ophthalmic sponge is a device that is an absorbant sponge, pad, or spear made of folded gauze, cotton, cellulose, or other material intended to absorb fluids from the operative field in ophthalmic surgery.
Special Controls
*Classification.* Class II (special controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 886.9.
Related Devices
K972693 — DEROYAL INDUSTRIES, INC. SURGICAL EYE SPEAR · Deroyal Industries, Inc. · Sep 30, 1997
K132796 — SUNTOUCH EYE SPEAR · Huizhou Foryou Medical Devices Co., Ltd. · Oct 30, 2013
K130117 — NETWORK EYE SPEARS, POINTS, DRAINS, WICKS AND SHIELDS · Network Medical Products, Ltd. · Oct 29, 2013
Submission Summary (Full Text)
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Food and Drug Administration 10903 New Hampshire Avenue Document Mail Center - WO66-G609 Silver Spring, MD 20993-0002
AlphaMed, Inc. c/o Mr. James M. Gubachy Vice President 3912 Mountain Avenue El Paso, TX 79930
OCT 2 8 2009
Re: K091240
Trade Name: AlphaMed™ Surgical Spear Regulation Number: 21 CFR 886.4790 Regulation Name: Ophthalmic Sponge Regulation Class: Class II Product Code: HOZ Dated: October 5, 2009 Received: October 7, 2009
Dear Mr. Gubachy:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and 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) that do not require approval of a premarket approval application (PMA). 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 (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
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Page 2 - Mr. James M. Gubachy
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/cdrl/mdr/ for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.
You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.
Sincerely yours,
Malvina B. Eydelman, M.D.
Malvina B. Eydelman, I Director Division of Ophthalmic, Neurological and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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## Indications for Use
510(k) Number (if known): K091240
Device Name: AlphaMed™ Surgical Spear, Model 70-5000
Indications For Use:
AlphaMed Surgical Spears are intended to absorb fluids from the operative field during ophthalmic surgery
Prescription Use × (Part 21 CFR 801 Subpart D) AND/OR
Over-The-Counter Use (21 CFR 801 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Paul Vanderhyde
Division Sign-Off
Division of Ophthalmic, Neurologica Nose and Throat Devices
Page 1 of 1
510(k) Number K091240
Panel 1
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