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510(k) Data Aggregation

    K Number
    K150291
    Date Cleared
    2015-03-27

    (49 days)

    Product Code
    Regulation Number
    878.3300
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    MEDTRONIC TYRX, INC.

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    TYRX Neuro Absorbable Antibacterial Envelope is intended to hold a vagus nerve stimulator, a spinal cord neuromodulator, a deep brain stimulator or a sacral nerve stimulator securely in order to create a stable environment when implanted in the body.

    TYRX Neuro Absorbable Antibacterial Envelope contains the antimicrobial agents rifampin and minocycline which have been shown to reduce infection in an in vivo model of bacterial challenge following surgical implantation of a pulse generator. This device is intended to be used in conjunction with vagus nerve stimulators implanted in the infraclavicular fossa, or in conjunction with spinal cord neuromodulators or sacral nerve stimulators implanted laterally to the body midline and slightly superior to the gluteal region.

    TYRX Neuro Absorbable Antiqacterial Envelope is intended for single patient, one-time use only.

    Device Description

    TYRX 110 Neuro Absorbable Antibacterial Envelope is a fully absorbable, dual component sterile device designed to hold a vagus nerve stimulator (VNS), a deep brain stimulator (DBS), a spinal cord neuromodulator (SCN) or a sacral nerve stimulator (SNS) securely to create a stable environment when implanted in the body. It is constructed of knitted filaments of a commercially available absorbable polymer, Glycoprene II, comprised of glycolide, caprolactone and trimethylene carbonate polymer, and coated with an absorbable polyarylate polymer mixture containing the antimicrobial agents rifampin and minocycline. Rifampin and minocvcline have been shown to reduce infection in an in vivo model of bacterial challenge following surgical implantation of an implantable electronic device. This device is to be used in a healthcare facility/hospital by qualified personnel experienced in the procedure of VNS, DBS, SCN, or SNS implantation.

    AI/ML Overview

    This document is a 510(k) summary for the TYRX Neuro Absorbable Antibacterial Envelope. It describes the device and its indications for use, and argues for its substantial equivalence to a predicate device (K142611).

    Here's an analysis of the provided text in relation to acceptance criteria and supporting studies, based on the specific questions:

    1. A table of acceptance criteria and the reported device performance

    The document does not explicitly present a table of acceptance criteria with corresponding performance metrics. Instead, it describes various studies and results to demonstrate safety and effectiveness for its expanded indications for use. The overall acceptance criterion is demonstrating substantial equivalence to the predicate device.

    Here's a summary of the performance claims based on the provided text, linked to the implicit acceptance criteria for establishing substantial equivalence:

    Acceptance Criterion (Implicit)Reported Device Performance
    Technological Characteristics Identical to PredicateThe technological characteristics of the TYRX™ Neuro Absorbable Antibacterial Envelope are identical to the predicate (TYRX™ Neuro Absorbable Antibacterial Envelope K142611). Both devices have the same intended use: to create a stable environment for the implanted device. The device is fully absorbable with the same Glycoprene II substrate mesh and coated with the same polyarylate polymer containing rifampin and minocycline at 102ug/cm². Manufacturing processes are also identical.
    Expanded Indications for Use SafetyThe animal study demonstrated that the device was safe, with no adverse clinical signs. Minocycline and rifampin in plasma and cerebrospinal fluid were not detectable, indicating no significant risk for CNS side effects from drug diffusion.
    BiocompatibilityThe device is supplied sterile, biocompatible, and non-pyrogenic. Biocompatibility testing of the predicate device (K142611) in accordance with ISO 10993 demonstrated the safety of the subject device.
    Antimicrobial Activity (In vitro)Referenced from predicate K142611: Demonstrated antimicrobial activity against Methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus aureus, Acinetobacter baumannii, Staphylococcus epidermidis, Staphylococcus lugdunensis, and Escherichia coli.
    Infection Reduction (In vivo)Referenced from predicate K142611: Demonstrated effectiveness in reducing infections. Bacteria tested: Staphylococcus aureus, Acinetobacter baumannii, Staphylococcus epidermidis, Escherichia coli, Methicillin-resistant Staphylococcus aureus (MRSA), and Staphylococcus lugdunensis. The activity of antimicrobials against non-epidermidis strains of coagulase-negative Staphylococci is noted as variable.
    SterilityTYRX follows the ISO 11137 standard for sterility.

    2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

    • Animal Study (for expanded indications):

      • Sample Size: 8 sheep (2 sheep per treatment group across 4 treatment groups).
      • Data Provenance: Not explicitly stated, but animal studies are typically prospective. No country of origin is mentioned.
    • In vitro and In vivo efficacy testing (referenced from predicate K142611):

      • Sample Size: Not specified in this document, as these studies belong to the predicate device.
      • Data Provenance: Not specified.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

    This device is a physical medical device (an absorbable antibacterial envelope), not an AI/imaging device requiring expert interpretation for ground truth establishment in the traditional sense. The "ground truth" here relates to objective measures like drug concentrations (in the animal study), microbial inhibition (in vitro), and infection rates (in vivo), or material properties. Therefore, there are no explicitly mentioned "experts" establishing ground truth in the way described for diagnostic AI.

    4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

    Not applicable. As this is not an AI/imaging device with human reader evaluations, there is no adjudication method for a test set of interpretations.

    5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

    Not applicable. This is not a diagnostic AI device, so no MRMC study involving human readers and AI assistance was conducted or described.

    6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

    Not applicable. This is not an algorithm or software device. The product is a physical medical device.

    7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

    • Animal Study: Ground truth was based on objective measurements:
      • Absence of adverse clinical signs (clinical observation).
      • Quantifiable concentrations of minocycline and rifampin in plasma and cerebrospinal fluid samples (laboratory analysis).
    • In vitro studies (referenced from predicate K142611): Ground truth would be based on laboratory methods for demonstrating antimicrobial activity (e.g., zones of inhibition, minimum inhibitory concentrations).
    • In vivo studies (referenced from predicate K142611): Ground truth would be based on outcomes data related to infection rates/reduction in animal models.

    8. The sample size for the training set

    Not applicable. This device is not an AI/machine learning model, so there is no training set in the context of AI development. The studies performed are for device safety and efficacy, not for training a model.

    9. How the ground truth for the training set was established

    Not applicable, as there is no training set.

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    K Number
    K142611
    Date Cleared
    2014-12-31

    (106 days)

    Product Code
    Regulation Number
    878.3300
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    MEDTRONIC TYRX, INC.

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    TYRX™ Neuro Absorbable Antibacterial Envelope is intended to hold a vagus nerve stimulator or spinal cord neuromodulator securely in order to create a stable environment when implanted in the body.

    TYRX™ Neuro Absorbable Antibacterial Envelope contains the antimicrobial agents rifampin and minocycline which have been shown to reduce infection in an in vivo model of bacterial challenge following surgical implantation of a pulse generator. This device is intended to be used in conjunction with vagus nerve stimulators implanted in the infraclavicular fossa, or spinal cord neuromodulators implanted laterally to the body midline and slightly superior to the gluteal region.

    TYRX™ Neuro Absorbable Antibacterial Envelope is intended for single patient, one-time use only.

    Device Description

    TYRX ™ Neuro Absorbable Antibacterial Envelope is a fully absorbable , dual component sterile device designed to hold a vagus nerve stimulator or spinal cord neuromodulator securely to create a stable environment when implanted in the body. It is constructed of knitted filaments of a commercially available absorbable polymer, Glycoprene II, comprised of glycolide, caprolactone and trimethylene carbonate polymer, and coated with an absorbable polyarylate polymer mixture containing the antimicrobial agents rifampin and minocycline. Rifampin and minocycline have been shown to reduce infection in an in vivo model of bacterial challenge following surgical implantation of an implantable electronic device is to be used in a healthcare facility/hospital by personnel experienced in the procedure of vagus nerve or spinal cord neuromodulator implantation.

    AI/ML Overview

    This document describes a 510(k) premarket notification for the TYRX™ Neuro Absorbable Antibacterial Envelope. It focuses on demonstrating substantial equivalence to predicate devices rather than proving the device meets new acceptance criteria through a dedicated study with specific performance metrics.

    Therefore, many of the requested elements for a study proving acceptance criteria cannot be extracted directly from this document. The document primarily details comparative information with predicate devices and safety testing.

    Here's an analysis of the provided information based on your questions:

    1. Table of Acceptance Criteria and Reported Device Performance

    This document does not present a table of specific acceptance criteria (e.g., a certain percentage reduction in infection rate, a specific tensile strength at a given time point) that the new device was tested against in its own clinical study. Instead, it relies on demonstrating equivalence to predicate devices, which were previously cleared.

    However, it does mention results from in vitro and in vivo studies that support the predicate devices' antimicrobial activity, which is a key performance aspect.

    Performance CharacteristicAcceptance Criteria (Implied from Predicate)Reported Device Performance (Inherited/Demonstrated through Equivalence)
    Antimicrobial ActivityEffective against common bacteria (MRSA, S. aureus, A. baumannii, S. epidermidis, S. lugdunensis, E. coli)Demonstrated by predicate devices (K132699 and K130943). The subject device uses the identical antimicrobial coating at the same concentrations.
    BiocompatibilityBiocompatible, non-pyrogenic"Supplied sterile, biocompatible, and non-pyrogenic." Demonstrated for predicate devices (ISO 10993).
    SterilitySterile"TYRX follows the ISO 11137 standard for sterility."
    DegradationGlycoprene II mesh degrades into constituent monomers"Bench testing demonstrated that the Glycoprene II mesh degrades into its constituent monomers."
    No Chemical InteractionNo chemical or physical interaction between components"Bench testing demonstrated... there is no chemical or physical interaction between the Glycoprene mesh, the polyarylate coating or the antibiotics."
    Stable EnvironmentAbility to hold a neuromodulator securely and create a stable environmentIntended Use is identical to the predicate device, implying similar mechanical stability for holding the device.

    2. Sample Size Used for the Test Set and Data Provenance

    • Test Set Sample Size: Not explicitly stated for any new clinical test set for the subject device. The document refers to "in vitro studies" and "in vivo efficacy testing" performed on the predicate devices. The sample sizes for these predicate studies are not provided in this document.
    • Data Provenance: The "in vivo efficacy testing" was "previously submitted with the primary predicate, K132699" and "previously submitted with predicate K130943." This implies the data is likely retrospective relative to this 510(k) submission, as it comes from prior submissions. The country of origin is not specified, but given the FDA submission, it would adhere to US regulatory standards.

    3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

    This information is not provided. The document highlights laboratory (in vitro), animal (in vivo), and bench testing, not studies requiring human expert adjudication of clinical outcomes in the same way a diagnostic imaging device might.

    4. Adjudication Method for the Test Set

    Not applicable for the types of tests described (in vitro, in vivo efficacy in animals, bench testing).

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, If So, What Was the Effect Size of How Much Human Readers Improve with AI vs Without AI Assistance

    Not applicable. This device is a medical implant (envelope for neuromodulators) containing antibiotics, not an AI-powered diagnostic or assistive tool for human readers.

    6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

    Not applicable, as this is not an algorithm. However, the in vitro and in vivo animal efficacy studies can be considered standalone performance assessments of the antimicrobial properties and safety profile.

    7. The Type of Ground Truth Used (Expert Consensus, Pathology, Outcomes Data, etc.)

    • For antimicrobial activity (in vitro): Direct observation of bacterial inhibition/killing.
    • For in vivo efficacy (animal studies): Likely based on direct measurement of infection rates or bacterial counts at the surgical site in animal models, comparing treated groups to control groups. This would be considered "outcomes data" in an animal model.
    • For biocompatibility: Standardized toxicological and immunological endpoints as per ISO 10993.
    • For degradation and interaction: Bench testing and chemical analysis.

    8. The Sample Size for the Training Set

    Not applicable. This device does not involve machine learning or AI that requires a "training set."

    9. How the Ground Truth for the Training Set Was Established

    Not applicable. This device does not involve machine learning or AI that requires a "training set."

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