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510(k) Data Aggregation

    K Number
    K203840
    Date Cleared
    2021-01-28

    (28 days)

    Product Code
    Regulation Number
    870.1250
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Marblehead Medical LLC

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

    The BOSS™ 8F Balloon Guide Catheter is indicated for use in facilitating the insertion and guidance of an intravascular catheter into a selected blood vessel in the peripheral and neurovascular systems. The balloon provides temporary vascular occlusion during these procedures. The balloon guide catheter is also indicated for use as a conduit for retrieval devices.

    Device Description

    The BOSS 8F Balloon Guide Catheter system is a sterile, single-use intravascular catheter. The BOSS 8F Balloon Guide Catheter is an 85 and 95 cm long, variable stiffness catheter utilizing a bifurcated dual port luer hub on the proximal end and a radiopaque marker band at the tip distal to the balloon. The catheter shaft has an annular inflation lumen and a coaxial central lumen with stainless steel coil and is braid reinforced. The hub central port leads to the central lumen to facilitate introduction of interventional devices through the central lumen. The inflation port is positioned at an angle to the central port, connecting to the annular inflation lumen, and is used to facilitate inflating and deflating the balloon with a syringe. The BOSS 8F Balloon Guide Catheter uses a distal hydrophilic coating to provide lubricity and reduce friction between the catheter shaft and the vessel wall. The BOSS 8F Balloon Guide Catheter is packaged with the 6F dilator to facilitate the option of direct access into the blood vessel without the use of an introducer sheath.

    AI/ML Overview

    This document describes the non-clinical performance testing for the BOSS 8F Balloon Guide Catheter, a medical device. There is no information regarding a study of an AI device. As such, I cannot provide details on factors like sample size, ground truth, expert qualifications, or comparative effectiveness studies related to AI.

    However, I can provide the acceptance criteria and reported device performance based on the non-clinical bench testing for the BOSS 8F Balloon Guide Catheter.

    1. Table of Acceptance Criteria and Reported Device Performance

    The device performance is uniformly reported as "Pass" for all tests, indicating that "All samples met the pre-determined acceptance criteria" or similar outcomes for biocompatibility (e.g., "Noncytotoxic," "Non-hemolytic"). The reference standards listed for each test effectively serve as the basis for the acceptance criteria.

    Study NameDescriptionReference Standard (Basis for Acceptance Criteria)Reported Device Performance
    Performance Bench Testing Summary
    Visual Inspection and Dimensional VerificationTo demonstrate that the product meets the dimensional specificationsISO 10555-1:2013Pass (All samples met the pre-determined acceptance criteria)
    Surface InspectionTo demonstrate the product satisfies the visual surface requirementsISO 10555-1:2013Pass (All samples met the pre-determined acceptance criteria)
    Torque TestingTo demonstrate that the product is capable of 360 degrees of rotation about the central lumen axis without failure.FDA guidance PTCA Catheters:2010 §VIII.A.10Pass (All samples met the pre-determined acceptance criteria)
    TensileTo demonstrate the product satisfies the tensile strength requirements for bonds and tip pull testISO 10555-1:2013, FDA guidance PTCA Catheters:2010 §VIII.A.7, 8Pass (All samples met the pre-determined acceptance criteria)
    Kink ResistanceTo demonstrate that the product has acceptable kink resistanceFDA Guidance PTCA:2010 §VIII.A.9 Kink TestPass (All samples met the pre-determined acceptance criteria)
    Catheter LubricityPad friction test to compare coated to uncoated samplesCharacterization onlyPass (Results show a 97% reduction in friction compared to uncoated samples)
    Particulates, Coating IntegrityThis study was conducted to determine the quantity and size of particles generated during simulated useAAMI TIR42:10, USPPass (All samples met the pre-determined acceptance criteria)
    RadiopacityTo determine the radiopaque characteristics of the device.ISO 10555-1:2013Pass (All samples met the pre-determined acceptance criteria)
    Push/Track, Simulated Use, Device CompatibilityTo demonstrate that the device is deliverable through tortuous path model without kinking or buckling, is able inflate, deflate balloon at target, is compatible with treatment devices and removed without damage.ISO 10555-1:2013Pass (All samples met the pre-determined acceptance criteria)
    System Leak - Liquid LeakTo demonstrate that the product meets the liquid leakage under pressure requirementsISO 10555-1:2013Pass (All samples met the pre-determined acceptance criteria)
    System Leak - AspirationTo demonstrate that the product meets the hub aspiration air leakage requirementsISO 10555-1:2013Pass (All samples met the pre-determined acceptance criteria)
    Tip StiffnessTo demonstrate that the stiffness of the distal end of the product is similar to other marketed devices.N/APass (All samples met the pre-determined acceptance criteria)
    Corrosion ResistanceTo demonstrate the product satisfies the corrosion resistance requirementsISO 10555-1:2013Pass (All samples met the pre-determined acceptance criteria)
    Catheter Burst Pressure Under Static ConditionsTo demonstrate the catheter does not leak or rupture up to rated internal pressure.ISO 10555-1:2013Pass (All samples met the pre-determined acceptance criteria)
    Balloon Inflation / DeflationTo demonstrate balloon meets the inflation and deflation time specificationsISO 10555-4:2013Pass (All samples met the pre-determined acceptance criteria)
    Balloon FatigueTo demonstrate that there is no degradation of the balloon after 10 inflation cycles.ISO 10555-4:2013Pass (All samples met the pre-determined acceptance criteria)
    Balloon Diameter / VolumeTo demonstrate that the product meets the inflation volume vs balloon diameter specificationsISO 10555-4:2013Pass (All samples met the pre-determined acceptance criteria)
    Balloon Rated Burst VolumeTo demonstrate that the balloon is capable of withstanding an injection volume to the rated burst volumeISO 10555-4:2013Pass (All samples met the pre-determined acceptance criteria)
    Small Bore Connector Compliance with StandardTo demonstrate that the product meets the requirements for small bore connectorsISO 80369-7: 2016Pass (All samples met the pre-determined acceptance criteria)
    Usability Study / Simulated UseEvaluation of device performance to meet the user needs under simulated use conditions with accessories and treatment devicesFDA Guidance Human Factors and Usability Engineering 2016, IEC 62366:2015Pass (All samples met the pre-determined acceptance criteria)
    Conditioning, Distribution, and Shelf-life AgingTo demonstrate the device met all specifications at both baseline (T=0) and following accelerated aging to a 6-month shelf life equivalent (T=6)Evaluation of device following accelerated aging to a 6-month shelf life equivalentPass (All samples met the pre-determined acceptance criteria)
    Package Testing: Conditioning, Distribution, Shelf-LifeEvaluation of packaging strength and integrity at both baseline (T=0) and following accelerated aging to a 6-month shelf life equivalent (T=6)ISTA procedure 3A (2018), ASTM D4169-16, ASTM F1980-16, ASTM F88-15, ASTM F2096-11, ASTM 1929-15Pass (All samples met the pre-determined acceptance criteria)
    Visual Inspection Packaging and LabelingTo demonstrate that the product meets the packaging and labeling visual and adherence requirementsN/APass (All samples met the pre-determined acceptance criteria)
    Biocompatibility Testing Summary
    CytotoxicityTested in accordance with ISO 10993-5:2009, Neutral Red Uptake MethodISO 10993-5:2009 (noncytotoxic according to predetermined acceptance criteria)Pass (Noncytotoxic according to the predetermined acceptance criteria)
    Intracutaneous IrritationTested in accordance with ISO 10993-10:2010ISO 10993-10:2010 (test requirements for intracutaneous reactivity met)Pass (Test requirements for intracutaneous reactivity were met according to the predetermined acceptance criteria)
    SensitizationTested in accordance with ISO 10993-10, Kligman Maximization TestISO 10993-10 (did not elicit a sensitization response)Pass (Did not elicit a sensitization response according to the predetermined acceptance criteria)
    Systemic ToxicityTested in accordance with ISO 10993-11:2017ISO 10993-11:2017 (test requirements for systemic toxicity met)Pass (Test requirements for systemic toxicity were met according to the predetermined acceptance criteria)
    Material Mediated PyrogenicityTested in accordance with ISO 10993-11:2017 and USP 40 Pyrogen TestISO 10993-11:2017, USP 40 (nonpyrogenic, met predetermined acceptance criteria)Pass (Nonpyrogenic, met the predetermined acceptance criteria)
    HemolysisTested in accordance with ASTM F756-17 and ISO 10993-4 (Direct and Indirect Methods)ASTM F756-17, ISO 10993-4 (non-hemolytic, met predetermined acceptance criteria)Pass (Non-hemolytic, met the predetermined acceptance criteria)
    Complement ActivationTested in accordance with ISO 10993-4:2017 (SC5b-9 Complement Activation)ISO 10993-4:2017 (demonstrates similar complement activation characteristics as the control device, met predetermined acceptance criteria)Pass (Demonstrates similar complement activation characteristics as the control device, met the predetermined acceptance criteria)
    In vivo ThromboresistanceTested in accordance with ISO 10993-4:2017ISO 10993-4:2017 (demonstrates similar thromboresistance characteristics as the control device, met predetermined acceptance criteria)Pass (Demonstrates similar thromboresistance characteristics as the control device, met the predetermined acceptance criteria)

    The following information is Not Applicable (N/A) as the provided document describes non-clinical performance testing for a physical medical device (catheter), not an AI/Software as a Medical Device (SaMD).

    1. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective): Not applicable, as this is bench testing of a physical device.
    2. 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): Not applicable. "Ground truth" in this context would refer to objective material properties or performance under specified conditions, measured by instrumentation.
    3. Adjudication method (e.g. 2+1, 3+1, none) for the test set: Not applicable.
    4. 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.
    5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not applicable.
    6. The type of ground truth used (expert consensus, pathology, outcomes data, etc): Not applicable. The "ground truth" for this device's testing is implicitly defined by the quantifiable limits and observable characteristics specified in the referenced ISO and FDA standards.
    7. The sample size for the training set: Not applicable.
    8. How the ground truth for the training set was established: Not applicable.
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    K Number
    K200910
    Manufacturer
    Date Cleared
    2020-05-02

    (26 days)

    Product Code
    Regulation Number
    870.1250
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Marblehead Medical

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

    The BOSS Balloon Guide Catheter is indicated for use in facilitating the insertion and guidance of an intravascular catheter into a selected blood vessel in the peripheral and neurovascular systems. The balloon provides temporary vascular occlusion during these procedures. The Balloon Guide Catheter is also indicated for use as a conduit for retrieval devices.

    Device Description

    The BOSS Balloon Guide Catheter system is a sterile, single-use intravascular catheter. The BOSS Balloon Guide Catheter is a 90 cm long, variable stiffness catheter utilizing a bifurcated dual port luer hub on the proximal end and a radiopaque marker band at the tip distal to the balloon. The catheter shaft has an annular inflation lumen and a coaxial central lumen with stainless steel coil and is braid reinforced. The hub central port leads to the central lumen to facilitate introduction of interventional devices through the central lumen. The inflation port is positioned at an angle to the central port, connecting to the annular inflation lumen, and is used to facilitate inflating and deflating the balloon with a syringe. The BOSS Balloon Guide Catheter uses a distal hydrophilic coating to provide lubricity and reduce friction between the catheter shaft and the vessel wall. The BOSS Balloon Guide Catheter is packaged with the 6F dilator to facilitate the option of direct access into the blood vessel without the use of an introducer sheath.

    AI/ML Overview

    This document is a 510(k) Summary for the BOSS™ Balloon Guide Catheter, a medical device. It describes the non-clinical performance testing conducted to demonstrate substantial equivalence to legally marketed predicate devices, which means no clinical studies were required. Therefore, the information typically associated with AI/ML device studies (e.g., training set, test set, expert adjudication, MRMC studies, standalone performance) is not applicable here as this is a medical device, not an AI/ML diagnostic tool.

    The "acceptance criteria" for this device are the pre-determined thresholds for various physical, functional, and biocompatibility tests, as detailed in the "NONCLINICAL PERFORMANCE TESTING SUMMARY" and "Biocompatibility Testing Summary" sections. The "study that proves the device meets the acceptance criteria" refers to the successful completion of all these non-clinical (bench and animal) tests.

    Here's a breakdown of the requested information based on the provided text, reinterpreting "acceptance criteria" and "study" in the context of a medical device 510(k) submission:


    1. Table of Acceptance Criteria and Reported Device Performance

    Study NameDescriptionReference StandardAcceptance Criteria (Implied / Stated)Reported Device Performance
    Visual Inspection and Dimensional VerificationTo demonstrate that the product meets the dimensional specificationsISO 10555-1:2013 Intravascular catheters - Sterile and single-use catheters - Part 1: General requirementsMeeting pre-determined specificationsPass: All samples met the pre-determined acceptance criteria
    Surface InspectionTo demonstrate the product satisfies the visual surface requirementsISO 10555-1:2013 Intravascular catheters - Sterile and single-use catheters - Part 1: General requirementsMeeting pre-determined requirementsPass: All samples met the pre-determined acceptance criteria
    Torque TestingTo demonstrate that the product is capable of 360 degrees of rotation about the central lumen axis without failure.FDA guidance PTCA Catheters:2010 §VIII.A.10360 degrees rotation without failure, meeting pre-determined criteriaPass: All samples met the pre-determined acceptance criteria
    TensileTo demonstrate the product satisfies the tensile strength requirements for bonds and tip pull testISO 10555-1:2013, FDA guidance PTCA Catheters:2010 §VIII.A.7, 8Meeting tensile strength requirementsPass: All samples met the pre-determined acceptance criteria
    Kink ResistanceTo demonstrate that the product has acceptable kink resistanceFDA Guidance PTCA:2010 §VIII.A.9 Kink TestAcceptable kink resistance, meeting pre-determined criteriaPass: All samples met the pre-determined acceptance criteria
    Catheter LubricityPad friction test to compare coated to uncoated samplesCharacterization onlyCharacterization: Implied reduction in friction desiredResults show a 97% reduction in friction compared to uncoated samples
    Particulates, Coating IntegrityThis study was conducted to determine the quantity and size of particles generated during simulated useAAMI TIR42:10 Evaluation of particulates associated with vascular medical devices, USP Particulate Matter in InjectionsMeeting pre-determined acceptance criteria for particulate quantity and sizePass: All samples met the pre-determined acceptance criteria
    RadiopacityTo determine the radiopaque characteristics of the device.ISO 10555-1:2013 Intravascular catheters - Sterile and single-use catheters - Part 1: General requirementsMeeting pre-determined acceptable radiopaque characteristicsPass: All samples met the pre-determined acceptance criteria
    Push/Track, Device CompatibilityTo demonstrate that the device is deliverable through tortuous path model without kinking or buckling, is able inflate, deflate balloon at target, is compatible with treatment devices and removed without damage.ISO 10555-1:2013 Intravascular catheters - Sterile and single-use catheters - Part 1: General requirementsDeliverability, proper inflation/deflation, compatibility, removal without damage, meeting pre-determined criteriaPass: All samples met the pre-determined acceptance criteria
    System Leak - Liquid LeakTo demonstrate that the product meets the liquid leakage under pressure requirementsISO 10555-1:2013 Intravascular catheters - Sterile and single-use catheters - Part 1: General requirementsMeeting liquid leakage requirementsPass: All samples met the pre-determined acceptance criteria
    System Leak - AspirationTo demonstrate that the product meets the hub aspiration air leakage requirementsISO 10555-1:2013 Intravascular catheters - Sterile and single-use catheters - Part 1: General requirementsMeeting hub aspiration air leakage requirementsPass: All samples met the pre-determined acceptance criteria
    Tip StiffnessTo demonstrate that the stiffness of the distal end of the product is similar to other marketed devices.N/A (Comparative, not a standard test)Stiffness similar to other marketed devices, meeting pre-determined criteriaPass: All samples met the pre-determined acceptance criteria
    Corrosion ResistanceTo demonstrate the product satisfies the corrosion resistance requirementsISO 10555-1:2013 Intravascular catheters - Sterile and single-use catheters - Part 1: General requirementsMeeting corrosion resistance requirementsPass: All samples met the pre-determined acceptance criteria
    Catheter Burst Pressure Under Static ConditionsTo demonstrate the catheter does not leak or rupture up to 300 psi of internal pressure.ISO 10555-1:2013 Intravascular catheters - Sterile and single-use catheters - Part 1: General requirementsNo leak or rupture at up to 300 psiPass: All samples met the pre-determined acceptance criteria
    Balloon Inflation / DeflationTo demonstrate balloon meets the inflation and deflation time specificationsISO 10555-4:2013 Intravascular Catheters - Sterile and Single-Use Catheters - Part 4: Balloon Dilatation CathetersMeeting inflation and deflation time specificationsPass: All samples met the pre-determined acceptance criteria
    Balloon FatigueTo demonstrate that there is no degradation of the balloon after 10 inflation cycles.ISO 10555-4:2013 Intravascular Catheters - Sterile and Single-Use Catheters - Part 4: Balloon Dilatation CathetersNo degradation after 10 inflation cyclesPass: All samples met the pre-determined acceptance criteria
    Balloon Diameter / VolumeTo demonstrate that the product meets the inflation volume vs balloon diameter specificationsISO 10555-4:2013 Intravascular Catheters - Sterile and Single-Use Catheters - Part 4: Balloon Dilatation CathetersMeeting inflation volume vs. balloon diameter specificationsPass: All samples met the pre-determined acceptance criteria
    Balloon Rated Burst VolumeTo demonstrate that the balloon is capable of withstanding an injection volume of 1.5 ml.ISO 10555-4:2013 Intravascular Catheters - Sterile and Single-Use Catheters - Part 4: Balloon Dilatation CathetersWithstanding 1.5 ml injection volumePass: All samples met the pre-determined acceptance criteria
    Small Bore Connector Compliance with StandardTo demonstrate that the product meets the requirements for small bore connectorsISO 80369-7 2016 Small-bore connectors for liquids and gases in healthcare applications - Part 7, Connectors for intravascular or hypodermic applications.Meeting requirements for small bore connectorsPass: All samples met the pre-determined acceptance criteria
    Usability Study / Simulated UseEvaluation of device performance to meet the user needs under simulated use conditions with accessories and treatment devicesFDA Guidance Human Factors and Usability Engineering 2016, IEC 62366:2015Meeting user needs under simulated use conditionsPass: All samples met the pre-determined acceptance criteria
    Conditioning, Distribution, and Shelf life AgingTo demonstrate the device met all specifications at both baseline (T=0) and following accelerated aging to a 12-month shelf life equivalent (T=12)Evaluation of device following accelerated aging to a 12-month shelf life equivalent; ISTA procedure 3A (2018), ASTM D4169-16, ASTM F1980-16, ASTM F88-15, ASTM F2096-11 (for packaging)Meeting all specifications at T=0 and T=12-month AA equivalentPass: All samples met the pre-determined acceptance criteria
    Visual Inspection Packaging and LabelingTo demonstrate that the product meets the packaging and labeling visual and adherence requirementsN/AMeeting visual and adherence requirements for packaging and labelingPass: All samples met the pre-determined acceptance criteria
    Biocompatibility Testing
    CytotoxicityTo demonstrate non-cytotoxicityISO 10993-5:2009Non-cytotoxicPass: Noncytotoxic according to the predetermined acceptance criteria
    Intracutaneous IrritationTo demonstrate acceptable intracutaneous reactivityISO 10993-10:2010Meeting test requirements for intracutaneous reactivityPass: Test requirements for intracutaneous reactivity were met according to the predetermined acceptance criteria
    SensitizationTo demonstrate no sensitization responseISO 10993-10:2010, Kligman Maximization TestNo sensitization responsePass: Did not elicit a sensitization response according to the predetermined acceptance criteria
    Systemic ToxicityTo demonstrate acceptable systemic toxicityISO 10993-11:2017Meeting test requirements for systemic toxicityPass: Test requirements for systemic toxicity were met according to the predetermined acceptance criteria
    Material Mediated PyrogenicityTo demonstrate non-pyrogenicityISO 10993-11:2017, USP 40 Pyrogen TestNon-pyrogenicPass: Nonpyrogenic, met the predetermined acceptance criteria
    HemolysisTo demonstrate non-hemolytic propertiesASTM F756-17, ISO 10993-4Non-hemolyticPass: Non-hemolytic, met the predetermined acceptance criteria
    Complement ActivationTo demonstrate similar complement activation characteristics as control deviceISO 10993-4:2017, SC5b-9 Complement ActivationSimilar complement activation characteristics to control devicePass: Demonstrates similar complement activation characteristics as the control device, met the predetermined acceptance criteria
    In vivo ThromboresistanceTo demonstrate similar thromboresistance characteristics as control deviceISO 10993-4:2017Similar thromboresistance characteristics to control devicePass: Demonstrates similar thromboresistance characteristics as the control device, met the predetermined acceptance criteria

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

    • Sample Size: The document repeatedly states "All samples met the pre-determined acceptance criteria" or similar for the non-clinical bench tests. While the exact numerical sample size for each test is not explicitly listed, it implies that a sufficient number of devices were tested to meet the requirements of the referenced standards (e.g., ISO 10555-1, FDA guidances). For the animal study, the sample size is not specified but it states "an acute porcine model."
    • Data Provenance:
      • Country of Origin: Not specified for the bench tests. The animal study used an "acute porcine model."
      • Retrospective or Prospective: All testing was prospective, designed specifically to evaluate the device against established standards and criteria for regulatory submission.

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

    This information is not applicable. The "ground truth" for this medical device 510(k) submission is established by the performance standards (e.g., ISO, ASTM, FDA guidances) and the physical properties of the device itself (e.g., dimensions, strength, material characteristics). Experts were involved in setting these standards and conducting the tests, but not in the "ground truth" establishment in the sense of labeling data for an AI/ML model for diagnostic purposes.

    4. Adjudication Method for the Test Set

    Not applicable. This is not a study requiring human adjudication of results in the context of an AI/ML model. The "adjudication" is inherent in whether the device "passes" or "fails" the pre-defined engineering and performance criteria.

    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 a medical device (catheter) and the submission is based on non-clinical performance and substantial equivalence to predicate devices, not an AI/ML diagnostic tool requiring MRMC studies.

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

    Not applicable. This is a physical medical device, not an algorithm.

    7. The Type of Ground Truth Used

    The "ground truth" in this context is based on:

    • Established international and national standards for medical devices (e.g., ISO 10555 series, ISO 10993 series, AAMI, ASTM).
    • FDA guidance documents for specific device types (e.g., PTCA Catheters).
    • Pre-determined engineering specifications and performance criteria for the device.
    • Results from a non-GLP (Good Laboratory Practice) animal study.

    8. The Sample Size for the Training Set

    Not applicable. This is not an AI/ML device that requires a training set.

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

    Not applicable. There is no training set for this device.

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