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510(k) Data Aggregation

    K Number
    K222846
    Date Cleared
    2023-12-18

    (453 days)

    Product Code
    Regulation Number
    876.5980
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    K190923, K971434

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

    The AMT G-Tube Balloon Gastrostomy Feeding Device is indicated to be used as a percutaneous gastrostomy tube. This device will assist in providing nutrition directly into the stomach through a secured (initial placement) or formed (replacement) stoma in a human patient, 10kg or above, who is unable to consume nutrition by conventional means. The AMT G-Tube Balloon Gastrostomy Feeding Device can also deliver medication and allow for decompression of the stomach.

    Device Description

    The Applied Medical Technology, Inc. G-Tube Balloon Gastrostomy Feeding Device (AMT G-Tube) is made of silicone elastomer and is designed for enteral feeding in a gastrostomy tract. The device can be used as a replacement device through a mature stoma tract or for initial placement in a supported stoma tract. The device is offered in several French (FR) sizes ranging from 12 FR to 24 FR. On the shaft near the end is located a balloon which, when properly inflated acts as an internal stabilizer preventing outward displacement through the stoma in the abdominal wall. The external bolster (preassembled on the AMT G-Tube) acts as a stabilizer to prevent inward migration. The device is sold as sterile and can be placed in an outpatient or home setting by a health care professional or care giver.

    AI/ML Overview

    Here's a breakdown of the acceptance criteria and study information for the AMT G-Tube Balloon Gastrostomy Feeding Device, based on the provided FDA 510(k) summary:

    This device is not an AI/ML powered device, therefore, sections 2-6 and 8-9 do not apply.

    Acceptance Criteria and Reported Device Performance

    Device Name: AMT G-Tube Balloon Gastrostomy Feeding Device

    Acceptance Criteria CategorySpecific Test/StandardAcceptance Criteria (Implied/Stated)Reported Device Performance (Summary)Basis for Acceptance (Study Type)
    BiocompatibilityISO 10993-1, -3, -5, -6, -7, -10, -11Met acceptance criteria for permanent contact (>30 days) with mucosal membrane and breached/compromised surfaces.Met all applicable biocompatibility requirements.Bench Testing
    SterilizationANSI/AAMI/ISO 11135-1:2014Sterility Assurance Level (SAL) of $10^{-6}$.Validated to confirm a SAL of $10^{-6}$. Sterilization processing complies.Bench Testing
    ISO 10993-7Compliance with Ethylene Oxide Sterilization Residuals.Complied with ISO 10993-7.Bench Testing
    Shelf LifeASTM F1980Evaluation of performance after simulated 3-year accelerated aging of packaging. Evaluation of performance of 50A durometer 18Fr TGJ assemblies after four years of accelerated aging. Evaluation of performance of 50A durometer 18Fr TGJ sprung tubing after four-year accelerated aging simulation.Validated shelf life of three years.Bench Testing
    Bench TestingAMT Design SpecificationsBalloon Assembly Bond Peel/Tear Strength: (Specific values not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Balloon Burst: (Specific values not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Fill Valve Blow Out: (Specific values not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Fill Valve Pullout: (Specific values not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Flow Rate: (Specific values not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Leak Test: (Specific values not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Tubing Tensile Test to determine strength (at gastric holes): (Specific values not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Minimum Overmold Bond Strength: (Specific values not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Stoma Pullout: (Specific values not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Tubing Cyclic and Tensile Test: (Specific values not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Main Strap Tensile Test: (Specific values not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Side Strap Tensile Test: (Specific values not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    ASTM F2528-06Balloon Integrity in Simulated Gastric Fluid: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Balloon volume maintenance: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Balloon size and shaft size: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Balloon concentricity: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Balloon integrity: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    ISO 80369-3Dimensional Verification: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Missed Connection Testing: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    ISO 80369-20Fluid leakage: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Stress cracking: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Resistance to separation from axial load: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Resistance to separation from unscrewing: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Resistance to overriding: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Disconnection by unscrewing: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    ISO 11607-1:2019 and ISO 11607-2:2019Packaging for terminally sterilized medical devices: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    EN 1615:2000, EN 1618:1997Leak Testing: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing
    Safety - PyrogenicityUSP 41-National Formulary (NF) 36: 2018Pyrogenicity testing: (Specific requirements not provided, but implied to be met)Met or exceeded all acceptance criteria.Bench Testing

    Study Information

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

    2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective):
    The provided document does not specify the sample sizes for the individual bench tests or the country of origin/provenance for the data. The studies performed were bench testing, meaning they were conducted in a laboratory setting rather than with human subjects, therefore, provenance like "country of origin" is less relevant than for clinical data. The tests are prospective in nature, as they are specifically designed to evaluate the performance of the manufactured device.

    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 section is not applicable as the studies described are bench tests (biocompatibility, sterilization, shelf life, and various physical performance tests) and do not involve expert review or establishment of ground truth in the context of diagnostic interpretation. The "ground truth" for these tests is the objective measurement against established engineering, material, and safety standards (e.g., a specific tensile strength, absence of pyrogens, a confirmed SAL).

    4. Adjudication method (e.g. 2+1, 3+1, none) for the test set:
    This section is not applicable. Adjudication methods like 2+1 or 3+1 refer to a consensus process among human readers/experts, typically in diagnostic studies. The studies performed were bench tests against pre-defined engineering and safety standards.

    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:
    This section is not applicable. The device is a physical medical device (gastrostomy feeding tube), not an AI/ML powered diagnostic or assistive tool for human readers. No MRMC study was conducted.

    6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:
    This section is not applicable. The device is a physical medical device and does not involve an algorithm or AI.

    7. The type of ground truth used (expert consensus, pathology, outcomes data, etc):
    The "ground truth" for the various performance tests (biocompatibility, sterilization, shelf life, and bench tests) is based on established industry standards, design specifications, and objective laboratory measurements. For instance, a confirmed Sterility Assurance Level ($10^{-6}$) is an objective measurement against a standard, not an expert consensus or pathology report. Similarly, meeting specific tensile strength, flow rate, or leak test criteria are objective measurements against defined engineering specifications.

    8. The sample size for the training set:
    This section is not applicable as the device is a physical medical device and does not involve AI/ML that requires a training set.

    9. How the ground truth for the training set was established:
    This section is not applicable as the device is a physical medical device and does not involve AI/ML that requires a training set and its associated ground truth establishment.

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