ESTECH EASYFLOW CANNULA WITH GUIDEWIRE

K091542 · Endoscopic Technologies, Inc. D/B/A Estech · DWF · Oct 20, 2009 · Cardiovascular

Device Facts

• Record ID: K091542
• Device Name: ESTECH EASYFLOW CANNULA WITH GUIDEWIRE
• Applicant: Endoscopic Technologies, Inc. D/B/A Estech
• Product Code: DWF · Cardiovascular
• Decision Date: Oct 20, 2009
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 870.4210
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The ESTECH EasyFlow Cannula with Guidewire is intended for use with cardiopulmonary bypass as an arterial return or venous drainage cannula for up to 6 hours.

Device Story

The ESTECH EasyFlow Cannula with Guidewire is a sterile, single-use, wire-reinforced polymer tube designed for cardiopulmonary bypass. It features multiple distal perforations for diffuse blood flow and a barbed proximal end for connection to bypass tubing. The device includes a flexible obturator, an optional stylet for insertion strength, a 0.035" guidewire, vessel dilators, an 18-gauge needle, and a scalpel. Used by surgeons in clinical settings (e.g., stopped-heart procedures), the cannula facilitates extracorporeal circulation. The guidewire and accessory kit enable percutaneous placement. The device provides a conduit for blood flow, supporting the patient during cardiac surgery.

Clinical Evidence

Bench testing only. Biocompatibility analysis performed in compliance with ISO 10993. No clinical data provided.

Technological Characteristics

Single-lumen, wire-reinforced polymer tube. Features distal perforations for diffuse flow. Includes flexible obturator, optional stylet, 0.035" guidewire, vessel dilators, 18G needle, and scalpel. Sterile, single-use. No electronic components or software.

Indications for Use

Indicated for patients requiring cardiopulmonary bypass for arterial return or venous drainage during surgical procedures for up to 6 hours.

Regulatory Classification

Identification

A cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to cannulate the vessels, perfuse the coronary arteries, and to interconnect the catheters and cannulas with an oxygenator. The device includes accessory bypass equipment.

Predicate Devices

• ESTECH Aortic EasyFlow Cannula (K060101)
• Medtronic EOPA Elongated One-Piece Arterial Cannula with Guidewire (K000274)
• Edwards Lifesciences Venous Flex II Peripheral And Intra-Operative Access Venous Return Cannulae (K974259)
• ESTECH Percutaneous Insertion Dilator Kit (K070749)

Submission Summary (Full Text)

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KC091542

ESTECH EasyFlow Cannula with Guidewire Premarket Notification

# Section 5: 510(k) Summary of Safety and Effectiveness

# Device Information:

OCT 20 2009

| Category | Comments |
|-------------------------------|--------------------------------------------------------------------------------------------|
| Sponsor: | ESTECH, Inc.<br>2603 Camino Ramon<br>Suite 100<br>San Ramon, CA 94583<br>Tel: [phone] |
| Correspondent: | Tamer Ibrahim |
| | Vice President, R&D, QA/RA<br>2603 Camino Ramon<br>San Ramon, CA 94523 |
| Contact Information: | Tel: [phone]<br>Fax: [phone] |
| Device Common Name: | Cardiopulmonary bypass vascular cannula |
| Device Classification & Code: | Class II, DWF (21 CFR 870.4210) |
| Device Classification Name: | Cardiopulmonary bypass vascular catheter, |
| | cannula or tubing |
| Device Proprietary Name: | ESTECH EasyFlow Cannula with |
| | Guidewire |

# Predicate Device Information:

:

| Predicate Device: | ESTECH Aortic EasyFlow Cannula |
|-----------------------------------------|---------------------------------------------------------------------------------|
| | (K060101) |
| Predicate Device Manufacturer: | ESTECH, Inc. |
| Predicate Device Common Name: | Cardiopulmonary bypass vascular cannula |
| Predicate Device Classification: | 21 CFR 870.4210 |
| Predicate Device Classification & Code: | Class II, DWF |
| Predicate Device: | Medtronic EOPA Elongated One-Piece<br>Arterial Cannula with Guidewire (K000274) |
| Predicate Device Manufacturer: | Medtronic, Inc. |
| Predicate Device Common Name: | Cardiopulmonary bypass vascular cannula |
| Predicate Device Classification: | 21 CFR 870.4210 |
| Predicate Device Classification & Code: | Class II, DWF |

| Predicate Device: | Edwards Lifesciences Venous Flex II<br>Peripheral And Intra-Operative Access<br>Venous Return Cannulae (K974259) |
|----------------------------------|------------------------------------------------------------------------------------------------------------------|
| Predicate Device Manufacturer: | Edwards Lifesciences, Inc. |
| Predicate Device Common Name: | Cardiopulmonary bypass vascular cannula |
| Predicate Device Classification: | 21 CFR 870.4210 |

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Endoscopic Technologies, Inc.

ESTECH EasyFlow Cannula with Guidewire Premarket Notification

| Predicate Device Classification & Code: | Class II, DWF |
|-----------------------------------------|---------------|
|-----------------------------------------|---------------|

| Predicate Device: | ESTECH Percutaneous Insertion Dilator Kit<br>(K070749) |
|-----------------------------------------|--------------------------------------------------------|
| Predicate Device Manufacturer: | ESTECH, Inc |
| Predicate Device Common Name: | Vessel dilator for percutaneous<br>catheterization |
| Predicate Device Classification: | 21 CFR 870.1310 |
| Predicate Device Classification & Code: | Class II, DRE |

#### b. Date Summary Prepared

19May09

### c. Description of Device

The ESTECH EasyFlow Cannula with Guidewire is a sterile, single-use device. The single-lumen wire reinforced polymer tube incorporates multiple perforations at the distal end to provide a diffuse flow pattern. The barbed proximal end is intended to connect into cardiopulmonary bypass tubing to provide extracorporeal circulation of the blood, most typically during stopped-heart surgical procedures. Each cannula is provided with a flexible obturator to assist with the placement and positioning of the cannula and an optional stylet which inserts into the obturator to provide additional column strength for insertion. The product also comes with a 0.035" diameter guidewire, up to 3 vessel dilators, an 18 gauge. needle, and scalpel for introduction

### d. Intended Use

The ESTECH EasyFlow Cannula with Guidewire is intended for use with cardiopulmonary bypass as an arterial return or venous drainage cannula for up to 6 hours.

#### e. Comparison to Predicate Device

The ESTECH EasyFlow Cannula with Guidewire is identical in technology, design, materials, manufacture, and packaging to the ESTECH Aortic EasyFlow Cannula (K060101) with the addition that it is packaged with a guidewire and accessory introduction components including scalpel, needle, and dilators. A small hole has been added to the cannula and obturator tips to facilitate pass through of the guidewire. The ESTECH EasyFlow Cannula with Guidewire is similar in intended use to the Medtronic EOPA Elongated One-Piece Arterial Cannula with Guidewire that it is intended for use with cardiopulomonary bypass as an arterial return cannula. The ESTECH EasyFlow Cannula with Guidewire is similar in intended use to the Edwards Lifesciences Venous Flex II Peripheral

Section 5, Page 2

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Endoscopic Technologies, Inc.

And Intra-Operative Access Venous Return Cannulae which are intended for use in situations in which short term cardiopulmonary bypass peripheral access venous return procedures, i.e., internal jugular vein, right innominate vein, and femoral vein access, as well as the standard intra-operative access venous return procedures, i.e right atrial appendage and right atriotomy access is desired.

ESTECH concludes that the ESTECH EasyFlow Cannula with Guidewire is substantially equivalent to the predicate devices.

## f. Summary of Supporting Data

Biocompatibility analysis demonstrates that the device is in compliance with ISO 10993

Bench testing has demonstrated that the device meets the proposed product specifications.

### CONFIDENTIAL

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular arrangement of the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" surrounding a stylized image of an eagle. The eagle is depicted with its wings spread, and its body is formed by three curved lines.

#### Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room W-O66-0609 Silver Spring, MD 20993-0002

1

OCT 20 2009

Endoscopic Technologies, Inc. c/o Mr. Tamer Ibrahim Vice President 2603 Camino Ramon, Suite 100 San Ramon, CA 94583

K091542 Re:

ESTECH EasyFlow Cannula with Guidewire Regulation Number: 21 CFR 870.4210 Regulation Name: Catheter, Cannula and Tubing Vascular, Cardiopulmonary Bypass Regulatory Class: Class II (two) Product Code: DWF Dated: September 21, 2009 Received: September 23, 2009

Dear Mr. Ibrahim:

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

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Page 2 -- Mr. Tamer Ibrahim

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.

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 Dovices 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/MedicalDevices/Safety/ReportaProblem/default.htm 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 [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours,

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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### Section 4: Indications for Use

510(k) Number (if known): Ke99542

Device Name: ESTECH EasyFlow Cannula with Guidewire

Indications For Use:

The ESTECH EasyFlow Cannula with Guidewire is intended for use with cardiopulmonary bypass as an arterial return or venous drainage cannula for up to 6 hours.

Prescription Use X

AND/OR

Over-The-Counter Use

(Part 21 CFR 801 Subpart D)

(21 CFR 807 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

| Concurrence of CDRH, Office of Device Evaluation (ODE) | |
|--------------------------------------------------------|------------------------|
| | Page 1 of 1 |
| | Cardiovascular Devices |
| 510(k) number | K091542 |

CONFIDENTIAL