CLEARWAY OTW MODEL 85912

K093431 · Atrium Medical Corp. · DQY · Apr 20, 2010 · Cardiovascular

Device Facts

• Record ID: K093431
• Device Name: CLEARWAY OTW MODEL 85912
• Applicant: Atrium Medical Corp.
• Product Code: DQY · Cardiovascular
• Decision Date: Apr 20, 2010
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 870.1250
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

For localized infusion or irrigation of various diagnostic and therapeutic agents into the peripheral vasculature. It is not indicated for use in the neurovasculature.

Device Story

ClearWay OTW catheter is a percutaneous device designed for localized delivery of diagnostic or therapeutic agents into peripheral vasculature. Operated by physicians in clinical settings; device facilitates targeted infusion/irrigation. By providing localized delivery, it aims to improve therapeutic efficacy or diagnostic accuracy within peripheral vessels while avoiding systemic distribution. Device is not for neurovascular use.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Percutaneous catheter (21 CFR 870.1250, Product Code DOY). Designed for peripheral vascular access and localized fluid delivery.

Indications for Use

Indicated for localized infusion or irrigation of diagnostic and therapeutic agents into the peripheral vasculature. Contraindicated for use in the neurovasculature.

Regulatory Classification

Identification

A percutaneous catheter is a device that is introduced into a vein or artery through the skin using a dilator and a sheath (introducer) or guide wire.

Submission Summary (Full Text)

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## DEPARTMENT OF HEALTH & HUMAN SERVICES

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

JUN 15 2010

Atrium Medical Corp. c/o Mr. Raymond Kelly Regulatory Affairs 5 Wentworth Drive Hudson, NH 03051

Re: K093431

ClearWay OTW catheter Regulation Number: 21 CFR 870.1250 Regulation Name: Percutaneous catheter Regulatory Class: Class II Product Code: DOY Dated: April 05, 2010 Received: April 08, 2010

Dear Mr. Kelly:

This letter corrects our substantially equivalent letter of April 20, 2010.

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. Dru 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. Please note: CDRH does not evaluate information related to contractly and warranties. We remind you, however, that device labeling must be truthful and not misleading.

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.

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Page 2 - Mr. Raymond Kelly

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.

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/MedicalDevices/Safety/ReportalProblem/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,
W.M.

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

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Atrium Medical Corporation 5 Wentworth Drive Hudson, NH 03051 Tel. [phone] Fax:[phone] www.alriommed.com

INDICATIONS FOR USE

510(k) Number (if known): _ K09343 |

Atrium Medical Corporation ClearWay OTW Device Name:

Indications for Use:

For localized infusion or irrigation of various diagnostic and therapeutic agents into the peripheral vasculature. It is not indicated for use in the neurovasculature.

Prescription Use V (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)

P. Valania

(Division Sign-Off) (Division of Cardiovascular Devices

510(k) Number_Kog3431