AMID STAPLER

K120268 · Safestich Medical, LLC · GDW · Feb 10, 2012 · General, Plastic Surgery

Device Facts

• Record ID: K120268
• Device Name: AMID STAPLER
• Applicant: Safestich Medical, LLC
• Product Code: GDW · General, Plastic Surgery
• Decision Date: Feb 10, 2012
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 878.4750
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The SafeStitch AMID Stapler® has application in general surgery procedures for fixation of mesh, in the repair of hernia defects and in other surgical specialties for the approximation of tissue(s), including skin.

Device Story

Manual surgical stapler containing 17 titanium staples; used in general surgery for mesh fixation, hernia repair, and tissue approximation. Operated by physician; handle squeeze deploys single staple per action. Staple legs penetrate tissue/mesh and form to anchor or approximate. Device modifications focus on manufacturing efficiency; mechanism of action remains unchanged from predicate.

Clinical Evidence

Bench testing only. Design verification testing compared subject device to predicate across five metrics: staple pull strength, maximum staple penetration, formed staple height, formed staple width, and maximum deployment force. All tests passed with results equivalent to the predicate device.

Technological Characteristics

Manual surgical stapler; 17 titanium staples. Mechanical actuation via handle squeeze. Sterilization process unchanged from predicate.

Indications for Use

Indicated for general surgery procedures requiring mesh fixation, hernia repair, and tissue approximation, including skin.

Regulatory Classification

Identification

An implantable staple is a staple-like device intended to connect internal tissues to aid healing. It is not absorbable.

Predicate Devices

• AMID Stapler® (K093253)

Submission Summary (Full Text)

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FEB 1 0 2012

## 510(k) Summary

This 510(k) Summary is provided per the requirements of 21 CFR 807.92.

#### Submitter Information:

| Name: | SafeStitch Medical, Inc. |
|-----------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------|
| Address: | 4400 Biscayne Blvd.<br>Miami, FL 33137 |
| Contact Person: | Alina Caraballo<br>Director, Regulatory Affairs and Quality Assurance<br>Telephone: [phone]<br>Fax: [phone]<br>Email: [e-mail] |

#### Device Information:

| Trade Name: | AMID Stapler® |
|----------------------|-----------------------------------------------------------------------------------|
| Common Name: | Surgical Stapler |
| Classification: | Stapler - Class I; Staple - Class II |
| Classification Name: | Stapler - Manual surgical instrument for general use; Staple - Implantable staple |

#### Predicate Devices:

The prodicate device is the AMID Stapler® that was cleared via 510(k) K093253 on November 12, 2009.

#### Device Description:

The SafeStitch AMID Stapler™ contains 17 titanium staples. The AMID Stapler™ places a staple each time the instrument's handle is squeezed. The staple legs first penetrate the tissue or mesh and then fully form, thus anchoring or approximating the tissue(s) and/or mesh.

#### Indications for Use:

The indications for use of the subject device, as described in its labeling, have not changed as a result of the modifications. The indications for use of the subject and predicate devices are identical.

"The SafeStitch AMID Stapler® has application in general surgery procedures for fixation of mesh, in the repair of hernia defects and in other surgical specialties for the approximation of tissues(s), including skin."

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#### Comparison to Predicate Device:

The subject AMID Stapler® is essentially the same as the predicate device with minor modifications and manufacturing process improvements aimed at improving manufacturing efficioncies while maintaining product robustness. These modifications do not change the mechanism of action of the device. In addition, the label and Instructions for Use were revised to better align them with the requirements of 21 CFR 801. To summarize, the subject and predicate devices share the same indications for use, materials, basic design, fundamental scientific technology, labeling, packaging materials and configuration, shelf life, and sterilization processes.

#### Non-Clinical Testing:

Design verification testing was conducted to verify that the subject device meets the required acceptance criteria and functions equivalent to the predicate device. Results of that testing is presented below:

| Test Method | Predicate Device Test<br>Results | Subject Device Test<br>Results |
|-------------------------------|----------------------------------|--------------------------------|
| Staple Pull Strength | Pass | Pass |
| Maximum Staple<br>Penetration | Pass | Pass |
| Formed Staple<br>Height | Pass | Pass |
| Formed Staple<br>Width | Pass | Pass |
| Maximum<br>Deployment Force | Pass | Pass |

#### Substantial Equivalence:

In esublishing substantial equivalence to the predicate device, SafeStitch Medical, Inc. evaluated the indications for use, materials, basic design, fundamental scientific technology, labeling, packaging materials and configuration, shelf life, and sterilization processes. The performance testing included in this submission demonstrates that the differences between the subject and predicate devices do not impact safety and effectiveness. Thus, based on the information presented herein, the subject AMID Stapler® is substantially equivalent to the predicate AMID Stapler® cleared via 510(k) K093253 on November 12, 2009.

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### DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with three heads, representing the three branches of government. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle.

#### Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

FEB 1 0 2012

SafeStitch Medical, Inc. % Ms. Alina Caraballo 4400 Biscayne Boulevard, Suite 670 Miami. Florida 33137

Re: K120268

Trade/Device Name: Amid Stapler Regulation Number: 21 CFR 878.4750 Regulation Name: Implantable staple Regulatory Class: Class II Product Code: GDW, GAG Dated: January 27, 2012 Received: January 30, 2012

Dear Ms. Caraballo:

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. Please note: CDRH does not evaluate information related to contract liability 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.

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 - Ms. Alina Caraballo

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/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,
Mark A. Millan

Mark N. Melkerson Director Division of Surgical, Orthopedic and Restorative Devices Office of Device Evaluation Center for Devices and · Radiological Health

Enclosure

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# Indications for Use

510(k) Number (if known):

Device Name: AMID Stapler®

Indications for Use:

The SafeStitch AMID Stapler® has application in general surgery procedures for fixation of mesh, in the repair of hernia defects and in other surgical specialties for the approximation of tissue(s), including skin.

Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (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)

Daniel Kane for MXM

(Division Sign-Off) (Division of Surgical, Orthopedic, and Restorative Devices

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510(k) Number K120268

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