Attachable Cath Lab Hemostasis Valve
K152528 · Galt Medical Corp. · DTL · Dec 2, 2015 · Cardiovascular
Device Facts
| Record ID | K152528 |
| Device Name | Attachable Cath Lab Hemostasis Valve |
| Applicant | Galt Medical Corp. |
| Product Code | DTL · Cardiovascular |
| Decision Date | Dec 2, 2015 |
| Decision | SESE |
| Submission Type | Traditional |
| Regulation | 21 CFR 870.4290 |
| Device Class | Class 2 |
Intended Use
The Attachable Cath Lab Hemostasis Valve is indicated to minimize blood loss during the introduction of catheters, guidewires and other intravascular devices into the vasculature.
Device Story
Device is a single-patient-use, disposable hemostasis valve assembly; consists of a molded hub with integrated valve, sideport tubing, and 3-way stopcock. Used in clinical settings (cath lab) by physicians or trained clinical staff during intravascular procedures. Device attaches to existing introducer systems to provide a seal around inserted catheters or guidewires. Function is to minimize blood loss during device exchange or insertion. Output is a physical seal; healthcare providers observe blood loss reduction directly. Benefits include maintenance of hemostasis during complex vascular interventions.
Clinical Evidence
Bench testing only. No clinical data provided. Functional testing included pressure leak, vacuum leak, guidewire insertion, dilator insertion, sidearm tubing to hub pull force, and spinlock collar adapter pull tests. Biocompatibility and shelf-life testing were leveraged from predicate device submissions (K043525 and K140028) based on identical raw materials and packaging.
Technological Characteristics
Molded hub with integrated hemostasis valve, sideport tubing, and 3-way stopcock. Accepts up to 8F devices. Pressure withstand: 7 PSI; Vacuum withstand: 0.47 in-Hg. Sterilization: Ethylene oxide (EO) cycle adopted from K043525. Materials identical to predicate devices.
Indications for Use
Indicated for patients undergoing percutaneous procedures requiring the introduction of catheters, guidewires, and other intravascular devices into the vasculature, where minimization of blood loss is required.
Regulatory Classification
Identification
A cardiopulmonary bypass adaptor, stopcock, manifold, or fitting is a device used in cardiovascular diagnostic, surgical, and therapeutic applications to interconnect tubing, catheters, or other devices.
Special Controls
*Classification.* Class II (special controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 870.9.
Predicate Devices
- Merit Medical IN-LINE Hemostasis Valve (K990975)
- Galt Medical Cath Lab Introducer Sheath (K043525)
- Galt VTI® Valved Tearaway Introducer Sheath (K112398)
Reference Devices
- Galt Medical VTI Valved Tearaway Introducer (K140028)
Related Devices
- K052459 — 6248VAL ADJUSTABLE VALVE · Medtronic Vascular · Jan 11, 2006
- K990975 — IN-LINE HEMOSTASIS VALVE · Merit Medical Systems, Inc. · Mar 15, 2000
- K131124 — COLIGN · Jilin Coronado Medical , Ltd. · Aug 28, 2013
- K072556 — HEMOSTASIS VALVE · Merit Medical Systems, Inc. · Nov 20, 2007
- K172453 — WATCHDOG Hemostasis Valve Kit · Boston Scientific Corporation · Nov 9, 2017
Submission Summary (Full Text)
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Image /page/0/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of three human profiles facing right, resembling a bird-like shape.
Public Health Service
Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
December 02, 2015
Galt Medical Corp. David Derrick Director Of Quality And Regulatory Affairs 2220 Merritt Dr. Garland, Texas 75041
Re: K152528
Trade/Device Name: Attachable Cath Lab Hemostasis Valve Regulation Number: 21 CFR 870.4290 Regulation Name: Cardiopulmonary Bypass Adaptor, Stopcock, Manifold, Or Fitting Regulatory Class: Class II Product Code: DTL Dated: September 1, 2015 Received: September 3, 2015
Dear David Derrick:
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 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 devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in
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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 contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.
Sincerely yours,
M.A. Hillebrenner
for
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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## INDICATIONS FOR USE
510(K) number (if known): K152528
Device Name: _________________________________________________________________________________________________________________________________________________________________
Indications for Use:
The Attachable Cath Lab Hemostasis Valve is indicated to minimize blood loss during the introduction of catheters, guidewires and other intravascular devices into the vasculature.
Prescription Use_ X (Per 21 CFR 801 Subpart D) OR
Over-The-Counter Use (Per 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)
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| Application Date: | September 01, 2015 |
|------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Application Type: | Traditional 510(k) |
| Applicant Information | Galt Medical Corporation<br>2220 Merritt Dr.<br>Garland, TX 75041<br>Phone: 214-778-1306<br>Fax: 972-271-4706 |
| Official Contact: | David Derrick<br>Director of Quality and Regulatory Affairs<br>Galt Medical Corporation<br>2220 Merritt Dr.<br>Garland, TX 75041<br>Phone: 214-778-1306<br>Fax: 972-271-4706<br>dderrick@galtmedical.com |
| Device Name: | Attachable Cath Lab Hemostasis Valve |
| Device Model Number: | TBD |
| Classification Name: | Cardiopulmonary bypass adaptor, Stopcock, Manifold, or<br>Fitting (DTL),<br>21 CFR 870.4290 |
| Device Classification: | Class II (Cardiovascular) |
| Predicate Device: | Merit Medical IN-LINE Hemostasis Valve (K990975)<br>Galt Medical Cath Lab Introducer Sheath (K043525)<br>Galt VTI® Valved Tearaway Introducer Sheath (K112398) |
| Manufacturer: | Galt Medical<br>2220 Merritt Drive<br>Garland, TX 75041<br>Phone: 214-778-5177<br>Fax: 972-271-4706 |
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Intended Use: The Attachable Cath Lab Hemostasis Valve is indicated to minimize blood loss during the introduction of catheters, guidewires and other intravascular devices into the vasculature.
Device Description: The Galt Medical Attachable Cath Lab Hemostasis Valve assembly consists of a molded hub with an integrated hemostasis valve, sideport tubing with 3 way stopcock. The design of the Attachable Cath Lab Hemostasis Valve is derived directly from the current line of Galt Medical Cath Lab Introducer Sheath (K043525). The subject and predicate device are both have an integrated hemostasis valve, and side port tubing with stopcock.
The Galt Cath Lab Introducer (K043525) has been previously determined to be substantially equivalent. In this submission, Galt Medical Corp will establish that the subject device Attachable Cath Lab Hemostasis is substantially equivalent to the current marketed devices; Merit Medical IN-LINE Hemostasis Valve, Galt Cath Lab Introducer Sheath and Galt VTI Valved Tearaway Introducer.
Comparison of Technological Characteristics: The Attachable Cath Lab Hemostasis Valve is substantially equivalent to the unmodified predicate in construction, materials, and device performance.
| | Subject device | Predicate Device | Predicate Device | Predicate Device |
|--------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Mfr. /<br>Product | Galt Medical<br>Attachable Cath<br>Lab Hemostasis<br>Valve | Merit Medical IN-<br>LINE Hemostasis<br>(K990975) | Galt Medical Cath<br>Lab Introducer<br>(K043525) | Galt Medical VTI<br>Valved Tearaway<br>(K140028 ) |
| 510(k)<br>Number | N/A | K112398 | K043525 | K140028 |
| Device<br>Classification | 870.4290 | 870.4290 | 870.1340 | 870.1340 |
| Product<br>Code | DTL | DTL | DYB | DYB |
| Intended use | Intended to<br>minimize blood<br>loss during the<br>introduction of<br>catheters,<br>guidewires and<br>other intravascular<br>devices into the<br>vasculature | Intended to<br>minimize blood<br>loss during the<br>introduction of<br>catheters,<br>guidewires and<br>other intravascular<br>devices into the<br>vasculature | The seath<br>introducer system<br>is indicated for use<br>in percutaneous<br>procedures to<br>introduce<br>catheters and<br>other intravascular<br>devices into the<br>vasculature. | These introducers<br>are used for the<br>percutaneous<br>introduction of<br>diagnostic or<br>therapeutic<br>devices, such as<br>catheters and<br>pacing leads into<br>the vasculature. |
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| | Subject device | Predicate Device | Predicate Device | Predicate Device |
|-----------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Design | The Galt Attachable<br>Cath Lab Hemostasis<br>Valve assembly<br>consists of a molded<br>hub with an<br>integrated<br>hemostasis valve,<br>sideport tubing with<br>3 way stopcock. | The Merit Medical<br>IN-LINE Hemostasis<br>Valve assembly<br>consists of a molded<br>hub with an<br>integrated<br>hemostasis valve,<br>sideport tubing with<br>3 way stopcock. | Cath Lab introducer<br>has a molded<br>hub/sheath with<br>integrated<br>hemostasis valve,<br>and side port tubing<br>with stopcock. The<br>device includes a<br>locking dilator to<br>assist in the insertion<br>of the device into<br>the vascular system. | The VTI valved<br>tearaway introducer<br>has a molded<br>hub/sheath with<br>integrated<br>hemostasis valve,<br>and side port tubing<br>with stopcock. The<br>device includes a<br>locking dilator to<br>assist in the insertion<br>of the device into<br>the vascular system |
| Color | White or Green<br>Colored hub and<br>cap with clear<br>sideport tubing<br>and stopcock | White Colored hub<br>with clear sideport<br>tubing and<br>stopcock | White Colored<br>hub, color coded<br>cap with clear<br>sideport tubing<br>and stopcock | Color coded hub,<br>clear cap with<br>clear sideport<br>tubing and<br>stopcock |
| Shape | Round hub with<br>spinlock collar | Round hub with<br>spinlock collar | Cylindrical cannula<br>with round hub | Cylindrical cannula<br>with winged hub |
| Sizes | Accepts up to 8F<br>device | Accepts up to 8F<br>device | 6cm, to120cm<br>lengths, sizes 4F -<br>9F | 13cm, and 23cm<br>lengths, sizes 6F -<br>16F |
| Pressure<br>withstand | 7 PSI | 7 PSI | 7 PSI | 6.1 PSI |
| Vacuum<br>Withstand | 0.47in-Hg | 0.47in-Hg | 0.47in-Hg | 0.47in-Hg |
| Dilator Lock | N/A | N/A | Dilator is retained | Dilator is retained |
Use Type: The Galt Attachable Cath Lab Hemostasis Valve is a single patient use, disposable device.
Summary of Non-Clinical Data Submitted: Functional testing on 4 year aged product was conducted to verify that the Attachable Cath Lab Hemostasis Valve met product specifications. Testing was conducted according to protocols based on international standards and Galt Medical requirements. Functional Testing included the following:
- . Pressure Leak Test
- Vacuum Leak Test .
- . Guidewire Insertion Test
- . Dilator Insertion Test
- Sidearm Tubing to Hub Pull Force Test
- . Spinlock Collar Adapter Pull Test
Additionally the Attachable Cath Lab Hemostasis Valve was adopted into the existing ethylene oxide sterilization cycle for the Galt Cath Lab Introducer Sheath cleared under K043525.
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Biocompatibility testing was provided in Galt Cath Lab Introducer Sheath submission K043525 and for the optional valve - Galt VTI Valved Tearaway Introducer submission K140028. The devices tested included identical raw materials and package configuration and materials utilized in the Galt Attachable Cath Lab Hemostasis Valve and Galt VTI Valved Tearaway Introducer.
Packaging shelf life testing was provided in the predicate submissions.
Conclusion: It will be shown in this 510(k) submission that the differences between the Galt Attachable Cath Lab Hemostasis Valve and the predicate device do not raise any questions regarding safety and effectiveness. The Galt Attachable Cath Lab Hemostasis Valve as designed and manufactured is determined to be substantially equivalent to the referenced predicate device.
End of Section