Depth Electrodes, Foramen Ovale Depth Eletrodes, Marco-Micro Depth Electrodes, Spencer Probe Depth Electrodes
K163355 · Ad-Tech Medical Instrument Corporation · GZL · Apr 12, 2017 · Neurology
Device Facts
| Record ID | K163355 |
| Device Name | Depth Electrodes, Foramen Ovale Depth Eletrodes, Marco-Micro Depth Electrodes, Spencer Probe Depth Electrodes |
| Applicant | Ad-Tech Medical Instrument Corporation |
| Product Code | GZL · Neurology |
| Decision Date | Apr 12, 2017 |
| Decision | SESE |
| Submission Type | Traditional |
| Regulation | 21 CFR 882.1330 |
| Device Class | Class 2 |
| Attributes | Therapeutic |
Intended Use
The Ad-Tech Depth Electrodes (Depth Electrodes, Foramen Ovale Depth Electrodes, Macro Micro Depth Electrodes, Spencer Probe Depth Electrodes, Wyler Sphenoidal Depth Electrodes) are intended for temporary (< 30 days) use with recording, monitoring and stimulation equipment for the recording, monitoring and stimulation of electrical signals at the subsurface level of the brain. The recording of electrical activity supports definition of the location of epileptogenic foci and brain mapping.
Device Story
Depth Electrodes are invasive medical devices designed for temporary (< 30 days) subsurface brain contact. They function as conductors, transmitting biopotential signals from the brain to external recording/monitoring equipment and delivering stimulation energy from external equipment to brain tissue. Used in intraoperative and neurological monitoring settings by physicians/surgeons. The device consists of electrode contacts (platinum or platinum/iridium) mounted on a probe body, often including a stylet for insertion and an optional silicone 'Stay Flange' accessory to secure the electrode tail to the skin, preventing movement. By enabling precise recording of electrical activity, the device assists clinicians in identifying epileptogenic foci and performing brain mapping, which guides surgical decision-making and potentially improves patient outcomes in epilepsy management.
Clinical Evidence
Bench testing only. Evaluations included electrical resistance measurements, dimensional verification, and stimulation testing at 30 µC/cm² to ensure electrode integrity. The optional stay flange accessory was validated for retention performance.
Technological Characteristics
Materials: Platinum or Platinum/Iridium contacts, silicone stay flange. Sensing/Actuation: Passive conductor for biopotential recording and stimulation energy delivery. Form factor: Probe-style electrodes with diameters ranging from 0.86 mm to 1.96 mm (macro) and 38-51 microns (micro). Connectivity: Wired connection to external user-supplied equipment. Sterilization: Provided sterile.
Indications for Use
Indicated for temporary (< 30 days) use in patients requiring recording, monitoring, and stimulation of subsurface brain electrical signals to define epileptogenic foci and perform brain mapping. Contraindicated for patients at risk for infection or for whom surgical recording/stimulation procedures cannot be performed safely.
Regulatory Classification
Identification
A depth electrode is an electrode used for temporary stimulation of, or recording electrical signals at, subsurface levels of the brain.
Predicate Devices
- Depth Electrode (K053358)
- Depth Electrode (K964644)
- Foramen Ovale Electrode (K990788)
- Macro-Micro Depth Electrode (K041604)
- PMT Depthalon Electrodes (K802151)
- PMT Depthalon Electrodes (K151790)
Reference Devices
- Cueva Cranial Nerve Electrode (K944061)
Related Devices
- K053358 — DEPTH ELECTRODE, FORAMEN OVALE DEPTH ELECTRODES, WYLER SPHENOIDAL DEPTH ELECTRODES · Ad-Tech Medical Instrument Corp · May 25, 2006
- K170959 — DIXI Medical Microdeep Depth Electrode · Dixi Medical · Nov 24, 2017
- K202087 — DIXI Medical Microdeep Micro-Macro Depth Electrodes · Dixi Medical · Nov 18, 2021
- K053363 — DUAL-SIDED INTERHEMISPHERIC SUBDURAL ELECTRODES, GRID SUBDURAL ELECTRODES, INTRAOPERATIVE SUBDURAL ELECTRODES · Ad-Tech Medical Instrument Corp · May 30, 2006
- K151790 — PMT Platinum Depthalon Depth Electrode · Pmt Corporation · Jul 14, 2016
Submission Summary (Full Text)
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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of a human figure, with three overlapping profiles suggesting a sense of community and support. The profiles are rendered in a dark color, creating a strong contrast against the white background. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the figure.
Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
April 12, 2017
Ad-tech Medical Instrument Corporation % Gary Syring Principal Consultant Quality & Regulatory Associates, LLC. 800 Levanger Lane Stoughton, Wisconsin 53589
Re: K163355
Trade/Device Name: Depth Electrodes (Depth Electrode, Foramen Ovale Depth Eletrodes, Marco Micro Depth Electrode, Spencer Probe Depth Electrodes, Wyler Sphenoidal Depth Electrode)
Regulation Number: 21 CFR 882.1330 Regulation Name: Depth Electrode Regulatory Class: Class II Product Code: GZL Dated: November 28, 2016 Received: November 30, 2016
Dear Mr. Syring:
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 device
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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 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,
# Carlos L. Pena -S Fr
Carlos L. Peña, PhD, MS Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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## Indications for Use
510(k) Number (if known) K163355
## Device Name
Depth Electrodes (Depth Electrode, Foramen Ovale Depth Electrode, Spencer Probe Depth Electrode, Wyler Sphenoidal Depth Electrode)
## Indications for Use (Describe)
The Ad-Tech Depth Electrodes (Depth Electrodes, Foramen Ovale Depth Electrodes, Macro Micro Depth Electrodes, Spencer Probe Depth Electrodes, Wyler Sphenoidal Depth Electrodes) are intended for temporary (< 30 days) use with recording, monitoring and stimulation equipment for the recording, monitoring and stimulation of electrical signals at the subsurface level of the brain. The recording of electrical activity supports definition of epileptogenic foci and brain mapping.
Type of Use (Select one or both, as applicable)
> Prescription Use (Part 21 CFR 801 Subpart D)
Over-The-Counter Use (21 CFR 801 Subpart C)
## PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.
## FOR FDA USE ONLY
Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)
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#### 5.0 510(k) Summary
This summary is provided to support the 510(k) pre-market notification for the Depth Electrodes.
| Company Name: | Ad-Tech Medical Instrument Corporation<br>1901 William Street<br>Racine, WI 53404<br>Phone: (262) 634-1555 |
|------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Company Contact: | Lisa Theama, Chief Operating Officer |
| Date Summary Prepared: | January 5, 2017 |
| Trade Name: | Depth Electrodes (Depth Electrode, Foramen Ovale Depth Electrode,<br>Macro Micro Depth Electrode, Spencer Probe Depth Electrode, Wyle<br>Sphenoidal Depth Electrode) |
| Common Name: | Depth Electrode |
| Classification Name: | Depth Electrode<br>21 CFR 882.1330<br>Product Code: GZL<br>Class II |
| Predicate Devices: | K053358 Depth Electrode (Primary Predicate)<br>Ad-Tech Medical Instrument Corporation |
| | K964644 Depth Electrode<br>Ad-Tech Medical Instrument Corporation |
| | K990788 Foramen Ovale Electrode<br>Ad-Tech Medical Instrument Corporation |
| | K041604 Macro-Micro Depth Electrode<br>Ad-Tech Medical Instrument Corporation |
| | K802151 and K151790 PMT Depthalon Electrodes<br>PMT Corporation |
| Reference Device: | K944061 Cueva Cranial Nerve Electrode<br>Ad-Tech Medical Instrument Corporation |
#### 5.1 Product Description
The device under review is a family of Depth Electrodes. These electrodes provide sub-surface brain contact to support recording, monitoring and stimulation from user supplied equipment.
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#### 5.2 Intended Use of the Device
The Ad-Tech Depth Electrodes (Depth Electrodes, Foramen Ovale Depth Electrodes, Macro Micro Depth Electrodes, Spencer Probe Depth Electrodes, Wyler Sphenoidal Depth Electrodes) are intended for temporary (< 30 days) use with recording, monitoring and stimulation equipment for the recording, monitoring and stimulation of electrical signals at the subsurface level of the brain. The recording of electrical activity supports definition of the location of epileptogenic foci and brain mapping.
The intended use of the Ad-Tech Depth Electrodes is not modified by this 510(k).
#### 5.3 Summary of Technological Characteristics
The fundamental technical characteristics of the Depth Electrodes are not affected by this submission. Fundamentally the Depth Electrodes are a conductor of the biopotential signals from subsurface levels of the brain to the user's equipment and as applicable conductors of the stimulation energy from the user's equipment to subsurface levels of the brain.
The following table provides a side-by-side comparison of the Depth Electrodes to the predicate devices applied to support this pre-market notification.
| Table 5.3-1: Substantial Equivalence Technical Characteristics | | | |
|----------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------|
| Feature | Depth Electrodes<br>(Under Review) | Depth Electrodes<br>(Primary Predicate K053358) | Comment |
| Indications for Use | The Ad-Tech Depth Electrodes<br>(Depth Electrodes, Foramen<br>Ovale Depth Electrodes, Macro<br>Micro Depth Electrodes,<br>Spencer Probe Depth<br>Electrodes, Wyler Sphenoidal<br>Depth Electrodes) are intended<br>for temporary (< 30 days) use<br>with recording, monitoring and<br>stimulation equipment for the<br>recording, monitoring and<br>stimulation of electrical signals<br>at the subsurface level of the<br>brain. The recording of<br>electrical activity supports<br>definition of the location of<br>epileptogenic foci and brain<br>mapping. | The Ad-Tech Depth Electrodes<br>(Depth Electrodes, Foramen<br>Ovale Depth Electrodes, Macro<br>Micro Depth Electrodes,<br>Spencer Probe Depth<br>Electrodes, Wyler Sphenoidal<br>Depth Electrodes) are intended<br>for temporary (< 30 days) use<br>with recording, monitoring and<br>stimulation equipment for the<br>recording, monitoring and<br>stimulation of electrical signals<br>at the subsurface level of the<br>brain. The recording of<br>electrical activity supports<br>definition of the location of<br>epileptogenic foci and brain<br>mapping. | Same |
| Clinical<br>Application | Placed in the subsurface level of<br>the brain to support recording,<br>monitoring and stimulation. | Placed in the subsurface level of<br>the brain to support recording,<br>monitoring and stimulation. | Same |
| Contraindications | These depth electrodes should<br>not be used on any patient who<br>the physician/surgeon considers<br>at risk for infection or for whom<br>the surgical recording and<br>stimulation procedure cannot be<br>performed safely and<br>effectively. | These depth electrodes should<br>not be used on any patient who<br>the physician/surgeon considers<br>at risk for infection or for whom<br>the surgical recording and<br>stimulation procedure cannot be<br>performed safely and<br>effectively. | Same |
| Single patient use,<br>Disposable | Yes | Yes | Same |
| Provided Sterile | Yes | Yes | Same |
| Environment of | Intraoperative and Neurological | Intraoperative and Neurological | Same |
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| Table 5.3-1: Substantial Equivalence Technical Characteristics | | | |
|----------------------------------------------------------------|------------------------------------|-------------------------------------------------|-------------------------------------------------------------------------------|
| Feature | Depth Electrodes<br>(Under Review) | Depth Electrodes<br>(Primary Predicate K053358) | Comment |
| Use | monitoring locations | monitoring locations | |
| Duration of Use | < 30 days | < 30 days | Same |
| Electrode Contact<br>Material | Platinum/Iridium | Platinum/Iridium | Same |
| Maximum<br>Stimulation<br>Charge Density | $ \leq 30 \mu C/cm^2 $ | Not indicated in labeling | Clarification of<br>stimulation charge<br>density limits for brain<br>tissue. |
The following table identifies features in comparison to predicate by Depth Electrode Commercial Name.
| Table 5.3-2: Feature comparison Spencer Probe Depth Electrodes | | | | |
|----------------------------------------------------------------|----------------------------------|----------------------------------------------------------|-------------------------------------------------------------------|----------------------------------------------------------------------------|
| Feature | Depth Electrodes<br>Under Review | Depth Electrode<br>(Predicate<br>K053358 and<br>K964644) | PMT Depthalon<br>Electrodes<br>(Predicate<br>K802151,<br>K151790) | Equivalence<br>Comments |
| Number of electrode<br>contacts | Up to 16 | Up to 12 | Up to 16 contacts | Equivalent |
| Electrode Material | Platinum | Platinum | Platinum or<br>Stainless Steel | Same |
| Electrode body<br>diameter<br>(brain contact) | 0.86 mm to 1.96<br>mm | 1 mm | 0.8 mm to 1.8 mm | Equivalent<br>Variations of<br>electrode body<br>diameter are<br>provided. |
| Stylet | Yes | Yes | Yes | Same |
| Neuro Navigation<br>Stylet compatible | Yes<br>(AD Style Only) | No | Yes<br>(ACCUNAC®<br>variation) | Equivalent |
| Table 5.3-3: Foramen Ovale Depth Electrodes Feature Comparison | | | |
|----------------------------------------------------------------|---------------------------------------------------|------------------------------------------------|--------------------------------------------------------------------------------|
| Feature | Foramen Ovale<br>Depth Electrodes<br>Under Review | Foramen Ovale Electrode<br>(Predicate K990788) | Equivalence Comments |
| Number of electrode<br>contacts | Up to 6 | Up to 6 | Same |
| Electrode Material | Platinum | Platinum | Same |
| Electrode body<br>diameter<br>(brain contact) | 1.1 mm | 1.0 $ ± $ 0.5 mm | Equivalent<br>Within the tolerance of the<br>predicate. |
| Overall length | $ ≤ $ 660 mm | $ ≤ $ 383 mm | A longer electrode accommodates<br>additional contacts and user<br>preference. |
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| Table 5.3-4: Feature Comparison of Macro Micro Depth Electrodes | | | |
|-----------------------------------------------------------------|---------------------------------------------------------------------|---------------------------------------------------------------------|-------------------------------------------------------|
| Feature | Macro Micro Depth<br>Electrodes<br>Under Review | Macro-Micro Depth<br>Electrode<br>(Predicate K041604) | Equivalence Comments |
| Number of electrode<br>contacts | Up to 12 (Macro)<br>Up to 24 (Micro)<br>(Up to 32 total contacts) | Up to 12 (Macro)<br>Up to 10 (Micro) | Additional Micro Electrode<br>contacts are available. |
| Electrode Material | Platinum (Macro Electrode)<br>Platinum/Iridium (Micro<br>Electrode) | Platinum (Macro Electrode)<br>Platinum/Iridium (Micro<br>Electrode) | Same |
| Electrode body<br>diameter<br>(brain contact) | 1.3 mm (Macro)<br>38 to 51 microns (Micro) | 1.2 to 1.4 mm (Macro)<br>15 to 30 microns (Micro) | Equivalent |
| Electrode contact<br>length<br>(along body of the<br>electrode) | 1.57 mm (Macro) | 1.32 to 1.57 mm (Macro) | Same |
| Overall length | ≤ 660 mm | ≤ 400 mm | A longer electrode<br>accommodates user preference. |
| Stylet | Yes | Yes | Same |
| Table 5.3-5: Stay Flange Comparison to Reference Device | | | |
|---------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Feature | Depth Electrodes<br>Under Review | Cueva Cranial Nerve<br>Electrode<br>(Reference Device<br>K944061) | Equivalence Comments |
| Indications for Use | The AD-TECH Depth<br>Electrodes (Depth Electrode,<br>Foramen Ovale Depth<br>Electrode, Macro Micro<br>Depth Electrode, Spencer<br>Probe Depth Electrode,<br>Wyler Sphenoidal Depth<br>Electrode) are intended for<br>temporary (< 30 days) use<br>with recording, monitoring<br>and stimulation equipment<br>for the recording, monitoring<br>and stimulation of electrical<br>signals at the subsurface<br>level of the brain.<br>The recording of electrical<br>activity supports definition<br>of the location of<br>epileptogenic foci and brain<br>mapping. | The Cueva Cranial Nerve<br>Electrode is intended for<br>use to monitor cranial<br>nerves during skull base<br>type surgeries. It is not for<br>implantation and is to be<br>used for surgical<br>procedures only. The<br>electrode and applicator<br>are for single use only, not<br>for reuse. The electrode<br>and applicator are not to<br>be resterilized. | Equivalent monitoring<br>indication of intracranial<br>nerves.<br>The Cueva Electrode resides on<br>the surface of a nerve. The<br>Depth Electrodes are placed<br>subsurface of a nerve (brain). |
| Duration of use | < 30 days | < 10 hours | The Cueva Electrode reference<br>device is limited to<br>intraoperative use. |
| Single patient use | Yes | Yes | Same |
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| Table 5.3-5: Stay Flange Comparison to Reference Device | | | |
|---------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Feature | Depth Electrodes<br>Under Review | Cueva Cranial Nerve<br>Electrode<br>(Reference Device<br>K944061) | Equivalence Comments |
| disposable | | | |
| Provided sterile | Yes | Yes | Same |
| Stay Flange | Yes<br>Optional accessory placed<br>around the Depth Electrode<br>Tail that exists the skull,<br>providing a surface to suture<br>to the skin, preventing<br>movement of the electrode. | Yes<br>Molded onto electrode<br>Tail.<br>Suture of Stay flange for<br>securing of connector end<br>electrode, prevents<br>movement of electrode. | Equivalent<br>For both devices the Stay<br>Flange provides a suturing<br>surface to support stabilizing<br>the electrode tail. |
| Stay Flange patient<br>contact material | Silicone | Silicone | Equivalent |
| Compatible Depth<br>Electrode Tail<br>Diameter | 0.86 mm to 1.3 mm | Not Applicable<br>Molded onto Electrode<br>Tail. | The Stay Flange is an optional<br>accessory to variations of Depth<br>Electrodes. The Stay Flange is<br>placed around the Depth<br>Electrode tail and provides an<br>optional method of providing<br>Depth Electrode retention and a<br>surface for suturing the Stay<br>Flange to skin. |
#### 5.4 Performance Tests to Demonstrate Substantial Equivalency
To establish the technical equivalency of the Depth electrodes, evaluations were conducted to confirm compliance with performance requirements, including:
| Test | Summary of Requirement | Result |
|--------------------------------|---------------------------------------------------------------------------------|--------|
| Electrical Resistance | Measure electrical resistance from the electrode contact to connector. | Pass |
| Dimensional Characteristics | Dimensional requirements are met by manufacturing. | Pass |
| Stimulation affect | Stimulation at 30 $\mu$ C/cm2 does not affect the electrodes. | Pass |
| Optional Accessory Stay Flange | The optional accessory Stay Flange supports adequate Depth Electrode retention. | Pass |
#### 5.5 Conclusion
The Depth Electrodes meet performance requirements. The intended use and technology of the Depth Electrodes are the same as the predicate devices.