HANAROSTENT LowAxTM Colon/Rectum (NNN), HANAROSTENT LowAxTM Duodenum/Pylorus (NNN)
Device Facts
| Record ID | K180180 |
|---|---|
| Device Name | HANAROSTENT LowAxTM Colon/Rectum (NNN), HANAROSTENT LowAxTM Duodenum/Pylorus (NNN) |
| Applicant | M.I.Tech Co., Ltd. |
| Product Code | MQR · General, Plastic Surgery |
| Decision Date | Nov 2, 2018 |
| Decision | SESE |
| Submission Type | Traditional |
| Regulation | 21 CFR 878.3610 |
| Device Class | Class 2 |
| Attributes | Therapeutic |
Indications for Use
The HANAROSTENT LowAxTM Colon/Rectum (NNN) is indicated for the palliative treatment of colorectal strictures produced by malignant neoplasms and to relieve large bowel obstruction prior to colectomy in patients with malignant structures. The HANAROSTENT LowAxTM DuodenumPylorus (NNN) is indicated for the palliative treatment of pyloric or duodenal obstructions caused by malignant neoplasms.
Device Story
Self-expanding tubular prosthesis designed to maintain patency of colorectal or duodenal obstructions caused by malignant tumors. Device consists of a Nitinol (nickel titanium alloy) wire stent and a polymeric delivery system. Stent is loaded into the distal delivery system; deployed by pulling the outer sheath under fluoroscopic or endoscopic guidance. Used in clinical settings by physicians. Stent provides mechanical radial force to keep the obstructed lumen open, facilitating palliative relief of symptoms. Single-use device.
Clinical Evidence
Bench testing only. Performance testing included axial force, compression force, corrosion, deployment force, deployment accuracy, dimensions, expansion force, repositioning force, stent separation, tensile strength, and trackability. Biocompatibility was assessed per ISO 10993-1:2003/2012.
Technological Characteristics
Self-expanding stent made of Nitinol (nickel titanium alloy) wire. Delivery system made of polymeric materials. Includes gold radiopaque markers. Sterilization via ethylene oxide. Single-use. Deployment via pulling outer sheath. Dimensions: 20-22mm body diameter, 60-120mm length. Delivery diameter 3.40mm (10.2Fr).
Indications for Use
Indicated for patients with malignant colorectal strictures requiring palliative treatment or relief of large bowel obstruction prior to colectomy, and patients with malignant pyloric or duodenal obstructions requiring palliative treatment.
Regulatory Classification
Identification
An esophageal prosthesis is a rigid, flexible, or expandable tubular device made of a plastic, metal, or polymeric material that is intended to be implanted to restore the structure and/or function of the esophagus. The metal esophageal prosthesis may be uncovered or covered with a polymeric material. This device may also include a device delivery system.
Special Controls
The special control for this device is FDA's “Guidance for the Content of Premarket Notification Submissions for Esophageal and Tracheal Prostheses.”
Predicate Devices
- Wallflex™ Enteral Colonic Stent with Anchor Lock Delivery System (K061877)
- Wallflex™ Enteral Duodenal Stent with Anchor Lock Delivery System (K062750)
Reference Devices
- Wallflex™ Enteral Colonic Stent with Anchor Lock Delivery System (K042065)
Submission Summary (Full Text)
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November 2, 2018
M.I. Tech Co., Ltd. % Carol Buchert Principal Medical Research Scientist NAMSA 400 Highway 169 South, Suite 500 Minneapolis, MN 55426
Re: K180180
Trade/Device Name: HANAROSTENT LowAxTM Colon/Rectum (NNN), HANAROSTENT LowAxTM Duodenum/Pylorus (NNN) Regulation Number: 21 CFR§ 878.3610 Regulation Name: Esophageal Prosthesis Regulatory Class: II Product Code: MQR, MUM Dated: September 20, 2018 Received: September 24, 2018
Dear Carol Buchert:
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 mav, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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.
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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 of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see
https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.html; good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
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 comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
# Jeffrey W. Cooper -S
for Benjamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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# Indications for Use
510(k) Number (if known) K180180
Device Name
HANAROSTENT LowAxTM Colon/Rectum (NNN) HANAROSTENT LowAxTM Duodenum/Pylorus (NNN)
Indications for Use (Describe)
The HANAROSTENT LowAxTM Colon/Rectum (NNN) is indicated for the palliative treatment of colorectal strictures produced by malignant neoplasms and to relieve large bowel obstruction prior to colectomy in patients with malignant structures.
The HANAROSTENT LowAxTM DuodenumPylorus (NNN) is indicated for the palliative treatment of pyloric or duodenal obstructions caused by malignant neoplasms.
| 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) |
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# Pre-Market Notification 510(k) Summary
This summary of 510(k) safety and effectiveness information is being submitted in accordance with requirements of 21 CFR Part 807.92.
#### 1. Submitter:
| Name: | M.I.Tech Co., Ltd.<br>174 Habuk 2-gil, Jinwi-myeon,<br>Pyeongtaek-si, Gyeonggi-do<br>17706, Republic of Korea |
|----------|---------------------------------------------------------------------------------------------------------------|
| Contact: | Ms. Inae Kim / Manager<br>Phone: +82 70-4304-7450<br>Fax: +82 2-3473-4702 |
#### 2. Device Name and Classification:
| Proprietary Name: | HANAROSTENT® LowAx™ Colon/Rectum (NNN) |
|-----------------------|----------------------------------------|
| Common Name: | Colon/Rectum Stent |
| Classification Name: | Stent, Colonic, Metallic, Expandable |
| Classification: | 21 CFR 878.3610 |
| Product Code: | MQR |
| Third Party Reviewed: | No |
| Proprietary Name: | HANAROSTENT® LowAx™ Duodenum/Pylorus (NNN) |
|-----------------------|--------------------------------------------|
| Common Name: | Duodenum/Pylorus Stent |
| Classification Name: | Stent, Duodenal, Metallic, Expandable |
| Classification: | 21 CFR 878.3610 |
| Product Code: | MUM |
| Third Party Reviewed: | No |
#### 3. Predicate Device:
Wallflex™ Enteral Colonic Stent with Anchor Lock Delivery System, K061877 Wallflex™ Enteral Duodenal Stent with Anchor Lock Delivery System, K062750
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#### 4. Description:
The same device description applies to both the HANAROSTENT® LowAx™ Colon/Rectum (NNN) and the HANAROSTENT® LowAx™ Duodenum/Pylorus (NNN).
This self-expanding tubular prosthesis is designed to maintain patency of colorectal or duodenal obstructions caused by malignant tumors. It consists of a self-expandable metal stent and a delivery system. The self-expandable metal stent is made of nickel titanium alloy (Nitinol) wire, and the delivery system is made of polymeric materials. The stent is loaded into the distal part of the delivery system, and expanded in the body by pulling the outer sheath of the delivery system. The HANAROSTENT® LowAx™ Colon/Rectum (NNN) and HANAROSTENT® LowAxTM Duodenum/Pylorus (NNN) are intended for single use only.
#### Indications for use: 5.
The HANAROSTENT® LowAx™ Colon/Rectum (NNN) is indicated for the palliative treatment of colorectal strictures caused by malignant neoplasms and to relieve large bowel obstruction prior to colectomy in patients with malignant structures.
The HANAROSTENT® LowAx™ Duodenum/Pylorus (NNN) is indicated for the palliative treatment of pyloric or duodenal obstructions caused by malignant neoplasms.
#### Technological Characteristics: 6.
The proposed devices are substantially equivalent to the predicate devices, the Wallflex™ Enteral Colonic Stent with Anchor Lock Delivery System, K061877 and Wallflex™ Enteral Duodenal Stent with Anchor Lock Delivery System, K062750.
Both predicate devices share identical technological characteristics to each other. This is evidenced in 510(k)s K061877 and K02750. Both predicate devices cite the same predicate device within their submission: Boston Scientific Corporation's WallflexTM Enteral Colonic Stent with Anchor Lock Delivery System, K042065
## Per K061877's Technological Characteristics section:
"The proposed Wallflex Enteral Colonic Stent with Anchor Lock Delivery System has the identical technological characteristics as the currently marketed Wallflex Enteral Colonic Stent with Anchor Lock Delivery System (K042065)."
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# Per K062750's Technological Characteristics section:
"The proposed WallFlex Enteral Duodenal Stent with Anchor Lock Delivery System has the identical technological (materials, construction, processing) characteristics as the predicate WallFlex Enteral Colonic Stent with Anchor Lock Delivery System and has the identical indication statement as the predicate Wallstent Enteral Endoprosthesis."
The proposed devices have the same characteristics as the predicate devices as listed below:
- -Stent design
- Single use -
- Sterilization method -
- Method of placement -
- Method of deployment -
- -Stent materials
The following technological differences exist between the proposed devices and the currently marketed predicate devices, the Wallflex™ Enteral Colonic Stent with Anchor Lock Delivery System and the Wallflex™ Enteral Duodenal Stent with Anchor Lock Delivery System.
- Stent diameter -
- -Stent length
- Delivery diameter -
- Radiopaque markers -
Please see the table below summarizing the technological characteristics of the subject devices and predicate devices.
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| Device Name | Subject Device #1<br>HANAROSTENT®<br>LowAxTM<br>Colon/Rectum (NNN) | Subject Device #2<br>HANAROSTENT®<br>LowAxTM<br>Duodenum/Pylorus (NNN) | Predicate Device #1<br>WallflexTM Enteral<br>Colonic Stent | Predicate Device #2<br>WallflexTM Enteral<br>Duodenal Stent | Comment | | Yes | Yes | Yes | Yes | Identical |
|---------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------|------------------------------------|------------------------------------|------------------------------------|------------------------------------|-------------------------------------------------------------------------------------------------------------------|
| Applicant | M.I. Tech Co., Ltd. | M.I. Tech Co., Ltd. | Boston Scientific Corp. | Boston Scientific Corp. | N/A | Single Use | | | | | |
| 510(k) Number | TBD | TBD | K061877 | K062750 | N/A | Sterilization Method | Ethylene Oxide | Ethylene Oxide | Ethylene Oxide | Ethylene Oxide | Identical |
| Decision Date | TBD | TBD | 09/15/2006 | 12/04/2006 | N/A | Method of Placement | Fluoroscopic,<br>Endoscopic | Fluoroscopic,<br>Endoscopic | Fluoroscopic,<br>Endoscopic | Fluoroscopic,<br>Endoscopic | Identical |
| Common Name | Colon/Rectum Stent | Duodenum/Pylorus<br>Stent | Colon/Rectum Stent | Duodenum/Pylorus<br>Stent | Identical | Method of Deployment | Release by pulling<br>outer sheath | Release by pulling<br>outer sheath | Release by pulling<br>outer sheath | Release by pulling<br>outer sheath | Identical |
| Indications for Use | The palliative treatment<br>of colorectal strictures<br>caused by malignant<br>neoplasms and to<br>relieve large bowel<br>obstruction prior to<br>colectomy in patients<br>with malignant<br>structures. | The palliative treatment<br>of gastroduodenal<br>obstructions caused by<br>malignant neoplasms. | The palliative treatment<br>of colonic strictures<br>caused by malignant<br>neoplasms and to<br>relieve large bowel<br>obstruction prior to<br>colectomy in patients<br>with malignant<br>structures. | The palliative treatment<br>of gastroduodenal<br>obstructions caused by<br>malignant neoplasms. | Identical | Stent Materials | Nitinol | Nitinol | Nitinol | Nitinol | Identical |
| Stent Diameter | 20mm body with 25mm<br>dumbbell<br>22mm body with 27mm<br>dumbbell | 20mm body with 25mm<br>dumbbell<br>22mm body with 27mm<br>dumbbell | 22mm body with 27mm<br>flare<br>25mm body with a<br>30mm flare | 22mm body with 27mm<br>flare | Equivalent. Subject<br>device offers a model<br>that is 2mm smaller in<br>stent diameter for the<br>body and dumbbell. | Radiopaque Marker<br>Materials | Gold | Gold | N/A | N/A | Equivalent. Subject device has 12 gold radiopaque markers. The predicate device does not have radiopaque markers. |
| Stent Length | 60mm<br>70mm<br>80mm<br>90mm<br>100mm<br>110mm<br>120mm | 60mm<br>70mm<br>80mm<br>90mm<br>100mm<br>110mm<br>120mm | 60mm<br>90mm<br>120mm | 60mm<br>90mm<br>120mm | Equivalent. The length<br>of subject device is<br>subdivided within the<br>smallest and largest<br>lengths of predicate<br>devices. | Shelf life | 3 years | 3 years | 3 years | 3 years | Identical |
| Delivery Diameter | 3.40mm (10.2Fr) | 3.40mm (10.2Fr) | 3.33mm (10Fr) | 3.33mm (10Fr) | Equivalent. The<br>diameter of our delivery<br>system is 0.06mm<br>larger than the predicate<br>device. This level is<br>within a 5% tolerance<br>of the dimension | | | | | | |
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K180180
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#### Performance Summary: 7.
Appropriate bench testing was performed to confirm the safety and effectiveness of the proposed devices as compared to the identified predicate device.
The device specific FDA guidance document was consulted in preparing this premarket submission, Guidance for the content of premarket notifications for esophageal and tracheal prostheses issued April 28th, 1998. Performance testing was performed as per the design control system and the following tests were conducted:
- Axial force i
- । Compression force
- Corrosion i
- Deployment force i
- । Deployment accuracy
- Dimensions ।
- Expansion force i
- Repositioning force ।
- Stent separation ।
- । Tensile strength
- Trackability -
Biocompatibility safety was assessed in accordance with ISO 10993-1:2003, 2012.
#### Conclusions: 8.
The non-clinical data supports the safety of the proposed devices and demonstrates that the HANAROSTENT LowAx™ Colon/Rectum (NNN) and the HANAROSTENT LowAx™ Duodenum/Pylorus (NNN) are safe and effective and will perform as intended in the specified use conditions.
The non-clinical data also demonstrates that the proposed device is substantially equivalent to the predicate devices, Wallflex™ Enteral Colonic Stent with Anchor Lock Delivery System (K061877) and Wallflex™ Enteral Duodenal Stent with Anchor Lock Delivery System (K062750).
