VaPro Plus Pocket, VaPro Plus

K193148 · Hollister Incorporated · GBM · Dec 13, 2019 · Gastroenterology, Urology

Device Facts

• Record ID: K193148
• Device Name: VaPro Plus Pocket, VaPro Plus
• Applicant: Hollister Incorporated
• Product Code: GBM · Gastroenterology, Urology
• Decision Date: Dec 13, 2019
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 876.5130
• Device Class: Class 2
• Attributes: Therapeutic, Pediatric

Intended Use

This intermittent catheter is a flexible tubular device that is inserted through the urethra by male, female and pediatric patients who need to drain urine from the bladder.

Device Story

Hydrophilic-coated, single-use intermittent catheter; manages urinary incontinence by draining bladder. Features include protective sleeve, introducer tip to shield against distal urethral bacteria, and color-coded funnel. Plus Pocket version includes integrated urine collection bag for use when external receptacles are unavailable. Packaging contains sealed water compartment for catheter hydration. Designed for discreet storage and use by patients with limited dexterity. Operated by patient or caregiver; used in home or clinical settings. Provides sterile, ready-to-use solution for bladder management; reduces risk of contamination during insertion.

Clinical Evidence

Bench testing only. Physical performance met EN 1618, EN 1616, EN 13868, ISO 8669-2, and ASTM-D1003-13. Biocompatibility testing met ISO 10993-1, 10993-5, 10993-11, and 10993-12. Sterilization validated per ISO 11137-1/2 and AAMI/ANSI/ISO 11737-1/2.

Technological Characteristics

Phthalate-free PVC catheter with PVP-based hydrophilic coating. Features protective sleeve, introducer tip, and funnel end. Sterile (Gamma radiation). Hydration via internal water compartment. Plus Pocket version includes collection bag. Complies with EN 1618, EN 1616, EN 13868, ISO 8669-2, and ASTM-D1003-13.

Indications for Use

Indicated for male, female, and pediatric patients requiring bladder drainage via urethral catheterization.

Regulatory Classification

Identification

A urological catheter and accessories is a flexible tubular device that is inserted through the urethra and used to pass fluids to or from the urinary tract. This generic type of device includes radiopaque urological catheters, ureteral catheters, urethral catheters, coudé catheters, balloon retention type catheters, straight catheters, upper urinary tract catheters, double lumen female urethrographic catheters, disposable ureteral catheters, male urethrographic catheters, and urological catheter accessories including ureteral catheter stylets, ureteral catheter adapters, ureteral catheter holders, ureteral catheter stylets, ureteral catheterization trays, and the gastro-urological irrigation tray (for urological use).

Predicate Devices

• VaPro 2 Plus & VaPro 2 Plus Pocket (K183253)

Reference Devices

• VaPro 2 Intermittent Catheter (K180824)

Submission Summary (Full Text)

{0}------------------------------------------------

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo features the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG" in blue, with the word "ADMINISTRATION" underneath.

December 13, 2019

Hollister Incorporated Michelle Schiltz-Taing Regulatory Affairs Manager 2000 Hollister Drive Libertyville, IL 60048

Re: K193148

Trade/Device Name: VaPro Plus Pocket, VaPro Plus Regulation Number: 21 CFR 876.5130 Regulation Name: Urological Catheter and Accessories Regulatory Class: II Product Code: GBM Dated: November 11, 2019 Received: November 13, 2019

Dear Michelle Schiltz-Taing:

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. 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.

{1}------------------------------------------------

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 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/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely.

Angel A .Soler-Garcia, Ph.D. Acting Assistant Director DHT3B: Division of Reproductive, Gynecology and Urology Devices OHT3: Office of GastroRenal, ObGyn, General Hospital and Urology Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

{2}------------------------------------------------

## Indications for Use

510(k) Number (if known)

#### K193148

Device Name VaPro 2 Pocket Line Extension

Indications for Use (Describe)

This intermittent catheter is a flexible tubular device that is inserted through the urethra by male, female and pediatric patients who need to drain urine from the bladder.

Type of Use (Select one or both, as applicable)

| <span style="font-size:16px">☑</span> Prescription Use (Part 21 CFR 801 Subpart D) |
|------------------------------------------------------------------------------------|
| <span style="font-size:16px">☐</span> Over-The-Counter Use (21 CFR 801 Subpart C) |

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

#### *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.*

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

> Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

{3}------------------------------------------------

Image /page/3/Picture/1 description: The image shows the Hollister logo. The logo consists of a red, stylized cross-like symbol on the left and the word "Hollister" in gray on the right. The font is sans-serif and the word is followed by a period.

# 510(k) Summary

| Applicant: | Hollister Incorporated<br>2000 Hollister Drive<br>Libertyville, IL 60048 |
|----------------------|-------------------------------------------------------------------------------------------------------------------------|
| Contact Person: | Michelle Schiltz-Taing<br>Hollister Incorporated<br>2000 Hollister Drive<br>Libertyville, IL 60018<br>(t) 847-680-2122 |
| Date Prepared: | 12 December 2019 |
| Trade Name: | VaPro 2TM Pocket Line Extension |
| Common Name: | Catheter, Urethral |
| Product Code/Class: | GBM/Class II |
| Classification Name: | Urological catheter and accessories |
| CFR: | 21 CFR 876.5130 |

### Predicate Device:

VaPro 2 Plus & VaPro 2 Plus Pocket, K183253 by Hollister Incorporated.

### Reference Device:

VaPro 2 Intermittent Catheter, K180824 by Hollister Incorporated

### Indications for Use:

This intermittent catheter is a flexible tubular device that is inserted through the urethra by male, female and pediatric patients who need to drain urine from the bladder.

### Description of Applicant Device:

This submission is to add an additional size (Fr 08) to the currently cleared 16-inch Pocket and Plus Pocket configurations of VaPro 2.

The VaPro 2 Pocket Line Extension is a hydrophilic coated, single use catheter to be used as a means of managing urinary incontinence by draining urine from the bladder. VaPro 2 Pocket Line Extension has the following features:

- . Hydrophilic-coated PVC catheter (phthalate free)

{4}------------------------------------------------

- Two smooth catheter eyelets
- . Protective sleeve
- Protective introducer tip as a way to shield the sterile catheter from bacteria in the distal urethra during insertion
- Color-coded funnel. ●
- Urine Collection bag (for the Plus Pocket version)

The packaging contains a sealed water compartment chamber from which the water migrates to the catheter compartment and hydrates (lubricates) the catheter. The outer packaging is designed to facilitate access for those with limited dexterity. The Pocket version is designed to be discreet and easy to store. In the Plus Pocket configuration, the urinary catheter is connected to a collection bag for use when drainage into a suitable receptacle is not feasible or practical.

#### Technological Characteristics:

The table below summarizes the technological characteristics of VaPro 2 Line Extension as compared to the predicate and reference devices.

| | Subject Device | | Predicate Device<br>(K183253) | Reference Device<br>(K180824) |
|---------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------|-------------------------------|-------------------------------|
| | Fr 08 Pocket | Fr 08 Plus<br>Pocket | | |
| Indication for Use | This intermittent catheter is a flexible tubular device that is inserted through the<br>urethra by male, female and pediatric patients who need to drain urine from the<br>bladder. | | | |
| Condition of Use | Single Use | | | |
| Pre-lubricated | Yes-by water vapor hydration | | | |
| Ready to use | Yes | | | |
| End Design | Funnel | | | |
| Sterile | Yes - Gamma Radiation | | | |
| No touch design | Yes - contains sleeve | | | |
| Hydrophilic Coating | PVP Based (polyvinylpyrollidone) Coating | | | |
| Protective Introducer Tip | Yes | | | |
| Protective Cap | Yes | | | |
| Catheter Material | PVC (phthalate free) | | | |
| Urine Collection Bag | No | Yes | Yes | No |

### Brief Description of Non-Clinical Testing:

The physical performance properties of VaPro 2 Pocket Line Extension met all applicable requirements of EN 1618, EN 1616 and EN 13868. Additionally the Plus Pocket version of the subject device met the physical performance properties of ISO 8669-2 and ASTM-D1003-13

Biocompatibility testing met the requirements of ISO 10993-1, 10993-5 and 10993-12. Additionally the Plus Pocket version met the requirements of ISO 10993-11.

Sterilization met all requirements of ISO 11137-1, ISO 11137-2, AAMI/ANSI/ISO 11737-1 and AAMI/ANSI/ISO 11737-2.

{5}------------------------------------------------

## Conclusion:

It is concluded that the information supplied in this submission has demonstrated that VaPro 2 Pocket Line Extension is substantially equivalent to the legally marketed predicate device.