THEROX INFUSION CATHETER, MODEL INCA-1

K052637 · Therox, Inc. · DQO · Mar 8, 2006 · Cardiovascular

Device Facts

• Record ID: K052637
• Device Name: THEROX INFUSION CATHETER, MODEL INCA-1
• Applicant: Therox, Inc.
• Product Code: DQO · Cardiovascular
• Decision Date: Mar 8, 2006
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 870.1200
• Device Class: Class 2
• Attributes: Therapeutic, 3rd-Party Reviewed

Intended Use

The TherOx® Infusion Catheter is intended to assist in the controlled infusion of diagnostic or therapeutic solutions into the peripheral and coronary vasculature. The target vessel effective diameter is ≥ 2.0 mm. The catheter is placed by a physician using a guide catheter and over a guidewire that extends beyond the final position of the infusion catheter.

Device Story

TherOx Infusion Catheter (Model INCA-1) is a sterile, single-use, 4.6F intravascular catheter (127 cm length). Device features distal atraumatic soft tip, semi-rigid flexible shaft, and proximal luer hub. Radiopaque band at distal tip enables fluoroscopic visualization. Used by physicians in clinical settings to deliver diagnostic or therapeutic solutions into peripheral or coronary vasculature. Device is introduced percutaneously via guide catheter over a guidewire. Output is the controlled delivery of fluids to target vessel; assists clinicians in localized treatment or diagnostic procedures. Benefits include maneuverability within vasculature and compatibility with smaller guide catheters due to 4.6F diameter.

Clinical Evidence

Bench testing only. Performance verified via strength, flexibility, flow, and pressure testing per ISO 10555-1, -2, and -3. Biocompatibility confirmed per ISO 10993-1. Sterilization validated per ISO 11135. Packaging tested per ISO 11607. No clinical data presented.

Technological Characteristics

4.6F intravascular catheter; 127 cm length. Materials: HDPE shaft, rigid HDPE luer, LDPE plasticized tip. Radiopaque marker band. Sterilized via ethylene oxide (ISO 11135). Conforms to ISO 10555 series for intravascular catheters. Single-lumen, end-hole design.

Indications for Use

Indicated for controlled infusion of diagnostic or therapeutic solutions into peripheral or coronary vasculature in patients with target vessel diameter ≥ 2.0 mm. Contraindicated for vessels < 2.0 mm diameter; not for pediatric or neonatal use.

Regulatory Classification

Identification

An intravascular diagnostic catheter is a device used to record intracardiac pressures, to sample blood, and to introduce substances into the heart and vessels. Included in this generic device are right-heart catheters, left-heart catheters, and angiographic catheters, among others.

Predicate Devices

• Boston Scientific/Target Therapeutics Tracker® - 38 Infusion Catheter (K853997, K862117)

Submission Summary (Full Text)

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#### 2006 MAR 8 510(k) SUMMARY

Date Prepared: August 19, 2005

Name and Address of Submitter: TherOx, Inc.

2400 Michelson Drive Irvine, CA 92612 Phone; [phone] FAX: [phone]

Contact Name : Kevin Larkin, President and CEO

Trade/ Proprietary Name: TherOx® Infusion Catheter (Model No.: INCA-1)

Classification Name: Catheter, Intravascular, Diagnostic

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Device Classification: Class II per 21 CFR 870.1200

### SUBSTANTIAL EQUIVALENCE STATEMENT

The TherOx® Infusion Catheter, manufactured by TherOx, Inc., is substantially equivalent to the Boston Scientific/Target Therapeutics Tracker® - 38 Infusion Catheter cleared for market under 510(k) nos. K853997 and K862117. 1 Both catheters are intended to enable delivery of diagnostic and therapeutic solutions into the peripheral and coronary vasculature when infroduced percutaneously to the body through commercially available guide catheters and over commercially available quidewires. Both catheters are sterile, single lumen, end-hole catheters intended for single-use only. The substantial equivalence of the catheters is supported by physical and mechanical characteristics that are very similar and by the fact that the peripheral and coronary vessel applications for each catheter are the same.

### DEVICE DESCRIPTION

The TherOx® Infusion Catheter is a sterile, single-use, 4.6 French (F) intravascular catheter with a 127 cm usable length. The catheter is comprised of three sections; 1) a distal atraumatic soft tip 2) a semi-rigid but flexible shaft; and 3) a proximal luer hub for connection of solution-delivery devices. A radiopaque band at the distal tip allows fluoroscopic visualization of the catheter's location in the vessel.

The TherOx® Infusion Catheter is packaged in standard medical product packaging and sterilized with ethylene oxide. The catheter and its packaging have been qualified for a three-year shelf life under conditions of proper storage and handling.

1 TherOx is a registered trademark of TherOx, Inc. All other trademarks referenced are the property of their respective owners.

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#### INTENDED USE

The TherOx® Infusion Catheter is intended to assist in the controlled infusion of diagnostic The Therox "Thidslon Outlotor to Interal and coronary vasculature. The target vessel of therapoutie colutions into int. The catheter is placed by a physician using a guide effective diameter is = 2.0 mm.
catheter and over a guidewire that extends beyond the final position of the infusion catheter.

#### CONTRAINDICATIONS

- Do not place in a vessel with an effective diameter of < 2.0 mm. .
- Not intended for pediatric or neonatal use. .

#### TECHNOLOGY COMPARISON

The TherOx® Infusion Catheter is very similar in design and performance characteristics when compared to the Tracker® - 38 Infusion Catheter predicate device. Both catheters have a soft atraumatic tip and a flexible shaft that facilitates maneuverability within the target vessel. Both catheters have a female luer hub for attachment of solution delivery devices and a radiopaque marker band at the tip to visualize catheter location under fluoroscopy. A comparison of catheter characteristics demonstrates that both catheters meet the requirements of the ISO 10555 series of standards for intravascular catheters. Both devices are substantially equivalent relative to strength, flexibility, pressure, and flow properties.

Minor differences are enumerated in Table 1, below, and are explained following the table.

| Characteristic | TherOx® Infusion<br>Catheter | Tracker® - 38 Infusion<br>Catheter |
|-------------------|--------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------|
| 1. Outer Diameter | 4.6 F (0.060 in) overall | 5.3 F (0.070 in) overall<br>5 F (0.066 in) at tip |
| 2. Inner Diameter | 0.046 in overall<br>0.037 in min at marker band | 0.046 in overall<br>0.040 in at marker band |
| 3. Usable Length | 127 cm | 115 cm1 |
| 4. Materials | High density polyethylene<br>(HDPE) shaft<br>Rigid HDPE luer<br>LDPE plasticized tip | Polypropylene/Low density<br>polyethylene (LDPE) shaft<br>Rigid clear thermoplastic luer<br>LDPE plasticized tip |

| TABLE 1 – Summary of Catheter Differences | | |
|-------------------------------------------|--|--|
|-------------------------------------------|--|--|

1 -- 117 cm as labeled which includes strain relief length

- 1. The TherOx® Infusion Catheter has a smaller outer diameter that allows use with smaller quide catheters.
- 2. The TherOx® Infusion Catheter has a slightly smaller inner diameter at the marker band but use of the recommended size guidewire is not impeded.

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# 510(k) SUMMARY

- The TherOx® Infusion Catheter has an extra 12 cm of usable length that aids 3. the There's "infaction and manipulating the catheter outside the body and that accommodates taller patients.
- 4. The distal tip materials for both catheters are the same but the shaft and luer hub materials are different. Despite these minor differences, adherence to ndb matterformance attributes as specified in applicable voluntary standards has been maintained.

## NON-CLINICAL TEST DATA SUMMARY

A battery of strength, flexibility, flow, and pressure tests as specified in the standards listed below was performed on both the TherOx® Infusion Catheter and the predicate Tracker® - 38 Infusion Catheter device. The tests were performed to verify Fradior - Go irfusion ce of the devices and to verify conformance to TherOx device specifications.

Test results were obtained for production samples that were sterilized twice in a validated sterilization cycle, and on samples that were sterilized twice and then thermally aged to simulate an expected shelf life. Dimensional conformance, joint strength, flexibility, pressure rating, and flow characteristics were tested on these sample groups and the test requirements were specified based on the following voluntary standard and guidance documents:

- 1. FDA "Guidance on Premarket Notification (510(k)) Submission for Short-Term and Long-Term Intravascular Catheters" March 1995
- 2. ISO 10555-1 " Sterile Single-Use Intravascular Catheters -- General Requirements"
- 3. ISO 10555-2 " Sterile Single-Use Intravascular Catheters Angiographic Catheters"
- 4. ISO 10555-3 " Sterile Single-Use Intravascular Catheters Central Venous Catheters"

In addition, the TherOx infusion catheter satisfies the biocompatibility requirements of ISO 10993-1 and is sterilized in an ethylene oxide (EtO) sterilization cycle validated per ISO 11135. The TherOx catheter packaging was designed and tested per the requirements of ISO 11607.

All functional and performance test results met their acceptance criteria and a 3-year shelf life was established for the finished product.

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Public Health Service

Image /page/3/Picture/2 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of the department's name arranged in a circular fashion around a symbol. The symbol is a stylized representation of a human figure embracing a globe, signifying the department's mission to protect the health of all Americans.

2006 MAR 8

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Therox, Inc. c/o Underwriters Laboratories, Inc. 1285 Walt Whitman Rd. Melville, NY 11747 Attn: Mr. Casey Conry

> K052637 TherOx® Infusion Catheter Regulation Number: 21 CFR 870.1200 Regulation Name: Diagnostic intravascular catheter Regulatory Class: II Product Code: DQO Dated: February 22, 2006 Received: February 24, 2006

Dear Mr. Conry:

Re:

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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such 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.

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Page 2 - Mr. Casey Conry

Please be advised that FDA's issuance of a substantial equivalence determination does not mean Please be advised that FDA s issualice of a subcline with other requirements of the Act
that FDA has made a determination that your device complies . You must that FDA has made a delectimation that your as rees by other Federal agencies. You must or any Federal statules and regulations willing, but not limited to: registration and listing (21
comply with all the Act's requirements, including, but not limited to set comply with all the Act s requirements, meres and couring practice requirements as setting CFK Part 807); labeling (21 CFR Part 800); good frankart 820); and if applicable, the electronic
forth in the quality systems (QS) regulation (21 CFR 1000 1050 forth in the quality systems (Q5) regaliation (Sections 531-542 of the Act); 21 CFR 1000-1050.
product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000 product radiation control provisions (Decions be r o vice as described in your Section 510(k)
This letter will allow you to begin marketing your device to a loggios to a logg I his letter will anow you to begin hanceling your antial equivalence of your device to a legally
premarket notification. The FDA finding of substantial equivalence of the p premarket notification. The PDA midning of substantial equice and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please If you desire specific advice for your done of the case note the regulation entitled, whitler, contact the Office of Compliance at (240) 270 - 126 - Fart 807.97). You may obtain "Misbranding by relefence to premarket notificances (x 1 from the Division of Small other general Information on your responsion in total free number [phone] or
Manufacturers, International and Consumer Assistance at its to be closes than Manufacturers, International and Consumer Assistance agos/cdrh/industry/support/index.html.

Sincerely yours,

Emma R. Viiner

1/) 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): Unknown

Device Name: TherOx® Infusion Catheter

## Indications for Use:

The infusion catheter is intended to assist in the controlled infusion of diagnostic or therapeutic solutions into the peripheral or coronary vasculature. The target vessel effective diameter is ≥ 2.0 mm. The catheter is placed by a physician using a guide catheter and over a guidewire that extends beyond the final position of the infusion catheter.

Over-The-Counter Use Prescription Use × AND/OR (21 CFR 801 Subpart C) (Part 21 CFR 801 Subpart D) (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

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una D. Vachner

(Division Sign-Off) (Division Orgin of Cardiovascular Devices

510((k) Number ك