MERIT HYDROPHILIC GUIDE WIRE

K123609 · Merit Medical Systems, Inc. · DQX · Jan 16, 2013 · Cardiovascular

Device Facts

• Record ID: K123609
• Device Name: MERIT HYDROPHILIC GUIDE WIRE
• Applicant: Merit Medical Systems, Inc.
• Product Code: DQX · Cardiovascular
• Decision Date: Jan 16, 2013
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 870.1330
• Device Class: Class 2

Intended Use

The Merit Hydrophilic Guide Wire is intended to facilitate the placement of devices during diagnostic and interventional procedures.

Device Story

Merit Hydrophilic Guide Wire consists of jacketed core wire with hydrophilic coating; available in straight and angled configurations in various lengths. Device facilitates placement of other medical devices during diagnostic and interventional procedures. Used by clinicians in clinical settings. Performance testing confirms mechanical integrity and compatibility with diagnostic/interventional catheters. Benefits include smooth navigation through vasculature during procedures.

Clinical Evidence

Bench testing only. Testing included tensile strength, torque strength, torquability, tip flexibility, coating adherence/integrity, catheter compatibility, surface, fracture test, flex test, size designation/dimensions, and particulate testing. Testing performed in accordance with FDA guidance for Coronary and Cerebrovascular Guide Wires, ISO 11070, ISO 11135-1, ASTM F1980-07, and ISO 10993-1.

Technological Characteristics

Jacketed core wire with hydrophilic coating. Dimensions vary by configuration. Sterilization via ethylene oxide (ISO 11135-1). Biocompatibility per ISO 10993-1. Mechanical testing per FDA guidance for Coronary and Cerebrovascular Guide Wires.

Indications for Use

Indicated for patients undergoing diagnostic and interventional procedures requiring the placement of medical devices.

Regulatory Classification

Identification

A catheter guide wire is a coiled wire that is designed to fit inside a percutaneous catheter for the purpose of directing the catheter through a blood vessel.

Special Controls

*Classification.* Class II (special controls). The device, when it is a torque device that is manually operated, non-patient contacting, and intended to manipulate non-cerebral vascular guide wires, 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 Hydrophilic Guide Wire (K120644)
• Radiofocus® Glidewire® (K863138)

Submission Summary (Full Text)

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K123609 Page 1 of 3

Merit Medical Systems, Inc.
Merit Hydrophilic Guide Wire
Special Premarket Notification 510(k)

## JAN 1 6 2013

| Section 5 | | | |
|-----------------------|--------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------|--|
| 510(k) Summary | | | |
| | | | |
| General<br>Provisions | Submitter Name: | Merit Medical Systems, Inc. | |
| | Address: | 1600 West Merit Parkway<br>South Jordan, UT 84095 | |
| | Telephone Number: | [phone] | |
| | Fax Number: | [phone] | |
| | Contact Person:<br>Registration Number: | Stephanie Erskine<br>1721504 | |
| | Correspondent Name: | Merit Medical Ireland Ltd. | |
| | Address: | Parkmore Business Park<br>Parkmore, Galway, Ireland | |
| | Telephone Number: | (353) 91 703700 (3168) | |
| | Fax Number: | (353) 91 771 888 | |
| | Contact Person: | Martha Folan | |
| | Date of Preparation: | 20-Dec-2012 | |
| | Registration Number: | 9616662 | |
| Subject<br>Device | Trade Name: | Merit Hydrophilic Guide Wire | |
| | Common/Usual Name: | Hydrophilic Guide Wire | |
| | Classification Name: | Catheter Guide Wire | |
| Predicate<br>Devices | Trade Name: | Merit Hydrophilic Guide Wire | |
| | Classification Name: | Catheter Guide Wire | |
| | Premarket Notification Predicate Device # 1<br>Merit Hydrophilic Guide Wire K120644<br>Manufacturer: Merit Medical Systems, Inc | | |
| | Premarket Notification Predicate Device # 2:<br>Radiofocus® Glidewire® K863138<br>Manufacturer: Terumo Medical Corp. | | |
| Classification | Class II<br>21 CFR § 870.1330,<br>Product code: DQX<br>Division of Cardiovascular Devices | | |
| Intended Use | The Merit Hydrophilic Guide Wire is intended to facilitate the<br>placement of devices during diagnostic and interventional<br>procedures. | | |

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K123609 Page 2 of 3

Merit Medical Systems, Inc. Merit Hydrophilic Guide Wire Special Premarket Notification 510(k)

The Merit Hydrophilic Guide Wire consists of a jacketed core wire with a Device Description hydrophilic coating applied to the jacket. The wire will be offered in straight and angled configurations in various lengths. Technological characteristics of the subject Merit Hydrophilic Guide Wire are substantially equivalent to those of the predicate, the Merit Comparison Hydrophilic Guide Wire [K120644]. The differences between the devices to Predicate relates to the guide wire diameter size. The guide wire design remains unchanged. Predicate device #2 [K863138] Terumo Radiofocus® Glidewire® is the predicate for performance testing parameters. No performance standards have been established under section 514 of the Food, Drug and Cosmetic Act for these devices. A battery of testing was conducted in accordance with protocols based on requirements outlined in guidance's and industry standards and these were shown to meet the acceptance criteria that were determined to demonstrate substantial equivalence. Where appropriate, the tests were based on the requirements of the following documents: FDA guidance Coronary and Cerebrovascular Guide Wire . Guidance January 1995. . ISO 11070: 1998, Sterile Single-Use Intravascular Catheter Introducers. ISO 11135-1: 2007 Sterilization of health care products-Ethylene . oxide- Part 1: Requirements for the development, validation and routine control of a sterilization process for medical devices. ASTM F1980-07 Standard Guide for Accelerated Aging of Sterile . Safety & Barrier Systems for Medical Devices Performance ISO 10993-1: 2009, Biological Evaluation of Medical Devices Part . Tests 1: Evaluation and Testing within a risk management process, and the FDA Modified ISO 10993 Test Profile FDA Memo G95-1. The Merit Hydrophilic Guide Wire was compared to the predicate device for various attributes that support substantial equivalence of the device. The differences in wire diameter between the modified device and the cleared device [K120644] has raised no new issues. Performance testing was based on Predicate device #2 [K863138] Terumo Radiofocus® Glidewire® . The following is a list of all the significant tests evaluated: Tensile Strength, Torque Strength, Torquability, Tip Flexibility, Coating Adherence/Integrity (including Evaluation using Anatomical Model), Catheter Compatibility (Durability), Surface, Fracture Test, Flex test, Size Designation/ Dimensions, Particulate Testing. As all test results were comparable to the predicate devices and all predetermined acceptance criteria for tests were successful this has demonstrated the subject device is substantially equivalent to predicate devices.

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K123609 Page 3 of 3

Merit Medical Systems, Inc. Merit Hydrophilic Guide Wire Special Premarket Notification 510(k)

Based on the Indications for Use, design, safety and performance of Summary testing, the subject Merit Medical Hydrophilic Guide Wire meets the Substantial requirements that are considered essential for its intended use and is Equivalence substantively equivalent to the predicate device, the Merit Hydrophilic Guide Wire manufactured by Merit Medical Systems Inc.

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### DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 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 symbol resembling a human figure in profile, with three overlapping heads or faces.

#### Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

Merit Medical Systems, Inc. Martha Folan . Senior Regulatory Affairs Specialist Parkmore Business Park West Parkmore, Galway, Ireland

JAN 1 6 2013

Re: K123609

Trade/Device Name: Merit Hydrophilic Guide Wire Regulation Number: 21 CFR 870.1330 Regulation Name: Catheter Guide Wire Regulatory Class: Class II Product Code: DOX Dated: November 19, 2012 Received: November 21, 2012

Dear Ms. Folan:

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 Amendmouts, 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 to he 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

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### Page 2 -- Ms. Martha Folan

device-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 go to http://www.fda.gov/AboutFDA/CentersOffices/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 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 Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely vours.

# Matthew G. 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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Merit Medica! Systems, Inc. Merit Hydrophilic Guide Wire Special Premarket Notification 510(k)

### Section 4

### Indications for Use Statement

510 (k) Number: K 123609

Device Name: Merit Hydrophilic Guide Wire

### Indications for Use:

The Merit Hydrophilic Guide Wire is intended to facilitate the placement of devices during diagnostic and interventional procedures

Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use : (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)

M.S. Hillelum

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

K123609

510(k) Number

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