Destino Reach

K151951 · Oscor, Inc. · DYB · Sep 22, 2015 · Cardiovascular

Device Facts

• Record ID: K151951
• Device Name: Destino Reach
• Applicant: Oscor, Inc.
• Product Code: DYB · Cardiovascular
• Decision Date: Sep 22, 2015
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 870.1340
• Device Class: Class 2

Intended Use

The steerable guiding sheath, Destino Reach is intended for the introduction of diagnostic and therapeutic devices into the human vasculature, including but not limited to intracardiac, renal or other peripheral placements. Do not use this device for neural placements.

Device Story

Destino Reach is a percutaneous steerable guiding sheath used by physicians to facilitate placement of diagnostic/therapeutic devices in intracardiac, renal, or peripheral vasculature. Device features adjustable distal tip controlled by rotating collar on handle, enabling bi-deflection. Includes hemostatic valve, sideport with stopcock, radiopaque distal tip, and side flush portholes. Accompanies dilator with depth markings and tapered tip, compatible with 0.035"-0.038" guidewires or transseptal needles. Physician operates device manually to navigate vasculature; bi-deflection capability allows precise positioning of diagnostic/therapeutic tools. Output is the established access path for secondary devices. Benefits include improved maneuverability and placement accuracy for cardiovascular/peripheral procedures.

Clinical Evidence

Bench testing only. Verification and validation included functional system testing, risk analysis, biocompatibility, and packaging/transportation qualification. No clinical data provided.

Technological Characteristics

Percutaneous steerable sheath with rotating collar for bi-deflection. Features hemostatic valve, sideport, radiopaque tip. Dilator compatible with 0.035"-0.038" guidewires. Sterilization via Ethylene Oxide (AAMI/ANSI/ISO 11135:2014). Compliance with ISO 10555-1 and ISO 11070.

Indications for Use

Indicated for patients requiring introduction of diagnostic or therapeutic devices into human vasculature, including intracardiac, renal, or peripheral sites. Contraindicated for neural placements.

Regulatory Classification

Identification

A catheter introducer is a sheath used to facilitate placing a catheter through the skin into a vein or artery.

Predicate Devices

• Adelante Destino (K120459, K122960)
• Destino Twist (K140406)

Submission Summary (Full Text)

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Image /page/0/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized design of three human profiles facing right, with flowing lines suggesting movement or connection. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the design.

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

September 22, 2015

Jan Flegeau Director of Regulatory Affairs Oscor Inc. 3816 DeSoto Blvd Palm Harbor, FL 34683

Re: K151951

Trade/Device Name: Destino Reach, Steerable Guiding Sheath Regulation Number: 21 CFR 870.1340 Regulation Name: Catheter introducer Regulatory Class: Class II Product Code: DYB Dated: July 14, 2015 Received: Aug 24, 2015

Dear Mr. Flegeau:

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-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.

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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 [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. 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 Industry and Consumer Education at its toll-free number [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely vours.

M. G. Hilleman

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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## Indications for Use Statement

510k Number (if known) K151951

Device Name: Steerable Guiding Sheath, Destino Reach

The steerable guiding sheath, Destino Reach is intended for the introduction of diagnostic and therapeutic devices into the human vasculature, including but not limited to intracardiac, renal or other peripheral placements. Do not use this device for neural placements.

Prescription Use X (Per 21 CFR 801.109) (Optional Format 1-2-96) OR

Over-The-Counter Use _____________

(PLEASE DO NOT WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

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## 510(k) SUMMARY

In accordance with the requirements of the Safe Medical Device Act of 1990 and 21 CFR 807.92, Oscor Inc. is hereby submitting the 510(k) Summary of Safety and Effectiveness for the 510(k) Number K151951

| DATE: | Septembre 21, 2015 |
|-----------------------------|-------------------------------------------------------------------------------------------------------------------------|
| APPLICANT: | OSCOR INC.<br>3816 De Soto Boulevard<br>Palm Harbor, Florida 34683 |
| CONTACT PERSON: | Jan Flégeau<br>Director of Regulatory Affairs<br>Phone: [phone]<br>Fax: [phone]<br>E-mail: [e-mail] |
| TRADE/DEVICE NAME: | Destino Reach, Steerable Guiding Sheath |
| DEVICE CLASSIFICATION NAME: | Introducer, catheter |
| REGULATORY CLASSIFICATION: | II |

REGULATION NUMBER: 870.1340

PRODUCT CODE: DYB

REVIEW ADVISORY COMMITTEE: Cardiovascular

MANUFACTURED BY: Oscor Inc.

| Sites | Activity | FDA Establishment<br>Registration |
|------------------------------------------------------|----------------------------------------------------|-----------------------------------|
| 3816 De Soto Boulevard<br>Palm Harbor, Florida 34683 | Design, development,<br>manufacture | 1035166 |
| 4875 Palm Harbor Blvd.<br>Palm Harbor FL 34683 | Design, development,<br>manufacture, sterilization | 3010274750 |
| 1053 Progress Court<br>Palm Harbor FL 34683 | Final pack and Labeling | 3010938037 |

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## STERILIZATION SITES: 1. International Sterilization Laboratory Inc. (ISL) 217 Sampey Road Groveland, FL 34736 Or 2. Oscor DMB Sterilizer 3816 De Soto Boulevard Palm Harbor, Florida 34683 INTENDED USE: The Destino Reach, steerable guiding sheath is intended for the introduction of diagnostic and therapeutic devices into the human vasculature, including but not limited to intracardiac, renal or other peripheral placements. Do not use this device for neural placements. DEVICE DESCRIPTION The Destino Reach Steerable Guiding Sheath is a percutaneous steerable sheath designed to facilitate the intracardiac, renal and peripheral placement of diagnostic and therapeutic devices. The device features an adjustable tip through use of a rotating collar that allows the physician to perform a bi-deflection at the distal tip section of the sheath. The sheath has a hemostatic valve, sideport with stopcock, radiopaque distal tip, contains side flush portholes and is deflectable by rotating the collar incorporated into the handle. The dilator has depth markings and locks onto the sheath. The dilator has a tapered distal tip and an inner lumen recommended for use with 0.035" to

0.038" guidewire and/or transseptal needle.

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| REASON FOR PREMARKET<br>NOTIFICATION: | New device submission seeking 510(k) clearance<br>for the Destino Reach, steerable guiding sheath. |
|-----------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| PREDICATE DEVICES<br>510(k) # and DESCRIPTION | Adelante Destino, steerable guiding sheath<br>K120459 (original submission) and<br>K122960 (modified intended use) |
| | Destino Twist, steerable guiding sheath<br>K140406 |
| MODIFICATION TO PREDICATE<br>DEVICES | The rotating collar/twisting mechanism in the<br>handle of the Destino Twist (K140406) was added<br>to the Adelante Destino (K120459 and K122960) to<br>create the proposed device Destino Reach. |
| | Rationale for these changes: physician preference/<br>customer demand for a bi-directional tip deflection<br>steerable guiding sheath with a rotating collar<br>twisting mechanism instead of a deflection lever. |
| | Intended use of the modified device, as described<br>in the labeling, has not changed as a result of the<br>modifications. |
| DEVICE PERFORMANCE | Standards followed include:<br>BS EN ISO 14971:2012, Medical devices<br>Application of risk management to medical devices |
| | AAMI/ANSI/ISO 11135: 2014, Sterilization of<br>health-care products Ethylene oxide -<br>Requirements for the development, validation and<br>routine control of a sterilization process for medical<br>devices |
| | AAMI/ANSI/ISO 10993-7:2008, Cor. 2009,<br>Biological evaluation of medical devices, Part 7,<br>Ethylene oxide sterilization residuals |
| | ISO 10555-1 2013, Intravascular catheters- Sterile<br>and single use catheters, Part 1, General<br>requirements. (Requirements for flow rate and<br>power injections not followed as this does not apply<br>to an introducer.) |

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ISO 11070: 1998. Sterile single-use intravascular catheter introducers. (Requirements for needles do not apply since the product is not packaged with a needle).

TESTING: Oscor Inc. conducted verification and validation testing including functional system testing, risk analysis, biocompatibility and packaging/transportation qualification. Based on this testing, we have determined that the device performs as well as the legally marketed predicate devices identified in this summary.

CONFIDENTIALITY STATEMENT: Oscor Inc. considers this 510(k) notification as confidential commercial information. Oscor Inc. has taken precautions to protect the existence of this submission. To the best of our knowledge, neither Oscor nor any other party has disclosed information concerning this submission through advertisements of any other manner. There have been no prior submissions for the subject device.

SUBSTANTIAL EQUIVALENCE: Oscor Inc. considers the Destino Reach as substantially equivalent in design, manufacturing materials, intended use, principles of operation, and technical characteristics to the Adelante Destino K120459 (original submission) and K122960 (modified intended use) and the Destino Twist, steerable guiding sheath K140406.