SONOTIP II 25-GAUGE ULTRASOUND NEEDLE SYSTEM, MODELS GUS-01-18-025 AND GUS-01-27-025

K083802 · Medi-Globe Corporation · FCG · Mar 20, 2009 · Gastroenterology, Urology

Device Facts

• Record ID: K083802
• Device Name: SONOTIP II 25-GAUGE ULTRASOUND NEEDLE SYSTEM, MODELS GUS-01-18-025 AND GUS-01-27-025
• Applicant: Medi-Globe Corporation
• Product Code: FCG · Gastroenterology, Urology
• Decision Date: Mar 20, 2009
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 876.1075
• Device Class: Class 2

Intended Use

The Medi-Globe SonoTip II 25-gauge Ultrasound Needle System for Fine Needle Aspiration (FNA), is used in conjunction with various legally marketed, FDA registered Ultrasound Endoscopes. The SonoTip II 25-gauge Needle System is used for ultrasonically guided, fine needle aspiration (FNA) of submucosal and extra-luminal lesions of the gastrointestinal tract (i.e., pancreatic masses, mediastinal masses, peri-pancreatic masses and lymph nodes).

Device Story

The Medi-Globe SonoTip II 25-gauge Ultrasound Needle System is a single-use, disposable instrument designed for fine needle aspiration (FNA). It functions as an accessory to legally marketed ultrasound endoscopes. The device allows clinicians to perform ultrasonically guided biopsies of submucosal and extra-luminal lesions within the gastrointestinal tract. By providing a needle path visualized via the ultrasound endoscope, the device enables precise targeting of masses and lymph nodes. The output is a tissue sample obtained through aspiration, which assists the physician in diagnostic decision-making. The device is intended for use in a clinical setting by trained medical professionals.

Clinical Evidence

Bench testing only. Design verification data demonstrated that the device meets performance requirements and is as safe and effective as the predicate devices.

Technological Characteristics

Disposable 25-gauge needle system for endoscopic ultrasound-guided biopsy. Utilizes endoscopic ultrasound technology for target visualization. Single-piece construction.

Indications for Use

Indicated for patients requiring fine needle aspiration of submucosal and extra-luminal gastrointestinal lesions, including pancreatic, mediastinal, and peri-pancreatic masses and lymph nodes, using ultrasound-guided endoscopic procedures.

Regulatory Classification

Identification

A gastroenterology-urology biopsy instrument is a device used to remove, by cutting or aspiration, a specimen of tissue for microscopic examination. This generic type of device includes the biopsy punch, gastrointestinal mechanical biopsy instrument, suction biopsy instrument, gastro-urology biopsy needle and needle set, and nonelectric biopsy forceps. This section does not apply to biopsy instruments that have specialized uses in other medical specialty areas and that are covered by classification regulations in other parts of the device classification regulations.

Predicate Devices

• Medi-Globe SonoTip II Ultrasound Needle System (K070129)
• Medi-Globe SonoTip II Ultrasound Needle System (K051247)
• Wilson-Cook Ultrasound Biopsy Needle (K013356)

Submission Summary (Full Text)

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K083802

## 510(k) SUMMARY OF SAFETY AND EFFECTIVENESS INFORMATION

- Submitter Information: A.
Submitter's Name: Medi-Globe Corporation

Submitter's Address: 110 West Orion Street #136 Tempe, Arizona 85283

Contact Person: Scott Karler

Contact Person's Telephone Number: [phone] ext. 208

Contact Person's FAX Number: [phone]

Contact Person's Email address: [e-mail]

- B. Device Name: Medi-Globe SonoTip II 25-gauge Ultrasound Needle System
- ﻥ Predicate Devices: Medi-Globe SonoTip II Ultrasound Needle System (K070129)

Medi-Globe SonoTip II Ultrasound Needle System (K051247)

Wilson-Cook Ultrasound Biopsy Needle (K013356)

- D. Device Description:
The Medi-Globe SonoTip II 25-gauge Ultrasound Needle System is a complete one-piece needle system for Fine Needle Aspiration and is a disposable instrument intended for single patient use only.

- E. Intended Use:
The Medi-Globe SonoTip II 25-gauge Ultrasound Needle System for Fine Needle Aspiration (FNA), is used in conjunction with various legally marketed, FDA registered Ultrasound Endoscopes. The SonoTip II 25-gauge Needle System is used for ultrasonically guided, fine needle aspiration (FNA) of submucosal and extra-luminal lesions of the gastrointestinal tract (i.e., pancreatic masses, mediastinal masses, peri-pancreatic masses and lymph nodes).

- F. Technological Characteristics Summary:
The Medi-Globe SonoTip II Ultrasound Needle System utilizes endoscopic ultrasound technology which, when used with an ultrasound endoscope, allows the user to ultrasonically guide the biopsy needle to its intended target within or adjacent to the gastrointestinal system.

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K08380r
pg 2 of 2

- Performance Data: G.
- Design verification data has demonstrated that the proposed Medi-Globe SonoTip I 25-gauge Design vertilication data the same performance requirements and is as safe and effective as Olirasonic Necule bystem moon the same perice. The 25-gauge SonoTip II Needle System is Medi-Group intended diagnostic/therapeutic effect, method of introduction/use, considered to nave the same mendou cange of descriptive features as the predicate Medi-Globe SonoTip II Ultrasound Needle System (K070129).

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## DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized caduceus symbol, which is a staff with two snakes coiled around it, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged in a circular pattern around the symbol. The text is in all caps and is evenly spaced around the circle.

## Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR 2 0 2009

Mr. Scott Karler Regulatory Affairs Coordinator Medi-Globe Corporation 110 West Orion Street, Suite 136 TEMPE AZ 85283

Re: K083802

Trade/Device Name: SonoTip II 25-Gauge Ultrasound Needle System Regulation Number: 21 CFR 876.1075

Regulation Name: Gastroenterology-urology biopsy instrument

Regulatory Class: II

Product Code: FCG

Dated: December 18, 2008

Received: December 22, 2008

Dear Mr. Karler:

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. Iisting 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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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; 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.

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding os substantial equivalence of your device to a legally marketed predicate device results in a classification for your device 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 contact the Office of Compliance at one of the following numbers, based on the regulation number at the top of this letter.

| 21 CFR 876.xxx | (Gastroenterology/Renal/Urology) | [phone] |
|----------------|----------------------------------|----------------|
| 21 CFR 884.xxx | (Obstetrics/Gynecology) | [phone] |
| 21 CFR 892.xxx | (Radiology) | [phone] |
| Other | | [phone] |

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometrics' (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. You may obtain other general information on your responsibilities under the Act from the Division of Small Manufactures, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/industry.suppor/index.html.

Sincerely yours,

Janine M. Morris

Acting Director, Division of Reproductive. Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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## Indications for Use

510(k) Number (if known): TBD

Device Name: SonoTip II 25-gauge Ultrasound Needle System

Indications for Use: The SonoTip II 25-gauge Ultrasound Needle System is used in conjunction with various legally marketed, FDA registered Ultrasound Endoscopes. The SonoTip II Needle System is used for ultrasonically guided fine needle aspiration, (FNA) of submucosal and extra-luminal lesions of the Gastrointestinal tract (i.e., pancreatic masses, mediastinal masses, peri-pancreatic masses and lymph nodes.

V Prescription Use (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)

Tom Whing

(Division Sign-Off)

Division of Reproductive, Abdominal. and Radiological Device 510(k) Number.