UROSURGE UROSTENT

K973504 · Princeton Regulatory Assoc. · FAD · Jan 30, 1998 · Gastroenterology, Urology

Device Facts

• Record ID: K973504
• Device Name: UROSURGE UROSTENT
• Applicant: Princeton Regulatory Assoc.
• Product Code: FAD · Gastroenterology, Urology
• Decision Date: Jan 30, 1998
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 876.4620
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The UroSurge UroStent™ is intended to be used for temporary drainage from the ureteropelvic junction to the bladder. Double pigtail stents have been employed to relieve obstruction in a variety of benign, malignant, and post-traumatic conditions. These stents may be placed using endoscopic, percutaneous, or open surgical techniques. The duration of the placement of these stents must not remain indwelling more than twenty nine (29) days. This product is intended for one-time use only. If the patient's status permits, the stent may be replaced with a new stent.

Device Story

UroSurge UroStent is a double pigtail ureteral stent designed for temporary urinary drainage. Device facilitates flow from ureteropelvic junction to bladder to relieve obstructions caused by benign, malignant, or post-traumatic conditions. Placed by physicians using endoscopic, percutaneous, or open surgical techniques. Stent remains indwelling for maximum 29 days; intended for single-use. Provides mechanical conduit for urine bypass, preventing hydronephrosis and associated complications. Clinical benefit includes relief of obstruction and restoration of urinary tract patency.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Double pigtail ureteral stent; polymeric construction; designed for temporary indwelling use (up to 29 days). Mechanical drainage device; non-active; sterile, single-use.

Indications for Use

Indicated for temporary drainage from ureteropelvic junction to bladder in patients with benign, malignant, or post-traumatic obstruction. For use via endoscopic, percutaneous, or open surgical placement. Indwelling duration limited to 29 days. Single-use only.

Regulatory Classification

Identification

A ureteral stent is a tube-like implanted device that is inserted into the ureter to provide ureteral rigidity and allow the passage of urine. The device may have finger-like protrusions or hooked ends to keep the tube in place. It is used in the treatment of ureteral injuries and ureteral obstruction.

Submission Summary (Full Text)

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 30 1998

Thomas Becze President Princeton Regulatory Associates 116 Village Boulevard, Suite 200 Princeton, NJ 08540-5799

Re: K973504 UroSurge UroStent™ Dated: December 26, 1997 Received: December 29, 1997 Regulatory Class: II 21 CFR 876.4620/Procode: 78 FAD

Dear Mr. Becze:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act). You may, therefore, whice, 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 III (Premarket Approval), 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 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of 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 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at [phone]. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

Wilian Li

Lillian Yin, Ph.D. Director, Division of Reproductive, Abdominal, Ear, Nose and Throat, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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## Indications For Use Statement

510(k) Number if known): TO BE ASSIGNED

Device Name: UroSurge UroStent™

Indications For Use:

The UroSurge UroStent™ is intended to be used for temporary drainage from the ureteropelvic junction to the bladder. Double pigtail stents have been employed to relieve obstruction in a variety of benign, malignant, and post-traumatic conditions. These stents may be placed using endoscopic, percutaneous, or open surgical techniques. The duration of the placement of these stents must not remain indwelling more than twenty nine (29) days.

This product is intended for one-time use only. If the patient's status permits, the stent may be replaced with a new stent.

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

_ Concurrence of CDRH, Office of Device Evaluation (ODE)

| Prescription Use | <div style="text-align:center;">✓</div> |
|----------------------|-----------------------------------------|
| (Per 21 CFR 801.109) | |

OR

Over-The-Counter Use_

Robert P. Stalling

(Optional Format 1-2-96)

(Division Sign-Off)
Division of Reproductive, Abdominal, ENT,
and Radiological Devices

510(k) Number

9 / 351