← Product Code [KNQ](/submissions/GU/subpart-f%E2%80%94therapeutic-devices/KNQ) · K033936

# BARD ELIMINATOR PET BALLOON DILATORS (K033936)

_C.R. Bard, Inc. · KNQ · Jan 14, 2004 · Gastroenterology, Urology · SESE_

**Canonical URL:** https://fda.innolitics.com/submissions/GU/subpart-f%E2%80%94therapeutic-devices/KNQ/K033936

## Device Facts

- **Applicant:** C.R. Bard, Inc.
- **Product Code:** [KNQ](/submissions/GU/subpart-f%E2%80%94therapeutic-devices/KNQ.md)
- **Decision Date:** Jan 14, 2004
- **Decision:** SESE
- **Submission Type:** Special
- **Regulation:** 21 CFR 876.5365
- **Device Class:** Class 2
- **Review Panel:** Gastroenterology, Urology
- **Attributes:** Therapeutic

## Indications for Use

The Bard® ELIMINATOR® PET Balloon Dilators are used to dilate strictures of the GI tract including the colon, pylorus and esophagus.

## Device Story

Bard® ELIMINATOR® PET Balloon Dilators are medical devices used to dilate strictures within the gastrointestinal tract, including the colon, pylorus, and esophagus. The device consists of a radiopaque polyurethane catheter with an internally fixed guide wire and a high-pressure, nondistending PET balloon. It is operated by a clinician in a clinical setting. The device functions by inflating the balloon to apply pressure to the stricture, thereby dilating the narrowed area. This process assists in restoring patency to the GI tract, potentially improving patient symptoms related to strictures. The current submission represents a product line extension adding a 20 mm balloon size to the existing device family.

## Clinical Evidence

Bench testing only. No clinical data was required or provided. Functionality testing, including failure pressure and inflation/deflation testing, was performed to validate the addition of the 20 mm balloon size.

## Technological Characteristics

Catheter: radiopaque polyurethane. Balloon: high-pressure nondistending PET. Components: stainless steel. Form factor: balloon dilator catheter with internally fixed guide wire. Sterilization: not specified.

## Regulatory Identification

An esophageal dilator is a device that consists of a cylindrical instrument that may be hollow and weighted with mercury or a metal olive-shaped weight that slides on a guide, such as a string or wire and is used to dilate a stricture of the esophagus. This generic type of device includes esophageal or gastrointestinal bougies and the esophageal dilator (metal olive).

## Special Controls

*Classification.* Class II (special controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.

## Predicate Devices

- Bard® ELIMINATOR® PET Balloon Dilators ([K033936](/device/K033936.md))

## Submission Summary (Full Text)

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BARD ENDOSCOPIC TECHNOLOGIES C.R. Bard, Inc. 129 Concord Road

K033936

Page 1 of 2

BARD

P.O. Box 7031 Billerica, MA 01821-7031 978-663-8989

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

As required by the Safe Medical Devices Act of 1990, codified under Section 513, Part (i)(3)(A) of the Food Drug and Cosmetic Act, a summary of the safety and effectiveness information upon which substantial equivalence determination is based follows.

| A. Submitter Information    |                                                   |  |
|-----------------------------|---------------------------------------------------|--|
| Submitter's Name:           | Bard Endoscopic Technologies<br>C.R. Bard, Inc.   |  |
| Address:                    | 129 Concord Road, Bldg. #3<br>Billerica, MA 01821 |  |
| Phone:                      | (978) 262 - 4868                                  |  |
| Fax:                        | (978) 262 - 4878                                  |  |
| Contact Person:             | Michael A. Patz                                   |  |
| Date of Preparation:        | December 18, 2003                                 |  |
| B. Device Name              |                                                   |  |
| Trade Name:                 | Bard® ELIMINATOR® PET Balloon Dilators            |  |
| Common/Usual Name:          | Dilator, Esophageal, Biliary                      |  |
| Classification Name:        | Biliary Catheter/Accessories, Esophageal Dilator  |  |
| C. Predicate Device Name(s) |                                                   |  |
| Trade Name:                 | Bard® ELIMINATOR® PET Balloon Dilators            |  |

- D. Device Description:
The Bard® ELIMINATOR® PET Balloon Dilators are comprised of a radioopaque polyurethanc catheter with an internally fixed guide wire and a high-pressure nondistending PET balloon.

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KC33936
Page 2 of 2

- E. Intended Use:
The Bard® ELIMINATOR® PET Balloon Dilators are used to dilate strictures of the GI tract including the colon, pylorus and esophagus.

- F. Technological Characteristics Summary:
The modified Bard® ELIMINATOR® PET Balloon Dilators is comprised of the same medical grade plastics, stainless steels and balloon material as the current device.

- G. Performance Data:
Biocompatibility testing was not conducted for this product line extension, as there were no material changes. The only design change was the addition of a 20 mm balloon dilator size. Functionality testing, Failure Pressure and Inflation/Deflation testing were completed and demonstrated that the modified Bard® ELIMINATOR® PET Balloon Dilators are substantially equivalent to the current Bard® ELIMINATOR® PET Balloon Dilators and that the device is safe for its intended use and patient population.

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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 circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract symbol resembling a stylized caduceus or a bird-like figure with three wing-like shapes.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 1 4 2004

Mr. Michael A. Patz Bard Endoscopic Technologies C. R. Bard, Inc. 129 Concord Road P.O. Box 7031 BILLERICA MA 01821-7031

Re: K033936

Trade/Device Name: Bard® ELIMINATOR PET® Balloon Dilators Regulation Number: 21 CFR §876.5365 Regulation Name: Esophageal dilator Regulatory Class: II Product Code: 78 KNQ Dated: December 18, 2003 Received: December 19, 2003

Dear Mr. Patz:

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 classificd (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); 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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This letter will allow you to begin marketing your device as described in your Section 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), please contact the Office of Compliance at one of the following numbers, based on the regulation number at the top of the letter:

| 8xx. 1xxx                        | (301) 594-4591 |
|----------------------------------|----------------|
| 876.2xxx, 3xxx, 4xxx, 5xxx       | (301) 594-4616 |
| 884.2xxx, 3xxx, 4xxx, 5xxx, 6xxx | (301) 594-4616 |
| 892.2xxx, 3xxx, 4xxx, 5xxx       | (301) 594-4654 |
| Other                            | (301) 594-4692 |

Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97) you may obtain. Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.

Sincerely yours,

Nancy C. Brogdon

Nancy C. I roodon Director, Division of Reproductive, Abdominal and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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K033936

## Indications for Use Statement

510(k) Number (if known):

TBD K033936

Device Name:

Indications For Use:

Bard® ELIMINATOR® PET Balloon Dilators

To dilate strictures of the GI tract including the colon, pylorus and esophagus.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use U (Per 21 CFR 801.109)

OR

Over-The-Counter Use (Optional Format 1-2-96)

Daniel B. Hyman
Division Sign Off

(Division Sign-Off) Division of Reproductive, Abdominal, and Radiological Dev 510(k) Number

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