Phenom Catheters

K210230 · Micro Therapeutics Lnc. D/B/A Ev3 Neurovascular · DQY · Feb 25, 2021 · Cardiovascular

Device Facts

• Record ID: K210230
• Device Name: Phenom Catheters
• Applicant: Micro Therapeutics Lnc. D/B/A Ev3 Neurovascular
• Product Code: DQY · Cardiovascular
• Decision Date: Feb 25, 2021
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 870.1250
• Device Class: Class 2

Intended Use

Phenom™ Catheters are intended for the introduction of interventional devices or diagnostic agents into the neuro, peripheral, and coronary vasculatures.

Device Story

Phenom Catheters are variable stiffness, single-lumen catheters designed for accessing small, tortuous vasculature. The device is used by physicians to introduce interventional devices or diagnostic agents into neuro, peripheral, and coronary vasculatures. The catheter features a hydrophilic-coated outer surface to enhance navigation and an inner PTFE liner to facilitate the movement of introduction devices. Radiopaque markers at the distal tip allow for visualization and positioning under fluoroscopy. The device is tracked coaxially over a steerable guidewire. It is provided with a shaping mandrel and may include a split introducer sheath. The catheter is sterilized via ethylene oxide. By providing a stable pathway, the device enables the delivery of therapeutic or diagnostic tools, potentially benefiting patients undergoing neurointerventional or vascular procedures.

Clinical Evidence

No clinical data. Bench testing only. Testing included compatibility with guide catheters/wires/RHV, coating lubricity, hub functional/dimensional requirements (ISO 80369-7/20), torque strength, tensile strength (ISO 10555-1), air aspiration, liquid leak, and particulate testing (USP 788). Biocompatibility testing confirmed the device is non-cytotoxic, non-sensitizing, non-irritant, non-toxic, non-pyrogenic, and hemocompatible.

Technological Characteristics

Variable stiffness, single-lumen catheter. Materials: PTFE liner, Pebax shaft, stainless steel reinforcement. Hydrophilic coating on distal segment. Radiopaque tip markers. Dimensions vary by model (17, 21, 27, Plus). Sterilization: Ethylene Oxide. Connectivity: None (mechanical device).

Indications for Use

Indicated for the introduction of interventional devices or diagnostic agents into the neuro, peripheral, and coronary vasculatures. Prescription use only.

Regulatory Classification

Identification

A percutaneous catheter is a device that is introduced into a vein or artery through the skin using a dilator and a sheath (introducer) or guide wire.

Predicate Devices

• Phenom™ 17 Catheter (K151638)
• Phenom™ 21 Catheter (K151638)
• Phenom™ 27 Catheter (K151638)
• Phenom™ Plus Catheter (K151638)
• Phenom™ 27 Catheter (K180959)

Reference Devices

• React™ 68 Catheter (K180715)
• Navien™ Intracranial Support Catheter

Submission Summary (Full Text)

{0}------------------------------------------------

Image /page/0/Picture/0 description: The image shows the logos of the U.S. Department of Health & Human Services and the U.S. Food & Drug Administration (FDA). The Department of Health & Human Services logo is on the left, and the FDA logo is on the right. The FDA logo is a blue square with the letters "FDA" in white, followed by the words "U.S. Food & Drug Administration" in blue.

February 25, 2021

Micro Therapeutics, Inc. d/b/a ev3 Neurovascular Prerana Gurubasavaraj Regulatory Affairs Specialist 9775 Toledo Way Irvine, California 92618

Re: K210230

Trade/Device Name: Phenom Catheters Regulation Number: 21 CFR 870.1250 Regulation Name: Percutaneous Catheter Regulatory Class: Class II Product Code: DQY, KRA, QJP Dated: January 27, 2021 Received: January 28, 2021

Dear Prerana Gurubasavaraj:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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.

{1}------------------------------------------------

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 of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely.

Naira Muradyan, Ph.D. Assistant Director DHT5A: Division of Neurosurgical, Neurointerventional and Neurodiagnostic Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

{2}------------------------------------------------

# Indications for Use

510(k) Number (if known) K210230

Device Name Phenom™ Catheters

Indications for Use (Describe)

Phenom™ Catheters are intended for the introduction of interventional devices or diagnostic agents into the neuro, peripheral, and coronary vasculatures.

| Type of Use (Select one or both, as applicable) | |
|-------------------------------------------------|--|
|-------------------------------------------------|--|

X Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

#### CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

### *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.*

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

> Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

{3}------------------------------------------------

## K210230

## 510(k) Summary

| 510(k) Owner: | Micro Therapeutics, Inc. d/b/a ev3 Neurovascular<br>9775 Toledo Way<br>Irvine, CA 92618<br>Establishment Registration: 2029214 |
|----------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person: | Prerana Gurubasavaraj<br>Specialist, Regulatory Affairs<br>Telephone: [phone]<br>Email: [e-mail] |
| Date Summary<br>Prepared: | February 24, 2021 |
| Trade Name of<br>Device: | Phenom™ Catheters |
| Device Classification<br>Name: | Catheter, Percutaneous |
| Regulation Medical<br>Specialty: | Cardiovascular |
| 510(k) Review Panel: | Cardiovascular |
| Classification Product<br>Code: | DQY |
| Subsequent Product<br>Code: | KRA, QJP |
| Regulation Number: | 870.1250<br>870.1210 |
| Regulation<br>Description: | Percutaneous catheter<br>Continuous flush catheter |
| Device Classification: | Class II |
| Predicate Device: | Phenom™ 17 Catheter, Phenom™ 21 Catheter, Phenom™ 27<br>Catheter, Phenom™ Plus Catheter<br>510(k): K151638<br>Phenom™ 27 Catheter<br>510(k): K180959 |
| Reference Device: | React™ 68 Catheter<br>510(k): K180715<br>Navien™ Intracranial Support Catheter |

# Device Description:

The Phenom™ Catheters are variable stiffness, single lumen catheters designed to access small, tortuous vasculature. They are available in a variety of lengths, stiffness and inner and outer diameters. The outer surface of the catheter is coated to enhance navigation in the vessel. The Phenom™ 17, 21, and 27 Catheters have a hydrophilic coating that spans the distal 100cm. The Phenom™ Plus Catheters have a hydrophilic coating that spans the distal 90cm. The catheter also incorporates a liner to facilitate movement of introduction devices passing through its lumen. The distal tip has radiopaque marker(s) to aid visualization and positioning under fluoroscopy. The Phenom™ Catheter is packaged with a shaping mandrel and may be accompanied with a split introducer sheath.

{4}------------------------------------------------

# Indication for Use Statement:

Phenom™ Catheters are intended for the introduction of interventional devices or diagnostic agents into the neuro, peripheral, and coronary vasculatures.

| | Legally Marketed Predicate Devices<br>(K151638 & K180959) | | | | Phenom™<br>Catheters |
|--------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------|-------------------------|---------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Indication for Use<br>Statement | The Phenom™ Catheters are intended for the introduction of<br>interventional devices and infusion of diagnostic or therapeutic<br>agents into the neuro, peripheral, and coronary vasculatures. | | | | Phenom™<br>Catheters are<br>intended for the<br>introduction of<br>interventional<br>devices or<br>diagnostic<br>agents into the<br>neuro,<br>peripheral, and<br>coronary<br>vasculatures. |
| Dimensions | Phenom™ 17<br>(K151638) | Phenom™ 21<br>(K151638) | Phenom™ 27<br>(K180959) | Phenom™ Plus<br>(K151638) | |
| Proximal/Distal<br>Outer Diameter<br>(OD) | 2.2 F / 1.8 F | 2.6 F / 2.3 F | 3.1 F / 2.8 F | 4.7 F / 4.2 F | Same |
| Internal<br>Diameter (ID) | 0.017" | 0.021" | 0.027" | 0.0445" | Same |
| Min. Guiding<br>Catheter ID | ≥ 0.035" | ≥ 0.038" | ≥ 0.0445" | ≥ 0.070 | Same |
| Max. Guidewire<br>OD | ≤ 0.014" | ≤ 0.018" | ≤ 0.025" | ≤ 0.041 | Same |
| Effective Length<br>(cm) | 75 - 170 | 75 - 170 | 75 - 160 | 75 - 150 | Phenom 17:<br>150<br>Phenom 21:<br>150, 160<br>Phenom 27:<br>150, 160<br>Phenom Plus:<br>120 |
| Distal segment<br>length (cm) | 6 - 20 | 6 - 20 | 6 - 20 | 6 - 20 | Same |
| Inner Lumen | Inner lumen lined with lubricious PTFE to facilitate movement of<br>guidewires and other devices. | | | | Same |
| No. of lumens | Single lumen | | | | Same |
| Shaft | Progressively softer from proximal end to distal tip | | | | Same |
| Method of<br>delivery/tracking | Coaxial tracking over steerable guidewire | | | | Same |
| Shaft Materials | PTFE and Pebax | | | | Same |
| Shaft<br>reinforcement | Metallic (Stainless Steel) reinforced | | | | Same |
| Inner Liner | PTFE liner | | | | Same |
| Tip Markers | 1 or 2 | 1 or 2 | 1 | 1 | Same |
| Tip Shaping | Steam shapeable straight tip;<br>Pre-shaped 45°, 90° and J | | Steam shapeable tip | Steam shapeable tip | Same |
| Coating | Hydrophilic coating | | | | |
| Packaging | | | | | |
| Pouch Material | PET/Tyvek | | | | NYLON/Tyvek |
| Pouch Dimensions | 11" X 12" (Hoop configuration)<br>11" X 13.75" (Tray configuration) | | | | 13" X 10.94" |
| Carton | Cardboard, Solid Bleach Sulfate | | | | Same |
| Accessories | | | | | |
| Shaping Mandrel | | | Yes | | Same |
| Split Introducer<br>Sheath<br>(Phenom™ 17) | | | No | | Yes |
| Sterilization | | | | | |
| Method | Ethylene Oxide (EO) | | | | Same |
| Stability | | | | | |
| Shelf Life | | | 36 Months | | 12 Months |

# Device Comparison:

{5}------------------------------------------------

## Performance Data – Bench:

The following non-clinical bench testing was performed to evaluate the performance of the Phenom™ Catheters. The passing results of the testing demonstrated that the changes do not raise new questions of safety and effectiveness, supporting the substantial equivalence to the predicate devices.

| Test | Test Method Summary | Results |
|---------------------------------------|--------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------|
| Performance | | |
| Compatibility – Guide Catheter | The Phenom™ Catheters were<br>evaluated for compatibility with<br>guide catheters in a simulated<br>tortuous path model. | The Phenom™ Catheters are<br>compatible for use with a guide<br>catheter. |
| Compatibility – Guide Wire | The Phenom™ Catheters were<br>evaluated for compatibility with<br>guide wires in a simulated<br>tortuous path model. | The Phenom™ Catheters are<br>compatible for use with a guide<br>wire. |
| Compatibility – RHV | The Phenom™ Catheters were<br>evaluated for compatibility with<br>a standard RHV. | The Phenom™ Catheters are<br>compatible with the standard<br>used RHV. |
| Coating Lubricity (Friction<br>Force) | The Phenom™ Catheters were<br>evaluated for coating lubricity<br>under simulated clinical<br>conditions. | The Phenom™ Catheters exhibit<br>acceptable friction force under<br>simulated clinical conditions. |
| Hub Functional & Dimensional | The Phenom™ Catheters were<br>evaluated per ISO 80369-<br>7:2016 and ISO 80369-20:<br>2015. | The Phenom™ Catheters met<br>the acceptance criteria for hub<br>functional & dimensional<br>requirements. |
| Torque Strength | The Phenom™ Catheters were<br>evaluated for torsional strength<br>integrity during use in a<br>simulated path model. | The Phenom™ Catheters exhibit<br>acceptable torsional strength<br>integrity. |

{6}------------------------------------------------

| Test | Test Method Summary | Results |
|-------------------|-----------------------------------------------------------------------|----------------------------------------------------------------------------------------------------|
| Tensile | The Phenom™ Catheters were evaluated per ISO 10555-1:2013, Annex B. | The Phenom™ Catheters met the acceptance criteria for tensile strength. |
| Air Aspiration | The Phenom™ Catheters were evaluated per ISO 10555-1:2013 | The Phenom™ Catheters met the acceptance criteria for air aspiration. |
| Liquid Leak | The Phenom™ Catheters were evaluated per ISO 10555-1:2013 | The Phenom™ Catheters met the acceptance criteria for liquid leak. |
| Particulate | The Phenom™ Catheters were evaluated per USP <788>. | The Phenom™ Catheters met the acceptance criteria for particulate. |
| Design Validation | The Phenom™ Catheters were evaluated per ANSI/AAMI HE75:2009/(R) 2018 | The Phenom™ Catheters met the user needs and intended use(s) for which it was designed and tested. |

## Biocompatibility:

Biocompatibility was conducted for the Phenom™ Catheters. The Phenom™ Catheters are categorized as a limited exposure (< 24 hours), external communicating devices contacting circulating blood. The following biocompatibility endpoint testing was conducted for the Phenom™ Catheters:

| Test | Test Method Summary | Results |
|---------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------|----------------|
| Cytotoxicity – MEM Elution | Cell culture treated with test sample exhibited slight reactivity (Grade 1). | Non-cytotoxic |
| Sensitization – Guinea Pig Maximization | Animals treated with test sample exhibited no dermal reactions (Grade 0). | Non-sensitizer |
| Irritation – Intracutaneous Study in Rabbits | Animals treated with test sample exhibited no dermal reactions (Score 0.0). | Non-irritant |
| Acute Systemic Toxicity –<br>Systemic Toxicity Study in Mice | Animals treated with test sample exhibited no mortality or evidence of systemic toxicity. | Non-toxic |
| Material Mediated Pyrogenicity –<br>USP Rabbit Pyrogen Study | Individual animals treated with test sample exhibited no temperature rise above 0.5°C. | Non-pyrogenic |
| Hemocompatibility – Platelet<br>and Leukocyte Counts | Blood treated with the test sample exhibited platelet and leukocyte counts within the average normalized values and control values. | Non-activator |
| Hemocompatibility – Partial<br>Thromboplastin Time | Blood treated with the test article exhibited clotting time within the control values. | Non-activator |
| Hemocompatibility – Hemolysis<br>Direct Contact and Extract Methods | Blood treated with the test sample directly and indirectly exhibited no hemolysis and was within the control values. | Non-hemolytic |
| Hemocompatibility –<br>Complement Activation | Normal human serum treated with the test sample exhibited complement activation within the control values. | Non-activator |

{7}------------------------------------------------

### Performance Data - Animal:

No animal testing was conducted. The differences in technological characteristics do not raise new questions of safety and effectiveness as demonstrated through non-clinical bench testing using wellestablished acceptable scientific methods.

### Performance Data - Clinical:

No clinical testing was conducted. The differences in technological characteristics do not raise new questions of safety and effectiveness as demonstrated through non-clinical bench testing using wellestablished acceptable scientific methods.

### Conclusion:

There is no change to the Intended Use for the Phenom™ Catheters in comparison to the legally marketed predicate device. In addition, the differences in technological characteristics do not raise new questions of safety and effectiveness as demonstrated through non-clinical bench testing using well-established acceptable scientific methods. The information provided in this submission supports a determination of substantial equivalence for the Phenom™ Catheters.