TRIAL CABLE RETENTION CLIP

K050633 · Advanced Neuromodulation Systems · GZB · Apr 21, 2005 · Neurology

Device Facts

• Record ID: K050633
• Device Name: TRIAL CABLE RETENTION CLIP
• Applicant: Advanced Neuromodulation Systems
• Product Code: GZB · Neurology
• Decision Date: Apr 21, 2005
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 882.5880
• Device Class: Class 2

Indications for Use

The ANS Neurostimulation system is indicated for Spinal Cord Stimulation (SCS) in the management of chronic pain of trunk and limbs, either as the sole mitigating agent, or as an adjunct to other modes of therapy used in a multidisciplinary approach. The Trial Cable Retention Clip is intended to be used with the ANS trial cable.

Device Story

Trial Cable Retention Clip is a mechanical accessory designed for use with the ANS trial cable during spinal cord stimulation procedures. It functions as a physical retention mechanism to secure the trial cable in place. Used in clinical settings by healthcare professionals during the trial phase of neurostimulation therapy. The device provides mechanical stability to the externalized trial cable, preventing accidental displacement or tension, thereby ensuring consistent delivery of stimulation to the patient. It does not involve electronic processing or software.

Clinical Evidence

Bench testing only.

Technological Characteristics

Mechanical retention clip; non-implantable accessory; used for cable management; no electronic components; no software; no energy source.

Indications for Use

Indicated for patients with chronic pain of the trunk and limbs requiring spinal cord stimulation (SCS) as a primary or adjunctive therapy.

Regulatory Classification

Identification

An implanted spinal cord stimulator for pain relief is a device that is used to stimulate electrically a patient's spinal cord to relieve severe intractable pain. The stimulator consists of an implanted receiver with electrodes that are placed on the patient's spinal cord and an external transmitter for transmitting the stimulating pulses across the patient's skin to the implanted receiver.

Submission Summary (Full Text)

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

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized eagle or bird-like symbol with three curved lines representing its wings or body. The logo is encircled by the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement.

APR 2 1 2005

Food and Drug Adrninistration 9200 Corporate Boulevard Rockville MD 20850

Rashmi Moza Regulatory Affairs Specialist Advanced Neuromodulation Systems, Inc. 6901 Preston Road Plano, Texas 75024

Re: K050633

Trade/Device Name: Trial Cable Retention Clip Regulation Number: 21 CFR 882.5880 Regulation Name: Implanted Spinal Cord Stimulator for Pain Relief Regulatory Class: Class II Product Code: GZB Dated: March 9, 2005 Received: March 11, 2005

Dear Ms. Mosa:

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 10 weeks 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 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.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has madc 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.

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

Page 2 – Ms. Rashmi Moza

This letter will allow you to begin marketing your device as described in your Section 510(k) remarket notification. The FDA finding of substantial equivalence of your device to a legally premated 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 [phone]. 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 from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Stupt Rhodes
Miriam C. Provost, Ph.D.

am C. Provost, Ph.D. Acting Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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

## Indications for Use

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Device Name: _ Trial Cable Retention Clip

Indications for Use:

The ANS Neurostimulation system is indicated for Spinal Cord Stimulation (SCS) in the THE ANS Frour of chronic pain of trunk and limbs, either as the sole mitigating agent, or as an adjunct to other modes of therapy used in a multidisciplinary approach.

The Trial Cable Retention Clip is intended to be used with the ANS trial cable.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ AND/OR (Part 21 CFR 801 Subpart D)

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Stypt Eluch
(Division Sign-Off)

(Divis Division of General, Restorative, and Neurological Devices

Page _1 of _1_

510(k) Number K050633