PCT · Prostate Immobilizer Rectal Balloon

Radiology · 21 CFR 892.5720 · Class 2

Overview

Product CodePCT
Device NameProstate Immobilizer Rectal Balloon
Regulation21 CFR 892.5720
Device ClassClass 2
Review PanelRadiology
3rd-Party ReviewableYes

Identification

A rectal balloon for prostate immobilization is a single use, inflatable, non-powered positioning device placed in the rectum to immobilize the prostate in patients undergoing radiation therapy. The device is intended to be used during all the phases of radiation therapy, including treatment planning, image verification, and radiotherapy delivery.

Classification Rationale

Class II (special controls). The special controls for this device are:

Special Controls

In addition to the general controls of the FD&C Act, the Prostate Immobilization Rectal Balloon is subject to the following special controls: - 1) The premarket notification submission must include methodology and results of the following non-clinical and clinical performance testing: - Biocompatibility testing of the final finished device; i) - ii) If provided sterile, sterilization validation; - iii) If not provided sterile, bioburden testing of the final finished device; - iv) Shelf life and expiration date validation; and - v) Performance testing, including, but not limited to: - A) Venting mechanism (if device has a vent mechanism); - B) Safety mechanism(s) to prevent advancement beyond its intended safe placement; and - C) Structural integrity testing (e.g., tensile strength, balloon leakage and burst strength). - 2) Labeling that includes: - i) Appropriate warnings and contraindications, including, but not limited to the following statements: - A ) "Do not transport the patient with the rectal balloon inserted. The balloon should be removed prior to transport."; - B) "Failure to perform the standard imaging position verification protocol may cause the device to not perform as intended." ; - C) "Reduce the rectal balloon fill volume if the patient experiences discomfort due to the rectal balloon inflation."; and - D) "Do not apply excessive pressure/force on the shaft or tubing of the rectal balloon."; - ii) Adequate instructions for use on the proper insertion procedure, positioning, and inflation of the rectal balloon; - iii) Whether the device is sterile or non-sterile; and, - iv) An expiration date.

*Classification.* Class II (special controls). The special controls for this device are:(1) The premarket notification submission must include methodology and results of the following non-clinical and clinical performance testing: (i) Biocompatibility testing of the final finished device; (ii) If provided sterile, sterilization validation; (iii) If not provided sterile, bioburden testing of the final finished device; (iv) Shelf life and expiration date validation; and (v) Performance testing including but not limited to: (A) Venting mechanism (if device has a vent mechanism); (B) Safety mechanism(s) to prevent advancement beyond its intended safe placement; and (C) Structural integrity testing ( *e.g.,* tensile strength, balloon leakage and burst strength).(2) Labeling that includes: (i) Appropriate warnings and contraindications, including, but not limited to the following statements: (A) “Do not transport the patient with the rectal balloon inserted. The balloon should be removed prior to transport.”; (B) “Failure to perform the standard imaging position verification protocol may cause the device to not perform as intended.”; (C) “Reduce the rectal balloon fill volume if the patient experiences discomfort due to the rectal balloon inflation.”; and (D) “Do not apply excessive pressure/force on the shaft or tubing of the rectal balloon.” (ii) Adequate instructions for use on the proper insertion procedure, positioning, and inflation of the rectal balloon; (iii) Whether the device is sterile or non-sterile; and (iv) An expiration date.

Recent Cleared Devices (5 of 5)

RecordDevice NameApplicantDecision DateDecision
K223249Pro-Tx Endorectal Balloon (PROT-25)Dxtx Medical, Inc.Feb 10, 2023SESE
K180478RectalPro 75 Endorectal BalloonQlrad International , Ltd.Nov 13, 2018SESE
K150234Myriad Prostate Caddy¿ Immobilization Rectal Balloon Item #9901,3301Myriad Medical, LLCMar 31, 2015SESE
K141958ERB ENDORECTAL BALLOONEdge Medical, LLCNov 18, 2014SESE
DEN130036PROSTATE IMMOBILIZER RECTAL BALLOONRadiadyneJan 28, 2014DENG

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