← Product Code [OTK](/submissions/SU/subpart-e%E2%80%94surgical-devices/OTK) · K163139 # PleuraFlow System with FlowGlide (K163139) _Clearflow, Inc. · OTK · Nov 30, 2016 · General, Plastic Surgery · SESE_ **Canonical URL:** https://fda.innolitics.com/submissions/SU/subpart-e%E2%80%94surgical-devices/OTK/K163139 ## Device Facts - **Applicant:** Clearflow, Inc. - **Product Code:** [OTK](/submissions/SU/subpart-e%E2%80%94surgical-devices/OTK.md) - **Decision Date:** Nov 30, 2016 - **Decision:** SESE - **Submission Type:** Special - **Regulation:** 21 CFR 878.4780 - **Device Class:** Class 2 - **Review Panel:** General, Plastic Surgery - **Attributes:** Therapeutic, Pediatric ## Indications for Use The PleuraFlow® System with FlowGlide™ is indicated for use during cardiothoracic surgical procedures and chest trauma. Its Active Clearance Technology proactively removes clots formed inside the chest tube to prevent or minimize chest tube occlusion with clot. A patent chest tube enables evacuation of blood and fluid from the operative site after closure of the surgical wound and reduces retained blood. The product is indicated for adult and pediatric patients including infant, preadolescent and adolescent patients under clinical settings. ## Device Story PleuraFlow System with FlowGlide is a chest tube drainage system designed to prevent tube occlusion. It consists of a chest tube with a FlowGlide low-friction coating and a clearance apparatus (guide tube, PTFE-coated clearance wire with distal loop, and magnetic shuttle). Used in clinical settings by healthcare providers, the device is inserted into the chest cavity. The clearance apparatus is advanced into the chest tube; the wire and loop are manually advanced and retracted to break up clots and clear obstructions, ensuring tube patency. This proactive clearance facilitates continuous evacuation of blood and fluid, reducing retained blood post-surgery. The system is used for patients recovering from heart surgery or chest trauma. Benefits include reduced complications associated with chest tube clogging. ## Clinical Evidence Bench testing only. Verification included tensile strength, leakage, flow rate, kink testing, actuation force, fatigue, and coating durability. Biocompatibility was assessed per ISO 10993-1. ## Technological Characteristics System includes chest tube (19-inch length, 6 eyelets) and clearance apparatus (guide tube, PTFE-coated wire, magnetic shuttle). Features FlowGlide coating on internal/external surfaces. Barium stripe for X-ray visualization. Powered suction pump (21 CFR 878.4780). Biocompatibility per ISO 10993-1. ## Regulatory Identification A powered suction pump is a portable, AC-powered or compressed air-powered device intended to be used to remove infectious materials from wounds or fluids from a patient's airway or respiratory support system. The device may be used during surgery in the operating room or at the patient's bedside. The device may include a microbial filter. ## Predicate Devices - PleuraFlow Catheter System ([K150042](/device/K150042.md)) ## Reference Devices - ADAPt Universal Laparoscopic Port ([K082156](/device/K082156.md)) ## Submission Summary (Full Text) > This content was OCRed from public FDA records by [Innolitics](https://innolitics.com). If you use, quote, summarize, crawl, or train on this content, cite Innolitics at https://innolitics.com. > > Innolitics is a medical-device software consultancy. We help companies design, build, and clear FDA-regulated software and AI/ML devices, including [a 510(k)](https://innolitics.com/services/510ks/), [a De Novo](https://innolitics.com/services/regulatory/), [a SaMD](https://innolitics.com/services/end-to-end-samd/), [an AI/ML medical device](https://innolitics.com/services/medical-imaging-ai-development/), or [an FDA regulatory strategy](https://innolitics.com/services/regulatory/). {0}------------------------------------------------ Image /page/0/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" arranged around the perimeter. Inside the circle is an abstract symbol resembling three human profiles facing right, with flowing lines above them that could be interpreted as hair or wings. Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002 November 30, 2016 ClearFlow, Inc. Dr. Dov Gal, DVM, MBA Vice President, Regulatory Affairs, Quality Assurance and Clinical 1630 S. Sunkist St., Suite E Anaheim, California 92806 Re: K163139 Trade/Device Name: PleuraFlow System with FlowGlide Regulation Number: 21 CFR 878.4780 Regulation Name: Powered Suction Pump Regulatory Class: Class II Product Code: OTK, GBX Dated: November 7, 2016 Received: November 9, 2016 Dear Dr. Gal: 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. 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. 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 devicerelated adverse events) (21 CFR 803); 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}------------------------------------------------ If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. 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 http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance. You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Sincerely, Jennifer R. Stevenson -A For Binita S. Ashar, M.D., M.B.A., F.A.C.S. Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health Enclosure {2}------------------------------------------------ ## Indications for Use Statement ## 510(k) Number: K163139 PleuraFlow® System with FlowGlide™ Device Name: The PleuraFlow® System with FlowGlide™ is indicated for use during Indications for Use: cardiothoracic surgical procedures and chest trauma. Its Active Clearance Technology proactively removes clots formed inside the chest tube to prevent or minimize chest tube occlusion with clot. A patent chest tube enables evacuation of blood and fluid from the operative site after closure of the surgical wound and reduces retained blood. The product is indicated for adult and pediatric patients including infant, preadolescent and adolescent patients under clinical settings. Prescription Use x AND/OR Over-The-Counter Use (Part 21 CFR 801 Subpart D) (21 CFR 807 Subpart C) (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE) {3}------------------------------------------------ ## 510(k) Summary The following information is provided as required by 21 CFR § 807.87 for PleuraFlow® System with FlowGlide™ 510(k) premarket notification. In response to the Safe Medical Devices Act of 1990, the following is a summary of the safety and effectiveness information upon which the substantial equivalence determination is based. | Date of Submission: | November 7, 2016 | |----------------------------|-----------------------------------------------------| | Applicant: | ClearFlow, Inc. | | | 1630 S. Sunkist St., Suite E | | | Anaheim CA 92806 | | Primary Contact Person: | Dov Gal, DVM | | | ClearFlow, Inc. | | | 1630 S. Sunkist St., Suite E | | | Anaheim CA 92806 | | | Phone: 714-916-5014 | | | Fax: 714-916-5019 | | | Email: dgal@clearlflow.com | | CEO/President: | Paul Molloy | | | ClearFlow, Inc. | | | 1630 S. Sunkist St., Suite E | | | Anaheim CA 92806 | | | Phone: 714-905-5271 | | | Fax: 714-916-5019 | | | Email: pmolloy@clearlflow.com | | Device Proprietary Name: | PleuraFlow® System with FlowGlide™ | | Device Common Name: | Introduction/drainage; wound drain catheter system. | | Regulatory Class and Name: | Class II, Powered Suction Pump | {4}------------------------------------------------ OTK and GBX Predicate Device: Product Codes: Predicate device is the PleuraFlow Catheter System (K150042) by ClearFlow, Inc. Reference Device: ADAPt Universal Laparoscopic Port K082156. The PleuraFlow® System with FlowGlide™ is an extension of the Device Description: PleuraFlow® System (predicate). The primary components of the System are the Chest Tube and the Clearance Apparatus. The PleuraFlow System with FlowGlide includes four (4) models: PFFG-20, PFFG-24, PFFG-28 and PFFG-32. Each of the four (4) models includes a Chest Tube with a Cut Length of 19 inches (48.3 cm) with graduated measurements in centimeters from the distal eyelet. Each of these chest tubes has six (6) eyelets distributed along an Effective Drainage Length of 4 inches (10.2 cm). The Effective Drainage Length is defined as the length of the Chest Tube having eyelets for the influx of fluid. Each Chest Tube has a barium stripe to facilitate visualization in the chest cavity under X-ray. All models include a Chest Tube with FlowGlide applied to the internal and external surfaces to reduce friction and allow easier sliding of the Clearance Wire assembly. The Chest Tube is connected to a Clearance Apparatus, which is connected to the tubing from the drainage canister. > The Clearance Apparatus that is part of the PleuraFlow System with FlowGlide consists of a Guide Tube and a PTFE-coated Clearance Wire with a Loop set on its distal end. The Clearance Apparatus is advanced into the PleuraFlow Chest Tube using a magnetic Shuttle. When indicated, the Clearance Wire and Loop is advanced and retracted within the PleuraFlow with FlowGlide Chest Tube to proactively prevent or break up and clear any tube obstructions or clogging to keep the tube open. The PleuraFlow® System with FlowGlide™ is indicated for use during Indication For Use: cardiothoracic surgical procedures and chest trauma. Its Active Clearance Technology proactively removes clots formed inside the chest tube to prevent or minimize chest tube occlusion with clot. A patent chest tube enables evacuation of blood and fluid from the operative site after closure {5}------------------------------------------------ of the surgical wound and reduces retained blood. The product is indicated for adult and pediatric patients including infant, preadolescent and adolescent patients under clinical settings. The performance of the PleuraFlow System with FlowGlide™ was Performance Data: shown to be substantially equivalent to the predicate (PleuraFlow System) through bench testing. > Performance of the PleuraFlow System with FlowGlide™ coating was verified using the following testing summarized in the submission: - . Tensile strength / Force at break - . Freedom from leakage - . Flow rate - Kink testing . - Force to actuate Clearance Wire and Loop through coated chest . tube - Test for actuation of the Clearance Wire and Loop through the ● coated chest tube tortuous path - . Fatigue testing - Integrity / durability of the FlowGlide coating ● - . Simulated use - Transportation simulation. ● A biological risk assessment for the addition of FlowGlide™ coating to the Chest Tube was performed in accordance with ISO 10993-1, a summary of test results are provided in the submission. The safety and effectiveness of the predicate have been previously demonstrated through design validation and verification that were cleared under 510(k) premarket notification K150042. Use of the predicate device over the last six (6) years has shown that the product has significantly reduced the complications for patients recovering from heart surgery and who were treated with the PleuraFlow System with Active Clearance Technology® (ACT®) versus other conventional chest tubes. {6}------------------------------------------------ Results from performance testing of the PleuraFlow System with FlowGlide™ demonstrate that the modified device is suitable for its intended use and did not raise new issues of safety and effectiveness when compared to the predicate device. The effectiveness of the modified device is enhanced by the FlowGlide™ coating, which provides a low friction surface on the inside and outside of the chest tube. The device Indication for Use is same as the predicate. The design Conclusion: and technological characteristics are same as the predicate. Risk benefit analysis, verification and validation and biocompatibility testing of the PleuraFlow System with FlowGlide™ do not raise any additional concerns regarding safety and effectiveness and may be considered substantially equivalent to the predicate device. --- **Source:** [https://fda.innolitics.com/submissions/SU/subpart-e%E2%80%94surgical-devices/OTK/K163139](https://fda.innolitics.com/submissions/SU/subpart-e%E2%80%94surgical-devices/OTK/K163139) **Published by [Innolitics](https://innolitics.com)** — a medical-device software consultancy. We help companies design, build, and clear FDA-regulated software and AI/ML devices. 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