Bundled Neurological Shunts and Accessories Product Families Labeling Modification to Support MR Conditional Labeling
Applicant
Integra LifeSciences Corporation
Product Code
JXG · Neurology
Decision Date
Mar 14, 2016
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 882.5550
Device Class
Class 2
Attributes
Therapeutic, Pediatric
Indications for Use
The Standard-LPV II and Mini-LPV II Valves, utilized in the treatment of hydrocephalic patients in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the brain into either the right atrium of the heart or the peritoneum. The Mini-LPV II Valve can be used in (but is not restricted to) situations where skin erosion may be a problem, as with older patients. The Novus and Novus Mini Valves, utilized in the treatment of hydrocephalic patients, are components in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the right atrium of the heart or the peritoneum. The Novus Mini Valve can be used in (but is not restricted to) situations where skin erosion may be a problem, as with older patients. Valves with a Physiological Flow Device are intended to reduce the hazard of negative intraventricular pressure (with respect to atmospheric pressure) when the patient is sitting, standing or semi-recumbent. The Multi-Purpose Valve, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the heart or the perioneum. Valves with an Anti-Siphon Device are intended to reduce the hazard of negative intraventricular pressure when the patient is sitting, semi-recumbent or standing. The Mishler Dual Chamber Flushing Valve, Flat Bottom Design, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the heart or the peritoneum. Valves with an Anti-Siphon Device are intended to reduce the hazard of negative intraventricular pressure when the patient is sitting, semi-recumbent or standing. The Pudenz Flushing Valve, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the brain into either the right atrium of the heart or the peritoneum. Valves with an Anti-Siphon Device are intended to reduce the intraventricular pressure when the patient is sitting, semi-recumbent or standing. The Ultra VS In-Line Valves, utilized in the treatment of hydrocephalic patients, are components in systems designed to shunt cerebrospinal fluid (CSF) from the lateral ventricles into either the peritoneal cavity or the right atrium of the heart. The in-line and burr-hole systems are designed to shunt cerebrospinal fluid from the lateral ventricles into the peritoneal cavity. A ventriculoperitoneal shunting system may be indicated to avoid the cardiovascular complications of an atrial shunt or for a hydrocephalic patient in whom an atrial shunt is contraindicated. The Small and Neonate Models can be used in (but are not restricted to) situations where skin erosion may be a problem, as with premature infants, pediatric patients and older patients. The Pudenz Cardiac Catheter, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the right atrium of the heart. The Infant Cardiac Catheter is utilized when the common facial and/or internal jugular veins are too small to accommodate the larger cardiac catheter. The Pudenz Ventricular Catheter, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the right atrium of the heart or the peritoneum. The Pudenz Peritoneal Catheter, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventriculoperitoneum. A ventriculoperitoneal shunting system may be indicated to avoid the cardiovascular complications of an atrial shunt or for a hydrocephalic patient in whom an atrial shunt is contraindicated. The Peritoneal Reflux Control Catheter and Peritoneal Open-Ended Catheter with Slits, utilized in the treatment of hydrocephalic patients, are components for systems designed to shunt cerebrospinal fluid from the lateral ventricles into the peritoneum. A ventriculoperitoneal shunting system may be indicated to avoid the cardiovascular complications of an atrial shunt or for a hydrocephalic patient in whom an atrial shunt is contraindicated. The Portnoy Ventricular Catheter, utilized in the treatments, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the heart or the peritoneum. The Neuroview Ventricular Catheter, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the heart or the peritoneum. The Integra CSF Reservoir provides access to the lateral cerebral ventricles via hypodermic puncture for sampling and/or injection of fluids. It is useful in obtaining CSF samples for cytological and chemical studies, for monitoring ventricular fluid pressure and for ventricular drainage. The Convertible Integra CSF Reservoir may be utilized in hydrocephalic patients as a component in systems designed to shunt CSF from the lateral ventricles into either the right atrium of the heart or the peritoneum. The CSF Control Valve, utilized in the treatments, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the right atrium of the heart or the peritoneum. The Essential Shunt Kit – Flat Bottom Design, utilized in the treatment of hydrocephalic patients, is designed to shunt cerebrospinal fluid from the lateral ventricles of the brain into the peritoneum. The Essential Shunt Kit – Flat Bottom Design, can be used in (but is not restricted to) situations where skin erosion may be a problem, as with older patients. Integra connectors are utilized principally in the treatment of hydrocephalic patients, as components in systems designed to shunt cerebrospinal fluid from the lateral cerebral ventricles of the right atrium of the heart or the peritoneum. The On-Off Flushing Reservoir, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the peritoneum. Reservoirs with an Anti-Siphon Device are intended to reduce the hazard of negative intraventricular pressure when the patient is sitting, semi-recumbent or standing. The Braden Flushing Reservoir, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the heart or the peritoneum. The Foltz Flushing Reservoir, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the heart or the peritoneum. The Anti-Siphon Device, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the right atrium of the heart or the heart or the peritoneum. The device is designed to reduce the potential hazards of excessive lowering of intraventricular pressure (with respect to atmospheric pressure) when the patient is in a sitting, standing or erect position.
Device Story
Hydrocephalus treatment via CSF shunting; system creates flow pathway from cerebral ventricles to peritoneal space or right atrium. Components include catheters (silicone elastomer), valves (diaphragm or miter mechanisms), reservoirs, and connectors. Valves control drainage rate; some include anti-siphon mechanisms to prevent over-drainage in upright positions. Reservoirs allow ventricular access for sampling, pressure monitoring, or drainage. Clinician-implanted; used in neurosurgical settings. Device modification adds MRI safety labeling (MR Conditional).
Clinical Evidence
Bench testing only. No clinical data. Testing performed to support MR Conditional labeling: Magnetically Induced Displacement Force (ASTM F2052-06e1), Magnetically Induced Torque (ASTM F2213-06), RF Heating (ASTM F2182-09), and Image Artifact (ASTM F2119-07).
Technological Characteristics
Materials: Silicone elastomer (catheters), nylon/silicone (connectors). Valve types: Diaphragm (umbrella component) and miter (duckbill flaps). MR Conditional. No metallic components in valve mechanisms.
Indications for Use
Indicated for hydrocephalic patients requiring cerebrospinal fluid (CSF) shunting from lateral ventricles to the right atrium of the heart or the peritoneum. Includes neonates, pediatric, and older patients; specific models indicated for skin erosion prevention. Anti-siphon devices indicated to reduce negative intraventricular pressure in sitting/standing positions.
Regulatory Classification
Identification
A central nervous system fluid shunt is a device or combination of devices used to divert fluid from the brain or other part of the central nervous system to an internal delivery site or an external receptacle for the purpose of relieving elevated intracranial pressure or fluid volume (e.g., due to hydrocephalus). Components of a central nervous system shunt include catheters, valved catheters, valves, connectors, and other accessory components intended to facilitate use of the shunt or evaluation of a patient with a shunt.
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Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - W 066-G609 Silver Spring, MD 20993-0002
March 24, 2016
Integra LifeSciences Corporation Mr. Timothy Connors Senior Regulatory Affairs Specialist 311 Enterprise Drive Plainsboro, New Jersey 08536
Re: K153041
Trade/Device Name: Integra Neurological Shunts and Accessories Products (LPV II Valves and Kits, Novus Valves and Kits, Multi-Purpose Valve, Mishler Dual Chamber Valve with Integral Connectors, Pudenz Flushing Valve with Integral Connectors, Ultra VS In-Line Valve System, Pudenz Cardiac and Infant Catheter, Pudenz Ventricular Catheter, Pudenz Peritoneal Catheter, Peritoneal Reflux Control Catheter and Peritoneal Open-Ended Catheter With Slits, Portnoy Ventricular Catheter, Neuroview Endoscopic Ventricular Catheter, Integra CSF Reservoir with Integral Connectors, Essential Shunt Kit Burr Hole Design, Essential Shunt Kit Flat Bottom Design. Connectors for Neurosurgical Use, On-Off Flushing Reservoirs, Braden Flushing Reservoir, Foltz Flushing Reservoir, Anti-Siphon Device) Regulation Number: 21 CFR 882.5550
Regulation Name: Central Nervous System Fluid Shunt and Components Regulatory Class: Class II Product Code: JXG Dated: December 14, 2015 Received: December 15, 2015
Dear Mr. Connors:
This letter corrects our substantially equivalent letter of March 14, 2016.
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 Actinclude 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.
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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 (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.
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 yours,
Carlos L. Pena -S
Carlos L. Peña, PhD, MS Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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# Indications for Use
510(k) Number (if known) K153041
#### Device Name
Integra Neurological Shunts and Accessories Products
# Indications for Use (Describe)
LPV II Valves and Kits
The Standard-LPV II and Mini-LPV II Valves, utilized in the treatment of hydrocephalic patients in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the brain into either the right atrium of the heart or the peritoneum. The Mini-LPV II Valve can be used in (but is not restricted to) situations where skin erosion may be a problem, as with older patients.
#### Novus Valves and Kits
The Novus and Novus Mini Valves, utilized in the treatment of hydrocephalic patients, are components in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the right atrium of the heart or the peritoneum. The Novus Mini Valve can be used in (but is not restricted to) situations where skin erosion may be a problem, as with older patients. Valves with a Physiological Flow Device are intended to reduce the hazard of negative intraventricular pressure (with respect to atmospheric pressure) when the patient is sitting, standing or semi-recumbent.
#### Multi-Purpose Valve
The Multi-Purpose Valve, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the heart or the perioneum. Valves with an Anti-Siphon Device are intended to reduce the hazard of negative intraventricular pressure when the patient is sitting, semi-recumbent or standing.
#### Mishler Dual Chamber Valve with Integral Connectors
The Mishler Dual Chamber Flushing Valve, Flat Bottom Design, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the heart or the peritoneum. Valves with an Anti-Siphon Device are intended to reduce the hazard of negative intraventricular pressure when the patient is sitting, semi-recumbent or standing.
#### Pudenz Flushing Valve with Integral Connectors
The Pudenz Flushing Valve, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the brain into either the right atrium of the heart or the peritoneum. Valves with an Anti-Siphon Device are intended to reduce the intraventricular pressure when the patient is sitting, semi-recumbent or standing.
#### Ultra VS In-Line Valve System
The Ultra VS In-Line Valves, utilized in the treatment of hydrocephalic patients, are components in systems designed to shunt cerebrospinal fluid (CSF) from the lateral ventricles into either the peritoneal cavity or the right atrium of the heart. The in-line and burr-hole systems are designed to shunt cerebrospinal fluid from the lateral ventricles into the peritoneal cavity. A ventriculoperitoneal shunting system may be indicated to avoid the cardiovascular complications of an atrial shunt or for a hydrocephalic patient in whom an atrial shunt is contraindicated. The Small and Neonate Models can be used in (but are not restricted to) situations where skin erosion may be a problem, as with premature infants, pediatric patients and older patients.
#### Pudenz Cardiac and Infant Catheter
The Pudenz Cardiac Catheter, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the right atrium of the heart. The Infant Cardiac
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Catheter is utilized when the common facial and/or internal jugular veins are too small to accommodate the larger cardiac catheter.
## Pudenz Ventricular Catheter
The Pudenz Ventricular Catheter, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the right atrium of the heart or the peritoneum.
## Pudenz Peritoneal Catheter
The Pudenz Peritoneal Catheter, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventriculoperitoneum. A ventriculoperitoneal shunting system may be indicated to avoid the cardiovascular complications of an atrial shunt or for a hydrocephalic patient in whom an atrial shunt is contraindicated.
## Peritoneal Reflux Control Catheter and Peritoneal Open-Ended Catheter With Slits
The Peritoneal Reflux Control Catheter and Peritoneal Open-Ended Catheter with Slits, utilized in the treatment of hydrocephalic patients, are components for systems designed to shunt cerebrospinal fluid from the lateral ventricles into the peritoneum. A ventriculoperitoneal shunting system may be indicated to avoid the cardiovascular complications of an atrial shunt or for a hydrocephalic patient in whom an atrial shunt is contraindicated.
### Portnoy Ventricular Catheter
The Portnoy Ventricular Catheter, utilized in the treatments, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the heart or the peritoneum.
## Neuroview Endoscopic Ventricular Catheter
The Neuroview Ventricular Catheter, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the heart or the peritoneum.
# Integra CSF Reservoir with Integral Connectors
The Integra CSF Reservoir provides access to the lateral cerebral ventricles via hypodermic puncture for sampling and/or injection of fluids. It is useful in obtaining CSF samples for cytological and chemical studies, for monitoring ventricular fluid pressure and for ventricular drainage. The Convertible Integra CSF Reservoir may be utilized in hydrocephalic patients as a component in systems designed to shunt CSF from the lateral ventricles into either the right atrium of the heart or the peritoneum.
### Essential Shunt Kit Burr Hole Design
The CSF Control Valve, utilized in the treatments, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the right atrium of the heart or the peritoneum.
### Essential Shunt Kit Flat Bottom Design
The Essential Shunt Kit – Flat Bottom Design, utilized in the treatment of hydrocephalic patients, is designed to shunt cerebrospinal fluid from the lateral ventricles of the brain into the peritoneum. The Essential Shunt Kit – Flat Bottom Design, can be used in (but is not restricted to) situations where skin erosion may be a problem, as with older patients.
### Connectors for Neurosurgical Use
Integra connectors are utilized principally in the treatment of hydrocephalic patients, as components in systems designed to shunt cerebrospinal fluid from the lateral cerebral ventricles of the right atrium of the heart or the peritoneum.
### On-Off Flushing Reservoirs
The On-Off Flushing Reservoir, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the peritoneum. Reservoirs with an Anti-Siphon Device are intended to reduce the hazard of negative intraventricular pressure when the patient is sitting, semi-recumbent or standing.
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## Braden Flushing Reservoir
The Braden Flushing Reservoir, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the heart or the peritoneum.
#### Foltz Flushing Reservoir
The Foltz Flushing Reservoir, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles into either the right atrium of the heart or the peritoneum.
#### Anti-Siphon Device
The Anti-Siphon Device, utilized in the treatment of hydrocephalic patients, is a component in systems designed to shunt cerebrospinal fluid from the lateral ventricles of the right atrium of the heart or the heart or the peritoneum. The device is designed to reduce the potential hazards of excessive lowering of intraventricular pressure (with respect to atmospheric pressure) when the patient is in a sitting, standing or erect position.
| Type of Use (Select one or both, as applicable) | |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| <div> <span> <svg height="10" width="10"> <rect height="10" style="fill:none;stroke-width:1;stroke:rgb(0,0,0)" width="10"></rect> <line style="stroke:rgb(0,0,0);stroke-width:1" x1="0" x2="10" y1="0" y2="10"></line> <line style="stroke:rgb(0,0,0);stroke-width:1" x1="0" x2="10" y1="10" y2="0"></line> </svg> </span> Prescription Use (Part 21 CFR 801 Subpart D) </div> | <div> <span> <svg height="10" width="10"> <rect height="10" style="fill:none;stroke-width:1;stroke:rgb(0,0,0)" width="10"></rect> </svg> </span> Over-The-Counter Use (21 CFR 801 Subpart C) </div> |
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# 510(k) SUMMARY
| 807.92(a)(1) – Submitter information | |
|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Name | Integra LifeSciences Corporation |
| Address | 311 Enterprise Drive<br>Plainsboro, New Jersey 08536 |
| Phone Number | (609) 936-531 |
| Establishment<br>Registration Number | 9004007 |
| Name of Contact Person | Timothy Connors |
| Date Prepared | October 16, 2015 |
| 807.92(a)(2) – Name of device | |
| Trade or Propriety Names | Integra Neurological Shunts and Accessories Products<br>(LPV II Valves and Kits, Novus Valves and Kits,<br>Multi-Purpose Valve,<br>Mishler Dual Chamber Valve with Integral Connectors,<br>Pudenz Flushing Valve with Integral Connectors,<br>Ultra VS In-Line Valve System,<br>Pudenz Cardiac and Infant Catheter,<br>Pudenz Ventricular Catheter,<br>Pudenz Peritoneal Catheter,<br>Peritoneal Reflux Control Catheter,<br>Peritoneal Open-Ended Catheter With Slits,<br>Portnoy Ventricular Catheter,<br>Neuroview Endoscopic Ventricular Catheter,<br>Integra CSF Reservoir with Integral Connectors,<br>Essential Shunt Kit Burr Hole Design,<br>Essential Shunt Kit Flat Bottom Design,<br>Connectors for Neurosurgical Use,<br>On-Off Flushing Reservoirs,<br>Braden Flushing Reservoir,<br>Foltz Flushing Reservoir,<br>Anti-Siphon Device) |
| Common or Usual Name | Hydrocephalus Shunt Systems and Components |
| Classification Name | Central Nervous System Fluid Shunt and Components |
| Classification Panel | Neurology |
| Regulation | Class II, under 21 CFR 882.5550 |
| Product Code(s) | JXG |
| 807.92(a)(3) - Legally marketed device(s) to which equivalence is claimed | |
| Equivalence is claimed to current Integra Neurological Shunts and Accessories Products,<br>as identified below: | |
LPV II Valves and Kits - K974708
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Novus Valves and Kits - K961859 Multi-Purpose Valve - Pre-amendment device Mishler Dual Chamber Valve with Integral Connectors - K760784 Pudenz Flushing Valve with Integral Connectors - K760501, K760502 Ultra VS In-Line Valve System - K894072 Pudenz Cardiac and Infant Catheter - Pre-amendment device Pudenz Ventricular Catheter - Pre-amendment device Pudenz Peritoneal Catheter - Pre-amendment device Peritoneal Reflux Control Catheter - K894072 Peritoneal Open-Ended Catheter With Slits – K894072 Portnoy Ventricular Catheter - Pre-amendment device Neuroview Endoscopic Ventricular Catheter - K971617 Integra CSF Reservoir with Integral Connectors - Pre-amendment device Essential Shunt Kit Burr Hole Design - K973525 Essential Shunt Kit Flat Bottom Design - K973525 Connectors for Neurosurgical Use - Pre-amendment device On-Off Flushing Reservoirs - Pre-amendment device Braden Flushing Reservoir - Pre-amendment device Foltz Flushing Reservoir - Pre-amendment device Anti-Siphon Device - K760785
# 807.92(a)(4) - Device description
Integra Neurological Shunts and Accessories are used in the treatment of hydrocephalus. Hydrocephalus is commonly treated by creating a CSF flow pathway from a cerebral ventricle to the peritoneal spaces in the abdomen or to the right atrium of the heart. This is commonly referred to as "shunting". Integra markets a full line of products for CSF shunting procedures including catheters, valves, reservoir devices, connectors and accessories to aid in implantation.
A shunt system may comprise of a catheter, valve, reservoir and connectors, depending on clinician preference and use. In practice, a catheter is implanted into the space where CSF drainage is necessary (ventricles of the brain or lumbar subarachnoid space) and connected to a valve. The valve is used to control the CSF drainage rate. The other side of the valve is connected to a catheter which is placed to allow drainage to the desired site, typically the right atrium of the heart or the peritoneal cavity. As needed, a clinician may also incorporate a reservoir, for a closed ventricular access site, and/or additional connectors into the shunt system.
Catheters are silicone elastomer and some models are made from high durometer silicone elastomer. Valve mechanisms are categorized as diaphragm and miter. For diaphragm valves, the mechanism is an umbrella shaped component oriented at right angles to the flow path. Miter valves incorporates two silicone flaps in the shape of a duckbill. The flaps part in response to a pressure differential to allow flow. Some vales are available with low, medium or high closing pressure ranges and some contain an anti-siphon component. Reservoirs are available as standard or side-inlet or convertible and in various sizes; some have an on-off flushing feature. A variety of connectors, made of
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| nylon or silicone elastomer material, are also available. | |
|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 807.92(a)(5) – Intended use of the device | |
| Indications for Use | LPV II Valves and Kits |
| | The Standard-LPV II and Mini-LPV II Valves, utilized in<br>the treatment of hydrocephalic patients, are components in<br>systems designed to shunt cerebrospinal fluid from the<br>lateral ventricles of the brain into either the right atrium of<br>the heart or the peritoneum. |
| | The Mini-LPV II Valve can be used in (but is not restricted<br>to) situations where skin erosion may be a problem, as with<br>older patients. |
| | Novus Valves and Kits |
| | The Novus and Novus Mini Valves, utilized in the treatment<br>of hydrocephalic patients, are components in systems<br>designed to shunt cerebrospinal fluid from the lateral<br>ventricles of the brain into either the right atrium of the heart<br>or the peritoneum. |
| | The Novus Mini Valve can be used in (but is not restricted<br>to) situations where skin erosion may be a problem, as with<br>older patients. |
| | Valves with a Physiological Flow Device are intended to<br>reduce the hazard of negative intraventricular pressure (with<br>respect to atmospheric pressure) when the patient is sitting,<br>standing or semi-recumbent. |
| | Multi-Purpose Valve |
| | The Multi-Purpose Valve, utilized in the treatment of<br>hydrocephalic patients, is a component in systems designed<br>to shunt cerebrospinal fluid from the lateral ventricles into<br>either the right atrium of the heart or the peritoneum. |
| | Valves with an Anti-Siphon Device are intended to reduce<br>the hazard of negative intraventricular pressure when the<br>patient is sitting, semi-recumbent or standing. |
| | Mishler Dual Chamber Valve with Integral Connectors |
| | The Mishler Dual Chamber Flushing Valve, Flat Bottom<br>Design, utilized in the treatment of hydrocephalic patients, is<br>a component in systems designed to shunt cerebrospinal<br>fluid from the lateral ventricles into either the right atrium of<br>the heart or the peritoneum. |
| Valves with an Anti-Siphon Device are intended to reduce<br>the hazard of negative intraventricular pressure when the<br>patient is sitting, semi-recumbent or standing. | |
| <b>Pudenz Flushing Valve with Integral Connectors</b><br>The Pudenz Flushing Valve, utilized in the treatment of<br>hydrocephalic patients, is a component in systems designed<br>to shunt cerebrospinal fluid from the lateral ventricles of the<br>brain into either the right atrium of the heart or the<br>peritoneum. | |
| Valves with an Anti-Siphon Device are intended to reduce<br>the hazard of negative intraventricular pressure when the<br>patient is sitting, semi-recumbent or standing. | |
| <b>Ultra VS In-Line Valve System</b><br>The Ultra VS In-Line Valves, utilized in the treatment of<br>hydrocephalic patients, are components in systems designed<br>to shunt cerebrospinal fluid (CSF) from the lateral ventricles<br>into either the peritoneal cavity or the right atrium of the<br>heart. The in-line and burr-hole systems are designed to<br>shunt cerebrospinal fluid from the lateral ventricles into the<br>peritoneal cavity. A ventriculoperitoneal shunting system<br>may be indicated to avoid the cardiovascular complications<br>of an atrial shunt or for a hydrocephalic patient in whom an<br>atrial shunt is contraindicated. | |
| The Small and Neonate Models can be used in (but are not<br>restricted to) situations where skin erosion may be a<br>problem, as with premature infants, pediatric patients and<br>older patients. | |
| <b>Pudenz Cardiac and Infant Catheter</b><br>The Pudenz Cardiac Catheter, utilized in the treatment of<br>hydrocephalic patients, is a component in systems designed<br>to shunt cerebrospinal fluid from the lateral ventricles of the<br>brain into the right atrium of the heart. The Infant Cardiac<br>Catheter is utilized when the common facial and/or internal<br>jugular veins are too small to accommodate the larger<br>cardiac catheter. | |
| <b>Pudenz Ventricular Catheter</b><br>The Pudenz Ventricular Catheter, utilized in the treatment of<br>hydrocephalic patients, is a component in systems designed<br>to shunt cerebrospinal fluid from the lateral ventricles of the | |
| brain into either the right atrium of the heart or the<br>peritoneum. | |
| <b>Pudenz Peritoneal Catheter</b><br>The Pudenz Peritoneal Catheter, utilized in the treatment of<br>hydrocephalic patients, is a component in systems designed<br>to shunt cerebrospinal fluid from the lateral ventricles into<br>the peritoneum. | |
| A ventriculoperitoneal shunting system may be indicated to<br>avoid the cardio vascular<br>complications of an atrial shunt or for a hydrocephalic<br>patient in whom an atrial shunt is contraindicated. | |
| <b>Peritoneal Reflux Control Catheter and Peritoneal<br/>Open-Ended Catheter With Slits</b><br>The Peritoneal Reflux Control Catheter and Peritoneal<br>Open-Ended Catheter with Slits, utilized in the treatment of<br>hydrocephalic patients, are components for systems<br>designed to shunt cerebrospinal fluid from the lateral<br>ventricles into the peritoneum. | |
| A ventriculoperitoneal shunting system may be indicated to<br>avoid the cardiovascular complications of an atrial shunt or<br>for a hydrocephalic patient in whom an atrial shunt is<br>contraindicated. | |
| <b>Portnoy Ventricular Catheter</b><br>The Portnoy Ventricular Catheter, utilized in the treatment<br>of hydrocephalic patients, is a component in systems<br>designed to shunt cerebrospinal fluid from the lateral<br>ventricles into either the right atrium of the heart or the<br>peritoneum. | |
| <b>Neuroview Endoscopic Ventricular Catheter</b><br>The Neuroview Ventricular Catheter, utilized in the<br>treatment of hydrocephalic patients, is a component in<br>systems designed to shunt cerebrospinal fluid from the<br>lateral ventricles into either the right atrium of the heart or<br>the peritoneum. | |
| <b>Integra CSF Reservoir with Integral Connectors</b><br>The Integra CSF Reservoir provides access to the lateral<br>cerebral ventricles via hypodermic puncture for sampling<br>and/or injection of fluids. It is useful in obtaining CSF<br>samples for cytological and chemical studies, for monitoring | |
| ventricular fluid pressure and for ventricular drainage. | |
| The Convertible Integra CSF Reservoir may be utilized in<br>hydrocephalic patients as a component in systems designed<br>to shunt CSF from the lateral ventricles into either the right<br>atrium of the heart or the peritoneum. | |
| Essential Shunt Kit Burr Hole Design<br>The CSF Control Valve, utilized in the treatment of<br>hydrocephalic patients, is a component in systems designed<br>to shunt cerebrospinal fluid from the lateral ventricles of the<br>brain into either the right atrium of the heart or the<br>peritoneum. | |
| Essential Shunt Kit Flat Bottom Design<br>The Essential Shunt Kit - Flat Bottom Design, utilized in the<br>treatment of hydrocephalic patients, is designed to shunt<br>cerebrospinal fluid from the lateral ventricles of the brain<br>into the peritoneum. | |
| The Essential Shunt Kit - Flat Bottom Design, can be used<br>in (but is not restricted to) situations where skin erosion may<br>be a problem, as with older patients. | |
| Connectors for Neurosurgical Use<br>Integra connectors are utilized principally in the treatment of<br>hydrocephalic patients, as components in systems designed<br>to shunt cerebrospinal fluid from the lateral cerebral<br>ventricles of the brain into either the right atrium of the heart<br>or the peritoneum. | |
| On-Off Flushing Reservoirs<br>The On-Off Flushing Reservoir, utilized in the treatment of<br>hydrocephalic patients, is a component in systems designed<br>to shunt cerebrospinal fluid from the lateral ventricles into<br>either the right atrium of the heart or the peritoneum. | |
| Reservoirs with an Anti-Siphon Device are intended to<br>reduce the hazard of negative intraventricular pressure when<br>the patient is sitting, semi-recumbent or standing. | |
| Braden Flushing Reservoir<br>The Braden Flushing Reservoir, utilized in the treatment of<br>hydrocephalic patients, is a component in systems designed<br>to shunt cerebrospinal fluid from the lateral ventricles into<br>either the right atrium of the heart or the peritoneum. |…
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Learn the FDA Browser
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.