Cleared Traditional

K091495 - SINGLE USE 3-LUMEN EXTRACTION BALLOON V, MODEL V B-V233P-A,B-V233P-B,B-V433P-A,B-V433P-B, BV243Q-A, B-V243Q-B, B-V443Q-A (FDA 510(k) Clearance)

Sep 2009
Decision
106d
Days
Class 2
Risk

K091495 is an FDA 510(k) clearance for the SINGLE USE 3-LUMEN EXTRACTION BALLOON V, MODEL V B-V233P-A,B-V233P-B,B-V433P-A,B-V433P-B, BV243Q-A, B-V243Q-B, B-V443Q-A. This device is classified as a Dislodger, Stone, Biliary (Class II - Special Controls, product code LQR).

Submitted by Olympus Medical Systems Corporation (Center Valley, US). The FDA issued a Cleared decision on September 3, 2009, 106 days after receiving the submission on May 20, 2009.

This device falls under the Gastroenterology & Urology FDA review panel. Regulated under 21 CFR 876.5010.

Submission Details

510(k) Number K091495 FDA.gov
FDA Decision Cleared Substantially Equivalent - Traditional 510(k) (SESE)
Date Received May 20, 2009
Decision Date September 03, 2009
Days to Decision 106 days
Submission Type Traditional
Review Panel Gastroenterology & Urology (GU)
Summary Summary PDF

Device Classification

Product Code LQR — Dislodger, Stone, Biliary
Device Class Class II - Special Controls
CFR Regulation 21 CFR 876.5010