Cleared Traditional

K221124 - MANTIS Clip

K221124 is the FDA 510(k) clearance for MANTIS Clip by Boston Scientific Corporation. It is a Class 2 Gastroenterology & Urology device (product code PKL) cleared through the Traditional 510(k) pathway after a 108-day FDA review.

K221124 · Boston Scientific Corporation · Gastroenterology & Urology device
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Aug 2022
Decision
108d
Days
Class 2
Risk

K221124 is an FDA 510(k) clearance for the MANTIS Clip. Classified as Hemostatic Metal Clip For The Gi Tract (product code PKL), Class II - Special Controls.

Submitted by Boston Scientific Corporation (Marlboro, US). The FDA issued a Cleared decision on August 4, 2022 after a review of 108 days - within the typical 510(k) review window.

This device falls under the Gastroenterology & Urology FDA review panel, regulated under 21 CFR 876.4400 - the FDA gastroenterology and urology device framework. The Traditional 510(k) pathway establishes clearance through substantial equivalence to a legally marketed predicate device, without requiring clinical trial data.

Device pattern: Standard predicate-based submission. Standard predicate reliance. This clearance follows a standard predicate-based equivalence path within the Gastroenterology & Urology review framework, consistent with the majority of Class II 510(k) submissions.

View all Boston Scientific Corporation devices

Submission Details

510(k) Number K221124 FDA.gov
FDA Decision Cleared Substantially Equivalent - Traditional 510(k) (SESE)
Date Received April 18, 2022
Decision Date August 04, 2022
Days to Decision 108 days
Submission Type Traditional
Review Panel Gastroenterology & Urology (GU)
Summary Summary PDF
Third-party Review No - reviewed directly by FDA
Combination Product No
PCCP Authorized No
Regulatory Context
Review time vs. panel average
22d faster than avg
Panel avg: 130d · This submission: 108d
Pathway characteristics
Predicate-based equivalence. No clinical trials required.

Device Classification

Product Code PKL Hemostatic Metal Clip For The Gi Tract
Device Class Class 2 - Special Controls
CFR Regulation 21 CFR 876.4400
Definition Clip Placement Within The Gastrointestinal (gi) Tract For The Purpose Of Endoscopic Marking, Hemostasis For Mucosal/sub-mucosal Defects, Bleeding Ulcers, Arteries, Polyps, Diverticula In The Colon, Prophylactic Clipping, Anchoring Feeding Tubes, Supplemental Closure Method Of Luminal Perforations.
What this classification means

Class II devices require demonstration of substantial equivalence to a legally marketed predicate device. This pathway does not require clinical trials - it relies on engineering equivalence and performance data. Most Gastroenterology & Urology devices follow this clearance model.

Regulatory Peers - PKL Hemostatic Metal Clip For The Gi Tract

All 54
Devices cleared under the same product code (PKL) and FDA review panel - the closest regulatory comparables to K221124.
Disposable Endoscopic Hemoclip
K222146 · Jiangsu Vedkang Medical Science and Technology Co., Ltd. · Mar 2023
Disposable hemoclip
K213217 · Beijing Zksk Technology Co., Ltd. · Nov 2022
Resolution Clip, Resolution 360 Clip, Resolution 360 ULTRA Clip
K222503 · Boston Scientific Corporation · Sep 2022
Hemoclip
K213143 · Hangzhou AGS MedTech Co., Ltd. · Jul 2022
CORE-CLIP
K213338 · Incore Co., Ltd. · Jun 2022
Disposable Hemostatic Closure Clip Device
K220157 · Micro-Tech (Nanjing) Co., Ltd. · Jun 2022