[Title 21 CFR 876]
[Code of Federal Regulations (annual edition) - April 1, 1999 Edition]
[Title 21 - FOOD AND DRUGS]
[Chapter I - FOOD AND DRUG ADMINISTRATION,]
[Subchapter H - MEDICAL DEVICES]
[Part 876 - GASTROENTEROLOGY-UROLOGY DEVICES]
[From the U.S. Government Printing Office]


21FOOD AND DRUGS81999-04-011999-04-01falseGASTROENTEROLOGY-UROLOGY DEVICES876PART 876FOOD AND DRUGSFOOD AND DRUG ADMINISTRATION,MEDICAL DEVICES
PART 876--GASTROENTEROLOGY-UROLOGY DEVICES--Table of Contents




                      Subpart A--General Provisions

Sec.
876.1  Scope.
876.3  Effective dates of requirement for premarket approval.
876.9  Limitations of exemptions from section 510(k) of the Federal 
          Food, Drug, and Cosmetic Act (the act).

                      Subpart B--Diagnostic Devices

876.1075  Gastroenterology-urology biopsy instrument.
876.1400  Stomach pH electrode.
876.1500  Endoscope and accessories.
876.1620  Urodynamics measurement system.
876.1725  Gastrointestinal motility monitoring system.
876.1800  Urine flow or volume measuring system.

                      Subpart C--Monitoring Devices

876.2040  Enuresis alarm.

                      Subpart D--Prosthetic Devices

876.3350  Penile inflatable implant.
876.3630  Penile rigidity implant.
876.3750  Testicular prosthesis.

                       Subpart E--Surgical Devices

876.4020  Fiberoptic light ureteral catheter.
876.4270  Colostomy rod.
876.4300  Endoscopic electrosurgical unit and accessories.
876.4370  Gastroenterology-urology evacuator.
876.4400  Hemorrhoidal ligator.
876.4480  Electrohydraulic lithotriptor.
876.4500  Mechanical lithotriptor.
876.4530  Gastroenterology-urology fiberoptic retractor.
876.4560  Ribdam.
876.4590  Interlocking urethral sound.
876.4620  Ureteral stent.
876.4650  Water jet renal stone dislodger system.
876.4680  Ureteral stone dislodger.
876.4730  Manual gastroenterology-urology surgical instrument and 
          accessories.
876.4770  Urethrotome.
876.4890  Urological table and accessories.

                     Subpart F--Therapeutic Devices

876.5010  Biliary catheter and accessories.
876.5030  Continent ileostomy catheter.
876.5090  Suprapubic urological catheter and accessories.
876.5130  Urological catheter and accessories.
876.5160  Urological clamp for males.
876.5210  Enema kit.
876.5220  Colonic irrigation system.
876.5250  Urine collector and accessories.
876.5270  Implanted electrical urinary continence device.
876.5280  Implanted mechanical/hydraulic urinary continence device.
876.5320  Nonimplanted electrical continence device.
876.5365  Esophageal dilator.
876.5450  Rectal dilator.
876.5470  Ureteral dilator.
876.5520  Urethral dilator.
876.5540  Blood access device and accessories.

[[Page 340]]

876.5600  Sorbent regenerated dialysate delivery system for 
          hemodialysis.
876.5630  Peritoneal dialysis system and accessories.
876.5665  Water purification system for hemodialysis.
876.5820  Hemodialysis system and accessories.
876.5830  Hemodialyzer with disposable insert (Kiil type).
876.5860  High permeability hemodialysis system.
876.5870  Sorbent hemoperfusion system.
876.5880  Isolated kidney perfusion and transport system and 
          accessories.
876.5895  Ostomy irrigator.
876.5900  Ostomy pouch and accessories.
876.5920  Protective garment for incontinence.
876.5955  Peritoneo-venous shunt.
876.5970  Hernia support.
876.5980  Gastrointestinal tube and accessories.

    Authority: 21 U.S.C. 351, 360, 360c, 360e, 360j, 360l, 371.

    Source: 48 FR 53023, Nov. 23, 1983, unless otherwise noted.



                      Subpart A--General Provisions



Sec. 876.1  Scope.

    (a) This part sets forth the classification of gastroenterology-
urology devices intended for human use that are in commercial 
distribution.
    (b) The identification of a device in a regulation in this part is 
not a precise description of every device that is, or will be, subject 
to the regulation. A manufacturer who submits a premarket notification 
submission for a device under part 807 may not show merely that the 
device is accurately described by the section title and identification 
provisions of a regulation in this part, but shall state why the device 
is substantially equivalent to other devices, as required by 
Sec. 807.87.
    (c) To avoid duplicative listings, a gastroenterology-urology device 
that has two or more types of uses (e.g., used both as a diagnostic 
device and as a therapeutic device) is listed only in one subpart.
    (d) References in this part to regulatory sections of the Code of 
Federal Regulations are to chapter I of title 21, unless otherwise 
noted.

[52 FR 17737, May 11, 1987; 52 FR 22577, June 12, 1987]



Sec. 876.3  Effective dates of requirement for premarket approval.

    A device included in this part that is classified into class III 
(premarket approval) shall not be commercially distributed after the 
date shown in the regulation classifying the device unless the 
manufacturer has an approval under section 515 of the act (unless an 
exemption has been granted under section 520(g)(2) of the act). An 
approval under section 515 of the act consists of FDA's issuance of an 
order approving an application for premarket approval (PMA) for the 
device or declaring completed a product development protocol (PDP) for 
the device.
    (a) Before FDA requires that a device commercially distributed 
before the enactment date of the amendments, or a device that has been 
found substantially equivalent to such a device, has an approval under 
section 515 of the act FDA must promulgate a regulation under section 
515(b) of the act requiring such approval, except as provided in 
paragraph (b) of this section. Such a regulation under section 515(b) of 
the act shall not be effective during the grace period ending on the 
90th day after its promulgation or on the last day of the 30th full 
calendar month after the regulation that classifies the device into 
class III is effective, whichever is later. See section 501(f)2)(B) of 
the act. Accordingly, unless an effective date of the requirement for 
premarket approval is shown in the regulation for a device classified 
into class III in this part, the device may be commerically distributed 
without FDA's issuance of an order approving a PMA or declaring 
completed a PDP for the device. If FDA promulgates a regulation under 
section 515(b) of the act requiring premarket approval for a device, 
section 501(f)(1)(A) of the act applies to the device.
    (b) Any new, not substantially equivalent, device introduced into 
commercial distribution on or after May 28, 1976, including a device 
formerly marketed that has been substantially altered, is classified by 
statute (section 513(f) of the act) into class III without any grace 
period and FDA must have issued an order approving a PMA or declaring 
completed a PDP for the device

[[Page 341]]

before the device is commercially distributed unless it is reclassified. 
If FDA knows that a device being commercially distributed may be a 
``new'' device as defined in this section because of any new intended 
use or other reasons, FDA may codify the statutory classification of the 
device into class III for such new use. Accordingly, the regulation for 
such a class III device states that as of the enactment date of the 
amendments, May 28, 1976, the device must have an approval under section 
515 of the act before commercial distribution.

[52 FR 17737, May 11, 1987]



Sec. 876.9  Limitations of exemptions from section 510(k) of the Federal Food, Drug, and Cosmetic Act (the act).

    (a) The Food and Drug Administration (FDA's) decision to grant an 
exemption from the requirement of premarket notification (section 510(k) 
of the act) for a generic type of class I device is based upon the 
existing and reasonably foreseeable characteristics of commercially 
distributed devices within that generic type. Because FDA cannot 
anticipate every change in intended use or characteristic that could 
significantly affect a device's safety or effectiveness, manufacturers 
of any commercially distributed class I device for which FDA has granted 
an exemption from the requirement of premarket notification must still 
submit a premarket notification to FDA before introducing or delivering 
for introduction into interstate commerce for commercial distribution 
the device when:
    (1) The device is intended for a use different from its intended use 
before May 28, 1976, or the device is intended for a use different from 
the intended use of a preamendments device to which it had been 
determined to be substantially equivalent; e.g., the device is intended 
for a different medical purpose, or the device is intended for lay use 
where the former intended use was by health care professionals only; or
    (2) The modified device operates using a different fundamental 
scientific technology than that in use in the device before May 28, 
1976; e.g., a surgical instrument cuts tissue with a laser beam rather 
than with a sharpened metal blade, or an in vitro diagnostic device 
detects or identifies infectious agents by using a deoxyribonucleic acid 
(DNA) probe or nucleic acid hybridization technology rather than culture 
or immunoassay technology.
    (b) The exemption from the requirement of premarket notification for 
a generic type of class II device applies only to those class II devices 
that have existing or reasonably foreseeable characteristics of 
commercially distributed devices within that generic type, or, in the 
case of in vitro diagnostic devices, for which a misdiagnosis, as a 
result of using the device, would not be associated with high morbidity 
or mortality. A class II device for which FDA has granted an exemption 
from the requirement of premarket notification must still submit a 
premarket notification when:
    (1) The device is intended for a use different from the intended use 
of a legally marketed device in that generic type of device; e.g., the 
device is intended for a different medical purpose, or the device is 
intended for lay use where the former intended use was by health care 
professionals only; or
    (2) The modified device operates using a different fundamental 
scientific technology than a legally marketed device in that generic 
type of device; e.g., a surgical instrument cuts tissue with a laser 
beam rather than with a sharpened metal blade, or an in vitro diagnostic 
device detects or identifies infectious agents by using deoxyribonucleic 
acid (DNA) probe or nucleic acid hybridization technology rather than 
culture or immunoassay technology; or
    (3) The device is an in vitro device that is intended:
    (i) For use in the diagnosis, monitoring, or screening of neoplastic 
diseases with the exception of immunohistochemical devices;
    (ii) For use in screening or diagnosis of familial and acquired 
genetic disorders, including inborn errors of metabolism;
    (iii) For measuring an analyte that serves as a surrogate marker for 
screening, diagnosis, or monitoring life-threatening diseases such as 
acquired immune deficiency syndrome

[[Page 342]]

(AIDS), chronic or active hepatitis, tuberculosis, or myocardial 
infarction or to monitor therapy;
    (iv) For assessing the risk of cardiovascular diseases;
    (v) For use in diabetes management;
    (vi) For identifying or inferring the identity of a microorganism 
directly from clinical material;
    (vii) For detection of antibodies to microorganism other than 
immunoglobulin G (IgG) and IgG assays when the results are not 
qualitative, or are used to determine immunity, or the assay is intended 
for use in matrices other than serum or plasma;
    (viii) For noninvasive testing; and
    (ix) For near patient testing (point of care).

[54 FR 25049, June 12, 1989, as amended at 63 FR 59227, Nov. 3, 1998]



                      Subpart B--Diagnostic Devices



Sec. 876.1075  Gastroenterology-urology biopsy instrument.

    (a) Identification. A gastroenterology-urology biopsy instrument is 
a device used to remove, by cutting or aspiration, a specimen of tissue 
for microscopic examination. This generic type of device includes the 
biopsy punch, gastrointestinal mechanical biopsy instrument, suction 
biopsy instrument, gastro-urology biopsy needle and needle set, and 
nonelectric biopsy forceps. This section does not apply to biopsy 
instruments that have specialized uses in other medical specialty areas 
and that are covered by classification regulations in other parts of the 
device classification regulations.
    (b) Classification. (1) Class II (performance standards).
    (2) Class I for the biopsy forceps cover and the non-electric biopsy 
forceps. The devices subject to this paragraph (b)(2) are exempt from 
the premarket notification procedures in subpart E of part 807 of this 
chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 61 FR 1122, Jan. 16, 1996]



Sec. 876.1400  Stomach pH electrode.

    (a) Identification. A stomach pH electrode is a device used to 
measure intragastric and intraesophageal pH (hydrogen ion 
concentration). The pH electrode is at the end of a flexible lead which 
may be inserted into the esophagus or stomach through the patient's 
mouth. The device may include an integral gastrointestinal tube.
    (b) Classification. Class I. The device is exempt from the premarket 
notification procedures in subpart E of part 807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 61 FR 1122, Jan. 16, 1996]



Sec. 876.1500  Endoscope and accessories.

    (a) Identification. An endoscope and accessories is a device used to 
provide access, illumination, and allow observation or manipulation of 
body cavities, hollow organs, and canals. The device consists of various 
rigid or flexible instruments that are inserted into body spaces and may 
include an optical system for conveying an image to the user's eye and 
their accessories may assist in gaining access or increase the 
versatility and augment the capabilities of the devices. Examples of 
devices that are within this generic type of device include cleaning 
accessories for endoscopes, photographic accessories for endoscopes, 
nonpowered anoscopes, binolcular attachments for endoscopes, pocket 
battery boxes, flexible or rigid choledochoscopes, colonoscopes, 
diagnostic cystoscopes, cystourethroscopes, enteroscopes, 
esophagogastroduodenoscopes, rigid esophagoscopes, fiberoptic 
illuminators for endoscopes, incandescent endoscope lamps, biliary 
pancreatoscopes, proctoscopes, resectoscopes, nephroscopes, 
sigmoidoscopes, ureteroscopes, urethroscopes, endomagnetic retrievers, 
cytology brushes for endoscopes, and lubricating jelly for transurethral 
surgical instruments. This section does not apply to endoscopes that 
have specialized uses in other medical specialty areas and that are 
covered by classification regulations in other parts of the device 
classification regulations.
    (b) Classification. (1) Class II (performance standards).
    (2) Class I for the photographic accessories for endoscope, 
miscellaneous bulb adapter for endoscope, binocular

[[Page 343]]

attachment for endoscope, eyepiece attachment for prescription lens, 
teaching attachment, inflation bulb, measuring device for panendoscope, 
photographic equipment for physiologic function monitor, special lens 
instrument for endoscope, smoke removal tube, rechargeable battery box, 
pocket battery box, bite block for endoscope, and cleaning brush for 
endoscope. The devices subject to this paragraph (b)(2) are exempt from 
the premarket notification procedures in subpart E of part 807 of this 
chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 61 FR 1122, Jan. 16, 1996]



Sec. 876.1620  Urodynamics measurement system.

    (a) Identification. A urodynamics measurement system is a device 
used to measure volume and pressure in the urinary bladder when it is 
filled through a catheter with carbon dioxide or water. The device 
controls the supply of carbon dioxide or water and may also record the 
electrical activity of the muscles associated with urination. The device 
system may include transducers, electronic signal conditioning and 
display equipment, a catheter withdrawal device to enable a urethral 
pressure profile to be obtained, and special catheters for urethral 
profilometry and electrodes for electromyography. This generic type of 
device includes the cystometric gas (carbon dioxide) device, the 
cystometric hydrualic device, and the electrical recording cystometer, 
but excludes any device that uses air to fill the bladder.
    (b) Classification. Class II (special controls). The device is 
exempt from the premarket notification procedures in subpart E of part 
807 of this chapter subject to Sec. 876.9.

[48 FR 53023, Nov. 23, 1983, as amended at 63 FR 59228, Nov. 3, 1998]



Sec. 876.1725  Gastrointestinal motility monitoring system.

    (a) Identification. A gastrointestinal motility monitoring system is 
a device used to measure peristalic activity or pressure in the stomach 
or esophagus by means of a probe with transducers that is introduced 
through the mouth into the gastrointestinal tract. The device may 
include signal conditioning, amplifying, and recording equipment. This 
generic type of device includes the esophageal motility monitor and 
tube, the gastrointestinal motility (electrical) system, and certain 
accessories, such as a pressure transducer, amplifier, and external 
recorder.
    (b) Classification. Class II (performance standards).



Sec. 876.1800  Urine flow or volume measuring system.

    (a) Identification. A urine flow or volume measuring system is a 
device that measures directly or indirectly the volume or flow of urine 
from a patient, either during the course of normal urination or while 
the patient is catheterized. The device may include a drip chamber to 
reduce the risk of retrograde bacterial contamination of the bladder and 
a transducer and electrical signal conditioning and display equipment. 
This generic type of device includes the electrical urinometer, 
mechanical urinometer, nonelectric urinometer, disposable nonelectric 
urine flow rate measuring device, and uroflowmeter.
    (b) Classification. (1) Class II (special controls). The device is 
exempt from the premarket notification procedures in subpart E of part 
807 of this chapter subject to Sec. 876.9.

[48 FR 53023, Nov. 23, 1983, as amended at 61 FR 1122, Jan. 16, 1996; 63 
FR 59228, Nov. 3, 1998]



                      Subpart C--Monitoring Devices



Sec. 876.2040  Enuresis alarm.

    (a) Identification. An enuresis alarm is a device intended for use 
in treatment of bedwetting. Through an electrical trigger mechanism, the 
device sounds an alarm when a small quantity of urine is detected on a 
sensing pad. This generic type of device includes conditioned response 
enuresis alarms.
    (b) Classification. Class II (special controls). The device is 
exempt from the premarket notification procedures in subpart E of part 
807 of this chapter subject to Sec. 876.9.

[48 FR 53023, Nov. 23, 1983, as amended at 63 FR 59228, Nov. 3, 1998]

[[Page 344]]



                      Subpart D--Prosthetic Devices



Sec. 876.3350  Penile inflatable implant.

    (a) Identification. A penile inflatable implant is a device that 
consists of two inflatable cylinders implanted in the penis, connected 
to a reservoir filled with radiopaque fluid implanted in the abdomen, 
and a subcutaneous manual pump implanted in the scrotum. When the 
cylinders are inflated, they provide rigidity to the penis. This device 
is used in the treatment of erectile impotence.
    (b) Classification. Class III (premarket approval).
    (c) Date PMA or notice of completion of a PDP is required. No 
effective date has been established of the requirement for premarket 
approval. See Sec. 876.3.

[48 FR 53023, Nov. 23, 1983, as amended at 52 FR 17738, May 11, 1987]



Sec. 876.3630  Penile rigidity implant.

    (a) Identification. A penile rigidity implant is a device that 
consists of a single semi-rigid rod or a pair of semi-rigid rods 
implanted in the penis to provide rigidity. It is used in the treatment 
of erectile impotence.
    (b) Classification. Class III (permarket approval).
    (c) Date PMA or notice of completion of a PDP is required. No 
effective date has been established of the requirement for premarket 
approval. See Sec. 876.3.

[48 FR 53023, Nov. 23, 1983, as amended at 52 FR 17738, May 11, 1987]



Sec. 876.3750  Testicular prosthesis.

    (a) Identification. A testicular prosthesis is an implanted device 
that consists of a solid or gel-filled silicone rubber prosthesis that 
is implanted surgically to resemble a testicle.
    (b) Classification. Class III (premarket approval).
    (c) Date premarket approval application (PMA) or notice of product 
development protocol (PDP) is required. A PMA or notice of completion of 
a PDP is required to be filed with the Food and Drug Administration on 
or before July 5, 1995, for any testicular prosthesis that was in 
commercial distribution before May 28, 1976, or that has on or before 
July 5, 1995, been found to be substantially equivalent to a testicular 
prosthesis that was in commercial distribution before May 28, 1976. Any 
other testicular prosthesis shall have an approved PMA or a declared 
completed PDP in effect before being placed in commercial distribution.

[48 FR 53023, Nov. 23, 1983, as amended at 52 FR 17738, May 11, 1987; 60 
FR 17216, Apr. 5, 1995]



                       Subpart E--Surgical Devices



Sec. 876.4020  Fiberoptic light ureteral catheter.

    (a) Identification. A fiberoptic light ureteral catheter is a device 
that consists of a fiberoptic bundle that emits light throughout its 
length and is shaped so that it can be inserted into the ureter to 
enable the path of the ureter to be seen during lower abdominal or 
pelvic surgery.
    (b) Classification. Class II (performance standards).



Sec. 876.4270  Colostomy rod.

    (a) Identification. A colostomy rod is a device used during the loop 
colostomy procedure. A loop of colon is surgically brought out through 
the abdominal wall and the stiff colostomy rod is placed through the 
loop temporarily to keep the colon from slipping back through the 
surgical opening.
    (b) Classification. Class II (performance standards).



Sec. 876.4300  Endoscopic electrosurgical unit and accessories.

    (a) Identification. An endoscopic electrosurgical unit and 
accessories is a device used to perform electrosurgical procedures 
through an endoscope. This generic type of device includes the 
electrosurgical generator, patient plate, electric biopsy forceps, 
electrode, flexible snare, electrosurgical alarm system, electrosurgical 
power supply unit, electrical clamp, self-opening rigid snare, flexible 
suction coagulator electrode, patient return wristlet, contact jelly, 
adaptor to the cord for transurethral surgical instruments, the electric 
cord for transurethral surgical instruments, and the transurethral 
desiccator.
    (b) Classification. Class II (performance standards).

[[Page 345]]



Sec. 876.4370  Gastroenterology-urology evacuator.

    (a) Identification. A gastroenterology-urology evacuator is a device 
used to remove debris and fluids during gastroenterological and 
urological procedures by drainage, aspiration, or irrigation. This 
generic type of device includes the fluid evacuator system, manually 
powered bladder evacuator, and the AC-powered vacuum pump.
    (b) Classification. (1) Class II (special controls) for the 
gastroenterology-urology evacuator when other than manually powered. The 
device is exempt from the premarket notification procedures in subpart E 
of part 807 of this chapter subject to Sec. 876.9.
    (2) Class I for the gastroenterology-urology evacuator when manually 
powered. The device subject to this paragraph (b)(2) is exempt from the 
premarket notification procedures in subpart E of part 807 of this 
chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 54 FR 25049, June 12, 1989; 
63 FR 59228, Nov. 3, 1998]



Sec. 876.4400  Hemorrhoidal ligator.

    (a) Identification. A hemorrhoidal ligator is a device used to cut 
off the blood flow to hemorrhoidal tissue by means of a ligature or band 
placed around the hemorrhoid.
    (b) Classification. Class II (performance standards).



Sec. 876.4480  Electrohydraulic lithotriptor.

    (a) Identification. An electrohydraulic lithotriptor is an AC-
powered device used to fragment urinary bladder stones. It consists of a 
high voltage source connected by a cable to a bipolar electrode that is 
introduced into the urinary bladder through a cystoscope. The electrode 
is held against the stone in a water-filled bladder and repeated 
electrical discharges between the two poles of the electrode cause 
electrohydraulic shock waves which disintegrate the stone.
    (b) Classification. Class III (premarket approval).
    (c) Date PMA or notice of completion of a PDP is required. No 
effective date has been established of the requirement for premarket 
approval. See Sec. 876.3.

[48 FR 53023, Nov. 23, 1983, as amended at 52 FR 17738, May 11, 1987]



Sec. 876.4500  Mechanical lithotriptor.

    (a) Identification. A mechanical lithotriptor is a device with steel 
jaws that is inserted into the urinary bladder through the urethra to 
grasp and crush bladder stones.
    (b) Classification. Class II (performance standards).



Sec. 876.4530  Gastroenterology-urology fiberoptic retractor.

    (a) Identification. A gastroenterology-urology fiberoptic retractor 
is a device that consists of a mechanical retractor with a fiberoptic 
light system that is used to illuminate deep surgical sites.
    (b) Classification. Class I. The device is exempt from the premarket 
notification procedures in subpart E of part 807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 54 FR 25049, June 12, 1989]



Sec. 876.4560  Ribdam.

    (a) Identification. A ribdam is a device that consists of a broad 
strip of latex with supporting ribs used to drain surgical wounds where 
copious urine drainage is expected.
    (b) Classification. Class I. The device is exempt from the premarket 
notification procedures in subpart E of part 807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 54 FR 25049, June 12, 1989]



Sec. 876.4590  Interlocking urethral sound.

    (a) Identification. An interlocking urethral sound is a device that 
consists of two metal sounds (elongated instruments for exploring or 
sounding body cavities) with interlocking ends, such as with male and 
female threads or a rounded point and mating socket, used in the repair 
of a ruptured urethra. The device may include a protective cap to fit 
over the metal threads.
    (b) Classification. Class I. The device is exempt from the premarket 
notification procedures in subpart E of part 807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 61 FR 1122, Jan. 16, 1996]

[[Page 346]]



Sec. 876.4620  Ureteral stent.

    (a) Identification. A ureteral stent is a tube-like implanted device 
that is inserted into the ureter to provide ureteral rigidity and allow 
the passage of urine. The device may have finger-like protrusions or 
hooked ends to keep the tube in place. It is used in the treatment of 
ureteral injuries and ureteral obstruction.
    (b) Classification. Class II (performance standards).



Sec. 876.4650  Water jet renal stone dislodger system.

    (a) Identification. A water jet renal stone dislodger system is a 
device used to dislodge stones from renal calyces (recesses of the 
pelvis of the kidney) by means of a pressurized stream of water through 
a conduit. The device is used in the surgical removal of kidney stones.
    (b) Classification. Class II (special controls). The device is 
exempt from the premarket notification procedures in subpart E of part 
807 of this chapter subject to Sec. 876.9.

[48 FR 53023, Nov. 23, 1983, as amended at 63 FR 59228, Nov. 3, 1998]



Sec. 876.4680  Ureteral stone dislodger.

    (a) Identification. A ureteral stone dislodger is a device that 
consists of a bougie or a catheter with an expandable wire basket near 
the tip, a special flexible tip, or other special construction. It is 
inserted through a cystoscope and used to entrap and remove stones from 
the ureter. This generic type of device includes the metal basket and 
the flexible ureteral stone dislodger.
    (b) Classification. Class II (special controls). The device is 
exempt from the premarket notification procedures in subpart E of part 
807 of this chapter subject to Sec. 876.9.

[48 FR 53023, Nov. 23, 1983, as amended at 63 FR 59228, Nov. 3, 1998]



Sec. 876.4730  Manual gastroenterology-urology surgical instrument and accessories.

    (a) Identification. A manual gastroenterology-urology surgical 
instrument and accessories is a device designed to be used for 
gastroenterological and urological surgical procedures. The device may 
be nonpowered, hand-held, or hand-manipulated. Manual gastroenterology-
urology surgical instruments include the biopsy forceps cover, biopsy 
tray without biopsy instruments, line clamp, nonpowered rectal probe, 
nonelectrical clamp, colostomy spur-crushers, locking device for 
intestinal clamp, needle holder, gastro-urology hook, gastro-urology 
probe and director, nonself-retaining retractor, laparotomy rings, 
nonelectrical snare, rectal specula, bladder neck spreader, self-
retaining retractor, and scoop.
    (b) Classification. Class I. The device is exempt from the premarket 
notification procedures in subpart E of part 807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 54 FR 25049, June 12, 1989]



Sec. 876.4770  Urethrotome.

    (a) Identification. A urethrotome is a device that is inserted into 
the urethra and used to cut urethral strictures and enlarge the urethra. 
It is a metal instrument equipped with a dorsal-fin cutting blade which 
can be elevated from its sheath. Some urethrotomes incorporate an 
optical channel for visual control.
    (b) Classification. Class II (performance standards).



Sec. 876.4890  Urological table and accessories.

    (a) Identification. A urological table and accessories is a device 
that consists of a table, stirrups, and belts used to support a patient 
in a suitable position for endoscopic procedures of the lower urinary 
tract. The table can be adjusted into position manually or electrically.
    (b) Classification. (1) Class II (special controls) for the 
electrically powered urological table and accessories. The device is 
exempt from the premarket notification procedures in subpart E of part 
807 of this chapter subject to Sec. 876.9.
    (2) Class I for the manually powered table and accessories, and for 
stirrups for electrically powered table. The device subject to this 
paragraph (b)(2) is

[[Page 347]]

exempt from the premarket notification procedures in subpart E of part 
807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 61 FR 1122, Jan. 16, 1996; 63 
FR 59228, Nov. 3, 1998]



                     Subpart F--Therapeutic Devices



Sec. 876.5010  Biliary catheter and accessories.

    (a) Identification. A biliary catheter and accessories is a tubular 
flexible device used for temporary or prolonged drainage of the biliary 
tract, for splinting of the bile duct during healing, or for preventing 
stricture of the bile duct. This generic type of device may include a 
bile collecting bag that is attached to the biliary catheter by a 
connector and fastened to the patient with a strap.
    (b) Classification. Class II (performance standards).



Sec. 876.5030  Continent ileostomy catheter.

    (a) Identification. A continent ileostomy catheter is a flexible 
tubular device used as a form during surgery for continent ileostomy and 
it provides drainage after surgery. Additionally, the device may be 
inserted periodically by the patient for routine care to empty the ileal 
pouch. This generic type of device includes the rectal catheter for 
continent ileostomy.
    (b) Classification. Class I. The device is exempt from the premarket 
notification procedures in subpart E of part 807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 54 FR 25050, June 12, 1989]



Sec. 876.5090  Suprapubic urological catheter and accessories.

    (a) Identification. A suprapubic urological catheter and accessories 
is a flexible tubular device that is inserted through the abdominal wall 
into the urinary bladder with the aid of a trocar and cannula. The 
device is used to pass fluids to and from the urinary tract. This 
generic type of device includes the suprapubic catheter and tube, 
Malecot catheter, catheter punch instrument, suprapubic drainage tube, 
and the suprapubic cannula and trocar.
    (b) Classification. (1) Class II (performance standards).
    (2) Class I for the catheter punch instrument, nondisposable cannula 
and trocar, and gastro-urological trocar. The devices subject to this 
paragraph (b)(2) are exempt from the premarket notification procedures 
in subpart E of part 807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 61 FR 1122, Jan. 16, 1996]



Sec. 876.5130  Urological catheter and accessories.

    (a) Identification. A urological catheter and accessories is a 
flexible tubular device that is inserted through the urethra and used to 
pass fluids to or from the urinary tract. This generic type of device 
includes radiopaque urological catheters, ureteral catheters, urethral 
catheters, coude catheters, balloon retention type catheters, straight 
catheters, upper urinary tract catheters, double lumen female 
urethrographic catheters, disposable ureteral catheters, male 
urethrographic catheters, and urological catheter accessories including 
ureteral catheter stylets, ureteral catheter adapters, ureteral catheter 
holders, ureteral catheter stylets, ureteral catheterization trays, and 
the gastro-urological irrigation tray (for urological use).
    (b) Classification. (1) Class II (performance standards).
    (2) Class I for the ureteral stylet (guidewire), stylet for gastro-
urological catheter, ureteral catheter adapter, ureteral catheter 
connector, and ureteral catheter holder. The devices subject to this 
paragraph (b)(2) are exempt from the premarket notification procedures 
in subpart E of part 807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 61 FR 1122, Jan. 16, 1996]



Sec. 876.5160  Urological clamp for males.

    (a) Identification. A urological clamp for males is a device used to 
close the urethra of a male to control urinary incontinence or to hold 
anesthetic or radiography contrast media in the urethra temporarily. It 
is an external clamp.

[[Page 348]]

    (b) Classification. Class I (general controls).



Sec. 876.5210  Enema kit.

    (a) Identification. An enema kit is a device intended to instill 
water or other fluids into the colon through a nozzle inserted into the 
rectum to promote evacuation of the contents of the lower colon. The 
device consists of a container for fluid connected to the nozzle either 
directly or via tubing. This device does not include the colonic 
irrigation system (Sec. 876.5220).
    (b) Classification. Class I (general controls). The device is exempt 
from the current good manufacturing practice regulations in part 820, 
with the exception of Sec. 820.180, with respect to general requirements 
concerning records, and Sec. 820.198, with respect to complaint files.



Sec. 876.5220  Colonic irrigation system.

    (a) Identification. A colonic irrigation system is a device intended 
to instill water into the colon through a nozzle inserted into the 
rectum to cleanse (evacuate) the contents of the lower colon. The system 
is designed to allow evacuation of the contents of the colon during the 
administration of the colonic irrigation. The device consists of a 
container for fluid connected to the nozzle via tubing and includes a 
system which enables the pressure, temperature, or flow of water through 
the nozzle to be controlled. The device may include a console-type 
toilet and necessary fittings to allow the device to be connected to 
water and sewer pipes. The device may use electrical power to heat the 
water. The device does not include the enema kit (Sec. 876.5210).
    (b) Classification. (1) Class II (performance standards) when the 
device is intended for colon cleansing when medically indicated, such as 
before radiological or endoscopic examinations.
    (2) Class III (premarket approval) when the device is intended for 
other uses, including colon cleansing routinely for general well being.
    (c) Date PMA or notice of completion of a PDP is required. A PMA or 
a notice of completion of a PDP is required to be filed with the Food 
and Drug Administration on or before December 26, 1996 for any colonic 
irrigation system described in paragraph (b)(2) of this section that was 
in commercial distribution before May 28, 1976, or that has, on or 
before December 26, 1996 been found to be substantially equivalent to a 
colonic irrigation system described in paragraph (b)(2) of this section 
that was in commercial distribution before May 28, 1976. Any other 
colonic irrigation system shall have an approved PMA in effect before 
being placed in commercial distribution.

[48 FR 53023, Nov. 23, 1983, as amended at 52 FR 17738, May 11, 1987; 61 
FR 50707, Sept. 27, 1996]



Sec. 876.5250  Urine collector and accessories.

    (a) Identification. A urine collector and accessories is a device 
intended to collect urine. The device and accessories consist of tubing, 
a suitable receptacle, connectors, mechanical supports, and may include 
a means to prevent the backflow of urine or ascent of infection. The two 
kinds of urine collectors are:
    (1) A urine collector and accessories intended to be connected to an 
indwelling catheter, which includes the urinary drainage collection kit 
and the closed urine drainage system and drainage bag; and
    (2) A urine collector and accessories not intended to be connected 
to an indwelling catheter, which includes the corrugated rubber sheath, 
pediatric urine collector, leg bag for external use, urosheath type 
incontinence device, and the paste-on device for incontinence.
    (b) Classification. (1) Class II (special controls) for a urine 
collector and accessories intended to be connected to an indwelling 
catheter. The device is exempt from the premarket notification 
procedures in subpart E of part 807 of this chapter subject to 
Sec. 876.9.
    (2) Class I (general controls) for a urine collector and accessories 
not intended to be connected to an indwelling catheter. If the device is 
not labeled or otherwise represented as sterile, it is exempt from the 
current good manufacturing practice regulations in part 820, with the 
exception of Sec. 820.180, with respect to general requirements

[[Page 349]]

concerning records, and Sec. 820.198, with respect to complaint files.

[48 FR 53023, Nov. 23, 1983, as amended at 63 FR 59228, Nov. 3, 1998]



Sec. 876.5270  Implanted electrical urinary continence device.

    (a) Identification. An implanted electrical urinary device is a 
device intended for treatment of urinary incontinence that consists of a 
receiver implanted in the abdomen with electrodes for pulsed-stimulation 
that are implanted either in the bladder wall or in the pelvic floor, 
and a battery-powered transmitter outside the body.
    (b) Classification. Class III (premarket approval).
    (c) Date PMA or notice of completion of a PDP is required. A PMA or 
a notice of completion of a PDP is required to be filed with the Food 
and Drug Administration on or before December 26, 1996 for any implanted 
electrical urinary continence device that was in commercial distribution 
before May 28, 1976, or that has, on or before December 26, 1996 been 
found to be substantially equivalent to an implanted electrical urinary 
continence device that was in commercial distribution before May 28, 
1976. Any other implanted electrical urinary continence device shall 
have an approved PMA or a declared completed PDP in effect before being 
placed in commercial distribution.

[48 FR 53023, Nov. 23, 1983, as amended at 52 FR 17738, May 11, 1987; 61 
FR 50707, Sept. 27, 1996]



Sec. 876.5280  Implanted mechanical/hydraulic urinary continence device.

    (a) Identification. An implanted mechanical/hydraulic urinary 
continence device is a device used to treat urinary incontinence by the 
application of continuous or intermittent pressure to occlude the 
urethra. The totally implanted device may consist of a static pressure 
pad, or a system with a container of radiopaque fluid in the abdomen and 
a manual pump and valve under the skin surface that is connected by 
tubing to an adjustable pressure pad or to a cuff around the urethra. 
The fluid is pumped as needed from the container to inflate the pad or 
cuff to pass on the urethra.
    (b) Classification. Class III (premarket approval).
    (c) Date PMA or notice of completion of a PDP is required. No 
effective date has been established of the requirement for premarket 
approval. See Sec. 876.3.

[48 FR 53023, Nov. 23, 1983, as amended at 52 FR 17738, May 11, 1987]



Sec. 876.5320  Nonimplanted electrical continence device.

    (a) Identification. A nonimplanted electrical continence device is a 
device that consists of a pair of electrodes on a plug or a pessary that 
are connected by an electrical cable to a battery-powered pulse source. 
The plug or pessary is inserted into the rectum or into the vagina and 
used to stimulate the muscles of the pelvic floor to maintain urinary or 
fecal continence. When necessary, the plug or pessary may be removed by 
the user. This device excludes an AC-powered nonimplanted electrical 
continence device and the powered vaginal muscle stimulator for 
therapeutic use (Sec. 884.5940).
    (b) Classification. Class II (performance standards).



Sec. 876.5365  Esophageal dilator.

    (a) Identification. An esophageal dilator is a device that consists 
of a cylindrical instrument that may be hollow and weighted with mercury 
or a metal olive-shaped weight that slides on a guide, such as a string 
or wire and is used to dilate a stricture of the esophagus. This generic 
type of device includes esophageal or gastrointestinal bougies and the 
esophageal dilator (metal olive).
    (b) Classification. Class II (performance standards).



Sec. 876.5450  Rectal dilator.

    (a) Identification. A rectal dilator is a device designed to dilate 
the anal sphincter and canal when the size of the anal opening may 
interfere with its function or the passage of an examining instrument.
    (b) Classification. Class I. The device is exempt from the premarket 
notification procedures in subpart E of part 807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 61 FR 1122, Jan. 16, 1996]

[[Page 350]]



Sec. 876.5470  Ureteral dilator.

    (a) Identification. A ureteral dilator is a device that consists of 
a specially shaped catheter or bougie and is used to dilate the ureter 
at the place where a stone has become lodged or to dilate a ureteral 
stricture.
    (b) Classification. Class II (performance standards).



Sec. 876.5520  Urethral dilator.

    (a) Identification. A urethral dilator is a device that consists of 
a slender hollow or solid instrument made of metal, plastic, or other 
suitable material in a cylindrical form and in a range of sizes and 
flexibilities. The device may include a mechanism to expand the portion 
of the device in the urethra and indicate the degree of expansion on a 
dial. It is used to dilate the urethra. This generic type of device 
includes the mechanical urethral dilator, urological bougies, metal or 
plastic urethral sound, urethrometer, filiform, and filiform follower.
    (b) Classification. (1) Class II (performance standards).
    (2) Class I for the urethrometer, urological bougie, filiform and 
filiform follower, and metal or plastic urethral sound. The devices 
subject to this paragraph (b)(2) are exempt from the premarket 
notification procedures in subpart E of part 807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 61 FR 1122, Jan. 16, 1996]



Sec. 876.5540  Blood access device and accessories.

    (a) Identification. A blood access device and accessories is a 
device intended to provide access to a patient's blood for hemodialysis 
or other chronic uses. When used in hemodialysis, it is part of an 
artificial kidney system for the treatment of patients with renal 
failure or toxemic conditions and provides access to a patient's blood 
for hemodialysis. The device includes implanted blood access devices, 
nonimplanted blood access devices, and accessories for both the 
implanted and nonimplanted blood access devices.
    (1) The implanted blood access device consists of various flexible 
or rigid tubes, which are surgically implanted in appropriate blood 
vessels, may come through the skin, and are intended to remain in the 
body for 30 days or more. This generic type of device includes various 
shunts and connectors specifically designed to provide access to  blood, 
 such  as  the  arteriovenous (A-V) shunt cannula and vessel tip.
    (2) The nonimplanted blood access device consists of various 
flexible or rigid tubes, such as catheters, cannulae or hollow needles, 
which are inserted into appropriate blood vessels or a vascular graft 
prosthesis (Secs. 870.3450 and 870.3460), and are intended to remain in 
the body for less than 30 days. This generic type of device includes 
fistula needles, the single needle dialysis set (coaxial flow needle), 
and the single needle dialysis set (alternating flow needle).
    (3) Accessories common to either type include the shunt adaptor, 
cannula clamp, shunt connector, shunt stabilizer, vessel dilator, 
disconnect forceps, shunt guard, crimp plier, tube plier, crimp ring, 
joint ring, fistula adaptor, and declotting tray (including contents).
    (b) Classification. (1) Class III (premarket approval) for the 
implanted blood access device.
    (2) Class II (performance standards) for the nonimplanted blood 
access device.
    (3) Class II (performance standards) for accessories for both the 
implanted and the nonimplanted blood access devices not listed in 
paragraph (b)(4) of this section.
    (4) Class I for the cannula clamp, disconnect forceps, crimp plier, 
tube plier, crimp ring, and joint ring, accessories for both the 
implanted and nonimplanted blood access device. The devices subject to 
this paragraph (b)(4) are exempt from the premarket notification 
procedures in subpart E of part 807 of this chapter.
    (c) Date PMA or notice of completion of a PDP is required. No 
effective date has been established of the requirement for premarket 
approval for the device described in paragraph (b)(1). See Sec. 876.3.

[48 FR 53023, Nov. 23, 1983, as amended at 52 FR 17738, May 11, 1987; 61 
FR 1122, Jan. 16, 1996]

[[Page 351]]



Sec. 876.5600  Sorbent regenerated dialysate delivery system for hemodialysis.

    (a) Identification. A sorbent regenerated dialysate delivery system 
for hemodialysis is a device that is part of an artificial kidney system 
for the treatment of patients with renal failure or toxemic conditions, 
and that consists of a sorbent cartridge and the means to circulate 
dialysate through this cartridge and the dialysate compartment of the 
dialyzer. The device is used with the extracorporeal blood system and 
the dialyzer of the hemodialysis system and accessories (Sec. 876.5820). 
The device includes the means to maintain the temperature, conductivity, 
electrolyte balance, flow rate and pressure of the dialysate, and alarms 
to indicate abnormal dialysate conditions. The sorbent cartridge may 
include absorbent, ion exchange and catalytic materials.
    (b) Classification. Class II (performance standards).



Sec. 876.5630  Peritoneal dialysis system and accessories.

    (a) Identification. (1) A peritoneal dialysis system and accessories 
is a device that is used as an artificial kidney system for the 
treatment of patients with renal failure or toxemic conditions, and that 
consists of a peritoneal access device, an administration set for 
peritoneal dialysis, a source of dialysate, and, in some cases, a water 
purification mechanism. After the dialysate is instilled into the 
patient's peritoneal cavity, it is allowed to dwell there so that 
undesirable substances from the patient's blood pass through the lining 
membrane of the peritoneal cavity into this dialysate. These substances 
are then removed when the dialysate is drained from the patient. The 
peritoneal dialysis system may regulate and monitor the dialysate 
temperature, volume, and delivery rate together with the time course of 
each cycle of filling, dwell time, and draining of the peritoneal cavity 
or manual controls may be used. This generic device includes the 
semiautomatic and the automatic peritoneal delivery system.
    (2) The peritoneal access device is a flexible tube that is 
implanted through the abdominal wall into the peritoneal cavity and that 
may have attached cuffs to provide anchoring and a skin seal. The device 
is either a single use peritioneal catheter, intended to remain in the 
peritoneal cavity for less than 30 days, or a long term peritoneal 
catheter. Accessories include stylets and trocars to aid in the 
insertion of the catheter and an obturator to maintain the patency of 
the surgical fistula in the abdominal wall between treatments.
    (3) The disposable administration set for peritoneal dialysis 
consists of tubing, an optional reservoir bag, and appropriate 
connectors. It may include a peritoneal dialysate filter to trap and 
remove contaminating particles.
    (4) The source of dialysate may be sterile prepackaged dialysate 
(for semiautomatic peritoneal dialysate delivery systems or ``cycler 
systems'') or dialysate prepared from dialysate concentrate and sterile 
purified water (for automatic peritoneal dialysate delivery systems or 
``reverse osmosis'' systems). Prepackaged dialysate intended for use 
with either of the peritoneal dialysate delivery systems is regulated by 
FDA as a drug.
    (b) Classification. Class II (performance standards).



Sec. 876.5665  Water purification system for hemodialysis.

    (a) Identification. A water purification system for hemodialysis is 
a device that is intended for use with a hemodialysis system and that is 
intended to remove organic and inorganic substances and microbial 
contaminants from water used to dilute dialysate concentrate to form 
dialysate. This generic type of device may include a water softener, 
sediment filter, carbon filter, and water distillation system.
    (b) Classification. Class II (performance standards).



Sec. 876.5820  Hemodialysis system and accessories.

    (a) Identification. A hemodialysis system and accessories is a 
device that is used as an artificial kidney system for the treatment of 
patients with renal failure or toxemic conditions and that consists of 
an extracorporeal blood system, a conventional dialyzer, a

[[Page 352]]

dialysate delivery system, and accessories. Blood from a patient flows 
through the tubing of the extracorporeal blood system and accessories to 
the blood compartment of the dialyzer, then returns through further 
tubing of the extracorporeal blood system to the patient. The dialyzer 
has two compartments that are separated by a semipermeable membrane. 
While the blood is in the blood compartment, undesirable substances in 
the blood pass through the semipermeable membrane into the dialysate in 
the dialysate compartment. The dialysate delivery system controls and 
monitors the dialysate circulating through the dialysate compartment of 
the dialyzer.
    (1) The extracorporeal blood system and accessories consists of 
tubing, pumps, pressure monitors, air foam or bubble detectors, and 
alarms to keep blood moving safely from the blood access device and 
accessories for hemodialysis (Sec. 876.5540) to the blood compartment of 
the dialyzer and back to the patient.
    (2) The conventional dialyzer allows a transfer of water and solutes 
between the blood and the dialysate through the semipermeable membrane. 
The semipermeable membrane of the conventional dialyzer has a 
sufficiently low permeability to water that an ultrafiltration 
controller is not required to prevent excessive loss of water from the 
patient's blood. This conventional dialyzer does not include 
hemodialyzers with the disposable inserts (Kiil type) (Sec. 876.5830) or 
dialyzers of high permeability (Sec. 876.5860).
    (3) The dialysate delivery system consists of mechanisms that 
monitor and control the temperature, conductivity, flow rate, and 
pressure of the dialysate and circulates dialysate through the dialysate 
compartment of the dialyzer. The dialysate delivery system includes the 
dialysate concentrate for hemodialysis (liquid or powder) and alarms to 
indicate abnormal dialysate conditions. This dialysate delivery system 
does not include the sorbent regenerated dialysate delivery system for 
hemodialysis (Sec. 876.5600), the dialysate delivery system of the 
peritoneal dialysis system and accessories (Sec. 876.5630), or the 
controlled dialysate delivery system of the high permeability 
hemodialysis system Sec. 876.5860).
    (4) Remote accessories to the hemodialysis system include the 
unpowered dialysis chair without a scale, the powered dialysis chair 
without a scale, the dialyzer holder set, dialysis tie gun and ties, and 
hemodialysis start/stop tray.
    (b) Classification. (1) Class II (performance standards) for 
hemodialysis systems and all accessories directly associated with the 
extracorporeal blood system and the dialysate delivery system.
    (2) Class I for other accessories of the hemodialysis system remote 
from the extracorporeal blood system and the dialysate delivery system, 
such as the unpowered dialysis chair, hemodialysis start/stop tray, 
dialyzer holder set, and dialysis tie gun and ties. The devices subject 
to this paragraph (b)(2) are exempt from the premarket notification 
procedures in subpart E of part 807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 54 FR 25050, June 12, 1989]



Sec. 876.5830  Hemodialyzer with disposable insert (Kiil type).

    (a) Identification. A hemodialyzer with disposable inserts (Kiil 
type) is a device that is used as a part of an artificial kidney system 
for the treatment of patients with renal failure or toxemic conditions 
and that includes disposable inserts consisting of layers of 
semipermeable membranes which are sandwiched between support plates. The 
device is used with the extracorporeal blood system and the dialysate 
delivery system of the hemodialysis system and accessories 
(Sec. 876.5820).
    (b) Classification. Class II (performance standards).

[48 FR 53023, Nov. 23, 1983, as amended at 53 FR 11253, Apr. 6, 1988]



Sec. 876.5860  High permeability hemodialysis system.

    (a) Identification. A high permeability hemodialysis system is a 
device that is used as an artificial kidney system for the treatment of 
patients with renal failure or toxemic conditions, and that has a 
dialyzer with a semipermeable membrane that is more permeable to

[[Page 353]]

water than the semipermeable membrane of the conventional dialyzer. The 
device system consists of an extracorporeal blood system, a high 
permeability dialyzer, and a controlled dialysate delivery system that 
incorporates an ultrafiltration controller to prevent excessive loss of 
water from the patient's blood. This highly permeable, semipermeable 
membrane may also permit greater loss of higher molecular weight 
substances from the blood, compared with the conventional dialyzer of 
the hemodialysis system and accessories (Sec. 876.5820). The 
extracorporeal blood system is the same generic type of extracorporeal 
blood system that is used in the hemodialysis system and accessories 
(Sec. 876.5820). The controlled dialysate delivery system also is 
similar to the conventional disalysate delivery system of the 
hemodialysis system and accessories (Sec. 876.5820), with the addition 
of an ultrafiltration controller to regulate the rate of the removal of 
water from the patient's blood and ensure that the pressure on the 
dialysate side of the membrane is always lower than on the blood side. 
This generic type of device includes the sealed dialysate delivery 
system.
    (b) Classification. Class III (premarket approval).
    (c) Date PMA or notice of completion of a PDP is required. No 
effective date has been established of the requirement for premarket 
approval. See Sec. 876.3.

[48 FR 53023, Nov. 23, 1983, as amended at 52 FR 17738, May 11, 1987]



Sec. 876.5870  Sorbent hemoperfusion system.

    (a) Identification. A sorbent hemoperfusion system is a device that 
consists of an extracorporeal blood system similar to that identified in 
the hemodialysis system and accessories (Sec. 876.5820) and a container 
filled with adsorbent material that removes a wide range of substances, 
both toxic and normal, from blood flowing through it. The adsorbent 
materials are usually activated-carbon or resins which may be coated or 
immobilized to prevent fine particles entering the patient's blood. The 
generic type of device may include lines and filters specifically 
designed to connect the device to the extracorporeal blood system. The 
device is used in the treatment of poisoning, drug overdose, hepatic 
coma, or metabolic disturbances.
    (b) Classification. Class III (premarket approval).
    (c) Date PMA or notice of completion of a PDP is required. No 
effective date has been established of the requirement for premarket 
approval. See Sec. 876.3.

[48 FR 53023, Nov. 23, 1983, as amended at 52 FR 17738, May 11, 1987]



Sec. 876.5880  Isolated kidney perfusion and transport system and accessories.

    (a) Identification. An isolated kidney perfusion and transport 
system and accesssories is a device that is used to support a donated or 
a cadaver kidney and to maintain the organ in a near-normal physiologic 
state until it is transplanted into a recipient patient. This generic 
type of device may include tubing, catheters, connectors, an ice storage 
or freezing container with or without bag or preservatives, pulsatile or 
nonpulsatile hypothermic isolated organ perfusion apparatus with or 
without oxygenator, and disposable perfusion set.
    (b) Classification. Class II (performance standards).



Sec. 876.5895  Ostomy irrigator.

    (a) Identification. An ostomy irrigator is a device that consists of 
a container for fluid, tubing with a cone-shaped tip or a soft and 
flexible catheter with a retention shield and that is used to wash out 
the colon through a colostomy, a surgically created opening of the colon 
on the surface of the body.
    (b) Classification. Class II (performance standards).



Sec. 876.5900  Ostomy pouch and accessories.

    (a) Identification. An ostomy pouch and accessories is a device that 
consists of a bag that is attached to the patient's skin by an adhesive 
material and that is intended for use as a receptacle for collection of 
fecal material or urine following an ileostomy, colostomy, or 
ureterostomy (a surgically created opening of the small intestine, large 
intestine, or the ureter on the surface of the body). This generic type

[[Page 354]]

of device and its accessories includes the ostomy pouch, ostomy 
adhesive, the disposable colostomy appliance, ostomy collector, 
colostomy pouch, urinary ileostomy bag, urine collecting ureterostomy 
bag, ostomy drainage bag with adhesive, stomal bag, ostomy protector, 
and the ostomy size selector, but excludes ostomy pouches which 
incorporate arsenic-containing compounds.
    (b) Classification. Class I. The device is exempt from the premarket 
notification procedures in subpart E of part 807 of this chapter.

[48 FR 53023, Nov. 23, 1983, as amended at 54 FR 25050, June 12, 1989]



Sec. 876.5920  Protective garment for incontinence.

    (a) Identification. A protective garment for incontinence is a 
device that consists of absorbent padding and a fluid barrier and that 
is intended to protect an incontinent patient's garment from the 
patient's excreta. This generic type of device does not include diapers 
for infants.
    (b) Classification. Class I. The device is exempt from the premarket 
notification procedures in subpart E of part 807 of this chapter. The 
device is also exempt from the current good manufacturing practice 
regulations in part 820 of this chapter, with the exception of 
Sec. 820.180, regarding general requirements concerning records, and 
Sec. 820.198, regarding complaint files.

[48 FR 53023, Nov. 23, 1983, as amended at 54 FR 25050, June 12, 1989]



Sec. 876.5955  Peritoneo-venous shunt.

    (a) Identification. A peritoneo-venous shunt is an implanted device 
that consists of a catheter and a pressure activated one-way valve. The 
catheter is implanted with one end in the peritoneal cavity and the 
other in a large vein. This device enables ascitic fluid in the 
peritoneal cavity to flow into the venous system for the treatment of 
intractable ascites.
    (b) Classification. Class III (premarket approval).
    (c) Date PMA or notice of completion of a PDP is required. No 
effective date has been established of the requirement for premarket 
approval. See Sec. 876.3.

[48 FR 53023, Nov. 23, 1983, as amended at 52 FR 17738, May 11, 1987]



Sec. 876.5970  Hernia support.

    (a) Identification. A hernia support is a device, usually made of 
elastic, canvas, leather, or metal, that is intended to be placed over a 
hernial opening (a weakness in the abdominal wall) to prevent protrusion 
of the abdominal contents. This generic type of device includes the 
umbilical truss.
    (b) Classification. Class I. The device is exempt from the premarket 
notification procedures in subpart E of part 807 of this chapter. The 
device is exempt from the current good manufacturing practice 
regulations in part 820 of this chapter, with the exception of 
Sec. 820.180, regarding general requirements concerning records, and 
Sec. 820.198, regarding complaint files.

[48 FR 53023, Nov. 23, 1983, as amended at 59 FR 63010, Dec. 7, 1994]



Sec. 876.5980  Gastrointestinal tube and accessories.

    (a) Identification. A gastrointestinal tube and accessories is a 
device that consists of flexible or semi-rigid tubing used for 
instilling fluids into, withdrawing fluids from, splinting, or 
suppressing bleeding of the alimentary tract. This device may 
incorporate an integral inflatable balloon for retention or hemostasis. 
This generic type of device includes the hemostatic bag, irrigation and 
aspiration catheter (gastric, colonic, etc.), rectal catheter, sterile 
infant gavage set, gastrointestinal string and tubes to locate internal 
bleeding, double lumen tube for intestinal decompression or intubation, 
feeding tube, gastroenterostomy tube, Levine tube, nasogastric tube, 
single lumen tube with mercury weight balloon for intestinal intubation 
or decompression, and gastro-urological irrigation tray (for 
gastrological use).
    (b) Classification. (1) Class II (performance standards).
    (2) Class I (general controls) for the dissolvable nasogastric feed 
tube guide for the nasogastric tube.

[49 FR 573, Jan. 5, 1984]

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