K Number
K030885

Validate with FDA (Live)

Date Cleared
2003-04-18

(28 days)

Product Code
Regulation Number
880.5725
Age Range
All
Reference & Predicate Devices
N/A
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticPediatricDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

PainPump2 is an electromechanical pump which delivers a controlled amount of medication to the patient for the purpose of managing pain. The pump delivers medication using one or both of the following drug delivery profiles: an hourly flow rate and a bolus PCA (patient controlled anesthetic) dosing option. Routes of administration may be intraoperative, subcutaneous, or percutaneous. Dosage rates and patient lock out times are programmed into the PainPump II unit by the physician. The PainPump II is contraindicated for infusion of blood and blood products, insulin, or life-supporting medication.

Device Description

The Stryker PainPump2 is intended an electromechanical pump which delivers a controlled amount of medication to the patient for the purpose of managing pain. The pump delivers medication using one or both of the following drug delivery profiles: an hourly flow rate and a bolus PCA (patient controlled anesthetic) dosing option. Routes of administration may be intraoperative, subcutaneous or percutaneous. Dosage rates and patient lock out times are programmed into the PainPump2 unit by the physician.

AI/ML Overview

This document, K030885, concerns a 510(k) premarket notification for the Stryker PainPump2. It is a submission for substantial equivalence to legally marketed predicate devices, not a study proving device performance against acceptance criteria. Therefore, most of the requested information regarding acceptance criteria and performance studies is not available within this document.

Here's a breakdown of the available information:

1. A table of acceptance criteria and the reported device performance

This document does not contain a table of acceptance criteria or reported device performance. A 510(k) submission primarily focuses on demonstrating substantial equivalence to a predicate device, rather than presenting a detailed performance study against specific acceptance criteria.

2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

Not applicable. This document does not describe a clinical study or a test set with sample sizes.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

Not applicable. This document does not describe the establishment of a ground truth by experts.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

Not applicable. This document does not describe an adjudication method for a test set.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

Not applicable. This document is for an electromechanical infusion pump and does not involve AI or human readers for diagnostic interpretation.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

Not applicable. This is not an AI or algorithm-based device.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

Not applicable. This document does not refer to a ground truth as it pertains to a performance study.

8. The sample size for the training set

Not applicable. There is no mention of a training set for an algorithm.

9. How the ground truth for the training set was established

Not applicable. There is no mention of a training set or ground truth for it.

Summary of what the document does provide:

  • Device Name: Stryker PainPump2
  • Intended Use: An electromechanical pump to deliver a controlled amount of medication for pain management, using hourly flow rates and/or bolus PCA dosing. Routes of administration can be intraoperative, subcutaneous, or percutaneous.
  • Contraindications: Infusion of blood products, insulin, or life-supporting medication.
  • Regulatory Basis: The submission is a 510(k) premarket notification, seeking substantial equivalence to existing infusion pump systems marketed by I-Flow Corporation.
  • Conclusion: The FDA determined the device is substantially equivalent to legally marketed predicate devices, meaning it does not raise new safety and efficacy concerns compared to existing devices.

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K030885

APR 1 8 2003

stryker
INSTRUMENTS

5300 East Milham Avenue
Kalamazoo, MI 49001
Phone (616) 323-7700
(616) 200-8210

Device Name:

Trade Name:Stryker PainPump2
Common Name:Electromechanical Ambulatory Infusion Pump
Classification Name:Pump, Infusion: 21 CFR 880.5725, Class II

Device Sponsor:

Manufacturer:Stryker Instruments
4100 E. Milham Avenue
Kalamazoo, MI 49001
Registration No.: 1811755

Regulatory Class: Class II

Summary of Safety and Effectiveness:

The Stryker PainPump2 is intended an electromechanical pump which delivers a controlled amount of medication to the patient for the purpose of managing pain. The pump delivers medication using one or both of the following drug delivery profiles: an hourly flow rate and a bolus PCA (patient controlled anesthetic) dosing option. Routes of administration may be intraoperative, subcutaneous or percutaneous. Dosage rates and patient lock out times are programmed into the PainPump2 unit by the physician.

The Stryker PainPump2 is contraindicated for infusion of blood products, insulin, or lifesupporting medication.

The Stryker PainPump2 2-Site Infusion Set is a kit that is comprised of a 2-Site infusion set, introducer needles, syringe, dressings and catheter securement accessories.

The Stryker PainPump2 is substantially equivalent in intended use, safety, and effectiveness to existing infusion pump systems being marketed by I-Flow Corporation.

The Stryker PainPump2 does not raise any new safety and efficacy concerns when compared to similar devices already legally marketed. Therefore, the Stryker PainPump2 is substantially equivalent to these existing devices.

By: __
Nicole Petty
Nicole Petty

Regulatory Analyst

Dated: 3.20.03

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Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle or bird symbol with three curved lines representing its wings or body. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the bird symbol. The logo is black and white.

APR 1 8 2003

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Ms. Nicole Petty Regulatory Analyst Stryker Instruments 4100 E. Milham Avenue Kalamazoo, Michigan 49001

Re: K030885

Trade/Device Name: Modification to Stryker PainPump 2 Regulation Number: 880.5725, 880.5120 Regulation Name: Infusion Pump Regulatory Class: II Product Code: FRN, BSO Dated: March 20, 2003 Received: March 21, 2003

Dear Ms. Petty:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such 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.

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Page 2 - Ms. Petty

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); 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.

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits vour device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at (301) 594-4618. Also, please note the regulation entitled. "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely vours.

Susan Ruane

Susan Runner, DDS, MA Interim Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Page 1

510(k) Number:
Device Name:Stryker PainPump2
Indications For Use:PainPump2 is an electromechanical pump which delivers a controlled amount of medication to the patient for the purpose of managing pain. The pump delivers medication using one or both of the following drug delivery profiles: an hourly flow rate and a bolus PCA (patient controlled anesthetic) dosing option. Routes of administration may be intraoperative, subcutaneous, or percutaneous. Dosage rates and patient lock out times are programmed into the PainPump II unit by the physician. The PainPump II is contraindicated for infusion of blood and blood products, insulin, or life-supporting medication.

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use _

OR

Over-The- Counter Use

(Per 21 CFR 801.109)

Patricia Cusack

(Optional Format 1-2-96)

(Division Sign-Off) (Division Sign-on)
Division of Anesthesiology, General Hospital, Division of Ancolnest, Dental Devices

510(k) Number: K030885

§ 880.5725 Infusion pump.

(a)
Identification. An infusion pump is a device used in a health care facility to pump fluids into a patient in a controlled manner. The device may use a piston pump, a roller pump, or a peristaltic pump and may be powered electrically or mechanically. The device may also operate using a constant force to propel the fluid through a narrow tube which determines the flow rate. The device may include means to detect a fault condition, such as air in, or blockage of, the infusion line and to activate an alarm.(b)
Classification. Class II (performance standards).