K Number
K111870

Validate with FDA (Live)

Manufacturer
Date Cleared
2011-07-29

(28 days)

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

The Amsco Warming Cabinet is designed to raise the temperature of blankets, linens and sterile surgical irrigation solutions and IV solutions to an acceptable level for various surgical, obstetrical, emergency, critical care and other healthcare applications.

Device Description

The Amsco Warming Cabinet is designed to store and warm sterile IV solutions, surgical irrigation solutions, linens and/or blankets to an acceptable level for hospital and surgical outpatient center applications. The 24" Wide Pass-thru model will be mounted in a wall opening. Doors (upper and lower compartment) added to the rear of the cabinet will allow users to load supplies in compartments from outside the operating room, while doors on the front side will allow access to compartments when inside the operating room. The upper compartment of this model holds up to 20( 1-liter) liquid bottles, or 6 ( 1liter) liquid (IV or Irrigation solution) bags; the lower compartment holds up to 40 (1-liter) liquid bottles or 12 (1 liter) liquid bags.

AI/ML Overview

Here's a breakdown of the acceptance criteria and the study information based on the provided text, formatted to match your request:

1. Table of Acceptance Criteria and Reported Device Performance

Test DescriptionAcceptance CriteriaReported Device Performance
Electrical Testing
Dielectric WithstandAchieve passing results through automated dielectric strength tester.PASS
Earth and Enclosure Leakage CurrentMust not exceed requirements listed in UL 61010-1 clause 6.3.1b (must not exceed .5mA normal condition and 3.5mA single fault condition).PASS
Ground bondMust not exceed 0.1 ohm and maintain ground continuity.PASS
Power Input & Line VoltageThe power input of equipment at rated voltage and steady state current shall not exceed the marked rating by 10%.PASS
System Functions
Main Power ON indicatorMain Power ON indicator at rear upper door is illuminated when Main Power Switch is set to the ON position.PASS
Exhaust fans and blowers operationExhaust fans and blowers must operate continuously when the main power is set to the ON position. Opening or closing the doors shall not cause fans or blowers to turn off.PASS
Input currentInput current must be within 11.4 - 14.25 Amps.PASS
Over-temp alarmOver-temp alarm must activate and displayed temperature flashes alternately with the error "Hi" when compartment temperature is more than 10°F above set point temperature.PASS
Door lockDoor must remain locked when 40 pounds of force is applied.PASS
Thermal Test
Temperature Limits (recessed mounted, normal condition)Temperatures of easily touched surfaces and identified components must comply with UL 61010-1 clauses 10.1 and 10.2, UL 61010-2-010 clause 10.1, temperature limits under normal conditions. Maintain normal operation without faults occurring.PASS
Single Fault Conditions
Cooling (single fault condition)Pass dielectric strength test per UL 61010-1, section 6, clause 6.8. Cabinet outer surface must not exceed 105°C at 40°C ambient. Transformer, blower and exhaust fan windings must not exceed 150°C under single fault condition at 40°C ambient. Voltage measurement of cabinet outer surfaces must not exceed test voltages per UL 61010-1, section 6, clause 6.3.2a. No signs of molten metal, burning insulation, flaming particles, etc. No signs of charring, glowing, or flaming of tissue paper or cheesecloth.PASS
Heating Devices (single fault condition)Pass dielectric strength test per UL 61010-1, section 6, clause 6.8. Cabinet outer surface must not exceed 105°C at 40°C ambient. Transformer, blower and exhaust fan windings must not exceed 150°C under single fault condition at 40°C ambient. Voltage measurement of cabinet outer surfaces must not exceed test voltages per UL 61010-1, section 6, clause 6.3.2a. No signs of molten metal, burning insulation, flaming particles, etc. No signs of charring, glowing, or flaming of tissue paper or cheesecloth.PASS
Protection against Hazards from FluidsPass dielectric strength test per UL 61010-1, section 6, clause 6.8. Voltage measurement of cabinet outer surfaces must not exceed test voltages per UL 61010-1, section 6, clause 6.3.2a.PASS
Heating Performance (empty compartment)Temperature reading of each thermocouple must not vary from set-point temperature by more than $\pm$ 3°F in upper compartment and $\pm$ 5°F in lower compartment. At a 160°F set-point temperature, the upper compartment display must reach set-point within 35 minutes and lower compartment display must be within 65 minutes. Normal system operation is maintained without over-temperature condition or faults occurring.PASS
Heating Performance (Full IV solution load in upper compartment and full blanket load in lower compartment)Temperature reading of each thermocouple must not vary from set-point temperature by more than $\pm$ 3°F in upper compartment and $\pm$ 5°F in lower compartment. Upper and lower compartment controls temperature display must reach set-point within 12 hours. Normal system operation is maintained without over-temperature condition or faults occurring.PASS
Heating Performance (Full irrigation solution load in upper and lower compartments)With a fully loaded compartment of Irrigation solution, bottles of solution shall not overbalance and fall off shelf when doors are opened. Temperature reading of each thermocouple must not vary from set-point temperature by more than $\pm$ 3°F in upper compartment and $\pm$ 5°F in lower compartment. Upper and lower compartment controls temperature display must reach set-point within 12 hours. Normal system operation is maintained without over-temperature condition or faults occurring.PASS
ETL/cETL Code ComplianceMeet UL 61010-1 Standard for Safety Electrical Equipment for Measurement, Control, and Laboratory Use. Meet CAN/CSA C22.2 61010-1 Standard for Safety Electrical Equipment for Measurement, Control and Laboratory Use.PASS

2. Sample size used for the test set and the data provenance

The document describes verification and validation activities performed on the physical device, not an algorithm using a dataset. Therefore, terms like "sample size for the test set" and "data provenance" (country of origin, retrospective/prospective) are not directly applicable in the context of this device's testing. The "test set" in this case refers to the physical Amsco Warming Cabinet, 24" Wide Pass-thru model, itself undergoing various engineering and functional tests.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable. This is a medical device (warming cabinet) and the ground truth for its performance is established through objective engineering tests against established safety and performance standards (UL, CAN/CSA). There are no "experts" establishing ground truth in the sense of clinical interpretations or diagnoses.

4. Adjudication method for the test set

Not applicable. The tests are objective measurements and evaluations against predefined quantitative and qualitative acceptance criteria (e.g., current limits, temperature ranges, successful operation of alarms). There is no ambiguity requiring adjudication by multiple readers or decision-makers.

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 is a medical device (warming cabinet), not an AI algorithm for diagnostic imaging or similar applications where MRMC studies or AI assistance for human readers would be relevant.

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

Not applicable. This is a physical warming cabinet, not an algorithm. The "standalone" performance is the device operating as intended based on the tests described.

7. The type of ground truth used

The ground truth for this device is based on established engineering and safety standards (UL 61010-1, CAN/CSA C22.2 61010-1), which define acceptable performance limits for electrical safety, temperature control, and mechanical integrity.

8. The sample size for the training set

Not applicable. This is a medical device undergoing physical and functional testing, not an AI model that requires a training set.

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

Not applicable, as no training set for an algorithm was used.

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JUL 2 9 2011

KI11870

STERIS®

510(k) Summary For Amsco Warming Cabinet 24" Wide Pass-thru Model

STERIS Corporation 5960 Heisley Road Mentor, OH 44060 Phone: (440) 354-2600 Fax No: (440) 357-9198

Contact:

Robert F. Sullivan -Senior Director, Regulatory Affairs

Telephone:440 392 7695
Fax No:440 357 9198

June 30, 2011 Summary Date:

STERIS Corporation ■ 5960 Heisley Road ■ Mentor. OH 44060-1834 USA ■ 440-354-2600

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Device Name 1.

Trade Name:Amsco Warming Cabinet, 24" Wide Pass-thru-Model
Common/usual Name:Warming Cabinet
Classification:Unclassified
Classification Name:Warmer, Thermal, Infusion Fluid; Unclassified,Product Code LGZ

Predicate Device 2.

Amsco Warming Cabinet (K092823)

Description of Device 3.

The Amsco Warming Cabinet is designed to store and warm sterile IV solutions, surgical irrigation solutions, linens and/or blankets to an acceptable level for hospital and surgical outpatient center applications.

The 24" Wide Pass-thru model will be mounted in a wall opening. Doors (upper and lower compartment) added to the rear of the cabinet will allow users to load supplies in compartments from outside the operating room, while doors on the front side will allow access to compartments when inside the operating room.

The upper compartment of this model holds up to 20( 1-liter) liquid bottles, or 6 ( 1liter) liquid (IV or Irrigation solution) bags; the lower compartment holds up to 40 (1-liter) liquid bottles or 12 (1 liter) liquid bags.

4. Intended Use

The Amsco Warming Cabinet is designed to raise the temperature of blankets, linens and sterile surgical irrigation solutions and IV solutions to an acceptable level for various surgical, obstetrical, emergency, critical care and other healthcare applications.

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Description of Safety and Substantial Equivalence રાં

Substantial Equivalence

The 24" Wide Pass-thru Amsco Warming Cabinet is identical in technology and intended use to the predicate Amsco Warming Cabinet models. A table comparing the technological characteristics of the proposed Amsco Warming Cabinet to the predicate is provided in Table 8-1.

路站,同: 上海: 下:: 上一篇: 上一篇: 上一篇: 上一篇:

FeaturesPREDICATE.Amsco Warming Cabinet.(K092823)PROPOSEDAmsco Warming Cabinet.24" Wide Pass-thru Model
Intended UseThe Amsco Warming Cabinet isdesigned to raise the temperatureof blankets, linens and sterilesurgical irrigation solutions andIV solutions to an acceptablelevel for various surgical,obstetrical, emergency, criticalcare and other healthcareapplications.Identical
Heating SystemElectric heater and fan blower(Convection heating)Identical
Unit ConfigurationSingle/Double chamberDouble chamber
Unit Depth18" or 24"18"
ModelFreestanding, mobile base (24"dual chamber only), or Counter(single chamber only)Freestanding
Interior andExterior SurfacesStainless Steel, ABS Plastic andlaminated galvanized steelStainless Steel and laminatedgalvanized steel
InstallationFree-Standing, Recessed, Mobile(24" dual chamber only), orCounter (single chamber only)Recessed only
DoorLaminated steel exterior andStainless Steel interior (Solid andGlass)Stainless steel exterior andinterior (Solid only)
FeaturesPREDICATE:Amsco Warming Cabinet(K092823)PROPOSED:Amsco Warming Cabinet24"-Wide-Pass-thru-Model
Cabinet StorageCapacity andVolume30" wide by 18" deep upper / single chamber - 3.2 cu ft - up to 24 (1-liter) bottles lower chamber - 8.5 cu ft - up to 72 (1-liter) bottlesUpper chamber - 2.1 cu ft - up to 20 (1-liter) bottlesLower chamber - 4.1 cu ft - up to 40 (1-liter) bottles
30" wide by 24" deep upper / single chamber - 4.3 cu ft - up to 30 (1-liter) bottles lower chamber - 11.6 cu ft - up to 90 (1-liter) bottles
30" wide by 18" deep OR Console upper chamber - 3.3 cu ft - up to 24 (1-liter) bottles lower chamber - 6.2 cu ft - up to 48 (1-liter) bottles
24" wide by 18" deep OR Console upper chamber - 2.4 cu ft - up to 20 (1-liter) bottles lower chamber - 4.7 cu ft - up to 40 (1-liter) bottle
ControlsDigital Push Button keypad / power switch / Digital LCD temperature display / mode selection buttons / door ajar indicator / Over-temperature light for each compartment / Data port for retrieval of stored temperatures.Identical
SoftwareUnit contains softwareIdentical - no changes were made to the software
TemperatureSelection Range90°F (32°C) to 160°F (71°C)Identical
Temperature LockTemperature lock-out function to prevent unauthorized temperature changes.Identical
FeaturesPREDICATEAmsco Warming Cabinet(K092823)PROPOSEDAmsco Warming Cabinet24"-Wide-Pass-thru-Model
Door LockAll configurations will beequipped with either a manualmechanical door lock or optionalelectronic door lock system foreach compartmentAll configurations will beequipped with a manualmechanical door lock for eachdoor on each compartment
Over TemperatureAlarm PointVisual and audible alarm if unithas a chamber temperaturegreater than 10°F (5.5°C) aboveset temperature. In the event of anover temp condition, the controlsautomatically turn off theheater(s).Identical
VoltageRequirements110/120 Vac, 220/240 Vacnominal,50/60 HZ110/120 Vac, 50/60 HZ

Table 8-1: Summary of the Proposed Device and Predicate Devices Technological Characteristics

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STERIS SPECIAL 510(k) – DEVICE MODIFICATION TO K092823

AMSCO WARMING CABINET – 24" WIDE PASS-THRU MODEL

1

1

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STERIS SPECIAL 510(k) - DEVICE MODIFICATION TO K092823 AMSCO WARMING CABINET - 24" WIDE PASS-THRU MODEL

Safety and Effectiveness

Mechanical, electrical and heating performance testing demonstrate that the proposed Amsco Warming Cabinet, 24" Wide Pass-thru model, operates as intended and is as safe and effective as the predicate. Table 8-2 summarizes the verification and validation activities that were performed to ensure that rorifications do not affect the safety or effectiveness of the Amsco Warming Cabinet.

Table 8-2: Summary of Verification and Validation Activities
for 24" Wide Pass-thru Warming Cabinet
Test DescriptionAcceptance CriteriaResults
Electrical TestingDielectric Withstand• Achieve passing results thru automated dielectricstrength tester.Earth and Enclosure Leakage Current• Must not exceed requirements listed in UL 61010-1clause 6.3.1b (must not exceed .5mA normalcondition and 3.5mA single fault condition)Ground bond• Must not exceed 0.1 ohm and maintain groundcontinuity.Power Input & Line Voltage• The power input of equipment at rated voltage andsteady state current shall not exceed the markedrating by 10%.PASS
Test DescriptionAcceptance CriteriaResults
System Functions• Main Power ON indicator at rear upper door is - illuminated when Main Power Switch is set to the ON position.• Exhaust fans and blowers must operate continuously when the main power is set to the ON position• Opening or closing the doors shall not cause fans or blowers to turn off• Input current must be within 11.4 - 14.25 Amps.• Over-temp alarm must activate and displayed temperature flashes alternately with the error "Hi" when compartment temperature is more than 10°F above set point temperature• Door must remain locked when 40 pounds of force is appliedPASS
Thermal TestTemperature Limits (recessed mounted, normal condition)• Temperatures of easily touched surfaces and identified components must comply with UL 61010- 1 clauses 10.1 and 10.2, UL 61010-2-010 clause 10.1, temperature limits under normal conditions.• Maintain normal operation without faults occurring.PASS
Single Fault ConditionsCooling (single fault condition)• Pass dielectric strength test per UL 61010-1, section 6, clause 6.8• Cabinet outer surface must not exceed 105°C at 40°C ambient• Transformer, blower and exhaust fan windings must not exceed 150°C under single fault condition at 40°C ambient• Voltage measurement of cabinet outer surfaces must not exceed test voltages per UL 61010-1, section 6, clause 6.3.2a• No signs of molten metal, burning insulation, flaming particles, etc.• No signs of charring, glowing, or flaming of tissue paper or cheesecloth.Heating Devices• Pass dielectric strength test per UL 61010-1, section 6, clause 6.8• Cabinet outer surface must not exceed 105°C at 40°C ambient• Transformer, blower and exhaust fan windings must not exceed 150°C under single fault condition at 40°C ambient• Voltage measurement of cabinet outer surfaces must not exceed test voltages per UL 61010-1, section 6, clause 6.3.2a• No signs of molten metal, burning insulation, flaming particles, etc.• No signs of charring, glowing, or flaming of tissue paper or cheesecloth.PASS
Test.DescriptionAcceptance CriteriaResults
Protection againstHazards from Fluids- Pass dielectric strength test per-UL.61010-1, section.6, clause 6.8- Voltage measurement of cabinet outer surfaces mustnot exceed test voltages per UL 61010-1, section 6,clause 6.3.2a.PASS
Heating Performance(empty compartment)- Temperature reading of each thermocouple must notvary from set-point temperature by more than $\pm$ 3°F inupper compartment and $\pm$ 5°F in lower compartment.- At a 160°F set-point temperature, the uppercompartment display must reach set-point within 35minutes and lower compartment display must bewithin 65 minutes.- Normal system operation is maintained without over-temperature condition or faults occurring.PASS
Heating Performance(Full IV solution load inupper compartment andfull blank load in lowercompartment)- Temperature reading of each thermocouple must notvary from set-point temperature by more than $\pm$ 3°F inupper compartment and $\pm$ 5°F in lower compartment.- Upper and lower compartment controls temperaturedisplay must reach set-point within 12 hours.- Normal system operation is maintained without over-temperature condition or faults occurring.PASS
Heating Performance(Full irrigation solutionload in upper and lowercompartments- With a fully loaded compartment of Irrigationsolution, bottles of solution shall not overbalance andfall off shelf when doors are opened.- Temperature reading of each thermocouple must notvary from set-point temperature by more than $\pm$ 3°F inupper compartment and $\pm$ 5°F in lower compartment- Upper and lower compartment controls temperaturedisplay must reach set-point within 12 hours.- Normal system operation is maintained without over-temperature condition or faults occurring.PASS
ETL/cETL CodeCompliance- Meet UL 61010-1 Standard for Safety ElectricalEquipment for Measurement, Control, andLaboratory Use.- Meet CAN/CSA C22.2 61010-1 Standard for SafetyElectrical Equipment for Measurement, Control andLaboratory Use.PASS

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STERIS SPECIAL 510(k) – DEVICE MODIFICATION TO K092823

AMSCO WARMING CABINET – 24" WIDE PASS-THRU MODEL

{6}------------------------------------------------

STERIS SPECIAL 510(k) - DEVICE MODIFICATION TO K092823 AMSCO WARMING CABINET - 24" WIDE PASS-THRU MODEL

Conclusion

Verification and validation testing demonstrate that the proposed Amsco Warming Cabinet, 24" Wide Pass-thru model, operates as intended and is as safe and effective as the predicate. The differences between the proposed and predicate device are limited to the described modifications of the device and these proposed changes raise no new concerns of safety and effectiveness when compared to the predicate device. The proposed Amsco Warming Cabinet, 24" Wide Pass-thru model, is substantially equivalent to the predicate.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/7/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" around the top half of the circle. Inside the circle is a stylized image of an eagle or bird-like figure with three tail feathers.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

Mr. Robert F. Sullivan Senior Director, Regulatory Affairs Steris Corporation 5960 Heisley Road Mentor, Ohio 44060

JAN 1 0 2017

Re: K111870

Trade/Device Name: Amsco Warming Cabinet Regulation Number: 21 CFR 880.5725 Regulation Name: Infusion Pump Regulatory Class: Class II Product Code: LGZ Dated: June 30, 2011 Received: July 1, 2011

Dear Mr. Sullivan:

This letter corrects our substantially equivalent letter of July 29, 2011.

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. 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.

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 Parts 801 and 809 ); medical device reporting (reporting of

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Page 2 - Mr. Robert F. Sullivan

medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) 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 Parts 801 and 809), 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" (21CFR 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,

Erin I. Keith -S

Erin I. Keith, M.S. Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control, and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known):

Device Name:

Amsco Warming Cabinet

Indications For Use:

The Amsco Warming Cabinet is designed to raise the temperature of blankets, linens and sterile surgical irrigation solutions and IV solutions to an acceptable level for various surgical, obstetrical, emergency, critical care and other healthcare applications

Prescription Use (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use X (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Ian Sti for Richard Chapman
(Division Sign-Off)

Division of Sign Only
Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number: K111876

Page 1 of 1

June 30, 2011

§ 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).