K Number
K132415

Validate with FDA (Live)

Date Cleared
2014-06-06

(308 days)

Product Code
Regulation Number
868.5730
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Rusch tracheal tubes are indicated for airway management by oral or nasal intubation of the trachea.

Device Description

The proposed Teleflex Medical Super Safety Silk and Nasal Safety Silk tracheal tubes are sterile, single use devices that are made from Polyvinyl chloride (PVC) resin that is formulated without DEHP ("Non-DEHP" = < 0.1% DEHP w/w). The tracheal tubes contain a compatible cuff, inflation line, pilot balloon and one-way valve. A radiopaque line is incorporated into the full length of the tracheal tube. Each tracheal tube is supplied with an appropriately sized 15mm connector. The oral version of the device (Super Safety Silk) will be sold in both Murphy eye and Magill styles. The nasal version of the device (Nasal Safety Silk) will be offered in the Murphy eye style only.

AI/ML Overview

This is a 510(k) premarket notification for a medical device (tracheal tube), not an AI/ML device. Therefore, the concepts of "acceptance criteria" and a "study that proves the device meets the acceptance criteria" are interpreted in the context of medical device performance testing for substantial equivalence, rather than a clinical study evaluating AI performance.

For this device, the "acceptance criteria" are the defined physical and mechanical properties the tracheal tube must exhibit, and the "study" is the performance testing conducted to demonstrate that the new device (Rusch Safety Silk Tracheal Tube Series) meets these criteria and is substantially equivalent to existing predicate devices.

Here's the breakdown of the requested information based on the provided text:

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

TestAcceptance CriteriaReported Device Performance
Cuff Bonding Leak EvaluationNo leak around the welding areaNot explicitly stated in a quantifiable manner, but the document implies successful testing by stating "Performance test results demonstrate that the proposed device is substantially equivalent."
Tube Curvature TestMust meet the product requirement of 140mm ± 20mmNot explicitly stated in a quantifiable manner, but the document implies successful testing by stating "Performance test results demonstrate that the proposed device is substantially equivalent."
Tube CollapseThe steel ball (OD = 75% of the stated ID) must pass through the lumen freely.Not explicitly stated in a quantifiable manner, but the document implies successful testing by stating "Performance test results demonstrate that the proposed device is substantially equivalent."
Cuff Resting DiameterThe cuff resting diameter shall be within ± 15% of specification for each individual sizeNot explicitly stated in a quantifiable manner, but the document implies successful testing by stating "Performance test results demonstrate that the proposed device is substantially equivalent."
Cuff HerniationNo abnormality or defect on the cuff (any part of the inflated cuff reaches beyond the nearest edge of the bevel will be considered as defect). No abnormality on the configuration of the cuff during deflating the cuff over a period of not less than 10s (any abnormality will be considered as defect).Not explicitly stated in a quantifiable manner, but the document implies successful testing by stating "Performance test results demonstrate that the proposed device is substantially equivalent."
Side Arm Bonding StrengthMust be able to sustain a minimum of 15NNot explicitly stated in a quantifiable manner, but the document implies successful testing by stating "Performance test results demonstrate that the proposed device is substantially equivalent."
Connector Bonding StrengthTube-Connector bonding must meet the minimum specification to 50NNot explicitly stated in a quantifiable manner, but the document implies successful testing by stating "Performance test results demonstrate that the proposed device is substantially equivalent."
Tube Compression EvaluationMust be within the range of current dataNot explicitly stated in a quantifiable manner, but the document implies successful testing by stating "Performance test results demonstrate that the proposed device is substantially equivalent."
Cuff Unrestrained Burst EvaluationMust be within the range of current dataNot explicitly stated in a quantifiable manner, but the document implies successful testing by stating "Performance test results demonstrate that the proposed device is substantially equivalent."
Cuff Restrained Burst EvaluationMust be within the range of current dataNot explicitly stated in a quantifiable manner, but the document implies successful testing by stating "Performance test results demonstrate that the proposed device is substantially equivalent."
Cuff Sealing Pressure EvaluationMust be within the range of current dataNot explicitly stated in a quantifiable manner, but the document implies successful testing by stating "Performance test results demonstrate that the proposed device is substantially equivalent."
BiocompatibilityMaterials have been tested per ISO 10993"All patient contacting materials are in compliance with ISO 10993-1. Testing included Cytotoxicity, sensitization, intracutaneous activity, implantation and genotoxicity testing."

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

  • Sample size used for the test set: Not specified in the provided text.
  • Data provenance: Not specified. This type of performance testing for medical devices is typically conducted in a laboratory setting by the manufacturer, not with human patient data in the sense of clinical trials for AI.

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)

This question is not applicable to this type of medical device submission. "Ground truth" in the context of expert consensus or clinical outcomes is relevant for AI/ML device evaluations. For a tracheal tube, performance testing involves objective measurements against defined physical and mechanical specifications, not expert interpretation of outputs.

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

Not applicable. As noted above, this involves objective physical testing, not subjective expert review requiring adjudication.

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 not an AI/ML device.

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

Not applicable. This is not an AI/ML device.

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

For the performance testing, the "ground truth" is defined by the established engineering specifications, relevant ISO standards (like ISO 5361 for tracheal tubes), and internal product requirements. This is a functional truth derived from known physical properties and design objectives, not a clinical or expert "ground truth."

8. The sample size for the training set

Not applicable. This is not an AI/ML device, so there is no "training set."

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

Not applicable. This is not an AI/ML device.

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JUN 0 6 2014

510(k) SUMMARY

Rusch Safety Silk Tracheal Tube Series

Name, Address, Phone and Fax Number of Applicant

Teleflex Medical, Incorporated 2917 Weck Drive Research Triangle Park, NC 27709 USA Phone: 919-491-8960 919-433-4996 Fax:

Contact Person

Lori Pfohl Regulatory Affairs Specialist

Date Prepared

6/3/2014

Device Name

Trade Name: Rusch Safety Silk Tracheal Tube Series

Common Name: Tracheal Tube

Classification Name: Tube, Tracheal (Class II per 21 CFR 868.5730, Product Code BTR)

Predicate Devices

Teleflex Medical's Rusch Oral/Nasal (Safety Clear Plus) Tracheal Tube Cuffed, Magill/Murphy - K993786

Teleflex Medical's Rusch Oral/Nasal Tracheal Tube Cuffed, Magill/Murphy -K961837

Device Description

The proposed Teleflex Medical Super Safety Silk and Nasal Safety Silk tracheal tubes are sterile, single use devices that are made from Polyvinyl chloride (PVC) resin that is formulated without DEHP ("Non-DEHP" = < 0.1% DEHP w/w). The tracheal tubes contain a compatible cuff, inflation line, pilot balloon and one-way valve. A radiopaque line is incorporated into the full length of the tracheal tube. Each tracheal tube is supplied with an appropriately sized 15mm connector.

Teleflex Medical

Page 1 of 5

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The oral version of the device (Super Safety Silk) will be sold in both Murphy eye and Magill styles.

The nasal version of the device (Nasal Safety Silk) will be offered in the Murphy eye style only.

Indications for Use

  • Rusch tracheal tubes are indicated for oral or nasal intubation for airway . management.
    Intended Population

  • Adults
    Intended Environment of Use

  • Locations where ET intubation may be performed. .

Contraindications

None

Substantial Equivalence

The proposed device is substantially equivalent to the predicate devices:

Teleflex MedicalSafety Silk SeriesOral / NasalachealTeleflex MedicalOral / Nasal Tracheal Tubeatety Clear Plus)Teleflex Medicalal / Nasal Tracheal
Classification NameTube, Trachea(w/wo connector)SameSame
Product Code73 BTRSameSame
Regulation Number868.5730SameSame
Indications for UseRusch trachealtubes are indicatedfor oral or nasalintubation forairwaymanagement.Rusch Oral / Nasal TracheaTube, Cuffed,Magill/Murphy is a deviceinserted into a patient'strachea via the nose ormouth and used to maintainan open airway.Oral or nasalintubation and airwaymanagement
Teleflex MedicalSafety Silk SeriesOral / NasalTracheal Tube(proposed)Teleflex MedicalOral / Nasal Tracheal Tube(Safety Clear Plus)(K993786)Teleflex MedicalOral / Nasal TrachealTube(K961837)
Features
Environment of UseLocations where ETintubation may beperformedNot statedNot stated
Patient PopulationAdultsNot statedNot stated
ContraindicationsNoneSameSame
Single UseYesSameSame
Size Range$5.0 mm - 10.0 mm$$2.0 mm - 4.0 mm$$4.5 mm - 11.0 mm$
CuffedYesSameSame
RadiopaqueYesSameSame
Connection toventilation source15 mm connectorSameSame
Method ofSterilizationEthylene Oxide 10-6SALSameSame
BiocompatibilityMaterials have beentested per ISO10993SameSame
No-DEHPYesNoNo
PackagingConfigurationTen (10) individualunits in a shelf box.Ten shelf boxes in ashipperSameSame
SterileYesSameSame
EyeMurphy and MagillSameSame
TipBeveledSameSame
GraduationsMultiple cmmarkingsSameSame
ShaftPVCSameSame
CuffPVCSameSame
Pilot BalloonPVCSameSame
Inflation ValvePVCSameSame
Inflation TubePVCSameSame
X-Ray Marker,StripePVC with BariumSulfateSameSame
ConnectorPolyamidePolypropylenePolypropylene

Teleflex Medical

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·

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Comparison to Predicate Device:

The proposed Safety Silk series tracheal tubes are substantially equivalent to the predicate devices with respect to indications for use, technology and construction. The proposed device is designed with different materials than the predicate. These proposed device materials are Non-DEHP.

Indications for Use -.

The indications for use are substantially equivalent for the proposed device when compared to the predicates. Each device is indicated for Oral or Nasal use in airway management.

Technology and construction -.

The design, fabrication, shape, size, etc. are substantially equivalent to the predicates. This design includes the disposable tracheal tube, cuff side arm assembly and 15mm connector.

. Environment of use -

While not specifically stated, the environments of use are equivalent to predicates

. Patient Population -

While not specifically stated, the patient population is equivalent to the predicate

Materials -.

All patient contacting materials are in compliance with ISO 10993-1. Testing included Cytotoxicity, sensitization, intracutaneous activity, implantation and genotoxicity testing.

TestReference toStandard (ifapplicable)Principle of TestAcceptance Criteria
Cuff BondingLeak EvaluationN/ATo perform a visual check atthe welding point of the cuffNo leak around thewelding area
Tube CurvatureTest150 5361To measure the curvature ofthe tubeMust meet the productrequirement of 140mm± 20mm
Tube CollapseISO 5361The patency of the ET tubeairway lumen is tested bypassing a steel ball throughthe tracheal tube lumen withthe cuff inflated within atransparent tubeThe steel ball (OD =75% of the stated ID)must pass through thelumen freelv.
Cuff RestingDiameterISO 5361The resting diameter of thecuff is measured when thecuff is inflated to a referencepressure which is intended toremove creases but minimizestretching of its wallsThe cuff restingdiameter shall be within± 15% of specificationfor each individual size
TestReference to Principle of TestAcceptance Criteria

Performance Testing

Teleflex Medical

Page 4 of 5

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Standard (if .applicable)
Cuff HerniationISO 5361The tendency of the cuff toherniate beyond the planeperpendicular to the long axisof the tube at the nearestedge of the bevel is tested byapplying an axial force withthe cuff inflated within atransparent tube. A cuff whichprotrudes excessively at itspatient end may partially orcompletely occlude the orificeat the patient endNo abnormality ordefect on the cuff (anypart of the inflated cuffreaches beyond thenearest edge of thebevel will be consideredas defect). Noabnormalitv on theconfiguration of the cuffduring deflating the cuffover a period of not lessthan 10s (anyabnormality will beconsidered as defect)."
Side ArmBonding StrengthN/ATo evaluate the retentionforce of the inflation lineconnection to the TrachealtubeMust be able to sustaina minimum of 15N
ConnectorBonding StrengthN/AThe security of theattachment of the connectorto the tracheal tube is testedby applying an axialseparation force to theconnectorTube-Connectorbonding must meet theminimum specificationto 50N
TubeCompressionEvaluationN/ATo measure the rigidity of thetubeMust be within therange of current data
Cuff UnrestrainedBurst EvaluationN/ATo determine minimum cuffburst pressure underunrestrained conditionsMust be within therange of current data
Cuff RestrainedBurst EvaluationN/ATo determine cuff burstvolume under restrainedconditions to simulateconditions in the tracheaMust be within therange of current data
Cuff SealingPressureEvaluationN/ATo determine the minimumcuff pressure required to sealthe corrugated tubeMust be within therange of current data

The Rusch Safety Silk Tracheal Tube Series has the same indications for use, technological characteristics and construction as its predicates. Performance test results demonstrate that the proposed device is substantially equivalent.

Teleflex Medical

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DEPARTMENT OF HEALTH & HUMAN SERVICES

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

June 6, 2014

Teleflex Medical, Incorporated Ms. Lori Pfohl Senior Regulatory Affairs Specialist 2917 Weck Drive Research Triangle Park, NC 27709

Re: K132415

Trade/Device Name: Rusch Safety Silk Tracheal Tube Series Regulation Number: 21 CFR 868.5730 Regulation Name: Tracheal tube Regulatory Class: II Product Code: BTR Dated: May 05, 2014 Received: May 06, 2014

Dear Ms. Pfohl:

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.

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Page 2 - Ms. Lori Pfohl

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), 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/ReportalProblem/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/Resourcesfor You/Industry/default.htm.

Sincerely yours,

Tejashri Purohit-Sheth, M.D.
Tejashri Purohit Sheth M.D. Clinical Deputy Director
DAGRID/ODE/CDRH FOR

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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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K132415

Device Name

Rusch Super Safety Silk Tracheal Tubes

Indications for Use (Describe)

Rusch tracheal tubes are indicated for airway management by oral or nasal intubation of the trachea.

Intended Population: Adults

Intended Environment of Use: Locations where ET intubation may be performed

Type of Use (Select one or both, as applicable)

Prescription Use (Part 21 CFR 801 Subpart D)

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

Please do not write below this line – continue on a separate page if needed.

A FREE FOR FOR FOREDA USE ONLY AND ANNE AND ANNA ANDREA ASSA Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

Todd D. Courtney -S 2014.06.05 15:19:37 -04

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§ 868.5730 Tracheal tube.

(a)
Identification. A tracheal tube is a device inserted into a patient's trachea via the nose or mouth and used to maintain an open airway.(b)
Classification. Class II (performance standards).