K Number
K212395
Device Name
Nebulizer
Date Cleared
2022-03-25

(235 days)

Product Code
Regulation Number
868.5630
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The ILI nebulizer is used to administer various aerosol treatments to adult and pediatric patients in both the homecare and healthcare settings. Its use is indicated whenever a physician or healthcare professional administers or prescribes medical aerosol products to a patient using a Small Volume Nebulizer is disposable, single-patient-use and intended for use with pediatric (5 years and older) and adult patient.

Device Description

The JLI nebulizer is a small volume jet nebulizer designed to deliver aerosolized medications for inhalation to the respiratory system, the compressed air is forced into the nebulizer through a nozzle cover, where it accelerates and emerges at a high velocity, creating a vacuum (Venturi effect), in the process the liquid medicine is converted into small droplets called aerosol by impacting upon a rigid baffle, the aerosol may be used for inhalation treatment of a physician's prescription. The JLI nebulizer is disposable, single-patient-use.

AI/ML Overview

The provided text describes the 510(k) premarket notification for the JLI nebulizer, asserting its substantial equivalence to a predicate device (BESMED Jet Nebulizer Bottle Set). However, it does not contain information about an AI/ML-driven medical device. The document details the non-clinical performance and biocompatibility testing of a nebulizer, a hardware device used to administer aerosol treatments.

Therefore, I cannot extract the requested information about acceptance criteria, study design, ground truth establishment, or expert involvement as these details are specific to the evaluation of AI/ML software performance, not hardware nebulizers.

The document discusses:

  • Acceptance Criteria for the Nebulizer: This is implied through the comparison of aerosol particle characteristics (MMAD, GSD, Respirable fraction, Total dose) between the JLI nebulizer and the predicate device. The goal is to show "not significant statistical difference" and "substantial equivalence."
  • Performance Study: Non-clinical tests were conducted for aerosol characterization using three drugs (Albuterol sulfate, Ipratropium bromide, Budesonide) at two sampling rates (28 L/min and 12 L/min).
  • Sample Size for Test Set: For aerosol characterization, the data shows means and standard deviations, implying multiple runs for each drug and sampling rate. For example, for Albuterol sulfate at 28 L/min, the data 7.4990±0.5384 indicates a sample size was used to calculate the mean and standard deviation. While the exact number of runs isn't explicitly stated as "N=X", it's implied that there were sufficient runs to provide statistical averages.
  • Data Provenance: The tests were non-clinical, likely performed in a lab setting by the manufacturer or a contracted lab. The document does not specify country of origin for the performance data beyond the manufacturer being in China. It is explicitly stated that "Substantial equivalence does not depend on clinical test data," meaning no patient data was used.
  • Ground Truth: For aerosol characterization, the 'ground truth' is the quantitative measurements of aerosol properties (MMAD, GSD, etc.) obtained through validated laboratory testing methods (e.g., in accordance with USP 40<601> Aerosols, Nasal Sprays, Metered-Dose Inhalers, and Dry Powder Inhalers). There are no human experts, adjudication, or MRMC studies involved because it's a hardware performance test, not an AI diagnostic tool.
  • Training Set: Not applicable, as this is a hardware device, not an AI/ML algorithm.

In summary, the provided document does not pertain to an AI/ML device and thus the specific questions about AI/ML acceptance criteria and study design elements (like expert readers, MRMC, training sets, etc.) cannot be answered from this text.

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Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

Shenzhen Homed Medical Device Co., Ltd. Shi Shengming Regulatory manager 3rd Floor, Block 1, Longquan Industrial Zone, Huarong Road. Dalang Street Shenzhen, Guangdong 518109 China

Re: K212395

Trade/Device Name: Nebulizer Regulation Number: 21 CFR 868.5630 Regulation Name: Nebulizer Regulatory Class: Class II Product Code: CAF Dated: January 25, 2022 Received: February 18, 2022

Dear Shi Shengming:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

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requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Brandon Blakely, PhD Assistant Director DHT1C: Division of Sleep Disordered Breathing, Respiratory and Anesthesia Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K212395

Device Name

JLI nebulizer

Indications for Use (Describe)

The ILI nebulizer is used to administer various aerosol treatments to adult and pediatric patients in both the homecare and healthcare settings. Its use is indicated whenever a physician or healthcare professional administers or prescribes medical aerosol products to a patient using a Small Volume Nebulizer is disposable, single-patient-use and intended for use with pediatric (5 years and older) and adult patient.

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)

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510(k) Summary

This summary of 510(K) safety and effectiveness information is being submitted in accordance with the requirement of 21 CFR 807.92 on March 24, 2022

1. Submitter

Submitter's NameShenzhen Homed Medical Device Co., Ltd.
Contact PersonShi Shengming
Address3rd Floor, Block 1, Longquan Industrial Zone, Huarong Road, Dalang Street. Longhua New District, Shenzhen City, Guangdong, China
Telephone+86-755-29821671
Fax number+86-755-29821673
E-mailshifei@homedgroup.com

2. Device Information

Type of 510(k) submission:Traditional
Trade Name:JLI Nebulizer
Classification name:Nebulizer
Classification:
Review Panel:Anesthesiology
Product Code:CAF
Regulation Number:868.5630

3. Predicate Device Information

Trade NameBESMED Jet Nebulizer Bottle Set
510(k) NumberK091272
Classification nameNebulizer
Classification:II
Review Panel:Anesthesiology
Product codeCAF
Regulation No.868.5630

4. Device Descriptions

The JLI nebulizer is a small volume jet nebulizer designed to deliver aerosolized medications for inhalation to the respiratory system, the compressed air is forced into the nebulizer through a nozzle cover, where it accelerates and emerges at a high velocity, creating a vacuum (Venturi effect), in the process the liquid medicine is converted into small droplets called aerosol by impacting upon a rigid baffle, the aerosol may be used for inhalation treatment of a physician's prescription. The JLI nebulizer is disposable, single-patient-use.

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The JLI nebulizer may replace the BESMED Jet Nebulizer Bottle (Besmed; Model PN-1128E; K091272), and connects to the accessories in K091272, which include Mouthpiece, T-piece, Corrugate tube and Air tube.

The JLI nebulizer is powered by air compressor, which is legally marketed on the USA (Manufacturer: HOMED; Model: JLN-2301AS, K161586).

5. Intended Use and Indications for Use

The JLI nebulizer is used to administer various aerosol treatments to adult and pediatric patients in both the homecare and healthcare settings. Its use is indicated whenever a physician or healthcare professional administers or prescribes medical aerosol products to a patient using a Small Volume Nebulizer is disposable, single-patient-use and intended for use with pediatric (5 years and older) and adult patient.

6. Comparisons of technological characteristics with the predicate device

The JLI nebulizer and Besmed Nebulizer (K091272) are similar in purpose, composition, function, scientific technology and method of operation, the following table provides a comparison of the devices.

ItemsSubject Device(JLI nebulizer, K212395)Predicate Device(Besmed nebulizer, K091272)Remark
Intendeduse/Indicati on forUseThe JLI nebulizer is used toadminister various aerosoltreatments to adult and pediatricpatients in both the homecareand healthcare settings. Its use isindicated whenever a physicianor healthcare professionaladministers or prescribes medicalaerosol products to a patientusing a Small Volume Nebulizer.The JLI nebulizer is disposable,single- patient-use and intendedfor use with pediatric (5 yearsand older)and adult patient.The BESMED Jet NebulizerBottle Set is used to administervarious aerosol treatments toadult and pediatric patients inboth the homecare and hospitalsettings.Its use is indicated whenever aphysician or healthcareprofessional administers orprescribes medical aerosolproducts to a patient using aSmall Volume Nebulizer.Same
TechnologyPneumatic Jet NebulizerPneumatic Jet NebulizerSame
OperationprincipleVenturiVenturiSame
Environme nt ofuseClinic, homecareClinic, homecareSame
PatientPopulationIntended for use with pediatric (5years and older) and adultpatientIntended for use with pediatricand adult patientSimilar
Singlepatient useonlyYesYesSame
OTC or RxRxRxSame
Anatomic. SiteMouthMouthSame

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CompositiNebulizer and accessories(mouthpiece, T-piece, corrugateNebulizer and accessories(mouthpiece, T-piece, corrugateSame
o n

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ItemsSubject Device(JLInebulizer,K212395)Predicate Device(Besmed nebulizer,K091272)Remark
tube, air tube)tube, air tube)
DimensionsHeight: 75.42mmHeight: about 75.9mmSimilar
External diameter of aerosol outlet: 18.59mmExternal diameter of aerosol outlet: about 18.0mm
Internal diameter of aerosol outlet:17.79mmInternal diameter of aerosol outlet: about 17.2mm
Diameter of air inlet: 5.73mmDiameter of air inlet: about5.8mm
AerosolizationContinuous during inhalation and exhalationContinuous during inhalation and exhalationSame
MaximumFill Volume6 mL6 mLSame
MaterialsPolypropylene (PP)Not publicly availableDifferent
Type of gassourceCompressed airCompressed airSame
BiocompatibilityConform to FDA guidance ofbiological evaluation of medicaldevicesConform to FDA guidance ofbiological evaluation ofmedical devicesSame
AerosolcharacterizationAerosol particulate performance were tested in the modes of adultand pediatric, then parameters of Total Mass, MMAD, GSD,Respirable fraction and Respirable mass were substantiallyequivalent to the predicate device in a confidence level of 95%.Similar

The subject device of JLI nebulizer and the predicated device of Besmed nebulizer are similar in purpose, composition, function, scientific technology and method of operation, both the subject device and predicated device have the similar patient population, type of gas source, biocompatibility performance, and there is not significant statistical difference in aerosol particles characteristics between subject device and predicate device. Only minor differences exist between the subject device and predicate device, which will not raise any new issue on safety and effectiveness of the subject device.

7. Brief discussions of the nonclinical tests

The subject device conforms to the following standards:

7.1 Biocompatibility evaluation

The biocompatibility evaluations of the subject device were conducted in accordance with the International Standard ISO 10993-1 "Biological Evaluation of Medical Devices - Part 1: Evaluation and Testing within a Risk Management Process" and FDA biocompatibility guidance, the subject devices will be classified as external communication devices-tissue contact, and considering the cumulative exposure, the contact time will be permanent, the biocompatibility tests should consider the Cytotoxicity test, Sensitization test, Pyrogen test, Systemic toxicity test, Implantation test, Genotoxicity test and Toxicological risk assessment. The testing standards include the following:

StandardDescriptions
------------------------

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ISO 10993-1:2018Biological evaluation of medical devices - Part 1: Evaluation andtesting within a risk management process
ISO 10993-5:2009Biological Evaluation of Medical Devices - Part 5: Tests For In Vitro

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Cytotoxicity
ISO 10993-10:2010Biological Evaluation of Medical Devices- Part 10: Tests for Irritationand Skin Sensitization
ISO 10993-11:2017Biological evaluation of medical devices - Part 11: Tests for systemictoxicity
ISO 10993-3: 2014Biological evaluation of medical devices-Part 3: tests for genotoxicity,carcinogenicity and reproductive toxicity
ISO 10993-6: 2016Biological evaluation of medical devices - Part 6: Tests for local effectsafter implantation
ISO 10993-17-2002Biological evaluation of medical devices-Part 17: Establishment ofallowable limits for leachable substances
ISO 10993-18:2020Biological evaluation of medical devices-Part 18: Chemicalcharacterization of medical device materials within a risk managementprocess

7.2 Dry Gas Pathway Testing

Testing pertaining to the dry gas pathway and associated risk assessments/conclusions were conducted by an independent source. Testing included the assessments of Emissions of volatile organic compounds (VOCs), Fine particles (particulate matter PM2.5&10). The testing standards include the following:

StandardDescriptions
ISO 18562-1:2017Biocompatibility evaluation of breathing gas pathways in healthcareapplications - Part 1: Evaluation and testing within a risk managementprocess
ISO 18562-2:2017Tests for emissions of volatile Biocompatibility evaluation of breathinggas pathways in healthcare applications - Part 2: Tests for emissionsof particulate matter
ISO 18562-3:2017Biocompatibility evaluation of breathing gas pathways in healthcareapplications - Part 3: Tests for emissions of volatile organiccompounds (VOCs)

7.3 Performance data

Aerosol characterization tests for the subject devices and predicate devices were conducted in accordance with the relevant sections of the CDRH Guidance Document "Reviewer Guidance for Nebulizer, Metered Dose Inhalers, Spacers and Actuators" (FDA/CDRH-1993), USP 40<601> Aerosols, Nasal Sprays, Metered-Dose Inhalers, and Dry Powder Inhalers. For each device, three drugs: Albuterol sulfate (10mg/2ml), Ipratropium bromide (0.25mg/2ml), Budesonide (0.5mg/2ml) were tested respectively. The comparison items include Mass Median Aerodynamic Diameter (MMAD), Geometric Standard Deviation (GSD), Respirable mass, Respirable Fraction and Total Mass. Also, the variability of intra-sample and inter-sample was tested for the subject devices.

ParametersDrugsJLI nebulizerBesmed nebulizer
Total dose(mg)Albuterol sulfate7.4990±0.53847.5360±0.7936
Ipratropium bromide0.1863±0.02480.1963±0.0150
Budesonide0.3873±0.02850.3953±0.0252
MMAD (μm)Albuterol sulfate3.1233±0.21133.2233±0.1301

7.3.1 Aerosol particle characteristics (the sampling rate is 28 L/min)

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Ipratropium bromide$2.7300\pm0.1389$$2.6167\pm0.1604$
Budesonide$3.3333\pm0.1365$$3.4733\pm0.1474$
GSDAlbuterol sulfate$2.1100\pm0.0781$$2.2267\pm0.0551$
Ipratropium bromide$2.7400\pm0.0173$$2.7600\pm0.1179$
Budesonide$2.7733\pm0.0569$$2.7867\pm0.0929$
Respirablefraction (%)Albuterol sulfate$72.84\pm2.30$$69.83\pm1.46$
Ipratropium bromide$68.68\pm1.28$$68.64\pm1.25$
Budesonide$62.25\pm0.65$$60.92\pm1.15$
Respirablemass (mg)Albuterol sulfate$5.4701\pm0.5632$$5.2694\pm0.6474$
Ipratropium bromide$0.1280\pm0.0175$$0.1349\pm0.0126$
Budesonide$0.2411\pm0.0178$$0.2408\pm0.0142$

7.3.2 Aerosol particle characteristics (the sampling rate is 12 L/min)

ParametersDrugsJLI nebulizerBesmed nebulizer
Total dose(mg)Albuterol sulfate6.9057±0.38566.5897±0.5465
Ipratropium bromide0.1513±0.01780.1527±0.0259
Budesonide0.3160±0.02880.3213±0.0326
MMAD (μm)Albuterol sulfate3.3033±0.14153.1933±0.1002
Ipratropium bromide2.8667±0.22372.7100±0.1587
Budesonide3.3700±0.21933.5533±0.1858
GSDAlbuterol sulfate2.1333±0.10602.2133±0.0702
Ipratropium bromide2.5600±0.03612.7567±0.2053
Budesonide2.6133±0.00582.6700±0.1136
Respirablefraction (%)Albuterol sulfate69.99±1.0670.40±0.50
Ipratropium bromide69.22±1.9967.92±2.26
Budesonide63.43±1.9261.37±12.59
Respirablemass (mg)Albuterol sulfate4.8332±0.28484.6375±0.3511
Ipratropium bromide0.1045±0.00960.1035±0.0158
Budesonide0.2006±0.02180.1971±0.0212

8. Clinical Testing

Substantial equivalence does not depend on clinical test data.

9. Conclusions

Based on device comparison information and performance data, the differences in technological characteristics between the subject devise and predicate device do not raise any new safety and effectiveness issue. Therefore, the subject device is substantially equivalent to the predicate device.

§ 868.5630 Nebulizer.

(a)
Identification. A nebulizer is a device intended to spray liquids in aerosol form into gases that are delivered directly to the patient for breathing. Heated, ultrasonic, gas, venturi, and refillable nebulizers are included in this generic type of device.(b)
Classification. Class II (performance standards).