(525 days)
A physical barrier for mouth to mouth resuscitation between the victim (patient) and the rescuer. This device makes no "guarantee" of disease protection, but it is designed to help protect the rescuer against potentially contaminated secretions and back drafts emanating from the victim while eliminating actual mouth to mouth contact. This device is to be used only by persons trained in CPR and the use of this device. DO NOT USE THIS DEVICE ON INFANTS.
The CPRotector 2000 device is a mouth-to-mouth barrier that offers protection to the CPR administrator from vomitus and other oral secretions. It is to be used only by persons trained in the application of CPR. Each CPRotector 2000 comes prepackaged with complete instructions for use. It is labeled as a single-use device and therefore must be disposed of after each use, in accordance with applicable rules and requlations. The CPRotector 2000 includes a one-way valve that directs the breathing gas flow from the CPR administrator to the patient, and directs the exhaled gases away from the rescuer and into the atmosphere. The components used in the manufacture of this device are made from PVC compounds which have been tested to meet the requirements of USP XXII, 1990, and Supplement 5, 1991, for the Biological Test for Plastics, Class VI-70°C.
The provided text is a 510(k) summary for a CPRotector 2000 Mouth-to-Mouth Barrier. It outlines the device's classification, intended use, and substantial equivalence to a previously cleared device. However, it does not contain specific acceptance criteria or details of a study proving the device meets acceptance criteria in the format requested.
The document states:
- "The CPRotector 2000 device is a mouth-to-mouth barrier that offers protection to the CPR administrator from vomitus and other oral secretions."
- "The components used in the manufacture of this device are made from PVC compounds which have been tested to meet the requirements of USP XXII, 1990, and Supplement 5, 1991, for the Biological Test for Plastics, Class VI-70°C."
This indicates that the material biocompatibility was tested against a standard (USP Class VI), which could be considered an acceptance criterion for the material. However, this is not a performance study for the device's function as a barrier.
The filing relies on substantial equivalence to an existing predicate device (CPRotector, cleared under K934821) rather than presenting new performance study data for the CPRotector 2000 itself. Substantial equivalence generally implies that the new device has the same intended use, technological characteristics, and performs as safely and effectively as the predicate device without raising new questions of safety or effectiveness.
Therefore, most of the requested information cannot be extracted from this document as it pertains to a new performance study.
Here's what can be provided based on the text:
1. A table of acceptance criteria and the reported device performance
| Acceptance Criteria (from text) | Reported Device Performance (from text) |
|---|---|
| Material Biocompatibility: Components meet USP XXII, 1990, and Supplement 5, 1991, for the Biological Test for Plastics, Class VI-70°C. | Components made from PVC compounds have been tested to meet these requirements. |
| New Performance Study: (Not applicable as reliance is on substantial equivalence to a predicate). | (No new performance study data provided in this summary). |
2. Sample sized used for the test set and the data provenance
- Sample Size for Test Set: Not applicable. No new device performance study is described for the CPRotector 2000.
- Data Provenance: Not applicable for device performance. The material biocompatibility testing would have been conducted on component samples, likely prospective testing for the manufacturing batch/materials. The document doesn't specify the country of origin for the material testing data.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
- Not applicable. No new performance study or ground truth establishment is described.
4. Adjudication method (e.g. 2+1, 3+1, none) for the test set
- Not applicable. No new performance study is described.
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 device is a physical barrier, not an AI-assisted diagnostic tool.
6. If a standalone (i.e. algorithm only without human-in-the loop performance) was done
- Not applicable. This is not an algorithm-based device.
7. The type of ground truth used (expert concensus, pathology, outcomes data, etc)
- Not applicable. No new performance study is described for the device's function. The "ground truth" for material biocompatibility is adherence to the USP Class VI standard.
8. The sample size for the training set
- Not applicable. This is a physical medical device, not a machine learning model requiring a training set.
9. How the ground truth for the training set was established
- Not applicable. (See #8).
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Exhibit D
K9600587
510(k) SUMMARY
THIS SUMMARY OF SAFETY AND EFFECTIVENESS INFORMATION IS BEING SUBMITTED IN ACCORDANCE WITH THE REQUIREMENTS OF THE SAFE MEDICAL DEVICE ACT OF 1990.
510(k) Summary of Safety and Effectiveness JUL 21 1997 CPRotector 2000 Mouth-to-Mouth Barrier
| Submitted by: | Certified Safety Manufacturing, Inc. |
|---|---|
| 1400 Chestnut | |
| Kansas City, MO. 64127 | |
| (816) 483-9090FAX (800) 854-9091 |
| Contact: | Howard Gerson, Vice-President |
|---|---|
| Date Prepared: | May 5, 1997 |
| Trade Name: | CPRotector 2000 Mouth-to-Mouth Barrier |
| Common Name: | CPR Assist Valve |
Classification Name: CPR Assist Valves are classified as Class II medical devices, and are listed in 21 CFR 868.5870 as non-rebreathing valves.
The CPRotector 2000 Mouth Barrier is substantially equivalent to our original CPRotector product which was found to be substantially equivalent by FDA in January, 1994, under K934821.
The CPRotector 2000 device is a mouth-to-mouth barrier that offers protection to the CPR administrator from vomitus and other oral secretions. It is to be used only by persons trained in the application of CPR. Each CPRotector 2000 comes prepackaged with complete instructions for use. It is labeled as a single-use device and therefore must be disposed of after each use, in accordance with applicable rules and requlations.
The CPRotector 2000 includes a one-way valve that directs the breathing gas flow from the CPR administrator to the patient, and directs the exhaled gases away from the rescuer and into the atmosphere. The components used in the manufacture of this device are made from PVC compounds which have been tested to meet the requirements of USP XXII, 1990, and Supplement 5, 1991, for the Biological Test for Plastics, Class VI-70°C.
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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 is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle with its wings spread, which is a common symbol of the United States. The eagle is depicted in a simple, black and white design.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
Mr. Howard Freedman Certified Safety Manufacturing, Inc. 1400 Chestnut Kansas City, Missouri 64127
JUL 21 1997
Re : K960587 CPRotector 2000 (CPR Assist Device) Regulatory Class: II (two) Product Code: 73 CBP Dated: May 5, 1997 Received: May 7, 1997
Dear Mr. Freedman:
We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). 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 (Premarket Approval), 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 895. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General requlation (2) CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.
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Page 2 - Mr. Howard Freedman
This letter will allow you to begin marketing your device as described in your 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 your device to proceed to the market : a market
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4648. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".
Sincerely yours,
Thomas J. Callehan
Thomas J. Callahan, Ph.D. Director Division of Cardiovascular, Respiratory, and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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Attachment D
Page 1 of 1 (7/17/97)
510(k) #: K960587 Device Name: CPRotector 2000 Manufacturer: Certified Safety Manufacturing
Indications for use:
A physical barrier for mouth to mouth resuscitation between the victim (patient) and the rescuer. This device makes no "guarantee" of disease protection, but it is designed to help protect the rescuer against potentially contaminated secretions and back drafts emanating from the victim while eliminating actual mouth to mouth contact. This device is to be used only by persons trained in CPR and the use of this device. DO NOT USE THIS DEVICE ON INFANTS.
(Divisio Sign-Off
Division of Cardiovascular, Respiratory,
and Neurological Devices
510(k) Number.
§ 868.5870 Nonrebreathing valve.
(a)
Identification. A nonrebreathing valve is a one-way valve that directs breathing gas flow to the patient and vents exhaled gases into the atmosphere.(b)
Classification. Class II (performance standards).