DAISY PROTECTED SCALP VEIN SET

K992999 · Diasol, Inc. · FPA · Nov 5, 1999 · General Hospital

Device Facts

Record IDK992999
Device NameDAISY PROTECTED SCALP VEIN SET
ApplicantDiasol, Inc.
Product CodeFPA · General Hospital
Decision DateNov 5, 1999
DecisionSESE
Submission TypeTraditional
Regulation21 CFR 880.5440
Device ClassClass 2
AttributesTherapeutic

Intended Use

Provides access to patients vascular system to administer IV fluids Is used in blood drawing Aid in prevention of needlestick injury.

Device Story

Daisy Protected Scalp Vein Set provides vascular access for IV fluid administration and blood collection. Device features integrated safety mechanism to reduce risk of needlestick injuries during use. Operated by healthcare professionals in clinical settings. Output is physical access to patient's vascular system. Benefit includes safe, reliable venous access and protection for clinicians against accidental sharps exposure.

Clinical Evidence

Bench testing only.

Technological Characteristics

Scalp vein set with integrated safety mechanism for needlestick injury prevention. Sterile, single-use device.

Indications for Use

Indicated for patients requiring vascular access for IV fluid administration or blood collection; includes safety mechanism to aid in the prevention of needlestick injuries.

Regulatory Classification

Identification

An intravascular administration set is a device used to administer fluids from a container to a patient's vascular system through a needle or catheter inserted into a vein. The device may include the needle or catheter, tubing, a flow regulator, a drip chamber, an infusion line filter, an I.V. set stopcock, fluid delivery tubing, connectors between parts of the set, a side tube with a cap to serve as an injection site, and a hollow spike to penetrate and connect the tubing to an I.V. bag or other infusion fluid container.

Special Controls

*Classification.* Class II (special controls). The special control for pharmacy compounding systems within this classification is the FDA guidance document entitled “Class II Special Controls Guidance Document: Pharmacy Compounding Systems; Final Guidance for Industry and FDA Reviewers.” Pharmacy compounding systems classified within the intravascular administration set are exempt from the premarket notification procedures in subpart E of this part and subject to the limitations in § 880.9.

Related Devices

Submission Summary (Full Text)

{0}------------------------------------------------ Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three heads, representing the department's commitment to health, human services, and science. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle. Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850 NOV - 5 1999 Ms. Monica Abeles President Diasol Inc. 13212 Raymer Street North Hollywood, CA 91605 Re : K992999 Daisy Protected Scalp Vein Set Trade Name: Regulatory Class: II Product Code: FPA Dated: September 3, 1999 Received: September 7, 1999 Dear Ms. Abeles: 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 The general controls provisions of the Act 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 Good Manufacturing Practice for Medical Devices: General (GMP) regulation (21 CFR Part 820) and that, through periodic GMP inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP requlation may result in requlatory 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 {1}------------------------------------------------ Page 2 - Ms. Abeles 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 requlations. 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. 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) 594-4692. 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, "Misbrandinq 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, Timothy A. Ulstad Timothy A. Ulatowski Director Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health Enclosure {2}------------------------------------------------ K992999 ## INDICATIONS FOR USE 510(k) Number: 长992999 Device Name: Daisy Protected Scalp Vein Set Indications for Use: Provides access to patients vascular system to administer IV fluids Is used in blood drawing Aid in prevention of needlestick injury. Concurrence of CDRH, Office of Device Evaluation (ODE) Prescription Use (Per 21 CFR 801.109) OR Over-The-Counter-Use (Optional Format 1-2-96) Patricia Cuccenti (Division Sign-Off) Division of Dental, Infection Control, and General Hospital D 510(k) Number .
Innolitics
510(k) Summary
Decision Summary
Classification Order
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