(184 days)
THE MEDCOMP 14.5F DOUBLE LUMEN HEMODIALYSIS CATHETER IS INDICATED FOR USE IN ATTAINING LONG-TERM VASCULAR ACCESS FOR HEMODIALYSIS AND APHERESIS. IT MAY BE INSERTED PERCUTANEOUSLY AND IS PRIMARILY PLACED IN THE INTERNAL JUGULAR VEIN. ALTERNATE INSERTION SITES INCLUDE THE SUBCLAVIAN VEIN. CATHETERS GREATER THAN 40CM ARE INTENDED FOR FEMORAL VEIN INSERTION.
The Medcomp 14.5F Double Lumen Hemodialysis Catheter is a polyurethane, double lumen catheter used to remove and return blood through two-segregated lumen passages. Both lumens open at the distal tip, each with a series of side holes. The distal venous lumen is tapered and extends beyond the arterial lumen to reduce recirculation. The lumens are connected to the extensions via a molded hub. The arterial and venous extensions are identified by red and blue luer connectors and clamps. Priming volume information is printed on the clamps for ease in identification. A removable suture wing is provided for securing the catheter after initial placement. The fixed polyester cuff allows for tissue ingrowth for long term placement. The Medcomp 14.5F Double Lumen Hemodialysis Catheter is available in varied implantable lengths, with straight or pre-curved configurations to be determined by the prescribing physician based on insertion site and patient anatomy.
This document describes the Medcomp 14.5F Double Lumen Hemodialysis Catheter and its substantial equivalence to a predicate device (K981994 Bard Opti-Flow).
1. Table of Acceptance Criteria and Reported Device Performance:
| Acceptance Criteria (Performance Data) | Reported Device Performance |
|---|---|
| Mechanical Integrity | |
| Tensile Strength | Demonstrated substantial equivalence to legally marketed devices. |
| Joint Strength | Demonstrated substantial equivalence to legally marketed devices. |
| Leakage | Demonstrated substantial equivalence to legally marketed devices. |
| Functional Performance | |
| Recirculation | Demonstrated substantial equivalence to legally marketed devices. |
| Flow Performance | Demonstrated substantial equivalence to legally marketed devices. |
| Accessory Effectiveness | |
| Clamp Effectiveness | Testing performed to assure safe and effective interaction between clamp and extension tube. |
| Material Compatibility | |
| Chemical Exposure Testing | Performed to demonstrate compatibility with typical site care solutions. |
2. Sample size used for the test set and the data provenance:
- The document states that clinical studies were not deemed necessary. All performance data was generated through in vitro testing.
- The specific sample size (number of catheters tested) for each in vitro test is not explicitly stated in the provided document.
- The data provenance is in vitro laboratory testing, directly related to the manufactured device, and therefore not tied to a specific country of origin in terms of patient data. It is inherently prospective in the sense that the device was manufactured and then tested.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:
- This information is not applicable as clinical studies were not conducted, and the ground truth was not established by human experts for patient outcomes. The acceptance criteria were based on engineering and material science principles, against which the in vitro performance was compared.
4. Adjudication method for the test set:
- This information is not applicable as clinical studies were not conducted, and there was no expert adjudication process for patient cases.
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:
- No, an MRMC comparative effectiveness study was not performed. This device is a medical catheter and does not involve AI for diagnostic or interpretive purposes.
6. If a standalone (i.e. algorithm only without human-in-the loop performance) was done:
- No, this refers to an AI algorithm's performance, which is not applicable to this medical device.
7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):
- The "ground truth" for this device, in the context of its substantial equivalence determination, was based on established performance characteristics of legally marketed predicate devices (K981994 Bard Opti-Flow) and industry standards for catheter performance and material properties. This is typically determined through engineering specifications, previous regulatory approvals, and documented performance of equivalent devices.
8. The sample size for the training set:
- This information is not applicable as this device does not involve a machine learning algorithm that requires a training set.
9. How the ground truth for the training set was established:
- This information is not applicable as this device does not involve a machine learning algorithm that requires a training set.
§ 876.5540 Blood access device and accessories.
(a)
Identification. A blood access device and accessories is a device intended to provide access to a patient's blood for hemodialysis or other chronic uses. When used in hemodialysis, it is part of an artificial kidney system for the treatment of patients with renal failure or toxemic conditions and provides access to a patient's blood for hemodialysis. The device includes implanted blood access devices, nonimplanted blood access devices, and accessories for both the implanted and nonimplanted blood access devices.(1) The implanted blood access device is a prescription device and consists of various flexible or rigid tubes, such as catheters, or cannulae, which are surgically implanted in appropriate blood vessels, may come through the skin, and are intended to remain in the body for 30 days or more. This generic type of device includes various catheters, shunts, and connectors specifically designed to provide access to blood. Examples include single and double lumen catheters with cuff(s), fully subcutaneous port-catheter systems, and A-V shunt cannulae (with vessel tips). The implanted blood access device may also contain coatings or additives which may provide additional functionality to the device.
(2) The nonimplanted blood access device consists of various flexible or rigid tubes, such as catheters, cannulae or hollow needles, which are inserted into appropriate blood vessels or a vascular graft prosthesis (§§ 870.3450 and 870.3460), and are intended to remain in the body for less than 30 days. This generic type of device includes fistula needles, the single needle dialysis set (coaxial flow needle), and the single needle dialysis set (alternating flow needle).
(3) Accessories common to either type include the shunt adaptor, cannula clamp, shunt connector, shunt stabilizer, vessel dilator, disconnect forceps, shunt guard, crimp plier, tube plier, crimp ring, joint ring, fistula adaptor, and declotting tray (including contents).
(b)
Classification. (1) Class II (special controls) for the implanted blood access device. The special controls for this device are:(i) Components of the device that come into human contact must be demonstrated to be biocompatible. Material names and specific designation numbers must be provided.
(ii) Performance data must demonstrate that the device performs as intended under anticipated conditions of use. The following performance characteristics must be tested:
(A) Pressure versus flow rates for both arterial and venous lumens, from the minimum flow rate to the maximum flow rate in 100 milliliter per minute increments, must be established. The fluid and its viscosity used during testing must be stated.
(B) Recirculation rates for both forward and reverse flow configurations must be established, along with the protocol used to perform the assay, which must be provided.
(C) Priming volumes must be established.
(D) Tensile testing of joints and materials must be conducted. The minimum acceptance criteria must be adequate for its intended use.
(E) Air leakage testing and liquid leakage testing must be conducted.
(F) Testing of the repeated clamping of the extensions of the catheter that simulates use over the life of the device must be conducted, and retested for leakage.
(G) Mechanical hemolysis testing must be conducted for new or altered device designs that affect the blood flow pattern.
(H) Chemical tolerance of the device to repeated exposure to commonly used disinfection agents must be established.
(iii) Performance data must demonstrate the sterility of the device.
(iv) Performance data must support the shelf life of the device for continued sterility, package integrity, and functionality over the requested shelf life that must include tensile, repeated clamping, and leakage testing.
(v) Labeling of implanted blood access devices for hemodialysis must include the following:
(A) Labeling must provide arterial and venous pressure versus flow rates, either in tabular or graphical format. The fluid and its viscosity used during testing must be stated.
(B) Labeling must specify the forward and reverse recirculation rates.
(C) Labeling must provide the arterial and venous priming volumes.
(D) Labeling must specify an expiration date.
(E) Labeling must identify any disinfecting agents that cannot be used to clean any components of the device.
(F) Any contraindicated disinfecting agents due to material incompatibility must be identified by printing a warning on the catheter. Alternatively, contraindicated disinfecting agents must be identified by a label affixed to the patient's medical record and with written instructions provided directly to the patient.
(G) Labeling must include a patient implant card.
(H) The labeling must contain comprehensive instructions for the following:
(
1 ) Preparation and insertion of the device, including recommended site of insertion, method of insertion, and a reference on the proper location for tip placement;(
2 ) Proper care and maintenance of the device and device exit site;(
3 ) Removal of the device;(
4 ) Anticoagulation;(
5 ) Management of obstruction and thrombus formation; and(
6 ) Qualifications for clinical providers performing the insertion, maintenance, and removal of the devices.(vi) In addition to Special Controls in paragraphs (b)(1)(i) through (v) of this section, implanted blood access devices that include subcutaneous ports must include the following:
(A) Labeling must include the recommended type of needle for access as well as detailed instructions for care and maintenance of the port, subcutaneous pocket, and skin overlying the port.
(B) Performance testing must include results on repeated use of the ports that simulates use over the intended life of the device.
(C) Clinical performance testing must demonstrate safe and effective use and capture any adverse events observed during clinical use.
(vii) In addition to Special Controls in paragraphs (b)(1)(i) through (v) of this section, implanted blood access devices with coatings or additives must include the following:
(A) A description and material characterization of the coating or additive material, the purpose of the coating or additive, duration of effectiveness, and how and where the coating is applied.
(B) An identification in the labeling of any coatings or additives and a summary of the results of performance testing for any coating or material with special characteristics, such as decreased thrombus formation or antimicrobial properties.
(C) A Warning Statement in the labeling for potential allergic reactions including anaphylaxis if the coating or additive contains known allergens.
(D) Performance data must demonstrate efficacy of the coating or additive and the duration of effectiveness.
(viii) The following must be included for A-V shunt cannulae (with vessel tips):
(A) The device must comply with Special Controls in paragraphs (b)(1)(i) through (v) of this section with the exception of paragraphs (b)(1)(ii)(B), (b)(1)(ii)(C), (b)(1)(v)(B), and (b)(1)(v)(C), which do not apply.
(B) Labeling must include Warning Statements to address the potential for vascular access steal syndrome, arterial stenosis, arterial thrombosis, and hemorrhage including exsanguination given that the device accesses the arterial circulation.
(C) Clinical performance testing must demonstrate safe and effective use and capture any adverse events observed during clinical use.
(2) Class II (performance standards) for the nonimplanted blood access device.
(3) Class II (performance standards) for accessories for both the implanted and the nonimplanted blood access devices not listed in paragraph (b)(4) of this section.
(4) Class I for the cannula clamp, disconnect forceps, crimp plier, tube plier, crimp ring, and joint ring, accessories for both the implanted and nonimplanted blood access device. The devices subject to this paragraph (b)(4) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.