K Number
K012942
Device Name
THE V BAG, CATALOG NUMBER VB1800; VAC-BOX FOR VACUUM ASSISTED VENOUS DRAINAGE, CATALOG NUMBER VACBOX1500
Date Cleared
2001-11-05

(66 days)

Product Code
Regulation Number
870.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The V-Bag™ with the Vac-Box™ are designed for use in an extracorporeal circuit to provide a volume reservoir, compliance, and assist in removing air during the vacuum assisted venous drainage operating mode.
Device Description
Not Found
More Information

Not Found

Not Found

No
The summary does not mention AI, ML, or any related concepts like image processing, training sets, or performance metrics typically associated with AI/ML devices. The description focuses on the mechanical function of the device in an extracorporeal circuit.

No
The device is described as assisting in removing air and providing a volume reservoir and compliance in an extracorporeal circuit, which are supportive functions for a medical procedure rather than directly treating a disease or condition.

No
The device is described as assisting in an extracorporeal circuit for volume reservoir, compliance, and air removal during vacuum-assisted venous drainage. This function is related to direct patient treatment or support, not diagnosis.

No

The description explicitly mentions physical components: "V-Bag™ with the Vac-Box™" and their function within an "extracorporeal circuit," indicating a hardware-based device.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use describes the device as being used in an "extracorporeal circuit" to manage blood volume and air during a surgical procedure (vacuum assisted venous drainage). This is a direct interaction with the patient's blood outside the body during a medical intervention.
  • Definition of IVD: In vitro diagnostics are tests performed on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health. They are used to diagnose, monitor, or screen for diseases or conditions.

The V-Bag and Vac-Box are part of a system used during a medical procedure to manage blood flow and volume, not to analyze a sample for diagnostic purposes.

N/A

Intended Use / Indications for Use

The V-Bag™ with the Vac-Box™ are designed for use in an extracorporeal circulation to provide a volume reservoir, compliance, and assist in removing air, during an open, on-pump, cardiac, or vacuum assisted venous drainage operating mode.

Product codes

DTN

Device Description

Not Found

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies

Not Found

Key Metrics

Not Found

Predicate Device(s)

Not Found

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.4400 Cardiopulmonary bypass blood reservoir.

(a)
Identification. A cardiopulmonary bypass blood reservoir is a device used in conjunction with short-term extracorporeal circulation devices to hold a reserve supply of blood in the bypass circulation.(b)
Classification. Class II (special controls), except that a reservoir that contains a defoamer or filter is classified into the same class as the defoamer or filter. The device, when it is a cardiopulmonary bypass blood reservoir that does not contain defoamers or blood filters, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 870.9.

0

Image /page/0/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an emblem featuring a stylized depiction of an eagle or bird with three wing-like shapes.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV 0 5 2001

Mr. Yehuda Tamari President Circulatory Technology Inc. 21 Singworth Street Oyster Bay, NY 11771

Re: K012942

Trade Name: The V-Bag and Vac-Box for Vacuum Assisted Venous Drainage Regulation Number: 21 CFR 870.4400 Regulation Name: Cardiopulmonary bypass blood reservoir Regulatory Class: II (two) Product Code: DTN Dated: August 30, 2001 Received: August 31, 2001

Dear Mr. Tamari

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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), 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 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

1

Page 2 - Mr. Yehuda Tamari

Please be advised that FDA's issuance of a substantial equivalence determination does not mean r todo oo actives made a determination that your device complies with other requirements of the Act or that I Dr. I has mutes 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); good manufacturing practice requirements as set forth in the quality labeling (21 CFR Part 820), and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally premailed nodicate 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 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of additionally 21 (301) 594-4646. Additionally, for questions on the promotion and advertising of Compliance at (301) 594-4639 of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

,

James E. Dillard III Director Division of Cardiovascular and Respiratory Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

KD129442 Page A10-1

Attachment 10 V-Bag™ and Vac-Box™ for VAVD Indications for Use

510(k) Number Device Name: Indications for Use: K01_294 レ V-Bag™ with the Vac-Box™ V-Bag™ with the Vac-Box™ are designed for use in an extracorporeal The V-Dag - und the vac Doservoir, compliance, and assist in removing air cheun to provide a volume rose. For, occar, or vacuum assisted venous drainage operating mode.

NOV 0 5 2001

Division of Cardiovascular & Respiratory Devices
510(k) Number K012947