K Number
K014061
Device Name
SIMPLICITY STARPLUS SOFT INFUSION SET
Date Cleared
2002-01-17

(38 days)

Product Code
Regulation Number
880.5440
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The intended use of the Simplicity StarPlus Soft Infusion Set is to provide a means for infusion and/or injection of fluids into the body below the surface of the skin when attached to an external pump or syringe.
Device Description
Sterling Medivations, Inc.'s ("SMI") Simplicity ™ StarPlus Soft Infusion Set is designed for use by people with diabetes to infuse insulin subcutaneously from a pump or syringe. The device consists of four main parts: (1) an infusion catheter made from polytetrafluorthylene (PTFE), (2) an infission hub that provides the patient the capability of disconnecting tube from the infusion catheter, (3) a comecting tube and (4) a female Luer connector. The Simplicity StarPlus Soft Infusion Set is an infusion administration set, connecting to a pump or syringe and inserted in the subcutaneous tissue of a patient. The Sterling Medivations Simplicity StarPlus Soft Infusion Set may be used with any infusion device that delivers continuous or intermittent flow. The administration set attaches to the pump or syringe by means of a female Luer connector, and subcutaneously in the patient through an indwelling catheter made of polytetrafluorthylene (PTFE). The connecting tubing is made from a polyethylene tube. The 25 gauge-indwelling PTFE catheter is introduced into the subcutaneous tissue using an insertion needle. The insertion needle is removed and a connector housing is attached to the indwelling catheter. This connector needle part of the connector hub pierces a septum formits the infusion of medication without leakage. The connector needle is connected to the connector housing. The connector housing. The connector tubing proximal end is attached to a female Luer connector for attachment to the medicine reservoir. The connecting tube is solvent bonded to the connector housing and to the Luer connector. The quick disconnect allows the patient to temporally disconnect the pump reservoir from the indwelling catheter to better facilitate bathing and reservoir changes.
More Information

Not Found

No
The device description and performance studies focus on the physical components, materials, and sterilization of a standard infusion set, with no mention of AI or ML capabilities.

No
The device is described as an "infusion administration set" used to deliver fluids/insulin, not to treat a specific medical condition.

No

The device is an infusion set designed to deliver fluids, such as insulin, into the body. Its function is to administer substances, not to diagnose medical conditions.

No

The device description explicitly details physical components such as an infusion catheter, infusion hub, connecting tube, and female Luer connector, all made of various materials like PTFE and polyethylene. This indicates it is a hardware device, not software-only.

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

Here's why:

  • Intended Use: The intended use is to "provide a means for infusion and/or injection of fluids into the body below the surface of the skin". This describes a device used on or in the body for delivering substances, not for testing samples outside the body to diagnose conditions.
  • Device Description: The description details a system for delivering insulin subcutaneously, consisting of a catheter, hub, tubing, and connector. This is consistent with an infusion administration set used for therapeutic purposes, not for diagnostic testing of biological samples.
  • Lack of IVD Characteristics: The text does not mention any components or functions related to analyzing biological samples (like blood, urine, tissue, etc.) or providing diagnostic information.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information for diagnosis, monitoring, or screening. This device's function is purely for delivering medication.

N/A

Intended Use / Indications for Use

The intended use of the Simplicity StarPlus Soft Infusion Set is to provide a means for infusion and/or injection of fluids into the body below the surface of the skin when attached to an external pump or syringe.

Product codes

FPA

Device Description

Sterling Medivations, Inc.'s ("SMI") Simplicity ™ StarPlus Soft Infusion Set is designed for use by people with diabetes to infuse insulin subcutaneously from a pump or syringe.
The device consists of four main parts: (1) an infusion catheter made from polytetrafluorthylene (PTFE), (2) an infission hub that provides the patient the capability of disconnecting tube from the infusion catheter, (3) a comecting tube and (4) a female Luer connector.
The Simplicity StarPlus Soft Infusion Set is an infusion administration set, connecting to a pump or syringe and inserted in the subcutaneous tissue of a patient. The Sterling Medivations Simplicity StarPlus Soft Infusion Set may be used with any infusion device that delivers continuous or intermittent flow.
The administration set attaches to the pump or syringe by means of a female Luer connector, and subcutaneously in the patient through an indwelling catheter made of polytetrafluorthylene (PTFE). The connecting tubing is made from a polyethylene tube.
The 25 gauge-indwelling PTFE catheter is introduced into the subcutaneous tissue using an insertion needle. The insertion needle is removed and a connector housing is attached to the indwelling catheter. This connector needle part of the connector hub pierces a septum formits the infusion of medication without leakage. The connector needle is connected to the connector housing. The connector tubing proximal end is attached to a female Luer connector for attachment to the medicine reservoir. The connecting tube is solvent bonded to the connector housing and to the Luer connector. The quick disconnect allows the patient to temporally disconnect the pump reservoir from the indwelling catheter to better facilitate bathing and reservoir changes.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

subcutaneously / into the body below the surface of the skin

Indicated Patient Age Range

Not Found

Intended User / Care Setting

people with diabetes

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

To provide substantial equivalence the Simplicity StarPlus Soft Infusion Set meets the catheter requirements of:
CDRH 21 C.F.R. section 880.54400 Intravascular administration set,
ISO 10555 Sterile, single use intravascular catheters (Part 1: General Requirements), and
ISO 10555 Sterile, single use intravascular catheters (Part 5: peripheral catheters).,
1SO 9626 Stainless steel needle tubing for the manufacture of medical devices,
ISO 1 1 1 35: 1994 Medical devices -- Validation and routine control of ethylene oxide sterilization,
ISO 11133-1994 Sterilization of health care products - Biological indicators -- Part 2: Biological indicators for ethylene oxide sterilization.
ISO 594-1: 1986 Conical fittings with a 6% )Luer) taper for syringes, needles and certain other medical equipment - Part 1: General requirements,
ISO 594-2: 1998 Conical fittings with 6% (Luer) taper for syringes, needles and certain other medical
equipment - Part 2: Lock fittings,
ISO 11607: 1997 Packaging for terminally sterilized medical devices,
ISO 8537: 1991 Sterile single use syringes, with or without needle for insulin,
ISO 11135: 1994 Medical devices -- Validation and routine control of ethylene oxide sterilization,
ISO 11138-2: 1994 Sterilization of health care products - Biological indicators - Part 2:Biological indicators for ethylene oxide sterilization.
FDA Guidelines on validation of the Limulus Amebocyte Lysate (LAL) Test as an end-product endotoxin test for human and animal parenteral drugs, biological products, and medical devices. ODE Blue Book Memorandum #K90-1.
The design process adhered to is the Center of Devices and Radiological Health. DESIGN CONTROL GUIDANCE FOR MEDICAL DEVICE MANUFACTURERS. This Guidance relates to FDA 21 CGR 820.30 and Sub-clause 4.4 of ISO 9001. This is substantially equivalent to the predicate device.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K010846

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 880.5440 Intravascular administration set.

(a)
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.(b)
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.

0

JAN 1 7 2002

Sterling Medivations, Inc. 25285 La Loma Drive Los Altos Hills, CA 94022 650-949-0470 (voice) 650-949-0342 (fax)

K014061

510(k) SUMMARY
Date Submitted:December 7, 2001
Submitter:Sterling Medivations, Inc. 25285 La Loma Drive, Los Altos Hills, CA 94022 Company Phone: 650-949-0470, Company fax 650-949-0
Contact:Joel Douglas, Chief Technology Officer
Sterling Medivations, Inc.
Applicant Phone 650-949-0470, Applicant Fax 650-949-0342
Trade Name of Device:Simplicity™ StarPlus Soft Infusion Set for use by people with diabetes to infuse insulin subcutaneously from a pump or syringe.
Common Name of Device:Intravascular administration set.
Classification Name:Percutaneous intravascular catheter.
Predicate Device: The predicate device for Sterling's Simplicity™ StarPlus Soft

Infusion set is the Sterling Medivations Simplicity™ Silver Soft Infusion, K010846.

Description of the New Device: Sterling Medivations, Inc.'s ("SMI") Simplicity ™ StarPlus Soft Infusion Set is designed for use by people with diabetes to infuse insulin subcutaneously from a pump or syringe.

The Simplicity ™ StarPlus Soft Infusion Set proposed for commercial distribution is similar in all significant respects to the existing Sterling Medivations Simplicity Silver Soft Infusion, K010846 and it has the same intended use.

The device consists of four main parts: (1) an infusion catheter made from polytetrafluorthylene (PTFE), (2) an infission hub that provides the patient the capability of disconnecting tube from the infusion catheter, (3) a comecting tube and (4) a female Luer connector.

The Simplicity StarPlus Soft Infusion Set is an infusion administration set, connecting to a pump or syringe and inserted in the subcutaneous tissue of a patient. The Sterling Medivations Simplicity StarPlus Soft Infusion Set may be used with any infusion device that delivers continuous or intermittent flow.

The administration set attaches to the pump or syringe by means of a female Luer connector, and subcutaneously in the patient through an indwelling catheter made of polytetrafluorthylene (PTFE). The connecting tubing is made from a polyethylene tube.

The 25 gauge-indwelling PTFE catheter is introduced into the subcutaneous tissue using an insertion needle. The insertion needle is removed and a connector housing is attached to the indwelling catheter. This connector needle part of the connector hub pierces a septum formits the infusion of medication without leakage. The connector needle is connected to the connector housing. The connector housing. The connector tubing proximal end is attached to a female Luer connector for attachment to the medicine reservoir. The connecting tube is solvent bonded to the connector housing and to the Luer connector. The quick disconnect allows the patient to temporally disconnect the pump reservoir from the indwelling catheter to better facilitate bathing and reservoir changes.

Intended Use of the New Device. The intended use of the Simplicity StarPlus Soft Infusion Set is to provide a means to infuse or inject insulin subcutaneously when the device is attached to a pump or syringe

1

Comparisons of the Technological Features of the New Device and Predicate Device:

The Simplicity StarPlus Soft Infusion Set proposed for commercial distribution is similar in all significant respects to the The Simplicity Start tus Son Micity Silver Soft Infusion 510(k) K010846.

The materials and manufacturing processes are substantially equivalent, the labeling is substantially equivalent to the The materials and mananciaring Silver Soft Infusion, FDA 510(k) K010846.

The differences that exist between the new and predicate device are as follows:

  1. The Simplicity StarPlus Soft Infusion Set indwelling catheter is bonded to the hub with Loctite 4011. The 1) The Sulphicly Start ras Soft Intester which is press fit into the hub and sealed with Locate 401 1.

  2. The Simplicity StarPlus Soft Infusion Set has a septum made of Silicone - ELASTOSIL @ R 401/40. The predicate device has a plug made of Silicone - ELASTOSIL ® R 401/40.

  3. The Simplicity StarPlus Soft Infusion Set has a septum in the infusion hub for injecting with a syringe. The predicate device has a septum in the plug cover for injecting with a syringe.

  4. The Simplicity StarPlus Soft Infusion Set indwelling catheter of Dupont PTFE-62 and the predicate device had a soft catheter made of Fluorinated Ethylene Propylene (FEP) (Dupont FEP-100).

  5. The Simplicity StarPlus Infusion Set uses Polycarbonate (PC) parts whereas the predicate device uses PVC parts.

Performance Data Supporting Substantial Equivalence: To provide substantial equivalence the Simplicity StarPlus Soft Infusion Set meets the catheter requirements of:

CDRH 21 C.F.R. section 880.54400 Intravascular administration set,

ISO 10555 Sterile, single use intravascular catheters (Part 1: General Requirements), and

ISO 10555 Sterile, single use intravascular catheters (Part 5: peripheral catheters).,

1SO 9626 Stainless steel needle tubing for the manufacture of medical devices,

ISO 1 1 1 35: 1994 Medical devices -- Validation and routine control of ethylene oxide sterilization,

ISO 11133-1994 Sterilization of health care products - Biological indicators -- Part 2: Biological indicators for ethylene oxide sterilization.

ISO 594-1: 1986 Conical fittings with a 6% )Luer) taper for syringes, needles and certain other medical equipment - Part 1: General requirements,

ISO 594-2: 1998 Conical fittings with 6% (Luer) taper for syringes, needles and certain other medical

equipment - Part 2: Lock fittings,

ISO 11607: 1997 Packaging for terminally sterilized medical devices,

ISO 8537: 1991 Sterile single use syringes, with or without needle for insulin,

ISO 11135: 1994 Medical devices -- Validation and routine control of ethylene oxide sterilization,

ISO 11138-2: 1994 Sterilization of health care products - Biological indicators - Part 2:Biological indicators for ethylene oxide sterilization.

FDA Guidelines on validation of the Limulus Amebocyte Lysate (LAL) Test as an end-product endotoxin test for human and animal parenteral drugs, biological products, and medical devices. ODE Blue Book Memorandum #K90-1.

The design process adhered to is the Center of Devices and Radiological Health. DESIGN CONTROL GUIDANCE FOR MEDICAL DEVICE MANUFACTURERS. This Guidance relates to FDA 21 CGR 820.30 and Sub-clause 4.4 of ISO 9001. This is substantially equivalent to the predicate device.

Signed

Joel S. Douglas Chief Technology Officer

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized caduceus symbol, which features a staff with a serpent entwined around it. The symbol is encircled by the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

'JAN 1 7 2002

Mr. Joel S. Douglas Chief Technology Officer Sterling Medivations, Incorporated 25285 La Loma Drive Los Altos Hills, California 94022-4583

Re: K014061

Trade/Device Name: Simplicity Starplus Soft Infusion Set Regulation Number: 880.5440 Regulation Name: Intravascular Administration Set Regulatory Class: II Product Code: FPA Dated: December 7, 2001 Received: December 10, 2001

Dear Mr. Douglas:

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.

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.

3

Page 2 - Mr. Douglas

You must comply with all the Act's requirements, including, but not limited to: registration 1 ou inust contify war a807); labeling (21 CFR Part 801); good manufacturing practice and listing (21 es reads in the quality systems (QS) regulation (21 CFR Part 820); and if requirences 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 110(k) premarket notification. The FDA finding of substantial equivalence of your device to 910(K) promaticate 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 Compliance at (301) 594-4618 . 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" (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,

Timothy A. Ulatowski

Tim Director Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

K014061

510(k) Number (if known):

Device Name: Simplicity StarPlus Soft Infusion Set

Indications For Use:

The intended use of the Simplicity StarPlus Soft Infusion Set is to provide a means for infusion and/or injection of fluids into the body below the surface of the skin when attached to an external pump or syringe.

Pattaro Cuscenti

(Division Sign-Off) Division of Dental, Infection Control, and General Hospital Devices KO14061 510(k) Number ________________________________________________________________________________________________________________________________________________________________