K Number
K022412
Device Name
FRESENIUS CAPD STAY.SAFE DISPOSABLE ADMINISTRATION SETS WITH STAY.SAFE CONNECTOR
Date Cleared
2003-03-05

(224 days)

Product Code
Regulation Number
876.5630
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Fresenius CAPD stay.safe® Disposable Administration Sets with stay•safe® Connector is indicated for use in end stage acute and chronic renal disease.
Device Description
The Fresenius CAPD stay•safe® Disposable Administration Sets with stay•safe® Connector consists of a circular housing designed with three, evenly spaced, outlet ports. Individual ports specifically provide for attachment either to the patient, to the peritoneal dialysis solution, or to a drain bag. The outlet port plugs allow the start or stop of solution flow; and prior to use the outlet port for the patient connection is covered with a cap. A knob is turned to different positions to initiate the various treatment steps of the peritoneal dialysis procedure.
More Information

Not Found

None

No
The summary describes a mechanical device for peritoneal dialysis with no mention of AI or ML.

Yes.
The device is used in the treatment of end-stage acute and chronic renal disease, making it a therapeutic device.

No

The device description indicates it is used for administering peritoneal dialysis solutions and managing fluid flow, not for diagnosing a disease or condition. Its intended use is for treating end-stage renal disease, not diagnosing it.

No

The device description clearly outlines physical components like a circular housing, outlet ports, plugs, a cap, and a knob, indicating it is a hardware device.

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

Here's why:

  • Intended Use: The intended use is for "end stage acute and chronic renal disease," which is a treatment for a medical condition, not for diagnosing a condition based on in vitro examination of specimens.
  • Device Description: The description details a system for peritoneal dialysis, which involves the exchange of fluids within the body cavity, not the analysis of samples outside the body.
  • Lack of IVD Indicators: There is no mention of analyzing biological samples (blood, urine, tissue, etc.) or providing diagnostic information. The device facilitates a therapeutic procedure.

Therefore, the Fresenius CAPD stay.safe® Disposable Administration Sets with stay•safe® Connector is a medical device used for treatment, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Fresenius CAPD stay.safe® Disposable Administration Sets with stay•safe® Connector is indicated for use in end stage acute and chronic renal disease.

Product codes

78 KDJ

Device Description

The Fresenius CAPD stay•safe® Disposable Administration Sets with stay•safe® Connector consists of a circular housing designed with three, evenly spaced, outlet ports. Individual ports specifically provide for attachment either to the patient, to the peritoneal dialysis solution, or to a drain bag. The outlet port plugs allow the start or stop of solution flow; and prior to use the outlet port for the patient connection is covered with a cap. A knob is turned to different positions to initiate the various treatment steps of the peritoneal dialysis procedure.

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 Applicable

Key Metrics

Not Found

Predicate Device(s)

CAPD Safe-Lock™ Transfer Sets with Pre-filled Connector

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.5630 Peritoneal dialysis system and accessories.

(a)
Identification. (1) A peritoneal dialysis system and accessories is a device that is used as an artificial kidney system for the treatment of patients with renal failure or toxemic conditions, and that consists of a peritoneal access device, an administration set for peritoneal dialysis, a source of dialysate, and, in some cases, a water purification mechanism. After the dialysate is instilled into the patient's peritoneal cavity, it is allowed to dwell there so that undesirable substances from the patient's blood pass through the lining membrane of the peritoneal cavity into this dialysate. These substances are then removed when the dialysate is drained from the patient. The peritoneal dialysis system may regulate and monitor the dialysate temperature, volume, and delivery rate together with the time course of each cycle of filling, dwell time, and draining of the peritoneal cavity or manual controls may be used. This generic device includes the semiautomatic and the automatic peritoneal delivery system.(2) The peritoneal access device is a flexible tube that is implanted through the abdominal wall into the peritoneal cavity and that may have attached cuffs to provide anchoring and a skin seal. The device is either a single use peritioneal catheter, intended to remain in the peritoneal cavity for less than 30 days, or a long term peritoneal catheter. Accessories include stylets and trocars to aid in the insertion of the catheter and an obturator to maintain the patency of the surgical fistula in the abdominal wall between treatments.
(3) The disposable administration set for peritoneal dialysis consists of tubing, an optional reservoir bag, and appropriate connectors. It may include a peritoneal dialysate filter to trap and remove contaminating particles.
(4) The source of dialysate may be sterile prepackaged dialysate (for semiautomatic peritoneal dialysate delivery systems or “cycler systems”) or dialysate prepared from dialysate concentrate and sterile purified water (for automatic peritoneal dialysate delivery systems or “reverse osmosis” systems). Prepackaged dialysate intended for use with either of the peritoneal dialysate delivery systems is regulated by FDA as a drug.
(b)
Classification. Class II (special controls). The following accessories are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9: A catheter finger grip that is non-patient contacting and intended for single use with a peritoneal catheter; a continuous ambulatory peritoneal dialysis (CAPD) belt; and a catheter stand that does not include weigh scales.

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page 1 of 2

K022412

510 (k) Summary

MAR 0 5 2003

Applicant:Fresenius Medical Care North America
Contact:Arthur E. Eilinsfeld
Director, Regulatory Affairs
Fresenius Medical Care North America
95 Hayden Avenue
Lexington, MA 02420-9192Telephone: 781-402-9068
Fax: 781-402-9082
Trade Name:Fresenius CAPD stay•safe® Disposable Administration Sets
with stay•safe® Connector
Common Name:Disposable Connector and Tubing Set for Solution Delivery
during Peritoneal Dialysis
Classification Name:Peritoneal Dialysis System and Accessories per 21CFR
876.5630
Equivalence Predicate:CAPD Safe-Lock™ Transfer Sets with Pre-filled Connector
Device Description:The Fresenius CAPD stay•safe® Disposable Administration
Sets with stay•safe® Connector consists of a circular
housing designed with three, evenly spaced, outlet ports.
Individual ports specifically provide for attachment either to
the patient, to the peritoneal dialysis solution, or to a drain
bag. The outlet port plugs allow the start or stop of solution
flow; and prior to use the outlet port for the patient
connection is covered with a cap.

A knob is turned to different positions to initiate the various
treatment steps of the peritoneal dialysis procedure. | |
| Statement of
Intended Use: | The Fresenius CAPD stay•safe® Disposable Administration
Sets with stay•safe® Connector are disposable devices for
single use. The areas under protective guards and the fluid
pathway are sterile and non-pyrogenic. The devices
continue to be restricted to the sale by or on the order of a
physician. | |

Fresenius Medical Care North America

Corporate Headquarters: 95 Hayden Avenue Lexington, MA 02420-9192

Fresenius CAPD stay•safe® Disposable Administration Sets with stay•safe® Connector

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Page 2 of 2

510 (k) Summary

It is indicated for use in patients with end-stage acute and Statement of Indications for Use: chronic renal disease.

  • Summary of In general, the design and materials of the subject devices Technological are the same as the Fresenius predicate devices. The materials have been tested to ISO10993 and are shown not Differences: to raise any different issues regarding safety and effectiveness. A hazard analysis determination indicates that the design differences do not impact the safety or effectiveness of the device; and that the differences are not critical to the intended therapeutic use of the device.
    Clinical Data: Not Applicable

Conclusions: Components of the proposed devices have met the ISO 10993-1 biological requirements for safety screening of materials in indirect contact for greater than 30 days. The sets are tested to a Limulus Amebocyte Lysate (LAL) specification of 0.01 EU/mL. Sets are sterilized by a method determined and verified to assure an SAL of ≥ 10°. Functional and physical testing is performed prior to product release.

Arthur E. Eilinsfeld

Director, Fresenius Regulatory Affairs

7/18/02
Date

K0224/2


Premarket Notification 510 (k) Number

Premarket Notification 510 (k) Number

AEE:dmk

Fresenius Medical Care North America

Corporate Headquarters: 95 Hayden Avenue Lexington, MA 02420-9192

Fresenius CAPD stay.safe® Disposable Administration Sets with stay.safe® Connector

2

Image /page/2/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo features a stylized eagle with three human profiles incorporated into its design. 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

MAR 0 5 2003

Mr. Arthur E. Eilinsfeld Director, Regulatory Affairs Fresenius Medical Care North America 95 Hayden Avenue LEXINGTON MA 02420-9192

Re: K022412

Trade/Device Name: Fresenius CAPD stay •safe® Disposable Administration Sets with stay safe® Connector Regulation Number: 21 CFR §876.5630 Regulation Name: Peritoneal dialysis system and accessories Regulatory Class: II Product Code: 78 KDJ Dated: December 3, 2002 Received: December 5, 2002

Dear Mr. Eilinsfeld:

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 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. 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 systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (sections 531-542 of the Act); 21 CFR 1000-1050.

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Page 2

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), please contact the Office of Compliance at one of the following numbers, based on the regulation number at the top of this letter:

8xx.1xxx(301) 594-4591
876.2xxx, 3xxx, 4xxx, 5xxx(301) 594-4616
884.2xxx, 3xxx, 4xxx, 5xxx, 6xxx(301) 594-4616
892.2xxx, 3xxx, 4xxx, 5xxx(301) 594-4654
Other(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, "Misbranding by reference to premarket notification" (21 CFR 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,

Nancy Crogdon

Nancy C. Brogdon Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

Indications for Use Statement

Device Name:

Fresenius CAPD stay•safe® Disposable Administration Sets with stay•safe® Connector

Indications for Use:

The Fresenius CAPD stay.safe® Disposable Administration Sets with stay•safe® Connector is indicated for use in end stage acute and chronic renal disease.

Please Do Not Write Below This Line - Continue On Another Page If Needed

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use
(Per 21 CFR 801.109

OR

Over-The-Counter Use

Nancy Brogdon
(Division Sign-Off Sign-Off)
Division of Reproductive, Abdominal,
and Radiological Devices
510(k) Number K022412

Fresenius Medical Care North America

Corporate Headquarters: 95 Hayden Avenue Lexington, MA 02420-9192

Fresenius CAPD stay.safe® Disposable Administration Sets with stay.safe® Connector