K Number
K023808
Device Name
IRRIGATION SETS
Date Cleared
2003-03-10

(116 days)

Product Code
Regulation Number
876.5130
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
This device is intended for delivery of irrigation solutions from the fluid container to the irrigation site during bladder irrigation or endoscopic procedures including cyctoscopy, transurethral resection (TUR) and arthroscopic procedures. This tubing segment is connected to the endoscope for delivery of solution to the irrigation site such as the bladder or knee.
Device Description
The International Medsurg Connections Irrigation Sets.
More Information

Not Found

Not Found

No
The summary describes a simple irrigation tubing set and the performance studies focus on material properties and physical connections, with no mention of AI/ML, image processing, or data-driven algorithms.

No
The device is used for delivery of irrigation solutions during medical procedures, not for treating a disease or condition itself.

No
The device is an irrigation set used for delivering solutions during medical procedures, not for diagnosing conditions.

No

The device description and performance studies clearly indicate a physical tubing set for delivering irrigation solutions, not a software application.

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

Here's why:

  • Intended Use: The intended use is for the delivery of irrigation solutions during surgical or endoscopic procedures. This is a therapeutic or procedural function, not a diagnostic one.
  • Device Description: The description is of an irrigation set, which is a delivery system for fluids.
  • Lack of Diagnostic Elements: There is no mention of analyzing biological samples, detecting analytes, or providing diagnostic information about a patient's condition.
  • Testing Focus: The summary of testing focuses on the physical and chemical properties of the device itself (material properties, connections, flow rate), not on its ability to perform a diagnostic test.

IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. This device's function is purely for delivering fluids during a procedure.

N/A

Intended Use / Indications for Use

This device is intended for delivery of irrigation solutions from the fluid container to the irrigation site during bladder irrigation or endoscopic procedures including cyctoscopy, transurethral resection (TUR) and arthroscopic procedures. This tubing segment is connected to the endoscope for delivery of solution to the irrigation site such as the bladder or knee.

Product codes

78 LJH, 87 HRX

Device Description

The International Medsurg Connections Irrigation Sets.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

bladder, knee

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

All materials used in the fabrication of the International Medsurg Connections Irrigation Sets were evaluated for: Oxidizable Matter, Acidity and Alkalinity, UV Absorbancy, Metallic ions, Evaporated Residual, Integrity, Connection between components, Closure-piecing device, Tubing, Drip chamber and drip tubing, Flow rate of infusion, Flow regulator, Self-sealing injection site, Protective caps, Symbol, Packing, Chemical property. Joined Tubing 5" and 20" was also evaluated for: Diameter of the end conical fitting, Length of conical fitting, Taper of conical fitting, Separate force of conical fitting, Tightness of conical fitting, Force of split the conical fitting, Diameter of conical aperature, Depth of conical aperature, Taper of conical aperature, Separate force of conical aperature, Tightness of conical aperature, Force of split the conical aperature, Outer diameter of conical fitting on outstanding position, Angle of conical fitting on outstanding postion, Length of tubing, Connection Strength.

Key Metrics

Not Found

Predicate Device(s)

Not Found

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.5130 Urological catheter and accessories.

(a)
Identification. A urological catheter and accessories is a flexible tubular device that is inserted through the urethra and used to pass fluids to or from the urinary tract. This generic type of device includes radiopaque urological catheters, ureteral catheters, urethral catheters, coudé catheters, balloon retention type catheters, straight catheters, upper urinary tract catheters, double lumen female urethrographic catheters, disposable ureteral catheters, male urethrographic catheters, and urological catheter accessories including ureteral catheter stylets, ureteral catheter adapters, ureteral catheter holders, ureteral catheter stylets, ureteral catheterization trays, and the gastro-urological irrigation tray (for urological use).(b)
Classification. (1) Class II (performance standards).(2) Class I for the ureteral stylet (guidewire), stylet for gastrourological catheter, ureteral catheter adapter, ureteral catheter connector, and ureteral catheter holder. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.

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Ko23808

SUMMARY OF SAFETY AND EFFECTIVENESS 9.0

INTERNATIONAL MEDSURG CONNECTIONS IRRIGATION SETS

| Manufacturer: | International Medsurg Connections, Inc.
935 N. Plum Grove Road, Suite F
Schaumburg, Illinois 60173-4770 | |
|-----------------------------|---------------------------------------------------------------------------------------------------------------|--|
| Regulatory Affairs Contact: | Michele Vovolka
P.O. Box 848
Grayslake, Illinois 60030 | |
| Telephone: | (847) 856-0355 | |
| Date Summary Prepared: | November 5, 2002 | |
| Product Trade Name: | TUR, Arthroscopic, Cystoscopy Irrigation Sets | |
| Common Name: | Irrigation Sets | |
| Classification: | Class II | |
| Predicate Devices: | | |

Description: The International Medsurg Connections Irrigation Sets.

Intended Use:

This device is intended for delivery of irrigation solutions from the fluid container to the irrigation site during bladder irrigation or endoscopic procedures including cyctoscopy, transurethral resection (TUR) and arthroscopic procedures. This tubing segment is connected to the endoscope for delivery of solution to the irrigation site such as the bladder or knee.

Substantial Equivalence:

The International Medsurg Connections Irrigation Sets are substantially equivalent to the Baxter Healthcare Corporation Irrigation Sets in that they provide the following characteristics:

  • Intended use is the same
  • Similar configurations
  • Similar materials

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Ko23808

Summary of Testing: All materials used in the fabrication of the International Medsurg Connections Irrigation Sets were evaluated for:

Joined Tubing 5" and 20"Irrigation Sets*
Oxidizable MatterOxidizable Matter
Acidity and AlkalinityAcidity and Alkalinity
UV AbsorbancyUV Absorbancy
Metallic ionsMetallic ions
Evaporated ResidualEvaporated Residual
Diameter of the end conical fittingIntegrity
Length of conical fittingConnection between components
Taper of conical fittingClosure-piecing device
Separate force of conical fittingTubing
Tightness of conical fittingDrip chamber and drip tubing
Force of split the conical fittingFlow rate of infusion
Diameter of conical aperatureFlow regulator
Depth of conical aperatureSelf-sealing injection site
Taper of conical aperatureProtective caps
Separate force of conical aperatureSymbol
Tightness of conical aperaturePacking
Force of split the conical aperatureChemical property
Outer diameter of conical fitting on
outstanding position
Angle of conical fitting on outstanding
postion
Length of tubing
Connection Strength
Integrity

2

Image /page/2/Picture/2 description: The image is a black and white seal for the Department of Health & Human Services - USA. The seal is circular with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the top half of the circle. The bottom half of the circle contains a stylized image of three human profiles facing to the right.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR 1 0 2003

International Medsurg Connection % Ms. Michele H. Vovolka Regulatory Consultant Vantage Consulting International, Ltd. P.O. Box 848 GRAYSLAKE IL 60030

Re: K023808

Trade/Device Name: Irrigation Sets Regulation Number: None Regulatory Class: Unclassified Product Code: 78 LJH Regulation Number: 21 CFR 888.1100 Regulation Name: Arthroscope Regulatory Class: II Product Code: 87 HRX Dated: February 18, 2003 Received: February 19, 2003

Dear Ms. Vovolka:

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.

3

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 C. Brogdon

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

Enclosure

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510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

International Medsurg Connections Irrigation Sets Device Name:

Indications For Use:

This device is intended for delivery of irrigation solutions from the fluid container to the irrigation site during bladder irrigation or endoscopic procedures including cyctoscopy, transurethral resection (TUR) and arthroscopic procedures. This tubing segment is connected to the endoscope for delivery of solution to the irrigation site such as the bladder or knee.

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

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Concurrence of CDRH, Office of Device Evaluation (ODE)