K Number
K030573
Device Name
BD VACUTAINER PUSH BUTTON BLOOD COLLECTION SET, MODELS 367338, 367344, 367336, 367342, 367335, 367341
Date Cleared
2003-05-08

(73 days)

Product Code
Regulation Number
862.1675
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The BD Vacutainer™ Push Button Blood Collection Set is a sterile, multiplesample, single-use winged blood collection set intended for venipuncture to obtain blood specimens from patients. The BD Vacutainer™ Push Button Blood Collection Set is also indicated for the intravenous administration of fluids as indicated in 21 CFR §880.5440. It may be used for any patient population with consideration given to patient size and appropriateness for the solution being infused and duration of therapy. The recommended use of the device is to activate the needle prior to removal from the venipuncture site. The retraction of the intravenous (IV) end of the needle aids in the prevention of accidental needlestick injury.
Device Description
The BD Vacutainer™ Push Button Blood Collection Set is for venous blood collection and IV administration. It contains a needle that will retract into the body of the device when a button is depressed, helping to prevent accidental needle sticks.
More Information

Not Found

No
The summary describes a mechanical blood collection set with a safety feature and does not mention any computational or data-driven components indicative of AI/ML.

No.
The device is primarily for blood collection and intravenous administration of fluids, which are diagnostic and supportive functions, not therapeutic. Its safety feature, needle retraction, prevents injury but does not treat a medical condition.

No
The device is described as a blood collection set for obtaining blood specimens and for intravenous administration of fluids. Its primary function is to aid in the process of drawing blood or administering fluids, not to diagnose a medical condition.

No

The device description clearly indicates it is a physical blood collection set with a needle and a retraction mechanism, not a software-only device.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The primary intended use is for venipuncture to obtain blood specimens and for the intravenous administration of fluids. These are procedures performed on the patient's body, not on a sample of the patient's body outside of the body.
  • Device Description: The description focuses on the physical components and function of the device for blood collection and fluid administration, not for analyzing a sample.
  • Lack of IVD Characteristics: An IVD device is used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. This device is used to collect the specimen or administer something to the patient, not to analyze the specimen.

While the device is used to collect blood, which is then used for IVD testing, the device itself is a blood collection device and an infusion device, not an IVD.

N/A

Intended Use / Indications for Use

The BD Vacutainer™ Push Button Blood Collection Set is a sterile, multiplesample, single-use winged blood collection set intended for venipuncture to obtain blood specimens from patients.

The BD Vacutainer™ Push Button Blood Collection Set is also indicated for the intravenous administration of fluids as indicated in 21 CFR §880.5440. It may be used for any patient population with consideration given to patient size and appropriateness for the solution being infused and duration of therapy.

The recommended use of the device is to activate the needle prior to removal from the venipuncture site. The retraction of the intravenous (IV) end of the needle aids in the prevention of accidental needlestick injury.

Product codes (comma separated list FDA assigned to the subject device)

75 JKA. 80 FPA

Device Description

The BD Vacutainer™ Push Button Blood Collection Set is for venous blood collection and IV administration. It contains a needle that will retract into the body of the device when a button is depressed, helping to prevent accidental needle sticks.

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

any patient population

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

Based upon previously demonstrated performance and successful completion of biocompatibility testing, Push Button Blood Collection Set will perform as intended.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K980414, K022875

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 862.1675 Blood specimen collection device.

(a)
Identification. A blood specimen collection device is a device intended for medical purposes to collect and to handle blood specimens and to separate serum from nonserum (cellular) components prior to further testing. This generic type device may include blood collection tubes, vials, systems, serum separators, blood collection trays, or vacuum sample tubes.(b)
Classification. Class II.

0

I. 510(K) SUMMARY OF SAFETY AND EFFECTIVENESS

510(k) Summary Of Safety and Effectiveness

  • I. General Information
  • This Summary of Safety and Effectiveness information is being submitted in accordance with the requirements of the SMDA of 1990 and 21 § 807.92 Establishment:

| • | Address: | BD Vacutainer Systems, Preanalytical
Solutions
1 Becton Drive
Franklin Lakes, NJ 07417-1885 |
|---|------------------------|--------------------------------------------------------------------------------------------------------------|
| • | Registration Number: | 2243072 |
| • | Contact Person: | M. Wendy Ballesteros
Regulatory Affairs Specialist
Telephone no.: 201-847-6280
Fax No. 201-847-4858 |
| • | Date of Summary: | February 21, 2003 |
| | Device | |
| • | Trade Name: | BD VacutainerTM Push Button Blood
Collection Set |
| • | Classification Name: | Tubes, Vials, Systems, Serum
Separators, Blood Collection |
| • | Classification: | Class II |
| • | Performance Standards: | None Established under 514 of the
Food Drug and Cosmetic Act |

KO35573

1

II. Safety and Effectiveness Information Supporting Substantial Equivalence

  • · Device Description
    The BD Vacutainer™ Push Button Blood Collection Set is for venous blood collection and IV administration. It contains a needle that will retract into the body of the device when a button is depressed, helping to prevent accidental needle sticks.

  • · Intended Use
    The BD Vacutainer™ Push Button Blood Collection Set is a sterile, multiplesample, single-use winged blood collection set intended for venipuncture to obtain blood specimens from patients.

The BD Vacutainer™ Push Button Blood Collection Set is also indicated for the intravenous administration of fluids as indicated in 21 CFR §880.5440. It may be used for any patient population with consideration given to patient size and appropriateness for the solution being infused and duration of therapy.

The recommended use of the device is to activate the needle prior to removal from the venipuncture site. The retraction of the intravenous (IV) end of the needle aids in the prevention of accidental needlestick injury.

  • · Synopsis of Performance Study Results
    Based upon previously demonstrated performance and successful completion of biocompatibility testing, Push Button Blood Collection Set will perform as intended.

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III. Predicate Device Summary Table

• Substantial Equivalence

Based on comparison of the device features, materials, intended use and performance, the BD Vacutainer™ Push Button Blood Collection Set is shown to be substantially equivalent to the commercially available predicate devices indicated in the table below. The predicate devices, K number, and clearance date are also identified in the table below.

ManufacturerPredicate DeviceK-NumberClearance Date
BD Vacutainer
Systems,
Preanalytical
SolutionsBD VACUTAINER™
Brand Safety-Lok™
Blood Collection SetK980414March 3, 1998
BD Vacutainer
Systems,
Preanalytical
SolutionsBD Vacutainer™ Push
Button Blood
Collection SetK022875September 11, 2002

M. Wendy Ballesta

2/21/03
Date

Date

M. Wendy Ballesteros Regulatory Affairs Specialist BD Vacutainer Systems, Preanalytical Solutions Becton Dickinson and Company

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of three human profiles facing to the right, stacked on top of each other.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAY - 8 2003

BD Vacutainer Systems, Preanalytical Solutions Ms. M. Wendy Ballesteros Regulatory Affairs Specialist 1 Becton Drive Franklin Lakes, New Jersey 07417-1885

Re: K030573

Trade/Device Name: BD Vacutainer™ Push Button Blood Collection Set Regulation Number: 21 CFR 862.1675, 21 CFR 880.5440 Regulation Name: Blood Specimen Collection Device, Intravascular Administration Set Regulatory Class: II Product Code: 75 JKA. 80 FPA Dated: February 21, 2003 Received: February 24, 2003

Dear Ms. Ballesteros:

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.

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Page 2 - Ms. Ballesteros

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 (OS) regulation (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 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 (301) 594-4618. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act 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,

Susan Dunner

Susan Runner, DDS, MA Interim Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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B. INDICATIONS FOR USE

510(k) Number (if known):K030543
------------------------------------

Device Name: BD Vacutainer™ Push Button Blood Collection Set

Indications for Use:

The BD Vacutainer™ Push Button Blood Collection Set is a sterile, multiplesample, single-use winged blood collection set intended for venipuncture to obtain blood specimens from patients.

The BD Vacutainer™ Push Button Blood Collection Set is also indicated for intravenous administration of fluids as indicated in 21 CFR §880.5440. It may be used for any patient population with consideration given to patient size and appropriateness for the solution being infused and duration of therapy.

The recommended use of the device is to activate the needle prior to removal from the venipuncture site. The retraction of the intravenous (IV) end of the needle aids in the prevention of accidental needlestick injury.

(Please do not write below this line-continue on another page if needed)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use
OrOver-the-Counter Use

(Per 21 CFR § 801.109)

(Division Sign-Off)
Division of Anesthesiology, General Hospital, Infection Control, Dental Devices(Optional format 1-2-96)
510(k) Number:K030575
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