K Number
K030936
Device Name
RITA CLIPS FOR INFUSION PUMPS
Date Cleared
2003-04-01

(7 days)

Product Code
Regulation Number
880.5725
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The RITA® Clips are used with Harvard 2 Syringe Pump to increase the syringe holding capacity of the Pump from two to five syringes to allow one Harvard 2 Syringe Pump to supply local delivery of saline through multiple irrigation ports of one RITA® Electrosurgical Device of the RITA® System. The RITA System is intended for use in percutaneous. laparoscopic, or intraoperative coagulation and ablation of soft tissue, including the partial or complete ablation of non-resectable liver lesions.
Device Description
The RITA® Clips are a syringe holder accessory to the Harvard 2 Syringe Pump to accommodate five (5) 20-cc syringes.
More Information

Harvard 2 Syringe Pump

Not Found

No
The summary describes a mechanical accessory (clips) for a syringe pump, with no mention of AI or ML in the intended use, device description, or performance studies.

No
The RITA® Clips are a syringe holder accessory and not a therapeutic device themselves; they facilitate the function of the RITA® System, which is used for therapeutic purposes (ablation of soft tissue), but the clips themselves do not directly treat a condition.

No
The device is described as an accessory (syringe holder clips) for a syringe pump which is part of a system intended for coagulation and ablation of soft tissue. Its function is to increase the syringe capacity for delivering saline. There is no information suggesting it is used for diagnosis or detection of disease.

No

The device description explicitly states that the RITA® Clips are a "syringe holder accessory" and mentions "hardware components" like the Harvard 2 Syringe Pump and syringes. The performance studies also focus on "flow rate and alarm function" of the physical devices.

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 with a syringe pump to deliver saline for coagulation and ablation of soft tissue. This is a therapeutic and surgical application, not a diagnostic one.
  • Device Description: The device is described as a syringe holder accessory. This is a mechanical component used in a delivery system, not a device that performs in vitro testing on biological samples.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens derived from the human body (like blood, urine, tissue samples) to provide information for diagnosis, monitoring, or screening.

Therefore, the RITA® Clips, as described, are not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The RITA® Clips are used with Harvard 2 Syringe Pump to increase the syringe holding capacity of the Pump from two to five syringes to allow one Harvard 2 Syringe Pump to supply local delivery of saline through multiple irrigation ports of one RITA® Electrosurgical Device of the RITA® System. The RITA System is intended for use in percutaneous, laparoscopic, or intraoperative coagulation and ablation of soft tissue, including the partial or complete ablation of non-resectable liver lesions.

Product codes

MRZ

Device Description

The RITA® Clips are a syringe holder accessory to the Harvard 2 Syringe Pump to accommodate five (5) 20-cc syringes.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

soft tissue, including the partial or complete ablation of non-resectable liver lesions.

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

The RITA® Clips and Harvard 2 Syringe Pump underwent testing to verify flow rate and alarm function. The devices passed the test criteria. The RITA® Clips do not directly contact the patient therefore no biocompatibility testing was required.

Key Metrics

Not Found

Predicate Device(s)

Harvard Clinical Technology - Harvard 2 Syringe Pump

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 880.5725 Infusion pump.

(a)
Identification. An infusion pump is a device used in a health care facility to pump fluids into a patient in a controlled manner. The device may use a piston pump, a roller pump, or a peristaltic pump and may be powered electrically or mechanically. The device may also operate using a constant force to propel the fluid through a narrow tube which determines the flow rate. The device may include means to detect a fault condition, such as air in, or blockage of, the infusion line and to activate an alarm.(b)
Classification. Class II (performance standards).

0


510(K) SUMMARY OF SAFETY AND EFFECTIVENESS Y 030 936 9.0

| Contact

InformationRITA Medical Systems
APR 01 2003
967 N. Shoreline Blvd.
Mountain View, CA 94043
Phone: 650 314-3400 Fax: 650 890-3905
Contact Person: Vicki Hacker, VP of Clinical Affairs
General
ProvisionsTrade Name: RITA® Clips
Common/Classification Name: Infusion Pump Accessory
Name of
Predicate DeviceHarvard Clinical Technology - Harvard 2 Syringe Pump
ClassificationClass II
Performance
StandardsPerformance standards have not been established for infusion pump accessory
(syringe holder) under section 514 of the Food, Drug and Cosmetic Act.
Intended UseThe RITA® Clips are used with Harvard 2 Syringe Pump to increase the syringe
holding capacity of the Pump from two to five syringes to allow one Harvard 2
Syringe Pump to supply local delivery of saline through multiple irrigation ports of
one RITA® Electrosurgical Device of the RITA® System. The RITA® System is
intended for use in percutaneous, laparoscopic, or intraoperative coagulation and
ablation of soft tissue, including the partial or complete ablation of non-resectable
liver lesions.
Device
DescriptionThe RITA® Clips are a syringe holder accessory to the Harvard 2 Syringe Pump to
accommodate five (5) 20-cc syringes.
Performance
DataThe RITA® Clips and Harvard 2 Syringe Pump underwent testing to verify flow
rate and alarm function. The devices passed the test criteria. The RITA® Clips do
not directly contact the patient therefore no biocompatibility testing was required.

1

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APR 0 1 2003

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

RITA Medical Systems Incorporated C/O Mr. Charles Mack Responsible Third Party Official Underwriters Laboratories Incorporated 2600 N.W. Lake Road Camas, Washington 98601-8542

Re: K030936

Trade/Device Name: RITA ® Clips for Infusion Pumps Regulation Number: 880.5725 Regulation Name: Infusion Pump Accessory Regulatory Class: II Product Code: MRZ Dated: March 19, 2003 Received: March 25, 2003

Dear Mr. Mack:

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 vour 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.

2

Page 2 - Mr. Mack

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 Raanes

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

3

INTENDED USE 3.0

Indications for Use Statement

510(K) Number (if known)

RITA® Clips for Infusion Pumps Device Name

The RITA® Clips are used with Harvard 2 Syringe Pump to increase the syringe holding capacity of the Pump from two to five syringes to allow one Harvard 2 Syringe Pump to supply local delivery of saline through multiple irrigation ports of one RITA® Electrosurgical Device of the RITA® System. The RITA System is intended for use in percutaneous. laparoscopic, or intraoperative coagulation and ablation of soft tissue, including the partial or complete ablation of non-resectable liver lesions.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use v (per 21 CFR 801).

OR

Over the Counter Use _________________________________________________________________________________________________________________________________________________________

Talcus Cicerite

Division of Anesthesiology, General Hospital, Infection Control, Dental Devices

510(k) Number:

March 6, 2003