K Number
K030975
Device Name
EXELTRA PLUS HIGH FLUX DIALYZER, MODEL 210
Date Cleared
2003-04-25

(28 days)

Product Code
Regulation Number
876.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Hemodialysis with EXELTRA™ Plus dialyzers is indicated for patients with renal failure when conservative therapy is judged to be inadequate. It also may be indicated in the treatment of patients intoxicated with poisons or drugs.
Device Description
Models EXELTRA™ Plus 210 Single Use Dialyzer
More Information

No
The summary describes a hemodialysis dialyzer, a physical device for filtering blood, and there is no mention of AI or ML in the provided text.

Yes
The device is a hemodialyzer used for renal failure and poison/drug intoxication, which are therapeutic interventions.

No
Explanation: The device is a dialyzer used for hemodialysis, which is a treatment for renal failure or poisoning. It does not diagnose conditions but rather treats them.

No

The device description clearly identifies the device as a "Single Use Dialyzer," which is a physical medical device used in hemodialysis, not a software-only product.

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

Here's why:

  • Intended Use: The intended use describes a treatment for renal failure and intoxication, which are clinical conditions treated directly on the patient. IVDs are used to examine specimens from the body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • Device Description: A dialyzer is a medical device used in hemodialysis, a process that filters blood outside the body and returns it to the patient. This is a therapeutic device, not a diagnostic one.
  • Lack of IVD Characteristics: The description doesn't mention any analysis of biological samples, diagnostic purposes, or the use of reagents or assays typically associated with IVDs.

Therefore, the EXELTRA™ Plus dialyzer is a therapeutic medical device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

Hemodialysis with the EXELTRA™ Plus Dialyzer is indicated for patients with acute or Flonic renal failure when conservative therapy is judged to be inadequate. It also may be indicated in the treatment of patients intoxicated with poisons or drugs.

Product codes

78 KDI

Device Description

Models EXELTRA™ Plus 210 Single Use Dialyzer

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

Components of the subject EXELTRA™ Plus dialyzers have met the biological requirements of ISO 10993-1: Biological Evaluation of Medical devices - Part: Guidance on selection of tests. The validation of the gamma sterilization cycle for the EXELTRA™ Plus dialyzer is based upon the AAMI/ISO 11137:1994 "Sterilization of Healthcare Products – Requirements for Validation and Routine Control – Radiation Sterilization". Functional testing for blood side integrity and conformance to manufacturing specifications are performed as in-process and/or final inspections prior to product release to ensure a quality product.

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

Not Found

Predicate Device(s)

K890315, K926568, K970663

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.5860 High permeability hemodialysis system.

(a)
Identification. A high permeability hemodialysis system is a device intended for use as an artificial kidney system for the treatment of patients with renal failure, fluid overload, or toxemic conditions by performing such therapies as hemodialysis, hemofiltration, hemoconcentration, and hemodiafiltration. Using a hemodialyzer with a semipermeable membrane that is more permeable to water than the semipermeable membrane of the conventional hemodialysis system (§ 876.5820), the high permeability hemodialysis system removes toxins or excess fluid from the patient's blood using the principles of convection (via a high ultrafiltration rate) and/or diffusion (via a concentration gradient in dialysate). During treatment, blood is circulated from the patient through the hemodialyzer's blood compartment, while the dialysate solution flows countercurrent through the dialysate compartment. In this process, toxins and/or fluid are transferred across the membrane from the blood to the dialysate compartment. The hemodialysis delivery machine controls and monitors the parameters related to this processing, including the rate at which blood and dialysate are pumped through the system, and the rate at which fluid is removed from the patient. The high permeability hemodialysis system consists of the following devices:(1) The hemodialyzer consists of a semipermeable membrane with an in vitro ultrafiltration coefficient (K
uf ) greater than 8 milliliters per hour per conventional millimeter of mercury, as measured with bovine or expired human blood, and is used with either an automated ultrafiltration controller or anther method of ultrafiltration control to prevent fluid imbalance.(2) The hemodialysis delivery machine is similar to the extracorporeal blood system and dialysate delivery system of the hemodialysis system and accessories (§ 876.5820), with the addition of an ultrafiltration controller and mechanisms that monitor and/or control such parameters as fluid balance, dialysate composition, and patient treatment parameters (e.g., blood pressure, hematocrit, urea, etc.).
(3) The high permeability hemodialysis system accessories include, but are not limited to, tubing lines and various treatment related monitors (e.g., dialysate pH, blood pressure, hematocrit, and blood recirculation monitors).
(b)
Classification. Class II. The special controls for this device are FDA's:(1) “Use of International Standard ISO 10993 ‘Biological Evaluation of Medical Device—Part I: Evaluation and Testing,’ ”
(2) “Guidance for the Content of 510(k)s for Conventional and High Permeability Hemodialyzers,”
(3) “Guidance for Industry and CDRH Reviewers on the Content of Premarket Notifications for Hemodialysis Delivery Systems,”
(4) “Guidance for the Content of Premarket Notifications for Water Purification Components and Systems for Hemodialysis,” and
(5) “Guidance for Hemodialyzer Reuse Labeling.”

0

APR 2 5 2003

. K030975

Page 11 2

510(K) SUMMARY

Submitter's Name:David E. Curtin, RAC
Address:1620 Waukegan Rd. MPGR-A2E
Phone:(847) 473-6079
Fax:(847) 473-6952
Contact:David E. Curtin
Date Prepared:3/27/03
Trade Name:EXELTRA™ Plus Dialyzer, Single Use
Common Name:Dialyzer
Classification Name:High Permeability Hemodialysis System per 21 CFR 876.5860
Equivalent Predicate:Baxter CT Dialyzer, Single Use (K890315, K926568,
K970663)
Device Description:Models EXELTRA™ Plus 210 Single Use Dialyzer
Intended Use:Hemodialysis with EXELTRA™ Plus dialyzers is indicated for
patients with renal failure when conservative therapy is judged
to be inadequate. It also may be indicated in the treatment of
patients intoxicated with poisons or drugs.
Summary of the
Technological
Characteristics
Compared to theThe general design and material of the EXELTRA™ Plus 210
is similar to the CT 110 and CT190G dialyzers cleared
under K890315, K926568 and K970663, and do not
raise any new types of safety and effectiveness issues, when
compared to the predicate product.
Predicate Device:Baxter CT Dialyzers
Clinical Data:N/A
Conclusions DrawnComponents of the subject EXELTRA™ Plus dialyzers have
met the biological requirements of ISO 10993-1: Biological
Evaluation of Medical devices - Part: Guidance on selection of
tests.
Additional
Information
Requested by FDA:The validation of the gamma sterilization cycle for the
EXELTRA™ Plus dialyzer is based upon the AAMI/ISO
11137:1994 "Sterilization of Healthcare Products –
Requirements for Validation and Routine Control – Radiation
Sterilization".
Functional testing for blood side integrity and conformance to
manufacturing specifications are performed as in-process
and/or final inspections prior to product release to ensure a
quality product.
None to date

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510(k) Premarket Notification EXELTRA™ Plus 210 Dialyzer Page 2 of 2

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Image /page/2/Picture/1 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" arranged around the perimeter. In the center of the seal is a stylized image of an eagle with its wings spread.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

APR 2 5 2003

David E. Curtin, RAC Associate Director, Regulatory Affairs Renal Division Baxter Healthcare Corporation 1620 Waukegan Road MCGAW PARK IL 60085

Re: K030975

Trade/Device Name: EXELTRA™ Plus 210 Dialyzer, Single Use Regulation Number: 21 CFR 8876.5860 Regulation Name: High permeability hemodialysis system Regulatory Class: II Product Code: 78 KDI Dated: March 27, 2003 Received: March 28, 2003

Dear Mr. Curtin:

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 (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.

3

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 C Brogdon

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

Enclosure

4

K030975 510(k) Number (if known):_____________________________________________________________________________________________________________________________________________________

Device Name: EXELTRA™ Plus Dialyzer

Indications For Use:

Hemodialysis with the EXELTRA™ Plus Dialyzer is indicated for patients with acute or Flonic renal failure when conservative therapy is judged to be inadequate. It also may be indicated in the treatment of patients intoxicated with poisons or drugs.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

David R.
(Division Sign-Off)
Division of Reproductive, Abdominal, and Radiological Devices
510(k) NumberK030945
Prescription UseOROver-The-Counter Use
(Per 21 CFR 801.109)

G:\SIOK\Exclura Plus 210 Single Use Dialyzcrs\submission\Indications for Use Statement