K Number
K033149
Device Name
ULTIMATE PROFESSIONAL CONTINUOUS FLOW COLONIC SYSTEM
Date Cleared
2004-03-23

(175 days)

Product Code
Regulation Number
876.5220
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
This device is intended for colon cleansing when medically indicated, such as before radiological or endoscopic examinations.
Device Description
This colonic irrigation system is a device intended to instill water into the colon through a nozzle inserted into the rectum to cleanse (evacuate) the contents of the lower colon. The system is designed to allow evacuation of the contents of the colon during the administration of the colonic irrigation. The device consists of a container for fluid connected to the nozzle via tubing and includes a system which enables the temperature, and gravity induced flow of water through the nozzle to be controlled. The device includes a console-type toilet and necessary fittings to allow the device to be connected to water and sewer pipes. This device uses water that comes from household type hot and cold outlets.
More Information

No
The device description focuses on mechanical and fluid control aspects, and there are no mentions of AI, ML, or related concepts in the provided text.

Yes.
The device is intended for colon cleansing when medically indicated (before radiological or endoscopic examinations), which classifies it as a therapeutic device.

No
Explanation: The device is intended for colon cleansing, which is a therapeutic or preparatory procedure, not for diagnosing a medical condition.

No

The device description clearly outlines physical components such as a container for fluid, tubing, a nozzle, a console-type toilet, and fittings, indicating it is a hardware-based medical 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 colon cleansing when medically indicated, such as before radiological or endoscopic examinations." This is a physical procedure performed on the body, not a test performed on a sample taken from the body.
  • Device Description: The description details a system for instilling water into the colon and allowing evacuation. This is a mechanical process for cleansing, not a diagnostic test.
  • Lack of IVD Characteristics: The description does not mention any analysis of biological samples (like blood, urine, or tissue), chemical reactions, or diagnostic measurements.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device's function is purely for physical cleansing.

N/A

Intended Use / Indications for Use

This device is intended for colon cleansing when medically indicated, such as before radiological or endoscopic examinations.

Product codes

76 KPL

Device Description

This colonic irrigation system is a device intended to instill water into the colon through a nozzle inserted into the rectum to cleanse (evacuate) the contents of the lower colon. The system is designed to allow evacuation of the contents of the colon during the administration of the colonic irrigation. The device consists of a container for fluid connected to the nozzle via tubing and includes a system which enables the temperature, and gravity induced flow of water through the nozzle to be controlled. The device includes a console-type toilet and necessary fittings to allow the device to be connected to water and sewer pipes. This device uses water that comes from household type hot and cold outlets.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

colon

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)

Not Found

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

Not Found

Predicate Device(s)

K003720

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.5220 Colonic irrigation system.

(a)
Identification. A colonic irrigation system is a device intended to instill water into the colon through a nozzle inserted into the rectum to cleanse (evacuate) the contents of the lower colon. The system is designed to allow evacuation of the contents of the colon during the administration of the colonic irrigation. The device consists of a container for fluid connected to the nozzle via tubing and includes a system which enables the pressure, temperature, or flow of water through the nozzle to be controlled. The device may include a console-type toilet and necessary fittings to allow the device to be connected to water and sewer pipes. The device may use electrical power to heat the water. The device does not include the enema kit (§ 876.5210).(b)
Classification. (1) Class II (performance standards) when the device is intended for colon cleansing when medically indicated, such as before radiological or endoscopic examinations.(2) Class III (premarket approval) when the device is intended for other uses, including colon cleansing routinely for general well being.
(c)
Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the Food and Drug Administration on or before December 26, 1996 for any colonic irrigation system described in paragraph (b)(2) of this section that was in commercial distribution before May 28, 1976, or that has, on or before December 26, 1996 been found to be substantially equivalent to a colonic irrigation system described in paragraph (b)(2) of this section that was in commercial distribution before May 28, 1976. Any other colonic irrigation system shall have an approved PMA in effect before being placed in commercial distribution.

0

K033 49 Premarket Notification - Ultimate Conce

MAR 2 3 2004

Ultimate Concepts Inc.

7835 South 1300 East Sandy, Utah 84094 Phone 800-682-3241 or 801-566-3214

SUMMARY

| Submitter's name:
Address: | Ultimate Concepts, Inc.
7835 South 1300 East
Sandy, Utah 84094 |
|-------------------------------|----------------------------------------------------------------------|
| Phone:
Fax number: | 800-632-3241
801-566-7152 |
| Name of contact person: | Grace Holland
Regulatory Specialists, Inc
3722 Ave, Sausalito |

Date the summary was prepared: September 8, 2003

| Name of the device: | Ultimate Professional Continuous Flow
Colonic System |
|----------------------------|---------------------------------------------------------|
| Trade or proprietary name: | Ultimate Professional Continuous Flow
Colonic System |
| Common or usual name: | Colonic Irrigation System |
| Classification name: | Colonic Irrigation System |

Irvine, CA 92606

Phone: 949-262-0411 fax: 949-552-2821

The legally marketed device to which we are claiming equivalence [807.92(a)(3)]:

Angel of Water, Colon Hydrotherapy System, manufactured by Lifestream Purification Systems. Reference K003720

Description of the device:

This colonic irrigation system is a device intended to instill water into the colon through a nozzle inserted into the rectum to cleanse (evacuate) the contents of the lower colon. The system is designed to allow evacuation of the contents of the colon during the administration of the colonic irrigation. The device consists of a container for fluid connected to the nozzle via tubing and includes a system which enables the temperature, and gravity induced flow of water through the nozzle to be controlled. The device includes a console-type toilet and

1

necessary fittings to allow the device to be connected to water and sewer pipes. This device uses water that comes from household type hot and cold outlets.

Indications:

This device is intended for colon cleansing when medically indicated, such as before radiological or endoscopic examinations.

Summary of the technological characteristics of our device compared to the predicate device:

The Angel of Water, K003720 and Ultimate Professional Continuous Flow Colonic System were compared in the following areas and found to have similar technological characteristics and to be equivalent.

Intended use Target Population Design Performance Where Used

2

Image /page/2/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS). The seal features a stylized eagle with three overlapping wings, representing the department's mission to protect and promote the health and well-being of all Americans. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" are arranged in a circular pattern around the eagle.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR 2 3 2004

Ultimate Concepts, Inc. c/o Ms. Grace Holland Regulatory Consultant Regulatory Specialists, Inc. 3722 Ave. Sausalito IRVINE CA 92606

Re: K033149

Trade/Device Name: Ultimate Professional Continuous Flow Colonic System Regulation Number: 21 CFR §876.5220 Regulation Name: Colonic irrigation system Regulatory Class; II Product Code: 76 KPL Dated: January 29, 2004 Received: February 2, 2004

·Dear Ms. Holland:

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 Section 510(k) I his letter will anow you to ough finding of substantial equivalence of your device to a legally prematication: "Privation: "Privesults 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 If you desire spositiv acceptiance at one of the following numbers, based on the regulation number at the top of the letter:

8xx. Ixxx(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 Other or complanos as (2005) was a mart 807.97) you may obtain. Other general information on your responsibilities under the Act may be obtained from the Division of Small miconnation on your volumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsmaldsmamain.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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Page 1 of of __

510(k) Number (if known):_____________________________________________________________________________________________________________________________________________________

Device Name: Ultimate Professional Continuous Flow Colonic System

Indications For Use:

This device is intended for colon cleansing when medically indicated, such as before radiological or endoscopic examinations.

(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 (Optional Format 1-2-96)

David G. Seymann
(Division Sign-Off)

Division of Reproductive, Abdominal, and Radiological Devices 510(k) Number