K Number
K040355
Device Name
VISION BLOOD CARDIOPLEGIA SYSTEM AND EXTRACORPORAL HEAT EXCHANGER WITH GBS COATING
Date Cleared
2004-03-15

(32 days)

Product Code
Regulation Number
870.4240
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Vision Blood Cardioplegia System with GBS™ coating is indicated for use in applications that require control of fluid temperature, such as blood or cardioplegia, typically in an extracorporeal circuit. The device may be used for normothermic or hypothermic applications. It is designed to operate at flow rates of one hundred (100) to six hundred (600) milliliters per minute for periods up to six (6.0) hours.
Device Description
The Gish Vision Blood Cardioplegia System with GBS™ coating consists of an extracorporeal heat exchanger and fluid administration set. The heat exchanger consists of a one piece, stainless steel bellows, configured heat exchanger as the primary element to effect heat exchange. This element is encased by a polycarbonate housing, which directs the blood through the outside convolutions of the stainless steel bellows, and therefore effects heat exchange while minimizing priming volume. All materials of the heat exchanger are biocompatible. The device allows for the monitoring of pressure and allows for trapping and removal of air. I he us not allow to the cludes an integral bubble trap, gross particulate filter (105 u) and Aaalonarely and evere designed to open in the event of excessive fluid pressure (600 mmHg) during use. Solutions are delivered to the patient through the extension line and appropriate cannula. Blood flow is driven by a roller pump connected through an extension line. The components of this system which have contact with the fluid path are sterile and nonpyrogenic. All blood contact materials of the Vision Blood Cardioplegia System with GBS™ coating are All Blood comatible and coated with a proprietary coating.
More Information

Not Found

No
The document describes a heat exchanger and fluid administration system with mechanical components and pressure monitoring. There is no mention of AI or ML in the intended use, device description, or performance studies.

Yes

The device is designed for “control of fluid temperature, such as blood or cardioplegia, typically in an extracorporeal circuit” which is a direct therapeutic intervention to manage patient physiology.

No
The device is described as an extracorporeal heat exchanger and fluid administration set used to control fluid temperature (blood or cardioplegia) during extracorporeal circulation. Its function is to facilitate heat exchange and fluid delivery, not to diagnose medical conditions or analyze biological data for diagnostic purposes.

No

The device description clearly outlines physical components like a heat exchanger, fluid administration set, stainless steel bellows, polycarbonate housing, bubble trap, and filter, indicating it is a hardware device with fluid contact.

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

Here's why:

  • Intended Use: The intended use describes a system for controlling the temperature of fluids (blood or cardioplegia) in an extracorporeal circuit. This is a therapeutic or supportive function, not a diagnostic one.
  • Device Description: The description details a heat exchanger and fluid administration set designed to manage fluid temperature and flow. It does not mention any components or processes related to analyzing biological samples to provide diagnostic information.
  • Lack of Diagnostic Elements: There is no mention of analyzing blood or other bodily fluids for diagnostic purposes, such as detecting biomarkers, identifying pathogens, or measuring physiological parameters for diagnosis.

The device is clearly designed for use in a medical procedure (likely cardiac surgery) to manage the temperature of fluids being circulated outside the body. This falls under the category of medical devices used for treatment or support, not in vitro diagnosis.

N/A

Intended Use / Indications for Use

The Gish Vision Blood Cardioplegia System with GBS™ coating is indicated for use in applications that require control of fluid temperature, such as blood or cardioplegia, typically in an extracorporeal circuit. The device may be used for normothermic or hypothermic applications. It is designed to operate at flow rates of one hundred (100) to six hundred (600) milliliters per minute for periods up to six (6.0) hours.

Product codes

DTR

Device Description

The Gish Vision Blood Cardioplegia System with GBS™ coating consists of an extracorporeal heat exchanger and fluid administration set. The heat exchanger consists of a one piece, stainless steel bellows, configured heat exchanger as the primary element to effect heat exchange. This element is encased by a polycarbonate housing, which directs the blood through the outside convolutions of the stainless steel bellows, and therefore effects heat exchange while minimizing priming volume. All materials of the heat exchanger are biocompatible.

The device allows for the monitoring of pressure and allows for trapping and removal of air. It includes an integral bubble trap, gross particulate filter (105 u) and are designed to open in the event of excessive fluid pressure (600 mmHg) during use. Solutions are delivered to the patient through the extension line and appropriate cannula. Blood flow is driven by a roller pump connected through an extension line.

The components of this system which have contact with the fluid path are sterile and nonpyrogenic.

All blood contact materials of the Vision Blood Cardioplegia System with GBS™ coating are biocompatible and coated with a proprietary coating.

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

The Gish Vision Blood Cardioplegia System with GBS™ Coating has been subjected to extensive safety, performance, and validations prior to release. Final testing for the systems demonstrated that the device meets all of its functional requirements and performance specifications.

Key Metrics

Not Found

Predicate Device(s)

K020106

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.4240 Cardiopulmonary bypass heat exchanger.

(a)
Identification. A cardiopulmonary bypass heat exchanger is a device, consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood or perfusion fluid flowing through the device.(b)
Classification. Class II (performance standards).

0

Summary

This summary of 510(k)-safety and effectiveness information is being submitted in accordance with the requirements of 21 CFR part 807.92.

    1. Company making the submission:
CompanyorCorrespondent (contract):
Name:Gish BioMedical, Inc.Delphi Consulting Group
Address:22942 Arroyo Vista
Rancho Santa Margarita
CA 92688-260011874 South Evelyn Circle
Houston, TX 77071-3404
Telephone:949-635-6240 voice
949-635-6294 fax832-285-9423 voice
832-615-3550 fax
Contact:Edward F. Waddell
Director RA/QA
edw@gishbiomedical.comJ. Harvey Knauss
Consultant
harvey@delphiconsulting.com
    1. Device:

| Proprietary Name: | Vision Blood Cardioplegia Sytem and Extracorporal Heat
Exchanger with GBS™ Coating |
|----------------------|---------------------------------------------------------------------------------------|
| Common Name: | Cardioplegia Heat Exchanger |
| Classification Name: | Cardiopulmonary Bypass heat exchanger |

    1. Predicate Devices:
      Gish Vision Blood Cardioplegia System and Extracorporal Heat Exchanger, Gish Biomedical, Inc., K020106.
    1. Classifications Names & Citations:
      21 CFR 870.4240, Cardiovascular bypass heat exchanger, Class II, DTR, Cardiovascular.
    1. Description:
      The Gish Vision Blood Cardioplegia System with GBS™ coating consists of an extracorporeal heat exchanger and fluid administration set. The heat exchanger consists of a one piece, stainless steel bellows, configured heat exchanger as the primary element to effect heat exchange. This element is encased by a polycarbonate housing, which directs the blood through the outside convolutions of the stainless steel bellows, and therefore effects heat exchange while minimizing priming volume. All materials of the heat exchanger are biocompatible.

The device allows for the monitoring of pressure and allows for trapping and removal of air. I he us not allow to the cludes an integral bubble trap, gross particulate filter (105 u) and Aaalonarely and evere designed to open in the event of excessive fluid pressure (600 mmHg) during use. Solutions are delivered to the patient through the extension line and appropriate cannula. Blood flow is driven by a roller pump connected through an extension line.

1

The components of this system which have contact with the fluid path are sterile and nonpyrogenic.

All blood contact materials of the Vision Blood Cardioplegia System with GBS™ coating are All Blood comatible and coated with a proprietary coating.

    1. Indications for use:
      The Gish Vision Blood Cardioplegia System with GBS™ coating is indicated for use in The Gist Vision Diood Oardloplegia Oyeem Prature, such as blood or cardioplegia, typically in
      applications that require control of fluid temperature, such as breathermin applications that require control of liaid tomporation of hypothermic or hypothermic an extracorpored circuit. The device maff on the hundred (100) to six hundred (600) applications: minute for periods up to six (6.0) hours.
    1. Contraindications:
      For heparin coated devices, heparin has been reported, on rare occasions, to induce For hepann coatied devices, hepant has boon reported, would be the buttingly thromocytopenia. Since patients undergoing caralopains.contributed by this device is systemically nepamized, and although the arream caution should be exercised when using very small in companson to the typroal dose as a sub-
  • Comparison: 8.
    The Gish Vision Blood Cardioplegia System with GBS™ coating has the same device characteristics as the predicate devices.

    1. Test Data:
      The Gish Vision Blood Cardioplegia System with GBS™ Coating has been subjected to The Gisli Vision Blood Oardloplogia Cystem Wall Books . Final testing for the systems
      extensive safety, performance, and validations prior to release. Final testing for the extensive salery, performance, and validation photographed that the device meets all of its functional requirements and performance specifications.
    1. Special Controls Section 514 of the ACT
      This submission complies with "Guidance for Cardiopulmonary Bypass Oxygenators 510(k) This submission complics with "Guidanto for Caracepain" and other Guidance and Standards listed in Tab 17.
    1. Literature Review:
      A review of literature pertaining to the safety and effectiveness has been conducted. A review of literature portaining to the can incorporated in the design of Gish Vision Blood Cardioplegia System with GBS™ Coating.
    1. Conclusions:
      The conclusion drawn from these tests is that Gish Vision Blood Cardioplegia System with The conclusion drawn from those fety and efficacy to its predicate device.

2

Image /page/2/Picture/2 description: The image shows the seal of the Department of Health & Human Services - USA. The seal is circular and contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES-USA" around the perimeter. In the center of the seal is an abstract image of an eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR 1 5 2004

Gish Biomedical, Inc. c/o Mr. J. Harvey Knauss Delphi Consulting Group 11874 South Evelyn Circle Houston, TX 77071

Re: K040355

K040355
Vision Blood Cardioplegia System and Extracorporal Heat Exchanger with GBS™ Coating Regulation Number: 21 CFR 870.4240 Regulation Name: Cardiopulmonary Bypass Heat Exchanger (Cardioplegia) Regulatory Class: Class II (two) Product Code: DTR Dated: February 10, 2004 Received: February 18, 2004

Dear Mr. Knauss:

We have reviewed your Section 510(k) premarket notification of intent to market the indication We have reviewed your Section 910(x) premained is substantially equivalent (for the indications
referenced above and have cletermined the device anarketed in interstate referenced and nave clecemined the arrest predicate devices marketed in interstate for use stated in the enclosure) to legally manced profits in enimal perior Amendments, or to
commerce prior to May 28, 1976, the enactment of the Federal Food. Drug commerce prior to May 28, 1970, the charger with the provisions of the Federal Food, Drug, devices that have been reciassified in accordance while approval application (PMA).
and Cosmetic Act (Act) that do not require approval of a provisions of the Act. The and Cosmetic Act (Act) that do not require approval controls provisions of the Act. The You may, merelore, market the device, subject to the gaments for annual registration, listing of
general controls provisions of the Act include requirements michreading and general controls provisions of the rice mericas requirems 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 in may be subject to such additional connois. Existing major regals In addition, FDA may
be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition be found in the Code of Poseral Regaring your device in the Federal Register.

3

Page 2 – Mr. J. Harvey Knauss

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. 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) 594-4646. 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" (21CFR Part 807.97) you may obtain. 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.

Duna R. lohner

( Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

Indications for Use

K040355 510(k) Number: Vision Blood and Extracorporal Heat Exchanger With GBS™ Device Name: Coating. The Vision Blood Cardioplegia System with GBS™ coating is Indications For Use: indicated for use in applications that require control of fluid temperature, such as blood or cardioplegia, typically in an extracorporeal circuit. The device may be used for normothermic or hypothermic applications. It is designed to operate at flow rates of one hundred (100) to six hundred (600) milliliters per minute for periods up to six (6.0) hours.

Prescription Use Yes (Part 21 CFR 801 Subplart D) AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Dune R. Lochner

(Division Sign-Off) Division of Cardiovascular Devices

510(k) Number_K0403555

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