(61 days)
Not Found
No
The summary describes a fluid removal system based on ultrafiltration and a clinician-selected rate, with no mention of AI, ML, or related concepts.
Yes
The device is indicated for ultrafiltration treatment of patients with fluid overload, which is a therapeutic intervention aimed at removing excess fluid to improve patient health.
No
The device description states its purpose is to "remove excess fluid from the patient in fluid overload by ultrafiltration of blood." This is a treatment, not a diagnostic function.
No
The device description explicitly states it is comprised of a console mounted on a cart, proprietary software, and accessories (catheters, extensions, blood pump circuit), indicating it includes significant hardware components beyond just software.
No, this device is not an IVD (In Vitro Diagnostic).
Here's why:
- IVD Definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body (like blood, urine, or tissue) to provide information about a person's health. This testing is done outside of the body (in vitro).
- Device Function: The Aquadex System 100 directly treats the patient by removing excess fluid from their blood through ultrafiltration. This is a therapeutic procedure performed on the patient's body, not a diagnostic test performed on a sample from the patient's body.
- Intended Use: The intended use is "temporary (up to eight hours) ultrafiltration treatment of patients with fluid overload," which is a treatment, not a diagnostic process.
The device description clearly outlines a system that interacts directly with the patient's blood circulation for therapeutic purposes.
N/A
Intended Use / Indications for Use
The System 100 is indicated for temporary (up to eight hours) ultrafiltration treatment of patients with fluid overload.
Product codes
78 KDI
Device Description
The Aquadex System 100 removes excess fluid from the patient in fluid overload by ultrafiltration of blood across a hollow-fiber hemofilter at the clinician selected rate. The system is comprised on a console mounted on a cart, proprietary software and accessories (venous access catheters, extensions and a blood pump circuit). Patient access is obtained via either peripheral or central venous veins.
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)
Bench testing was performed to validate the software change and to generate data in support of the labeling change which incorporates a catheter compatibility chart using the principles of ISO 14971:2000 "Medical devices - Application of risk management to medical devices. Data generated demonstrated the Aquadex System 100 continues to be safe and effective.
Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)
Not Found
Predicate Device(s)
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
Aquadex System 100 Adjustable Blood Flow Rate
APR 2 7 2004
Attachment C
K04-0489
510(k) Summary
Prepared on February 25, 2004
This 510(k) Summary is submitted in accordance with 21 CFR 807.92.
| Trade Names: | Aquadex™ System 100 (trademark pending) | |
|---|---|---|
| Manufacturer: | CHF Solutions, Inc., Suite 170 - 7601 Northland Drive, Brooklyn Park, MN | |
| 55428 | ||
| Official | ||
| Contact: | Amy Peterson | |
| Vice President, RA/QA/CR | Telephone: 763-463-4620 | |
| Fax: 763-463-4606 | ||
| Device | ||
| Generic Name: | Aquadex™ System 100 | |
| Classification: | High permeability dialysis systems - classified as Class II | |
| Predicate | ||
| Devices: | System 100 (K013733) | PRISMA ™ CFM Systems (K981681) |
| Device | ||
| Description: | The Aquadex System 100 removes excess fluid from the patient in fluid | |
| overload by ultrafiltration of blood across a hollow-fiber hemofilter at the | ||
| clinician selected rate. The system is comprised on a console mounted on | ||
| a cart, proprietary software and accessories (venous access catheters, | ||
| extensions and a blood pump circuit). Patient access is obtained via either | ||
| peripheral or central venous veins. | ||
| Indication | ||
| for Use: | System 100 is indicated for temporary (up to 8 hours) ultrafiltration | |
| treatment of patients with fluid overload. | ||
| Safety & | ||
| Performance: | Bench testing was performed to validate the software change and to | |
| generate data in support of the labeling change which incorporates a | ||
| catheter compatibility chart using the principles of ISO 14971:2000 "Medical | ||
| devices - Application of risk management to medical devices. Data | ||
| generated demonstrated the Aquadex System 100 continues to be safe and | ||
| effective. | ||
| Conclusion: | Based on the similar intended use, patient population, technology | |
| characteristics, and performance as assessed with bench testing the | ||
| software revision has been shown to be safe and effective for its intended | ||
| use. This product is substantially equivalent7 and considered acceptable for | ||
| the intended use. |
7 This document uses the term "substantial equivalent" as intended in 21 CFR 807.87 and not as defined in Title 36 of the U.S. Code.
1
Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract symbol that resembles an eagle or bird in flight, composed of three curved lines.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
APR 2 7 2004
Ms. Amy Peterson Vice-President RA/QA/CR CHF Solutions, Inc. Suite 170-7601 Northland Drive BROOKLYN PARK MN 55428
Re: K040489
Trade/Device Name: Aquadex System 100 and System 100 Ultrafiltration Catheter Regulation Number: 21 CFR §876.5860 Regulation Name: High permeability hemodialysis system Regulatory Class: II Product Code: 78 KDI Dated: April 1, 2004 Received: April 2, 2004
Dear Ms. Peterson:
We have reviewed your Scction 510(k) prematket 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 cither class II (Spccial 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 sct 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.
2
This letter will allow you to begin marketing your device as described in your Section 510(k) I ms letter will and wyou've FDA finding of substantial equivalence of your device to a legally prematication. " www.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 If you desko specific of Compliance at one of the following numbers, based on the regulation number at the top of the 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 Addition 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 mioritactor on 300 consumer 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
3
.
INDICATIONS FOR USE STATEMENT (Page 1 of 1)
510(k) Number (if know): ___K04 04 8 9
Device Name: System 100 and System 100 Ultrafiltration Catheter
FDA's Statement of the Indication For Use for Device:
The System 100 is indicated for temporary (up to eight hours) ultrafiltration treatment of patients with fluid overload.
(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)
Over-The-Counter Use
David R. Segerson
OR
(Division Sign-Off) Division of Reproductive, Abdominal, and Radiological D 510(k) Number