K Number
K041845
Device Name
NEXUS PAV LUER LOCK DEVICE, MODEL NIS-4
Manufacturer
Date Cleared
2004-08-24

(47 days)

Product Code
Regulation Number
880.5440
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Nexus PAV TM Luer Lock (NIS-4) is to be used for the delivery of drugs and fluids as an accessory to intravascular administration sets. The Nexus PAV TM Luer Lock Device (NIS-4) may aid in the prevention of needle stick injuries.
Device Description
Not Found
More Information

Not Found

Not Found

No
The summary describes a mechanical luer lock device for fluid delivery and needle stick prevention, with no mention of AI or ML.

No
The device is described as an accessory for the delivery of drugs and fluids and aids in the prevention of needle stick injuries. It does not directly treat or mitigate a disease or condition.

No

The intended use describes the device as being for the "delivery of drugs and fluids as an accessory to intravascular administration sets" and aiding "in the prevention of needle stick injuries." There is no mention of diagnosis.

No

The intended use describes a physical luer lock device, which is a hardware component used for fluid delivery. There is no mention of software in the provided text.

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

Here's why:

  • Intended Use: The intended use is for the "delivery of drugs and fluids as an accessory to intravascular administration sets" and to "aid in the prevention of needle stick injuries." This describes a device used in vivo (within the body) for administering substances and for safety, not for testing samples in vitro (outside the body) to diagnose conditions.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring specific analytes
    • Providing diagnostic information

Therefore, the Nexus PAV TM Luer Lock (NIS-4) is a medical device used for drug/fluid delivery and safety, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Nexus PAV TM Luer Lock (NIS-4) is to be used for the delivery of drugs and fluids as an accessory to intravascular administration sets. The Nexus PAV TM Luer Lock Device (NIS-4) may aid in the prevention of needle stick injuries.

Product codes

FPA

Device Description

Not Found

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)

Not Found

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

Not Found

Predicate Device(s)

Not Found

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 880.5440 Intravascular administration set.

(a)
Identification. An intravascular administration set is a device used to administer fluids from a container to a patient's vascular system through a needle or catheter inserted into a vein. The device may include the needle or catheter, tubing, a flow regulator, a drip chamber, an infusion line filter, an I.V. set stopcock, fluid delivery tubing, connectors between parts of the set, a side tube with a cap to serve as an injection site, and a hollow spike to penetrate and connect the tubing to an I.V. bag or other infusion fluid container.(b)
Classification. Class II (special controls). The special control for pharmacy compounding systems within this classification is the FDA guidance document entitled “Class II Special Controls Guidance Document: Pharmacy Compounding Systems; Final Guidance for Industry and FDA Reviewers.” Pharmacy compounding systems classified within the intravascular administration set are exempt from the premarket notification procedures in subpart E of this part and subject to the limitations in § 880.9.

0

Image /page/0/Picture/1 description: The image shows the seal of the U.S. Department of Health & Human Services. The seal is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is an abstract symbol that resembles an eagle or bird-like figure with three curved lines representing its wings or body.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG 2 4 2004

Mr. Al Boedeker Director, Regulatory Affairs/Quality Assurance Nexus Medical, LLC 11315 Strang Line Road Lenexa, Kansas 66215

Re: K041845

Trade/Device Name: Nexus PAV™ Luer Lock Device (NIS-4) Regulation Number: 880.5440 Regulation Name: Intravascular Administration Set Regulatory Class: II Product Code: FPA Dated: August 18, 2004 Received: August 19, 2004

Dear Mr. Boedeker:

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 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 Eederal Register.

1

Page 2 - Mr. Boedeker

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 fincan that 177. Ind. mace statutes and regulations administered by other Federal agencies. or the Act of ally a oder a requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice and fishing (21 CFR Part 807), abolity systems (QS) regulation (21 CFR Part 820); and if requirements as set form in the quadisation 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) This letter will anow you to overnment of your device of your device of your device to a premarket notification. - 11 your 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), If you desire specific at not 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 may obtain other generational 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

Sincercly yours,

Chiu Lin, Ph.D.

Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

KCH1745

Indications for Use Statement

Applicant:Nexus Medical LLC
510(k) Number (if known):K041845
Device Name:Nexus PAV TM Luer Lock (NIS-4)
Indications For Use:The Nexus PAV TM Luer Lock (NIS-4) is to be used for the delivery of drugs and fluids as an accessory to intravascular administration sets. The Nexus PAV TM Luer Lock Device (NIS-4) may aid in the prevention of needle stick injuries.
Prescription Use
(Part 21 CFR 801 Subpart D)X
AND/OROver-The -Counter Use
(21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

(Division Sign-Off)

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

510(k) Number: K041845

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