K Number
K043207
Device Name
OZONE GENERATOR
Date Cleared
2005-11-04

(350 days)

Product Code
Regulation Number
876.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The O3Z Ozone System is an optional accessory for the Solution Delivery Systems (SDS) manufactured by GE Infrastructure, Water & Process Technologies and is intended to be used for disinfection of the SDS bicarb mixing and distribution system. The mix tank of the SDS system is filled with either RO or deionized water and the mix tank ozone concentration is increased to 0.70 mg/L. The solution is then distributed to the distribution tank of the SDS system. From the distribution tank, the ozonated water is distributed throughout the distribution loop of the SDS system until a minimum ozone concentration level of 0.30 mg/L is established at the end of the SDS bicarb distribution loop. The solution is then recirculated for a minimum of 15 minutes throughout the distribution system. To complete the disinfection process, the system is then rinsed with RO or deionized water until the system is residual free of ozone.
Device Description
The Ozone Generating System attaches to the Solution Delivery System (SDS) through a valve bypass system and an injector. It is wall mounted in the vicinity of the SDS and is connected to the injector, which is installed in the output piping of the mix pump. The SDS mix tank is filled with RO or DI water; the bypass valves are manually configured for ozone production and then the mix pump is started, causing the injector to draw O3/air mixture into solution. When the proper concentrations of ozone are achieved, the ozonated water is re-circulated throughout the mixing and delivery system to disinfect the fluid path.
More Information

No
The description focuses on a chemical disinfection process using ozone generation and distribution, with no mention of AI or ML algorithms for control, analysis, or decision-making.

No.
The "Intended Use" clearly states that the device is "intended to be used for disinfection of the SDS bicarb mixing and distribution system," which is a system for preparing and delivering solutions, not for treating a patient or a disease. The device disinfects equipment, not a therapeutic target.

No

The device is described as an "O3Z Ozone System" that is "intended to be used for disinfection of the SDS bicarb mixing and distribution system." Its purpose is to generate ozonated water to clean the system, not to diagnose any medical condition.

No

The device description clearly outlines a physical system involving an ozone generator, valve bypass system, injector, and connections to the SDS system, indicating it is a hardware device.

Based on the provided information, the O3Z Ozone System is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use is clearly stated as "disinfection of the SDS bicarb mixing and distribution system." This system is used to prepare and deliver solutions, likely for medical or industrial processes, but the ozone system's purpose is to clean the equipment itself, not to perform a diagnostic test on a biological sample.
  • Device Description: The description details how the system generates and introduces ozone into the water within the SDS system for disinfection. It does not describe any interaction with biological samples for diagnostic purposes.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring analytes in biological samples
    • Providing information for the diagnosis, monitoring, or treatment of a disease or condition in a patient.
  • Predicate Device: The predicate device listed, K873200 Karlson Ozone Sterilizer, further supports that this device is for sterilization/disinfection purposes, not in vitro diagnostics.

In summary, the O3Z Ozone System is a disinfection system for equipment, not a device used to perform diagnostic tests on biological samples. Therefore, it does not fit the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The O3Z Ozone System is an optional accessory for the Solution Delivery Systems (SDS) manufactured by GE Infrastructure, Water & Process Technologies, and is intended to be used for disinfection of the SDS bicarb mixing and distribution system. The mix tank of the SDS system is filled with either RO or deionized water and the mix tank ozone concentration is increased to 0.70 mg/L. The solution is then distributed to the distribution tank of the SDS system. From the distribution tank, the ozonated water is distributed throughout the distribution loop of the SDS system until a minimum ozone concentration level of 0.30 mg/L is established at the end of the SDS bicarb distribution loop. The solution is then recirculated for a minimum of 15 minutes throughout the distribution system. To complete the disinfection process, the system is then rinsed with RO or deionized water until the system is residual free of ozone.

Product codes (comma separated list FDA assigned to the subject device)

FIN, NII

Device Description

The Ozone Generating System attaches to the Solution Delivery System (SDS) through a valve bypass system and an injector. It is wall mounted in the vicinity of the SDS and is connected to the injector, which is installed in the output piping of the mix pump. The SDS mix tank is filled with RO or DI water; the bypass valves are manually configured for ozone production and then the mix pump is started, causing the injector to draw O3/air mixture into solution. When the proper concentrations of ozone are achieved, the ozonated water is re-circulated throughout the mixing and delivery system to disinfect the fluid path.

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)

Testing of the ozone generator demonstrated that the disinfection process was effective, reliable and consistent in reducing microorganisms with high total organism counts to acceptable levels after disinfection when used in accordance with the Operation and Maintenance Manual for the Ozone Generating System.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K873200

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

K830575

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

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

K043207

Image /page/0/Picture/2 description: The image shows the General Electric (GE) logo. The logo consists of the letters "GE" in a stylized, cursive font, enclosed within a circle. There are three decorative swirls or flourishes evenly spaced around the outer edge of the circle. The logo is black and white.

GE Infrastructure Water & Process Technologies

510(k) SUMMARY

DATE PREPARED:

November 2, 2005

SUBMITTER 1.

GE Infrastructure, Water & Process Technologies 5951 Clearwater Drive Minnetonka, MN 55343-8995

CONTACT PERSON 2.

Name: Charlene Nash Phone: (952) 988-6359 Fax: (952) 988-6136 Email: Charlene.nash@ge.com

DEVICE IDENTIFICATION 3.

Ozone Generator/Ozone Generating System Common Name:

Trade Name/Proprietary Name:

O3Z Ozone System used on the Solution Delivery Systems (SDS) manufactured by GE Infrastructure, Water & Process Technologies

CLASSIFICATION NAME AND REFERENCE 4.

Classification Names: Tank, Holding, Dialysis and Accessories

Classification: Class II, 21 CFR 876.5820 Panel: Gastroenterology Product Code: FIN

PREMARKET NOTIFICATION NUMBER: K043207 ട.

General Electric Company 5951 Clearwater Drive Minnetonko, MN 55343-8995 USA

T 952-933-2277 952-988-6056 F

Image /page/0/Picture/21 description: The image shows the General Electric (GE) logo. The logo consists of the letters 'G' and 'E' intertwined within a circle. The circle has decorative swirls around its perimeter, giving it a classic and recognizable appearance.

Poge 1 of 2

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Image /page/1/Picture/0 description: The image shows the General Electric (GE) logo. The logo consists of the letters 'G' and 'E' intertwined in a stylized, cursive font. The letters are white and set against a black circular background. The circle has three white decorative elements around its perimeter.

  • The O3Z Ozone System is an optional accessory for the INDICATION FOR USE: ട. Solution Delivery Systems (SDS) manufactured by GE Infrastructure, Water & Process Technologies, and is intended to be used for disinfection of the SDS bicarb mixing and distribution system. The mix tank of the SDS system is filled with either RO or deionized water and the mix tank ozone concentration is increased to 0.70 mg/L. The solution is then distributed to the distribution tank of the SDS system. From the distribution tank, the ozonated water is distributed throughout the distribution loop of the SDS system until a minimum ozone concentration level of 0.30 mg/L is established at the end of the SDS bicarb distribution loop. The solution is then recirculated for a minimum of 15 minutes throughout the distribution system. To complete the disinfection process, the system is then rinsed with RO or deionized water until the system is residual free of ozone.
  • The Ozone Generating System attaches to the Solution 7. DEVICE DESCRIPTION: Delivery System (SDS) through a valve bypass system and an injector. It is wall mounted in the vicinity of the SDS and is connected to the injector, which is installed in the output piping of the mix pump. The SDS mix tank is filled with RO or DI water; the bypass valves are manually configured for ozone production and then the mix pump is started, causing the injector to draw O3/air mixture into solution. When the proper concentrations of ozone are achieved, the ozonated water is re-circulated throughout the mixing and delivery system to disinfect the fluid path.
  • STATEMENT OF SUBSTANTIAL EQUIVALENCE: The ozone generator for system 8. disinfection is substantially equivalent in technological characteristics of the Karlson Ozone Sterilizer (K873200). It is substantially equivalent in intended use to Minncare®, which is commonly used in hemodialysis clinics to disinfect the reverse osmosis water purification equipment and the water distribution loop and Renalin® (K830575), another common disinfectant used in dialysis clinics primarily to reprocess dialyzers and disinfect dialysis machines.

PERFORMANCE: SAFETY AND EFFECTIVENESS INFORMATION 9.

Testing of the ozone generator demonstrated that the disinfection process was effective, reliable and consistent in reducing microorganisms with high total organism counts to acceptable levels after disinfection when used in accordance with the Operation and Maintenance Manual for the Ozone Generating System.

Image /page/1/Picture/7 description: The image shows the General Electric (GE) logo. The logo consists of the letters 'G' and 'E' intertwined in a stylized, cursive font. The letters are enclosed within a circular border that has small, teardrop-shaped embellishments around its perimeter. The logo is presented in black and white.

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General Electric Company 5951 Clearwater Drive Minnetonka, MN 55343-8995

952-933-2277 952-988-6056

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains an abstract image of an eagle. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged around the perimeter of the circle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV 0 4 2005

Ms. Charlene Nash Quality Assurance & Regulatory Affairs Manager GE Infrastructure Water & Process Technologies GE Osmonics, Minnetonka Medical Operations 5951 Clearwater Drive Minnetonka, Minnesota 55343

Re: K043207

Trade/Device Name: 03Z 0Zone System Regulation Number: 21 CFR 876.5820 Regulation Name: Hemodialysis System and Accessories Regulatory Class: II Product Code: NII Dated: October 14, 2005 Received: October 19, 2005

Dear Ms. Nash:

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 Federal Register.

3

Page 2 - Ms. Nash

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 (240) 276-0115. 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 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/industry/support/index.html.

Sincerely yours.

Chiu Lin, Ph.D.

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

4

GE Infrastructure, Water & Process Technologies 5951 Clearwater Drive Minnetonka, MN 55343-8995

510(k) Number (if known): K043207

Device Name:

OzZ Ozone System used on the Solution Delivery Systems (SDS) manufactured by GE Infrastructure, Water & Process Technologies

Indications for Use Statement

The OzZ Ozone System is an optional accessory for the Solution Delivery Systems (SDS) manufactured by GE Infrastructure, Water & Process Technologies and is intended to be used for disinfection of the SDS bicarb mixing and distribution system. The mix tank of the SDS system is filled with either RO or deionized water and the mix tank ozone concentration is increased to 0.70 mg/L. The solution is then distributed to the distribution tank of the SDS system. From the distribution tank, the ozonated water is distributed throughout the distribution loop of the SDS sustem until a minimum ozone concentration level of 0.30 mg/L is established at the end of the SDS bicarb distribution loop. The solution is thenrecirculated for a minimum of 15 minutes throughout the distribution system. To complete the disinfection process, the system is then rinsed with RO or deionized water until the system is residual free of ozone.

Concurrence of CDRH, Office of Device Evoluation (ODE)

Prescription Use (Per 21 CFR 801.109) OR

Over-The-Counter Use X

Shiela A. Murphy, MD 10/3/00
Division Sign Off

sion of Anesthesiology. General Hospital Infection Control. Dantal Devices

510(k) Number: K043207