K Number
K050312
Date Cleared
2005-05-09

(90 days)

Product Code
Regulation Number
880.5725
Panel
HO
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Amigo Insulin Pump is intended for the subcutaneous infusion of insulin.

Device Description

The Amigo Insulin Pump is a small, lightweight, battery-operated programmable Insulin infusion pump. The pump houses a replaceable Nipro GlucoPro™ single-use insulin syringe containing up to 300 units of U-100 insulin. Programming is accomplished via a keypad and LCD display. A microcomputer controls the rotation of a stepper-motor which is connected to a gear reduction assembly. The output of the reduction assembly turns a lead-screw which moves a linear piston. The piston mechanically engages the plunger of the insulin syringe, and the programmed amount of insulin is dispensed through an external seal and luer lock connector to an infusion set.

AI/ML Overview

This document is a 510(k) summary for the Amigo Insulin Pump. It describes the device and its intended use, and argues for its substantial equivalence to a previously cleared device, the GlucoPro EVA Pump (K013309).

Based on the provided information, the following answers can be given:

1. A table of acceptance criteria and the reported device performance

The document does not provide acceptance criteria or detailed device performance metrics in the way one would typically find for an AI/software device undergoing validation studies with specific performance targets (e.g., sensitivity, specificity, accuracy).

Instead, the submission focuses on demonstrating substantial equivalence to a predicate device (GlucoPro EVA Pump K013309) by comparing key characteristics. The "performance" in this context refers to the functional equivalence of the Amigo Insulin Pump to the predicate device.

CharacteristicAcceptance Criteria (Predicate's Performance)Reported Device Performance (Amigo Insulin Pump)
Intended UseSubcutaneous infusion of insulinSubcutaneous infusion of insulin
Pump TypeLinear PistonLinear Piston
Control TechnologyMicroprocessorMicroprocessor
Insulin Reservoir3 mL (300 Units)3 mL (300 Units)
Insulin TypeU-100U-100
Power SourceOne 3 Volt lithium batteryOne 3 Volt lithium battery
Programmable Basal DeliveryYesYes
Programmable Bolus DeliveryYesYes
User NotificationAudible, visual, and vibrationAudible, visual, and vibration
Visual DisplayLCDLCD
Insulin Syringe / reservoirNipro GlucoProNipro GlucoPro
Infusion Set ConnectorStandard luer lockStandard luer lock

Study Proving Acceptance Criteria:

The "study" that proves the device meets the acceptance criteria is the 510(k) submission itself, which argues for substantial equivalence. It does so by directly comparing the Amigo Insulin Pump's specifications and features to those of the legally marketed predicate device, the GlucoPro EVA Pump (K013309). The FDA's letter (K050312) confirms that based on this comparison, the device is deemed substantially equivalent. This is not a clinical study in the traditional sense, but rather a regulatory comparison.

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

This information is not applicable/not provided in the given document. The submission is for a physical medical device (an insulin pump), not an AI/software device that would typically rely on a "test set" of data for performance evaluation in the context of AI. The "test" here is the comparison of device specifications to a predicate.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

This information is not applicable/not provided. As above, this is a physical device submission, not an AI/software validation involving expert ground truth for a test set.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

This information is not applicable/not provided.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

This information is not applicable/not provided. This type of study is relevant for AI-assisted diagnostic or decision-making tools, not for an insulin pump.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

This information is not applicable/not provided. The device is an insulin pump; it does not perform an "algorithm only" function in the way an AI diagnostic tool would. It is inherently a "human-in-the-loop" device in that a patient or caregiver programs and uses it.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

This information is not applicable/not provided. In the context of "substantial equivalence" for a physical device, the "ground truth" is established by the predicate device's cleared specifications and performance, which the new device aims to match. There isn't an external "ground truth" in the AI sense.

8. The sample size for the training set

This information is not applicable/not provided. The device is a physical insulin pump, not an AI model that undergoes training on a dataset.

9. How the ground truth for the training set was established

This information is not applicable/not provided.

§ 880.5725 Infusion pump.

(a)
Identification. An infusion pump is a device used in a health care facility to pump fluids into a patient in a controlled manner. The device may use a piston pump, a roller pump, or a peristaltic pump and may be powered electrically or mechanically. The device may also operate using a constant force to propel the fluid through a narrow tube which determines the flow rate. The device may include means to detect a fault condition, such as air in, or blockage of, the infusion line and to activate an alarm.(b)
Classification. Class II (performance standards).