K Number
K050931
Manufacturer
Date Cleared
2005-06-15

(62 days)

Product Code
Regulation Number
880.5970
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The PowerPICC™ Catheters are intended for short or long term peripheral access to the central venous system for intravenous therapy and blood sampling.
The PowerPICC™ catheter is indicated for short or long term peripheral access to the central venous system for intravenous therapy and power injection of contrast media. For blood sampling, infusion or therapy, use a 4 French or larger catheter. The maximum recommended infusion rate is 5cc/sec. The maximum pressure of power injectors used with the PowerPICC catheter may not exceed 300 psi.

Device Description
  • The PowerPICC™ Catheters are open-ended radiopaque polyurethane catheters. .
  • Catheter size is 6 Fr DL with 50 cm usable length. ●
  • The catheter has a reverse taper design. ●
  • Catheter shaft tubing is marked with depth indicators, with "0" indicated to serve as a reference for the catheter insertion point.
  • Catheters are provided sterile in basic radiology PICC configurations. .
  • Purple colorants were added to the catheter materials to provide the catheter with an . appearance that allows the end user to differentiate the PowerPICC from other PICC catheters.
  • The catheter extension leg, junction and clamp ID tag were printed with markings to identify . the catheter as PowerPICC and to include information to facilitate proper use of the device.
AI/ML Overview

This 510(k) summary describes a medical device, the 6 Fr DL PowerPICC™ Catheter, and its substantial equivalence to predicate devices. It does not contain information about studies proving the device meets acceptance criteria, as is common for this type of submission which primarily focuses on demonstrating substantial equivalence to existing, cleared devices.

Therefore, many of the requested categories cannot be populated from the provided text.

Here's a breakdown of what can be extracted and what cannot:

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

The document states: "The 6 Fr DL PowerPICC™ catheter meets all the predetermined performance acceptance criteria of the testing performed..." and "Performance data gathered in design verification testing demonstrated that the 6 Fr DL PowerPICC™ catheter is substantially equivalent to the predicate 5 Fr SL PowerPICC™ catheter..."

However, the specific acceptance criteria and the corresponding reported performance values are not provided in this document. The document refers to testing performed "according to protocols based on the above referenced guidance document recommendations and standards, as well as in-house protocols," but it does not detail these protocols or their results.

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

This information is not provided in the document.

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 provided in the document. This is not a study involving human interpretation of data where ground truth would be established by experts.

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

This information is not provided in the document.

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 provided in the document. This device is a catheter, not an AI-assisted diagnostic tool, so an MRMC study with AI assistance would not be applicable.

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

This information is not provided in the document. As this is not an AI algorithm, standalone performance as described for AI devices is not relevant.

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

This information is not provided in the document. For a physical device like a catheter, "ground truth" would relate to its physical and functional performance against engineering specifications and international standards, rather than diagnostic accuracy.

8. The sample size for the training set

This is not applicable as this is a physical medical device, not an AI/ML algorithm that requires a training set.

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

This is not applicable for the same reason as above.


Summary of available information:

CategoryInformation from Document
1. Acceptance Criteria and Reported Device PerformanceAcceptance Criteria: Not explicitly detailed, but implied to be "predetermined performance acceptance criteria" based on FDA guidance and international standards (ISO 10555-1:1997, ISO 10555-3:1997, AAMI/ANSI/ISO 11135:1994, and FDA's Guidance on Premarket Notification [510(k)] Submission for Short-Term and Long-Term Intravascular Catheters). Reported Performance: "The 6 Fr DL PowerPICC™ catheter meets all the predetermined performance acceptance criteria of the testing performed..." and "Performance data gathered in design verification testing demonstrated that the 6 Fr DL PowerPICC™ catheter is substantially equivalent to the predicate 5 Fr SL PowerPICC™ catheter, and the risks associated with use of the new device were found acceptable when evaluated by FMEA." Specific performance metrics and their values are not provided.
2. Sample size and Data Provenance (test set)Not provided.
3. Number and Qualifications of Experts (for ground truth)Not applicable/Not provided. (Ground truth in this context would be related to engineering specifications and performance, not expert interpretation of data).
4. Adjudication Method (test set)Not applicable/Not provided.
5. MRMC Comparative Effectiveness Study (AI assist)Not applicable. This is a physical medical device, not an AI-assisted diagnostic tool.
6. Standalone Performance (algorithm only)Not applicable. This is a physical medical device.
7. Type of Ground Truth UsedNot explicitly stated in terms of "ground truth" as it would be for diagnostic AI. For a physical device, performance is typically measured against established engineering specifications, material properties, and functionality requirements outlined in the referenced international standards and guidance documents.
8. Sample Size for Training SetNot applicable. This is a physical medical device, not an AI/ML algorithm.
9. How Ground Truth for Training Set was EstablishedNot applicable.

Conclusion:

The provided 510(k) summary for the 6 Fr DL PowerPICC™ Catheter asserts that the device meets its predetermined performance acceptance criteria through design verification testing. This testing demonstrated substantial equivalence to predicate devices, and risks were assessed with FMEA. However, the document does not detail the specific acceptance criteria, the quantitative results of the performance testing, the sample sizes used, or the specifics of how the "ground truth" (in the context of device performance) was established beyond referencing industry standards and internal protocols. This level of detail is typical for a 510(k) summary, which focuses on demonstrating substantial equivalence rather than providing a detailed study report.

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K050931/

6 Fr DL PowerPICC™ Special 510(k)

Section 6

JUN 1 5 2005

510(k) Summary

6 Fr DL PowerPICC™ Catheter

510(k) Summary of Safety and Effectiveness Information 21CFR 807.92

Submitter Information 6. I

Submitter Name:Bard Access Systems, Inc. (BAS)
[Subsidiary of C.R. Bard, Inc.]
Address:5425 W. Amelia Earhart Drive
Salt Lake City, UT 84116
Telephone Number:(801) 595-0700, Ext. 4903
Fax Number:(801) 595-5425
Contact Person:Peggy Keiffer
Date of Preparation:April 13, 2005

Device Name 6.2

Device Name:6 Fr DL PowerPICC™ Catheter
Trade Name:6 Fr DL PowerPICC™ Catheter
Common/Usual Name:Peripherally Inserted Central Catheter (PICC)
Classification Panel:General Hospital
Classification Name:80LJS - Long Term Intravascular Catheter
21 CFR 880.5970, Class II
Peripherally Inserted Central Catheter (PICC)

Predicate Device Name(s) 6.3

Device Name:5 Fr SL PowerPICC™ Catheter
Trade Name:5 Fr SL PowerPICC™ Catheter
Common/Usual Name:Peripherally Inserted Central Catheter (PICC)
Classification Name:Long Term Intravascular Catheter (80 LJS)
Premarket Notification:K033389, concurrence date - March 19, 2004
Device Name:Poly Per-Q-Cath PICC Catheter
Trade Name:Poly Per-Q-Cath PICC Catheter
Common/Usual Name:Peripherally Inserted Central Catheter (PICC)
Classification Name:Long Term Intravascular Catheter (80 LJS)
Premarket Notification:K034019, concurrence date - January 21, 2004

Device Description 6.4

  • The PowerPICC™ Catheters are open-ended radiopaque polyurethane catheters. .
  • Catheter size is 6 Fr DL with 50 cm usable length. ●
  • The catheter has a reverse taper design. ●
  • Catheter shaft tubing is marked with depth indicators, with "0" indicated to serve as a � reference for the catheter insertion point.
  • Catheters are provided sterile in basic radiology PICC configurations. .

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K050931/

6 Fr DL PowerPICC TM Special 510(k)

  • Purple colorants were added to the catheter materials to provide the catheter with an . appearance that allows the end user to differentiate the PowerPICC from other PICC catheters.
  • The catheter extension leg, junction and clamp ID tag were printed with markings to identify . the catheter as PowerPICC and to include information to facilitate proper use of the device.

Intended Use 6.5

The PowerPICC™ Catheters are intended for short or long term peripheral access to the central venous system for intravenous therapy and blood sampling.

The intended use has not changed.

Indications for Use 6.6

The indications for use have not changed from the predicate 5 Fr SL PowerPICC™ catheter (K033389).

The PowerPICC™ catheter is indicated for short or long term peripheral access to the central venous system for intravenous therapy and power injection of contrast media. For blood samoling, infusion or therapy, use a 4 French or larger catheter. The maximum recommended infusion rate is 5cc/sec. The maximum pressure of power injectors used with the PowerPICC catheter may not exceed 300 psi.

Summary of Technological Characteristics in Relation to the Predicate Device 6.7

Does the new device have the same technological characteristics, e.g. design, material, etc.?

Not in all regards. The 6 Fr DL PowerPICC™ catheter has some minor differences from the predicate 5 Fr SL PowerPICC™ catheter. However, the basic fundamental scientific technology of the catheter has not changed.

Could the new characteristics affect safety or effectiveness?

Yes. The new characteristics could affect safety or effectiveness of the device.

Do the new characteristics raise new types of safety and effectiveness questions?

No. There are no new types of issues of safety and effectiveness.

Do accepted scientific methods exist for assessing effects of the new characteristics?

Yes. The following FDA guidance documents and international standards were used to evaluate the device's performance:

  • Guidance on Premarket Notification [510(k)] Submission for Short-Term and Long-Term . Intravascular Catheters, March 16, 1995
  • ISO 10555-1:1997, Sterile, Single-Use Intravascular Catheters, General requirements ●
  • ISO 10555-1:1997, Sterile, Single-Use Intravascular Catheters, General requirements, . Amendment I
  • ISO 10555-3:1997, Sterile, Single-Use Intravascular Catheters, Central venous catheters .
  • AAMI/ANSI/ISO 11135:1994, Medical Devices Validation and Routine Control of Ethylene . Oxide Sterilization

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K057931

6 Fr DL PowerPICC™ Special 510(k)

No new design validation was required. The design validation for the predicate device covered all issues pertaining to the subject device

Biocompatibility requirements of ISO 10993 Biological Evaluation of Medical Devices Part-1: Evaluation and Testing and the FDA Modified ISO 10993 Test Profile for externally communicating, blood contacting, long-term devices were met. All materials used in the manufacture of the subject device were previously cleared for similar applications by Bard Access Systems.

Are performance data available to assess effects of new characteristics?

Yes. Verification and validation testing was performed according to protocols based on the above referenced guidance document recommendations and standards, as well as in accordance with inhouse protocols.

Do performance data demonstrate equivalence?

Yes. Performance data gathered in design verification testing demonstrated that the 6 Fr DL PowerPICC™ catheter is substantially equivalent to the predicate 5 Fr SL PowerPICC™ catheter, and the risks associated with use of the new device were found acceptable when evaluated by FMEA.

6.8 Conclusion

The 6 Fr DL PowerPICC™ catheter meets all the predetermined performance acceptance criteria of the testing performed and, based on FDA's decision tree, is substantially equivalent to the predicate device 5 Fr SL PowerPICC™ catheter, K033389, cleared March, 2004 and the Poly Per-Q-Cath PICC Catheters, cleared under K034019.

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized caduceus symbol, which is a staff with two snakes entwined around it. The text "DEPARTMENT OF HEALTH AND HUMAN SERVICES - USA" is arranged in a circular pattern around the caduceus symbol. The logo is black and white.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUN 1 5 2005

Ms. Peggy Keiffer Senior Regulatory Affairs Manager Bard Access System, Incorporated 5425 West Amelia Earhart Drive Salt Lake City, Utah 84116

Re: K050931

Trade/Device Name: 6 Fr DL PowerPICCTM Catheter Regulation Number: 21 CFR 880.5970 Regulation Name: Percutaneous, Implanted, Long-term Intravascular Catheter Regulatory Class: II Product Code: LJS Dated: April 28, 2005 Received: May 17, 2005

Dear Ms. Keiffer:

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.

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Page 2 - Ms. Keiffer

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,

Sustie y. Mchale Dus.

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

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K 050431

6 Fr DL PowerPICC™M Special 510(k)

Section 1.2

Indications for Use Statement

510(k) Number (if known):

Device Name: 6 Fr DL PowerPICCTN Catheter

Indications For Use:

The PowerPICC™ catheter is indicated for short or long term peripheral access to the central venous system for intravenous therapy and power injection of contrast media. For blood sampling, infusion or therapy, use a 4 French or larger catheter. The maximum recommended infusion rate is 5cc/sec. The maximum pressure of power injectors used with the PowerPICC catheter may not exceed 300 psi.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ (Part 21 CFR 801 Subpart 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)

Chr. V. Amm

(Division Sign-Off) Division of Anesthesiology, General Hospital, Infection Control, Dental Devices

510(k) Number: k45993i

§ 880.5970 Percutaneous, implanted, long-term intravascular catheter.

(a)
Identification. A percutaneous, implanted, long-term intravascular catheter is a device that consists of a slender tube and any necessary connecting fittings, such as luer hubs, and accessories that facilitate the placement of the device. The device allows for repeated access to the vascular system for long-term use of 30 days or more, and it is intended for administration of fluids, medications, and nutrients; the sampling of blood; and monitoring blood pressure and temperature. The device may be constructed of metal, rubber, plastic, composite materials, or any combination of these materials and may be of single or multiple lumen design.(b)
Classification. Class II (special controls) Guidance Document: “Guidance on Premarket Notification [510(k)] Submission for Short-Term and Long-Term Intravascular Catheters.”