K Number
K051814
Device Name
JMS SYSLOC MINI A.V. FISTULA NEEDLE SET AND APHERESIS NEEDLE SET
Date Cleared
2005-08-04

(30 days)

Product Code
Regulation Number
876.5540
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Use for temporary cannulation (non-implantable, less than 30 days) to vascular access for extracorporeal blood treatment. The device is intended for single use only and has an anti-stick feature integrated as part of the Needle Set which aids in prevention of needle-stick injuries.
Device Description
JMS SysLoc MINI™ A.V. Fistula & JMS SysLoc MINI™ Apheresis Needle Set is intended as non-implanted blood access device, which consists of flexible tube and needle with integrated sharps safety features as described in 21 CFR 876.5540. Just like the predicate device, JMS SysLoc MINI™ A.V. Fistula Needle Set & JMS SysLoc MINIT™ Apheresis Needle Set comes with a rotational feature and the needle is retracted with the wing sheath after deliberate release of secured external lock, and final locking is assured by an audible 'click' sound when the hub/tube is pulled rearwards. JMS SysLoc MINI™ A.V. Fistula Needle Set & JMS SysLoc MINI™ Apheresis Needle Set included in this 510(k) is a modification from the legally marketed device. JMS SysLoc® A.V. Fistula Needle Set & JMS SysLoc® Apheresis Needle Set. The SysLoc MINI™, is a 'mini' version of the predicate device (JMS SysLoc®) with modification made to reduce the overall length, so that the device is more user/patient friendly. Modifications are done accordinaly to the other components such as wing and hub in order to realize the intended device.
More Information

Not Found

No
The description focuses on mechanical features and modifications to a predicate device, with no mention of AI or ML.

No.
The device, a needle set, is for temporary vascular access and is used as part of extracorporeal blood treatment, but it does not intrinsically provide therapeutic treatment itself.

No

The device is described as a non-implanted blood access device used for temporary cannulation and extracorporeal blood treatment, which are therapeutic functions, not diagnostic.

No

The device description clearly outlines physical components like needles, tubes, wings, and hubs, indicating it is a hardware device, not software-only.

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

Here's why:

  • Intended Use: The intended use is for "temporary cannulation... to vascular access for extracorporeal blood treatment." This describes a device used to access the bloodstream for procedures like dialysis or apheresis, which are treatments performed on the blood outside the body.
  • Device Description: The description details a "non-implanted blood access device" consisting of a tube and needle with safety features. This aligns with a device used for accessing blood vessels.
  • Lack of IVD Characteristics: An IVD device is used to examine specimens (like blood, urine, or tissue) in vitro (outside the body) to provide information for diagnosis, monitoring, or screening. The provided text does not mention any analysis or testing of blood or other specimens. The device's function is solely to provide access to the vascular system.

Therefore, the device described is a vascular access device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

JMS SysLoc MINI™ A.V. Fistula Needle Set & JMS SysLoc MINI™ Apheresis Needle Set is intended for temporary cannulation (non-implantable, less than 30 days) to vascular access for extracorporeal blood treatment. The device is intended for single use only and has an anti-stick feature integrated as part of the Needle Set which aids in prevention of needle-stick injuries.

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

FIE, FOZ

Device Description

JMS SysLoc MINI™ A.V. Fistula & JMS SysLoc MINI™ Apheresis Needle Set is intended as non-implanted blood access device, which consists of flexible tube and needle with integrated sharps safety features as described in 21 CFR 876.5540. Just like the predicate device, JMS SysLoc MINI™ A.V. Fistula Needle Set & JMS SysLoc MINIT™ Apheresis Needle Set comes with a rotational feature and the needle is retracted with the wing sheath after deliberate release of secured external lock, and final locking is assured by an audible 'click' sound when the hub/tube is pulled rearwards. JMS SysLoc MINI™ A.V. Fistula Needle Set & JMS SysLoc MINI™ Apheresis Needle Set included in this 510(k) is a modification from the legally marketed device. JMS SysLoc® A.V. Fistula Needle Set & JMS SysLoc® Apheresis Needle Set. The SysLoc MINI™, is a 'mini' version of the predicate device (JMS SysLoc®) with modification made to reduce the overall length, so that the device is more user/patient friendly. Modifications are done accordinaly to the other components such as wing and hub in order to realize the intended device.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

vascular access

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 conducted to verify that the SysLoc MINI™ device is performing as intended to be a safe and effective medical device, data and reports are enclosed within this submission document.

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.

K030479

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.

Not Found

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

§ 876.5540 Blood access device and accessories.

(a)
Identification. A blood access device and accessories is a device intended to provide access to a patient's blood for hemodialysis or other chronic uses. When used in hemodialysis, it is part of an artificial kidney system for the treatment of patients with renal failure or toxemic conditions and provides access to a patient's blood for hemodialysis. The device includes implanted blood access devices, nonimplanted blood access devices, and accessories for both the implanted and nonimplanted blood access devices.(1) The implanted blood access device is a prescription device and consists of various flexible or rigid tubes, such as catheters, or cannulae, which are surgically implanted in appropriate blood vessels, may come through the skin, and are intended to remain in the body for 30 days or more. This generic type of device includes various catheters, shunts, and connectors specifically designed to provide access to blood. Examples include single and double lumen catheters with cuff(s), fully subcutaneous port-catheter systems, and A-V shunt cannulae (with vessel tips). The implanted blood access device may also contain coatings or additives which may provide additional functionality to the device.
(2) The nonimplanted blood access device consists of various flexible or rigid tubes, such as catheters, cannulae or hollow needles, which are inserted into appropriate blood vessels or a vascular graft prosthesis (§§ 870.3450 and 870.3460), and are intended to remain in the body for less than 30 days. This generic type of device includes fistula needles, the single needle dialysis set (coaxial flow needle), and the single needle dialysis set (alternating flow needle).
(3) Accessories common to either type include the shunt adaptor, cannula clamp, shunt connector, shunt stabilizer, vessel dilator, disconnect forceps, shunt guard, crimp plier, tube plier, crimp ring, joint ring, fistula adaptor, and declotting tray (including contents).
(b)
Classification. (1) Class II (special controls) for the implanted blood access device. The special controls for this device are:(i) Components of the device that come into human contact must be demonstrated to be biocompatible. Material names and specific designation numbers must be provided.
(ii) Performance data must demonstrate that the device performs as intended under anticipated conditions of use. The following performance characteristics must be tested:
(A) Pressure versus flow rates for both arterial and venous lumens, from the minimum flow rate to the maximum flow rate in 100 milliliter per minute increments, must be established. The fluid and its viscosity used during testing must be stated.
(B) Recirculation rates for both forward and reverse flow configurations must be established, along with the protocol used to perform the assay, which must be provided.
(C) Priming volumes must be established.
(D) Tensile testing of joints and materials must be conducted. The minimum acceptance criteria must be adequate for its intended use.
(E) Air leakage testing and liquid leakage testing must be conducted.
(F) Testing of the repeated clamping of the extensions of the catheter that simulates use over the life of the device must be conducted, and retested for leakage.
(G) Mechanical hemolysis testing must be conducted for new or altered device designs that affect the blood flow pattern.
(H) Chemical tolerance of the device to repeated exposure to commonly used disinfection agents must be established.
(iii) Performance data must demonstrate the sterility of the device.
(iv) Performance data must support the shelf life of the device for continued sterility, package integrity, and functionality over the requested shelf life that must include tensile, repeated clamping, and leakage testing.
(v) Labeling of implanted blood access devices for hemodialysis must include the following:
(A) Labeling must provide arterial and venous pressure versus flow rates, either in tabular or graphical format. The fluid and its viscosity used during testing must be stated.
(B) Labeling must specify the forward and reverse recirculation rates.
(C) Labeling must provide the arterial and venous priming volumes.
(D) Labeling must specify an expiration date.
(E) Labeling must identify any disinfecting agents that cannot be used to clean any components of the device.
(F) Any contraindicated disinfecting agents due to material incompatibility must be identified by printing a warning on the catheter. Alternatively, contraindicated disinfecting agents must be identified by a label affixed to the patient's medical record and with written instructions provided directly to the patient.
(G) Labeling must include a patient implant card.
(H) The labeling must contain comprehensive instructions for the following:
(
1 ) Preparation and insertion of the device, including recommended site of insertion, method of insertion, and a reference on the proper location for tip placement;(
2 ) Proper care and maintenance of the device and device exit site;(
3 ) Removal of the device;(
4 ) Anticoagulation;(
5 ) Management of obstruction and thrombus formation; and(
6 ) Qualifications for clinical providers performing the insertion, maintenance, and removal of the devices.(vi) In addition to Special Controls in paragraphs (b)(1)(i) through (v) of this section, implanted blood access devices that include subcutaneous ports must include the following:
(A) Labeling must include the recommended type of needle for access as well as detailed instructions for care and maintenance of the port, subcutaneous pocket, and skin overlying the port.
(B) Performance testing must include results on repeated use of the ports that simulates use over the intended life of the device.
(C) Clinical performance testing must demonstrate safe and effective use and capture any adverse events observed during clinical use.
(vii) In addition to Special Controls in paragraphs (b)(1)(i) through (v) of this section, implanted blood access devices with coatings or additives must include the following:
(A) A description and material characterization of the coating or additive material, the purpose of the coating or additive, duration of effectiveness, and how and where the coating is applied.
(B) An identification in the labeling of any coatings or additives and a summary of the results of performance testing for any coating or material with special characteristics, such as decreased thrombus formation or antimicrobial properties.
(C) A Warning Statement in the labeling for potential allergic reactions including anaphylaxis if the coating or additive contains known allergens.
(D) Performance data must demonstrate efficacy of the coating or additive and the duration of effectiveness.
(viii) The following must be included for A-V shunt cannulae (with vessel tips):
(A) The device must comply with Special Controls in paragraphs (b)(1)(i) through (v) of this section with the exception of paragraphs (b)(1)(ii)(B), (b)(1)(ii)(C), (b)(1)(v)(B), and (b)(1)(v)(C), which do not apply.
(B) Labeling must include Warning Statements to address the potential for vascular access steal syndrome, arterial stenosis, arterial thrombosis, and hemorrhage including exsanguination given that the device accesses the arterial circulation.
(C) Clinical performance testing must demonstrate safe and effective use and capture any adverse events observed during clinical use.
(2) Class II (performance standards) for the nonimplanted blood access device.
(3) Class II (performance standards) for accessories for both the implanted and the nonimplanted blood access devices not listed in paragraph (b)(4) of this section.
(4) Class I for the cannula clamp, disconnect forceps, crimp plier, tube plier, crimp ring, and joint ring, accessories for both the implanted and nonimplanted blood access device. The devices subject to this paragraph (b)(4) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.

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Image /page/0/Picture/1 description: The image shows the text "K051814 Page 1 of 2" in a handwritten style. The text is black and the background is white. The text is slightly blurry, but still legible. The text is likely part of a document or form.

510(k) Summary of Safety and Effectiveness

Manufacturer and contact Information 1.

  • 1.1 Manufacturer JMS Singapore Pte Ltd 440 Ang Mo Kio Industrial Park 1 Singapore 569620
  • 1.2 Sponsor JMS North America Corporation 22320 Foothill Blvd., Suite 350 Hayward, CA 94541 USA
  • 1.3 Contact Information Swee Cheau. Chong Manager of RA & QA JMS North America Corporation 22320 Foothill Blvd., Suite 350 Hayward, CA 94541 Telephone: (510) 888-9090 Fax: (510) 888-9099

2. Device Classification Name

Gastroenterology Devices Panel has classified JMS SysLoc MINI™ A.V. Fistula Needle Set & JMS SysLoc MINI™ Apheresis Needle Set as Class II. Reference 21 CFR 876.5540.

3. Predicate Device Name

The predicate device used in this submission is JMS SysLoc® A.V. Fistula Needle Set & JMS SysLoc® Apheresis Needle Set (K030479, 8/18/2003),

4. Device Intended use

JMS SysLoc MINI™ A.V. Fistula Needle Set & JMS SysLoc MINI™ Apheresis Needle Set is intended for temporary cannulation (non-implantable, less than 30 days) to vascular access for extracorporeal blood treatment. The device is intended for single use only and has an anti-stick feature integrated as part of the Needle Set which aids in prevention of needle-stick injuries.

5. Device Description

JMS SysLoc MINI™ A.V. Fistula & JMS SysLoc MINI™ Apheresis Needle Set is intended as non-implanted blood access device, which consists of flexible tube and needle with integrated sharps safety features as described in 21 CFR 876.5540.

1

Just like the predicate device, JMS SysLoc MINI™ A.V. Fistula Needle Set & JMS SysLoc MINIT™ Apheresis Needle Set comes with a rotational feature and the needle is retracted with the wing sheath after deliberate release of secured external lock, and final locking is assured by an audible 'click' sound when the hub/tube is pulled rearwards.

JMS SysLoc MINI™ A.V. Fistula Needle Set & JMS SysLoc MINI™ Apheresis Needle Set included in this 510(k) is a modification from the legally marketed device. JMS SysLoc® A.V. Fistula Needle Set & JMS SysLoc® Apheresis Needle Set. The SysLoc MINI™, is a 'mini' version of the predicate device (JMS SysLoc®) with modification made to reduce the overall length, so that the device is more user/patient friendly. Modifications are done accordinaly to the other components such as wing and hub in order to realize the intended device. The review of modifications is documented within this submission document.

Technological Characteristics and Substantial Equivalence ે.

JMS SysLoc MINI™ A.V. Fistula Needle Set & JMS SysLoc MINI™ Apheresis Needle Set has the same intended usage, same materials used in the blood-contact components, and adopts identical fundamental scientific technology as the predicate device. Bench testing was conducted to verify that the SysLoc MINI™ device is performing as intended to be a safe and effective medical device, data and reports are enclosed within this submission document.

Thus, the information provided in this submission clearly demonstrates the substantial equivalence of JMS JMS SysLoc MINI™ A.V. Fistula Needle Set and JMS JMS SysLoc MINI M Apheresis Needle Set to the predicate device JMS SysLoc® A.V. Fistula Needle Set & JMS SysLoc® Apheresis Needle Set.

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Image /page/2/Picture/1 description: The image shows a stylized drawing of a bird in flight. The bird is facing right, and its wings are spread. There is a circular border around the bird, and some text is written along the border. The text is difficult to read, but it appears to be in a cursive font.

Public Health Service

AUG 4 - 2005

Food and Drug Administration 9200 Corporate Boulevard Rockville MO 20050

Swee Cheau, Chong Manager of Regulatory Affairs & Quality Assurance JMS North American Corporation 22320 Foothill Blvd. Suite 350 HAYWARD CA 94541

Re: K051814

Trade/Device Name: JMS SysLoc MINI AVF Needle Set and JMS SysLoc MINI Apheresis Needle Set Regulation Number: 21 CFR §876.5540 Regulation Name: Blood access device and accessories Product Code: FIE Regulation Number: 21 CFR §880.5200 Regulation Name: Intravascular catheter Product Code: FOZ Regulatory Class: II ﺍﻟﻤﺴﺎﺣﺔ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘ Dated: June 27, 2005 Received: July 5, 2005

Dear Ms. Chong:

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 (Premarket Approval), 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.

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.

3

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 one of the following numbers, based on the regulation number at the top of this letter:

21 CFR 876.xxxx(Gastroenterology/Renal/Urology)240-276-0115
21 CFR 884.xxxx(Obstetrics/Gynecology)240-276-0115
21 CFR 892.xxxx(Radiology)240-276-0120
Other240-276-0100

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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,

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

4

INDICATIONS FOR USE STATEMENT

510(K) Number:

K051814

Device Name:

JMS SysLoc MINI AVF Needle Set JMS SysLoc MINI Apheresis Needle Set

Indications For Use:

Indications For Use; Use for temporary cannulation (non-implantable, less than 30 days) to vascular access for extracorporeal blood treatment. The device is intended for single use only and has an anti-stick feature integrated as part of the Needle Set which aids in prevention of needle-stick injuries.

(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 Section 801.109)

OR

Over-The-Counter Use

Nancy C brogdon
(Division Sign-Off)

Division of Reproductive, Abdominal, and Radiological Devices 510(k) Number