K Number
K052764
Device Name
DIACAP ULTRA DIALYSIS FLUID FILTER
Date Cleared
2006-06-09

(252 days)

Product Code
Regulation Number
876.5820
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Diacap Ultra Dialysis Fluid Filter is intended to filter bacteria and endotoxins from dialysate used for hemodialysis treatments.
Device Description
The Diacap Ultra dialysis fluid filter is sterile, non-pyrogenic dialysis fluid filter for use with machines providing hemodialysis treatments. The device is composed of a hollow core polysulfone and polyvinylpyrrolidone membrane, polycarbonate housing and headers (end-caps) with Hansen type connectors, silicone O-rings, and polyethylene port caps.
More Information

Not Found

No
The summary describes a physical filter device and does not mention any software, algorithms, or data processing that would indicate the use of AI or ML.

No
This device is a filter to remove bacteria and endotoxins from dialysate, which is used in hemodialysis treatments. It is not directly applied to a patient for therapeutic benefit, but rather prepares the fluid for a therapeutic procedure.

No
The device is described as a filter for dialysate used in hemodialysis treatments, which is a therapeutic function, not a diagnostic one. It removes bacteria and endotoxins from the fluid, it does not analyze or detect medical conditions or diseases.

No

The device description clearly outlines physical components (membrane, housing, connectors, O-rings, caps) and its function is to physically filter fluid, indicating it is a hardware device.

Based on the provided information, the Diacap Ultra Dialysis Fluid Filter is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is to "filter bacteria and endotoxins from dialysate used for hemodialysis treatments." This describes a device that acts on the dialysis fluid itself, which is a substance used in a medical procedure, not a sample taken from the patient to diagnose a condition.
  • Device Description: The description details a filter with a membrane and housing, designed to physically remove contaminants from the dialysate. This aligns with a filtration device, not a diagnostic test.
  • Lack of Diagnostic Elements: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting biomarkers, or providing diagnostic information about a patient's health status.

IVD devices are specifically designed to examine specimens derived from the human body to provide information for the diagnosis, monitoring, or treatment of a disease or condition. The Diacap Ultra's function is to purify the fluid used in a treatment, not to analyze a patient's biological sample.

N/A

Intended Use / Indications for Use

The Diacap Ultra dialysis fluid filter is intended to filter bacteria and endotoxins from dialysate used for hemodialysis treatments.

Product codes

FKP, FKQ

Device Description

The Diacap Ultra dialysis fluid filter is sterile, non-pyrogenic dialysis fluid filter for use with machines providing hemodialysis treatments. The device is composed of a hollow core polysulfone and polyvinylpyrrolidone membrane, polycarbonate housing and headers (end-caps) with Hansen type connectors, silicone O-rings, and polyethylene port caps.

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)

K993806, K003957, K983126

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.5820 Hemodialysis system and accessories.

(a)
Identification. A hemodialysis system and accessories is a device that is used as an artificial kidney system for the treatment of patients with renal failure or toxemic conditions and that consists of an extracorporeal blood system, a conventional dialyzer, a dialysate delivery system, and accessories. Blood from a patient flows through the tubing of the extracorporeal blood system and accessories to the blood compartment of the dialyzer, then returns through further tubing of the extracorporeal blood system to the patient. The dialyzer has two compartments that are separated by a semipermeable membrane. While the blood is in the blood compartment, undesirable substances in the blood pass through the semipermeable membrane into the dialysate in the dialysate compartment. The dialysate delivery system controls and monitors the dialysate circulating through the dialysate compartment of the dialyzer.(1) The extracorporeal blood system and accessories consists of tubing, pumps, pressure monitors, air foam or bubble detectors, and alarms to keep blood moving safely from the blood access device and accessories for hemodialysis (§ 876.5540) to the blood compartment of the dialyzer and back to the patient.
(2) The conventional dialyzer allows a transfer of water and solutes between the blood and the dialysate through the semipermeable membrane. The semipermeable membrane of the conventional dialyzer has a sufficiently low permeability to water that an ultrafiltration controller is not required to prevent excessive loss of water from the patient's blood. This conventional dialyzer does not include hemodialyzers with the disposable inserts (Kiil type) (§ 876.5830) or dialyzers of high permeability (§ 876.5860).
(3) The dialysate delivery system consists of mechanisms that monitor and control the temperature, conductivity, flow rate, and pressure of the dialysate and circulates dialysate through the dialysate compartment of the dialyzer. The dialysate delivery system includes the dialysate concentrate for hemodialysis (liquid or powder) and alarms to indicate abnormal dialysate conditions. This dialysate delivery system does not include the sorbent regenerated dialysate delivery system for hemodialysis (§ 876.5600), the dialysate delivery system of the peritoneal dialysis system and accessories (§ 876.5630), or the controlled dialysate delivery system of the high permeability hemodialysis system § 876.5860).
(4) Remote accessories to the hemodialysis system include the unpowered dialysis chair without a scale, the powered dialysis chair without a scale, the dialyzer holder set, dialysis tie gun and ties, and hemodialysis start/stop tray.
(b)
Classification. (1) Class II (performance standards) for hemodialysis systems and all accessories directly associated with the extracorporeal blood system and the dialysate delivery system.(2) Class I for other accessories of the hemodialysis system remote from the extracorporeal blood system and the dialysate delivery system, such as the unpowered dialysis chair, hemodialysis start/stop tray, dialyzer holder set, and dialysis tie gun and ties. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.

0

B BRAUN

B. Braun Medizintechnologie GmbH
Division Medizintechnik

Postfach 11 20
D-34209 Melsungen

K052764
Page 1 of 1

7.0 510(k) Summary

| APPLICANT: | B. Braun Medizintechnologie GmbH
Schwarzenberger Weg 73-79
34212 Melsungen, Germany | | JUN - 9 2006 |
|-----------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--|--------------|
| SUBMITTER: | B. Braun Medical Inc.
901 Marcon Boulevard
Allentown, PA 18109-9341
(610) 266-0500, ext. 2376
Contact: Scott J. Pease, Mgr., Regulatory Affairs | | |
| DEVICE NAME: | Diacap Ultra Dialysis Fluid Filter | | |
| COMMON OR USUAL
NAME: | Dialysis Fluid Filter to Remove Bacteria and Endotoxins | | |
| DEVICE
CLASSIFICATION: | Class II, 21 CFR §876.5820, System, Dialysate Delivery, Single
Patient, Product Code: FKP | | |
| PREDICATE DEVICE: | K993806 Clarigen, Inc., DialGuard™
K003957 GAMBRO® Renal Products, Dialclear™ Ultrafilter
K983126 Minntech FibreFlo | | |
| DESCRIPTION: | The Diacap Ultra dialysis fluid filter is sterile, non-pyrogenic dialysis
fluid filter for use with machines providing hemodialysis treatments.
The device is composed of a hollow core polysulfone and
polyvinylpyrrolidone membrane, polycarbonate housing and headers
(end-caps) with Hansen type connectors, silicone O-rings, and
polyethylene port caps. | | |
| INTENDED USE: | The Diacap Ultra dialysis fluid filter is intended to filter bacteria and
endotoxins from dialysate used for hemodialysis treatments. | | |
| SUBSTANTIAL
EQUIVALENCE: | The Diacap Ultra is similar in indications for use and design to the
DialGuard™ Endotoxin Removal Device for treatment of dialysate
and dialysis water, previously cleared in Clarigen, Inc. 510(k)
K993806, the Dialclear™ Ultrafilter, previously cleared in
GAMBRO® Renal Products 510(k) K003957 and the FioberFlo
previously cleared in Minntech Corp. 510(k) K983126. | | |

510(k) for Diacap Ultra

.. . . . . . .. ..

1

Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract symbol that resembles a stylized caduceus or a bird in flight. The logo is black and white.

Food and Drug Administration 9200 Corporate Blvd. Rockville MD 20850

JUN - 9 2006

Mr. Scott J. Pease Manager, Regulatory Affairs B. Braun Medical, Inc. 901 Marcon Blvd. ALLENTOWN PA 18109

Re: K052764

Trade/Device Name: DIACAP Ultra Dialysis Fluid Filter Regulation Number: 21 CFR 876.5820 Regulation Name: Hemodialysis system and accessories Regulatory Class: II Product Code: FKQ Dated: June 1, 2006 Received: June 2, 2006

Dear Mr. Pease:

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.

Image /page/1/Picture/10 description: The image shows the FDA Centennial logo, which includes the years 1906-2006. The logo is circular and contains the letters FDA in bold. Below the letters, the word Centennial is written in a smaller font. The text "Protecting and Promoting Public Health" is written in a decorative font below the logo.

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Page 2 -

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

21 CFR 876.xxx(Gastroenterology/Renal/Urology)240-276-0115
21 CFR 884.xxx(Obstetrics/Gynecology)240-276-0115
21 CFR 894.xxx(Radiology)240-276-0120
Other240-276-0100

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 (240) 276-3150

or at its Internet address http://www.fda.gov/cdrl/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

3

Indications for Use Statement 2.0

Page of

510(k) Number (if known):K052764
Device Name:Diacap Ultra Dialysis Fluid Filter

Indications For Use:

The Diacap Ultra Dialysis Fluid Filter is intended to filter bacteria and endotoxins from dialysate.

Prescription UseX
(Per 21 CFR 801.109)

OR

Over-The-Counter Use
------------------------

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

Concurrence of CDRH, Office of Device Evaluation (ODE

E)
ancyl Brodon
(Division Sign-Off)
Division of Reproductive, Abdominal,

Radiological Devices
510(k) Number K052764

510(k) for Diacap Ultra

28 September 2005