K Number
K052903
Manufacturer
Date Cleared
2005-11-09

(26 days)

Product Code
Regulation Number
876.5980
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Infant Feeding tube is intended to be placed into the stomach to permit the introduction of fluids as directed by the physician. Intended for nasogastric or orogastric placement. Limited to < 30 day placement. Not intended for transpyloric placement.

Device Description

The Infant Feeding Tube is a small diameter tube of various diameters, 5, 6, and 8 French, and lengths, 14.5", 35" and 41". It has an integral female luer fitting. There are 2 eyelets near the tip of the tube. It has marking along the shaft of the tubing and an integral radiopaque line. It is provided sterile.

AI/ML Overview

This document describes a 510(k) premarket notification for a medical device, the "Infant Feeding Tube." The submission seeks to demonstrate substantial equivalence to a predicate device, rather than proving performance against specific acceptance criteria for a new clinical claim. Therefore, many of the requested categories related to clinical study design (sample size, ground truth, expert adjudication, MRMC studies, standalone performance) are not applicable in this context.

Here's an analysis based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

For a 510(k) submission based on substantial equivalence, the "acceptance criteria" are typically the characteristics and performance of the predicate device. The "reported device performance" demonstrates that the new device meets or is equivalent to these characteristics.

AttributeAcceptance Criteria (Predicate ProMedic Infant Feeding Tube – K020005)Reported Device Performance (Proposed Device)
Indications for Use
To be placed into the stomach to permit the introduction of fluids as directed by the physician. Nasogastric or orogastric placement.YesYes
Intended for single patient use for a duration of < 30 daysYesYes
PrescriptionYesYes
Intended population infantsYesYes
Intended Environment of Use - Hospital or environments where placement of a Feeding tube is required.YesYes
Design Features
Provided in various diameters5,6,8 Fr5,6,8 Fr
Standard slip fit female luer connectorYesYes
Two (2) eyelet holes near tipYesYes
Radiopaque line entire length of tubingYesYes
Markings along the length of the tubingYesYes
Materials
Tubing and Connector – PVC with no DEHPYesYes
Packaging
SterileYesYes
Performance
None under Section 514 (Implies performance is similar to predicate and no specific performance standards apply to this class of device)YesYes

2. Sample size used for the test set and the data provenance

Not applicable. This is a 510(k) submission demonstrating substantial equivalence to a predicate device, not a performance study with a test set of patient data. The "test" here involves comparing the characteristics of the new device to those of the predicate device.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable. Ground truth, in the context of clinical studies and AI, is not relevant for this type of substantial equivalence submission.

4. Adjudication method for the test set

Not applicable.

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

Not applicable. This device is an Infant Feeding Tube, a physical medical device, not an AI-powered diagnostic or assistive tool.

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

Not applicable. This is a physical medical device.

7. The type of ground truth used

Not applicable.

8. The sample size for the training set

Not applicable. There is no AI algorithm being trained for this device.

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

Not applicable.

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NOV - 9 2005

Non-Confidential Summary of Safety and Effectiveness Page 1 of 2

13-Oct-05
ProMedic, Inc.6329 W. Waterview Ct.McCordsville, IN 46055Tel (317) 335-3780Fax (317) 335-9270
Official Contact:Paul Dryden - President
Proprietary or Trade Name:Infant Feeding Tube
Common/Usual Name:Feeding Tube or NG /OG Tube
Classification Name:Tubes, Gastrointestinal (and Accessories)
Predicate Devices:ProMedic - Infant Feeding Tubes -- K020005

Device Description:

The Infant Feeding Tube is a small diameter tube of various diameters, 5, 6, and 8 French, and lengths, 14.5", 35" and 41". It has an integral female luer fitting. There are 2 eyelets near the tip of the tube. It has marking along the shaft of the tubing and an integral radiopaque line. It is provided sterile.

Indications for Use:
Indications for Use --The Infant Feeding tube is intended to be placed into the stomachto permit the introduction of fluids as directed by the physician.
Intended for nasogastric or orogastric placement. Limited to lessthan 30 day placement.
Not intended for transpyloric placement.
Environment of Use --Hospital or environment where placement of a feeding tube isrequired.

{1}------------------------------------------------

Non-Confidential Summary of Safety and Effectiveness

Page 2 of 2 13-Oct-05

AttributeProposed devicePredicate ProMedic InfantFeeding Tube – K020005
Indications for Use
To be placed into the stomach topermit the introduction of fluidsas directed by the physician.Nasogastric or orogastricplacement.YesYes
Intended for single patient use fora duration of < 30 daysYesYes
PrescriptionYesYes
Intended population infantsYesYes
Intended Environment of Use -Hospital or environments whereplacement of a Feeding tube isrequired.YesYes
Design Features
Provided in various diameters5,6,8 Fr5,6,8 Fr
Standard slip fit female luerconnectorYesYes
Two (2) eyelet holes near tipYesYes
Radiopaque line entire length oftubingYesYes
Markings along the length of thetubingYesYes
Materials
Tubing and Connector – PVCwith no DEHPYesYes
Packaging
SterileYesYes
Performance
None under Section 514YesYes

Differences between Other Legally Marketed Predicate Devices

There are no significant differences between the intended device and the predicate -- ProMedic Infant Feeding Tube - K020005.

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Image /page/2/Picture/1 description: The image shows a circular logo with text around the perimeter and a stylized bird-like symbol in the center. The text appears to be "DEPARTMENT OF HEALTH & HUMAN SERVICES U.S.A.", arranged along the top and sides of the circle. The central symbol resembles a bird with three curved lines extending from its body, creating a sense of motion or flight.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV - 9 2005

Mr. Paul Dryden President ProMedic, Inc. 6329 W. Waterview Court MCCORDSVILLE IN 46055

Re: K052903

Trade/Device Name: Infant Feeding Tube Regulation Number: 21 CFR §876.5980 Regulation Name: Gastrointestinal tube and accessories Regulatory Class: II Product Code: KNT Dated: October 13, 2005 Received: October 14, 2005

Dear Mr. Dryden:

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 (0S) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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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. Hogdon

Nancy C. Brogdon Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Infant Feeding Tube

Page 1 of 1

510(k) Number:K052903 (To be assigned)
Device Name:Infant Feeding Tube
Indications for Use:The Infant Feeding tube is intended to be placed into thestomach to permit the introduction of fluids as directed bythe physician. Intended for nasogastric or orogastricplacement. Limited to < 30 day placement. Not intendedfor transpyloric placement.

Prescription Use XX (Part 21 CFR 801 Subpart D) 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)

Nancy C hogdon

(Division Sign-Off) Division of Reproductive, Abdominal, and Radiological Devices 052903 510(k) Number _ 1

§ 876.5980 Gastrointestinal tube and accessories.

(a)
Identification. A gastrointestinal tube and accessories is a device that consists of flexible or semi-rigid tubing used for instilling fluids into, withdrawing fluids from, splinting, or suppressing bleeding of the alimentary tract. This device may incorporate an integral inflatable balloon for retention or hemostasis. This generic type of device includes the hemostatic bag, irrigation and aspiration catheter (gastric, colonic, etc.), rectal catheter, sterile infant gavage set, gastrointestinal string and tubes to locate internal bleeding, double lumen tube for intestinal decompression or intubation, feeding tube, gastroenterostomy tube, Levine tube, nasogastric tube, single lumen tube with mercury weight balloon for intestinal intubation or decompression, and gastro-urological irrigation tray (for gastrological use).(b)
Classification. (1) Class II (special controls). The barium enema retention catheter and tip with or without a bag that is a gastrointestinal tube and accessory or a gastronomy tube holder accessory is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I (general controls) for the dissolvable nasogastric feed tube guide for the nasogastric tube. The class I device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 876.9.