K Number
K052946
Device Name
MPS ACACIA NERVE BLOCK NEEDLE
Manufacturer
Date Cleared
2005-12-08

(49 days)

Product Code
Regulation Number
868.5140
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
1. The MPS Acacia Nerve Block Needle is intended for the administration of local anesthetic agents to provide regional anesthesia or the administration of anti-inflammatory medication to relieve chronic pain conditions, or to facilitate placement of a catheter. 2. The MPS Acacia Nerve Block Stimulating Needle version is also intended to aid in locating specific peripheral nerves or nerve plexuses for the precise delivery of local anesthetic agents or anti-inflammatory medication for the relief of chronic pain conditions or to provide regional anesthesia, or to facilitate placement of a catheter. 3. Routes of administration may include Peripheral nerve blocks, Sympathetic blocks, Selective nerve blocks, Intra-articular injections (i.e. Facet blocks), Interlaminar and Transforaminal approaches.
Device Description
The MPS Acacia Nerve Block Needle consists of a stainless steel cannula with various tip types (Blunt, Housted, Touhy, Crawford, Quincke, Chiba, Sprotte, Freeman) and a molded plastic hub. A stylet is also provided consisting of a stainless steel shaft and a molded plastic hub. The MPS Acacia Nerve Block Stimulating Needle version is electrically conductive at the distal end of the device. The Nerve Block Needle will be provided as a sterile, single use, non-pyrogenic, disposable device and will be available in a variety of lengths and gauges. The Nerve Block Needle may be packaged individually or as part of a kit consisting of a catheter, various syringe sizes, introducer, extension set, gauze sponge, sponge applicator, drape, absorbent towel, hospital wrap, sterile gloves, and other commonly used FDA approved accessories dependent on the application as determined by the clinician.
More Information

Not Found

No
The device description and intended use focus on the physical characteristics and function of a needle for administering medication or facilitating catheter placement, with a stimulating version for nerve location. There is no mention of AI or ML in the provided text.

Yes
The device is used for the administration of medication to provide regional anesthesia and relieve chronic pain conditions. These are therapeutic uses.

No
The device is intended for the administration of agents, not for diagnosing conditions. While the stimulating version aids in locating nerves, its purpose is for precise delivery of medication or catheter placement, not for diagnosis.

No

The device description clearly outlines physical components made of stainless steel and molded plastic, including a cannula, hub, and stylet. The stimulating version is also described as electrically conductive at the distal end. These are hardware components, not software.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, tissue) to provide information about a person's health. This testing is done outside of the body ("in vitro").
  • Device Description and Intended Use: The MPS Acacia Nerve Block Needle is a device used directly on the patient's body to administer medication or facilitate catheter placement. It is an invasive device used for therapeutic and diagnostic procedures performed in vivo (within the body).
  • Lack of Specimen Analysis: There is no mention of this device being used to collect or analyze any biological specimens.

Therefore, based on the provided information, the MPS Acacia Nerve Block Needle is a medical device used for procedures performed on the patient, not for in vitro diagnostic testing of specimens.

N/A

Intended Use / Indications for Use

The MPS Acacia Nerve Block Needle is intended for the administration of local anesthetic agents to provide regional anesthesia or the administration of anti-inflammatory medication to relieve chronic pain conditions, or to facilitate placement of a catheter.

The MPS Acacia Nerve Block Stimulating Needle version is also intended to ald in locating specific peripheral nerves or nerve plexuses for the precise delivery of local anesthetic agents or anti-inflammatory medication for the relief of chronic pain conditions or to provide regional anesthesia, or to facilitate placement of a catheter.

Routes of administration may include Peripheral nerve blocks, Sympathetic blocks, Selective nerve blocks, Intra-articular injections (i.e. Facet blocks), Interlaminar and Transforaminal approaches.

Product codes

CAZ

Device Description

The MPS Acacia Nerve Block Needle consists of a stainless steel cannula with various tip types (Blunt, Housted, Touhy, Crawford, Quincke, Chiba, Sprotte, Freeman) and a molded plastic hub. A stylet is also provided consisting of a stainless steel shaft and a molded plastic hub.

The MPS Acacia Nerve Block Stimulating Needle version is electrically conductive at the distal end of the device.

The Nerve Block Needle will be provided as a sterile, single use, non-pyrogenic, disposable device and will be available in a variety of lengths and gauges.

The Nerve Block Needle may be packaged individually or as part of a kit consisting of a catheter, various syringe sizes, introducer, extension set, gauze sponge, sponge applicator, drape, absorbent towel, hospital wrap, sterile gloves, and other commonly used FDA approved accessories dependent on the application as determined by the clinician.

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

The submission is based upon similar physical characteristics and intended use to the predicate devices.

Key Metrics

Not Found

Predicate Device(s)

K041843, K040965, K013041

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 868.5140 Anesthesia conduction kit.

(a)
Identification. An anesthesia conduction kit is a device used to administer to a patient conduction, regional, or local anesthesia. The device may contain syringes, needles, and drugs.(b)
Classification. Class II (performance standards).

0

DEC 8 2005

K052946

510(k) Summary

| 1. | Submitter: | MPS Acacia
785 Challenger Street
Brea, CA 92821
Tel: 714-257-0470
Fax: 714-257-0513 |
|----|-----------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------|
| 2. | Contact: | Fergie F. Ferguson, RA/QA Manager
MPS Acacia |
| 3. | Date prepared: | October 18, 2005 |
| 4. | Device trade name: | Nerve Block Needle |
| | Common name: | Nerve Block Needle |
| 5. | Predicate device:
510(k) number:
Marketed by: | Blunt Nerve Block Needle
K041843
Epimed International
141 Sal Landrio Drive
Johnstown, NY 12095 |
| | Predicate device:
510(k) number:
Marketed by: | Pajunk Anesthesia Conduction Needle
K040965
Pajunk Medical Technology
Karl-Hall-Str. 1
78187 Geisingen
Germany |
| | Predicate device:
510(k) number:
Marketed by: | Plexolong Set
K013041
Pajunk Medical Technology
Karl-Hall-Str. 1
78187 Geisingen
Germany |

ნ. Description:

The MPS Acacia Nerve Block Needle consists of a stainless steel cannula with various tip types (Blunt, Housted, Touhy, Crawford, Quincke, Chiba, Sprotte, Freeman) and a molded plastic hub. A stylet is also provided consisting of a stainless steel shaft and a molded plastic hub.

The MPS Acacia Nerve Block Stimulating Needle version is electrically conductive at the distal end of the device.

The Nerve Block Needle will be provided as a sterile, single use, non-pyrogenic, disposable device and will be available in a variety of lengths and gauges.

The Nerve Block Needle may be packaged individually or as part of a kit consisting of a catheter, various syringe sizes, introducer, extension set, gauze sponge, sponge applicator, drape, absorbent towel, hospital wrap, sterile gloves, and other commonly used FDA approved accessories dependent on the application as determined by the clinician.

2 - 3

1

510(k) Summary

    1. Intended Use:
      The MPS Acacia Nerve Block Needle is intended for the administration of local anesthetic agents to provide regional anesthesia or the administration of anti-inflammatory medication to relieve chronic pain conditions, or to facilitate placement of a catheter.

The MPS Acacia Nerve Block Stimulating Needle version is also intended to ald in locating specific peripheral nerves or nerve plexuses for the precise delivery of local anesthetic agents or anti-inflammatory medication for the relief of chronic pain conditions or to provide regional anesthesia, or to facilitate placement of a catheter.

Routes of administration may include Peripheral nerve blocks, Sympathetic blocks, Selective nerve blocks, Intra-articular injections (i.e. Facet blocks), Interlaminar and Transforaminal approaches.

  • Technological comparison to predicate device: 8.
    The MPS Acacia Nerve Block Needle has similar physical and technical characteristics to the predicate devices.

    1. Non-clinical test summary:
      The submission is based upon similar physical characteristics and intended use to the predicate devices.
    1. Conclusion:
      The comparison between the predicate devices and the proposed device demonstrates that the MPS Acacia Nerve Block Needle is safe and effective and is substantially equivalent to the products currently being legally marketed by Epimed International, and Pajunk Medical Technology.

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of three overlapping shapes that resemble an abstract symbol.

2005 DEC 8

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Fergie F. Ferguson Regulatory Affairs/Quality Assurance Manager MPS Acacia 785 Challenger Street Brea, California 92821

Re: K052946

K032940
Trade/Device Name: MedFlo Pain Kit, MedFlo Nerve Block, MedFlo Ll and MedFlo LI-KVO Regulation Number: 868.5140 Regulation Name: Anesthesia Conduction Kit Regulatory Class: II Product Code: CAZ Dated: October 18, 2005 Received: October 20, 2005

Dear Mr. Ferguson:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave revious your becater over 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 Interstate conmisive prior to frid] 20, 20, 20, 20, 2017 accordance with the provisions of Amendinents, or to devroes that has in (Act) that do not require approval of a premarket the rederar I vou, Drag, therefore, market the device, subject to the general approvisions of the Act. The general controls provisions of the Act include controls provisions of the Fist - 100 , listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (sec above) into either class II (Special Controls) or class III If your device to subject to such additional controls. Existing major regulations affecting (1 MA), it may of subject to the Code of Federal Regulations, Title 21, Parts 800 to 898. In your device can be found in the announcements concerning your device in the Federal Register.

3

Page 2 - Mr. Ferguson

Please be advised that FDA's issuance of a substantial equivalence determination does not i least be advised that I Dr o testained on that your device complies with other requirements Incall that I DTT may made a autes and regulations administered by other Federal agencies. of the Act of ally I ederal barates as requirements, including, but not limited to: registration 1 ou must comply with an are rebeling (21 CFR Part 801); good manufacturing practice allu listing (21 CF RT rur 007), abstitisg (QS) regulation (21 CFR Part 820); and if requirents as sections in the quality ajon 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) I mis letter will anow your to one finding of substantial equivalence of your device to a premarket notification. The PDF 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), If you desire specific at not Compliance at (240) 276-0120. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You entition, "Phoonalianing al information on your responsibilities under the Act from the may oveall other generalacturers, 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,

Clars

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

4

Indications for Use Statement

Applicant: MPS Acacia

510(k) NUMBER (IF KNOWN): __

DEVICE NAME: MedFlo, MedFlo Pain Kit, MedFlo Nerve Block, MedFlo LI and MedFlo LI-KVO INDICATIONS FOR USE:

    1. The MPS Acacia Nerve Block Needle is intended for the administration of local anesthetic agents The MI O Acadia Nerve Brook News in the administration of anti-inflammatory medication to relieve chronic pain conditions, or to facilitate placement of a catheter.
    1. The MPS Acacia Nerve Block Stimulating Needle version is also intended to aid in locating The Mir O Acadia Nerves or nerve plexuses for the precise delivery of local anesthetic agents on specific portphord her voo or for the relief of chronic pain conditions or to provide regional anesthesia, or to facilitate placement of a catheter.
    1. Routes of administration may include Peripheral nerve blocks, Sympathetic blocks, Selective routes on administration may include (i.e. Facet blocks), Interlaminar and Transforaminal approaches.

Prescription Use XX (Part 21 CFR 801 Subpart D) Over-The-Counter-Use (Part 21 CFR 801 Subpart C)

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

AND/OR

CONCURRENCE OF CDRH, OFFICE OF DEVICE EVALUATION (ODE)

Arie Sulam

Dept. Of Anesthesiology, General Hospital,

trol, Dental Devices

K052946

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