K Number
K060333
Device Name
DIALYSIS SERVICES, INC., TYPHOON BICARB MIXING AND DISTRIBUTION SYSTEM
Date Cleared
2006-09-08

(211 days)

Product Code
Regulation Number
876.5820
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The bicarbonate mixing and distribution system and its components consisting of; tanks, pumps, piping, and controls, are designed to consistently, safely, and effectively mix and distribute bicarbonate solutions for hemodialysis treatments. NOTE: Federal Law restricts this device to sale by or on the order of a physician for use as a bicarbonate mixing and distribution system for hemodialysis.
Device Description
Device is designed to provide the user with a system for consistent and easy to use system by which they may be able to mix and distribute bicarbonate solution for use in a hemodialysis clinic.
More Information

Not Found

No
The summary describes a system for mixing and distributing bicarbonate solution using standard components like tanks, pumps, piping, and controls, with no mention of AI or ML capabilities.

No
This device is a bicarbonate mixing and distribution system used in hemodialysis treatments. It facilitates the preparation of a solution, but it is not directly applied to the patient to treat a disease or condition. The function is to provide a component (bicarbonate solution) that is then used in a therapeutic procedure (hemodialysis), rather than being a therapeutic device itself.

No
The device is described as a "bicarbonate mixing and distribution system" for "hemodialysis treatments." Its function is to prepare and distribute solutions, not to diagnose a medical condition or provide information about a patient's health status.

No

The device description explicitly lists hardware components such as tanks, pumps, and piping, indicating it is a physical system, not software-only.

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

Here's why:

  • Intended Use: The intended use is to "mix and distribute bicarbonate solutions for hemodialysis treatments." This describes a system for preparing and delivering a solution used in a medical procedure (hemodialysis), not a device used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes.
  • Device Description: The description focuses on the system's function in mixing and distributing the solution, not on analyzing biological samples.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring analytes
    • Providing diagnostic information
    • Using reagents or assays

The device is clearly intended to be part of the infrastructure and process for performing hemodialysis, which is a treatment procedure.

N/A

Intended Use / Indications for Use

The TYPHOON by Dialysis Services, Inc. is intended to be used for the safe and effective mixing and distributing of a bicarbonate solution in a hemodialysis facility.
The bicarbonate mixing and distribution system and its components consisting of; tanks, pumps, piping, and controls, are designed to consistently, safely, and effectively mix and distribute bicarbonate solutions for hemodialysis treatments.

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

78 FIP, FIN

Device Description

Device is designed to provide the user with a system for consistent and easy to use system by which they may be able to mix and distribute bicarbonate solution for use in a hemodialysis clinic.

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

hemodialysis clinic, physician

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)

Non-Clinical Performance Data: The Dialysis Services, Inc. TYPHOON Bicarb Mixing and Distribution System utilizes similar components and fluid confact materials as other items currently cleared for use in hemodialysis.
Clinical Testing: N/A

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.

K031502

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

§ 876.5820 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

Services, IncTYPHOON Bicarb System 510(k) Submission
K060333
SEP - 8 2006PAGE 1 OF 4
4.0 510(k) Summary of Safety and Effectiveness
4.1 Submitter:Dialysis Services, Inc.
130 Elder.
Springfield, TN 37172
4.2 Establishment Registration Number:3004486997
4.3 Phone:(615) 384-4810
4.4 Fax:(615) 384-4847
4.5 Date Prepared:02-06-2006
4.6 Contact Person:Mike Sterling
4.7 Device Names:
Trade Name: TYPHOON Bicarb Mixing & Distribution System
Common Name: Bicarb Mixing & Distribution System
Classification Name: Hemodialysis Systems and Accessories (21 CFR 876.5820) Class II Critical Medical Device
Product Code: 78 FIP
4.8 Predicate Device:USFilter Bicarbonate Mixing and Dispensing System
K031502
510(k) Summary

DETVASE

130 Elder Dr.

4.9 Device Description: Device is designed to provide the user with a system for consistent and easy to use system by which they may be able to mix and distribute bicarbonate solution for use in a hemodialysis clinic.

4.10 Intended Use: The TYPHOON by Dialysis Services, Inc. is intended to be used for the safe and effective mixing and distributing of a bicarbonate solution in a hemodialysis facility.

Fax: 615,384,4847

1

4.11 Predicate Device: The Dialysis Services Typhoon Bicarbonate Mixing and Distribution System and its components are substantially equivalent to the USFilter Bicarbonate Mixing and Dispensing System, K031502. Both the predicate device system and the Dialysis Services, Inc TYPHOON systems ufilize similar technology. Further comparisons are made in the chart below.

Image /page/1/Figure/3 description: The image contains the text '10(k) Summa'. The text is vertically oriented and appears to be part of a title or heading. The font is bold and the letters are closely spaced together.

Image /page/1/Figure/4 description: The image shows the text "Page 12" in bold black font. The text is likely a page number from a document. The number 12 is written in a slightly larger font size than the word "Page".

2

K060333
AGE 3 OF 4 PAGE

| Technical Specifications and
Information | Dialysis Services, Inc.
TYPHOON | USFilter BICARB50SYS &
BICARB100SYS |
|---------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Requirements | | |
| Inlet Water: | RO or DI water which meets
AAMI standards for Hemodialy-
sis | RO or DI water which meets
AAMI standards for Hemodi-
alysis |
| Drain: | Minimum of 1" | Minimum of 1" |
| Electrical: | 115 vac, Single Phase, 20 amp | 115 vac, Single Phase, 20 amp |
| Piping: | | |
| Water Inlet: | 1" schedule 80 PVC | 1/2" schedule 80 PVC |
| Loop Feed: | 3/4" schedule 80 PVC, or 5/8"
polyethylene | 3/4" schedule 80 PVC |
| Loop Return: | 3/4" schedule 80 PVC, or 5/8"
polyethylene | 3/4" schedule 80 PVC |
| Drain: | 1 ½" schedule 80 PVC | 1" schedule 80 PVC |
| Level Controls: | | |
| Mix Tank Level Control: | The Dialysis Services TYPHOON
gives the user the ability to mix
and distribute from both tanks,
so there is not a separate Mix
and Distribution tank. Because
of this, both tanks utilize the
same level control sensor and
operate the same. The sensor | The mix tank is equipped with
a high level float that closes
the fill valve if the water in the
tank exceeds 100 gals. (50
gals. for a 50 gal. system). The
fill valve will not reactivate
unless the water level is below
float level. |
| Distribution Tank Level Control: | automatically allows the sys-
tem to fill in 50 gal., 75 gal.,
and 100 gal. increments (user
selected). The level sensor
controls the fill valve with these
levels. In addition, when the
bicarbonate level drops to 10
gallons in the tank being used,
it will give an audible and vis-
ual alarm and/or automati-
cally switch tanks. (See Opera-
tor's Manual for details) | The distribution tank is
equipped with a low-level
float that lights a warning light
if the bicarbonate in the tank
drops below 25 gals. if the dis-
tribution tank is allowed to go
empty, and audible alarm will
sound. |
| Technical Specifications and
Information | Dialysis Services, Inc.
TYPHOON | USFilter BICARB50SYS & BI-
CARB100SYS |
| | Pumps: | |
| Mix Pump: | 1/3 hp Totally Enclosed Fan
Cooled (TEFC) motor | 3/4 hp Totally Enclosed Fan
Cooled (TEFC) motor |
| Distribution Pumps: | 1/4 hp Totally Enclosed Fan
Cooled (TEFC) motor | 1/9 hp Totally Enclosed Fan
Cooled (TEFC) motor |
| | Material | |
| Tank Materials: | Polyethylene | Polyethylene |

10(k) Summar

Page 13

3

Dialysis Services, me

4.12 Non-Clinical Performance Data:

The Dialysis Services, Inc. TYPHOON Bicarb Mixing and Distribution System utilizes similar components and fluid confact materials as other items currently cleared for use in hemodialysis

4.13 Clinical Testing:

N/A

4.14 Biocompatibility Testing:

Dialysis Services, Inc. certifies that most materials and components utilized in the TYPHOON Bicarb System are identical to those previously cleared and regisfered with the FDA. Additional testing is provided in Section 9.0 of this submission.

4.15 Conclusions:

As with the USFilter Bicarbonate Mixing and Distribution System, the Dialysis Services, Inc, TYPHOON Bicarbonate Mixing and Distribution System is intended to consistently mix and distribute bicarbonate solution for use in hemodialysis.

Page 14

30 Elder Dr oll Free: 1.888.DSI.WATER

Fax: 615.384.4847

10(k) Summa

4

Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of an eagle or bird-like figure with outstretched wings. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the bird-like figure.

Food and Drug Administration 9200 Corporate Blvd. Rockville MD 20850

Mr. Mike Sterling VP/COO Dialysis Services, Inc. 3620 Kelton Jackson Road SPRINGFIELD TN 37172

Re: K060333

Trade/Device Name: Dialysis Services, Inc. TYPHOON Bicarb Mixing and Distribution System Regulation Number: 21 CFR §876.5820 Regulation Name: Hemodialysis system and accessories Regulatory Class: II Product Code: FIN Dated: August 23, 2006 Received: August 24, 2006

Dear Mr. Sterling:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your boother is of if your is substantially equivalent (for the indications for referenced as over and harv to legally marketed predicate devices marketed in interstate commerce use stated in the encrosure) to regally manovical Device Amendments, or to devices that provision in accordance with the provisions of the Federal Food, Drug, and Cosmetic nave been rectablined in ure approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general therefore, mainer the active, basyer reasurements for annual registration, listing of devices, good controls provibitions or and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket r your device is etablined (oo such additional controls. Existing major regulations affecting your Apploval), it thay be saoject to sach aderal Regulations, Title 21, Parts 800 to 898. In addition, FDA device our of loand announcements concerning your device in the Federal Register.

Image /page/4/Picture/10 description: The image shows a circular logo with the text "FDA Centennial" and the years "1906-2006". The logo features the letters "FDA" in a bold, stylized font above the word "Centennial". There are three stars below the word "Centennial". The logo is surrounded by a circular border with additional text.

noting Public J

5

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.

Sincercly vours,

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

6

Indications for Use

510(k) Number (if known):_ K060333

Device Name: Dialysis Services, Inc. TYPHOON Bicarb Mixing and Distribution System

Indications For Use:

The bicarbonate mixing and distribution system and its components consisting of; tanks, pumps, piping, and controls, are designed to consistently, safely, and effectively mix and distribute bicarbonate solutions for hemodialysis treatments.

NOTE: Federal Law restricts this device to sale by or on the order of a physician for use as a bicarbonate mixing and distribution system for hemodialysis.

Prescription Use V (Part 21 CFR 801 Subpart D) ANDIOR

Over-The-Counter Use (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

David h. Layman

(Division Sian-Off Division of Reproductive. and Radiological Devices 510(k) Number

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(vers 6/25/05)