K Number
K063018
Device Name
GLASS LOSS OF RESISTANCE SYRINGE
Date Cleared
2007-01-22

(112 days)

Product Code
Regulation Number
868.5140
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Glass Loss of Resistance Syringe is intended for use in conjunction with an epidural needle, to verify the needle tip placement in the epidural space by the loss of Resistance technique; it will be filled with air and/or saline during use. The loss of Resistance Syringe is not intended for injection or aspiration. The Syringe will be sold sterile individually packaged, and as part of a sterile kit.
Device Description
The Glass Loss of Resistance Syringe is a single use device, which is sold as sterile individually packaged and sterile packaged inside a kit/procedure tray. The syringe will be available in luer lock and luer slip tip.
More Information

Not Found

Not Found

No
The description focuses on a mechanical syringe for a standard medical technique and explicitly states "Not Found" for mentions of AI, DNN, or ML.

No.
The device is used to verify needle tip placement during a medical procedure, not to treat a condition or disease.

Yes

The device is intended to "verify the needle tip placement in the epidural space by the loss of Resistance technique," which is a diagnostic function to determine the location of the needle.

No

The device description clearly states it is a "Glass Loss of Resistance Syringe," which is a physical medical device, not software.

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

Here's why:

  • Intended Use: The intended use is to verify needle tip placement in the epidural space using the loss of resistance technique. This is a procedural or diagnostic aid used during a medical procedure, not a test performed on a sample of human origin in vitro (outside the body).
  • Device Description: The device is a syringe used to facilitate a physical technique (loss of resistance). It does not involve the analysis of biological samples.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in biological samples
    • Providing information about a patient's health status based on sample analysis

The device is a medical device used in vivo (within the body) to aid in a medical procedure.

N/A

Intended Use / Indications for Use

The Glass Loss of Resistance Syringe is intended for use in conjunction with an epidural needle, to verify the needle tip placement in the epidural space by the loss of Resistance technique, it will be filled with air and/or saline during use. The loss of Resistance Syringe is not intended for injection or aspiration. The Syringe will be sold sterile individually packaged, and as part of a sterile kit.

Product codes

CAZ

Device Description

The Glass Loss of Resistance Syringe is a single use device, which is sold as sterile individually packaged and sterile packaged inside a kit/procedure tray. The syringe will be available in luer lock and luer slip tip.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

epidural space

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

Summary of Testing: All materials used in the fabrication of the specialty needles were evaluated through biological qualification safety tests. The biocompatibility tests performed were L929 Men Elution Test, Intracutaneous Injection Test, Systemic Injection Test, Salmonella Typhimurium and Escherichia Coli Reverse Mutation Assay, Hemolysis - Rabbit Blood Test, and Kligman Maximization Test. These materials have met the testing requirements and were found to be acceptable for the intended use. Technological Characteristics: [21 CFR 807.92(a)(6)] The subject device has the same Technological Characteristics as a legally marketed predicate device.

Key Metrics

Not Found

Predicate Device(s)

BD Glass Loss of Resistance Syringe - (Pre-Amendment Device)

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

K063018

SUMMARY

B

510(k) SUMMARY OF SAFETY AND EFFECTIVENESS

| Regulatory Affairs Contact: | Muhamad Ansari
Busse Hospital Disposables
PO Box: 11067
75 Arkay Dr.
Hauppauge NY 11788 | JAN 2 2 2007 |
|-----------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------|
| Telephone: | 631-435-4711 Ext: 254 | |
| Fax: | 631-435-2849 | |
| Date Summary Revised: | January 17, 2007 | |
| Product Trade Name: | Glass Loss of Resistance Syringe | |
| Common Name: | Conduction Anesthetic | |
| Classification: | Class II, 21 CFR 868.5140 | |
| Product Code: | CAZ | |
| Predicate Device: | BD Glass Loss of Resistance Syringe -
(Pre-Amendment Device) | |
| Device Description: | The Glass Loss of Resistance Syringe is a single use
device, which is sold as sterile individually
packaged and sterile packaged inside a
kit/procedure tray. The syringe will be available in
luer lock and luer slip tip. | |
| Intended Use: | The Glass Loss of Resistance Syringe is intended
for use in conjunction with an epidural needle, to
verify the needle tip placement in the epidural space
by the loss of Resistance technique, it will be filled
with air and/or saline during use. The loss of
Resistance Syringe is not intended for injection or
aspiration. The syringe will be sold sterile
individually packaged, and as part of a sterile kit. | |

44 - 11 - 11,

1

510(k) SUMMARY OF SUBSTANTIAL EQUIVALENCE

Summary of Testing: All materials used in the fabrication of the specialty needles were evaluated through biological qualification safety tests. The biocompatibility tests performed were L929 Men Elution Test, Intracutaneous Injection Test, Systemic Injection Test, Salmonella Typhimurium and Escherichia Coli Reverse Mutation Assay, Hemolysis - Rabbit Blood Test, and Kligman Maximization Test. These materials have met the testing requirements and were found to be acceptable for the intended use.

Technological Characteristics: [21 CFR 807.92(a)(6)]

The subject device has the same Technological Characteristics as a legally marketed predicate device.

Conclusion: [21 CFR 807.92(b)(3)] The above statements are accurate representations of the device Busse intents to market. All data and information submitted in this premarket notification is truthful and accurate and no material fact has been omitted.

2

Public Health Service

Image /page/2/Picture/2 description: The image shows the seal of the Department of Health & Human Services, USA. The seal is circular, with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES, USA" arranged around the perimeter. In the center of the seal is an abstract emblem that resembles a stylized caduceus or a symbol representing health and well-being.

ood and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 2 2 2007

Mr. Muhamad Ansari Director of Regulatory Affairs Busse Hospital Disposables, Incorporated P.O. Box 11067 75 Arkay Drive Hauppauge, New York 11788

Re: K063018

Trade/Device Name: Glass Loss of Resistance Syringe Regulation Number: 21 CFR 868.5140 Regulation Name: Anesthesia Conduction Kit Regulatory Class: II Product Code: CAZ Dated: December 12, 2006 Received: December 15, 2006

Dear Mr. Ansari:

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 (PMA), 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 Eederal Register.

3

Page 2 - Mr. Ansari

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 (240) 276-0120. 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/cdrh/industry/support/index.html.

Sincerely yours,

Chris

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

510(k) Number (if known):

Device Name: Glass Loss of Resistance Syringe.

Indication for Use: The Glass Loss of Resistance Syringe is intended for use in conjunction with an epidural needle, to verify the needle tip placement in the epidural space by the loss of Resistance technique; it will be filled with air and/or saline during use. The loss of Resistance Syringe is not intended for injection or aspiration. The Syringe will be sold sterile individually packaged, and as part of a sterile kit.

Prescription Use × (Per 21 CFR 801Subpart D) AND/OR

Over-The-Counter Use_ (Per 21 CFR 801Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Susan Pearson

11 10 2017

K068018