K Number
K070414
Device Name
GAMBRO CARTRIDGE BLOOD SETS
Date Cleared
2007-10-12

(242 days)

Product Code
Regulation Number
876.5820
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Gambro Cartridge® Blood Set is intended for single use in a hemodialysis treatment using the Phoenix and Centrysystem 3 Dialysis Delivery Systems. The Low Weight model is used when a low extra-corporeal blood volume is recommended. The Low Weight model with a priming volume of 75 ml is indicated for patients with body weight greater than 20 Kg and lower or equal to 40 Kg. The standard models with a priming volume ranging from 103 ml to 162 ml are indicated for patients with body weight greater than 40 Kg.
Device Description
The Gambro Cartridge® Blood Sets are single use sterile tubing sets employed in the Gambro hemodialysis equipments extracorporeal circulation. They convey the patient's blood from the arterial-venous access fistula to the dialyzing filter (arterial line) and back after purification (venous line) and they are commonly referred to as bloodlines. A Gambro Cartridge® Blood Set can be safely connected to hemodialyzers, vascular accesses and various perfusion lines, under the responsibility of the physician in charge.
More Information

Not Found

No
The summary describes a single-use tubing set for hemodialysis, a purely mechanical device. There is no mention of AI, ML, image processing, or any computational analysis of data. The performance studies are bench tests of physical properties.

No
The device is a component of a hemodialysis system, specifically the tubing set that conveys blood to and from the dialyzing filter. The therapeutic effect is provided by the dialyzer and the dialysis machine, not by the blood set itself.

No

The device is described as a "Blood Set" or "bloodlines" used for conveying blood during hemodialysis. There is no mention of it being used to diagnose a medical condition or disease.

No

The device description clearly states it is a "single use sterile tubing set" and "convey the patient's blood," indicating a physical, hardware-based medical device.

Based on the provided information, the Gambro Cartridge® Blood Set is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use is to convey blood during hemodialysis treatment using specific dialysis delivery systems. This is a therapeutic procedure, not a diagnostic test performed on samples outside the body.
  • Device Description: The device is described as a sterile tubing set used in the extracorporeal circulation of hemodialysis equipment. It physically transports blood.
  • Lack of Diagnostic Function: There is no mention of the device being used to analyze blood or other biological samples to provide diagnostic information about a patient's condition.
  • Performance Studies: The performance studies focus on the physical and functional aspects of the tubing set (flow rate, biocompatibility, mechanical hemolysis, etc.) and its compatibility with the dialysis machine, not on the accuracy or reliability of diagnostic results.

IVD devices are typically used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for the diagnosis, monitoring, or treatment of a disease or condition. The Gambro Cartridge® Blood Set's function is to facilitate the physical process of hemodialysis, not to perform a diagnostic test.

N/A

Intended Use / Indications for Use

The Gambro Cartridge® Blood Set is intended for single use in a hemodialysis treatment using the Phoenix and Centrysystem 3 Dialysis Delivery Systems. The Low Weight model is used when a low extra-corporeal blood volume is recommended. The Low Weight model with a priming volume of 75 ml is indicated for patients with body weight greater than 20 Kg and lower or equal to 40 Kg. The standard models with a priming volume ranging from 103 ml to 162 ml are indicated for patients with body weight greater than 40 Kg.

Product codes

KOC, FJK

Device Description

The Gambro Cartridge® Blood Sets are single use sterile tubing sets employed in the Gambro hemodialysis equipments extracorporeal circulation. They convey the patient's blood from the arterial-venous access fistula to the dialyzing filter (arterial line) and back after purification (venous line) and they are commonly referred to as bloodlines. A Gambro Cartridge® Blood Set can be safely connected to hemodialyzers, vascular accesses and various perfusion lines, under the responsibility of the physician in charge.

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)

The non-clinical testing consisted of performance testing (bench) that included testing for biocompatibility, flow rate, validation of system injection ports (access sites), hemodialysis machine compatibility, mechanical hemolysis, expiration dating, integrity of the strength between connections, kink resistance, clamping of tubing and testing required by process to ensure compliance with other international standards applicable to extracorporeal blood circuit for hemodialysers.
The successful non-clinical testing demonstrates the safety and effectiveness of the Gambro Cartridge® Blood Set when used for the defined indications for use and demonstrates that the device for which the 510(k) is submitted performs as well as or better than the legally marketed predicate device.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

Cobe Cartridge Blood Tubing Set

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

K070414 Page 1 of 4

Gambro Traditional 510(k)
Gambro Cartridge® Blood Set

5.0 510(K) SUMMARY

007 1 2 2007

Submitter's NameGambro Renal Products
Address10810 West Collins Avenue
Lakewood, CO 80215
Establishment
Number2087532
Date of SubmissionFebruary 9, 2007
Contact PersonThomas B. Dowell, Regulatory Affairs Project Manager
Telephone Number
Fax Number(303) 231-4094
(303) 542-5138
Name of the DeviceGambro Cartridge® Blood Set
Catalogue Numbers003409-400 Single Needle
003409-410 Single Needle (with prime line attached)
003410-500 Double Needle
003410-510 Double Needle (with prime line attached)
003410-710 Double Needle (with prime line attached with injection site)
003411-500 Double Needle (with longer patient line)
003412-500 Double Needle - Low Weight
003414-500 Double Needle (with extended dialyzer line)
003414-510 Double Needle (with extended dialyzer line and prime line
attached)
003415-510 Double Needle (with prime line attached)
003429-500 Single Needle Conversion Kit
Common or Usual
NameExtracorporeal blood circuit for hemodialysers
Classification NameClassification Name: Hemodialysis system and accessories
Device Class: II
Product Code: KOC
Regulation Number: 21 CFR 876.5820
Identification of the
Legally Marketed
Device
(Predicate Device)Cobe Cartridge Blood Tubing Set

1

K070914 Page 2 of 4

Traditional 510(k) Gambro Cartridge® Blood Set

510(k) SUMMARY, continued

The Gambro Cartridge® Blood Sets are single use sterile tubing sets Device Description employed in the Gambro hemodialysis equipments extracorporeal circulation. They convey the patient's blood from the arterial-venous access fistula to the dialyzing filter (arterial line) and back after purification (venous line) and they are commonly referred to as bloodlines. A Gambro Cartridge® Blood Set can be safely connected to hemodialyzers, vascular accesses and various perfusion lines, under the responsibility of the physician in charge.

Device Comparison Table

PREDICATEMODIFIED DEVICE
Cobe Cartridge Blood Tubing SetGambro Cartridge® Blood Set
Indication for UseThe Cobe Cartridge Blood Tubing Set
may be used with the following
hemodialysis devices: The Gambro
Dasco Phoenix; The Gambro Model Cx,
and the Cobe Centrysystem 3 (and 3+)
Systems.The Gambro Cartridge® Blood Set is
intended for single use in a
hemodialysis treatment using the
Phoenix® and Centrysystem® 3
Dialysis Delivery Systems. The Low
Weight model is used when a low
extra-corporeal blood volume is
recommended. The Low Weight
model with a priming volume of 75
ml is indicated for patients with body
weight greater than 20 Kg and lower
or equal to 40 Kg. The standard
models with a priming volume
ranging from 103 ml to 162 ml are
indicated for patients with body
weight greater than 40 Kg.
Catalogue No.Single Needle (SN):
003409-400
003409-410
Double Needle (DN):
003410-500
003410-510
003411-500
003414-500
Single Needle conversion kit (SNK):
003429-500
Double Needle Pediatric (P):
003412-500Single Needle (SN):
003409-400
003409-410
Double Needle (DN):
003410-500
003410-510
003411-500
003414-510
003414-500
003415-510
003410-710
Single Needle conversion kit (SNK):
003429-500
Double Needle Low Weight (LW):
003412-500
PREDICATEMODIFIED DEVICE
Cobe Cartridge Blood Tubing SetGambro Cartridge® Blood Set
CartridgeYesYes
Dialysis Machine
Compatibility (U.S.)Phoenix and Centrysystem 3Phoenix and Centrysystem 3
ClampsPinchPinch
Blood Tubing
MaterialSoft PVC materialSoft PVC material with DEHP-free
plasticizer
Blood Tubing LengthPatient length:
SN: 198 cm
DN: from 183 cm to 244 cm
P: 183 cmPatient length:
SN: 198 cm
DN: from 183 cm to 244 cm
LW: 183 cm
Dialyzer length (venous):
SN: 46 cm
DN: from 46 cm to 53 cm
SNK: 46 cm
P: 46 cmDialyzer length (venous):
SN: 46 cm
DN: from 46 cm to 53 cm
SNK: 46 cm
LW: 46 cm
Dialyzer length (arterial):
SN: 46 cm
DN: from 30 cm to 46 cm
SNK: 50 cm
P: 30 cmDialyzer length (arterial):
SN: 46 cm
DN: from 30 cm to 51 cm
SNK: 51 cm
LW: 30 cm
Blood Tubing
ThicknessBlood Pathway:
SN-DN: 1.16 mm
P: 1.62 cmBlood Pathway:
SN-DN: 1.16 mm
SN-DN Connections to dialyzer
lines: 1.32 mm
LW: 1.63 mm
Blood Pump segment:
SN-DN: 1.59 mm
P: 1.59 mmBlood Pump segment:
SN-DN: 1.59 mm
LW: 1.59 mm
Priming VolumesSN: 145 ml
DN: from 103 ml to 120 ml
SNK: 45 ml
P: 75 mlSN: 162 ml
DN: from 103 ml to 119 ml
SNK: 45 ml
LW: 75 ml
Injection Plug
MaterialLatex-freeLatex-free
PackagingPouchBlister
Sterilization MethodRadiationRadiation
Expiration3 years3 years
Single UseYesYes
Storage Temperature-18°C (0°F) and 49°C (120°F)-18°C (0°F) and 49°C (120°F)

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K070 4/7 page 3 of 4

Gambro Cartridge® Blood Set

3

KO70 4/4 P392 4 of 4

Traditional 510(k) Gambro Cartridge® Blood Set

Description and Conclusion of Testing

Nonclinical Testing:

The non-clinical testing consisted of performance testing (bench) that included testing for biocompatibility, flow rate, validation of system injection ports (access sites), hemodialysis machine compatibility, mechanical hemolysis, expiration dating, integrity of the strength between connections, kink resistance, clamping of tubing and testing required by process to ensure compliance with other international standards applicable to extracorporeal blood circuit for hemodialysers.

Conclusion:

The successful non-clinical testing demonstrates the safety and effectiveness of the Gambro Cartridge® Blood Set when used for the defined indications for use and demonstrates that the device for which the 510(k) is submitted performs as well as or better than the legally marketed predicate device.

4

Image /page/4/Picture/0 description: The image shows the logo for the Department of Health & Human Services - USA. The logo is a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of a bird or abstract human figure, composed of three curved lines.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Food and Drug Administration 9200 Corporate Blvd. Rockville MD 20850

OCT 1 2 2007

Mr. Thomas B. Dowell Quality Systems Program Manager Gambro® Renal Products 10810 W. Collins Avenue LAKEWOOD CO 80215

Re: K070414

Trade/Device Name: Gambro Cartridge® Blood Set Regulation Number: 21 CFR §876.5820 Regulation Name: Hemodialysis system and accessories Regulatory Class: II Product Code: FJK Dated: July 9, 2007 Received: July 10, 2007

Dear Mr. Dowell:

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 Eederal Register.

Image /page/4/Picture/10 description: The image shows a circular logo with the text "1906-2006 FDA Centennial" in it. The logo is black and white and has a star design at the bottom. The text is arranged in a circular fashion around the central FDA letters.

Protecting and Promoting Public Health

5

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/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

6

Traditional 510(k) Gambro Cartridge® Blood Set

Indications for Use

510(k) Number (if known): K070414

Device Name: Gambro Cartridge® Blood Set

Indications for Use:

The Gambro Cartridge® Blood Set is intended for single use in a hemodialysis treatment using the Phoenix and Centrysystem 3 Dialysis Delivery Systems. The Low Weight model is used when a low extra-corporeal blood volume is recommended. The Low Weight model with a priming volume of 75 ml is indicated for patients with body weight greater than 20 Kg and lower or equal to 40 Kg. The standard models with a priming volume ranging from 103 ml to 162 ml are indicated for patients with body weight greater than 40 Kg.

Prescription Use X Over-The-Counter Use AND/OR (Part 21 CFR 801 Subpart D) (21 CFR 801 Subpart C) (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Halut Peunand

(Division Si(i-Uff)
Page 17 of 57
Division of Reproductive, Abdominal and
Radiological Devices
510(k) Number K070414