K Number
K071222
Device Name
INFUSOR SV AND LV ELASTOMERIC INFUSION DEVICES
Date Cleared
2007-05-25

(23 days)

Product Code
Regulation Number
880.5725
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Infusion Pumps can be utilized for slow, continuous delivery through clinically acceptable routes of administration such as intravenous (IV), intra-arterial (IA), and subcutaneous or epidural infusion of medications directly into an intra-operative site or subcutaneously for post operative pain management
Device Description
Baxter's Infusor SV and LV devices are single-use, disposable elastomeric infusion pumps designed to deliver solution at a constant preset flow rate ranging from 0.5mL/hr to 10 mL/hr, depending on device configuration. The modifications made to the Infusor SV and LV devices include replacing the glass restrictor tube and housing used in previous versions of the device with a plastic tubing flow restrictor, a coupler to connect the tubing flow restrictor to the tube set and a Luer lock connector.
More Information

Not Found

No
The description focuses on mechanical and material modifications to an elastomeric infusion pump, with no mention of AI or ML capabilities.

No
The device is an infusion pump designed to deliver medication, which is a supportive function to a therapeutic intervention rather than a therapeutic device itself.

No

Explanation: The device description clearly states its function is to deliver solutions at a constant preset flow rate, which is a therapeutic function, not a diagnostic one. There is no mention of measurement, analysis, or diagnosis of physiological conditions.

No

The device description explicitly states it is a "single-use, disposable elastomeric infusion pump" with physical components like tubing, a coupler, and a Luer lock connector, indicating it is a hardware device, 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 clearly states the device is for the "slow, continuous delivery through clinically acceptable routes of administration such as intravenous (IV), intra-arterial (IA), and subcutaneous or epidural infusion of medications". This describes a device used for administering substances into the body, not for testing samples from the body to diagnose conditions.
  • Device Description: The description details an "elastomeric infusion pump designed to deliver solution at a constant preset flow rate". This aligns with a drug delivery device, not a diagnostic test.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting analytes, or providing diagnostic information.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device's function is entirely focused on delivering substances to the patient.

N/A

Intended Use / Indications for Use

The Infusion Pumps can be utilized for slow, continuous delivery through clinically acceptable routes of administration such as intravenous (IV), intra-arterial (IA), and subcutaneous or epidural infusion of medications directly into an intra-operative site or subcutaneously for post operative pain management.

Product codes

MEB, MEA

Device Description

Baxter's Infusor SV and LV devices are single-use, disposable elastomeric infusion pumps designed to deliver solution at a constant preset flow rate ranging from 0.5mL/hr to 10 mL/hr, depending on device configuration. The modifications made to the Infusor SV and LV devices include replacing the glass restrictor tube and housing used in previous versions of the device with a plastic tubing flow restrictor, a coupler to connect the tubing flow restrictor to the tube set and a Luer lock connector.

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

Nonclinical tests were conducted. Baxter Healthcare conducts risk analyses using procedures based on ISO 14971 (2000) "Medical Devices – Application of Risk Management to Medical Devices." The risk analysis method used to assess the impact of the modification was Failure Modes and Effects Analysis (FMEA). Design verification tests based on the result of risk analysis and design input were performed to verify the modifications. Testing of the device and components included mechanical, biocompatibility, and flow rate testing. All test results meet the acceptance criteria, and prove that the modifications are appropriate.

Key Metrics

Not Found

Predicate Device(s)

K041738, K002380

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 880.5725 Infusion pump.

(a)
Identification. An infusion pump is a device used in a health care facility to pump fluids into a patient in a controlled manner. The device may use a piston pump, a roller pump, or a peristaltic pump and may be powered electrically or mechanically. The device may also operate using a constant force to propel the fluid through a narrow tube which determines the flow rate. The device may include means to detect a fault condition, such as air in, or blockage of, the infusion line and to activate an alarm.(b)
Classification. Class II (performance standards).

0

.....

5. 510(K) SUMMARY

DATE PREPARED:

April 10, 2007

MAY 2 5 2007

OWNER:

Baxter Healthcare Corporation One Baxter Parkway Deerfield, Illinois 60015

CONTACT PERSON:

Nanette Hedden Regulatory Affairs Manager 1620 Waukegan Rd. McGaw Park, IL 60085 Telephone: (847) 473-6281 Fax: (847) 784-5116

DEVICE NAME:

Trade name: Infusor SV and LV Elastomeric Infusion Devices

Infusor SV 0.5 Infusor SV 1 Infusor SV 2 Infusor SV 4 Infusor LV 1.5 Infusor LV 2 Infusor LV5 Infusor LV 7 Infusor LV 10

COMMON NAME:

Infusion Pump

CLASSIFICATION NAME:

Infusion Pump (21 CFR 880.5725, Product Code MEB, MEA,

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PREDICATE DEVICE(S):

Previous 510(k)s
DevicePrevious 510(k)Clearance date
Baxter SV/LV Infusor
Elastomeric Infusion DeviceK041738July 9, 2004
Baxter Pain Management Infusor
Elastomeric Infusion DeviceK002380September 5, 2000

Table 5-1.

DESCRIPTION OF THE DEVICE AND MODIFICATION:

Baxter's Infusor SV and LV devices are single-use, disposable elastomeric infusion pumps designed to deliver solution at a constant preset flow rate ranging from 0.5mL/hr to 10 mL/hr, depending on device configuration. The modifications made to the Infusor SV and LV devices include replacing the glass restrictor tube and housing used in previous versions of the device with a plastic tubing flow restrictor, a coupler to connect the tubing flow restrictor to the tube set and a Luer lock connector.

STATEMENT OF INTENDED USE:

The Infusion Pumps can be utilized for slow, continuous delivery through clinically acceptable routes of administration such as intravenous (IV), intra-arterial (IA), and subcutaneous or epidural infusion of medications directly into an intra-operative site or subcutaneously for post operative pain management.

TECHNOLOGICAL CHARACTERISTICS:

The plastic tubing flow restrictor, Luer lock connector and coupler are replacing the current glass flow restrictor and Luer housing. These components provide the equivalent performance; however the materials differ in that the glass is replaced by plastic tubing and the coupler and Luer together replace the function of the current Luer housing by connecting the restrictor to the device tubing set and providing a Luer lock for connection to the patient's catheter.

DISCUSSION OF NONCLINICAL TESTS:

Baxter Healthcare conducts risk analyses using procedures based on ISO 14971 (2000) "Medical Devices – Application of Risk Management to Medical Devices." The risk analysis method used to assess the impact of the modification was Failure Modes and

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Effects Analysis (FMEA). Design verification tests based on the result of risk analysis and design input were performed to verify the modifications. Testing of the device and components included mechanical, biocompatibility, and flow rate testing. All test results meet the acceptance criteria, and prove that the modifications are appropriate.

CONCLUSION:

The Infusor SV and LV Elastomeric Infusion Devices with the modifications are as safe and effective as the predicate device and the performance is substantially equivalent to the predicate device

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized caduceus symbol, which is a staff with two snakes coiled around it, and the words "DEPARTMENT OF HEALTH & HUMAN SERVICES · USA" arranged in a circular pattern around the symbol. The text is in all caps and is evenly spaced around the circle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAY 2 5 2007

Ms. Nanette Hedden Manager, Global Regulatory Affairs Baxter Healthcare Corporation Medication Delivery 1620 Waukegan Road McGaw Park, Illinois 60085

Re: K071222

Trade/Device Name: Infusor SV and LV Elastomeric Infusion Devices Regulation Number: 21 CFR 880.5725 Regulation Name: Infusion Pump Regulatory Class: II Product Code: MEB Dated: April 30, 2007 Received: May 2, 2007

Dear Ms. Hedden:

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 Federal Register.

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Page 2 - Ms. Hedden

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) 276-0115. 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,

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

Enclosure

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K071222

INDICATIONS FOR USE

510(k) Number (if known):

Device Name: Infusor SV and LV Elastomeric Infusion Devices

Indications For Use: The Infusion Pumps can be utilized for slow, continuous delivery through clinically acceptable routes of administration such as intravenous (IV), intraarterial (IA), and subcutaneous or epidural infusion of medications directly into an intraoperative site or subcutaneously for post operative pain management

Prescription Use X

AND/OR

Over-The-Counter Use

(Part 21 CFR 801 Subpart D)

(21 CFR 807 Subpart C)

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

Jon Sign-Off) cion of Anesthesiology, General Hospital, Concurrence of CDRH, Officie of CDetroit, Entation (SDE)

大47122 " : C(k) Number :_

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