K Number
K072172
Device Name
JOSTRA PEDIATRIC ARTERIAL PREFUSION CANNULAE
Date Cleared
2007-08-31

(25 days)

Product Code
Regulation Number
870.4210
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Jostra Pediatric Arterial Perfusion Cannulae are designed to be used as perfusion cannulae to return arterial blood from the extracorporeal circuit to the patient during cardiopulmonary bypass up to 6 hours or less.
Device Description
The Jostra Pediatric Arterial Perfusion Cannulae are designed to be used as perfusion cannulae to return arterial blood from the extracorporeal circuit to the patient during cardiopulmonary bypass up to 6 hours or less.
More Information

Not Found

Not Found

No
The summary describes a physical medical device (cannulae) and does not mention any software, algorithms, or data processing that would indicate the use of AI/ML.

No
Explanation: The device is used to return arterial blood to a patient during cardiopulmonary bypass, which is a supportive function rather than a direct therapeutic intervention for a disease.

No
Explanation: The device is a perfusion cannula used to return arterial blood during cardiopulmonary bypass. It is an active medical device involved in treatment, not diagnosis.

No

The device is described as "cannulae," which are physical tubes used in medical procedures. The description focuses on material changes and physical testing, indicating a hardware device.

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

Here's why:

  • Intended Use: The intended use is to "return arterial blood from the extracorporeal circuit to the patient during cardiopulmonary bypass." This is a direct therapeutic intervention on the patient's circulatory system, not a test performed on a sample taken from the body to diagnose a condition.
  • Device Description: The description reiterates the same intended use, confirming its function in a medical procedure.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing a biological sample (blood, urine, tissue, etc.)
    • Providing diagnostic information
    • Using reagents or assays

Therefore, the Jostra Pediatric Arterial Perfusion Cannulae are a medical device used in a surgical procedure, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Jostra Pediatric Arterial Perfusion Cannulae are designed to be used as perfusion cannulae to return arterial blood from the extracorporeal circuit to the patient during cardiopulmonary bypass up to 6 hours or less.

Product codes

DWF

Device Description

The Jostra Pediatric Arterial Perfusion Cannulae are designed to be used as perfusion cannulae to return arterial blood from the extracorporeal circuit to the patient during cardiopulmonary bypass up to 6 hours or less.

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

Pediatric

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 risk analysis method used to assess the impact of the modification was done acc. to the logic of a Failure Modes and Effects Analysis (FMEA). The design verification tests were performed as a result of this risk analysis assessment. All possible risks for the user and the patient related to the design change (material change) have been assessed by evaluation or testing acc. to the risk analysis for the Pediatric Arterial Perfusion Cannulae. The following hazards have been addressed: General hazards related to biocompatibility, Hazards related to manufacturing - adhesiveness of the position marker. The evaluation and test results do not show any kind of risk potential for the user and/or the patient. Based on the test results and evaluation the Pediatric Arterial Perfusion Cannulae are safe and effective for its intended use and are substantially equivalent to the named predicate device. The modification does not alter the fundamental scientific technologies of the Pediatric Arterial Perfusion Cannulae.

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

Not Found

Predicate Device(s)

Jostra Pediatric Arterial Cannulae

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.4210 Cardiopulmonary bypass vascular catheter, cannula, or tubing.

(a)
Identification. A cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to cannulate the vessels, perfuse the coronary arteries, and to interconnect the catheters and cannulas with an oxygenator. The device includes accessory bypass equipment.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image shows a sequence of handwritten characters, which appear to be 'K072172'. The characters are written in a bold, somewhat rough style, with varying stroke thicknesses. The 'K' is distinct with its angled lines, followed by the rounded '0' and the numbers '7', '2', '1', '7', and '2'.

MAQUET

Special 510(k): Device Modification: Jostra Pediatric Arterial Cannulae

Fax:

July 31, 2007

Arterial Cannulae

cannula or tubing

510(k) SUMMARY

AUG 3 1 2007

SUBMITTER:

Maquet Cardiopulmonary AG Hechinger Strasse 38 72145 Hirrlingen, Germany

Phone: (011) 49 7478 921- 151

Jostra Pediatric Arterial Cannulae

(011) 49 7478 921- 400

Cardiopulmonary bypass vascular catheter,

Katrin Schwenkglenks

CONTACT PERSON:

DATE PREPARED:

DEVICE TRADE NAME:

COMMON/USUAL NAME

CLASSIFICATION NAME

PREDICATE DEVICES OR LEGALLY MARKETED DEVICES

Jostra Pediatric Arterial Cannulae

DEVICE DESCRIPTION / INDICATONS FOR USE STATEMENT

The Jostra Pediatric Arterial Perfusion Cannulae are designed to be used as perfusion cannulae to return arterial blood from the extracorporeal circuit to the patient during cardiopulmonary bypass up to 6 hours or less.

STATEMENT OF TECHNICAL CHARACTERISTICS COMPARISON

Jostra Pediatric Arterial Cannulae are identical to the originally cleared Jostra Pediatric Arterial Cannulae, with the only exception that the Jostra Pediatric Arterial Cannulae uses a different material for the white depth markings. Besides this difference the devices are the same in design, intended use, method of operation, components, packaging, and fundamental scientific technology.

RISK ANALYSIS

The risk analysis method used to assess the impact of the modification was done acc. to the logic of a Failure Modes and Effects Analysis (FMEA). The design verification tests were performed as a result of this risk analysis assessment.

1

MAQUET

All possible risks for the user and the patient related to the design change (material change) have been assessed by evaluation or testing acc. to the risk analysis for the Pediatric Arterial Perfusion Cannulae. The following hazards have been addressed:

General hazards related to

  • · biocompatibility
    Hazards related to manufacturing

  • · adhesiveness of the position marker
    The evaluation and test results do not show any kind of risk potential for the user and/or the patient. Based on the test results and evaluation the Pediatric Arterial Perfusion Cannulae are safe and effective for its intended use and are substantially equivalent to the named predicate device. The modification does not alter the fundamental scientific technologies of the Pediatric Arterial Perfusion Cannulae.

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle or bird symbol with three curved lines representing its wings or feathers. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the bird symbol.

ood and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG 3 1 2007

Maquet Cardiopulmonary AG c/o Ms. Katrin Schwenkglenks Regulatory Affairs Manager Hechinger Strasse 38 72145 Hirrlingen, Germany

Re: K072172

Jostra Pediatric Arterial Perfusion Cannulae Regulation Number: 21 CFR 870.4210 Regulation Name: Cardiopulmonary bypass vascular catheter, cannula or tubing Regulatory Class: Class II Product Code: DWF Dated: July 31, 2007 Received: August 6, 2007

Dear Ms. Schwenkglenks:

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.

3

Page 2- Ms. Katrin Schwenkglenks

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 vours.

Dwna R. Lachner

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

Indications for Use

510(k) Number (if known): Ko72172 Device Name: Jostra Pediatric Arterial Perfusion Cannulae

Indications for Use:

The Jostra Pediatric Arterial Perfusion Cannulae are designed to be used as perfusion cannulae to return arterial blood from the extracorporeal circuit to the patient during cardiopulmonary bypass up to 6 hours or less. .

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)

una R. Vahner
Division Sign Off

(Division Sign-Off)
Division of Cardiovascular Devices

510(k) Number Koral 72

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(Posted November 13, 2003)