K Number
K081361
Device Name
CHEMOCLAVE CYTOTOXIC MEDICATION PREPARATION AND DELIVERY SYSTEM, MODEL, CH-XXXX
Manufacturer
Date Cleared
2008-08-28

(105 days)

Product Code
Regulation Number
880.5440
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The ChemoCLAVE Cytotoxic Medication Preparation and Delivery System consists of 6 previously cleared components (CLAVE®, Spikes, SPIROS™, GENIE™, Vial Access, and Admin Sets) that can be combined into various configurations intended for use in the preparation and patient administration of cytotoxic medications.
Device Description
The ChemoCLAVE Cytotoxic Medication Preparation and Delivery System is a combination of ICU Medical's products and tested for compatibility with lipids and/or cytotoxic agents. The "System" part is where these devices are packaged individually or sold together as a custom set upon order of the physician for the purpose of enabling the user a safe and inexpensive alternative to other passively closed systems.
More Information

Not Found

No
The document describes a system of previously cleared components for preparing and delivering cytotoxic medications and does not mention AI or ML.

No.
The device is described as a "preparation and patient administration" system for cytotoxic medications, not for treating a disease or condition itself.

No
The device is described as a "preparation and patient administration" system for cytotoxic medications, similar to an IV set, and does not mention any diagnostic functions.

No

The device description clearly states it is a "combination of ICU Medical's products" which are physical components (CLAVE®, Spikes, SPIROS™, GENIE™, Vial Access, and Admin Sets). It is a system of hardware components for preparing and delivering medication, not a software-only device.

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

Here's why:

  • Intended Use: The intended use is for the "preparation and patient administration of cytotoxic medications." This describes a system used for handling and delivering drugs to a patient, which is a therapeutic or drug delivery function, not a diagnostic one.
  • Device Description: The description focuses on the components and their use in creating a "safe and inexpensive alternative to other passively closed systems" for handling cytotoxic agents. This reinforces its role in drug preparation and delivery.
  • Lack of Diagnostic Elements: There is no mention of the device being used to test samples from the human body (like blood, urine, tissue, etc.) to provide information about a disease or condition. IVDs are specifically designed for this purpose.

Therefore, the ChemoCLAVE Cytotoxic Medication Preparation and Delivery System falls under the category of a medical device used for drug preparation and administration, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The ChemoCLAVE Cytotoxic Medication Preparation and Delivery System consists of 6 previously cleared components (CLAVE®, Spikes, SPIROS™, GENIE™, Vial Access, and Admin Sets) that can be combined into various configurations intended for use in the preparation and patient administration of cytotoxic medications.

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

LHI, FPA

Device Description

The ChemoCLAVE Cytotoxic Medication Preparation and Delivery System is a combination of ICU Medical's products and tested for compatibility with lipids and and/or cytotoxic agents. The "System" part is where these devices are packaged individually or sold together as a custom set upon order of the physician for the purpose of enabling the user a safe and inexpensive alternative to other passively closed systems. The predicate devices have been successfully used in the practice of administration of chemotherapy agents to patients for many years. In this submission, we are specifically requesting to market the name "ChemoCLAVE Cytotoxic Medication Preparation and Delivery System."

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)

Not Found

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.

K970855, K070633, K934591, K070532, K080989, K964435, K070856, K024239, K003730, K003513, K974431

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

§ 880.5440 Intravascular administration set.

(a)
Identification. An intravascular administration set is a device used to administer fluids from a container to a patient's vascular system through a needle or catheter inserted into a vein. The device may include the needle or catheter, tubing, a flow regulator, a drip chamber, an infusion line filter, an I.V. set stopcock, fluid delivery tubing, connectors between parts of the set, a side tube with a cap to serve as an injection site, and a hollow spike to penetrate and connect the tubing to an I.V. bag or other infusion fluid container.(b)
Classification. Class II (special controls). The special control for pharmacy compounding systems within this classification is the FDA guidance document entitled “Class II Special Controls Guidance Document: Pharmacy Compounding Systems; Final Guidance for Industry and FDA Reviewers.” Pharmacy compounding systems classified within the intravascular administration set are exempt from the premarket notification procedures in subpart E of this part and subject to the limitations in § 880.9.

0

ICU MEDICAL INC.

4455 Atherton Drive Salt Lake City, Utah (801) 264 - 1332, Phone (801) 264 - 1755, Fax Mr. Tracv S. Best, Sr. Regulatory Affairs Specialist Preparation Date: August 26th 2008

Image /page/0/Picture/2 description: The image contains the logo for ICU Medical, Inc. along with a horse graphic. Above the logo, there is a handwritten number, K081361. The logo is in bold, black font.

AUG 2 8 2008

510(K) Summary of Safety and Effectiveness for the:

Trade Name:ChemoCLAVE® Cytotoxic Medication Preparation and Delivery System
Common Name:Chemotherapy I.V. Preparation, Transfer and Administration Sets
Classification Name:Set, I.V. Fluid Transfer & Set, Administration, Intravascular
21 CFR 880.5440, Class II Device
Product Codes:Primary Code – LHI, Secondary Code – FPA

Legally Marketed Predicate Devices for Substantial Equivalence:

*Clave Connector - K970855 *Genie™ - K070633 *Clave Vial Access Spike - K934591 *Spiros - K070532 *Universal Vial Access Spike - K080989 *Primary IV Set - K964435 *Single Use Syringe - K070856

*Chemo Dispensing Pin - K024239 *Chemo-AIDE - K003730 *Taxol Administration Set - K003513 *Chemo Spike II Reconstitution Device - K974431

Rationale for SE:

The ChemoCLAVE Cytotoxic Medication Preparation and Delivery Systems are a combination of ICU Medical devices that are already legally marketed around the world. In short, we are incorporating these previously cleared devices to withdraw cytotoxic agents from a vial for transfer to the administration set and finally, to the patient. All of the predicate devices listed above left are part of this submission.

Description of Submitted Device:

The ChemoCLAVE Cytotoxic Medication Preparation and Delivery System is a combination of ICU Medical's products and tested for compatibility with lipids and/or cytotoxic agents. The "System" part is where these devices are packaged individually or sold together as a custom set upon order of the physician for the purpose of enabling the user a safe and inexpensive alternative to other passively closed systems. The predicate devices have been successfully used in the practice of administration of chemotherapy agents to patients for many years. In this submission, we are specifically requesting to market the name "ChemoCLAVE Cytotoxic Medication Preparation and Delivery System."

Intended Use:

The ChemoCLAVE Cytotoxic Medication Preparation and Delivery System consists of 6 previously cleared components (CLAVE®, Spikes, SPIROS™, GENIE™, Vial Access, and Admin Sets) that can be combined into various configurations intended for use in the preparation and patient administration of cytotoxic medications.

1

Device:CLAVE®SPIKESSPIROST™GENIETMVIAL ACCESSADMIN SETS
The
ChemoCLAVE
Cytotoxic
Medication
Preparation
and Delivery
System is any
combination of
these already
approved &
marketed
devices.Same
design,
materials,
assemblyPurchased
and
qualified
componentSame
design,
materials,
& assemblySame
design,
materials,
& assemblyMaterials &
assembly similarSame design
and materials
and assembly
NeedlelessNeedlelessNeedlelessNeedlelessNeedlelessN/A
Passively
closedN/APassively
ClosedPassively
ClosedN/AN/A
GammaGammaGammaGammaGammaGamma
K970855K964435
& OEMK070532K070633K934591;
K934561 &
K080989K964435 &
OEM
C1000;
B3300;
CH3000;
etc.CH-12;
CH-13;
CH-14;
CH-15;
etc.CH2000;
CH3000;
etc.CH-77; etc.
(vial size)CH-10; CH-50;
CH-51; CH-52;
CH-55; CH-60;
CH-70; etc. (vial
size)Too numerous
to list ( due to
tubing length &
and accessories)

Technological Characteristics and Substantial Equivalence Table:

Safety and Performance:

ICU Medical conforms to international standards in the design, development, and manufacturing of all of their unique disposable medical devices. Additionally, ICU Medical's Sterility Assurance Level, (SAL) has an established and validated history of meeting a 10t4 level. The single use ChemoCLAVE Cytotoxic Medication Preparation and Delivery System components are packaged in blister packs with Tyvek lidding.

Conclusion:

The materials, performance, and operational features of both the submitted device and the predicate device are substantially equivalent and are safe and effective for their intended use.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized depiction of an eagle with its wings spread, symbolizing protection and care. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle, indicating the department's name and national affiliation.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG 2 8 2008

Mr. Tracy S. Best Senior Regulatory Affairs Specialist ICU Medical, Incorporated 4455 Atherton Drive Salt Lake City, Utah 84123

Re: K081361

Trade/Device Name: ChemoCLAVE® Cytotoxic Medication Preparation and Delivery System Regulation Number: 21 CFR 880.5440 Regulation Name: Intravascular Administration Set Regulatory Class: II Product Code: FPA, LHI Dated: August 21, 2008 Received: August 22, 2008

Dear Mr. Best:

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 - Mr. Best

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 Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. 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

4

Indications for Use

510(k) Number (if known): K081361

Device Name: ChemoCLAVE® Cytotoxic Medication Preparation and Delivery System:

Indications for Use:

The ChemoCLAVE Cytotoxic Medication Preparation and Delivery System consists of 6 previously cleared components (CLAVE®, Spikes, SPIROS™, GENIE™, Vial Access, and Admin Sets) that can be combined into various configurations intended for use in the preparation and patient administration of cytotoxic medications.

Prescription Use XX (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Anthony D. m

(Division Sign-Off) Division of Anesthesiology, General Hospital Infection Control, Dental Devices

K681361 510(k) Number: __