K Number
K081449
Manufacturer
Date Cleared
2008-06-03

(11 days)

Product Code
Regulation Number
880.5570
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The UltiGuard Home Insulin Pen Needle Dispenser and Sharps Container by Ulti Med Inc. is intended to be used to transport, store and dispense insulin pen needles in the home. After use the used pen needle can be placed back into the container for safe storage and eventual disposal according to local regulations.

Device Description

The UltiGuard Home Insulin Pen Needle Dispenser and Sharps Container contains 100 insulin pen needles. Pen needles can be removed from the dispenser as needed, and used pen needles can be removed and deposited back into the top of the container for safe storage. When all 100 pen needles have been used and discarded into the container, the container is disposed according to local regulations. The disposable pen needles and UltiGuard container are intended for single use only.

AI/ML Overview

The UltiGuard™ Home Insulin Pen Needle Dispenser and Sharps Container is a Class II medical device (product code MMK) intended for home use to transport, store, and dispense insulin pen needles, and to safely store used pen needles for eventual disposal. The device's acceptance criteria and the study proving it meets these criteria are outlined below:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance Criteria (Standards Met)Reported Device Performance
BS 7320 (1990): Specifications for Sharps ContainersThe device meets this standard.
ASTM F2132 (2001): Puncture Resistance of Materials Used in Containers for Discarded Medical NeedlesThe device meets this standard.
Substantial Equivalence to Predicate Device (K021983)Substantially equivalent in intended use, function, and basic composition.

2. Sample Size and Data Provenance

The provided 510(k) summary does not specify a sample size for any test set nor does it provide details on data provenance (e.g., country of origin or whether data was retrospective or prospective). The evaluation is based on compliance with established standards and comparison to a predicate device.

3. Number and Qualifications of Experts for Ground Truth

The summary does not mention the use of experts to establish ground truth for a test set. The assessment is based on compliance with engineering standards and substantial equivalence, not clinical performance requiring expert interpretation.

4. Adjudication Method

No adjudication method is mentioned as there was no test set requiring expert review.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No MRMC study was conducted or mentioned in the provided text. The device is a physical container and dispenser, not an AI or imaging diagnostic tool that would typically involve a multi-reader multi-case study.

6. Standalone Performance Study

A standalone performance evaluation was done in the sense that the device was tested against specific engineering standards (BS 7320 and ASTM F2132). The conclusion of the submission relies on the device's ability to meet these published standards, demonstrating its physical and material performance characteristics relevant to its function as a sharps container and dispenser.

7. Type of Ground Truth Used

The "ground truth" for this device's acceptance is based on compliance with recognized engineering standards (BS 7320 and ASTM F2132) and detailed descriptive data demonstrating its technical characteristics and intended use are substantially equivalent to a legally marketed predicate device. This is a non-clinical assessment.

8. Sample Size for Training Set

The concept of a "training set" is not applicable here as the device is a physical product and not an AI or machine learning algorithm.

9. How Ground Truth for Training Set Was Established

Similarly, the establishment of ground truth for a training set is not applicable given the nature of the device and the substantial equivalence pathway used for its clearance.

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UltiGuard™ Home Insulin Pen Needle Dispenser and Sharps Container Traditional 510(k)

510(k) Summary

K081449

Submitter

Ulti Med Inc. 287 East Sixth Street St. Paul, Minnesota Contact Person: Thomas E. Erickson Telephone: (651) 291-7909 Fax: (651) 291-7074

May 19, 2008

Date Prepared

JUN - 3 2008

Name of Device

Common Name:Sharps Container
Proprietary Name:UltiGuard™ Home Insulin Pen Needle Dispenser and Sharps Container
Classification Name:Hypodermic single lumen needles
Regulation:880.5570
Class:Class II
Product Code:MMK

Predicate Devices

The UltiGuard Home Insulin Pen Needle Dispenser and Sharps Container is substantially equivalent in intended use, function and basic composition to the currently marketed UltiGuard Home Insulin Syringe Dispenser and Sharps Container, K021983.

Device Description

The UltiGuard Home Insulin Pen Needle Dispenser and Sharps Container contains 100 insulin pen needles. Pen needles can be removed from the dispenser as needed, and used pen needles can be removed and deposited back into the top of the container for safe storage. When all 100 pen needles have been used and discarded into the container, the container is disposed according to local regulations. The disposable pen needles and UltiGuard container are intended for single use only.

Intended Use

The UltiGuard Home Insulin Pen Needle Dispenser and Sharps Container by Ulti Med Inc. is intended to be used to transport, store and dispense insulin pen needles in the home. After use the used pen needle can be placed back into the container for safe storage and eventual disposal according to local regulations.

Technological Characteristics

The UltiGuard Home Insulin Pen Needle Dispenser and Sharps Container has similar technological characteristics to the currently marketed predicate device listed above. The UltiGuard Home Insulin Pen Needle Dispenser and Sharps Container meets the following standards:

BS 7320 (1990), Specifications for Sharps Containers

ASTM F2132 (2001), Puncture Resistance of Materials Used in Containers for Discarded Medical Needles

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UltiGuard™ Home Insulin Pen Needle Dispenser and Sharps Container Traditional 510(k)

Performance Data (non-clinical or clinical)

The UltiGuard Home Insulin Pen Needle Dispenser and Sharps Container is substantially equivalent to the predicate device based on the descriptive data, compliance with standards, and indications for use.

Conclusion

The technological characteristics and performance data for the UltiGuard Home Insulin Pen Needle Dispenser and Sharps Container demonstrate it is substantially equivalent to the predicate device.

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Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features the department's name in a circular arrangement around a stylized eagle emblem. The eagle is depicted with flowing lines, suggesting movement and freedom. The text is in uppercase letters and is arranged to follow the curve of the circle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUN - 3 2008

Ulti Med Incorporated C/O Mr. Mark Job Responsible Third Party Official Regulatory Technology Services, LLC 1394 25th Street NW Buffalo, Minnesota 55313

Re: K081449

Trade/Device Name: UltiGuard™ Home Insulin Pen Needle Dispenser and Sharps Container Regulation Number: 21 CFR 880.5570 Regulation Name: Hypodermic Single Lumen Needle Regulatory Class: II Product Code: MMK Dated: March 27, 2008 Received: May 23, 2008

Dear Mr. Job:

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 - Mr. Job

Please be advised that FDA's issuance of a substantial equivalence determination does not mcan 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 (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Chiu-Ling, Ph.D.

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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UltiGuard™ Home Insulin Pen Needle Dispenser and Sharps Container Traditional 510(k)

Indications for Use

510(k) Number: Not assigned

Device Name: UltiGuard™ Home Insulin Pen Needle Dispenser and Sharps Container

Indications For Use:

The UltiGuard Home Insulin Pen Needle Dispenser and Sharps Container by Ulti Med Inc. is intended to be used to transport, store and dispense insulin pen needles in the home. After use the used pen needle can be placed back into the container for safe storage and eventual disposal according to local regulations.

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

Over-The-Counter Use X (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)

Shule A. Murphy
(Division Sign-Off)

Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number: K081449

§ 880.5570 Hypodermic single lumen needle.

(a)
Identification. A hypodermic single lumen needle is a device intended to inject fluids into, or withdraw fluids from, parts of the body below the surface of the skin. The device consists of a metal tube that is sharpened at one end and at the other end joined to a female connector (hub) designed to mate with a male connector (nozzle) of a piston syringe or an intravascular administration set.(b)
Classification. Class II (performance standards).