K Number
K081838
Date Cleared
2009-01-26

(210 days)

Product Code
Regulation Number
870.4240
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Gish Vision Blood Cardioplegia System with HA coating is indicated for use in applications that require control of fluid temperature, such as blood or cardioplegia, typically in an extracorporeal circuit The device may be used for normothermic or hypothermic applications It is designed to operate at flow rates of one hundred (100) to six hundred (600) milliliters per minute for periods up to six (6 0) hours

Device Description

The Gish Vision Blood Cardioplegia System with hyaluronan based coating (HA coating) consists of an extracorporeal heat exchanger and fluid administration set The heat exchanger consists of a one piece, stainless steel bellows, configured heat exchanger as the primary element to effect heat exchange This element is encased by a polycarbonate housing, which directs the blood through the outside convolutions of the stainless steel bellows, and therefore effects heat exchange while minimizing priming volume All materials of the heat exchanger are brocompatible. The device allows for the monitoring of pressure and allows for trapping and removal of air Additionally, the device includes an integral bubble trap, gross particulate filter (105 u) and pressure relief device designed to open in the event of excessive fluid pressure (600 mmHq) during use Solutions are delivered to the patient through the extension line and appropriate cannula Blood flow is driven by a roller pump connected through an extension line. The components of this system which have contact with the fluid path are sterle and nonpyrogenic. All blood contact materials of the Vision Blood Cardioplegia System with HA coatung are biocompatible and coated with a proprietary coating.

AI/ML Overview

This document describes a 510(k) submission for the Gish Vision Blood Cardioplegia System and Extracorporeal Heat Exchanger with HA Coating. It is a medical device, and the submission focuses on demonstrating its substantial equivalence to previously cleared predicate devices rather than proving its effectiveness through a new clinical study with specific acceptance criteria as you might see for a novel device.

Therefore, the information you've requested regarding acceptance criteria, study details, sample sizes, expert involvement, and ground truth establishment (which are typical for studies evaluating diagnostic accuracy or clinical outcomes of a novel device) is not explicitly present in this type of regulatory submission. The goal of a 510(k) is to show that the new device is as safe and effective as a legally marketed predicate device, often relying on engineering and performance testing.

However, I can extract the relevant information about the "Test Data" and "Comparison" sections to infer what the manufacturer claims regarding device performance and how it meets its functional requirements.

Here's an attempt to answer your questions based on the provided text, acknowledging the limitations inherent in a 510(k) summary for a "substantially equivalent" claim:


1. A table of acceptance criteria and the reported device performance

The document does not explicitly present a table of acceptance criteria with corresponding performance metrics in the format typically seen for rigorous clinical studies. Instead, it states that the device was subjected to various performance tests designed to ensure that the device meets all of its functional requirements and performance specifications.

The functional requirements and specifications are implied by the device's intended use and comparison to the predicate devices. The key performance aspects mentioned are:

Acceptance Criterion (Implied)Reported Device Performance
Control of fluid temperatureConfirmed (indicated for use)
Operable flow rates (Blood/Cardioplegia)100 to 600 ml/min
Operation durationUp to 6 hours
Pressure monitoring capabilityYes
Air trapping and removalYes (includes integral bubble trap)
Gross particulate filtrationYes (105 µ)
Pressure relief device activation600 mmHg
Biocompatibility of materialsAll blood contact materials are biocompatible and HA coated.
Sterility and non-pyrogenicityComponents in fluid path are sterile and non-pyrogenic.
Overall Safety and EffectivenessEquivalent to predicate devices (K020106)

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

The document does not specify a "test set" in the context of a clinical study or a specific number of devices tested. The testing mentioned appears to be engineering and performance validation rather than clinical trial data.

  • Sample Size: Not specified. It refers generally to "the systems."
  • Data Provenance: Not specified, but likely refers to internal testing conducted by Gish Biomedical, Inc. in the USA.
  • Retrospective or Prospective: Not applicable in the context of device performance/engineering testing described.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

Not applicable. The testing described is performance and functional verification, not a clinical study requiring expert ground truth establishment for a diagnostic output.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

Not applicable. This is not a clinical study involving human assessment or adjudication of outcomes for a test set.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

Not applicable. This device is a cardiopulmonary bypass heat exchanger, not an AI-assisted diagnostic tool.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

Not applicable. This device is not an algorithm.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

For the performance tests, the "ground truth" would be the engineering specifications and established standards for heat exchangers in cardioplegia systems. For biocompatibility, it would be compliance with relevant biocompatibility standards.

8. The sample size for the training set

Not applicable. This device is not an AI/machine learning model that requires a training set.

9. How the ground truth for the training set was established

Not applicable. This device is not an AI/machine learning model.

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Image /page/0/Picture/0 description: The image shows the text 'K081838' at the top, followed by the text '510(k) (Traditional) Submission' and 'Section 5, 510(k) Summary' below it. The text appears to be part of a document or submission related to the 510(k) process. The number at the top may be a reference or identification number for the submission. The text is black and the background is white.

Summary

This summary of 510(k)-safety and effectiveness information is being submitted in accordance with the requirements of 21 CFR § 807 92

1 Company making the submission

JAN 2 6 2009

NameGish Biomedical, Inc
Address22942 Arroyo Vista
Rancho Santa Margarita, CA
92688-2600
Telephone949-635-6200 voice
949-635-6291 fax
martıns@gıshbıomedical com
ContactMartın Sellers
Director of Regulatory Affairs

Device 2

Proprietary NameVision Blood Cardioplegia System andExtracorporeal Heat Exchanger with HA Coating
Common NameCardioplegia Heat Exchanger
Classification NameCardiopulmonary Bypass Heat Exchanger

3. Predicate Devices

Vision Blood Cardioplegia System and Extracorporeal Heat Exchanger, K020106 and Vision Blood Cardiopleara System and Extracorporeal Heat Exchanger with GBS 110 Coating, K020106 Both manufactured by Gısh Bıomedical, Inc

ব Classifications Names & Citations

21 CFR 870 4240, Cardiovascular bypass heat exchanger, Class II, DTR, Cardiovascular

ਦ Description

The Gish Vision Blood Cardioplegia System with hyaluronan based coating (HA coating) consists of an extracorporeal heat exchanger and fluid administration set The heat exchanger consists of a one piece, stainless steel bellows, configured heat exchanger as the primary element to effect heat exchange This element is encased by a polycarbonate housing, which directs the blood through the outside convolutions of the stainless steel bellows, and therefore effects heat exchange while minimizing priming volume All materials of the heat exchanger are brocompatible

The device allows for the monitoring of pressure and allows for trapping and removal of air Additionally, the device includes an integral bubble trap, gross particulate filter

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(105 u) and pressure relief device designed to open in the event of excessive fluid pressure (600 mmHq) during use Solutions are delivered to the patient through the extension line and appropriate cannula Blood flow is driven by a roller pump connected through an extension line

The components of this system which have contact with the fluid path are sterle and nonpyrogenic

All blood contact materials of the Vision Blood Cardioplegia System with HA coatung are biocompatible and coated with a proprietary coating

6 Indications for use

The Gish Vision Blood Cardioplegia System with HA coating is indicated for use in applications that require control of fluid temperature, such as blood or cardioplegia, typically in an extracorporeal circuit The device may be used for normothermic or hypothermic applications It is designed to operate at flow rates of one hundred (100) to sıx hundred (600) milliliters per mınute for periods up to sıx (6 0) hours

7 Contra-Indications

For HA coated blood cardioplegia systems, no contra-indications have been noted

8 Comparıson

The Gish Vision Blood Cardioplegia System with HA Coating has the same device characteristics as the predicate devices

ਹੈ Test Data

The Gish Vision Blood Cardioplegia System with HA Coating has been subjected to extensive safety, performance, and validations prior to release Final testing for the systems includes various performance tests designed to ensure that the device meets all of its functional requirements and performance specifications

10 Literature Review:

A review of literature pertaining to the safety and effectiveness has been conducted Appropriate safeguards have been incorporated in the design of Gish Vision Blood Cardioplegia System with HA Coating

11 Conclusions

Based upon the testing and comparison to the predict device the Gish Biomedical, Inc , Vision Blood Cardioplegia System with HA Coating has the same intended use, with similar technological characteristics Gish Biomedical, Inc , therefore posits that its device is equivalent in safety and effectiveness to predicate devices

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 2 6 2009

Gish Biomedical, Inc c/o Ms Janet Peets Regulatory & Clinical Affairs Specialist 22942 Arroyo Vista Rancho Santa Margarita, CA 92688

Re K081838

Vision Blood Cardioplegia and Extracorporeal Heat Exchanger with HA Coating Regulation Number 21 CFR 870 4240 Regulation Name Cardiopulmonary Bypass Heat Exchanger Regulatory Class Class II Product Code DTR Dated January 8, 2009 Received January 12, 2009

Dear Ms Peets

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 pror 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 Janet Peets

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 requrements, 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) 276-0120 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 Biometrics' (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.

R. lo. Lunes

Image /page/3/Picture/5 description: The image contains a handwritten symbol or character. It appears to be a cursive letter or a stylized mark, possibly part of a signature or a unique identifier. The symbol is drawn with a thick line, and it has a loop or curve at the top and a diagonal stroke at the bottom.

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

Enclosure

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510(k) Number K_081838

Device Name Gish Vision Blood Cardioplegia System and Extracorporeal Heat Exchanger with HA Coating

Indications for use

The Vision Biood Cardioplegia System with HA Coating is indicated for use in applications that require control of fluid temperature, such as blood or cardioplegia, typically in an extracorporeal circuit The device may be used for normothermic or hypothermic applications It is designed to operate at flow rates of one hundred (100) to six hundred (600) milliliters per minute for periods up to six (6 0) hours

Prescription Device

Federal Law (US) restricts this device to sale by or on the order of a physician

Prescription Use Yes

OR

Over-The-Counter Use No

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Duna R. Vahner

(Division Sign-Off) Division of Cardiovascular Devices

510(k) Number_Ko81838

§ 870.4240 Cardiopulmonary bypass heat exchanger.

(a)
Identification. A cardiopulmonary bypass heat exchanger is a device, consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood or perfusion fluid flowing through the device.(b)
Classification. Class II (performance standards).