K Number
K082818
Device Name
SUBCUTANEOUS NEEDLE INFUSION SET
Date Cleared
2008-12-23

(89 days)

Product Code
Regulation Number
880.5440
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Subcutaneous Infusion Set is designed specifically for the delivery of medication to the subcutaneous tissue
Device Description
The subcutaneous needle infusion set consists of a sterile packaged kit including the infusion set and an adhesive dressing to hold the device in place. The unique Single, Bifurcated, Trifurcated, and Quadfurcated for the Sub-Q have a luer lock at one end and a 90 degree needle mounted to a butterfly stabilizer at the other end. The sets are convenient to use, associated with less trauma, and offer an opportunity to improve compliance cost-effectively through the use of a dedicated infusion set. The device is for single use only.
More Information

Not Found

No
The description focuses on the mechanical components and function of a subcutaneous infusion set, with no mention of AI or ML.

Yes.
The device is described as an infusion set for the delivery of medication to subcutaneous tissue, indicating its role in administering therapeutic substances.

No
Explanation: The device is described as an "Infusion Set" for "delivery of medication to the subcutaneous tissue," which indicates a therapeutic purpose rather than a diagnostic one.

No

The device description clearly outlines physical components like a needle, luer lock, butterfly stabilizer, and adhesive dressing, indicating it is 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 "for the delivery of medication to the subcutaneous tissue." This describes a device used to administer substances into the body, not to test samples from the body to diagnose conditions.
  • Device Description: The description details a needle infusion set with a luer lock and a needle, designed for subcutaneous delivery. 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 from the human body to provide information for the diagnosis, monitoring, or treatment of diseases or conditions. This device's function is purely for administering medication.

N/A

Intended Use / Indications for Use

The Subcutaneous Infusion Set is designed specifically for the delivery of medication to the subcutaneous tissue

Product codes

FPA

Device Description

The subcutaneous needle infusion set consists of a sterile packaged kit including the infusion set and an adhesive dressing to hold the device in place. The unique Single, Bifurcated, Trifurcated, and Quadfurcated for the Sub-Q have a luer lock at one end and a 90 degree needle mounted to a butterfly stabilizer at the other end. The sets are convenient to use, associated with less trauma, and offer an opportunity to improve compliance cost-effectively through the use of a dedicated infusion set. The device is for single use only.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

subcutaneous tissue

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

K020530, K891072

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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.

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K082818

page 1 of

510(K) SUMMARY (as required by 807.92(c))

DEC 2 3 2008

| Regulatory Correspondent | AJW Technology Consultants Inc
962 Allegro Lane
Apollo Beach, FL 33572
awconsltng@aol.com |
|--------------------------|----------------------------------------------------------------------------------------------------|
| Submitter of 510(k): | Marcal Medical, Inc.
1114 Benfield Blvd, Suite H
Millersville, MD 21108
USA |
| | Phone: (410) 987-4001
Fax: (410) 987-4004 |
| Contact Person: | Candace Keaton |
| Date of Summary: | 6/17/08 |
| Trade/Proprietary Name: | Subcutaneous Needle Infusion Set |
| Classification Name: | Set Administrative Intravascular |
| Product Code: | FPA |

Intended Use:

The Subcutaneous Infusion Set is designed specifically for the delivery of medication to the subcutaneous tissue

Device Description:

The subcutaneous needle infusion set consists of a sterile packaged kit including the infusion set and an adhesive dressing to hold the device in place. The unique Single, Bifurcated, Trifurcated, and Quadfurcated for the Sub-Q have a luer lock at one end and a 90 degree needle mounted to a butterfly stabilizer at the other end. The sets are convenient to use, associated with less trauma, and offer an opportunity to improve compliance cost-effectively through the use of a dedicated infusion set. The device is for single use only.

Predicate Device:

K020530 - Evans Medical, Inc - Evans Sub-Q, Model MC4206 K891072 - Multi-Med, Inc - Intravascular Administration Set.

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K$\phi$82818 page 2 of 2

Substantial Equivelance:

The Marcal Medical Subcutancous Needle Infusion Set meets all established acceptance criteria for performance testing and design verification testing. The components of the Sub-Q Set are substantially equivalent to the predicate device presented in this 510k.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with three stripes forming its wing and body. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle.

Public Health Service

DEC 2 3 2008

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Marcal Medical, Incorporated C/O Mr. Arthur Ward President AJW Technology Consultants Incorporated 962 Allegro Lane Apollo Beach, Florida 33572

Re: K082818

Trade/Device Name: Subcutaneous Needle Infusion Set Regulation Number: 21 CFR 880,5440 Regulation Name: Intravascular Administration Set Regulatory Class: II Product Code: FPA Dated: September 17, 2008 Received: September 30, 2008

Dear Mr. Ward:

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. Ward

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.

Chris S. Liem, Ph.D.

Chiu S. Lin. Ph. D Division 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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K082818

Indications for Use

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Device Name: Subcutaneous Needle Infusion Set

Indications for Use:

The Subcutaneous Infusion Set is designed specifically for the delivery of medication to the subcutaneous tissue

Prescription Use X (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 OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Anthong 2. Ownt

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

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510(k) Number: 482818

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