K Number
K083712
Manufacturer
Date Cleared
2009-07-10

(207 days)

Product Code
Regulation Number
876.5665
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The DiPure Deionization Tanks are exchangeable mix bed tanks intended to remove ions from the water to a sufficient level to allow safe treatment of Hemodialysis patients. These deionization tanks are not to be used alone, but are intended to be a part of a larger water treatment system employing adequate pre-treatment and post-treatment. Upon exhaustion, these tanks will be replaced with other tanks containing newly regenerated resin, or new resin altogether.

The DiPure Carbon Exchange Tanks are activated carbon tanks intended to remove chlorine and chloramines from the water to allow safe treatment of Hemodialysis patients. These carbon tanks are not to be used alone, but are intended to be a part of a larger water treatment system employing adequate pre-treatment and post-treatment. Upon exhaustion, these tanks are replaced with other tanks containing new activated carbon.

Device Description

DiPure's DI Exchange Tanks for Dialysis are approved tanks filled with mixed bed resin. Connectors are used in conjunction with a machined PVC schedule 80 head, stand pipe, fill port, and distributor basket. Our tanks are designed to supply AAMI standard water for dialysis through ion exchange. The DI exchange tanks are based on the Ameriwater Dialysis Deionizer Exchange Tanks.

DiPure's Carbon Exchange Tanks for Dialysis are approved tanks filled with activated carbon. Connectors are used in conjunction with a machined PVC schedule 80 head, stand pipe, fill port, and distributor basket. These tanks are designed to remove chlorine and chloramines. These tanks are based on the Ameriwater Carbon Exchange Tanks.

AI/ML Overview

The provided document is a 510(k) summary for "Carbon and DI Exchange Tanks for Hemodialysis," which is a Class II medical device. The submission focuses on demonstrating substantial equivalence to a predicate device (AmeriWater Dialysis Deionizer and Carbon Exchange Tanks, K991519) rather than presenting a study with acceptance criteria and performance data for a novel device.

Therefore, the requested information elements related to device performance studies (acceptance criteria table, sample size, expert ground truth, adjudication, MRMC study, standalone performance, training set details) are not applicable to this type of regulatory submission as presented in the provided text.

The document asserts substantial equivalence based on the following comparisons:

  • Indications for Use: Both DiPure and AmeriWater tanks are intended to remove ions (deionization tanks) or chlorine and chloramines (carbon exchange tanks) from water to allow safe treatment of hemodialysis patients, and are part of a larger water treatment system.
  • Technological Characteristics:
    • Deionization tanks: Both utilize mixed bed resins (cation and anion), and use NSF and/or FDA approved parts/materials.
    • Carbon exchange tanks: Both utilize activated carbon with an iodine number of 900 or greater, use NSF and/or FDA approved materials, and recommend dual filters in series with pre-shift chlorine/chloramine checks.
  • Conclusion: The submission concludes that "the DiPure water purification components and the AmeriWater predicate device components are substantially equivalent to one another. The core water purification components and technology are exactly the same."

Since this is a substantial equivalence claim for water purification components, there is no clinical performance study with acceptance criteria and measured device performance in the traditional sense of a diagnostic or therapeutic medical device. The "performance" is implicitly deemed equivalent to the predicate device's established performance in providing AAMI standard water for dialysis.

{0}------------------------------------------------

KO83712

PAGE 1 OF 2

JUL 1,0 2009

Pre-Market Notification 510(K) Summary

Water Purification Components for Hemodialysis

DateDecember 4, 2008
Prepared/Submitted ByDiPure, LLCDiPure Water Technologies1919 Edwards StreetHouston, Texas 77007
ContactTim MarcoPresident/General Manager713.686.4049
Device NameCarbon and DI Exchange Tanks for Hemodialysis
Device ClassificationClass II Medical Device, 21 CFR 876.5665Product Code 78 FIP
Predicate DeviceAmeriWater Dialysis Deionizer and Carbon Exchange TanksRegistration Number K991519
Device DescriptionDiPure's DI Exchange Tanks for Dialysis are approved tanksfilled with mixed bed resin. Connectors are used inconjunction with a machined PVC schedule 80 head, standpipe, fill port, and distributor basket. Our tanks are designedto supply AAMI standard water for dialysis through ionexchange. The DI exchange tanks are based on theAmeriwater Dialysis Deionizer Exchange Tanks.DiPure's Carbon Exchange Tanks for Dialysis are approvedtanks filled with activated carbon. Connectors are used inconjunction with a machined PVC schedule 80 head, standpipe, fill port, and distributor basket. These tanks aredesigned to remove chlorine and chloramines. These tanksare based on the Ameriwater Carbon Exchange Tanks.

{1}------------------------------------------------

K083712 PAGE 2 OF 2

Indications for Use

Comparison to Predicate AmeriWater Device

The DiPure Deionization Tanks are exchangeable/rechargeable mix bed tanks intended to remove ions from the water to a sufficient level to allow safe treatment of Hemodialysis patients. These deionization tanks are not to be used alone, but are intended to be a part of a larger water treatment system employing adequate pretreatment and post-treatment. Upon exhaustion, these tanks will be replaced with other tanks containing newly regenerated resin, or new resin altogether.

The DiPure Carbon Exchange Tanks are activated carbon tanks intended to remove chlorine and chloramines from the water to allow safe treatment of Hemodialysis patients. These carbon tanks are not to be used alone, but are intended to be a part of a larger water treatment system employing adequate pre-treatment and post-treatment. Upon exhaustion, these tanks are replaced with other tanks containing new activated carbon.

Deionization tanks from both DiPure and AmeriWater are utilized to remove dissolved solids from the water. Both utilize mixed bed resins, consisting of cation and anion resins to remove the charged particles in the water. Both utilize parts and materials that are NSF and/or FDA approved.

Activated carbon filtration is utilized by both DiPure and AmeriWater to filter out chlorine and chloramines from the water. DiPure uses carbon filter made from materials that are NSF and/or FDA approved. Both companies use two (2) carbon filters in a series configuration. Both DiPure and AmeriWater recommend the chlorine and chloramines are checked before each patient shift. Both companies utilize an activated carbon with an iodine number of 900 or greater. DiPure always recommends using dual carbon filters in series in every dialysis water system installed, including single patient systems.

In Summary, the DiPure water purification components and the AmeriWater predicate device components are substantially equivalent to one another. The core water purification components and technology are exactly the same.

{2}------------------------------------------------

Image /page/2/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is an abstract symbol resembling an eagle or bird in flight, rendered in a stylized, minimalist design.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUL 1 0 2009

Mr. Tim Marco President/General Manager DiPure, LLC DiPure Water Technologies 1919 Edwards Street HOUSTON TX 77007

Re: K083712

Trade/Device Name: Carbon and Deionized Exchange Tanks for Hemodialysis Regulation Number: 21 CFR §876.5665 Regulation Name: Water purification system for hemodialysis Regulatory Class: II Product Code: FIP Dated: June 22, 2009 Received: June 25, 2009

Dear Mr. Marco:

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 vour device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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.

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); medical device reporting (reporting of medical

{3}------------------------------------------------

device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/cdrh/mdr/ for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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. unu

Janine M. Morris Acting Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

{4}------------------------------------------------

Indications for Use

510(k) Number: K083712

Device Name: Carbon and Deionized Exchange Tanks for Hemodialysis

Indications for Use:

The DiPure Deionization Tanks are exchangeable mix bed tanks intended to remove ions from the water to a sufficient level to allow safe treatment of Hemodialysis patients. These deionization tanks are not to be used alone, but are intended to be a part of a larger water treatment system employing adequate pre-treatment and post-treatment. Upon exhaustion, these tanks will be replaced with other tanks containing newly regenerated resin, or new resin altogether.

DiPure Deionization Tank Model Numbers:

DMB025 - . 25 cu ft Deionization Tank DMB05 - . 5 cu ft Deionization Tank DMB12 - 1.2 cu ft Deionization Tank DMB20 - 2.0 cu ft Deionization Tank DMB36 - 3.6 cu ft Deionization Tank

The DiPure Carbon Exchange Tanks are activated carbon tanks intended to remove chlorine and chloramines from the water to allow safe treatment of Hemodialysis patients. These carbon tanks are not to be used alone, but are intended to be a part of a larger water treatment system employing adequate pre-treatment and post-treatment. Upon exhaustion, these tanks are replaced with other tanks containing new activated carbon.

DiPure Carbon Tank Model Numbers:

DAC025 - .25 cu ft Carbon Tank DAC05 - .5 cu ft Carbon Tank DAC12 - 1.2 cu ft Carbon Tank DAC20 - 2.0 cu ft Carbon Tank DAC 36 - 3.6 cu ft Carbon Tank

Prescription Use (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

(Division Sign-Off)
Division of Reproductive, Abdominal, and Radiological Devices
510(k) NumberK083712

Page 1 of 11

§ 876.5665 Water purification system for hemodialysis.

(a)
Identification. A water purification system for hemodialysis is a device that is intended for use with a hemodialysis system and that is intended to remove organic and inorganic substances and microbial contaminants from water used to dilute dialysate concentrate to form dialysate. This generic type of device may include a water softener, sediment filter, carbon filter, and water distillation system.(b)
Classification. Class II (special controls). The device, when it is a water purification subsystem disinfectant, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.