K Number
K092687
Device Name
VENTI.PLUS HYPERINFLATION BAG SYSTEM WITH PRESSURE MANOMETER
Manufacturer
Date Cleared
2009-11-23

(83 days)

Product Code
Regulation Number
868.5905
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Single patient use non self-inflating manual resuscitator for use in hospital and transport to temporary ventilate neonate, infant and pediatric patients. The pressure manometer in this product provides a visual indication of airway pressure during ventilation.
Device Description
Single patient use hyperinflation bag with pressure manometer offered in 0.25, 0.50 and 1.0 liter ventilation bag sizes. End user manipulates gas flow and respiratory rate and exhalation port to control amount of gas, inspiratory pressure supplied to the patient. Each device has an integrated 0 - 60 cm H2O pressure manometer.
More Information

Not Found

No
The description focuses on a manual resuscitator with a pressure manometer and does not mention any AI or ML components or functionalities.

Yes
The device is a manual resuscitator used to temporarily ventilate patients, which directly administers a medical intervention to support a physiological function.

No
The device is a manual resuscitator, which is a therapeutic device used for ventilation. While it includes a pressure manometer to indicate airway pressure, this feature assists in controlling gas delivery (a therapeutic function) rather than diagnosing a medical condition.

No

The device description clearly outlines physical components like a hyperinflation bag, pressure manometer, and different bag sizes, 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 to "temporarily ventilate neonate, infant and pediatric patients." This is a direct therapeutic intervention, not a diagnostic test performed on samples from the body.
  • Device Description: The device is a manual resuscitator (hyperinflation bag) used to deliver gas to a patient's airway. It measures airway pressure, which is a physiological parameter, not a substance or characteristic measured in vitro.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting specific substances, or providing diagnostic information about a disease or condition.

This device falls under the category of a medical device used for respiratory support.

N/A

Intended Use / Indications for Use

Single patient use non self-inflating manual resuscitator for use in hospital and transport to temporary ventilate neonate, infant and pediatic patients. The pressure manometer in this provides a visual indication of arway pressure during ventilation.

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

NHK, CAP

Device Description

Single patient use hyperinflation bag with pressure manometer offered in 0.25, 0.50 and 1.0 liter ventilation bag sizes. End user manipulates gas flow and respiratory rate and exhalation port to control amount of gas, inspiratory pressure supplied to the patient. Each device has an integrated 0 - 60 cm H2O pressure manometer.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

airway

Indicated Patient Age Range

neonate, infant and pediatic patients

Intended User / Care Setting

hospital and transport

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)

Bench testing confirmed that the A Plus Medical VentiPlus Hyperinflation System with Pressure Manometer and predicate device have similar performance characteristics and the accuracy of the integrated pressure manometer in the VentiPlus Hyperinflation System with Pressure Manometer is equivalent to the predicate device when used with its associated pressure manometer.

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.

K970785, K961318

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

§ 868.5905 Noncontinuous ventilator (IPPB).

(a)
Identification. A noncontinuous ventilator (intermittent positive pressure breathing-IPPB) is a device intended to deliver intermittently an aerosol to a patient's lungs or to assist a patient's breathing.(b)
Classification. Class II (performance standards).

0

(a) A Plus Medical
Solutions for Respiratory Care

510(k) Summary

K092687

NOV 2 8 2009

Owner:

A Plus Medical 5431 Avenida Encinas, STE G Carlsbad, CA 92008-4411 + 760-930-4025 Tel: + 760-930-0040 Fax:

Owner/Operator Number:

10023166

Official Contact:

Thomas C. Loescher + 760-930-4025 Tel:

  • 760-930-0040 Fax:

Trade Names:

VESSA.Plus" Hyperinflation Bag System with Pressure Manometer

Common/Usual Name:

Hyperinflation Bag with Pressure Manometer

Classification Name:

Device Name:Resuscitator, Manual, Non Self-Inflating
Product Code:NHK
Regulation:CFR 868.5905
Device Class:II
Device Name:Monitor, Airway Pressure
Product Code:CAP
Regulation:CFR 868.2600
Device Class:II

Device:

4.2

Venti*Plus Hyperinflation Bag System with Pressure Manometer

Predicate Devices:

Number:K970785
Product Name:SIMS Hyperinflation Bag System
Manufacturer:Smiths Medical (Intertech Resources)
Product Codes:008330DM, 008330VM, 008332DM, 008335DM,
008430, 008430DM, 00843M, 008430T,,
008430VM, 008431T, 008432, 008432DM,
008432T, 008435 & 008435DM
Number:K961318
Product Name:1st Response Disposable Manometer
Manufacturer:Smiths Medical (Intertech Resources)
Product Codes:008201

5411 Avenida Encinas, STE G Carlsbad, CA 92008-4411 盆 +740-930-4025 Fax: +760-930-0040

1

Image /page/1/Picture/0 description: The image shows the logo for A Plus Medical. The logo features the letter A inside of a circle on the left. To the right of the circle is the text "A Plus Medical" in a bold font. Below the company name is the text "Solutions for Respiratory Care" in a smaller font.

Device Description:

Single patient use hyperinflation bag with pressure manometer offered in 0.25, 0.50 and 1.0 liter ventilation bag sizes. End user manipulates gas flow and respiratory rate and exhalation port to control amount of gas, inspiratory pressure supplied to the patient. Each device has an integrated 0 - 60 cm H2O pressure manometer.

Indications for Use:

Single patient use non self-inflating manual resuscitator for use in hospital and transport to temporary ventilate neonate, infant and pediatic patients. The pressure manometer in this provides a visual indication of arway pressure during ventilation.

Contraindications:

None identified.

Patient Population:

Patient populations of neonate, newborn and pediatric.

Environment of Use:

Hospital and patient transport

Comparative of Technological Characteristics:

The A Plus Medical Ventit Plus Hyperinflation System with Pressure Manometer is substantially equivalent in indications for use, environment of use, patient population, material and function to the identified predicate. The A Plus Medical Ventif Plus Hyperinflation System with Pressure Manometer and identified predicate device meet the requirements set forth ISO 5356- 1:2004 entitled "Anaesthetic and respiratory equipment - Conical connectors: Part 1: Cones and sockets". Bench testing confirmed that the A Plus Medical VentiPlus Hyperinflation System with Pressure Manometer and predicate device have similar performance characteristics and the accuracy of the integrated pressure manometer in the VentiPlus Hyperinflation System with Pressure Manometer is equivalent to the predicate device when used with its associated pressure manometer.

Conclusion:

The Venti*Plus Hyperinflation System with Pressure Manometer is substantially equivalent to the identified predicates. The Ventif Plus Hyperinflation System with Pressure Manometer and the identified predicates have substantially equivalent performance.

The Ventif Plus Hyperinflation System with Pressure Manometer and the identified predicates are made from substantially equivalent material, intended use, patient populations and environment of use

5411 Avenida Encinas, STE G Carlsbad, CA 92008-4411 2. +740-930-4025 Fax: +760-930-0040 ~ 14~

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Image /page/2/Picture/1 description: The image shows the seal of the U.S. Department of Health & Human Services. The seal features a stylized eagle-like symbol on the right. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged in a circular pattern around the symbol.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room W-O66-0609 Silver Spring, MD 20993-0002

Thomas C. Loescher, R.R.T. President A Plus Medical 5431 Avenida Encinas, Suite G Carlsbad, California 92008-4411

NOV 2 3 2009

Re: K092687

Trade/Device Name: Venti.Plus™ Hyperinflation Bag System with Pressure Manometer Regulation Number: 21 CFR 868.5905 Regulation Name: Noncontinuous Ventilator (IPPB) Regulatory Class: II Product Code: NHK Dated: November 4, 2009 Received: November 10, 2009

Dear Mr. Loescher:

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 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. Loescher

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 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/CDRH/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,

for

Susan Runner, D.D.S., M.A. Acting 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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Image /page/4/Picture/0 description: The image shows the logo for A Plus Medical. The logo features the letter 'a' inside of a parenthesis. The text 'A Plus Medical' is to the right of the parenthesis, and the text 'Solutions for Respiratory Care' is below 'A Plus Medical'.

Indications for Use Statement

510(k) Number:

."

KD92689 (To be assigned)

Device Name: Indications for Use: VENEA. Plus" Hyperinflation Bag System with Pressure Manometer

Single patient use non self-inflating manual resuscitator for use in hospital and transport to temporary ventilate neonate, infant and pediatric patients. The pressure manometer in this product provides a visual indication of airway pressure during ventilation.

X Prescription Use (Part 21 CFR 801 Subpart D)

Over-the-counter use (21 CFR 807 Subpart C)

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

or

Concurrence of CDRH, Office of Device Evaluation (ODE)

Y. Schutte

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

510(k) Number: K092687