K Number
K092745
Device Name
VIS-U-ALL LOW TEMPERATURE TYVEK STERILIZATION POUCH FOR ETHYLENE OXIDE, MODELS: SELF AND HEAT SEAL POUCHES, HEAT SEAL TU
Manufacturer
Date Cleared
2010-11-19

(437 days)

Product Code
Regulation Number
880.6850
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Vis-U-All Low Temperature Tyvek Sterilization Pouch for ethylene oxide has been qualified by STERIS Corporation as suitable for use by health care providers to enclose and seal other medical devices to be sterilized by ethylene oxide (ETO). The Vis-U-All Low Temperature Tyvek Sterilization Pouch for ethylene oxide is designed to maintain sterility of properly processed medical devices during normal handling and storage until the pouch is opened and the medical device is removed for use.
Device Description
The proposed Vis-U-All Low Temperature Tyvek Sterilization Pouch for Ethylene Oxide is a Tyvek/plastic film sterilization containment pouch designed for devices to be sterilized by the health care provider using ethylene oxide (ETO). The proposed pouch is available as a self seal pouch, a heat seal pouch, or heat seal tubing. The material composition of the proposed and predicate device is identical with the exception of the addition of an ISO 11140 Class 1 compliant, ethylene oxide chemical indicator on the proposed device.
More Information

Not Found

No
The device is a sterilization pouch and the description focuses on its physical properties and performance in sterilization processes, with no mention of AI or ML.

No.
The device is a sterilization pouch used to maintain the sterility of other medical devices, not to treat or diagnose a medical condition.

No

The device is a sterilization pouch designed to maintain the sterility of other medical devices, not to diagnose medical conditions or diseases.

No

The device is a physical sterilization pouch made of Tyvek and plastic film, not software.

Based on the provided text, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is to enclose and seal other medical devices for sterilization and maintain their sterility. This is a function related to the processing and storage of medical devices, not the diagnosis of a disease or condition using in vitro methods.
  • Device Description: The description focuses on the physical characteristics of a sterilization pouch (Tyvek/plastic film, self-seal/heat-seal, chemical indicator). This aligns with a device used in the sterilization process, not for analyzing samples from the human body.
  • Lack of IVD Characteristics: The text does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in those samples
    • Providing information for diagnosis, monitoring, or treatment decisions based on in vitro analysis.

The device is clearly intended for use in the sterilization and storage of other medical devices within a healthcare setting.

N/A

Intended Use / Indications for Use

The Vis-U-All Low Temperature Tyvek Sterilization Pouch for ethylene oxide has been qualified by STERIS Corporation as suitable for use by health care providers to enclose and seal other medical devices to be sterilized by ethylene oxide (ETO). The Vis-U-All Low Temperature Tyvek Sterilization Pouch for ethylene oxide is designed to maintain sterility of properly processed medical devices during normal handling and storage until the pouch is opened and the medical device is removed for use.

Product codes

KCT

Device Description

The proposed Vis-U-All Low Temperature Tyvek Sterilization Pouch for Ethylene Oxide is a Tyvek/plastic film sterilization containment pouch designed for devices to be sterilized by the health care provider using ethylene oxide (ETO). The proposed pouch is available as a self seal pouch, a heat seal pouch, or heat seal tubing.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

health care providers

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)

The following table summarizes the non-clinical testing performed for both indicated sterilization cycles to demonstrate that the Vis-U-All Low Temperature Tyvek Sterilization Pouch for Ethylene Oxide is safe and effective. The performance testing has demonstrated that the proposed device is substantially equivalent to its predicates and raises no new questions of safety or effectiveness.

Testing:
Sterilant Penetration: PASS - Testing demonstrated that ethylene oxide can effectively penetrate the pouches to sterilize the load.
Event Related Sterility Maintenance: PASS - All packs processed in an ethylene oxide sterilizer and subjected to accelerated aging and handling maintained their performance (strength and microbial resistance).
Microbial Barrier Properties: PASS - No microbial growth occurred on test articles or negative control pouches. Test articles from positive control pouches demonstrated microbial growth.
Tensile / Tear / Puncture Resistance / Seal Peel Strength: PASS - The differences in tensile properties (elongation, breaking force) of processed and unprocessed Tyvek and plastic samples were not statistically significant. All processed but un-aged pouches resulted in clean peels and all processed pouches had acceptable burst strength, indicating that ethylene oxide sterilization does not compromise pouch sealing.
Cytotoxicity: PASS - Following ethylene oxide sterilization, the Vis-U-All Low Temperature Tyvek Pouch/Tubing plastic and Tyvek were not cytotoxic.
Sterilant Residues: PASS - Following sterilization and aeration, pouch materials were confirmed to not retain harmful levels of ethylene oxide or its byproducts as outlined in ISO 10993-7:1995.
Chemical Indicator Class 1 Compliance: PASS - Chemical Indicators were validated against the ethylene oxide process indicator requirements of ANSI/AAMI/ISO 11140-1:2005.
Chemical Indicator Toxicity: PASS - The indicator ink on its substrate- either exposed to ethylene oxide or unexposed - is not cytotoxic per the methodology and limits defined in ANSI/AAMI/ISO10993-5:1999.
Chemical Indicator Post-Processed Color Stability: PASS - The post-processed chemical (process) indicator color is stable, after exposure to ETO sterilization conditions, for at least one year of storage at ambient conditions.
Simulated Use: PASS - All criteria of the study were met, demonstrating that, ethylene oxide can penetrate through the Vis-U-All Low Temperature Tyvek Pouch and Tubing to sterilize loads.
Process Indicator End Point Stability - Aged Vis-U-All Tyvek pouches: PASS - The chemical indicator on Vis-U-All Low Temperature Tyvek Pouches stored at warehouse conditions still meet performance criteria.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K070765, K071087

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 880.6850 Sterilization wrap.

(a)
Identification. A sterilization wrap (pack, sterilization wrapper, bag, or accessories, is a device intended to be used to enclose another medical device that is to be sterilized by a health care provider. It is intended to allow sterilization of the enclosed medical device and also to maintain sterility of the enclosed device until used.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image shows the text "K692745 p 1 of 5" at the top. Below that is the word "STERIS" with a registered trademark symbol. At the bottom of the image is a logo consisting of several horizontal lines.

NOV 1 9 2010

510(k) Summary For Vis-U-All Low Temperature Tyvek Sterilization Pouch for Ethylene Oxide Sterilization

STERIS Corporation 5960 Heisley Road Mentor, OH 44060 Phone: (440) 354-2600 Fax No: (440) 639-4459

Contact:

Robert F. Sullivan Senior Director FDA Regulatory Affairs Telephone:(440) 392-7695 Fax No: (440) 357-9198

Summary Date:

November 19, 2010

STERIS Corporation ■ 5960 Heisley Road ■ Mentor, OH 44060-1834 USA ■ 440-354-2600

1

K092745/RC STERIS Response to 11/18/10 Request for Clarification Vis-U-All Low Temperature Tyvek Sterilization Pouch for Ethylene Oxide Sterilization

1. Device Name

Vis-U-All Low Temperature Tyvek Sterilization Trade Name: Pouch for Ethylene Oxide Sterilization Sterilization Pouch Common/usual Name: Classification Name: Sterilization Wrap (21 CFR 880.6850) . КСТ Product Code:

2. Predicate Device

  • ' Vis-U-All Self Seal Pouch (K070765)
  • I Vis-U-All Heat Seal Pouch and Tubing (K071087)

3. Description of Device

The proposed Vis-U-All Low Temperature Tyvek Sterilization Pouch for Ethylene Oxide is a Tyvek/plastic film sterilization containment pouch designed for devices to be sterilized by the health care provider using ethylene oxide (ETO). The proposed pouch is available as a self seal pouch, a heat seal pouch, or heat seal tubing.

4. Intended Use

The Vis-U-All Low Temperature Tyvek Sterilization Pouch for ethylene oxide has been qualified by STERIS Corporation as suitable for use by health care providers to enclose and seal other medical devices to be sterilized by ethylene oxide (ETO). The Vis-U-All Low Temperature Tyvek Sterilization Pouch for ethylene oxide is designed to maintain sterility of properly processed medical devices during normal handling and storage until the pouch is opened and the medical device is removed for use.

2

STERIS Part #TypeSize (inches)
875037Pouch, Heat Seal,3 x 7
875049Tyvek (low temp)4 x 9
8754124 x 12
8754224 x 22
8756106 x 10
8758128 x 12
87511510 x 15
87511812 x 18
876037Pouch, Self Seal,3 x 7
876049Tyvek (low temp)4 x 9
8764124 x 12
8764224 x 22
8766106 x 10
8768128 x 12
87611510 x 15
87611812 x 18
872031Tubing, Heat Seal,3" x 100 ft
872041Tyvek (low temp)4" x 100 ft
8720616" x 100 ft
8720919" x 100 ft
87214114" x 100 ft

Pouch and Tubing Sizes for STERIS Vis-U-All Low Temperature Products

The following are the validation test conditions:

  • 1 hour exposure; at 130(±5) °F*, >30% RH using 100% ETO (750-790 mg/L);
  • · 4.5 hour exposure; at 100(±5) °F*, >30% RH using 100% ETO (750-790 mg/L);
  • ±5 °F is during sterilization phase following an equilibration period of 10% of exposure time.

The ethylene oxide process indicator is intended to be used by a health care provider with the Vis-U-All Low Temperature Tyvek Sterilization Pouches to distinguish between processed and unprocessed units.

3

K092745

p4 JR 5

Description of Safety and Substantial Equivalence 5.

The Vis-U-All Low Temperature Tyvek Sterilization Pouch models have been qualified by STERIS Corporation as suitable for use by health care providers to enclose and seal other medical devices to be sterilized using ethylene oxide. The predicates. Vis-U-All Self Seal Pouch (K070765) and Vis-U-All Heat Seal Pouch and Tubing (K071087) are also intended to enclose and seal medical devices to be sterilized. The proposed device's intended use is identical to the predicates, exceptingh thelow temperature sterilization modality to which the pouch is exposed: ethylene oxide (ETO) instead of hydrogen peroxide (VHP).

The proposed device is identical to the predicate devices in terms of physical and chemical properties, configurations and dimensions, air permeance and percent of surface perforations. The material composition of the proposed and predicate device is identical with the exception of the addition of an ISO 11140 Class 1 compliant, ethylene oxide chemical indicator on the proposed device.

As described in the next section, performance testing of the Vis-U-All Low Temperature Tyvek Sterilization Pouch for Ethylene Oxide demonstrated that the proposed product is qualified for use with ethylene oxide (ETO) sterilization and is as safe, as effective, and performs the same as the predicate devices.

6. Performance Testing

The following table summarizes the non-clinical testing performed for both indicated sterilization cycles to demonstrate that the Vis-U-All Low Temperature Tyvek Sterilization Pouch for Ethylene Oxide is safe and effective. The performance testing has demonstrated that the proposed device is substantially equivalent to its predicates and raises no new questions of safety or effectiveness.

4

K092745

K092745/RC STERIS Response to 11/18/10 Request for Clarification Vis-U-All Low Temperature Tyvek Sterilization Pouch for Ethylene Oxide Sterilization

| 12 | ে

  • | て
    0 | 1
    )
    1 |
    |----|-------------|--------|-------------|
    |----|-------------|--------|-------------|
TestingResults
Sterilant PenetrationPASS
Testing demonstrated that ethylene oxide can effectively penetrate the
pouches to sterilize the load.
Event Related
Sterility
MaintenancePASS
All packs processed in an ethylene oxide sterilizer and subjected to
accelerated aging and handling maintained their performance (strength
and microbial resistance).
Microbial Barrier
PropertiesPASS
No microbial growth occurred on test articles or negative control
pouches. Test articles from positive control pouches demonstrated
microbial growth
Tensile / Tear /
Puncture Resistance
/ Seal Peel StrengthPASS
The differences in tensile properties (elongation, breaking force) of
processed and unprocessed Tyvek and plastic samples were not
statistically significant. All processed but un-aged pouches resulted in
clean peels and all processed pouches had acceptable burst strength,
indicating that ethylene oxide sterilization does not compromise pouch
sealing.
CytotoxicityPASS
Following ethylene oxide sterilization, the Vis-U-All Low
Temperature Tyvek Pouch/Tubing plastic and Tyvek were not
cytotoxic.
Sterilant ResiduesPASS
Following sterilization and aeration, pouch materials were confirmed
to not retain harmful levels of ethylene oxide or its byproducts as
outlined in ISO 10993-7:1995.
Chemical Indicator
Class 1 CompliancePASS
Chemical Indicators were validated against the ethylene oxide process
indicator requirements of ANSI/AAMI/ISO 11140-1:2005
Chemical Indicator
ToxicityPASS
The indicator ink on its substrate- either exposed to ethylene oxide or
unexposed - is not cytotoxic per the methodology and limits defined in
ANSI/AAMI/ISO10993-5:1999
Chemical Indicator
Post-Processed
Color StabilityPASS
The post-processed chemical (process) indicator color is stable, after
exposure to ETO sterilization conditions, for at least one year of
storage at ambient conditions.
Simulated UsePASS
All criteria of the study were met, demonstrating that, ethylene oxide
can penetrate through the Vis-U-All Low Temperature Tyvek Pouch
and Tubing to sterilize loads.
Process Indicator
End Point Stability -
Aged Vis-U-All
Tyvek pouchesPASS
The chemical indicator on Vis-U-All Low Temperature Tyvek Pouches
stored at warehouse conditions still meet performance criteria.

5

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/5/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized caduceus, which is a symbol of medicine, and the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged in a circular pattern around the caduceus. The caduceus is depicted as a stylized bird with three tail feathers.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

Ms. Marcia Benedict Director, Regulatory Affairs Steris Corporation 5960 Heisley Road Mentor, Ohio 44060

NOV 1 9 2010

Re: K092745

Trade/Device Name: Vis-U-All Low Temperature Tyvek Sterilization Pouch with Ethylene Oxide Process Indicator Regulation Number: 21 CFR 880.6850 Regulation Name: Sterilization Wrap Regulatory Class: II Product Code: KCT Dated: November 11, 2010 Received: November 12, 2010

Dear Ms. Benedict:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

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.

6

Page 2 - Ms. Benedict

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 (OS) 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.goy/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/MedicalDevices/Safety/ReportaProblem/default.htm 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 (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,
fum I. Sated
for

Anthony D. Watson, B.S., M.S., M.B.A. Director Division of Anesthesiology. General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

7

K092745/S001 STERIS Response to 11/10/09 Request for Additional Information Vis-U-All Low Temperature Tyvek Sterilization Pouch for Ethylene Oxide Sterilization

Indications for Use

NOV 1 9 2010

510(k) Number (if known): K092745

Device Name:

Vis-U-All Low Temperature Tyvek Sterilization Pouch with Ethylene Oxide Process Indicator

Indications For Use:

The Vis-U-All Low Temperature Tyvek Sterilization Pouch for ethylene oxide has been qualified by STERIS Corporation as suitable for use by health care providers to enclose and seal other medical devices to be sterilized by ethylene oxide (ETO). The Vis-U-All Low Temperature Tyvek Sterilization Pouch for ethylene oxide is designed to maintain sterility of properly processed medical devices during normal handling and storage until the pouch is opened and the medical device is removed for use.

Pouch and Tubing Sizes for STERIS Vis-U-All Low Temperature Products

STERIS Part #TypeSize (inches)
875037Pouch, Heat Seal,3 x 7
875049Tyvek (low temp)4 x 9
8754124 x 12
8754224 x 22
8756106 x 10
8758128 x 12
87511510 x 15
87511812 x 18
876037Pouch, Self Seal,3 x 7
876049Tyvek (low temp)4 x 9
8764124 x 12
8764224 x 22
8766106 x 10
8768128 x 12
87611510 x 15
87611812 x 18
872031Tubing, Heat Seal,3" x 100 ft
872041Tyvek (low temp)4" x 100 ft
8720616" x 100 ft
8720919" x 100 ft
87214114" x 100 ft

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

Page 1 of 2

510(k) Number:

May 05, 2010

8

The following are the validation test conditions:

  • 1 hour exposure; at 130(±5) °F*, >30% RH using 100% ETO (750-790 mg/L); .
  • 4.5 hour exposure; at 100(±5) ºF*, >30% RH using 100% ETO (750-790 mg/L); .
  • ±5 °F is during sterilization phase following an equilibration period of 10% of exposure time.

The ethylene oxide process indicator is intended to be used by a health care provider with the Vis-U-All Low Temperature Tyvek Sterilization Pouches to distinguish between processed and unprocessed units.

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

Over-The-Counter Use X (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)

Sted N. Murphey D. Matz J. Ellevan-Williams
(Division Sign Off)

Anesthesiology, General Hospital Control, Dental Devices

510(k) Number: K092245

Page 2 of 2