K Number
K100480
Device Name
ROTA-TRACH TRACHEOSTOMY TUBE MODEL ROTA-TRACH
Date Cleared
2010-06-11

(113 days)

Product Code
Regulation Number
868.5800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Tracheostomy Tubes are intended for use in providing direct tracheal access for airway management.
Device Description
The VITALTEC Rota-Trach Tracheostomy Tubes are made from the raw material of The VITALIEC Kota Track Track Tracksonsyland of connector and valve. The the seeff with Sincolle for medical ass, while the components of the propriate hardness, the cuff with tubes have such good perfectionsment tube and excellent biocompatibility.
More Information

No
The document describes a standard medical device (tracheostomy tube) and does not mention any AI/ML components, image processing, or data-driven performance metrics typically associated with AI/ML devices.

Yes
The "Intended Use / Indications for Use" states that Tracheostomy Tubes are "intended for use in providing direct tracheal access for airway management," which is a therapeutic purpose.

No

The device is a tracheostomy tube, which is used for direct tracheal access for airway management, not for diagnosing a condition. Its function is to provide an airway, which is a therapeutic intervention, not a diagnostic one.

No

The device description clearly states it is a physical tracheostomy tube made from raw materials, including a connector and valve, 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 "providing direct tracheal access for airway management." This describes a device used in vivo (within the body) for a therapeutic or supportive purpose, not for examining specimens in vitro (outside the body) to diagnose a condition.
  • Device Description: The description focuses on the physical components and materials of a tube inserted into the trachea. This aligns with a medical device used for airway management, not an IVD.
  • Lack of IVD Characteristics: There is no mention of analyzing biological specimens (blood, urine, tissue, etc.), using reagents, or providing diagnostic information based on in vitro testing.
  • Predicate Device: The predicate device is "Medical Tracheostomy Tubes," which are also in vivo medical devices, not IVDs.

In summary, the VITALTEC Rota-Trach Tracheostomy Tube is a medical device used for airway management in vivo, not an IVD.

N/A

Intended Use / Indications for Use

Tracheostomy Tubes are intended for use in providing direct tracheal access for airway management.

Product codes

BTO

Device Description

The VITALTEC Rota-Trach Tracheostomy Tubes are made from the raw material of Silicone and consist of connector and valve. The body of the tube and the cuff with such good properties for medical use, while the components of the tube have appropriate hardness, and excellent biocompatibility.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Tracheal

Indicated Patient Age Range

Various sizes for Pediatric and Adult

Intended User / Care Setting

licensed professionals.

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 dimension, design, material, sterility and packaging of VITALTEC Rota-Trach Tracheostomy Tubes are conformed to ISO 5356-1 and ISO 17665-1.

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

Not Found

Predicate Device(s)

K031553

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 868.5800 Tracheostomy tube and tube cuff.

(a)
Identification. A tracheostomy tube and tube cuff is a device intended to be placed into a surgical opening of the trachea to facilitate ventilation to the lungs. The cuff may be a separate or integral part of the tracheostomy tube and is, when inflated, intended to establish a seal between the tracheal wall and the tracheostomy tube. The cuff is used to prevent the patient's aspiration of substances, such as blood or vomit, or to provide a means for positive-pressure ventilation of the patient. This device is made of either stainless steel or plastic.(b)
Classification. Class II.

0

VITALTEC CORPORATION

No.12, Lane 4-30, Chyuan Zhou Rd., Hou Li Hsiang, Taichung, 42142, Taiwan, ROC Tel: 886-4-25580886 Fax: 886-4-25568632 Email: info@vitaltec.com.tw

5. 510(K) SUMMARY (as required by 807.92(c))

JUN 11 2010

K100480

DATE OF SUBMISSION: SUBMITTER:

January 27, 2010 president, Mr. Joseph Chang VITALTEC CORPORATION No. 12, Lane 4-30, Chyuan Zhou Rd., Hou Li Hsiang, Taichung, 42142, Taiwan TEL: 886-4-25580886 FAX: 886-4-25568632

ESTABLISHMENT 3003851906 REGISTRATION NO:

OFFICIAL CONTACT: Dr. JEN, KE-MIN ROC CHINESE-EUROPEAN INDUSTRIAL RESEARCH SOCIETY No 58, Fu Chiun Street. Hsin Chu City, 30067, Taiwan TEL: 886-3-5208829 FAX:886-3-5209783

VITALTEC Rota-Trach Tracheostomy Tube TRADE NAME:

Tracheostomy Tube COMMON/USUAL

Tube, Tracheostomy (W/Wo connector)

CLASSIFICATION NAME:

NAME:

CLASSIFICATION PANEL:

BTO, Class II, 868.5800

PREDICATED DEVICE: INTENDED USE:

NON-CLINIC DATA:

  • ISO 5356-1: Anaesthetic and respiratory equipment -. Conical connectors: Part 1: Cones and sockets. 2004.
    Tracheostomy Tubes are intended for use in providing direct

Medical Tracheostomy Tubes; 510K No. ( K031553 )

tracheal access for airway management.

  • ISO 10993-1: Biological Evaluation of medical ● devices, part 1: Evaluation and testing, 2003.
  • 10993-5: Biological Evaluation of medical ● ISO devices, part 5: Tests for in vitro cytotoxicity, 1999.
  • ISO 10993-10: Biological Evaluation of medical ● devices, part 10: Tests for irritation and sensitization, 2002.

િર

1

VITALTEC CORPORATION

No.12, Lane 4-30, Chyuan Zhou Rd., Hou Li Hsiang, Taichung, 42142, Taiwan, ROC Tel: 886-4-25580886 Fax: 886-4-25568632 Email: info@vitaltec.com.tw

  • ISO 17665-1: Sterilization of health care products, part . 1: validation and control of sterilization process for medical devices, 2006.

DEVICE DESCRIPTION:

The VITALTEC Rota-Trach Tracheostomy Tubes are made from the raw material of The VITALIEC Kota Track Track Tracksonsyland of connector and valve. The the seeff with Sincolle for medical ass, while the components of the propriate hardness, the cuff with tubes have such good perfectionsment tube and excellent biocompatibility.

ITEMPREDICATE DEVICESUBJECT DEVICE
NameMedical Tracheostomy Tubes
( K031553 )VITALTEC Rota-Trach
Tracheostomy Tubes
Intended UseTracheostomy Tubes are intended
for use in providing direct tracheal
access for airway management.Same
MaterialSiliconeSame
Connector15 O.D. per ISO 5356-1Same
Sterilization
MethodETOMoist Heat
SpecificationVarious sizes for Pediatric and AdultPediatric I.D.: 5.0mm, 6.0mm
Adult I.D.:7.0mm, 8.0mm,
9.0mm, 10.0mm
Cuff StyleVarious types for Pediatric and AdultEach one type of Air Cuff to
match with each one size of
Tracheostomy Tube

COMPARISON WITH PREDICATE DEVICE:

PERFORMANCE DATA

The dimension, design, material, sterility and packaging of VITALTEC Rota-Trach Tracheostomy Tubes are conformed to ISO 5356-1 and ISO 17665-1.

CONCLUSION

In accordance with the FDA 21 CFR 807 and based on the information provided in this areas In accordance with the I DVD DEC Rota-Trach Tracheostomy Tubes have the same
Premarket notification, VITALTEC Rota-Trach Tracheostomy Tubes worlding intended use, material, and use the same specification of connector which is complied mich ISO 5356-1; and the different sterilization method was also got the validation. I The with 100 950 1, and 11.
main differences of the two devices are the subject device only has one type of air cuff and simpler specifications.

Thus the two devices are substantial equivalence.

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 a stylized symbol featuring three abstract shapes resembling birds in flight, stacked on top of each other.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

Vitaltec Corporation C/O Ms. Jen Ke-Min Roc Chinese-European Industry Research Society No. 58, Fu Chiun Street Hsin Chu City China (Taiwan) 30067

JUN 1 1 2010

Re: K100480

Trade/Device Name: Rota-Trach Tracheostomy Tube Model Rota-Trach Regulation Number: 21 CFR 868.5800 Regulation Name: Tracheostomy Tube and Tube Cuff Regulatory Class: II Product Code: BTO Dated: June 3, 2010 Received: June 10, 2010

Dear Ms. Ke-Min:

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.

3

Page 2- Ms. Ke-Min

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/CDRHQffices/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/Resourcesfor You/Industry/default.htm.

Sincerely yours,

Susan Runner

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

Enclosure

4

VITALTEC CORPORATION

No.12, Lane 4-30, Chyuan Zhou Rd., Hou Li Hsiang, Taichung, 42142, Taiwan, ROC Tel: 886-4-25580886 Fax: 886-4-25568632 Email: info@@vitaltec.com.tw

Indications for Use .

510 (K) Number ( If Known ):

Device Name: VITALTEC Rota-Trach Tracheostomy Tube ●

Indications for Use :

Tracheostomy Tubes are intended for use in providing direct tracheal access for airway management.

CAUTION: U.S. Federal law restricts the use of this device to licensed professionals.

Prescription Use AND/OR Over-The-Counter Use (Part 21 CFR 801 Subpart D) (21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

L. Schultin

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

510(k) Number: N 100480