K Number
K100988
Device Name
HUMAPEN LUXURA HD
Date Cleared
2010-08-17

(130 days)

Product Code
Regulation Number
880.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The HumaPen Luxura HD is a reusable pen injector designed for the self-injection of a desired dose of insulin. The pen injector uses 3.0 mL cartridges of Lilly insulin and a single use detachable and disposable pen needle (supplied separately). The pen injector allows the user to dial the desired dose from 0.5 to 30 units in one-half (1/2) unit increments.
Device Description
HumaPen Luxura HD is a reusable mechanical pen-injector designed for use for the self-injection of insulin. The pen-injector is intended for use with Eli Lilly and Company 3.0 mL insulin cartridges and single-use, detachable and disposable pen needles (supplied separately).
More Information

Not Found

No
The description focuses on the mechanical aspects of a reusable pen injector for insulin, with no mention of AI or ML capabilities.

Yes
The device is described as a "reusable pen injector designed for the self-injection of a desired dose of insulin," indicating it delivers medication to treat a medical condition (diabetes).

No

This device is a reusable pen injector designed for the self-injection of insulin. It delivers medication and does not perform any diagnostic functions.

No

The device is a reusable mechanical pen-injector, which is a hardware device designed for insulin injection. The description clearly outlines its physical components and mechanical function.

Based on the provided information, the HumaPen Luxura HD is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use is for the self-injection of insulin. This is a drug delivery device, not a device used to examine specimens derived from the human body to provide information for diagnosis, monitoring, or compatibility.
  • Device Description: The description confirms it's a mechanical pen-injector for insulin.
  • No mention of IVD activities: The document does not mention any activities related to testing samples, analyzing biological markers, or providing diagnostic information.
  • Performance Studies: The performance studies focus on dose accuracy, functionality, and biocompatibility, which are relevant to a drug delivery device, not an IVD.

Therefore, the HumaPen Luxura HD is a medical device, but it falls under the category of a drug delivery system, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The HumaPen Luxura HD is a reusable pen injector designed for the self-injection of a desired dose of insulin. The pen injector uses 3.0 mL cartridges of Lilly insulin and a single use detachable and disposable pen needle (supplied separately). The pen injector allows the user to dial the desired dose from 0.5 to 30 units in one-half (1/2) unit increments.

Product codes

FMF

Device Description

HumaPen Luxura HD is a reusable mechanical pen-injector designed for use for the self-injection of insulin. The pen-injector is intended for use with Eli Lilly and Company 3.0 mL insulin cartridges and single-use, detachable and disposable pen needles (supplied separately).

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

self-injection by diabetics

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)

HumaPen Luxura HD was tested per ISO 11608-1 for dose accuracy and functionality. HumaPen Luxura. HumaPen Luxura HD components were evaluated for biocompatibility per ISO 10993-1.

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

Not Found

Predicate Device(s)

K063151

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 880.5860 Piston syringe.

(a)
Identification. A piston syringe is a device intended for medical purposes that consists of a calibrated hollow barrel and a movable plunger. At one end of the barrel there is a male connector (nozzle) for fitting the female connector (hub) of a hypodermic single lumen needle. The device is used to inject fluids into, or withdraw fluids from, the body.(b)
Classification. Class II (performance standards).

0

510(k) Summary

AUG 1 7 2010

09988

1. Submitter's Name

Eli Lilly and Company Lilly Corporate Center Indianapolis, Indiana 46285 (317) 276-2000

Contact Person

Steve Johnson, M.B.A, P.E. Associate Regulatory Consultant Phone: (317) 433-4685 Fax:

Date Prepared: April 2, 2010

2. Device Name

Proprietary Name:HumaPen Luxura HD
Common Name:Pen-Injector
Classification Name:Piston Syringe
Regulation:21 CFR 880.5860
Product Code:FMF
Class:II

3. Predicate Device

Manufacturer:Eli Lilly and Company
Proprietary Name:HumaPen Luxura HD®
Submission:K063151

4. Device Description

HumaPen Luxura HD is a reusable mechanical pen-injector designed for use for the self-injection of insulin. The pen-injector is intended for use with Eli Lilly and Company 3.0 mL insulin cartridges and single-use, detachable and disposable pen needles (supplied separately).

LY888889 HumaPen Luxura 0.5 Response to Questions US (Quality)

August 2010 CONFIDENTIAL - Eli Lilly and Company

1

5. Intended Use

The HumaPen Luxura HD is a reusable pen injector designed for use by diabetics for the self-injection of a desired dose of insulin. The pen injector uses 3.0 mL cartridges of Lilly insulin and a single use detachable and disposable pen needle (supplied separately). The pen injector allows the user to dial the desired dose from 0.5 to 30 units in one-half (1/2) unit increments.

6. Technological Characteristics

Pen FeatureNew DevicePredicate Device
Similarities
Syringe TypePiston SyringePiston Syringe
Intended UseDelivery of Lilly insulins in
3 mL cartridgesDelivery of Lilly insulins in
3 mL cartridges
Reusable DeviceYesYes
Delivery AccuracyMeets ISO 11608-1.2000
requirementsMeets ISO 11608-1.2000
requirements
Cartridge Volume3 ml (300 units)3 ml (300 units)
Maximum Delivered Dose30 Units30 Units
Audible Clicks with
Each IncrementYesYes
Two-Way Dose DialingYesYes
Differences
Unit IncrementsHalf-Unit increments after
0.5 UnitHalf-Unit increments after
1 Unit

7. Performance data

HumaPen Luxura HD was tested per ISO 11608-1 for dose accuracy and functionality. HumaPen Luxura. HumaPen Luxura HD components were evaluated for biocompatibility per ISO 10993-1.

2

8. Conclusion

HumaPen Luxura HD has met the standards for dose accuracy and functionality. HumaPen Luxura HD has also met tighter dose accuracy tolerance based on the dialing resolution of 0.5 units. Biocompatibility investigation of materials has shown that the materials used in the HumaPen Luxura HD are safe for patient contact. Pen operation and pen function are unchanged from the currently cleared HumaPen Luxura HD. The HumaPen Luxura HD is substantially equivalent to the currently cleared HumaPen Luxura HD.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health and 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 image of an eagle or bird-like figure with three curved lines representing its wings or body. The logo is black and white.

Public Health Service

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

Mr. Steven T. Johnson PE, MBA Associate Regulatory Consultant Eli Lilly and Company Lilly Corporate Center Indianapolis, Indiana 46285

AUG | 7 2010

Re: K100988

Trade/Device Name: HumanPen Luxura HD Regulation Number: 21 CFR 880.5860 Regulation Name: Piston Syringe Regulatory Class: II Product Code: FMF Dated: July 26, 2010 Received: July 27, 2010

Dear Mr. Johnson:

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 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.

4

Page 2- Mr. Johnson

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/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,

Wh 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

5

Indications for Use

510(k) Number (if known):

Device Name: HumaPen Luxura HD

Indications for Use:

The HumaPen Luxura HD is a reusable pen injector designed for the self-injection of a desired dose of insulin. The pen injector uses 3.0 mL cartridges of Lilly insulin and a single use detachable and disposable pen needle (supplied separately). The pen injector allows the user to dial the desired dose from 0.5 to 30 units in one-half (1/2) unit increments.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ X AND/OR

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

(Part 21 CFR 801 Subpart D)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Adel C. Chapman

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

510(k) Number: K100988