K Number
K102584
Date Cleared
2011-01-14

(128 days)

Product Code
Regulation Number
880.5570
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

This device is intended for use to inject fluids into or withdraw fluids from parts of the body below the surface of the skin.

Device Description

This device is consist of hub, cannula and protector and has difference hub color per each of gauges.

AI/ML Overview

The provided text describes the IMC Hypodermic Needle and its substantial equivalence to a predicate device. It includes performance data for a single characteristic, "Hub/needle bond strength."

Here's an analysis of the acceptance criteria and study information:

1. Table of Acceptance Criteria and Reported Device Performance

Performance CharacteristicTest MethodAcceptance CriteriaIMC Hypodermic Needle Performance
Hub/needle bond strengthISO 7894 : 199316G-19G: >69NMeets Standard Criteria
20G: >54NMeets Standard Criteria
21G: >44NMeets Standard Criteria
22G: >40NMeets Standard Criteria
23G-24G: >34NMeets Standard Criteria
25G-30G: >22NMeets Standard Criteria

2. Sample Size Used for the Test Set and Data Provenance

The document does not specify the sample size used for testing, nor its provenance (e.g., country of origin, retrospective or prospective). It simply states "Meets Standard Criteria" for the IMC Hypodermic Needle performance.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

This information is not applicable as the described device is a physical medical device (hypodermic needle) and the performance data pertains to a mechanical bond strength test, not an AI or diagnostic imaging device requiring expert ground truth for interpretation.

4. Adjudication Method for the Test Set

This information is not applicable for the same reasons as point 3. Mechanical testing does not involve human adjudication in this context.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and the Effect Size

This information is not applicable as the described device is a physical medical device, not an AI or diagnostic imaging system that would involve human readers or comparative effectiveness studies with AI assistance.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

This information is not applicable as the described device is a physical medical device, not an algorithm or AI system.

7. The Type of Ground Truth Used

The "ground truth" for the performance data (Hub/needle bond strength) is established by objective mechanical testing against the specified force thresholds outlined in the ISO 7894:1993 standard. This is a direct physical measurement, not based on expert consensus, pathology, or outcomes data in the traditional sense of diagnostic devices.

8. The Sample Size for the Training Set

This information is not applicable as the device is a physical medical device and does not involve AI or machine learning that would require a training set.

9. How the Ground Truth for the Training Set Was Established

This information is not applicable for the same reason as point 8.

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JAN 1 4 2011

8. 510(K) SUMMARY

8. 510(K) SUMMARY
Proprietary Name:IMC Hypodermic Needle
Common Name:HypodermicNeedle
Classification Name:Hypodermic Single Lumen Needle (21 CFR 880.5570)
Device Clarification:Class II
Panel Code:80
Product Code:FMI
Submitter Information:International Medsurg Connection935 N Plum Grove Rd, STE FSchaumburg, Illinois 60173
Summary Prepared By:Peter KimDirector of Quality AssuranceInternational Medsurg Connection935 N Plum Grove Rd, STE FSchaumburg, Illinois 60173Telephone: 847-619-9926Fax: 847-619-9927e-mail: peterkim@intlmedsurg.com
Date Prepared:January 4, 2010
Predicate Devices:• Nipro Medical Corporation (K052474)

Device Name(s):

IMC Hypodermic Needle (non-sterile and sterile)

Classification Panel:

General Hospital

Legally Marketed Device Under Which Substantial Equivalence is Being Claimed:

International Medsurg Connections, Inc is claiming substantial equivalence of the IMC Hypodermic Needle with the currently marketed:

Description510(k) Number
Nipro Hypodermic NeedleK052474

Device Description

This device is intended for use to inject fluids into or withdraw fluids from parts of the body below the surface of the skin.

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This device is consist of hub, cannula and protector and has difference hub color per each of gauges.

Statement of Intended Use

Indications For Use: This device is intended for use to inject fluids into or withdraw fluids from parts of the body below the surface of the skin.

DescriptionSizeSterility
16 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
17 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
18 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
19 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
20 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
21 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
22 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
23 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
24 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
25 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
26 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
27 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
28 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
29 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
30 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile

Name/Descrintion

New Devices as Compared to Marketed Device(s)

The IMC Hypodermic needle and the predicate device (Nipro Hypodermic needle) are intended to be used to inject fluids into or withdraw fluids from parts of the body below the surfince of the skin.

Feature/ CharacteristicIMC Hypodermic NeedleNipro Hypodermic Needle: K052474(Predicate)
Intended Useis device is intended for use to injectfluids into or withdraw fluids fromparts of the body below the surfaceof the skinipro Hypodermic Needles are intendedfor use to inject fluids into or withdrawfluids from the parts of the body
Material
Hub of NeedlePolypropylene (PP)Polypropylene (PP)
ProtectorPolypropylene (PP)Polypropylene (PP)
Feature/ CharacteristicIMC Hypodermic NeedleNipro Hypodermic Needle: K052474(Predicate)
CannulaSUS 304SUS 304
Adhesive.Epoxy ResinEpoxy Resin
colors
16GWhite colorWhite color
17GRed-violet colorMauve color
18GPink colorPink color
19GCream colorCream color
20GYellow colorYellow color
21GDeep green colorGreen color
22GBlack colorBlack color
23GDeep Blue colorBlue color
24GMedium purple colorPurple color
25GOrange colorOrange color
26GBrown colorBrown color
27GMedium gray colorGray color
28GBlue-green colorBlue-green color
29GRed colorRed color
30GYellow colorYellow color
Length½", 5/8", ¾", 7/8", 1", 1 ¼" and1 ½"½", 5/8", ¾", 7/8", 1", 1 ¼" and1 ½"
Gauge16G, 17G, 18G, 20G, 21G, 22G, 23G,24G, 25G, 26G, 27G, 28G, 29G & 30G16G, 17G, 18G, 20G, 21G, 22G, 23G,24G, 25G, 26G, 27G, 28G, 29G & 30G
Cover dimension½" size: 40mm½" size: 42mm
5/8" size: 40mm5/8" size: 42mm
¾" size: 40mm¾" size: 42mm
7/8" size: 40mm7/8" size: 42mm
1" size: 40mm1" size: 42mm
1 ¼" size: 56mm1 ¼" size: 55mm
1 ½" size: 56mm1 ½" size: 55mm
All gauges have the same dimension.
Cover colorClear (for all gauges)Clear (for all gauges)
Tip configurationBevelBevel

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Performance Data:

Performance CharacteristicsTest MethodAcceptanceCriteriaIMC HypodermicNeedleNipro HypodermicNeedleK052474
Hub/needle bond strengthISO 7894 : 199316G-19G: >69N20G: >54N21G: >44N22G: >40N23G-24G: >34N25G-30G: >22NMeets StandardCriteriaMeets StandardCriteria

Conclusions:

The indications for use, technology, specification, safety of the IMC Hypodermic needle and the predicate devices K052474 are essentially the same. The differences between the hypodermic needle are minor and do not raise new issues of safety or effectiveness. Hence, the IMC Hypodermic needles are substantially equivalent to the predicate device.

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Image /page/4/Picture/1 description: The image shows the logo for the Department of Health & Human Services USA. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" written around the perimeter. Inside the circle is an abstract image of an eagle.

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

Mr. Peter Kim Director of Quality Assurance International Medsurg Connection 935 North Plum Grove Road, Suite F Schaumburg, Illinois 60173

JAN 1 4 2011

Re: K102584

Trade/Device Name: IMC Hypodermic Needle Regulation Number: 21 CFR 880.5570 Regulation Name: Hypodermic Single Lumen Needle Regulatory Class: II Product Code: FMI Dated: December 10, 2010 Received: December 20, 2010

Dear Mr. Kim:

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.

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Page 2- Mr. Kim

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 /ucm 115809.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

Jum J. Robert
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

Enclosure

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Indications for Use

Kio2584

510(k) Number :

Device Name: IMC Hypodermic needle

Indications For Use: This device is intended for use to inject fluids into or withdraw fluids from parts of the body below the surface of the skin.

GaugeSizeSterility
16 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
17 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
18 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
19 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
20 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
21 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
22 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
23 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
24 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
25 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
26 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
27 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
28 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
29 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile
30 Gauge Hypodermic needle½", 5/8", ¾", 7/8", 1", 1 ¼" and 1 ½"Sterile & Non-sterile

Name/Description

X Prescription Use (Part 21 CFR 801 Subpart D) (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)

filter for the River Richard as Appines of (Division Sign-Off) Division of Anesthesiology, General Hospital Page 13 Infection Control, Dental Devices

510(k) Number: _______________________________________________________________________________________________________________________________________________________________

§ 880.5570 Hypodermic single lumen needle.

(a)
Identification. A hypodermic single lumen needle is a device intended to inject fluids into, or withdraw fluids from, parts of the body below the surface of the skin. The device consists of a metal tube that is sharpened at one end and at the other end joined to a female connector (hub) designed to mate with a male connector (nozzle) of a piston syringe or an intravascular administration set.(b)
Classification. Class II (performance standards).