K Number
K103434
Device Name
3B FLEX-LITE
Manufacturer
Date Cleared
2011-10-13

(324 days)

Product Code
Regulation Number
868.5905
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The 3B Flex-Lite™ channels airflow noninvasively to a patient from a positive airway pressure (PAP) device such as a continuous positive airway pressure (CPAP) or a bilevel system. The 3B Flex-Lite™ is: - to be used by adult patients (>66lb / 30 kg); (1) - to be used for single-patient reuse in the home environment and multipatient (2) reuse in the hospital/institutional environment. - (3) to be used in the following environments: home, hospital, and sub-acute institutions. - intended for prescription use. (4)
Device Description
The 3B Flex-Lite™ is a mask interface, of the nasal pillow variety, that directs airflow from a positive pressure device to the patient's nose. The mask is held in place with adjustable headgear that straps the mask to the face. The 3B Flex-Lite™ is safe when used under the conditions and purposes intended as indicated in the labeling provided with the product. The 3B Flex-Lite™ is a prescription device supplied non-sterile.
More Information

No
The device description and performance studies focus on the physical characteristics and airflow performance of a nasal mask, with no mention of AI or ML.

Yes
The device is a mask interface that channels airflow from a PAP device to a patient, which is used in the treatment of sleep apnea or other respiratory conditions. It is used to deliver therapy rather than diagnose.

No

The device is a mask interface that channels airflow from a PAP device to the patient's nose; its function is to deliver positive airway pressure, not to diagnose a medical condition.

No

The device description explicitly states it is a "mask interface, of the nasal pillow variety," which is a physical hardware component. The performance studies also focus on physical characteristics like airflow, resistance, and CO2 re-breathing, further indicating it is a hardware device.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, or tissue) to provide information about a person's health.
  • 3B Flex-Lite™ Function: The 3B Flex-Lite™ is a mask interface that delivers airflow from a PAP device to the patient's nose. It is a physical interface for delivering therapy, not a device that analyzes biological samples.
  • Intended Use: The intended use clearly states it "channels airflow noninvasively to a patient." This is a therapeutic delivery function, not a diagnostic function.
  • Device Description: The description focuses on the physical components of the mask and its function in directing airflow.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, detecting biomarkers, or providing diagnostic information based on in vitro testing.

The 3B Flex-Lite™ is a medical device used for respiratory therapy, specifically for delivering positive airway pressure. It does not fit the definition or function of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The 3B Flex-Lite™ channels airflow noninvasively to a patient from a positive airway pressure (PAP) device such as a continuous positive airway pressure (CPAP) or a bilevel system. The 3B Flex-Lite™ is:

  • to be used by adult patients (>66lb / 30 kg);
  • to be used for single-patient reuse in the home environment and multipatient reuse in the hospital/institutional environment.
  • to be used in the following environments: home, hospital, and sub-acute institutions.
  • intended for prescription use.

Indications for Use:

    1. To be used by adult patients (>66lb /30kg);
    1. To be used for single-patient reuse in the home environment or multi-patient reuse in the hospital/institutional environment;
    1. To be used in the following environments: Home, Hospital, and sub-acute institutions

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

BZD

Device Description

The 3B Flex-Lite™ is a mask interface, of the nasal pillow variety, that directs airflow from a positive pressure device to the patient's nose. The mask is held in place with adjustable headgear that straps the mask to the face.
The 3B Flex-Lite™ is safe when used under the conditions and purposes intended as indicated in the labeling provided with the product.
The 3B Flex-Lite™ is a prescription device supplied non-sterile.
The nasal mask itself incorporates four vent holes to provide continuous air, leak to flush out The nask Room moorporates a rebreathed by the patient. The design of the mask and infinitize the anount of these vent-holes does not interfere with the intended performance of the mask.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Nose (patient's nose)

Indicated Patient Age Range

Adult patients (>66lb / 30 kg)

Intended User / Care Setting

Home, hospital, and sub-acute institutions. To be used for single-patient reuse in the home environment and multipatient reuse in the hospital/institutional environment. Prescription use.

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)

Performance bench testing of both the 3B Flex-Lite™ and the predicate device Nasal Aire II were conducted by Piper Medical. The testing consisted of three sets of testing: passive exhalation port flow, resistance to flow, CO2 re-breathing percentage, and measurement of dead space. Based on the results, the report finds that the 3B Flex-Lite™ is "substantially equivalent to the Nasal-Aire II in terms of performance".

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.

K022465, K090244

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.

K110008, K063036, K050359

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

3B™

3B Flex-Lite Nasal Mask

OCT 1 3 2011

Section 5:

510(k) SUMMARY

[As required by 21 CFR §807.92(c)]

DATE PREPARED:

March 28, 2011

Revised September 8, 2011

OFFICIAL CONTACT:

Albert A. Lucio

Managing Partner

3B Products, LLC

1142 N. Scenic Highway

Lake Wales, FL 33853

Tel: (863) 676-5948

Email: alucio@3Bproducts.com

DEVICE TRADE NAME: 3B FLEX-LITE™

DEVICE COMMON NAME/

CLASSIFICATION NAME: Vented Nasal Mask:

Accessory to Noncontinuous Ventilator (IPPB)

CLASSIFICATION:

21 CFR 868.5905, 73 BZD (CLASS II)

Manufacturer:

PREDICATE DEVICES:

InnoMed Technologies, Inc.

Trade Name: Nasal-Aire II

510(k) Number: K022465

1

3B Flex-Lite Nasal Mask (K 103434)

000008

Resmed, Ltd. Manufacturer: Swift FX Trade Name: 510(k) Number: K090244

DEVICE DESCRIPTION

The 3B Flex-Lite™ is a mask interface, of the nasal pillow variety, that directs airflow from a positive pressure device to the patient's nose. The mask is held in place with adjustable headgear that straps the mask to the face.

The 3B Flex-Lite™ is safe when used under the conditions and purposes intended as indicated in the labeling provided with the product.

The 3B Flex-Lite™ is a prescription device supplied non-sterile.

INTENDED USE

The 3B Flex-Lite™ channels airflow noninvasively to a patient from a positive airway pressure (PAP) device such as a continuous positive airway pressure (CPAP) or a bilevel system. The 3B Flex-Lite™ is:

  • to be used by adult patients (>66lb / 30 kg); (1)
  • to be used for single-patient reuse in the home environment and multipatient (2) reuse in the hospital/institutional environment.
  • (3) to be used in the following environments: home, hospital, and sub-acute institutions.
  • intended for prescription use. (4)

CONTRAINDICATIONS: None

TECHNOLOGICAL CHARACTERISTICS COMPARISON

The 3B Flex-Lite™ is differentiated from the predicate devices based primarily on differences in form, fit and comfort. The headgear is constructed out of Breath-O-Prene™ fabric, a laminated knit textile which serves as the loop for a Velcro fastener. Breath-O-Prene™ is a popular fabric for the CPAP headgear market used in the predicate devise Swift FX, and is also currently being used in similar applications by several other manufacturers, including Phillips Respironics GoLife Nasal Mask K110008) , Fisher & Paykel (Opus Nasal Mask K063036) and Resmed (Ultra Mirage Nasal Mask K050359).

2

3B"

The nasal mask itself incorporates four vent holes to provide continuous air, leak to flush out The nask Room moorporates a rebreathed by the patient. The design of the mask and infinitize the anount of these vent-holes does not interfere with the intended performance of the mask.

The 3B Flex-Lite™ nasal mask is very similar to the predicate InnoMed Nasal Aire-II mask. Both rre cannula style mask systems with similar performance characteristics. Performance bench are connula style mash by virus™ and the Nasal Aire II were conducted. These tests demonstrate testing of both the BB Tion of the proposed device with the predicate device. Copies of test reports are included in Appendix A.

The 3B Flex-Lite™ is similar to the predicate Resmed Swift FX inasmuch as they have similar air The DD Fex alle - b and pillow design) and utilize the same headgear fabric (i.e. Breath-O-9car 3f3cms (inst hase phonomisons of the proposed device and the predicate devises is shown below in tabular form:

COMPARATIVE TABLE:

| FEATURES | PREDICATE NASAL-
AIRE II (K022465) | PREDICATE SWIFT FX
(K090244) | PROPOSED DEVICE 3B
FLEX-LITE (K103434) |
|-------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------|
| Indications for Use | A patient interface
accessory for use with
CPAP and bi-level
systems used in the
treatment of adult
OSA and/or ventilator
support. | A patient interface
accessory for use with
CPAP and bi-level
systems used in the
treatment of adult
OSA and/or ventilator
support. | A patient interface
accessory for use with
CPAP and bi-level
systems used in the
treatment of adult
OSA and/or ventilator
support. |
| Environment of Use | Hospitals, sub-acute
institutions, sleep
laboratories and
home. | Same | Same |
| Patient Population | Adult | Same | Same |
| Contraindications | None | None | None |
| Single patient, multi-
use | Yes | Yes | Yes |
| Components | Nasal interface (no
headgear) | Nasal interface with
pillows and headgear | Nasal interface with
pillows and headgear |
| Dead Space | Interface - 24-28 ml /
Pillows 2-4 ml | Interface - 24-28 ml /
Pillows 2-4 ml | Interface 10.5ml
Pillows 3.5 ml |
| Fixed leak port | Yes | Yes | Yes |

000000

3

| Deliverable pressure

range3-18 cmH204-20 cmH204-20 cmH20
Materials:
Nasal InterfaceSiliconeSiliconeSilicone
(Biocompatibility per
ISO 10993-1)
HeadgearNoneBreath-O-Prene™Breath-O-Prene™
Comparative testing for safety and efficacyFlow vs. Leak Pressure
Dead space
CO2 rebreathingFlow vs. Leak Pressure
Dead space
CO2 rebreathingFlow vs. Leak Pressure
Dead space
CO2 rebreathing

Non-clinical Tests

Testing of the 3B Flex-Lite™ was compared to the predicate innoMed Nasal Aire II for performance and safety. Performance testing of both the proposed device, the 3B Flex-Lite™, and the Nasal-Aire II predicate device was performed by Piper Medical. A copy of the test report dated March 23, 2011 is annexed at Appendix A.

In terms of design, both the Nasal-Aire If and the proposed device are cannula style nasal interfaces, with the air flow supplied to the interface from lateral sides. The performance bench testing consisted of three sets of testing: passive exhalation port flow (App. A at p. 6), resistance to flow (App. A at p. 8), CO2 re-breathing percentage (App. at p. 9), and measurement of dead space (App. A at p. 9). Based on the results of these tests, the report finds that the 3B Flex-Lite™ is "substantially equivalent to the Nasal-Aire II in terms of performance".

Substantial Equivalence Conclusion:

3B Flex-Lite™ is substantially equivalent to the predicate devices. It has the same intended use. It has similar technological characteristics to both predicates. It does not raise new questions of safety and effectiveness. And, it is at least as safe and effective as the predicate devices Nasal-Aire II and Swift FX.

000010

4

Image /page/4/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" around the perimeter. Inside the circle is an abstract symbol resembling an eagle or bird in flight, composed of three curved lines.

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

OCT 1 3 2011

Mr. Albert A. Lucio Managing Partner 3B Products. LLC 1142 N. Scenic Highway Lake Wales, Florida 33853

Re: K103434

Trade/Device Name: Flex-Lite™ CPAP Nasal Pillows Mask Regulation Number: 21 CFR 868.5905 Regulation Name: Noncontinuous Ventilator Regulatory Class: II Product Code: BZD Dated: September 15, 2011 Received: September 20. 2011

Dear Mr. Lucio:

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.

5

Page 2 - Mr. Lucio

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/MedicallDevices/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,

ાંડ

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

6

4.0 Indications for Use Form

510(k) Number (if known): K103434

Device Name: Flex-Lite™ CPAP Nasal Pillows Mask

Indications for Use:

    1. To be used by adult patients (>66lb /30kg);
    1. To be used for single-patient reuse in the home environment or multi-patient reuse in the hospital/institutional environment;
    1. To be used in the following environments: Home, Hospital, and sub-acute institutions

Prescription Use _____________________________________________________________________________________________________________________________________________________________

AND/OR

Over –The-Counter Use

000006

(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)

Division Sign-Off

Office of Device Evaluation

Evaluation and Safety

510(k) K103434

L. Schultheis

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

510(k) Number: