K Number
K103564
Device Name
VENOFER PUMP
Date Cleared
2011-02-10

(66 days)

Product Code
Regulation Number
876.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The intended use of the Venofer Pump 1.1 is identical to the unmodified device. The Venofer® Pump Is an optional accessory for use on Fresenius 2008T Hemodialysis Machines and is intended to administer Venofer®, an iron sucrose, to treat iron deficiency anemia in patients with chronic kidney disease undergoing hemodialysis, where Venofer®, in conjunction with hemodialysis, is prescribed by a physician. Fresenius 2008T is indicated for acute and chronic dialysis therapy.
Device Description
The Venofer Pump Module is an optional module for use on Fresenius 2008T Hemodialysis Machines. The module is designed to administer Venofer, an iron sucrose supplement, during dialysis treatments. The Venofer Pump Module is to be used in accordance with the approved Venofer Indications for Use and the physician's prescription. The Venofer Pump Module fits into the module compartment of Fresenius 2008T Machines and consists of a control panel, vial holder, fluld detector, and a peristaltic pump.
More Information

Not Found

No
The description focuses on a peristaltic pump and control system for administering medication, with no mention of AI or ML technologies. The performance studies described are standard verification and validation tests for medical devices, not studies related to AI/ML model performance.

No.
The device is described as an "optional accessory" for a hemodialysis machine, intended to administer a medication (Venofer) used to treat a condition. While it delivers a therapeutic substance, the device itself is an administration tool rather than a therapeutic device in the sense of directly treating the disease through its own mechanism of action. The therapy is provided by the Venofer and the hemodialysis machine.

No

The device is described as a pump intended to administer a substance (Venofer) to treat an existing condition (iron deficiency anemia), not to diagnose a condition.

No

The device description explicitly states that the Venofer Pump Module "consists of a control panel, vial holder, fluld detector, and a peristaltic pump," which are all hardware components. The summary also details hardware-related testing like EMC and biocompatibility.

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

Here's why:

  • Intended Use: The intended use is to administer Venofer, an iron sucrose, to treat iron deficiency anemia in patients with chronic kidney disease undergoing hemodialysis. This is a therapeutic intervention, not a diagnostic test performed on samples taken from the body.
  • Device Description: The device is a pump module that fits into a hemodialysis machine and administers a substance. This aligns with a drug delivery system, not a diagnostic device.
  • Lack of Diagnostic Activity: There is no mention of analyzing samples (blood, urine, etc.) or providing diagnostic information about a patient's condition. The device's function is to deliver a prescribed medication.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. The Venofer Pump does not perform any of these functions.

N/A

Intended Use / Indications for Use

The Venofer® Pump Is an optional accessory for use on Fresenius 2008T Hemodialysis Machines and is intended to administer Venofer®, an iron sucrose, to treat iron deficiency anemia in patients with chronic kidney disease undergoing hemodialysis, where Venofer®, in conjunction with hemodialysis, is prescribed by a physician.

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

KDI

Device Description

The Venofer Pump Module is an optional module for use on Fresenius 2008T Hemodialysis Machines. The module is designed to administer Venofer, an iron sucrose supplement, during dialysis treatments. The Venofer Pump Module is to be used in accordance with the approved Venofer Indications for Use and the physician's prescription.

The Venofer Pump Module fits into the module compartment of Fresenius 2008T Machines and consists of a control panel, vial holder, fluld detector, and a peristaltic pump.

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

Not Found

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 verification (non-clinical) testing information consists of performance, safety, and software testing that was performed to verify the Venofer Pump meets its performance specifications and to demonstrate the device is substantially equivalent to the established predicate devices.

The following table summarizes the 510(k) verification testing activities performed. These include performance, safety and software testing, which demonstrates by technical examination that the Venofer Pump meets its performance specifications, the designated (FDA Consensus) standard requirements, and the software design input requirements.

Venofer Pump Performance Testing: Functional testing that demonstrates that the device performs as designed and expected, includes the following: The specific verification tests conducted A description of all test protocol including: objective of the tests test articles used in the tests test methods and procedures pre-defined acceptance or pass/fail criteria. System-level hazard analysis that confirms that the device does not perform in an unexpected and/or unsafe manner.

Venofer Pump Safety Testing: Product safety testing that demonstrates that the device performs per the FDA Consensus Standards, as identified below: Electromagnetic compatibility (EMC) testing (IEC 60601-1-2: 2007 - Medical Electrical Equipment - Part 1-2: General Requirements for Safety - Collateral Standard: Electromagnetic Compatibility - Requirements for Testing Biocompatibility Testing (AAMI / ANSI / ISO 10993-1:2009 Biological evaluation of medical devices Part 1: Evaluation & testing ).

Venofer Pump Software Testing: Software testing that demonstrates the device software meets the design input requirements. The device was tested and Includes the following Structure chart of flow chart describing software architecture Summary of software development procedures, including changes made to the software Software requirements specification with traceability back to the hazard analysis Verification and validation test plans, including pass/fail criteria and traceability back to the requirements; System level test results Current software version number and date of latest revision.

The conclusions drawn from this testing demonstrates that the Venofer Pump is as safe, as effective, and performs at least as safely and effectively as the legally marketed devices identified as predicate devices to which it was compared.

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.

K093964

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.

Not Found

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

§ 876.5860 High permeability hemodialysis system.

(a)
Identification. A high permeability hemodialysis system is a device intended for use as an artificial kidney system for the treatment of patients with renal failure, fluid overload, or toxemic conditions by performing such therapies as hemodialysis, hemofiltration, hemoconcentration, and hemodiafiltration. Using a hemodialyzer with a semipermeable membrane that is more permeable to water than the semipermeable membrane of the conventional hemodialysis system (§ 876.5820), the high permeability hemodialysis system removes toxins or excess fluid from the patient's blood using the principles of convection (via a high ultrafiltration rate) and/or diffusion (via a concentration gradient in dialysate). During treatment, blood is circulated from the patient through the hemodialyzer's blood compartment, while the dialysate solution flows countercurrent through the dialysate compartment. In this process, toxins and/or fluid are transferred across the membrane from the blood to the dialysate compartment. The hemodialysis delivery machine controls and monitors the parameters related to this processing, including the rate at which blood and dialysate are pumped through the system, and the rate at which fluid is removed from the patient. The high permeability hemodialysis system consists of the following devices:(1) The hemodialyzer consists of a semipermeable membrane with an in vitro ultrafiltration coefficient (K
uf ) greater than 8 milliliters per hour per conventional millimeter of mercury, as measured with bovine or expired human blood, and is used with either an automated ultrafiltration controller or anther method of ultrafiltration control to prevent fluid imbalance.(2) The hemodialysis delivery machine is similar to the extracorporeal blood system and dialysate delivery system of the hemodialysis system and accessories (§ 876.5820), with the addition of an ultrafiltration controller and mechanisms that monitor and/or control such parameters as fluid balance, dialysate composition, and patient treatment parameters (e.g., blood pressure, hematocrit, urea, etc.).
(3) The high permeability hemodialysis system accessories include, but are not limited to, tubing lines and various treatment related monitors (e.g., dialysate pH, blood pressure, hematocrit, and blood recirculation monitors).
(b)
Classification. Class II. The special controls for this device are FDA's:(1) “Use of International Standard ISO 10993 ‘Biological Evaluation of Medical Device—Part I: Evaluation and Testing,’ ”
(2) “Guidance for the Content of 510(k)s for Conventional and High Permeability Hemodialyzers,”
(3) “Guidance for Industry and CDRH Reviewers on the Content of Premarket Notifications for Hemodialysis Delivery Systems,”
(4) “Guidance for the Content of Premarket Notifications for Water Purification Components and Systems for Hemodialysis,” and
(5) “Guidance for Hemodialyzer Reuse Labeling.”

0

Response to FDA Questions K103564

Venofer Pump Version 1.1 Special 510(k)

FEB 1 0 2011

Section 5: 510(k) Summary

510(k) Summary

Submitter's Information

NameRenal Solutions, Inc.
Address770 Commonwealth Drive
Warrendale, Pa 15086
Phone: (724) 720-2840
FAX: (724) 772-6925
Official ContactDavid J. Vanella
Senior Vice President, Quality Systems
Date PreparedJanuary 7, 2011
Device Information
NameVenofer Pump, for use on the Fresenius
2008T Hemodialysis Machine
Common/Usual NameHemodialysis System
Product CodeKDI
Classification NameDialyzer, High Permeability With Or Without
Sealed Dialysate System
Regulation Number876.5860
Proprietary NameVenofer Pump
Unmodified DeviceVenofer Pump (K093964)
Reason for SubmissionModification to existing device

Substantial Equivalence

The Venofer Pump 1.1 is substantially equivalent to the unmodified device (Venofer Pump K093964) in terms its intended use, environment of use, operating principles, and technology.

Renal Solutions, Inc.

Venofer® Pump 1.1 Special 510(k)

1

Venofer Pump Version 1.1 Special 510(k)

Section 5: 510(k) Summary

Intended Use

The intended use of the Venofer Pump 1.1 is identical to the unmodified device.

The Venofer® Pump Is an optional accessory for use on Fresenius 2008T Hemodialysis Machines and is intended to administer Venofer®, an iron sucrose, to treat iron deficiency anemia in patients with chronic kidney disease undergoing hemodialysis, where Venofer®, in conjunction with hemodialysis, is prescribed by a physician.

Venofer Pump 510(k) Verification Testing Non-Clinical Summary

The verification (non-clinical) testing information consists of performance, safety, and software testing that was performed to verify the Venofer Pump meets its performance specifications and to demonstrate the device is substantially equivalent to the established predicate devices.

The following table summarizes the 510(k) verification testing activities performed. These include performance, safety and software testing, which demonstrates by technical examination that the Venofer Pump meets its performance specifications, the designated (FDA Consensus) standard requirements, and the software design input requirements.

510(k) Verification Testing510(K) Verification Testing Activities
Venofer Pump Performance Testing
The performance (verification)
testing results support the
performance characteristics of the
Venofer Pump.Functional testing that demonstrates that
the device performs as designed and
expected, includes the following:
The specific verification tests
conducted A description of all test protocol
including: objective of the tests test articles used in the tests test methods and procedures pre-defined acceptance or pass/fail
criteria. System-level hazard analysis that
confirms that the device does not
perform in an unexpected and/or
unsafe manner

Renal Solutions, Inc.

Venofer® Pump 1.1 Special 510(k)

2

Venofer Pump Version 1.1 Special 510(k)

Section 5: 510(k) Summary

510(k) Verification Testing510(K) Verification Testing Activities
Venofer Pump Safety Testing
The verification testing results
support the safety characteristics ofProduct safety testing that demonstrates that
the device performs per the FDA Consensus
Standards, as identified below:
the Venofer Pump.
Biocompatibility testing was
performed on all new materials that
are patient-fluid contactingElectromagnetic compatibility (EMC)
testing (IEC 60601-1-2: 2007 - Medical
Electrical Equipment - Part 1-2: General
Requirements for Safety - Collateral
Standard: Electromagnetic Compatibility
  • Requirements for Testing Biocompatibility Testing (AAMI / ANSI /
    ISO 10993-1:2009 Biological evaluation
    of medical devices Part 1: Evaluation &
    testing ) |
    | Venofer Pump Software Testing
    The testing includes the required | Software testing that demonstrates the
    device software meets the design input
    requirements. The device was tested and
    Includes the following |
    | documentation as described in the
    guidance titled Guidance for the
    Content of Premarket Submissions
    for Software | Structure chart of flow chart describing
    software architecture Summary of software development
    procedures, including changes made to
    the software Software requirements specification with
    traceability back to the hazard analysis Verification and validation test plans,
    including pass/fail criteria and traceability
    back to the requirements; System level test results Current software version number and
    date of latest revision. |

Renal Solutions, Inc. Venofer® Pump 1.1 Special 510(k)

3

Response to FDA Questions K103564

Venofer Pump Version 1.1 Special 510(k)

Section 5: 510(k) Summary

The conclusions drawn from this testing demonstrates that the Venofer Pump is as safe, as effective, and performs at least as safely and effectively as the legally marketed devices identified as predicate devices to which it was compared.

General Safety and Effectiveness

The Venofer Pump 1.1 is an updated version of the Venofer Pump (K093964). The performance and technological characteristics of the modified device are equivalent to those of the unmodified device and raise no new types of safety or effectiveness questions.

Device Description

The Venofer Pump Module is an optional module for use on Fresenius 2008T Hemodialysis Machines. The module is designed to administer Venofer, an iron sucrose supplement, during dialysis treatments. The Venofer Pump Module is to be used in accordance with the approved Venofer Indications for Use and the physician's prescription.

The Venofer Pump Module fits into the module compartment of Fresenius 2008T Machines and consists of a control panel, vial holder, fluld detector, and a peristaltic pump.

Renal Solutions, Inc. Venofer® Pump 1.1 Special 510(k)

4

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 Mail Center - WO66-G609 Silver Spring. MD 20993-0002

Mr. David J. Vanella Senior Vice President, Quality Systems Renal Solutions®, Inc. 770 Commonwealth Drive, Suite 101 WARRENDALE PA 15086

FEB 10 201

Re: K103564

Trade/Device Name: Venofer Pump Regulation Number: 21 CFR §876.5860 Regulation Name: High permeability hemodialysis system Regulatory Class: II Product Code: KDI Dated: January 7, 2011 Received: January 11, 2011

Dear Mr. Vanella:

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.

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 of medical device-related

5

Page 2

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/CDRHOffices/ucm 17-10-11-11-15 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 tolloffree 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,

Hubert Lemmer MD

Herbert P. Lerner, M.D., Director (Acting) Division of Reproductive, Gastro-Renal and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health.

Enclosure

6

KI03564

Venofer Pump Version 1.1 Special 510(k)

Section 5: Indications for Use Statement

Indications for Use Statement

510(k) Number (if known): N/A

Device Name: Venofer Pump

Indications for Use:

Fresenius 2008T is indicated for acute and chronic dialysis therapy.

Prescription Use × (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (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)

tive, Gastro-Renal, and SIU(K) NUME

Renal Solutions, Inc. Venofer® Pump 1.1 Special 510(k)