(55 days)
Not Found
No
The device description explicitly states it is "mechanical (no electronics)" and there is no mention of AI or ML in the provided text.
Yes
The device is indicated for the continuous subcutaneous infusion of insulin for the management of diabetes mellitus, which is a therapeutic purpose.
No
This device is an insulin delivery device, used to infuse insulin into the body to manage diabetes. It delivers therapy, rather than diagnosing a condition.
No
The device description explicitly states it is a "mechanical (no electronics)" device with an "integrated stainless steel subcutaneous needle," indicating it is a hardware-based insulin delivery system, not software-only.
No, this device is not an IVD (In Vitro Diagnostic).
Here's why:
- IVD Definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, or tissue) to provide information about a person's health. These tests are performed outside of the body.
- Device Function: The V-Go Disposable Insulin Delivery Device is designed to deliver insulin directly into the patient's body subcutaneously. It is a therapeutic device, not a diagnostic one.
- Intended Use: The intended use is for the "continuous subcutaneous infusion of insulin" and "on-demand bolus dosing," which are actions performed on the patient, not on a sample from the patient.
- Device Description: The description details a mechanical device for delivering insulin, not for analyzing biological samples.
The V-Go is a therapeutic medical device used for the management of diabetes, specifically for insulin delivery.
N/A
Intended Use / Indications for Use
V-Go 20: The V-Go Disposable Insulin Delivery Device is indicated for continuous subcutaneous infusion of 20 Units of insulin in one 24hour time period (0.83U/hr) and on-demand bolus dosing in 2-Unit increments (up to 36 Units per one 24-hour time period) in adult patients requiring insulin
V-Go 30: The V-Go Disposable Insulin Delivery Device is indicated for continuous subcutaneous infusion of 30 Units of insulin in one 24hour time period (1.25U/hr) and on-demand bolus dosing in 2-Unit increments (up to 36 Units per one 24-hour time period) in adult patients requiring insulin
V-Go 40: The V-Go Disposable Insulin Delivery Device is indicated for continuous subcutaneous infusion of 40 Units of insulin in one 24hour time period (1.67U/hr) and on-demand bolus dosing in 2-Unit increments (up to 36 Units per one 24-hour time period) in adult patients requiring insulin
Product codes
LZG, FPA
Device Description
The Valeritas V-Go Disposable Insulin Delivery Device is a mechanical (no electronics), self-contained, sterile, patient fillable, single-use disposable insulin infusion device with an integrated stainless steel subcutaneous needle. It is designed for the subcutaneous infusion of insulin for the management of diabetes mellitus in persons requiring insulin. After filling the V-Go with insulin using the EZ Fill, the device is secured to the patient's skin over the infusion site with an adhesive backed foam pad, which is attached to the back of the pump. Once activated, the V-Go delivers a continuous infusion of insulin at a fixed rate. The device also allows the user to initiate bolus injections to supplement their daily basal insulin requirements. Three device models (20, 30 and 40 Units/day) will be available to address the different basal and bolus requirements of each patient. A window in the top of the pump allows the user to see into the reservoir to check the drug and to monitor the progress of the infusion.
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
adult patients
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
No clinical performance data is required to validate the intended uses and user needs of the system. Design validation is completed by human factors simulated use and clinical evaluation testing.
Key Metrics
Accuracy: +/- 10%
Predicate Device(s)
Reference Device(s)
Not Found
Predetermined Change Control Plan (PCCP) - All Relevant Information
Not Found
§ 880.5725 Infusion pump.
(a)
Identification. An infusion pump is a device used in a health care facility to pump fluids into a patient in a controlled manner. The device may use a piston pump, a roller pump, or a peristaltic pump and may be powered electrically or mechanically. The device may also operate using a constant force to propel the fluid through a narrow tube which determines the flow rate. The device may include means to detect a fault condition, such as air in, or blockage of, the infusion line and to activate an alarm.(b)
Classification. Class II (performance standards).
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Image /page/0/Picture/0 description: The image shows the word "valeritas" in a stylized font. There are two sets of dots above and below the word. The dots are arranged in a curved pattern, giving the impression of movement or a decorative element.
..............................................................................................................................................................................
K103825 800 Turnpike Road
Shrewsbury, MA 01545
Phone
— --- ---
FEB 2 3 2011
510(k) Summary
| Owner's Name: | Valeritas, Inc.
750 Route 202 South, Suite 100
Bridgewater, NJ 08807 |
|----------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Company Contact: | Scott Huie
Vice President, Regulatory Affairs and Product Compliance
Valeritas, Inc.
800 Boston Turnpike
Shrewsbury, MA 01545
(508) 845-1177 X222
shuie@valeritas.com |
| Date Summary Prepared: | 9 February 2011 |
| Trade Name: | Valeritas V-Go™ Insulin Delivery Device |
| Common Name: | Disposable Insulin Delivery Device |
| Classification Name: | Pump, Infusion, Insulin/Set, Administration, Intravascular |
| Classification regulation: | Class II: 21 CFR 880.5725
Panel: 80, LZG External Insulin Infusion Pump
FPA Intravascular Administration Set |
| Substantial Equivalence: | The Valeritas V-Go Disposable Insulin Delivery Device is
substantially equivalent to the Valeritas V-Go Disposable Insulin
Delivery Device K100504, cleared by this Center on December 1,
2010 |
| Device Description: | The Valeritas V-Go Disposable Insulin Delivery Device is a
mechanical (no electronics), self-contained, sterile, patient fillable,
single-use disposable insulin infusion device with an integrated
stainless steel subcutaneous needle. |
| | It is designed for the subcutaneous infusion of insulin for the
management of diabetes mellitus in persons requiring insulin.
After filling the V-Go with insulin using the EZ Fill, the device is
secured to the patient's skin over the infusion site with an adhesive
backed foam pad, which is attached to the back of the pump. Once
activated, the V-Go delivers a continuous infusion of insulin at a |
1
fixed rate. The device also allows the user to initiate bolus injections to supplement their daily basal insulin requirements. Three device models (20, 30 and 40 Units/day) will be available to address the different basal and bolus requirements of each patient. A window in the top of the pump allows the user to see into the reservoir to check the drug and to monitor the progress of the infusion.
Intended Use:
V-Go 20:
The V-Go Disposable Insulin Delivery Device is indicated for continuous subcutaneous infusion of 20 Units of insulin in one 24hour time period (0.83U/hr) and on-demand bolus dosing in 2-Unit increments (up to 36 Units per one 24-hour time period) in adult patients requiring insulin
V-Go 30:
The V-Go Disposable Insulin Delivery Device is indicated for continuous subcutaneous infusion of 30 Units of insulin in one 24hour time period (1.25U/hr) and on-demand bolus dosing in 2-Unit increments (up to 36 Units per one 24-hour time period) in adult patients requiring insulin
V-Go 40:
The V-Go Disposable Insulin Delivery Device is indicated for continuous subcutaneous infusion of 40 Units of insulin in one 24hour time period (1.67U/hr) and on-demand bolus dosing in 2-Unit increments (up to 36 Units per one 24-hour time period) in adult patients requiring insulin
Technological Characteristics:
The V-Go has two delivery mechanisms, one for basal infusion and one for bolus delivery. Both operate by providing force against a plunger, which is inserted into a cylindrical reservoir filled with high viscosity fluid. This force is directly translated against the rear of the delivery piston at the rear of the insulin reservoir.
The Basal Hydraulic Pump operates by applying a constant force by means of a compressed spring. The spring pushes against a disk inserted internally at the rear of the cylindrical fluid filled basal reservoir, forcing the fluid through a restrictive orifice. This displacement translates into displacement of the medicinal delivery
2
piston, providing a continuous basal infusion. The basal delivery rate can be varied by the substitution of a different orifice into the device during assembly.
The Bolus Hydraulic Pump operates by applying a force by means of a manually depressed actuator (Bolus Button). Manual actuation allows the displacement of a disk inserted internally at the rear of the cylindrical fluid-filled bolus reservoir in pre-set increments that will displace the volume of fluid and the medicinal delivery piston. The manual actuation requires two steps. First, the user must press the Bolus Release Button. Displacement of the Bolus Release allows the Bolus Button to "pop-out" so that it protrudes slightly from the end of the pump. The user then depresses the Bolus Button, which displaces the Bolus Piston and delivers a pre-set bolus increment. This process is repeated until the desired volume has been delivered or the labeled number of actuations are used up. The Bolus Release Button extends from the pump and locks preventing further use as there are no additional bolus actuations remaining.
Substantial Equivalence:
The Valeritas V-Go Insulin Delivery Device is substantially equivalent to the predicate device, the Valeritas V-Go Insulin Delivery Device cleared by this center on 1 December 2010 (K100504). The Valeritas V-Go device has the same intended use and performance characteristics. The primary difference qualifies the use of NovoLog in the device in addition to Humalog.
Non-Clinical Performance Data:
Physical Specifications
Maximum Dimensions: Weight: Cannula: Pump Mechanism: Interfaces:
84 mm x 47 mm x 13 mm 20 - 50 grams Stainless Steel' J' shaped needle (J-needle) Spring and Manual Hydraulic Displacement Mechanical Buttons
3
Operational Specifications
| Operational Specifications | |||
|---|---|---|---|
| Pump Model | V-Go 20 | V-Go 30 | V-Go 40 |
| Reservoir volume | 560 µL | ||
| (56 IU of insulin) | 660 µL | ||
| (66 IU of insulin) | 760 µL | ||
| (76 IU of insulin) | |||
| Basal Rate | 8.3 µL/hr | ||
| (0.6 IU/hr) | 12.5 µL/hr | ||
| (1.2 IU/hr) | 16.7 µL/hr | ||
| (1.8 IU/hr) | |||
| Bolus Increments | 20 µL (2 IU) | ||
| 18 Actuations | 20 µL (2 IU) | ||
| 18 Actuations | 20 µL (2 IU) | ||
| 18 Actuations | |||
| Nominal Bolus | |||
| Volume | 360 µL (36 IU) | 360 µL (36 IU) | 360 µL (36 IU) |
| Basal Volume | |||
| (24 Hours) | 200 µL (20 IU) | 300 µL (30 IU) | 400 µL (40 IU) |
| Accuracy | +/- 10% | +/- 10% | +/- 10% |
Environmental Specifications - Per AAMI ID26, IPX8.
| Temperature: | +5 to +37°C |
|---|---|
| Humidity: | 20 - 90% |
| Water Ingress Protection: | IPX8 (submerged at 1 meter for 24 hours) |
| Atmospheric Testing: | 0-10,000 feet |
Biocompatibility - Per ISO 10993-1
Drug and skin contact materials passed all testing per ISO 10993-1. Drug Contact materials were tested and found to be compatible with insulin for the duration of use. Please see the package insert for specific insulin information.
Sterilization and Package Stability
The V-Go and EZ Fill are sterilized using Ethylene Oxide to a Sterility Assurance Level (SAL) of 10 " per ANSI/AAMI ST67:2003(R)2008, Sterilization of Health Care Products - Requirements for products labeled "Sterile".
The V-Go and EZ Fill have been tested as pyrogen free using USP Bacterial Endotoxin Testing Gel Clot Method with an acceptable maximum limit of 20EU/device.
Packaging consists of a thermoformed plastic tray with a Tyvek heat sealable lidstock. Packaging validation demonstrated that the packaging can maintain sterility integrity for up to 36 months per AAMI/ISO 11607-1:2006, Packaging for terminally sterilized medical devices - Part 1: Requirements for materials, sterile barrier systems, and packaging systems.
4
Drug Stability
Humalog has been tested in the V-Go and has been demonstrated to be stable for up to 24 hours storage refrigerated or at room temperature followed by 24 hours wear. NovoLog has been demonstrated to be stable for up to 5 days at refrigerated storage or 3 days at room temperature storage followed by 24 hours wear. The EZ Fill has been demonstrated to be acceptable for filling Humalog and NovoLogfor up to 30 days use.
Clinical Performance Data:
No clinical performance data is required to validate the intended uses and user needs of the system. Design validation is completed by human factors simulated use and clinical evaluation testing.
Conclusion:
Results of performance testing demonstrated substantial equivalence of the V-Go Disposable Insulin Delivery System to the predicate 510(k) device.
5
DEPARTMENT OF HEALTH & HUMAN SERVICES
Image /page/5/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three lines representing its body and wings. The eagle is enclosed in a circle with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter of the circle.
Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002
Mr. Scott Huie Vice President, Regulatory Affairs and Product Compliance Valeritas, Incorporated 800 Boston Turnpike Shrewbury, Massachusetts 01545
FEB 2 3 2011
Re: K103825
Trade/Device Name: V-Go™ 20 Disposable Insulin Delivery Device, V-Go™ 40 Disposable Insulin Delivery Device & V-Go™ 30 Disposable Insulin Delivery Device Regulation Number: 21 CFR 880.5725 Regulation Name: Infusion Pump Regulatory Class: II Product Code: LZG, FPA Dated: December 29, 2010 Received: December 30, 2010
Dear Mr. Huie:
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. and the contract of the states of the states of the subscription . . . . . . . .
6
Page 2- Mr. Huie
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/ReportalProblem/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,
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
7
7. Indications for Use Statement
510(k) Number (if known):
Device Name:
V-GoTM 20 Disposable Insulin Delivery Device
Indications For Use:
The V-Go 20 Disposable Insulin Delivery Device is indicated for continuous subcutaneous infusion of 20 Units of insulin in one 24hour time period (0.83U/hr) and on-demand bolus dosing in 2-Unit increments (up to 36 Units per one 24-hour time period) in adult patients requiring insulin
Prescription Use X (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) (Division Sign-Off) (Division Sign-Off)
Division of Anesthesiology, General Hospital Division of AneSthesithogy, Son.
Infection Control, Dental Devicesse 1 of 510(k) Number:
8
Indications for Use Statement
510(k) Number (if known):
Device Name:
V-GoTM 30 Disposable Insulin Delivery Device
Indications For Use:
The V-Go 30 Disposable Insulin Delivery Device is indicated for continuous subcutaneous infusion of 30 Units of insulin in one 24hour time period (1.25U/hr) and on-demand bolus dosing in 2-Unit increments (up to 36 Units per one 24-hour time period) in adult patients requiring insulin
Prescription Use X (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)
(Division Sign-Off)
2/23/14
Division of Anesthesiology, General Hospital
Infection Control, Dental Devices
Page 2 of _ 3_________________________________________________________________________________________________________________________________________________________________
510(k) Number: K103825
9
Indications for Use Statement
510(k) Number (if known):
Device Name:
V-GoTM 40 Disposable Insulin Delivery Device
Indications For Use:
The V-Go 40 Disposable Insulin Delivery Device is indicated for continuous subcutaneous infusion of 40 Units of insulin in one 24hour time period (1.67U/hr) and on-demand bolus dosing in 2-Unit increments (up to 36 Units per one 24-hour time period) in adult patients requiring insulin
Prescription Use X (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)
2/23/16
(Division Sign-Off) Division of Anesthesiology, General Hospital Infection Control, Dental Devices
Page 3 of 3
510(k) Number: K103825