K Number
K111275
Device Name
CADD SOLIS VIP AMBULATORY INFUSION PUMP AND CADD SOLIS MEDICATION SAFETY SOFTWARE
Date Cleared
2013-02-01

(637 days)

Product Code
Regulation Number
880.5725
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The CADD®-Solis VIP Ambulatory Infusion Pump is indicated for intravenous, intraarterial, subcutaneous, intraperitoneal, perineural, surgical site, epidural space, or subarachnoid space infusion. PCA (patient-controlled analgesia) delivery is used for therapies that require a continuous rate of infusion, patient-controlled demand doses, or both, such as patientcontrolled analgesia. Continuous delivery allows the infusion of drug/fluid at a constant, programmed rate. Intermittent delivery allows the infusion of a specific volume of drug/fluid at a regular, programmed interval. Step delivery allows an incremental increase in infusion rate to a specified maximum infusion rate for a specified total infusion volume. Taper delivery allows a plateau rate of infusion with the option of tapering at the beginning and/or end and has a programmable KVO rate at the end of the infusion. The CADD™ Solis Medication Safety Software – Administrator allows use of a computer to create therapy-based protocol libraries to be used with the CADD -Solis VIP Ambulatory Infusion Pump, CADD -Solis Ambulatory Infusion Pump or CADD-Prizm® PCS II Ambulatory Infusion Pump (software revision H or higher). The CADD™ Solis Medication Safety Software -- Point of Care allows use of a computer to send therapy-based protocols developed by the CADD™-Solis Medication Safety Software - Administrator to the CADD® Solis Ambulatory Infusion Pump and CADD-Prizm® PCS II Ambulatory Infusion Pump (software revision H or higher).
Device Description
The CADD®-Solis VIP Ambulatory Infusion Pump ("Solis VIP Pump") has a microprocessor and linear peristaltic pumping mechanism, similar in design to the Smiths Medical ASD, Inc. CADD®-Solis Ambulatory Infusion Pump (K072144) and CADD-Prizm® VIP Ambulatory Infusion Pump (K960826). The user activates the Solis VIP Pump via a color LCD screen and keypad user interface. Commands are issued to the microprocessor by activating the user interface. Microprocessor actions are controlled by a program, which is contained in the pump's memory. The Solis VIP Pump consists of components, such as the user interface, sensors, communication ports, power ports, structural (housing) components, electronics, pumping mechanism, watchdog timer, pump battery and circuitry, real time clock, on-board memory, and pump log. The Solis VIP Pump exterior surface components include the pump housing, LCD lens, labels, and keypad, and the materials of construction for these components are widely used in the medical industry. The Solis VIP Pump is designed to be used with an infusion disposable, such as medication cassette reservoir. The Solis VIP Pump provides measured drug therapy to patients in the hospital, homecare, and outpatient settings. The Solis VIP Pump is intended for therapies that require a Continuous. Intermittent. Tapering, or Step rates of infusion, and Patient Controlled Analgesia (including Clinician Bolus). The CADD™-Solis Medication Safety Software-Administrator ("Administrator") module allows the user to create, edit, and save therapy-based protocols and pump settings within user-defined protocol libraries. The system administrator user determines user access and library editing capabilities. Other Administrator module features include barcode printing, reports, and sending and receiving pump protocol information. The CADD™-Solis Medication Safety Software-Point of Care ("POC") module allows the user to download therapy based protocols to the Solis Pump, and Prizm Pump (software revision H or higher) and send and receive pump settings via USB connection.
More Information

Not Found

No
The description focuses on standard microprocessor-controlled pump functions and software for protocol management, with no mention of AI/ML terms or capabilities.

Yes
The device is an infusion pump designed to deliver drug/fluid for various therapies, including patient-controlled analgesia, directly administering treatment to the patient.

No

This device is an infusion pump designed to deliver medication. It does not perform diagnostic functions like analyzing patient data to identify a disease or condition.

No

The device description clearly states that the CADD®-Solis VIP Ambulatory Infusion Pump has hardware components such as a microprocessor, pumping mechanism, sensors, communication ports, power ports, structural components, electronics, watchdog timer, battery, real time clock, and memory. While the submission also describes software components (Administrator and POC software), the primary device is a physical infusion pump.

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

Here's why:

  • Intended Use: The intended use clearly describes the device as an infusion pump used for delivering drugs and fluids directly into various anatomical sites within the body (intravenous, intraarterial, subcutaneous, etc.). This is a therapeutic function, not a diagnostic one.
  • Device Description: The description details the mechanical and electronic components of an infusion pump, including a pumping mechanism, sensors, and software for programming infusion protocols. There is no mention of analyzing biological samples or providing diagnostic information.
  • Lack of IVD Characteristics: IVD devices are designed to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. This device does not perform any such analysis.

The device is a medical device used for administering treatment, not for performing in vitro diagnostic tests.

N/A

Intended Use / Indications for Use

"The CADD®-Solis VIP Ambulatory Infusion Pump is indicated for intravenous, intraarterial, subcutaneous, intraperitoneal, perineural, surgical site, epidural space, or subarachnoid space infusion.

PCA (patient-controlled analgesia) delivery is used for therapies that require a continuous rate of infusion, patient-controlled demand doses, or both, such as patientcontrolled analgesia.

Continuous delivery allows the infusion of drug/fluid at a constant, programmed rate.

Intermittent delivery allows the infusion of a specific volume of drug/fluid at a regular, programmed interval.

Step delivery allows an incremental increase in infusion rate to a specified maximum infusion rate for a specified total infusion volume.

Taper delivery allows a plateau rate of infusion with the option of tapering at the beginning and/or end and has a programmable KVO rate at the end of the infusion."

"The CADD™ Solis Medication Safety Software - Administrator allows use of a computer to create therapy-based protocol libraries to be used with the CADD -Solis VIP Ambulatory Infusion Pump, CADD -Solis Ambulatory Infusion Pump or CADD-Prizm® PCS II Ambulatory Infusion Pump (software revision H or higher)."

"The CADD™ Solis Medication Safety Software -- Point of Care allows use of a computer to send therapy-based protocols developed by the CADD™-Solis Medication Safety Software - Administrator to the CADD® Solis Ambulatory Infusion Pump and CADD-Prizm® PCS II Ambulatory Infusion Pump (software revision H or higher)."

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

FRN

Device Description

The CADD®-Solis VIP Ambulatory Infusion Pump ("Solis VIP Pump") has a microprocessor and linear peristaltic pumping mechanism, similar in design to the Smiths Medical ASD, Inc. CADD®-Solis Ambulatory Infusion Pump (K072144) and CADD-Prizm® VIP Ambulatory Infusion Pump (K960826). The user activates the Solis VIP Pump via a color LCD screen and keypad user interface. Commands are issued to the microprocessor by activating the user interface. Microprocessor actions are controlled by a program, which is contained in the pump's memory.

The Solis VIP Pump consists of components, such as the user interface, sensors, communication ports, power ports, structural (housing) components, electronics, pumping mechanism, watchdog timer, pump battery and circuitry, real time clock, on-board memory, and pump log. The Solis VIP Pump exterior surface components include the pump housing, LCD lens, labels, and keypad, and the materials of construction for these components are widely used in the medical industry. The Solis VIP Pump is designed to be used with an infusion disposable, such as medication cassette reservoir.

The Solis VIP Pump provides measured drug therapy to patients in the hospital, homecare, and outpatient settings. The Solis VIP Pump is intended for therapies that require a Continuous. Intermittent. Tapering, or Step rates of infusion, and Patient Controlled Analgesia (including Clinician Bolus).

The CADD™-Solis Medication Safety Software-Administrator ("Administrator") module allows the user to create, edit, and save therapy-based protocols and pump settings within user-defined protocol libraries. The system administrator user determines user access and library editing capabilities. Other Administrator module features include barcode printing, reports, and sending and receiving pump protocol information.

The CADD™-Solis Medication Safety Software-Point of Care ("POC") module allows the user to download therapy based protocols to the Solis Pump, and Prizm Pump (software revision H or higher) and send and receive pump settings via USB connection.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

intravenous, intraarterial, subcutaneous, intraperitoneal, perineural, surgical site, epidural space, or subarachnoid space

Indicated Patient Age Range

Not Found

Intended User / Care Setting

patients in the hospital, homecare, and outpatient settings.

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)

Smiths Medical performed extensive verification and validation testing on the Solis VIP Pump and Administrator and POC software.

Testing was completed in accordance with FDA's draft guidance, Total Product Life Cycle-Infusion Pump - Premarket Notification [510(k)] Submissions, issued on April 23, 2010; and the General Principles of Software Validation; Final Guidance for Industry and FDA Staff, issued on January 11, 2002.

Also, testing was completed in accordance with FDA consensus standards, IEC 60601-1:1988 Medical electrical equipment - Part 1: General reguirements for safety, plus Amendment 1:1991. Amendment 2:1995 and Amendment 2 Corrigendum: 2005, and IEC 60601-2-24:1998 - Medical electrical equipment - Part 2-24: Particular requirements for the safety of infusion pumps and controllers.

An overall summary of the performance testing was, as follows:

  • Electrical and mechanical safety tests
  • Electromagnetic compatibility tests
  • Solis VIP Pump software validation
  • Administrator and POC software validation
  • Usability/human factors validations for the Solis VIP Pump and Administrator and POC Software
  • Infusion disposable biocompatibility testing, including extractables and leachables

Human clinical studies were deemed unnecessary to evaluate the safety or effectiveness of the Solis VIP Pump, and Administrator and POC software.

All testing met pre-established specifications. and successfully demonstrated that the devices performed as intended. The testing results allowed for a conclusion to be made that the Solis VIP Pump, and Administrator and POC software were as safe and effective as the predicate devices.

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.

K072144, K960826, K082783, K072144

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

§ 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).

0

KIII 275

510(k) Summary

FEB 0 1 2013

DATE PREPAREDJanuary 29, 2013
I. GENERAL INFORMATION
Applicant's Name and
Address:Smiths Medical ASD, Inc.
1265 Grey Fox Road
St. Paul, MN 55112
Contact Person:Julie Tapper
Senior Regulatory Affairs Specialist
Common/Usual Name:Ambulatory Infusion Pump
Pump Communications System
Proprietary Name:CADD®-Solis VIP Ambulatory Infusion Pump
CADD™-Solis Medication Safety Software
Predicate Devices:K072144, CADD®-Solis Ambulatory Infusion Pump
K960826, CADD-Prizm® VIP Ambulatory Infusion Pump
K082783, CADD™-Solis Medication Safety Software-Point of Care
K072144, CADD™-Solis Medication Safety Software-Administrator

II. DEVICE DESCRIPTION

CADD®-Solis VIP Ambulatory Infusion Pump

The CADD®-Solis VIP Ambulatory Infusion Pump ("Solis VIP Pump") has a microprocessor and linear peristaltic pumping mechanism, similar in design to the Smiths Medical ASD, Inc. CADD®-Solis Ambulatory Infusion Pump (K072144) and CADD-Prizm® VIP Ambulatory Infusion Pump (K960826). The user activates the Solis VIP Pump via a color LCD screen and keypad user interface. Commands are issued to the microprocessor by activating the user interface. Microprocessor actions are controlled by a program, which is contained in the pump's memory.

The Solis VIP Pump consists of components, such as the user interface, sensors, communication ports, power ports, structural (housing) components, electronics, pumping mechanism, watchdog timer, pump battery and circuitry, real time clock, on-board memory, and pump log. The Solis VIP Pump exterior surface components include the pump housing, LCD lens, labels, and keypad, and the materials of construction for these components are widely used in the medical industry. The Solis VIP Pump is designed to be used with an infusion disposable, such as medication cassette reservoir.

The Solis VIP Pump provides measured drug therapy to patients in the hospital, homecare, and outpatient settings. The Solis VIP Pump is intended for therapies that require a Continuous. Intermittent. Tapering, or Step rates of infusion, and Patient Controlled Analgesia (including Clinician Bolus).

1

CADDTM-Solis Medication Safety Software-Administrator

The CADD™-Solis Medication Safety Software-Administrator ("Administrator") module allows the user to create, edit, and save therapy-based protocols and pump settings within user-defined protocol libraries. The system administrator user determines user access and library editing capabilities. Other Administrator module features include barcode printing, reports, and sending and receiving pump protocol information.

CADD™-Solis Medication Safety Software-Point of Care

The CADD™-Solis Medication Safety Software-Point of Care ("POC") module allows the user to download therapy based protocols to the Solis Pump, and Prizm Pump (software revision H or higher) and send and receive pump settings via USB connection.

III. INTENDED USE OF THE DEVICE

CADD®-Solis VIP Ambulatory Infusion Pump

The CADD®-Solis VIP Ambulatory Infusion Pump is indicated for intravenous, intraarterial, subcutaneous, intraperitoneal, perineural, surgical site, epidural space, or subarachnoid space infusion.

PCA (patient-controlled analgesia) delivery is used for therapies that require a continuous rate of infusion, patient-controlled demand doses, or both, such as patientcontrolled analgesia.

Continuous delivery allows the infusion of drug/fluid at a constant, programmed rate.

Intermittent delivery allows the infusion of a specific volume of drug/fluid at a regular, programmed interval.

Step delivery allows an incremental increase in infusion rate to a specified maximum infusion rate for a specified total infusion volume.

Taper delivery allows a plateau rate of infusion with the option of tapering at the beginning and/or end and has a programmable KVO rate at the end of the infusion.

CADD™-Solis Medication Safety Software-Administrator

The CADD™ Solis Medication Safety Software – Administrator allows use of a computer to create therapy-based protocol libraries to be used with the CADD -Solis VIP Ambulatory Infusion Pump, CADD®-Solis Ambulatory Infusion Pump or CADD-Prizm® PCS II Ambulatory Infusion Pump (software revision H or higher).

CADD"-Solis Medication Safety Software-Point of Care:

The CADDIM Solis Medication Safety Software-Point of Care allows use of a computer to send therapy-based protocols developed by the CADD™-Solis Medication Safety Software-Administrator to the CADD® Solis Ambulatory

2

Infusion Pump and CADD-Prizm® PCS II Ambulatory Infusion Pump (software revision H or higher).

VI. SUMMARY OF STUDIES

Performance Testing

Smiths Medical performed extensive verification and validation testing on the Solis VIP Pump and Administrator and POC software.

Testing was completed in accordance with FDA's draft guidance, Total Product Life Cycle-Infusion Pump - Premarket Notification [510(k)] Submissions, issued on April 23, 2010; and the General Principles of Software Validation; Final Guidance for Industry and FDA Staff, issued on January 11, 2002.

Also, testing was completed in accordance with FDA consensus standards, IEC 60601-1:1988 Medical electrical equipment - Part 1: General reguirements for safety, plus Amendment 1:1991. Amendment 2:1995 and Amendment 2 Corrigendum: 2005, and IEC 60601-2-24:1998 - Medical electrical equipment - Part 2-24: Particular requirements for the safety of infusion pumps and controllers.

An overall summary of the performance testing was, as follows:

Electrical and mechanical safety testsElectromagnetic compatibility tests
Solis VIP Pump software validationAdministrator and POC software validation
Usability/human factors validations for
the Solis VIP Pump and Administrator
and POC SoftwareInfusion disposable biocompatibility
testing, including extractables and
leachables

Clinical Studies

Human clinical studies were deemed unnecessary to evaluate the safety or effectiveness of the Solis VIP Pump, and Administrator and POC software.

Testing Conclusion

All testing met pre-established specifications. and successfully demonstrated that the devices performed as intended. The testing results allowed for a conclusion to be made that the Solis VIP Pump, and Administrator and POC software were as safe and effective as the predicate devices.

VII. STATEMENT OF EQUIVALENCE

The Solis VIP Pump, and Administrator and POC software are substantially equivalent to the predicate devices, based on comparisons of the device classifications. intended use, and technological characteristics. Verification and validation tests confirmed the suitability of the devices for their intended uses. The test results did not raise new safety or performance questions, and confirmed that the Solis VIP Pump, and Administrator and POC software devices are substantially equivalent to the predicate devices.

3

ADD®-Solis VIP Ambulatory Infusion Pu
evice nameCADD®-ADD®-Solis Ambulatory Infusio PumpCADD-Prizm® VIP Ambulator Smiths Mesical ASS
Smiths Medical ASD, K072144 (March 7, 2008)
Tanufacturer Notification numbr Substantial equivalence Substantial Eguivalence Subscription EDATURES Pump Lym FEAT UREST Display- Linear Peristaltic display with 320 x 320 pixe
ColorLinear Peristaltic olor display with 320 x 320 pixel32
Linear Peristalic Tonchromatics displayatriis Pixol, Dixplandisplanding Mariity Program Pixel, Mistrials EPS Portalian Provinsian Provinsia EPS Power Power Power Provinsian P
ower requiremen
4AA Batteries AC Adapter echargeable Battery Pac
d4AA Batteries
NoNoYes
NoNoNo
rinting capabilities Remote communications capabilities USB port PROGRAMMING FUNCTIONSYesYesNo
StepYesNoNo
ntermittenYesNoYes
aperYesNoYes (TPN
YesY esYes
ontinuous infusion ontinuous infusion with bolus (PC)Yesਿੰਡ ਨੇੜੇ ਵਿੱਚ ਮੈਡYes
ecurityYesYes
YesY esY es
YesY esYes
YesYesYes
Y esYesYes
YesNoYes
ﺮ ،
YesYesYes
YesYesY es
YesYesYes
YesYesYes
YesYesYes
CADD®-Solis VIP Ambulatory Infusion Pump
Device nameCADD®-Solis VIP Ambulatory
Infusion PumpCADD®-Solis Ambulatory Infusion
PumpCADD-Prizm® VIP Ambulatory
Infusion Pump
No-battery alertYesYesYes
Pump in stop modeYesYesYes
High pressureYesYesYes
Power up faultYesYesYes
Low volume in medication reservoirYesYesYes
Cassette detachmentYesYesYes
Upstream occlusionYesYesYes
Downstream occlusionYesYesYes
Air-in-lineYesYesYes
Key stuckYesYesYes
INFUSION SPECIFICATIONS
Minimum continuous delivery rate0 mL/hr0 mL/hr0 mL/hr
Maximum continuous delivery rate100 mL/hr in PCA
500 mL/hr in Continuous,
Intermittent, Taper, Step30 mL/hr30 mL/hr in PCA
350 mL/hr in Continuous,
Intermittent, TPN
Maximum patient bolus50 mL20 mL9.9 mL
Maximum clinician bolus50 mL20 mL20 mL
Reservoir volume1 to 9999 mL1 to 9999 mL1 to 9999 mL
Patient controlled access PCA (dosing)YesYesYes
Dose lockout timeYesYesYes
Doses per hour limitYesYesYes
Delivery limitYesYesYes
Clinician bolusYesYesYes
Programmable maximum delivery rate
(Continuous rate + bolus)YesYesYes

COMPARISION OF TECHNOLOGICAL CHARACTERISTICS v.

.

Page 4 of 6

.

K111275 510(k) Summar

Smiths Medical ASD, Inc

4

:

:

·

1

: :

:

·

: 上一篇:

K111275 510(k) Summary

.

Smiths Medical ASD, Inc.

.

.

Page 5 of 6

: 上一

5

| CADD TM-Solis Medication Safety
Software Administrator and POC
Device Name | CADDTM-Solis Medication Safety
Software (software update) | CADDTM-Solis Medication Safety
Software | |
|----------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------|
| Manufacturer | Smiths Medical ASD, Inc. | Smiths Medical ASD, Inc. | |
| 10(k) notification number
(substantial equivalence date) | K111275
(TBD) | K082783
(December 17, 2008) | K072144
(March 7, 2008) |
| COMPATIBILITY | | | |
| Pump compatibility | CADD®-Solis VIP Ambulatory
Infusion Pump, CADD®-Solis
Ambulatory Infusion Pump and
CADD-Prizm® PCS II 6101 (rev H
and higher) | CADD®-Solis Ambulatory Infusion
Pump and CADD-Prizm® PCS II 6101
(rev H and higher) | CADD®-Solis Ambulatory Infusion
Pump and CADD-Prizm® PCS II 6101
(rev H and higher) |
| Accessory compatibility | USB cable for the CADD®-Solis VIP
pump, and CADD®-Solis pump
21-6144 Interface cable/null modem
cable for CADD-Prizm® pump | USB cable for the CADD®-Solis
pump
21-6144 Interface cable/null modem
cable for CADD-Prizm® pump | USB cable for the CADD®-Solis
pump
21-6144 Interface cable/null modem
cable for CADD-Prizm® pump |
| PC software compatibility
Computer equipment | Windows 2000, XP, VISTA
RS232 serial port, USB, and CD-
ROM | Windows 2000, XP, VISTA
RS232 serial port, USB, and CD-
ROM | Windows 2000, XP, VISTA
RS232 serial port, USB, and CD-
ROM |

KI11275 510(k) Summary

Smiths Medical ASD, Inc

Page 6 of 6

:

. .

.

6

Image /page/6/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three stripes representing the three levels of government: federal, state, and local. The eagle is encircled by the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

Febauary 1, 2013

Ms. Julie Tapper Senior Regulatory Affairs Specialist Smiths Medical ASD, Incorporated 1265 Grey Fox Road ST. PAUL, MN 55112

Re: K111275

Trade/Device Name: CADD® -Solis VIP Ambulatory Infusion Pump and CADD™-Solis Medication Safety Software Regulation Number: 21 CFR 880.5725 Regulation Name: Infusion Pump Regulatory Class: II Product Code: FRN Dated: January 21, 2013 Received: January 22, 2013

Dear Ms. Tapper:

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.

7

Page 2 - Ms. Tapper

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/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;

hor
Theth
Harshita.D.

Anthony D. Watson, B.S., M.S., M.B.A. Director

Division of Anesthesiology, General Hospital, Respiratory, Infection Control and

Dental Devices Office of Device Evaluation

Center for Devices and Radiological Health

Enclosure

8

SMITHS MEDICAL ASD, INC. 510(k) Premarket Notification

CADD®-Solis VIP Ambulatory Infusion Pump CADD"-Solis Medication Safety Software

Indications for Use --

510(k) Number: K 111275

TAB 5 - Page 1 of 2

1 389

Device Name: CADD®-Solis VIP Ambulatory Infusion Pump

Indications for Use:

"The CADD®-Solis VIP Ambulatory Infusion Pump is indicated for intravenous, intraarterial, subcutaneous, intraperitoneal, perineural, surgical site, epidural space, or subarachnoid space infusion.

PCA (patient-controlled analgesia) delivery is used for therapies that require a continuous rate of infusion, patient-controlled demand doses, or both, such as patientcontrolled analgesia.

Continuous delivery allows the infusion of drug/fluid at a constant, programmed rate.

Intermittent delivery allows the infusion of a specific volume of drug/fluid at a regular, programmed interval.

Step delivery allows an incremental increase in infusion rate to a specified maximum infusion rate for a specified total infusion volume.

Taper delivery allows a plateau rate of infusion with the option of tapering at the beginning and/or end and has a programmable KVO rate at the end of the infusion."

Prescription Use _____________________________________________________________________________________________________________________________________________________________ Over-The Counter Use _ OR Per 21 CFR 801.109)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Digitally signed by Richard C. Chapman Date: 2013.02.01 13:20:30 -05'00'

(Division Sign-Off)

: vision of Anesthesiology, General Hespital rection Control, Dental Devices

510(k) Number:

9

SMITHS MEDICAL ASD, INC. 510(k) Premarket Notification CADD -Solis VIP Ambulatory Infusion Pump CADD™-Solis Medication Safety Software

Indications for Use --

510(k) Number: _______________________________________________________________________________________________________________________________________________________________

Device Name: CADD" Solis Medication Safety Software - Administrator

Indications for Use:

"The CADD" Solis Medication Safety Software - Administrator allows use of a computer to create therapy-based protocol libraries to be used with the CADD -Solis VIP Ambulatory Infusion Pump, CADD -Solis Ambulatory Infusion Pump or CADD-Prizm® PCS II Ambulatory Infusion Pump (software revision H or higher)."

Prescription Use _____________________________________________________________________________________________________________________________________________________________ Over-The Counter Use _________________________________________________________________________________________________________________________________________________________ OR Per 21 CFR 801.109

Device Name: CADD" Solis Medication Safety Software - Point of Care

Indications for Use:

"The CADD" Solis Medication Safety Software -- Point of Care allows use of a computer to send therapy-based protocols developed by the CADD"-Solis Medication Safety Software - Administrator to the CADD® Solis Ambulatory Infusion Pump and CADD-Prizm® PCS II Ambulatory Infusion Pump (software revision H or higher)."

Prescription Use _____________________________________________________________________________________________________________________________________________________________ OR Over-The Counter Use _________________________________________________________________________________________________________________________________________________________ Per 21 CFR 801.109

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Digitally signed by Richard C. Chapman Date: 2013.01.30 10:21:19 -05'00'

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

510(k) Number: _

TAB 5 - Page 2 of 2

1390