K Number
K111417
Device Name
THE POWERWAND (R) SAFETY INTRODUCER WITH AN EXTENDED DWELL CATHETER
Date Cleared
2011-07-15

(56 days)

Product Code
Regulation Number
870.1340
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The POWERWAND® Safety Introducer with an Extended Dwell Catheter is used to gain access to the vascular system to sample blood and administer fluids intravenously. May be used for power injection of contrast media at a rate of 5cc/sec at up to 300 psi fluid pressure.
Device Description
The POWERWAND® Safety Introducer with an Extended Dwell Catheter is an all-in-one preassembled intravascular catheter introducer with intravascular catheter that consists of the following basic components: Introducer Needle, Nitinol Guidewire. Dilator and an Extended Dwell Catheter. It is intended to provide the clinician with a safe, simple and accelerated approach, using the Accelerated Seldinger Technique, to place the in-dwelling intravascular catheter through the skin into the circulatory system. The Extended Dwell Catheter allows for withdrawal of blood and the administration of fluids, including power injection of contrast media. The device includes a Fast-flash™ feature that provides the clinician with feedback that the introducer needle is in the intraluminal position within the blood vessel. The device also incorporates a safety mechanism to guard against accidental needle stick.
More Information

Not Found

No
The description focuses on mechanical components and physical features for vascular access and fluid administration. There is no mention of AI/ML terms, image processing, or data-driven analysis.

No
The device is used for gaining access to the vascular system for blood sampling and administering fluids, including contrast media for imaging. It does not directly treat a disease or medical condition.

No

Explanation: The device is used to gain access to the vascular system for blood sampling and fluid administration, including contrast media. It is an introducer and catheter system, not a device designed to diagnose a medical condition. While it can sample blood, the sampling itself is not the diagnostic part of the device; rather, the blood would then be analyzed by a separate diagnostic device.

No

The device description clearly outlines physical components like an Introducer Needle, Nitinol Guidewire, Dilator, and an Extended Dwell Catheter, indicating it is a hardware device.

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

Here's why:

  • Intended Use: The intended use is to gain access to the vascular system to sample blood and administer fluids intravenously. This is a procedure performed on the patient, not a test performed on a sample outside the body to diagnose a condition.
  • Device Description: The description details a physical device used for accessing blood vessels and delivering substances. It does not describe a reagent, instrument, or system used for testing biological samples.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, detecting analytes, or providing diagnostic information based on testing.

The device is a medical device used for accessing the vascular system for therapeutic and sampling purposes, not for in vitro diagnostic testing.

N/A

Intended Use / Indications for Use

The POWERWAND® Safety Introducer with an Extended Dwell Catheter is used to gain access to the vascular system to sample blood and administer fluids intravenously. May be used for power injection of contrast media at a rate of 5cc/sec at up to 300 psi fluid pressure.

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

DYB, FOZ

Device Description

The POWERWAND® Safety Introducer with an Extended Dwell Catheter is an all-in-one preassembled intravascular catheter introducer with intravascular catheter that consists of the following basic components: Introducer Needle, Nitinol Guidewire. Dilator and an Extended Dwell Catheter. It is intended to provide the clinician with a safe, simple and accelerated approach, using the Accelerated Seldinger Technique, to place the in-dwelling intravascular catheter through the skin into the circulatory system. The Extended Dwell Catheter allows for withdrawal of blood and the administration of fluids, including power injection of contrast media. The device includes a Fast-flash™ feature that provides the clinician with feedback that the introducer needle is in the intraluminal position within the blood vessel. The device also incorporates a safety mechanism to guard against accidental needle stick.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

vascular system

Indicated Patient Age Range

Not Found

Intended User / Care Setting

clinician

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)

Design verification testing was conducted to demonstrate that the performance characteristics of the modified POWERWAND® Safety Introducer with and Extended Dwell Catheter are equivalent to the predicate device and satisfy the requirements of the product design specification for its intended use. This testing included the following: Special 510(k) Modification: 1. Needle Hub and Dilator Hub Attachment Testing to qualify Special 510(k) modification 1. Needle Hub to Dilator Separation Force and Removal Force 2. Removal Testing. Letter-to-file Modifications: There were no Letter-to-file Modifications (i.e. changes that have been implemented via letterto-file since the clearance of the 510(k) for the predicate POWERWAND® Safety Introducer with an Extended Dwell Catheter) that required physical performance testing.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Needle Hub to Dilator Separation Force and Removal Force, Removal Testing

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.

K101422

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

§ 870.1340 Catheter introducer.

(a)
Identification. A catheter introducer is a sheath used to facilitate placing a catheter through the skin into a vein or artery.(b)
Classification. Class II (performance standards).

0

KI11417

JUL 1 5 2011

510(K) SUMMARY

SUBMITTER INFORMATION 11.1

A.Company Name:Access Scientific, Inc.
B.Company Address:12526 High Bluff Drive, Suite 360
San Diego, CA 92130

C. Company Phone: (858) 259-8333

D. Company Facsimile: (858) 259-5298

  • E. Contact Person: Albert Misajon Vice President, Regulatory Affairs and Quality Assurance amisajon(@the-wand.com
  • July 1, 2011 F. Date Summary Prepared:

11.2 Device Identification

| A. | Device Trade Name: | the POWERWAND® Safety Introducer with an Extended
Dwell Catheter |
|----|-------------------------------|------------------------------------------------------------------------|
| B. | Common Name: | Catheter Introducer
Intravascular Catheter, Therapeutic, Short-term |
| C. | Classification Name(s): | Introducer, Catheter |
| D. | Classification Regulation(s): | 21 CFR 870.1340
21 CFR 880.5200 |
| E. | Device Class: | Class II |
| F. | Product Code: | DYB, FOZ |
| G. | Advisory Panel: | Cardiovascular |

Identification of Predicate Device 11.3

The predicate device is the POWER WAND® Safety Introducer with an Extended Dwell Catheter that was cleared for commercial distribution under 510(k) K101422.

11.4 Device Description

The POWERWAND® Safety Introducer with an Extended Dwell Catheter is an all-in-one preassembled intravascular catheter introducer with intravascular catheter that consists of the following basic components: Introducer Needle, Nitinol Guidewire. Dilator and an Extended Dwell Catheter. It is intended to provide the clinician with a safe, simple and accelerated approach, using the Accelerated Seldinger Technique, to place the in-dwelling intravascular catheter through the skin into the circulatory system. The Extended Dwell Catheter allows for

1

withdrawal of blood and the administration of fluids, including power injection of contrast media. The device includes a Fast-flash™ feature that provides the clinician with feedback that the introducer needle is in the intraluminal position within the blood vessel. The device also incorporates a safety mechanism to guard against accidental needle stick.

11.5 INDICATIONS FOR USE

The POWER WAND® Safety Introducer with an Extended Dwell Catheter is used to gain access to the vascular system to sample blood and administer fluids intravenously. May be used for power injection of contrast media at a rate of 5cc/sec at up to 300 psi fluid pressure.

TECHNOLOGICAL CHARACTERISTICS 11.6

The proposed modified device has the same technological characteristics as the predicate device in terms of components, materials, chemical composition, and design. The changes to the device are in the mechanism of attaching the Needle Hub to/from the Dilator Hub. Performance testing has been conducted to confirm that the modified device satisfies performance requirements.

In addition to the changes identified above, the following changes have been implemented via letter-to-file since the clearance of the 510(k) for the predicate, the POWER WAND® Safety Introducer with an Extended Dwell Catheter.

    1. Removed numbers from the Dilator Hub. Dilator Nut and Guidewire Can.
    1. The StatLock IV Ultra accessory has been removed from the POWERWAND.
    1. The device labels were modified to assure the information is adequate to allow users to safely operate the device.
    1. The DFU was revised to reflect the changes listed above, if they had an impact upon the text of the DFU.

11.7 SUMMARY OF TESTING

Design verification testing was conducted to demonstrate that the performance characteristics of the modified POWERWAND® Safety Introducer with and Extended Dwell Catheter are equivalent to the predicate device and satisfy the requirements of the product design specification for its intended use.

2

This testing included the following:

Special 510(k) Modification:

    1. Needle Hub and Dilator Hub Attachment
      Testing to qualify Special 510(k) modification
    1. Needle Hub to Dilator Separation Force and Removal Force
    1. Removal Testing

Letter-to-file Modifications:

There were no Letter-to-file Modifications (i.e. changes that have been implemented via letterto-file since the clearance of the 510(k) for the predicate POWERWAND® Safety Introducer with an Extended Dwell Catheter) that required physical performance testing.

11.8 CONCLUSIONS DRAWN FROM STUDIES

The results of testing demonstrate that the modified POWERWAND® Safety Introducer with an Extended Dwell Catheter is substantially equivalent to the predicate device in design, function, and indications for use.

3

Image /page/3/Picture/1 description: The image shows the logo for the Department of Health & Human Services USA. The logo consists of a circular arrangement of the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" surrounding a stylized eagle symbol. The eagle is depicted with three swooping lines representing its wings and a curved line representing its body.

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

Access Scientific, Inc. c/o Mr. Albert Misajon Vice President, Regulatory Affairs and Quality Assurance 12526 High Bluff Drive, Suite 360 San Diego, CA 92130

JUL 15 2011

Re: K111417

Trade/Device Name: the POWERWAND® Safety Introducer with an Extended Dwell Catheter

Regulation Number: 21 CFR 870.1340 Regulation Name: Catheter Introducer Regulatory Class: Class II Product Code: DYB Dated: July 1, 2011 Received: July 1, 2011

Dear Mr. Misajon:

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.

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

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Page 2 - Mr. Albert Misajon

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 (240) 276-3150 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours. ·

,
/"

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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INDICATIONS FOR USE

KI11417 510(k) Number (if known):

Device Name:

the POWERWAND® Safety Introducer with an Extended Dwell Catheter

Indications for Use:

The POWERWAND® Safety Introducer with an Extended Dwell Catheter is used to gain access to the vascular system to sample blood and administer fluids intravenously. May be used for power injection of contrast media at a rate of 5cc/sec at up to 300 psi fluid pressure.

Prescription Use × (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

:

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Division Sian-Off) Division of Cardiovascular Devices

510(k) Number 111417

Access Scientific, Inc. the POWERWAND® Safety Introducer with an Extended Dwell Catheter Special 510(k) Premarket Notification