K Number
K111841

Validate with FDA (Live)

Date Cleared
2012-03-01

(246 days)

Product Code
Regulation Number
880.5860
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Shifeng Disposable Syringe with or without needle are intended to be used to inject fluid into, or withdraw fluids from, part of the body below the surface of the skin.

Device Description

The ShiFeng Disposable Syringe is a sterile, single use device consisting of a needle attached to a syringe. The ShiFeng Disposable Syringe manufactured by Chengdu Xinjin Shifeng Medical Apparatus & Instruments Co., Ltd., China is substantially equivalent to the IMC Piston syringe with Hypodermic Lumen Needle manufactured by IMC and cleared under K102969. The device consists of a metal tube that is sharpened at one end and the end joined to a female connector (hub) designated to mate with a male connector ( nozzle ) of a piston syringe consisting of a calibrated hollow barrel and a movable plunger.

AI/ML Overview

Here's an analysis of the provided text regarding the acceptance criteria and study for the Shifeng Piston Syringe with or without needle:

Summary of Device Acceptance Criteria and Performance

The Shifeng Disposable Syringe with or without needle demonstrates substantial equivalence to a predicate device (IMC Piston Syringe with Hypodermic Lumen Needle, K102969) by meeting various performance standards outlined in ISO 7886-1:1993/Cor. 1: 1995 and ISO 10993 for biocompatibility and ISO 11135 for sterilization.

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance Criteria (ISO Standard/Aspect)Reported Device Performance (Compliance/Details)
ISO 7886-1:1993/Cor. 1: 1995 (General)
Cleanliness (Clause 5)Tests performed according to standard
Limits for acidity or alkalinity (Clause 6)Tests performed according to standard
Limits for extractable metals (Clause 7)Tests performed according to standard
Lubricant (Clause 8)Tests performed according to standard
Tolerance on graduated capacity (Clause 9)Tests performed according to standard
Scale (Clause 10.1)Tests performed according to standard
Numbering of scale (Clause 10.2)Tests performed according to standard
Overall length of scale to nominal capacity line (Clause 10.3)Tests performed according to standard
Position of scale (Clause 10.4)Tests performed according to standard
Dimensions (Clause 11.1)Complying with ISO 7886-1
Finger grips (Clause 11.2)Tests performed according to standard
Design (Clause 12.1)Tests performed according to standard
Fit of piston in barrel (Clause 12.2)Tests performed according to standard
Fiducial line (Clause 12.3)Tests performed according to standard
Conical fitting (Clause 13.1)Tests performed according to standard
Position of nozzle on end of barrel (Clause 13.2)Tests performed according to standard
Nozzle lumen (Clause 13.3)Tests performed according to standard
Dead space (Clause 14.1)Tests performed according to standard
Freedom from air and liquid leakage past piston (Clause 14.2)Tests performed according to standard
Primary container (Clause 15.1)Tests performed according to standard
Secondary container (Clause 15.2)Tests performed according to standard
Storage container (Clause 16.3)Tests performed according to standard
Transport wrapping (Clause 16.4)Tests performed according to standard
Barrel Diameter1ml: 4.65-4.70mm; 2ml: 8.85-8.90mm; 3ml: 9.00-9.05mm; 5ml: 12.40-12.45mm; 10ml: 14.95-15.00mm (Similar to predicate)
Barrel Marking SpecsComplying with ISO7886-1
Gradations legibilityLegible
Lubricant amount / cm2Not exceed 0.25mg
Barrel TransparencyTransparent
Delivery AccuracyComplying with ISO 7886-1, 10.1 ~10.4
Reuse DurabilityNot applicable, single use device
LabelingComplying with ISO7886-1: 1993
ISO 10993 (Biocompatibility)
BiocompatibilityComplying with ISO 10993 (blood contacting materials are biocompatible)
Ethylene Oxide Residual LevelsNot exceed maximum daily dose levels proposed (1.501ug/device for Lot 20100301; 10.9ug/device for Lot 20110926)
Ethylene Chlorohydrin (ECH) Residual Levels10.9ug/device (Lot 20110926)
ISO 11135 (Sterilization)
SterilizationETO, ISO 11135 compliance
Sterility Assurance Level (SAL)10^-6 (validated according to ISO 11135-1:2007 to provide SAL of 10^-8 mentioned, but typically 10^-6 for devices)

2. Sample Size Used for the Test Set and Data Provenance

The provided text does not explicitly state the sample size used for the various tests conducted. It only lists the test items performed in accordance with the specified ISO standards.

The data provenance is retrospective, as the tests were performed on the device "manufactured by Chengdu Xinjin Shifeng Medical Apparatus & Instrument Co., Ltd., China," implying that the devices already existed. The manufacturer is based in China.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

This information is not provided in the document. The testing appears to be based on adherence to international standards (ISO), which typically involve standardized test methods rather than expert consensus on a "ground truth" for each specific test item in the way one might see for diagnostic image interpretation.

4. Adjudication Method for the Test Set

This information is not provided. Given that the tests are based on ISO standards with specific pass/fail criteria, an adjudication method for reconciling expert disagreements is unlikely to be relevant in the traditional sense. The results would be objectively measured against the standard's requirements.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and the Effect Size

No, a Multi-Reader Multi-Case (MRMC) comparative effectiveness study was not done. This device is a piston syringe, a physical medical instrument, and not a diagnostic AI system where human reader performance (with or without AI assistance) would be a relevant metric.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

No, a standalone (algorithm only) performance study was not done. This device is a physical instrument, not an algorithm or AI. The performance refers to its physical and material properties, rather than algorithmic output.

7. The Type of Ground Truth Used

The "ground truth" for the performance tests conducted on the Shifeng Disposable Syringe is based on established international standards (ISO 7886-1, ISO 10993, ISO 11135). This means that the device's physical properties and functionalities are measured against the predefined specifications and acceptable ranges set forth by these standards. It's not "expert consensus" in the diagnostic sense, nor pathology or outcomes data, but rather objective compliance with engineering and quality standards.

8. The Sample Size for the Training Set

The concept of a "training set" is not applicable to this device. This is a physical, non-AI medical device; therefore, there is no algorithm or model that requires a training set.

9. How the Ground Truth for the Training Set Was Established

As there is no training set for this physical device, this question is not applicable.

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Chengdu Xinjin Shifeng Medical Apparatus & Instrument Co., Ltd. Company: Shifeng Piston Syringe with or without needle Product:

No.46, 7ª group, Wanjie Village, Xinping town, Xinjin County, Chengdu City, P. R. China Address: +86(028)85757683, Fax: +86(028)85157183, Email: xjshifeng2011(@163.com Tel:

MAR - 1 2012

240 (K) Summary

Device Name

Proprietary Name:

Shifeng Disposable Syringe with or without needle

Classification Name:

Piston Syringe 21 CFR, Section 880.5860 21 CFR, Section 880.5570 Classification: Class II

Common Name;

Piston Syringe with or without needle

Intended Use

The Shifeng Disposable Syringe with or without needle are intended to be used to inject fluid into, or withdraw fluids from, part of the body below the surface of the skin.

Device Description

The ShiFeng Disposable Syringe is a sterile, single use device consisting of a needle attached to a syringe. The ShiFeng Disposable Syringe manufactured by Chengdu Xinjin Shifeng Medical Apparatus & Instruments Co., Ltd., China is substantially equivalent to the IMC Piston syringe with Hypodermic Lumen Needle manufactured by IMC and cleared under K102969. (Refer to Pic 1)

{1}------------------------------------------------

Company: Chengdu Xinjin Shifeng Medical Apparatus & Instrument Co., Ltd. Shifeng Piston Syringe with or without needle Product: Address: No.46; 740 group, Wanjie Village, Xinping town, Xinjin County, Chengdu City, P. R. China +86(028)85757683, Fax: +86(028)85157183, Email: xjshifeng2011@163.com Tel:

The device consists of a metal tube that is sharpened at one end and the end joined to a female connector (hub) designated to mate with a male connector ( nozzle ) of a piston syringe consisting of a calibrated hollow barrel and a movable plunger

XinJin Shifeng buy the Shangdong Qiaopai needle (510(K) 073705) and do the assembly with the syringe together.

Image /page/1/Figure/3 description: The image shows a diagram of a syringe with labels. The syringe consists of four parts: needle, piston, plunger, and barrel. The needle is labeled as "1. Needle", the piston is labeled as "2. Piston", the plunger is labeled as "3. Plunger", and the barrel is labeled as "4. Barrel".

Pic 1

Predicate Device Name and 510(K) No. :

IMC Piston syringe with Hypodermic Lumen Needle manufactured by IMC and cleared under K102969

Substantial Equivalence

The ShiFeng Disposable Syringe manufactured by Chengdu Xinjin Shifeng Medical Apparatus & Instruments Co., Ltd., China is substantially equivalent to IMC Piston syringe with Hypodermic Lumen Needle manufactured by IMC and cleared under K102969.

Principle of Operation/Technology

Both devices are operated manually

{2}------------------------------------------------

Chengdu Xinjin Shifeng Medical Apparatus & Instrument Co., Ltd. Company: Shifeng Piston Syringe with or without needle Product: No.46, 7ª group, Wanjie Village, Xinping town, Xinjin County, Chengdu City, P. R. China Address: +86(028)85757683, Fax: +86(028)85157183, Email: xjshifeng2011@163.com Tel:

Materials

The materials used in the ShiFeng Disposable Syringe manufactured by Chengdu Xinjin Shifeng Medical Apparatus & Instruments Co., Ltd., China are same as the predicate devices, which do not raise any new issues of safety or effectives.

PartsMaterialSpecification
BarrelPolypropyleneK4912
PlungerPolypropyleneV30G
LubricantPolydimethysiloxaneHC-SS36
PistonSynthetic rubberSK1
Primary Package MaterialMedical rubberizing Dialysis paperand PE65g/m² Medical rubberizingDialysis paper
NeedleQiaopai needle ( 510(K) 073705)

Specifications

SyringeNeedle
1ml Luer Slip_sterile0.45 (26G)
2ml Luer Slip_sterile0.50 (25G)
3ml Luer Slip_sterile0.60 (23G)
5ml Luer slip_sterile0.60 (23G) , 0.7 (22G)
10ml Luer Slip_sterile0.90 (20G), 1.2 (18G)

{3}------------------------------------------------

Company:Chengdu Xinjin Shifeng Medical Apparatus & Instrument Co., Ltd.
Product:Shifeng Piston Syringe with or without needle
Address:No.46, 7th group, Wanjie Village, Xinping town, Xinjin County, Chengdu City, P. R. China
Tel:+86(028)85757683, Fax: +86(028)85157183, Email: xjshifeng2011@163.com

Performance

The following tests were performed on the Shifeng Disposable Syringe manufactured by Chengdu Xinjin Shifeng Medical Apparatus & Instrument Co., Ltd, China in accordance with ISO 7886-1:1993/Cor. 1: 1995:

ISO Clause No.Test Items
5Cleanliness
6Limits for acidity or alkalinity
7Limits for extractable metals
8Lubricant
9Tolerance on graduated capacity
10.1Scale
10.2Numbering of scale
10.3Overall length of scale to nominal capacity line
10.4Position of scale
11.1Dimensions
11.2Finger grips
12.1Design
12.2Fit of piston in barrel
12.3Fiducial line
13.1Conical fitting
13.1Conical fitting
13.2Position of nozzle on end of barrel
13.2Position of nozzle on end of barrel
13.3Nozzle lumen
14.1Dead space
14.2Freedom from air and liquid leakage past piston
14.2Freedom from air and liquid leakage past piston
15.1Primary container
15.2Secondary container
16.1Primary container
16.2Secondary container
16.3Storage container
16.4Transport wrapping

.

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Company:Chengdu Xinjin Shifeng Medical Apparatus & Instrument Co., Ltd.
Product:Shifeng Piston Syringe with or without needle
Address:No.46, 7th group, Wanjie Village, Xinping town, Xinjin County, Chengdu City, P. R. China
Tel:+86(028)85757683, Fax: +86(028)85157183, Email: xjshifeng2011@163.com

None of the data raises any new issues of safety and effectiveness.

The Shifeng Disposable Syringe with or without needle manufactured by Chengdu Xinjin Shifeng Medical Apparatus & Instruments Co., Ltd., China is substantially equivalent to IMC Piston syringe with Hypodermic Lumen Needle manufactured by IMC and cleared under K102969.

Comparison table:

The Shifeng Disposable syringe with or without needle manufactured by XinJin Shifeng in Sichuang, China is substantially equivalent to the IMC Piston syringe with Hypodermic Lumen Needle manufactured by IMC and cleared under K102969.

Element of ComparisonSubject DeviceClaimed SE Device
Syringe TypePiston SyringeClassification II, FMFSame
Intended Use (s)are intended to be used to injectfluid into or withdraw fluids from,the body.Same
Principle of OperationThe operation principle ispushing or pulling the plunger toinject fluid into or withdraw fluidsfrom the body, suitable forhuman skin, muscle,intravenous injection, etcSame
Specific Drug UseNOSame
LengthVarious sizes complying withISO 7886-1, 11.1Same
Barrel Diameter1ml: 4.65-4.70mm2ml: 8.85-8.90mm3ml: 9.00-9.05mm5ml: 12.40-12.45mm10ml: 14.95-15.00mmSimilar
Tip TypeCentricSame
VolumeSize various from 1ml to 10 mlSame
Nozzle TypeSlip tipSame
Barrel Marking SpecsComplying with ISO7886-1Same
Gradations legibilityLegibleSame
Lubricant amount / cm2Not exceed 0.25mgSame
Barrel TransparencyTransparentSame

{5}------------------------------------------------

Chengdu Xinjin Shifeng Medical Apparatus & Instrument Co., Ltd. Company: Product: Shifeng Piston Syringe with or without needle

No.46, 7ª group, Wanjie Village, Xinping town, Xinjin County, Chengdu City, P. R. China Address:

Tel:

+86(028)85757683, Fax: +86(028)85157183, Email: xjshifeng2011(@163.com

Delivery AccuracyComplying with ISO 7886-1,10.1 ~10.4Same
Reuse DurabilityNot applicable, single usedeviceSame
BiocompatibilityComplying with ISO 10993Same
Materials
• LubricantPolydimethylsiloxaneSimilarSee Section VIII, A.1,page 5
• BarrelPolypropyleneSame
• PlungerPolypropyleneSame
• PistonSynthetic rubberSimilarSee Section VIII, A.2,page 9
LabelingComplying with ISO7886-1:1993Same
SterilizationETO, ISO 11135 complianceSame
Needle & Needle CoverShangdong Qiaopai needle510(K) 073705Similar

Additional Safety Information

The sterilization conditions are validated according to ISO 11135-1:2007 to provide a Sterility Assurance Level (SAL) of 10-8.

Ethylene Oxide residual levels after 7 days aeration resulting from EtO sterilization will not exceed the maximum daily dose levels proposed 10993-7:2008 and indicated as follows:

Ethylene Oxide1.501ug/device (Lot. 20100301)
10.9ug/device (Lot. 20110926)
ECH10.9ug/device (Lot. 20110926)

The device's materials were tested in accordance with the tests recommended in the FDA General Program Memorandum #g95-1 (5/1/95): Use of International Standard ISO-10993, "Biological Evaluation of Medical Devices Part-1: Evaluation

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Chengdu Xinjin Shifeng Medical Apparatus & Instrument Co., Ltd. Company: Shifeng Piston Syringe with or without needle Product:

No.46, 70 group, Wanjie Village, Xinping town, Xinjin County, Chengdu City, P. R. China Address:

Tel:

+86(028)85757683, Fax: +86(028)85157183, Email: xjshifeng2011(@163.com

and Testing. Results of the testing demonstrate that the blood contacting materials are biocompatible.

Conclusion

The Shifeng Disposable Syringe with or without needle manufactured by XinJin Shifeng in Sichuang, China is substantially to the Disposable Hypodermic Syringe manufactured by IMC Piston syringe with Hypodermic Lumen Needle manufactured by IMC and cleared under K102969 with respect to intended use, design, technology/principles of operation, materials and performance. Differences between the devices do not raise any new issues of safety or effectiveness.

Date Prepared:

2011-11-15

Prepared by:

Name: Position: Tel: Fax: E-mail:

Mr. Xinglong Tian QA & RA Vice President +86-28-62812121 +86-28-82459393 xjshifeng2011@163.com

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Image /page/7/Picture/0 description: The image shows the text "DEPARTMENT OF HEALTH & HUMAN SERVICES". The text is in black and is in all caps. To the left of the text is a symbol that appears to be three lines that are curved.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Document Control Room -WO

  • 1 2012 Silver Spring, MD 20993-0002

Mr. Xinglong Tian Ouality Assurance & Regulatory Affairs Vice President Chengdu Xinjin Shifeng Medical Apparatus & Instrument Company, Limited No.46, 7th Group Wanjie Village, Xinping Town Xinjin County Chengdu City P.R. CHINA

Re: K111841

Trade/Device Name: Shifeng Disposable Syringe with or without Needle Regulation Number: 21 CFR 880.5860 Regulation Name: Piston Syringe Regulatory Class: II Product Code: FMF / FMI Dated: February 16, 2012 Received: February 16, 2012

Dear Mr. Tian:

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.

{8}------------------------------------------------

Page 2 - Mr. Tian

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/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours,

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

{9}------------------------------------------------

Chengdu Xinjin Shifeng Medical Apparatus & Instrument Co., Ltd. Company: Shifeng Piston Syringe with or without needle Product:

No.46, 7th group, Wanjie Village, Xinping town, Xinjin County, Chengdu City, P. R. China Address:

Tel:

+86(028)85757683, Fax: +86(028)85157183, Email: xjshifeng2011@163.com

510(k) Number (if known): K111841

Shifeng Disposable Syringe with or without needle Device Name:

Indications for Use:

The Shifeng Disposable Syringe with or without needle are intended to be used to inject fluid into, or withdraw fluids from, part of the body below the surface of the skin.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use
(Per 21 CFR 801.109vision Sign-Off)
OR
Over-The-Counter Use
3/1/12

(Per 21 CFR 807.19)Vision Sign-On

Division of Anesthesiology, General Hospital Infection Control, Dental Devices

(Optional Format 1-2-96)

510(k) Number. K111841

Page I of I

§ 880.5860 Piston syringe.

(a)
Identification. A piston syringe is a device intended for medical purposes that consists of a calibrated hollow barrel and a movable plunger. At one end of the barrel there is a male connector (nozzle) for fitting the female connector (hub) of a hypodermic single lumen needle. The device is used to inject fluids into, or withdraw fluids from, the body.(b)
Classification. Class II (performance standards).