K Number
K113689
Device Name
DUKAL LUBRICATING JELLY
Manufacturer
Date Cleared
2012-05-04

(141 days)

Product Code
Regulation Number
880.6375
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Dukal Sterile Lubricating Jelly is a medical device intended for medical purposes, to lubricate body orifices to facilitate entry of diagnostic devices when a sterile field is required.
Device Description
The Dukal Sterile Lubricating Jelly is a clear, greaseless, water soluble jelly.
More Information

Not Found

No
The device description and intended use clearly indicate a simple lubricating jelly, with no mention of any computational or analytical capabilities that would involve AI/ML.

No.
The device's intended use is to lubricate body orifices to facilitate the entry of diagnostic devices, which is a supportive function and not a direct treatment or therapy for a disease or condition.

No
The device is a lubricating jelly used to facilitate the entry of diagnostic devices, not to diagnose.

No

The device description clearly states it is a "clear, greaseless, water soluble jelly," which is a physical substance, not software.

Based on the provided information, the Dukal Sterile Lubricating Jelly is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly states it's for lubricating body orifices to facilitate the entry of diagnostic devices. This is a topical application and a physical aid for a medical procedure.
  • Device Description: It's described as a "clear, greaseless, water soluble jelly." This is a physical substance applied externally or internally to a body orifice, not a reagent or instrument used to examine specimens in vitro (outside the body).
  • Lack of IVD Characteristics: The description lacks any mention of analyzing biological samples, detecting substances in samples, or providing diagnostic information based on in vitro testing.

IVDs are devices used to examine specimens (like blood, urine, tissue) taken from the human body to provide information for diagnosis, monitoring, or screening. The Dukal Sterile Lubricating Jelly does not perform this function.

N/A

Intended Use / Indications for Use

The Dukal Sterile Lubricating Jelly is a medical device intended for medical purposes, to lubricate body orifices to facilitate entry of diagnostic devices when a sterile field is required.

Product codes

KMJ

Device Description

The Dukal Sterile Lubricating Jelly is a clear, greaseless, water soluble jelly.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

body orifices

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies

Not Found

Key Metrics

Not Found

Predicate Device(s)

K092488

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 880.6375 Patient lubricant.

(a)
Identification. A patient lubricant is a device intended for medical purposes that is used to lubricate a body orifice to facilitate entry of a diagnostic or therapeutic device.(b)
Classification. Class I (general controls). Except when the device is a vaginal patient lubricant or an oral lubricant, it is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 880.9.

0

K113689

MAY - 4 2012

510(k) Summary (as required by 807.92(c)

| Submitter of 510(k): | Dukal Corporation
2 Fleetwood Court
Ronkonkoma, NY 11779 |
|-------------------------|----------------------------------------------------------------|
| Contact Person: | Patrick J. Lamb
VP International/Operations Manager |
| Date of Summary: | December 5, 2011 |
| Trade/Proprietary Name: | Dukal Sterile Lubricating Jelly |
| Classification Name: | Lubricant, Patient |
| Product Code: | KMJ |

Intended Use:

. The Dukal Sterile Lubricating Jelly is a medical device intended for medical purposes, to lubricate body orifices to facilitate entry of diagnostic devices when a sterile field is required.

Device Description:

The Dukal Sterile Lubricating Jelly is a clear, greaseless, water soluble jelly.

Device Packaging:

A typical packaging configuration for the Dukal Sterile Lubricating Jelly ls a 2.7g or 5gm foil packs and 2oz or 4oz tubes. Other sizes may become available.

Predicate Device:

Dynarex Sterile Lubricating Jelly, 510(k) K092488 is manufactured for Dynarex 10 Glenshaw St. Orangeburg, NY 10962.

Substantial Equivalence:

The Dukal Sterile Lubricating Jelly provides effective lubrication during the insertion of diagnostic and therapeutic devices into the body orifices. Its function and performance are similar to the predicate device as presented in this 510(k).

1

Safety and Effectiveness of the device:

This device is as safe and effective as the predicate device cited above based on the following:

Summary comparing technological characteristics with other predicate device: Dukal Sterile Lubricating Jelly is similar in terms of intended use and technological characteristics to predicate devices reviewed as a lubricating jelly to facilitate the entry of a diagnostic or therapeutic device. The device is substantially equivalent with respect to indications for use and other characteristics to predicate devices in terms of section 510(k) substantial equivalency.

Please find below a tabulated comparison supporting that this device is substantially equivalent to the predicate device in commercial distribution.

| Technological

CharacteristicsDukalDynarex
Purified WaterYesYes
Carbomer ThickenersYesYes
MethylparabensYesYes
Labeled Water SolubleYesYes
Labeled Non StainingYesYes
Labeled Alcohol and
fragrance freeYesYes
Container MaterialPlastic/Film LaminatePlastic/Film Laminate
SterileYesYes
Physical Tests
Biocompatibility
TestingISO 10993ISO 10993
In-Vitro Cytotoxicity -PassIn-Vitro Cytotoxicity -Pass
Implantation-PassImplantation-Pass
Irritation & Hypersensitivity
-PassIrritation & Hypersensitivity -Pass
Systemic Toxicity - PassSystemic Toxicity - Pass

Comparative Chart

Sterilization:

The Dukal Sterile Lubricating Jelly is sterilized by gamma irradiation under parameters that have been validated according to ISO/AAMI 11137 requirements (sterilization of health care products - requirements for validation and routine control radiation sterilization) with SAL of 10°

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/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 its wings spread, and the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle. The eagle is black, and the text is also black. The background is white.

Public Health Service

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

Mr. Patrick J. Lamb Vice President International/Operations Manager Dukal Corporation 2 Fleetwood Court Ronkonkoma, New York 11779

MAY - 4 2012

Re: K113689

Trade/Device Name: Dukal Sterile Lubricating Jelly Regulation Number: 21 CFR 880.6375 Regulation Name: Patient Lubricant Regulatory Class: II Product Code: KMJ Dated: April 17, 2012 Received: April 25, 2012

Dear Mr. Lamb:

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.

3

Page 2 - Mr. Lamb

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.

Wh for

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

4

Indications for Use

510(k) Number (if known)

Device Name:

Dukal Sterile Lubricating Jelly

Indications for use:

The Dukal Sterile Lubricating Jelly is a medical device intended for medical purposes, to l he banal other of acilitate entry of diagnostic devices when a sterile field is required.

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

Over-The Counter Use X (Part 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 of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number:_

All Ch 5/3/12

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

510(k) Number: K113689