K Number
K121050
Device Name
0.9% SODIUM CHLORIDE INJECTION USP BD POSIFLUSH FLUSH SYRINGE, SF FLUSH SYRINGE
Date Cleared
2013-02-07

(307 days)

Product Code
Regulation Number
880.5200
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
BD PosiFlush™ Normal Saline Flush Syringes are intended to be used only for the flushing of indwelling vascular access devices. 10ml BD PosiFlush™ Normal Saline. Flush Svringes are generally compatible for use with syringe pumps.
Device Description
The modified BD PosiFlush Flush Syringe is a three-piece, sterile, single use syringe with a 6% (Luer) connector pre-filled with 0.9% Sodium Chloride Injection, USP and sealed with a tip cap. BD has altered the modified device from the predicate by changing the stopper material and adding an extra thread to the plunger rod, threaded stopper insert. All performance characteristics are equivalent to the predicate device. The 0.9% Sodium Chloride Injection, USP BD PosiFlush Flush Syringes are intended for use in maintaining patency of vascular access devices (VAD's). This submission represents two 2 devices: the BD PosiFlush Flush Syringe, which is provided with a sterile fluid path; and the BD PosiFlush Flush SF Syringe, which is provided externally sterile for use on a sterile field. Both configurations are sterilized via moist heat.
More Information

Not Found

No
The device description and performance studies focus on the physical characteristics and fluid properties of a pre-filled syringe, with no mention of AI or ML.

No.
This device is intended to flush and maintain the patency of vascular access devices, not to treat a disease or condition.

No

The device is a pre-filled syringe used for flushing vascular access devices to maintain patency, not for diagnosing medical conditions.

No

The device description clearly outlines a physical syringe pre-filled with saline, a hardware component. The performance studies also focus on physical characteristics and material properties, not software validation.

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

Here's why:

  • Intended Use: The intended use is for "flushing of indwelling vascular access devices" and "maintaining patency of vascular access devices (VAD's)". This is a therapeutic or maintenance function within the body, not a diagnostic test performed on samples taken from the body.
  • Device Description: The device is a pre-filled syringe containing saline solution. This is a delivery system for a substance used in a medical procedure, not a reagent or instrument used to analyze biological samples.
  • Lack of IVD Characteristics: The description does not mention any components or functions related to analyzing biological samples (like blood, urine, tissue, etc.) or providing diagnostic information.

IVD devices are used to examine specimens from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device's function is purely related to the physical maintenance of a medical device within the body.

N/A

Intended Use / Indications for Use

BD PosiFlush™ Normal Saline Flush Syringes are intended to be used only for the flushing of indwelling vascular access devices. 10ml BD PosiFlush™ Normal Saline. Flush Svringes are generally compatible for use with syringe pumps.

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

NGT

Device Description

The modified BD PosiFlush Flush Syringe is a three-piece, sterile, single use syringe with a 6% (Luer) connector pre-filled with 0.9% Sodium Chloride Injection, USP and sealed with a tip cap. BD has altered the modified device from the predicate by changing the stopper material and adding an extra thread to the plunger rod, threaded stopper insert. All performance characteristics are equivalent to the predicate device. The 0.9% Sodium Chloride Injection, USP BD PosiFlush Flush Syringes are intended for use in maintaining patency of vascular access devices (VAD's).

This submission represents two 2 devices: the BD PosiFlush Flush Syringe, which is provided with a sterile fluid path; and the BD PosiFlush Flush SF Syringe, which is provided externally sterile for use on a sterile field. Both configurations are sterilized via moist heat.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

indwelling vascular access devices

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

Design Verification testing included the following:
Functional Testing - Container Closure Integrity, Break Loose Force, Break Out Force, Sustaining Force, Pump Force, Dead Space / Expelled Volume, Syringe Induced Reflux.
Sodium Chloride Injection, USP Testing - Bacterial Endotoxin, Particulate Matter, Assay of NaCl, Heavy Metals, Iron, UV/vis, pH.
Biocompatibility Testing - Cytotoxicity, Hemolysis, Acute Systemic Toxicity, Intracutaneous Reactivity, Sensitization, Bacterial Mutagenicity, In Vitro Mouse Lymphoma, Mouse Embryo Assay, Occular Irritation, Rabbit Pyrogen, Subchronic Intracutaneous Toxicity, Chemical Extractables Analysis.

Results demonstrated that the BD PosiFlush Flush Syringe performed in an equivalent manner to the predicate device and is safe and effective when used as intended.

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.

K003553, K042061

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

§ 880.5200 Intravascular catheter.

(a)
Identification. An intravascular catheter is a device that consists of a slender tube and any necessary connecting fittings and that is inserted into the patient's vascular system for short term use (less than 30 days) to sample blood, monitor blood pressure, or administer fluids intravenously. The device may be constructed of metal, rubber, plastic, or a combination of these materials.(b)
Classification. Class II (performance standards).

0

KI2050

510(k) Summarv

FEB 7 2013

】. Submitted Bv:

Avital Merl Staff Regulatory Affairs Specialist BD Medical - Medical Surgical Systems I Becton Drive Franklin Lakes. NJ 07417 201 847 4739 Tel: 201 847 5307 Fax:

ri Device Name: .

Trade Name: 1) 0.9% Sodium Chloride Injection, USP, BD PosiFlush Flush Syringe 2) 0.9% Sodium Chloride Injection, USP, BD PosiFlush SF Flush Syringe

0.9% Sodium Chloride Injection Flush Syringe Common Name: Classification Name: Saline, Vascular Access Flush Class II, 21 CFR § 880.5200 Classificiation:

3. Predicate Device:

Trade Name: 0.9% Sodium Chloride Injection, USP, BD Pre-Filled Flush Syringe Manufacturer: Becton, Dickinson and Company 510(k) Number: K003553

Trade Name: 0.9% Sodium Chloride Injection, USP, BD PosiFlush SF Flush Syringe Becton. Dickinson and Company Manufacturer: 510(k) Number: K042061

4. Device Description:

The modified BD PosiFlush Flush Syringe is a three-piece, sterile, single use syringe with a 6% (Luer) connector pre-filled with 0.9% Sodium Chloride Injection, USP and sealed with a tip cap. BD has altered the modified device from the predicate by changing the stopper material and adding an extra thread to the plunger rod, threaded stopper insert. All performance characteristics are equivalent to the predicate device. The 0.9% Sodium Chloride Injection, USP BD PosiFlush Flush Syringes are intended for use in maintaining patency of vascular access devices (VAD's).

This submission represents two 2 devices: the BD PosiFlush Flush Syringe, which is provided with a sterile fluid path; and the BD PosiFlush Flush SF Syringe, which is provided externally sterile for use on a sterile field. Both configurations are sterilized via moist heat.

1

Intended Use: ri

BD PosiFlush™ Normal Saline Flush Syringes are intended to be used only for the flushing of indwelling vascular access devices. 10ml BD PosiFlush™ Normal Saline. Flush Svringes are generally compatible for use with syringe pumps.

Technological Characteristics: 6.

The principal device of this 510(k) premarket notification is the result of a design change to the predicate device (K003553 and K042061) conducted in accordance with Quality System Regulations, 21 CFR § 820. The BD PosiFlush Flush Syringe is Substantially Equivalent to the predicate device, given that:

  • a) The BD PosiFlush Flush Syringe has the same intended use as the predicate device
  • b) The BD PosiFlush Flush Syringe operates under the same operating principle as the predicate device
  • c) The BD PosiFlush Flush Syringe barrel and stopper use a design identical to the predicate device.
  • d) The BD PosiFlush Flush Syringe barrel and plunger rod use materials identical to the predicate device.
  • e) The BD PosiFlush Flush Syringe pre-filled 0.9% Sodium Chloride Injection solution meets the requirements of USP 34: Sodium Chloride Injection, as does the predicate device.
  • The BD PosiFlush Flush Syringe meets the requirements of ISO 10993 as applicable f) to the intended use of the device, as does the predicate device.
  • g) The BD PosiFlush Flush Syringe are sterilized to an SAL of 106 (sterile fluid path or externally sterile) via a Moist Heat sterilization process, as does the predicate device.
  • h) The BD PosiFlush Flush Syringe demonstrated equivalent performance to the predicate device during design verification testing.

Performance: 6.

Design Verification testing included the following:

Performance CharacteristicAcceptance Criteria
Functional Testing
Container Closure IntegrityNo Dye in Solution;
No Leakage in the luer well or tip threads;
No Leakage Past the Stopper Ribs;
No Dye Between Stopper Ribs
Break Loose ForceEquivalence to Predicate
Break Out ForceEquivalence to Predicate
Sustaining ForceEquivalence to Predicate
Pump Force10ml/hr – 20N
1ml/hr - 13N

Table VI - Modified Device Performance

2

.

0.1ml/hr - 9N
Dead Space / Expelled VolumeEquivalent to labeled volume (3ml. 5ml or 10ml)
Syringe Induced Reflux0 average reflux when connected to a 4 Fr catheter
Sodium Chloride Injection, USP Testing
Bacterial EndotoxinPer USP
Particulate MatterPer USP
Assay of NaClPer USP
Heavy MetalsPer USP
IronPer USP
UV/visPer USP
pHPer USP
Biocompatibility Testing
TestMethod/Acceptance
CytotoxicityPer ISO10993-5:1999, Non-Toxic
HemolysisPer ISO10993-4:2002/A:2006, Non-Toxic
Acute Systemic ToxicityPer ISO10993-11:2006, Non-Toxic
Intracutaneous ReactivityPer ISO10993-10:2002/A1:2006, Non-Irritant
SensitizationPer ISO10993-10:2002/A1:2006, Non-Sensitizer
Bacterial MutagenicityPer ISO10993-3, Non-Mutagenic
In Vitro Mouse LymphomaPer ISO10993-3, Non-Mutagenic
Mouse Embryo AssayPer ISO10993-3, Non-Mutagenic
Occular IrritationPer ISO10993-10:2002/A1:2006, Non-Irritant
Rabbit PyrogenPer ISO10993-11:2006, Non-Pyrogenic
Subchronic Intracutaneous ToxicityPer ISO10993-11:2006, Non-Toxic.
Chemical Extractables AnalysisLC/DAD/MS & GC/MS. No significant extractables

Design Verification tests were performed based on the risk analysis conducted, and the results of these tests demonstrate that the BD PosiFlush Flush Syringe performed in an equivalent manner to the predicate device and is safe and effective when used as intended.

3

Image /page/3/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 tail feathers, representing the department's commitment to health, human services, and well-being. The eagle is positioned within a circle, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged around the circle's perimeter.

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

February 7, 2013

Ms. Avital Merl Staff Regulatory Affairs Specialist Becton, Dickinson and Company One Becton Drive FRANKLIN LAKES NJ 07417

Re: K121050

Trade/Device Name: 0.9% Sodium Chloride Injection, USP BD PosiFlush Flush Syringe 0.9% Sodium Chloride Injection, USP BD PosiFlush SF Flush

Svringe Regulation Number: 21 CFR 880.5200 Regulation Name: Intravascular Catheter Regulatory Class: II Product Code: NGT Dated: February 1, 2013

Received: February 4, 2013

Dear Ms. Merl:

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.

4

Page 2 - Ms. Merl

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 Lo m

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

5

Indications for Use Statement

510(k) Number (if known): K121050

1

Device Name:

0.9% Sodium Chloride Injection, USP BD PosiFlush Flush Syringe

Model NumberSyringe Size/Fill Volume
3065443mL BD PosiFlush™ SP
3065455mL BD PosiFlush™ SP
30654610mL BD PosiFlush™ SP with Regular Plunger Rod
30654710mL BD PosiFlush™ SP
30655310mL BD PosiFlush™ SF with Regular Plunger Rod
3065493mL BD PosiFlush™ SP with BPC (Blunt Plastic
Cannula)
3065505mL BD PosiFlush™ SP with BPC
30655110mL BD PosiFlush™ SP (Regular Plunger Rod) with
BPC

Over-The-Counter Use

(21 CFR 801 Subpart C)

Indications for Use:

Prescription Use

(Part 21 CFR 801 Subpart D)

X

BD PosiFlush™ Normal Saline Flush Syringes are intended to be used only for the flushing of indwelling vascular access devices. Catalog No. 306547 10ml BD PosiFlush™ Normal Saline Flush Syringes are generally compatible for use with syringe pumps.

AND/OR

(PLEASE DO NOT WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)
--------------------------------------------------------
Elizabeth F. Claverie
2013.02.07 11:32:28 -05'00'
Page __ of __(Division Sign-Off)
Division of Anesthesiology, General Hospital
Infection Control, Dental Devices
510(k) Number:

Page 10 of 249