K Number
K122449
Device Name
ENTERAL NUTRITION WARMER
Manufacturer
Date Cleared
2013-06-13

(304 days)

Product Code
Regulation Number
880.5725
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Enteral Nutrition Warmer is an electronically powered dry warmer, which supplies external heat to the plastic tubing incorporated administration sets for intermittent use and low flow rate applications at 0 to 7mL/min.
Device Description
The Enteral Nutrition Warmer is an electronically powered dry warmer, which supplies external heat to the outside of the administration set tubing. The warmer includes an LED light to indicate the warmer is operating and a switch that will turn the warmer on and off. The Enteral Nutrition Warmer is reusable and provided non-sterile.
More Information

No
The device description and performance studies focus on basic electronic heating and temperature control, with no mention of AI or ML algorithms for data analysis, decision-making, or adaptive control.

No
The device warms enteral nutrition, which is food, not a therapeutic agent. It does not provide treatment for a disease or condition, but rather facilitates a basic physiological need (nutrition delivery).

No

The device is an enteral nutrition warmer, designed to warm administration sets for intermittent use and low flow rate applications. It supplies external heat to tubing and is used by hospital NICU staff. Its function is to warm fluids, not to diagnose medical conditions or analyze biological data for diagnostic purposes.

No

The device description explicitly states it is an "electronically powered dry warmer" with hardware components like an LED light and a switch.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, or tissue) to provide information about a person's health. These tests are performed outside the body.
  • Device Function: The Enteral Nutrition Warmer's function is to warm enteral fluids before they are administered to a patient. It acts on the administration set tubing, which is part of the delivery system for nutrition. It does not perform any tests on biological samples.
  • Intended Use: The intended use clearly states it warms enteral fluids for feeding, not for diagnostic testing.

Therefore, the device's purpose and mechanism of action do not align with the definition of an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The Enteral Nutrition Warmer is an electronically powered dry warmer, which supplies external heat to the plastic tubing incorporated administration sets for intermittent use and low flow rate applications at 0 to 7mL/min.

Product codes

LGZ

Device Description

The Enteral Nutrition Warmer is an electronically powered dry warmer, which supplies external heat to the outside of the administration set tubing. The warmer includes an LED light to indicate the warmer is operating and a switch that will turn the warmer on and off.

The Enteral Nutrition Warmer is reusable and provided non-sterile.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

hospital NICU staff

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

A human factors study was conducted to assess the clinical risks related to the use of the Enteral Nutrition Warmer for warming enteral fluids during the feeding of neonatal patients by the hospital NICU staff. All identified risks have been identified and adequately mitigated to ensure the system is safe for use.

The following non-clinical tests were performed to ensure the device is capable of meeting the predicate device's specifications when tested for the addition of enteral fluids to the intended use:

  • ◆ Maximum temperature outside housing (top)
  • Maximum temperature outside housing (bottom)
  • Maximum temperature heat sink (tubing track)
  • Maximum temperature of enteral fluid (portion under heater)
  • Maximum temperature of enteral fluid (at extension set feeding tube portion)
  • Time to reach nominal temperature

Key Metrics

Not Found

Predicate Device(s)

Elltec Enteral Nutrition Warmer (K024373)

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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

JUN 1 3 2013

510(k) Summary of safety and effectiveness

This 510(k) summary of safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

APPLICANT:Acacia, Inc.
APPLICANT ADDRESS785 Challenger Street
Brea, CA 92821
APPLICANT PHONE(714) 257-0470
CONTACT PERSONFergie Ferguson
PREPARATION DATE05/15/13
TRADE NAME:Enteral Nutrition Warmer
COMMON NAME:Warmer, Thermal, Infusion Fluid
CLASSIFICATION NAME:Warmer, Thermal, Infusion Fluid
DEVICE CLASSIFICATION:Unclassified
PRODUCT CODELGZ
PREDICATE DEVICES:Elltec Enteral Nutrition Warmer (K024373)

Purpose

The purpose of this submission is to introduce a new device for Enteral Nutrition Warming.

Substantially Equivalent To:

The Acacia, Inc. Enteral Nutrition Warmer is substantially equivalent in intended use, principle of operation and technological characteristics to the Elltec Enteral Nutrition Warmer (K024373) for the delivery of enteral fluids.

The Acacia, Inc. Enteral Nutrition Warmer and the Elltec Enteral Nutrition Warmer are both electronically powered dry warmers, which supplies external heat to the outside of the administration set tubing. The flow rates, output temperature, along with dimensions and weight are equivalent.

The table below describes the characteristics reviewed to determine substantial equivalence.

Item ReviewedProposed DevicePredicate DeviceEquivalence
Intended UseThe Enteral Nutrition
Warmer is an
electronically powered
dry warmer, which
supplies external heat
to the plastic tubing
incorporated
administration sets for
intermittent use and lowThe Enteral Nutrition
Warmer LIFORT LT-1 is
an electronically
powered, dry warmer
which supplies external
heat to the plastic tubing
incorporated
administration sets for
intermittent use and lowSame
Principle of
Operationflow rate applications at
0 to 7mL/min.flow rate applications at
0 to 7ml/min. The LT-1
is available in two sizes:
4mm and 5mm channels
for administration sets.Same
Electrically powered
device that incorporates
controlled heat to the
outer wall of an
extension set that is
delivering enteral fluid
to the patient.Electrically powered
device that incorporates
controlled heat to the
outer wall of an
extension set that is
delivering enteral fluid to
the patient.
MaterialsAll materials are fire
rated for the proposed
device's intended useUnknownAll materials are fire
rated for the
proposed device's
intended use
Flow rate0 to 7mL/min0 to 7mL/minSame
Tubing OD size2.4mm4.1mm to 5.0mmAcacia utilizes a
more commonly used
tubing outer diameter
for enteral feeding of
premature infants
Number of
heatersOneUnknownOnly one sensor is
required for the
proposed device to
perform as intended
Maximum
heating plate
temperature48.8 C46 CThe proposed
device's maximum
heating plate
temperature does not
pose a burn hazard
Output
temperature32 C to 41 C32 C to 41 CSame
Temperature
sensorThermocoupleThermocoupleSame
Safety featureTemperature fuse shuts
off power in case
sensor becomes
inoperableTemperature fuse shuts
off power in case sensor
becomes inoperableSame
Electrical
sourceStandard 120V
electrical outletStandard 120V electrical
outletSame
Operating
condition0 C to 40 C0 C to 40 CSame
Warmer weight22.8 ounces19.75 ouncesThe proposed device
weighs 3.05 ounces
more than the
predicate device;
however, the unit that
warms the tubing
near bedside only
weighs 3 ounces.
The predicate device
includes the
temperature
controller and the
warming unit all in
one unit, which
makes the device
more difficult to place
at the bedside.
Warmer
dimensions4.67in(length) x 3.42in
(width) x
0.74in(height)6.9in(length) x
2.6in(width) x
1.5in(height)The warming unit
footprint of both the
proposed and
predicate devices is
similar. The
differences are not
significant.

Acacia, Inc. Enteral Nutrition Warmer

Page 1 of 4

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510(k) Summary of safety and effectiveness

Acacia, Inc. Enteral Nutrition Warmer

:

Page 2 of 4

:

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510(k) Summary of safety and effectiveness

Description of the Device Subiect to Premarket Notification:

The Enteral Nutrition Warmer is an electronically powered dry warmer, which supplies external heat to the outside of the administration set tubing. The warmer includes an LED light to indicate the warmer is operating and a switch that will turn the warmer on and off.

The Enteral Nutrition Warmer is reusable and provided non-sterile.

Indications for Use:

The Enteral Nutrition Warmer is an electronically powered dry warmer, which supplies external heat to the plastic tubing incorporated administration sets for intermittent use and low flow rate applications at 0 to 7mL/min.

Technical Characteristics:

The Enteral Nutrition Warmer is the same in indications for use, principle of operation and overall technological characteristic compared to the predicate device.

Performance Data:

A human factors study was conducted to assess the clinical risks related to the use of the Enteral Nutrition Warmer for warming enteral fluids during the feeding of neonatal patients by the hospital NICU staff. All identified risks have been identified and adequately mitigated to ensure the system is safe for use.

The following non-clinical tests were performed to ensure the device is capable of meeting the predicate device's specifications when tested for the addition of enteral fluids to the intended use:

  • ◆ Maximum temperature outside housing (top)
  • Maximum temperature outside housing (bottom) .
  • Maximum temperature heat sink (tubing track) .

Acacia, Inc. Enteral Nutrition Warmer

Page 3 of 4

3

510(k) Summary of safety and effectiveness

  • Maximum temperature of enteral fluid (portion under heater) �
  • Maximum temperature of enteral fluid (at extension set feeding tube portion) .
  • Time to reach nominal temperature .

.

Basis for Determination of Substantial Equivalence:

Since the proposed and predicate devices have no significant technological differences, it is concluded that the proposed device is as safe, as effective, and performs at least as safely and effectively as the legally marketed predicate device.

.

Acacia, Inc. Enteral Nutrition Warmer

Page 4 of 4

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Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized depiction of an eagle or bird-like figure with three overlapping wing-like shapes. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the bird symbol. The text is in all caps and is in a sans-serif font.

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

· June 13, 2013

Ms. Fergie Ferguson Director of Operations 785 Challenger Street BREA California 92821

Re: K122449

Trade/Device Name: Enteral Nutrition Warner Regulation Number: Unclassified Regulation Name: Warmer, Thermal, Infusion Fluid Regulatory Class: Unclassified Product Code: LGZ Dated: May 15, 2013 Received: May 24, 2013

Dear Ms. Ferguson:

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. Ilisting 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.

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

5

Page 2 - Ms. Ferguson

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 (OS) 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 contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. 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.

Image /page/5/Picture/8 description: The image contains the names "Susan Runner DDS, MA" and "Mary S. Runner -S". The text is in a variety of fonts and sizes. The image appears to be a business card or advertisement.

Kwame Ulmer M.S. Acting Division Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

6

Indications for Use

510(k) Number (if known): K122449

Device Name: Enteral Nutrition Warmer

Indications for Use:

The Enteral Nutrition Warmer is an electronically powered dry warmer, which supplies external heat to the plastic tubing incorporated administration sets for intermittent use and low flow rate applications at 0 to 7mL/min.

Prescription Use ਮ (Part-21-CFR 801-Subpart-D)- AND/OR Over-The-Counter Use (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)

FDA

Richard C. Chapman 2013.06.12 13:47:56 -04'00'

  • Ivision Sign-Off)

ാടion of Anesthesiology, General Hospital ection Control, Dental Devices

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510(k) Number: K122449