K Number
K123267
Date Cleared
2012-11-02

(14 days)

Product Code
Regulation Number
880.5200
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The SURFLASH® Plus Safety I.V. Catheter is inserted into the patient's vascular system for short term use (<30 days) to withdraw blood samples, administer fluid intravenously, or monitor blood pressure by attaching a monitoring line. The needle shaft cover and tip shield feature aids in the prevention of needle stick injuries. These catheters may be used for any patient population with consideration given to adequacy of vascular anatomy and appropriateness for the solution being infused and duration of therapy. The 18 to 22 gauge catheters are suitable for use with power injectors rated for a maximum of 325 psi.

Device Description

The SURFLASH® Plus Safety I.V. Catheter is manually operated and contains a passive safety feature that automatically activates as the needle is withdrawn from the catheter. The devices consist of catheter assembly (catheter, caulking pin and catheter hub containing valve, seal component and plug), needle assembly (needle, needle housing, transparent flash chamber with filter and needle protector) and a passive needle-shielding mechanism (shutter and needle shaft cover consisting of inner cylinder, outer cylinder, junction cylinder). The SURFLASH® Plus Safety I.V. Catheter has a valve and a seal component inside the catheter hub to minimize the possibility of blood leakage at catheter hub after needle removal. The catheter hub is also provided with a plug inside which penetrates the valve to create a fluid path when a connector is inserted in the catheter hub. The fluid path is permanently opened once a secure luer connection is made. The devices are an over-the needle, peripheral catheter made of a slender, flexible, radio-opaque plastic with a hub that is inserted into the patient's vascular system for short term (<30 days) use to withdraw blood samples, administer fluids intravenously, or monitor blood pressure by attaching a monitoring line. Whole length cannula including the sharp end of the inner needle is covered by the needle shielding mechanism as the needle is withdrawn from catheter's hub to aid in the prevention of needle stick injuries. The grooved cannula which allows the clinician to visualize flashback detection through the groove indicating that there is confirmation of vessel entry is the same as the TERUMO® Surshield® PUR Safety I.V. Catheter (K100282) and TERUMO® SURFLASH® I.V. Catheter (K991406). The stainless steel cannula is placed in the catheter to maintain rigidity and is withdrawn after the catheter is placed in the vascular system. The catheter that is advanced into the vessel is made of polyurethane which is the same as the TERUMO® Surshield®-PUR Safety I.V. Catheter (K100282) and TERUMO® SURFLASH® I.V. Catheter (K991406).

AI/ML Overview

The provided text is a 510(k) summary for the Terumo SURFLASH® Plus Safety I.V. Catheter. It outlines the device's description, intended use, non-clinical tests, and substantial equivalence to predicate devices. However, it does not describe an AI/ML-based medical device. Therefore, the information required to answer your questions regarding acceptance criteria, study details, expert involvement, and ground truth for an AI/ML device is not present in the provided document.

To directly answer your request, here's what can be extracted from the document regarding the device (the I.V. catheter) meeting its intended performance, even though it's not an AI/ML device:

1. A table of acceptance criteria and the reported device performance:

The document states that "Performance testing was conducted to ensure the safety and effectiveness of the SURFLASH® Plus Safety I.V. Catheter throughout the shelf life, to verify conformity to the applicable part of ISO standards and demonstrate substantial equivalence to the predicate devices." It also lists various performance tests conducted.

Performance Test (Acceptance Criteria Implicitly Met if "X" is checked)Compliance to ISO 10555-1Compliance to ISO 10555-5Compliance to ISO 23908Testing by Internal Standard (Required by ISO)Reported Device Performance (Implied "Meets Criteria")
Force to needle breaking shutter (Puncture resistance of needle shield)Not requiredNot requiredXRequired by ISOEffectively activated.
Tensile strength of needle shaft and needle housing (Break strength of safety mechanism)Not requiredNot requiredXRequired by ISOVerified satisfactory.
Force to release shutter and reactive force when the shutter opens to cover the cannula tip (Reaction force generated by the activation mechanism)Not requiredNot requiredNot requiredXVerified satisfactory.
Force to detach needle shaft cover from catheter hub (Force to activate safety feature)Not requiredNot requiredXRequired by ISOAll safety features activated effectively.
Simulated maximum pressureNot requiredNot requiredNot requiredXVerified satisfactory.
Burst pressure (whole device)XNot requiredNot requiredRequired by ISOVerified satisfactory.
Collapse (under negative pressure)XNot requiredNot requiredRequired by ISOVerified satisfactory.
Catheter to catheter hub tensile strength (Force at break of catheter / hub)XNot requiredNot requiredRequired by ISOVerified satisfactory.
Strength of union between transparent flash chamber (needle connecting part) and needleNot requiredXNot requiredRequired by ISOVerified satisfactory.
Needle attachment to catheter (Initial sliding friction)Not requiredNot requiredNot requiredXVerified satisfactory.
Detection of flashback at catheter tipNot requiredNot requiredNot requiredXVerified satisfactory.
Detection of flashback at transparent flash chamber (needle connecting part)Not requiredXNot requiredRequired by ISOVerified satisfactory.
Flow rateNot requiredXNot requiredRequired by ISOVerified satisfactory.
Vent fittingNot requiredXNot requiredRequired by ISOVerified satisfactory.
Protector attachment (Drop test)Not requiredNot requiredNot requiredXVerified satisfactory.
Conical fittings of catheter hubXNot requiredNot requiredRequired by ISOVerified satisfactory.
Pressure monitoringNot requiredNot requiredNot requiredXVerified satisfactory.
Blood leakage at catheter hubNot requiredNot requiredNot requiredXVerified satisfactory (Minimized by design).
Measurement of valve penetration resistance to catheter hubNot requiredNot requiredNot requiredXVerified satisfactory.
Simulated use studyNot requiredNot requiredXRequired by ISOAll safety features activated effectively; no de-activations after discarding; users operated safely and effectively.
Corrosion resistanceXNot requiredNot requiredRequired by ISOVerified satisfactory.
Catheter body tensile strength (Force at break)XNot requiredNot requiredRequired by ISOVerified satisfactory.
StiffnessNot requiredNot requiredNot requiredXVerified satisfactory.
ElongationNot requiredNot requiredNot requiredXVerified satisfactory.
Flexural fatigue toleranceNot requiredNot requiredNot requiredXVerified satisfactory.
Radio-detectabilityNot requiredXNot requiredRequired by ISOVerified satisfactory.
SurfaceXNot requiredNot requiredRequired by ISOVerified satisfactory.
Catheter unitNot requiredXNot requiredRequired by ISOVerified satisfactory.
Needle pointNot requiredXNot requiredRequired by ISOVerified satisfactory.

2. Sample size used for the test set and the data provenance:

  • Simulated Use Study: "study participants" (number not specified). "Healthcare workers who use these types of safety I.V. catheters."
  • Other Performance Tests: Sample sizes are not explicitly stated for the enumerated tests (e.g., burst pressure, tensile strength).
  • Data Provenance: The tests were conducted by Terumo Corporation, presumably within their facilities or via third-party labs on their behalf. The country of origin of the data is not specified beyond the manufacturer's location in Japan, with regulatory affairs in the US. The studies are prospective as they are tests performed on the device to demonstrate conformity.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

This information is not applicable and therefore not provided in the document as this is a physical medical device, not an AI/ML-based device requiring expert annotation for ground truth. For the simulated use study, "healthcare workers who use these types of safety I.V. catheters" were participants, but their role was to evaluate usability and safety activation, not to establish a "ground truth" in the AI/ML sense.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set:

Not applicable in the context of a physical device's performance testing. The simulated use study reported that "All participants were able to read and activate the catheter safety feature without further explanation or training." This implies a very high level of consistent success, not requiring an adjudication method.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:

Not applicable, as this is not an AI/ML device.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

Not applicable, as this is not an AI/ML device. The "simulated use study" evaluates the human-device interaction, confirming the safety feature's activation.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):

For the safety function, the "ground truth" is the successful activation of the sharps injury prevention feature and prevention of needle stick injuries during simulated use. This is determined by observation of the device's physical function and user interaction. For other performance tests, the "ground truth" is the established engineering and materials standards (ISO standards and internal standards) for the properties being measured.

8. The sample size for the training set:

Not applicable, as this is not an AI/ML device that requires a training set.

9. How the ground truth for the training set was established:

Not applicable, as this is not an AI/ML device.

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K123267

Terumo Corporation TERUMO® SURFLASH® Plus Safety I.V. Catheter 510k II. 510(k) Summary

510(k) SUMMARY

NOV 2 2012

Prepared by Sandi Hartka Manager Regulatory Affairs Terumo Medical Corporation Tel. 410 392-7243 Fax 410 398 6079

Date prepared : September 11, 2012

Prepared for : Owner/Operator

TERUMO CORP. 44-1, 2-Chome, Hatagaya Shibuya-Ku, Tokyo, JAPAN 151-0072 Registration Number: 8010026

Manufacturer and Sterilization Facility

KOFU FACTORY OF TERUMO CORP. 1727-1, Tsuijiarai, Showa-Cho Nakakoma-Gun, Yamanashi, JAPAN 409-3853 Registration Number: 9681835

Contact Person

SANDI HARTKA Regulatory Affairs Manager TERUMO MEDICAL CORP. 950 Elkton, Blvd. Elkton, MD 21921 Phone: 410 3927243 Ext Fax: 410 3986079 Sandi.hartka@terumomedical.com

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erumo Corporation RUMO® SURFLASH® Plus Safety I.V. Catheter 510k II. 510(k) Summary

A. DEVICE NAME

Proprietary Name

SURFLASH® Plus Safety I.V. Catheter

Classification Name

Intravascular Catheter

Intravascular Catheter (880.5200) Product Code: FOZ Panel: General Hospital Classification: Class II

Common Name

Intravascular catheter with needle protection device

B. INTENDED USE

The SURFLASH® Plus Safety I.V. Catheter is inserted into the patient's vascular system for short term use (<30 days) to withdraw blood samples, administer fluid intravenously, or monitor blood pressure by attaching a monitoring line. The needle shaft cover and tip shield feature aids in the prevention of needle stick injuries. These catheters may be used for any patient population with consideration given to adequacy of vascular anatomy and appropriateness for the solution being infused and duration of therapy. The 18 to 22 gauge catheters are suitable for use with power injectors rated for a maximum of 325 psi.

C. DEVICE DESCRIPTION (SUMMARY OF TECHNOLOGICAL CHARACTERISTICS)

Principle of Operation/Technology

The SURFLASH® Plus Safety I.V. Catheter is manually operated and contains a passive safety feature that automatically activates as the needle is withdrawn from the catheter.

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Terumo Corporation TERUMO® SURFLASH® Plus Safety I.V. Catheter 510k II. 510(k) Summary

Design / Construction

The SURFLASH® Plus Safety I.V. Catheter are devices consisting of catheter assembly (catheter, caulking pin and catheter hub containing valve, seal component and plug), needle assembly (needle, needle housing, transparent flash chamber with filter and needle protector) and a passive needle-shielding mechanism (shutter and needle shaft cover consisting of inner cylinder, outer cylinder, junction cylinder).

The SURFLASH® Plus Safety I.V. Catheter has a valve and a seal component inside the catheter hub to minimize the possibility of blood leakage at catheter hub after needle removal. The catheter hub is also provided with a plug inside which penetrates the valve to create a fluid path when a connector is inserted in the catheter hub. The fluid path is permanently opened once a secure luer connection is made.

The devices are an over-the needle, peripheral catheter made of a slender, flexible, radio-opaque plastic with a hub that is inserted into the patient's vascular system for short term (<30 days) use to withdraw blood samples, administer fluids intravenously, or monitor blood pressure by attaching a monitoring line.

Whole length cannula including the sharp end of the inner needle is covered by the needle shielding mechanism as the needle is withdrawn from catheter's hub to aid in the prevention of needle stick injuries.

The grooved cannula which allows the clinician to visualize flashback detection through the groove indicating that there is confirmation of vessel entry is the same as the TERUMO® Surshield® PUR Safety I.V. Catheter (K100282) and TERUMO® SURFLASH® I.V. Catheter (K991406).

Material

The stainless steel cannula is placed in the catheter to maintain rigidity and is withdrawn after the catheter is placed in the vascular system.

The catheter that is advanced into the vessel is made of polyurethane which is the same as the TERUMO® Surshield®-PUR Safety I.V. Catheter (K100282) and TERUMO® SURFLASH® I.V. Catheter (K991406).

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Specifications

The SURFLASH® Plus Safety I.V. Catheter are available in 6 sizes with combination of 18, 20, 22 and 24 gauge catheters diameters and 19, 25 and 32 mm catheters length.

D. NON-CLINICAL TESTS

Performance testing was conducted to ensure the safety and effectiveness of the SURFLASH® Plus Safety I.V. Catheter throughout the shelf life, to verify conformity to the applicable part of ISO standards and demonstrate substantial equivalence to the predicate devices as mentioned in the table on next pages.

No new issues of safety and effectiveness were raised with the testing performed. Performance testing demonstrates that the SURFLASH® Plus Safety 1.V. Catheter conforms to the recognized consensus ISO standards, is substantially equivalent to the predicate devices and acceptable for clinical use throughout the shelf life.

A simulated use study was conducted in accordance with FDA's Guidance For Industry and Staff, Medical Devices with Sharps Injury Prevention Features issued on August 9. 2005. The objectives of this study were designed to confirm that study participants are able to read and follow the Instructions for Use to safely and effectively operate the safety feature of the device. The objectives were:

    1. Verify that proper activation of the sharps injury prevention feature of the device can be accomplished in simulated clinical environments by healthcare workers who use these types of safety I.V. catheters.
    1. Determine if the Instructions for Use are adequate for proper activation of the sharps injury prevention feature.

All safety features activated effectively and there were no de-activations after discarding. All participants were able to read and activate the catheter safety feature without further explanation or training. No adverse events occurred.

Conclusion: The safety feature of the device operates safely and effectively as intended. Users with various levels of experience can read the IFU and operate the device safely and effectively.

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Terumo Corporation TERUMO® SURFLASH® Plus Safety I.V. Catheter Response to Comments dated September 20, 2012

Attachment 2

Performance testTesting
Compliance to ISO
ISO 10555-1ISO 10555-5ISO 23908Testing byinternalstandard
Force to needle breaking shutter (Puncture resistance of needleshield)Not requiredNot requiredXRequired bySO
Tensile strength of needle shaft and needle housing (Breakstrength of safety mechanism)Not requiredNot requiredXRequired byISO
Force to release shutter and reactive force when the shutteropens to cover the cannula tip (Reaction force generated by theactivation mechanism)Not requiredNot requiredNot requiredX
Force to detach needle shaft cover from catheter hub (Force toactivate safety feature)Not requiredNot requiredXRequired byISO
Simulated maximum pressureNot requiredNot requiredNot requiredX
Burst pressure ( whole device)XNot requiredNot requiredRequired byISO
Collapse (under negative pressure)XNot requiredNot requiredRequired byISO
Catheter to catheter hub tensile strength (Force at break ofcatheter / hub)XNot requiredNot requiredRequired byISO
Strength of union between transparent flash chamber (needleconnecting part) and needleNot requiredXNot requiredRequired byISO
Needle attachment to catheter (Initial sliding friction)Not requiredNot requiredNot requiredX
Detection of flashback at catheter tipNot requiredNot requiredNot requiredX
Detection of flashback at transparent flash chamber (needleconnecting part)Not requiredXNot requiredRequired byISO
Flow rateNot requiredXNot requiredRequired byISO
Vent fittingNot requiredXNot requiredRequired byISO
Protector attachment (Drop test)Not requiredNot requiredNot requiredX
Conical fittings of catheter hubXNot requiredNot requiredRequired byISO
Pressure monitoringNot requiredNot requiredNot requiredX
Blood leakage at catheter hubNot requiredNot requiredNot requiredX
Measurement of valve penetration resistance to catheter hubNot requiredNot requiredNot requiredX
Simulated use studyNot requiredNot requiredXRequired byISO
Corrosion resistanceXNot requiredNot requiredRequired byISO
Catheter body tensile strength (Force at break)XNot requiredNot requiredRequired byISO
StiffnessNot requiredNot requiredNot requiredX
ElongationNot requiredNot requiredNot requiredX
Flexural fatigue toleranceNot requiredNot requiredNot requiredX
Radio-detectatbilityNot requiredXNot requiredRequired byISO
SurfaceXNot requiredNot requiredRequired byISO
Catheter unitNot requiredXNot requiredRequired byISO
Needle pointNot requiredXNot requiredRequired byISO

X: Confirmed the conformance to the standard.

. "

Image /page/4/Picture/4 description: The image shows the numbers 00015 written on top of 00000. The numbers are handwritten and appear to be written with a thick marker. The numbers are aligned vertically, with the ones place aligned on the right.

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The SURFLASH® Plus Safety I.V Catheter is classified as

-Catheter and lubricant: Externally Communicating Device, Circulating Blood, Prolonged Exposure (24hrs - 30 days).

-All other materials contacting with patient's body: Externally Communicating Devices, Blood path indirect, Prolonged Exposure (24 hrs to 30 days)

As mentioned below table, the device's materials contacting with patient's body 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 and Testing." Screening tests were performed on accelerated aged whole devices to show that the biocompatibility is maintained throughout the shelf life of the product. Results of the testing demonstrate that the materials contacting with patient's body are biocompatible throughout the shelf life of the product.

Test
Cytotoxicity
Sensitization
Intracutaneous reactivity
Systemic toxicity (acute)
Pyrogen
Genotoxicity
Implantation / Subchronic toxicity
Hemolysis
Physicochemical
Characterization

E. ADDITIONAL SAFETY INFORMATION

The sterility of the device is assured using a sterilization method validated in accordance with Method C: Half-cycle method in Annex B of ANSI/AAMI/ISO 11135: Sterilization of health care products -- ethylene oxide. The product is sterilized to provide a Sterility Assurance Level (SAL) of 10°.

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F. SUBSTANTIAL EQUIVALENCE

The SURFLASH® Plus Safety I.V. Catheter manufactured by Terumo Corporation is substantially equivalent to:

    1. K100282 TERUMO® Surshield®-PUR Safety I.V. Catheter (Terumo Corporation)
  • TERUMO® SURFLASH® I.V. Catheter (Terumo Corporation) 2. K991406
  • BD Insyte Autoguard BC shielded I.V. Catheter (Becton Dickinson) 3. K110443
  • BD Insyte TM Autoguard TM shielded I.V. Catheter (Becton Dickinson) 4. K971339
  • Saf-T-Intima Closed IV Catheter System (Becton Dickinson) 4. K923702

Comparison of the intended use/indication for use statements and technological characteristics are summarized in the following pages.

The minor differences of intended use and the technological differences do not impact the safety and effectiveness of the device in clinical settings.

G. CONCLUSION

The SURFLASH® Plus Safety I.V. Catheter is substantially equivalent to the predicate devices in intended use and technological characteristics.

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Terumo Corporation
TERUMO® SURFLASH® Plus Safety I.V. Catheter 5
II. 510(k) Summary

omparison of Intended Use/Indications for Use statements
SURFLASH® Plus Safety I.V. Cather intentions for use statements are different from those of the predicate devices as below.

FLASH®Plusafety I.V.eter (subjectis 510k)TERUMO®Surshield®-PUR Safety I.V.CatheterTERUMO®SURFLASH®I.V. CatheterK991406BD InsyteAutoguard BCshielded I.V.CatheterK110443BD InsyteAutoguardshieldedI.V.CatheterK971339BD Saf-T-IntimaClosed I.V.Catheter SystemK923702
K100282Is a device consisting of aslender, flexible,radiopaque, plasticcatheter with hub.The stainless steel cannula,placed in the catheter tomaintain rigidity,is withdrawn after thecatheter is placed in thevascular system.The deviceconsists of aslender, flexible,radiopaque, plasticcatheter with ahub... (see belowsection)The steel needle(stylet) placed inthe catheter tomaintain rigidity iswithdrawn after
SummarySectionSURFLASH®PlusSafety I.V.Catheter (subjectof this 510k)TERUMO®Surshield®-PUR Safety I.V.CatheterK100282TERUMO®SURFLASH®I.V. CatheterK991406BD InsyteAutoguard BCshielded I.V.CatheterK110443BD InsyteAutoguardshieldedI.V.CatheterK971339BD Saf-T-IntimaClosed I.V.Catheter SystemK923702
IIInserted intopatient's vascularsystem for shortterm use (<30days) to withdrawblood samples,administer fluidintravenously, ormonitor bloodpressure byattaching amonitoring deviceInserted into thepatient's vascularsystem for shortterm use (<30days) towithdraw bloodsamples,administer fluidintravenously, ormonitor bloodpressure byattaching amonitoring line.The plastic catheter isinserted into the patient'svascular system for shortterm use to withdrawsamples, administer fluidintravenously or throughwhich to place monitoringequipment such as pressuremonitors.The BD InsyteAutoguard BCcatheter isinserted into apatient'svascular systemto sample blood,monitor bloodpressure, oradministerfluids.As indicated in21CFR 870.1200,to sample blood,to monitor bloodpressure, or tointroducesubstances intothe heart andvessels.the catheter isplaced in thevascular system...that is insertedinto the patient'svascular systemfor short-term useto sample blood,monitor bloodpressure, oradminister fluidsintravenously.
SectionSummarySURFLASH®PlusSafety I.V.Catheter (subjectof this 510k)TERUMO®Surshield®-PUR Safety I.V.CatheterK100282TERUMO®SURFLASH®I.V. CatheterK991406BD InsyteAutoguard BCshielded I.V.CatheterK110443BD InsyteAutoguardshieldedI.V.CatheterK971339the classification thatapplies to the proposeddevice and the predicatedevices in this subject510k.BD Saf-T-IntimaClosed I.V.Catheter SystemK923702
The needle shaftcover & tip shieldfeature aids in theprevention ofneedle stickinjuriesThe needle shieldfeature aids in theprevention ofneedle stickinjuries.
These cathetersmay be used forany patientpopulation withconsideration giveThese cathetersmay be used forany patientpopulation withconsiderationThese cathetersmay be used forany patientpopulation withconsideration give
AI
ASH®PlusTERUMO®Surshield®(subject to 510k)TERUMO®-PUR Safety I.V.CatheterK100282TERUMO®SURFLASH®BD InsyteAutoguard BCshielded I.V.CatheterK110443BD InsyteAutoguardshieldedI.V.CatheterK971339BD Saf-T-IntimaClosed I.V.Catheter SystemK923702
given toadequacy ofanatomyto patient size,appropriatenessfor the solutionbeing infused, andduration oftherapy.
adequacy ofvascular anatomyandappropriatenessfor the solutionbeing infusedand duration oftherapy
The cathetersmaybe used withpower injectorsfor which themaximum ratedpressure is 300psi.
22 Garefor usepoweris rated formaximum of 325

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Terumo Corporation
TERUMO® SURFLASH® Plus Safety I.V. Catheter 51
II. 510(k) Summary

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Terumo Corporation
TERUMO® SURFLASH® Plus Safety I.V. Catheter 5100
11. 510(k) Summary________________________________________________________________________________________

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Terumo Corporation
TERUMO® SURFLASH® Plus Safety I.V. Catheter 516
II. 510(k) Summary

11:00 PM

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Discussion of Sections of the Intended Use/Indications for Use

I. Device Descriptive section (Full physical description of the device):

A full physical description of the device is not necessary for a discussion in the Intended Use/Indications for Use section. Omission of a physical description in the Intended Use/Indications for use of the proposed device subject of this 510k is not relevant to a comparison of the device's intended use/indication for use. Comparison of the physical description is presented in the comparison of technological characteristics of this 510k. The omission of a physical description in the Intended Use/Indication for use has no impact on the safety and effectiveness. The physical attributes of the proposed device have been tested and compared to the appropriate predicate that has the same/similar physical attribute.

II. Basic Device description and use as prescribed in 21CFR 880.5200

The proposed device and the predicate devices are classified under 21CFR880.5200 which states:

" 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 davs) 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. "

The proposed device and the predicate devices use a similar statement (underlined portion) regarding the actual use of the device.

Note: BD Insyte Autoguard states in the 510k that the device is classified under 21CFR 870.1200, however, FDA has classified this 510k (K971339) under 21CFR880.5200 which is identical to the proposed device subject of this 510k and the predicate devices.

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III. Description of Sharps Injury Protection

Terumo has included the description of the sharps injury protection feature in the Intended Use/Indications for Use statement for the proposed device and for one predicate device (TERUMO® Surshield®-PUR Safety I.V. Catheter (K100282). Although three of the other predicate devices (K110443, K971339 & K923702) contain a sharps injury protection feature, the manufacturers have not included this description in their Intended Use/Indication for Use statement of their cleared 510k (this feature is discussed in the Technological Characteristics section). Even though the descriptive statement does not appear in the Intended Use/Indication for Use for those predicates, the feature is cleared under the respective 510ks.

Note: The predicate cleared under K991406 does not include a sharps injury protection feature as discussed in the Technological Characteristics section and, therefore, does not have this feature described herein.

IV. Discussion of usage in populations

The proposed device and two of the predicate devices (K100282 and K971339) clarify that these devices may be used in any population based on medical judgment. There is no restriction placed on the use of devices in any specific population and no specific indication of use in a specific population, but rather the statement indicates these devices can be used wherever medical judgment deems appropriate. These devices are general medical use devices and can be used in any population deemed acceptable by a medical professional. These devices are "Rx only."

These clarifying statements have no impact on the general use of the products and do not affect the safety or effectiveness nor the determination of substantial equivalence.

V. Use with Power Injectors

The proposed device and one of the predicate devices (K971339) include an indication for use with Power Injectors. The other three predicate devices do not include this indication. Appropriate testing has been included in this 510k to address the new issues of safety and effectiveness raised by this indication. The test results demonstrate the substantial equivalence of this indication with the product covered under K971339. This indication in

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Terumo Corporation TERUMO® SURFLASH® Plus Safety I.V. Catheter 510k II. 510(k) Summary

the 510(k) subject device has no impact on the other indications for use for which substantial equivalence is being claimed. This indication can effectively be reviewed separately regarding substantial equivalence.

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Terumo Corporation
TERUMO® SURFLASH® Plus Safety 1.V. Catheter 5 I
II. 510(k) Summary

It - Torinal Partier State Plan Safety I V. Catheter are similar to the predicate devices in terms of principle

Trade NameSubject of this 510(k)ManufacturerOperation principleDesign /ConstructionNeedle Shape/MaterialFlashbackII. 510(k) SummaryTrade NameSURFLASH® PlusSafety I.V.CatheterTERUMO®Surshield®-PURSafety I.V.CatheterTERUMO®SURFLASH®I.V. CatheterBD InsyteAutoguard BCshielded I.V.CatheterBD InsyteAutoguardshielded I.V.CatheterSaf-T-IntimaClosed IVCatheter System
SURFLASH® Plus Safety I.V. CatheterTerumo CorporationConduit as fluid pathway Operated manually.a. Catheter assemblyb. Needle assemblyc. Needle shield assemblyd. Filtere. Needle protectorf. Valveg. Seal componenth. PlugNotched cannula Stainless steelVisible throughSubject of this 510(k)Subject of this 510(k)K100282K991406K110443K971339K923702
TERUMO® Sursbield®-PUR Safety I.V. CatheterK100282Terumo CorporationConduit as fluid pathway Operated manually.a. Catheter assemblyb. Needle assemblyc. Needle shield assemblyd. Filter cap with filtere. ProtectorNotched cannula Stainless steelVisible throughCatheter materialditch on the cannula surface.PolyurethaneBiocompatibility of material confirmed.ditch on the cannula surface.PolyurethaneBiocompatibility of material confirmed.ditch on the cannula surface.PolyurethaneBiocompatibility of material confirmed.on the cannula surface.Polyurethaneon the cannula surface.Polyurethaneneedle lumen to tube.Polyurethane
TERUMO® SURFLASH® I.V. CatheterK991406Terumo CorporationConduit as fluid pathway Operated manually.a. Catheter assemblyb. Needle assemblyc. Filter cap with filterd. ProtectorNotched cannula. Stainless steelVisible throughRadiopaque mediumYes (Barium sulfate)Yes (Barium sulfate)Yes (Barium sulfate)Yes (material not identified)Yes (material not identified)Yes (material not identified)
BD Insyte Autoguard BC shielded I.V. CatheterK110443Becton DickinsonConduit as fluid pathway Operated manually.a. Catheter assemblyb. Needle assemblyc. Needle shield assemblyd. Filtere. Needle protectorf. Valve (called Septum)g. plug*Holed cannula. Stainless steelVisible through holeSafety mechanismPassive needle shieldingPassive needle shieldingNonePassively needle shieldingPassively needle shieldingPassive needle shielding
BD Insyte Autoguard shielded I.V. CatheterK971339Becton DickinsonConduit as fluid pathway Operated manually.a. Catheter assemblyb. Needle assemblyc. Needle shield assemblyd. Filtere. Needle protectorHoled cannula. Stainless steelVisible through holeValveYES to reduce the blood leakage at catheter hub in view of blood exposure riskNoNoYES to reduce the blood leakage at catheter hub in view of blood exposure riskNoNo
Saf-T-Intima Closed IV Catheter SystemK923702Becton DickinsonConduit as fluid pathway Operated manuallya. Catheter assembly with tube and I or Y adaptorb. Needle assemblyc. Needle shieldd. Filter cap with air filtere. Needle coverf. IV access portg. Wings available Notched cannula.Stainless steelVisible throughColor code of catheter hubIn accordance with ISO 10555-5In accordance with ISO 10555-5In accordance with ISO 10555-5In accordance with ISO 10555-5In accordance with ISO 10555-5In accordance with ISO 10555-5
PackageSterility barrier:Blister packageUnit boxCardboardSterility barrier:CasingUnit boxCardboardSterility barrier:CasingUnit boxCardboardSterility barrier:Blister packageSterility barrier:Blister packageSterility barrier:Blister Package
Sterilization methodEthylene oxideEthylene oxideEthylene oxideEthylene oxideEthylene oxideEthylene oxide

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Terumo Corporation
TERUMO® SURFLASH® Plus Safety I.V. Catheter 510
L. 510/k) Summary

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Terumo Corporation
TERUMO® SURFLASH® Plus Safety I.V. Catheter 5
II. 510(k) Summary
II. 510(k) Summary
Conclusion

SURFLASH® Plus Safety I.V. Catheter and the predicate devices have the same Technological Characteristics excep

  • e predicate cleared under K991406 does not include a sharps injury protection teature as mentioned in the above table.
    ne predicates cleared under K100282, K991406, K971339

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/17/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features the department's name arranged in a circular fashion around a symbol. The symbol is a stylized representation of a person embracing or supporting another, conveying a sense of care and assistance. The overall design is simple and professional, reflecting the department's role in public health and human services.

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-002

Kofu Factory of Terumo Corporation C/O Terumo Medical Corporation Ms. Sandi Hartka Regulatory Affairs Manager 950 Elkton Boulevard Elkton, Maryland 21921

November 2, 2012

Re: K123267

Trade/Device Name: SURFLASH® Plus Safety I.V. Catheter Regulation Number: 21 CFR 880.5200 Regulation Name: Intravascular Catheter Regulatory Class: II Product Code: FOZ Dated: October 18, 2012 Received: October 19, 2012

Dear Ms. Hartka:

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.

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Page 2 - Ms. Hartka

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/ucm1115809.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.

Digitally signed by Anthony D. Watson DN: c=US, o=U.S. Government, ou=HHS, ou=FDA, ou=People, cn=Anthony D. Watson, 0.9.2342.19200300.100.1.1=1300092402 Date: 2012.11.02 13:08:22 -04/00'

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 .

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Indications for Use Form

Indications for Use

510(k) Number (if known): _KIL 326 7

SURFLASH® Plus Safety I.V. Catheter Device Name:

Indications for Use:

The SURFLASH® Plus Safety I.V. Catheter is inserted into the patient's vascular system for short term use (<30 days) to withdraw blood samples, administer fluid intravenously; or monitor blood pressure by attaching a monitoring line. The needle shaft cover and tip shield feature aids in the prevention of needle stick injuries. These catheters may be used for any patient population with consideration given to adequacy of vascular anatomy and appropriateness for the solution being infused and duration of therapy. The 18 to 22 gauge catheters are suitable for use with power injectors rated for a maximum of 325 psi.

Prescription Use X (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 OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Khd. Chay 11/1/2012

(Division Sign-Off) (Division Sign-Off)
Division of Anesthesiology, General Hospital
Division of Anesthesiology, General Devices Division of Anest. Dental Devices

510(k) Number:

Page of

§ 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).