K Number
K131300
Device Name
THE POWERWAND SAFETY INTRODUCER WITH AN EXTENDED DWELL CATHETER
Date Cleared
2013-06-07

(31 days)

Product Code
Regulation Number
870.1340
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The POWERWAND® Safety Introducer with an Extended Dwell Catheter is used to gain access to the vascular system to sample blood and administer fluids intravenously. May be used for power injection of contrast media at a rate of 5 ml/sec at up to 300 psi fluid pressure.
Device Description
The POWERWAND® Safety Introducer with an Extended Dwell Catheter is an all-in-one preassembled intravascular catheter introducer with intravascular catheter that consists of the following basic components: Introducer Needle, Nitinol Guidewire, Dilator and an Extended Dwell Catheter. It is intended to provide the clinician with a safe, simple and accelerated approach, using the Accelerated Seldinger Technique, to place an in-dwelling intravascular catheter through the skin into the circulatory system. The Extended Dwell Catheter allows for withdrawal of blood and the administration of fluids, including power injection of contrast media. The device also incorporates a mechanism that provides passive needle stick safety.
More Information

Not Found

No
The description focuses on the mechanical components and technique for vascular access, with no mention of AI/ML terms or functionalities.

No
The device is used to access the vascular system for sampling blood and administering fluids, which is a diagnostic and facilitative function, not a therapeutic one.

No

The device is used to gain access to the vascular system for blood sampling and fluid administration, including contrast media for power injection. It is an access device, not one that performs diagnostic analysis itself.

No

The device description clearly outlines physical components like an Introducer Needle, Nitinol Guidewire, Dilator, and an Extended Dwell Catheter, indicating it is a hardware device.

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

Here's why:

  • Intended Use: The intended use is to gain access to the vascular system for blood sampling and fluid administration, including power injection of contrast media. This is a direct interaction with the patient's circulatory system for therapeutic and diagnostic imaging purposes, not for testing samples in vitro (outside the body).
  • Device Description: The description details a catheter and introducer system designed for insertion into the body. This is consistent with an in-vivo medical device.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples in vitro, reagents, or any of the typical components or processes associated with in vitro diagnostics.

Therefore, the POWERWAND® Safety Introducer with an Extended Dwell Catheter is an in-vivo medical device, not an IVD.

N/A

Intended Use / Indications for Use

The POWERWAND® Safety Introducer with an Extended Dwell Catheter is used to gain access to the vascular system to sample blood and administer fluids intravenously. May be used for power injection of contrast media at a rate of 5 ml/sec at up to 300 psi fluid pressure.

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

DYB

Device Description

The POWERWAND® Safety Introducer with an Extended Dwell Catheter is an all-in-one preassembled intravascular catheter introducer with intravascular catheter that consists of the following basic components: Introducer Needle, Nitinol Guidewire, Dilator and an Extended Dwell Catheter. It is intended to provide the clinician with a safe, simple and accelerated approach, using the Accelerated Seldinger Technique, to place an in-dwelling intravascular catheter through the skin into the circulatory system. The Extended Dwell Catheter allows for withdrawal of blood and the administration of fluids, including power injection of contrast media. The device also incorporates a mechanism that provides passive needle stick safety.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

vascular system

Indicated Patient Age Range

Not Found

Intended User / Care Setting

clinician / 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 was conducted to demonstrate that the performance characteristics of the modified POWERWAND® Safety Introducer with an Extended Dwell Catheter (Makrolon Model) is equivalent to the predicate device and satisfy the requirements of the product design specification for its intended use.

The testing conducted for the POWERWAND® with IV Catheter with Makrolon® Hub is shown in Table 11.1.

Table 11.1: Prospective Testing of the POWERWAND®
Component: IV Catheter with Makrolon® Luer Hub
Testing: Biocompatibility testing in accordance with ISO 10993-1:2009

Component: IV Catheter with Makrolon® Luer Hub -- Standard Performance Testing
Testing:
• Tensile Strength
• Burst Pressure
• Hub Gauging
• Leakage Test - Liquid
• Leakage Test - Air
• Air Leakage during Aspiration
• Hub Separation Force
• Hub Unscrewing Force
• Hub Ease of Assembly
• Hub Resistance to Overriding
• Hub Stress Cracking
• Strain Relief Cover Tensile Test
• Strain Relief Cover Flex Test

Component: IV Catheter with Makrolon® Luer Hub - Testing after Pre-Conditioning
Testing:
• Visual Inspection
• Burst Pressure

Component: Introducer System
Testing:
• Dilator Hub to Catheter Hub Removal Torque
• Dilator Hub to Catheter Hub Separation Force

The results of testing demonstrate that the modified POWERWAND® Safety Introducer with an Extended Dwell Catheter (IV Catheter with Makrolon® Luer Hub) is substantially equivalent to the predicate device in design, function, and indications for use.

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.

K111417, K121748

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

§ 870.1340 Catheter introducer.

(a)
Identification. A catheter introducer is a sheath used to facilitate placing a catheter through the skin into a vein or artery.(b)
Classification. Class II (performance standards).

0

510(K) SUMMARY

11.1 SUBMITTER INFORMATION

JUN 0 7 2013

A.Company Name:Access Scientific, LLC.
B.Company Address:3910 Sorrento Valley Boulevard, Suite 200
San Diego, CA 92121
C.Company Phone:(858) 259-8333
D.Company Facsimile:(858) 259-5298
E.Contact Person:Albert Misajon
Chief Compliance Officer
amisajon@the-wand.com
F.Date Summary Prepared:May 6, 2013
11.2 DEVICE IDENTIFICATION
A.Device Trade Name:the POWERWAND® Safety Introducer with ar
Extended Dwell Catheter
B.Common Name:Catheter Introducer
Intravascular Catheter, Therapeutic, Short-term
C.Classification Name(s):Introducer, Catheter
D.Classification Regulation(s):21 CFR 870.1340
E.Device Class:Class II
F.Product Code:DYB
G.Advisory Panel:Cardiovascular

11.3 IDENTIFICATION OF PREDICATE DEVICE

The predicate device is the POWERWAND® Safety Introducer with an Extended Dwell Catheter (5 Fr Models) cleared for commercial distribution under Premarket Notification Numbers K111417 and K121748.

11.4 DEVICE DESCRIPTION

The POWERWAND® Safety Introducer with an Extended Dwell Catheter is an all-in-one preassembled intravascular catheter introducer with intravascular catheter that consists of the following basic components: Introducer Needle, Nitinol Guidewire, Dilator and an Extended Dwell Catheter. It is intended to provide the clinician with a safe, simple and accelerated approach, using the Accelerated Seldinger Technique, to place an in-dwelling intravascular catheter through the skin into the circulatory system. The Extended Dwell Catheter allows for withdrawal of blood and the administration of fluids, including power injection of

1

contrast media. The device also incorporates a mechanism that provides passive needle stick safety.

11.5 INDICATIONS FOR USE

The POWERWAND® Safety Introducer with an Extended Dwell Catheter is used to gain access to the vascular system to sample blood and administer fluids intravenously. May be used for power injection of contrast media at a rate of 5 ml/sec at up to 300 psi fluid pressure.

11.6 TECHNOLOGICAL CHARACTERISTICS

The proposed modified device has the same technological characteristics as the predicate device in terms of components, materials, chemical composition, and design. The changes to the device impact the material of the female Luer hub on the IV Catheter, which has been changed from Pellathane® (polyurethane) to Makrolon® (polycarbonate). Performance testing has been conducted to confirm that the modified device satisfies performance requirements.

11.7 SUMMARY OF TESTING

Design verification testing was conducted to demonstrate that the performance characteristics of the modified POWERWAND® Safety Introducer with an Extended Dwell Catheter (Makrolon Model) is equivalent to the predicate device and satisfy the requirements of the product design specification for its intended use.

The testing conducted for the POWERWAND® with IV Catheter with Makrolon® Hub is shown in Table 11.1.

2

ComponentTesting
IV Catheter with
Makrolon® Luer HubBiocompatibility testing in accordance
with ISO 10993-1:2009
IV Catheter with
Makrolon® Luer Hub --
Standard Performance
Testing• Tensile Strength
• Burst Pressure
• Hub Gauging
• Leakage Test - Liquid
• Leakage Test - Air
• Air Leakage during Aspiration
• Hub Separation Force
• Hub Unscrewing Force
• Hub Ease of Assembly
• Hub Resistance to Overriding
• Hub Stress Cracking
• Strain Relief Cover Tensile Test
• Strain Relief Cover Flex Test
IV Catheter with
Makrolon® Luer Hub -
Testing after
Pre-Conditioning• Visual Inspection
• Burst Pressure
Introducer System• Dilator Hub to Catheter Hub Removal
Torque
• Dilator Hub to Catheter Hub Separation
Force

TABLE 11.1: PROSPECTIVE TESTING OF THE POWERWAND®

11.8 CONCLUSIONS DRAWN FROM STUDIES

The results of testing demonstrate that the modified POWERWAND® Safety Introducer with an Extended Dwell Catheter (IV Catheter with Makrolon® Luer Hub) is substanially equivalent to the predicate device in design, function, and indications for use.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle or bird symbol with three wing-like shapes. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES-USA" is arranged in a circular fashion around the bird symbol.

Public Health Service

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

June 7, 2013

Access Scientific, LLC C/O Albert Misajon 3910 Sorrento Valley Blvd Ste 200 San Diego, CA 92121 US

Re: K131300

Trade/Device Name: POWERWAND® Safety Introducer with an Extended Dwell Catheter Regulation Number: 21 CFR 870.1340 Regulation Name: Catheter Introducer Intravascular Catheter, Therapeutic, Short-Term Regulatory Class: Class II Product Code: DYB Dated: May 8, 2013 Received: May 9, 2013

Dear Mr. Misajon:

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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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 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/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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,

Matthew G. Hillebrenner

for
Bram D. Zuckerman, Ph.D.
Director
Division of Cardiovascular Devices
Office of Device Evaluation
Center for Devices and
Radiological Health

Enclosure

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INDICATIONS FOR USE

510(k) Number (if known): K131300

Device Name:

the POWERWAND® Safety Introducer with an Extended Dwell Catheter

Indications for Use:

The POWERWAND® Safety Introducer with an Extended Dwell Catheter is used to gain access to the vascular system to sample blood and administer fluids intravenously. May be used for power injection of contrast media at a rate of 5 ml/sec at up to 300 psi fluid pressure.

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

Over-The-Counter Use (21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Matthew GJWillebrenner