K Number
K131646
Device Name
DISPOSABLE INFUSION SET
Date Cleared
2013-11-26

(174 days)

Product Code
Regulation Number
880.5440
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
JT series Disposable infusion set is used to administer fluids from a container to a patient's vascular system through a needle or catheter inserted into the vein.
Device Description
The applicant device-JT series disposable infusion set is plastic, single-use, sterile disposable infusion device, which is intended to be used to administer fluids from a container to a patient's vascular system through a needle or catheter inserted into the vein. The protective cap is intended to protect the needle; The puncturing needle is made of Polyethylene and used to pierce the container; the catheter is made of Polyvinyl chloride and used to connect various components; the drip is transparent so that the user can observe the dropping condition of the medical solution, and it has a filtration mesh which can prevent the micro particle with diameter larger than 200 um to from entering human vessel; Flow regulator is used to adjust the flow rate from zero to maximum; Male conical fitting is used for connecting with vein needle for medical solution transfusion. The proposed device is provided sterilized.
More Information

No
The device description and performance studies focus on the physical components and standard testing of a disposable infusion set, with no mention of AI or ML capabilities.

No.
A therapeutic device is one that treats or prevents a disease or condition. This device is used to administer fluids, which is a supportive function, not a direct treatment or prevention.

No
The device is described as an infusion set used to administer fluids, which is a therapeutic function rather than a diagnostic one. It does not mention detection, monitoring, or analysis of disease or medical conditions.

No

The device description explicitly details physical components made of plastic, including a puncturing needle, catheter, drip chamber, flow regulator, and male conical fitting. This indicates a hardware-based medical device, not a software-only one.

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

Here's why:

  • Intended Use: The intended use is to "administer fluids from a container to a patient's vascular system through a needle or catheter inserted into the vein." This describes a device used for delivering substances into the body, not for testing samples from the body to diagnose or monitor a condition.
  • Device Description: The description details components like a puncturing needle, catheter, drip chamber, flow regulator, and male conical fitting. These are all components of a system for intravenous fluid administration. There is no mention of reagents, test strips, or any components used for analyzing biological samples.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting specific analytes (proteins, genes, pathogens, etc.)
    • Providing diagnostic or monitoring information based on test results.

In summary, the JT series Disposable infusion set is a medical device used for administering fluids intravenously, which falls under a different regulatory category than In Vitro Diagnostics.

N/A

Intended Use / Indications for Use

JT series Disposable infusion set is used to administer fluids from a container to a patient's vascular system through a needle or catheter inserted into the vein.

Product codes

FPA, LHI

Device Description

The applicant device-JT series disposable infusion set is plastic, single-use, sterile disposable infusion device, which is intended to be used to administer fluids from a container to a patient's vascular system through a needle or catheter inserted into the vein.
The protective cap is intended to protect the needle; The puncturing needle is made of Polyethylene and used to pierce the container; the catheter is made of Polyvinyl chloride and used to connect various components; the drip is transparent so that the user can observe the dropping condition of the medical solution, and it has a filtration mesh which can prevent the micro particle with diameter larger than 200 um to from entering human vessel; Flow regulator is used to adjust the flow rate from zero to maximum; Male conical fitting is used for connecting with vein needle for medical solution transfusion.
The proposed device is provided sterilized.

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

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

Summary of Non-Clinical Tests:
The Disposable infusion set and its applications comply with voluntary standards as detailed in Section 9, 11 and 17 of this premarket submission. The following quality assurance measures were applied to the development of the system:

  • . Risk Analysis
  • Requirements Reviews
  • . Design Reviews
  • o Testing on unit level (Module verification)
  • . Integration testing (System verification)
  • . Final acceptance testing (Validation)
  • . Performance testing (Verification)
  • . Safety testing (Verification)

Summary of Clinical Tests:
The subject of this premarket submission, Disposable infusion set, did not require clinical studies to support substantial equivalence.

Key Metrics

Not Found

Predicate Device(s)

K083687

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 880.5440 Intravascular administration set.

(a)
Identification. An intravascular administration set is a device used to administer fluids from a container to a patient's vascular system through a needle or catheter inserted into a vein. The device may include the needle or catheter, tubing, a flow regulator, a drip chamber, an infusion line filter, an I.V. set stopcock, fluid delivery tubing, connectors between parts of the set, a side tube with a cap to serve as an injection site, and a hollow spike to penetrate and connect the tubing to an I.V. bag or other infusion fluid container.(b)
Classification. Class II (special controls). The special control for pharmacy compounding systems within this classification is the FDA guidance document entitled “Class II Special Controls Guidance Document: Pharmacy Compounding Systems; Final Guidance for Industry and FDA Reviewers.” Pharmacy compounding systems classified within the intravascular administration set are exempt from the premarket notification procedures in subpart E of this part and subject to the limitations in § 880.9.

0

ﺮ ﺗﺮ

510(k) Summary

In accordance with 21 CFR 807.92 the following summary of information is provided:
Date:June 27, 2012
Submitter:Shanghai Jinta Medical Co., Ltd.
No. 18, Jianding Road, Fengjing Town, Jinshan District, Shanghai,
China
Primary Contact Person:Mike Gu
Regulatory Affairs Manager
Guangzhou Osmunda Medical Device Consulting Co., Ltd
Tel: +86-20-62321333
Fax: +86-20-86330253
Secondary Contact Person:Mr. Wang Changqing
Vice General Manager
Shanghai Jinta Medical Co., Ltd.
+86-21-67361700
NOV 2 6 2013
Device:
Trade Name:Disposable infusion set
Common/Usual Name:Disposable infusion set
Classification Names:Class II per Code of Federal Regulations,
Title 21, 880.5440, Intravascular Administration Sets
Product Code:FPA
Predicate Device(s):K083687
Device Description:The applicant device-JT series disposable infusion set is plastic,
single-use, sterile disposable infusion device, which is intended
to be used to administer fluids from a container to a patient's
vascular system through a needle or catheter inserted into the
vein.
The protective cap is intended to protect the needle; The
puncturing needle is made of Polyethylene and used to pierce
the container; the catheter is made of Polyvinyl chloride and
used to connect various components; the drip is transparent so
that the user can observe the dropping condition of the medical
solution, and it has a filtration mesh which can prevent the micro
particle with diameter larger than 200 um to from entering
human vessel; Flow regulator is used to adjust the flow rate from
zero to maximum; Male conical fitting is used for connecting
with vein needle for medical solution transfusion.
The proposed device is provided sterilized.
Intended Use:JT series Disposable infusion set is used to administer fluids from
a container to a patient's vascular system through a needle or
catheter inserted into the vein.

1

Technology:

Shanghai Jinta JT series Disposable infusion set is Constructed of high grade extruded Polyvinyl Chloride (PVC). The primary components of Jinta Disposable infusion set are manufactured to identical or similar specifications of the predicated devices listed above. The intended use, basic design, function and materials used are identical or similar to the predicated devices. The technical characteristic is substantially equivalent to the predicate devices. For details refer to the SE section in the application package.

Determination of Substantial Equivalence:

Summary of Non-Clinical Tests:

The Disposable infusion set and its applications comply with voluntary standards as detailed in Section 9, 11 and 17 of this premarket submission. The following quality assurance measures were applied to the development of the system:

  • . Risk Analysis
  • Requirements Reviews
  • . Design Reviews
  • o Testing on unit level (Module verification)
  • . Integration testing (System verification)
  • . Final acceptance testing (Validation)
  • . Performance testing (Verification)
  • . Safety testing (Verification)

Summary of Clinical Tests:

The subject of this premarket submission, Disposable infusion set, did not require clinical studies to support substantial equivalence.

  • Conclusion: Shanghai Jinta Medical Co., Ltd considers the JT series Disposable infusion set to be as safe, as effective, and performance is substantially equivalent to the predicate device(s).

2

Image /page/2/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 mission to protect the health of all Americans and provide essential human services. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the eagle.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Food and Drug Administration 0903 New Hampshire Avenue ocument Control Center - WO66-G609 Silver Spring MD 20993-0002

November 26, 2013

Shanghai Jinta Medical Company, Limited C/O Mike Gu Guangzhou Osmunda Medical Device Consulting Co., Ltd. Guangzhou, Guangdong CHINA 510420

Re: K131646

Trade/Device Name: Disposable Infusion Set, Models JT-DST1 and JT-DST2 Regulation Number: 21 CFR 880.5440 Regulation Name: Intravascular administration set Regulatory Class: Class II Product Code: LHI Dated: August 20, 2013 Received: August 30, 2013

Dear Mr. Gu:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food. Drug. and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

3

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/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/ReportalProblem/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,

for

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

Enclosure

4

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K 13 1646

Device Name

Disposable Infusion Set, Models JT-DST1 and JT-DST2

Indications for Use (Describe)

IT series Disposable infusion set is used to adminer to a patient's vascular system through a needle or catheter inserted into the vein.

Type of Use (Select one or both, as applicable)

[x] Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE – CONTINUE ON A SEPARATE PAGE IF NEEDED.

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Digitally signed by Richard C. Chapman Date: 2013.11.26 12:25:02 -05'00'

Form Approved: OMB No. 0910-0120 Expiration Date: December 31, 2013 See PRA Statement on last page.