K Number
K132321
Device Name
JMS SYRINGE
Date Cleared
2014-02-20

(210 days)

Product Code
Regulation Number
880.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
JMS Syringe is intended to be used to inject fluids into or withdraw fluids out of the body.
Device Description
JMS syringe is a single use standard piston syringe without hypodermic needle, which consists of a calibrated hollow barrel and a movable plunger with a male Luer lock or Luer slip connector on the tip of barrel.
More Information

Not Found

No
The document describes a standard mechanical syringe and explicitly states "Not Found" for mentions of AI, DNN, or ML.

No.
The device is used for fluid delivery and withdrawal, which are supportive functions, not direct therapeutic treatments.

No

The provided information states that the JMS Syringe is intended for injecting or withdrawing fluids from the body. It does not mention any function related to diagnosing a condition or disease, but rather for general medical procedures.

No

The device description clearly states it is a "single use standard piston syringe without hypodermic needle," which is a physical 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 inject fluids into or withdraw fluids out of the body." This describes a direct interaction with the patient's body for therapeutic or diagnostic purposes within the body, not for testing samples outside the body.
  • Device Description: The description details a standard syringe for fluid handling in a clinical setting. It doesn't mention any components or functions related to analyzing biological samples.
  • Lack of IVD Indicators: There is no mention of:
    • Analyzing biological samples (blood, urine, tissue, etc.).
    • Detecting or measuring substances in biological samples.
    • Providing information for diagnosis, monitoring, or treatment based on sample analysis.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information about a person's health. This syringe's function is purely for the physical transfer of fluids into or out of the body.

N/A

Intended Use / Indications for Use

JMS Syringe is intended to be used to inject fluids into or withdraw fluids out of the body.

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

FMF

Device Description

JMS syringe is a single use standard piston syringe without hypodermic needle, which consists of a calibrated hollow barrel and a movable plunger with a male Luer lock or Luer slip connector on the tip of barrel.

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

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)

Non-Clinical Performance Data:

  • Test: Physical requirements (cleanliness) - Pass
  • Test: Chemical requirements (Limits for acidity or alkalinity) - Pass
  • Test: Chemical requirements (Limits for extractable metals) - Pass
  • Test: Lubrication (Amount of lubrication) - Pass
  • Test: Tolerance of the nominal capacity (Tolerance on graduated capacity) - Pass
  • Test: Piston/plunger assembly (Design) - Pass
  • Test: Nozzle (Nozzle Lumen) - Pass
  • Test: Performance (Dead space) - Pass
  • Test: Performance (Freedom from air and liquid leakage past piston (positive pressure)) - Pass
  • Test: Performance (Freedom from air and liquid leakage past piston (negative pressure)) - Pass
  • Key Results: All tests showed acceptable results.

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.

K991904

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

§ 880.5860 Piston syringe.

(a)
Identification. A piston syringe is a device intended for medical purposes that consists of a calibrated hollow barrel and a movable plunger. At one end of the barrel there is a male connector (nozzle) for fitting the female connector (hub) of a hypodermic single lumen needle. The device is used to inject fluids into, or withdraw fluids from, the body.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/1 description: The image shows the logo for JMS North America Corporation. The logo features the letters "JMS" in a bold, stylized font, with horizontal lines running through the letters. Below the letters, the words "North America Corporation" are written in a smaller, serif font.

MAIN OFFICE 2320 Foothill Blvd. Suite 350 avward. CA 944 el. (510) 888-9090 Fax (510) 888-9099

SALES OFFICE 480 Sawgrass Corp. Pkwy. Sulte 120 Sunrise, FL 33325 Tel. (954) 689-9280 Fax (954) 689-9289

Section 05: 510(k) Summary [807.92(c)]

Owner [807.92(a)1]:

Company Name:JMS North America Corp.
Company Address:22320 Foothill Blvd., Suite 350
Hayward, CA 94541
Telephone:510-888-9090
Fax:510-888-9099
Contact Person:Sho Hosoki
Summary Preparation Date:09/01/2013

Device of Submission [807.92(a)(2)]

Classification Name:Piston Syringe
Common/Usual Name:Piston Syringe
Proprietary Name:JMS Syringe
Classification:Class II
Product Code:FMF
Code of Federal Regulations:21 CFR 880.5860

Predicate Device [807.92(a)(3)]

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Device Description [807.92(a)(4)}

JMS syringe is a single use standard piston syringe without hypodermic needle, which consists of a calibrated hollow barrel and a movable plunger with a male Luer lock or Luer slip connector on the tip of barrel.

Intended Use [807.92(a)(5)]

JMS Syringe is intended to be used to inject fluids into or withdraw fluids out of the body.

Predicate of this device includes intended use of JMS needle and JMS syringe. This submission only covers JMS syringe so the intended use portion which describes JMS needle has been excluded.

FEB 2 0 2014

1

Image /page/1/Picture/0 description: The image shows the logo for JMS North America Corporation. The logo features the letters "JMS" in a bold, stylized font, with horizontal lines running through the letters. Below the letters, the words "North America Corporation" are written in a smaller, simpler font.

MAIN OFFICE 22320 Foothill Blvd. Suite 350 Hayward, CA 94541 Tel. (510) 888-9090 Fax (510) 888-9099

SALES OFFICE 480 Sawgrass Corp. Pkwy. Suite 120 Sunrise, FL 33325 Tel. (954) 689-9280 Fax (954) 689-9289

Modified DevicePredicate
Device NameJMS SyringeModification of JMS Needle and Syringe
510(k) #---K991904
ClassificationClass IIClass II
Intended UseJMS Syringe is intended to be used to inject fluids into or withdraw fluids out of the body.JMS Needle is intended to be used for infusion of drug, collecting solution or blood. Insert the Needle to patient's body and use it as a fluid pathway which connects inside and outside of the body. JMS Syringe is intended to be used for infusion of solution or collecting blood connecting JMS Needle. It is also used for continuous drug infusion put in Syringe Pump. JMS Needle and JMS Syringe must be discarded after one time use.
MaterialSee Section 15 for material comparison
Used materials are the same, but some have different gradesSee Section 15 for material comparison
Used materials are the same, but some have different grades
Syringe tip typeLuer Slip/Luer LockLuer Slip/Luer Lock
Syringe Volume30, 50, 100mL1, 2, 2.5, 5, 10, 20, 30, 50, 100mL
Nozzle TypeCenter/ SideCenter/ Side
Graduation LegibilityLegibleLegible
Movability (KPa)30, 50 100mL : Less than 9830, 50 100mL : Less than 98
Leakage (KPa)30, 50 100mL: More than 19630, 50 100mL: More than 200
Dead Space30mL: Less than 0.17mL
50mL: Less than 0.20mL
100mL: Less than 0.20mL30mL: Less than 0.17mL
50mL: Less than 0.20mL
100mL: Less than 0.20mL
LabelingSee Section 13 for LabelingSee Section 13 for Labeling
SterilizationE-beam sterilizationy-sterilization

Predicate Comparison [807:92(a)(6)]

The submitted device is equivalent to the predicate device. It has same technological characteristics as a syringe. The only difference is the method of sterilization and material grade in which respective section of this submission show equivalency to predicate.

2

Image /page/2/Picture/0 description: The image shows the logo for JMS North America Corporation. The logo consists of the letters "JMS" in a bold, stylized font, with horizontal lines running through the letters. Below the letters, the words "North America Corporation" are written in a smaller, serif font. The logo is black and white.

MAIN OFFICE 22320 Foothill Blvd. Sulte 350 Hayward, CA 94541 Tel. (510) 888-9090 Fax (510) 888-9099

SALES OFFICE 480 Sawgrass Corp. Pkwy. Sulte 120 Sunrise, FL 33325 Tel. (954) 689-9280 Fax (954) 689-9289

Non-Clinical Performance Data [807.92(b)(1)]

TestPass or Fail
Physical requirementscleanlinessPass
Chemical requirementsLimits for acidity or alkalinityPass
Limits for extractable metalsPass
LubricationAmount of lubricationPass
Tolerance of the nominal capacityTolerance on graduated capacityPass
Piston/plunger assemblyDesignPass
NozzleNozzle LumenPass
PerformanceDead spacePass
Freedom from air and liquid
leakage past piston (positive
pressure)Pass
Freedom from air and liquid
leakage past piston (negative
pressure)Pass

Summary of Non-clinical performance data

More detailed description of non-clinical performance data is described in section 18 of this submission and all show acceptable results.

J807.92(b)(2)I

Not applicable as no clinical tests were referenced in this submission

Conclusion {807.92(b)(3)}

The device of submission is the modification of predicate device (K991904). This submission does not include needles so the needle portion has been omitted from the submission. In addition, only the larger sizes (30, 50, and 100mL) will be covered in this modification. The only difference between the submitted device and predicate are some material components and method of sterilization. The intended use of the predicate syringe is identical to the intended use of the submitted device for the syringe portion (JMS needle excluded).

3

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 circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized symbol that resembles an abstract caduceus or a representation of human services.

Public Health Service

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

February 20, 2014

JMS North America Corporation Mr. Sho Hosoki Regulatory 22320 Foothill Boulevard, Suite 350 Hayward, CA 94541

Re: K132321

Trade/Device Name: JMS Syringe Regulation Number: 21 CFR 880.5860 Regulation Name: Piston Syringe Regulatory Class: II Product Code: FMF Dated: May 15, 2013 Received: August 1, 2013

Dear Mr. Hosoki:

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 - Mr. Hosoki

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/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/4/Picture/7 description: The image shows the name "Kwame Ulmer's" in a stylized font. The letters are bold and black, and they appear to be slightly distorted. The name is arranged in two lines, with "Kwame" on the top line and "Ulmer's" on the bottom line. The letters are overlapping each other, creating a sense of depth and dimension.

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

for

Enclosure

5

Section 4: Indications for Use

510(k) Number (if known): K132321

Device Name: JMS Syringe

Indications for Use:

JMS Syringe is intended to be used to inject fluids into or withdraw fluids out of the body.

Prescription Use (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 OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Image /page/5/Picture/10 description: The image is blurry and contains a lot of noise, making it difficult to discern any specific details. There are some dark spots and lighter areas scattered throughout the image. Due to the poor quality, it is impossible to identify any objects, text, or patterns with certainty.

Digitally signed by Richard C. Chapman Date: 2014.02.19 15:17:07 -05'00'

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