K Number
K132424
Device Name
METRIXCARE
Manufacturer
Date Cleared
2014-02-12

(191 days)

Product Code
Regulation Number
876.5980
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The device is intended to deliver liquid nutritional formulas or water to a patient's enteral access device (feeding tube).
Device Description
The sets are constructed from flexible, medical grade, Non-DEHP tubing in various configurations with a stepped connector at one end. One configuration may include an Enteral solution container constructed of a laminate material with a stepped connector to connect to a gastric tube (or an extension set) or another configuration may simply be an administration set which connects the patient gastric tube to the nutrition liquid container.
More Information

51584, 00056, 00089, 00061, 62562

Not Found

No
The summary describes a simple enteral feeding set (tubing and bag) with no mention of AI or ML capabilities. The performance studies are bench tests related to flow rate and manufacturing process, not algorithmic performance.

No.
The device is described as an administration set for delivering nutritional formulas or water to a patient via a feeding tube, which is a supportive function rather than directly treating a disease or condition for therapeutic benefit.

No

Explanation: The device is intended to deliver liquid nutritional formulas or water to a patient's enteral access device. It is an administration device, not a diagnostic one.

No

The device description explicitly details physical components like tubing, connectors, and containers, indicating it is a hardware device, not software-only.

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

Here's why:

  • Intended Use: The intended use is to "deliver liquid nutritional formulas or water to a patient's enteral access device (feeding tube)." This describes a device used for administering substances directly to a patient's body, not for examining specimens taken from the body to diagnose or monitor a condition.
  • Device Description: The description details tubing, connectors, and solution containers used for delivery, not components typically found in IVD devices (like reagents, test strips, or analyzers).
  • Lack of IVD Indicators: There is no mention of analyzing biological samples, detecting analytes, or providing diagnostic information. The focus is purely on the physical delivery of fluids.

Therefore, this device falls under the category of a medical device used for patient care, specifically for enteral feeding, rather than an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The device is intended to deliver liquid nutritional formulas or water to a patient's enteral access device (feeding tube).

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

KNT

Device Description

The sets are constructed from flexible, medical grade, Non-DEHP tubing in various configurations with a stepped connector at one end. One configuration may include an Enteral solution container constructed of a laminate material with a stepped connector to connect to a gastric tube (or an extension set) or another configuration may simply be an administration set which connects the patient gastric tube to the nutrition liquid container.

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)

The following bench test reports are provided in Appendix A and B of this submission to support the performance characteristics of the proposed sets.

    1. Validation 703V A study of the accuracy of the current drop factor given on gravity feed sets.
    1. Validation Protocol 868V: A Study to qualify the process to manufacture Gravity Set w/ Bag.

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.

51584, 00056, 00089, 00061, 62562

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

§ 876.5980 Gastrointestinal tube and accessories.

(a)
Identification. A gastrointestinal tube and accessories is a device that consists of flexible or semi-rigid tubing used for instilling fluids into, withdrawing fluids from, splinting, or suppressing bleeding of the alimentary tract. This device may incorporate an integral inflatable balloon for retention or hemostasis. This generic type of device includes the hemostatic bag, irrigation and aspiration catheter (gastric, colonic, etc.), rectal catheter, sterile infant gavage set, gastrointestinal string and tubes to locate internal bleeding, double lumen tube for intestinal decompression or intubation, feeding tube, gastroenterostomy tube, Levine tube, nasogastric tube, single lumen tube with mercury weight balloon for intestinal intubation or decompression, and gastro-urological irrigation tray (for gastrological use).(b)
Classification. (1) Class II (special controls). The barium enema retention catheter and tip with or without a bag that is a gastrointestinal tube and accessory or a gastronomy tube holder accessory is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I (general controls) for the dissolvable nasogastric feed tube guide for the nasogastric tube. The class I device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 876.9.

0

5.0 510(k) Summary

In accordance with 21 CFR 807.87(h) and 21 CFR 807.92 the 51(k) Summary for the Gravity Enteral Feeding Sets is provided below.

Date Prepared:June 28, 2013
Device Common Name:Gastrointestinal tubes and accessories
Device Proprietary Name:METRIXCARE™
Submitter:The Metrix Company
4400 Chavenelle Rd
Dubuque, IA 52002
Contact:Nicholas J. Specht
Quality Assurance Manager
The Metrix Company
Phone: 563-556-8800
Fax: 563-556-4704
nspecht@metrixco.com
Classification
Regulation:21 CFR 876.5980
Panel:Gastroenterology/Urology
Product Code:KNT
Indication for Use:The device is intended to deliver liquid nutritional
formulas or water to a patient's enteral access
device (feeding tube).

CONFIDENTIAL INFORMATION

This document Includes confidential and proprietary business information that is account from disclosure
under the U.S. Freedom of Information Act (FOIA). Prior to any (The Metrix Company) for a pre-release review pursuant 21 CFR §20.61.

FEB 1222014

Page 17 of 46

1

The sets are constructed from flexible, medical grade, Device Description: Non-DEHP tubing in various configurations with a stepped connector at one end. One configuration may include an Enteral solution container constructed of a laminate material with a stepped connector to connect to a gastric tube (or an extension set) or another configuration may simply be an administration set which connects the patient gastric tube to the nutrition liquid container.

Performance Testing Summary:

Stepped Adaptor: The stepped adaptor meets the requirements of AAMI/ANSI ID54:1996/(R)2012, Enteral Feeding Set Adapters and Connectors.

Safety Screw Connector: The safety screw connector meets the requirements of AAMI/ANSI/ISO 80369-1, Small-Bore Connectors For Liquids and Gases In Healthcare Applications - Part 1 : General Requirements.

The following bench test reports are provided in Appendix A and B of this submission to support the performance characteristics of the proposed sets.

    1. Validation 703V A study of the accuracy of the current drop factor given on gravity feed sets.
    1. Validation Protocol 868V: A Study to qualify the process to manufacture Gravity Set w/ Bag.

Substantial Equivalence: The Gravity Enteral Feeding Sets are substantially equivalent to commercially marketed Abbott Nutrition sets in terms of principle of materials, operation, and intended use.

CONFIDENTIAL INFORMATION

This document includes confidential and proprietary business information that is exempt from disclasure under the U.S. Freedom of Information Act (FOIA). Prior to Boy FOIA response, contact the submitter (The Metrix Company) for a pre-release review pursuant 21 CFR §20.61.

2

The Metrix Company Traditional 510(k) Submission

Technological Charachteristics:

TECHNOLOGICAL CHARACTERISTICS OF DEVICE COMPARED TO PREDICATE
THE METRIX
COMPANY
MODEL
SEEKING
CLEARANCEDESCRIPTIONPREDICATE
MODEL: ROSS
LABORATORIES
AND/OR ABBOTTDIFFERENCES IN
DESIGNDIFFERENCES IN
MATERIALS
(All materials
used In all the
product are listed
in Table B.)DIFFERENCES IN
CHEMICAL
COMPOSITIONDIFFERENCES IN
ENERGY SOURCE
70010500ml Enteral Bag with
Gravity Set51584None - Product and
component
dimensions are
Identical.None - Both made
from the same
materials from the
same source.None - Both made
from the same
materials from the
same source.None - Flow rate of
both determined
by gravity.
700201000ml Enteral Bag with
Gravity Set00056None - Product and
component
dimensions are
Identical.None - Both made
from the same
materials from the
same source.None - Both made
from the same
materials from the
same source.None - Flow rate of
both determined
by gravity.
700301000ml Enteral Bag with
Screw Cap & Gravity Set00089None - Product and
component
dimensions are
Identical.None - Both made
from the same
materials from the
same source.None - Both made
from the same
materials from the
same source.None - Flow rate of
both determined
by gravity.
70040Gavity Set with Feeding
Cap00061None - Product and
component
dimensions are
Identical.None - Both made
from the same
materials from the
same source.None - Both made
from the same
materials from the
same source.None - Flow rate of
both determined
by gravity.
70050Gravity Set with Cross
Screw Connector62562None - Product and
component
dimensions are
Identical.None - Both made
from the same
materials from the
same source.None - Both made
from the same
materials from the
same source.None - Flow rate of
both determined
by gravity.

CONFIDENTIAL INFORMATION

This document includes confidential and proprietary business information that is secures the submitter (The Metrix Company) for a pre-release review pursuant 21 CFR 520.61.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health and 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 eagle or bird-like figure with three wing-like extensions.

Public Health Service

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

February 12, 2014

The Metrix Company Nicholas Specht Quality Assurance Manager 4400 Chavenelle Road Dubuque, IA 52002

Re: K132424

Trade/Device Name: Gravity Enteral Feeding Sets Regulation Number: 21 CFR§ 876.5980 Regulation Name: Gastrointestinal tube and accessories Regulatory Class: II Product Code: KNT Dated: January 6, 2014 Received: January 7, 2014

Dear Nicholas Specht,

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.

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.

4

Page 2 - Nicholas Specht

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/ucm115809.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,

Image /page/4/Picture/6 description: The image shows the text "Benjamin Fisher-S" in a bold, sans-serif font. The words are arranged horizontally, with "Benjamin" on the left, followed by "Fisher" in the middle, and "-S" on the right. The word "Fisher" is stylized with a decorative, geometric pattern filling the letters.

Beniamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

4.0 Indications For Use Statement

510(k) Number (if known): K132424

Device Name: Gravity Enteral Feeding Sets

Indications For Use:

The device is intended to deliver liquid nutritional formulas or water to a patient's enteral access device (feeding tube).

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 IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Image /page/5/Picture/11 description: The image shows the text "Benian 2014.0 -05'00'". The text appears to be part of a document or label. The font is bold and the text is black.

Page 1 of 1

CONFIDENTIAL INFORMATION

This document includes confidential and proprietary business information that is exempt from disclosure under the U.S. Freedom of Information Act (FOIA). Prior to any FOIA response, contact the submitter (The Metrix Company) for a pre-release review pursuant 21 CFR §20.61.

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