K Number
K141492
Device Name
ADVANCED MEMBRANCE GAS EXCHANGE PMP STERILE (A.M.G PMP STERILE)
Manufacturer
Date Cleared
2015-02-06

(246 days)

Product Code
Regulation Number
870.4350
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Advanced Membrane Gas Exchange PMP STERILE (A.M.G. PMP STERILE) is intended for use in adult Surgical procedures requiring extracorporeal gas exchange support and blood temperature control for periods of up to 6 hours. The Advanced Membrane Gas Exchange PMP STERILE (A.M.G. PMP STERILE) for extracorporeal circulation is a microporous hollow-fiber oxygenator with an integral heat exchanger used to perform cardiopulmonary bypass. It includes a detachable 4.5 liter blood reservoir.
Device Description
The Advanced Membrane Gas Exchange and accessories PMP STERILE (A.M.G. PMP STERILE) is a microporous hollow-fiber oxygenator with an integral heat exchanger, used to perform cardiopulmonary bypass or surgical procedures requiring extracorporeal gas exchange support and blood temperature control for periods of up to 6 hours. It includes a detachable 4.5 liter blood reservoir. The A.M.G. PMP STERILE is equipped with polymethyl pentene fibres, more hydrophobic than the polyethylene used for the predicate device and so considered a more reliable barrier between the blood pathway and gas pathway of the oxygenator. The A.M.G. PMP STERILE is provided in different configurations: - microporous hollow-fiber oxygenator with temperature probe and pre-connected venous cardiotomy reservoir (“A.M.G. PMP STERILE”), - microporous hollow-fiber oxygenator with temperature probe and without pre-connected venous cardiotomy reservoir (“A.M.G. MODULE PMP STERILE”), - microporous hollow-fiber oxygenator without temperature probe and without pre-connected venous cardiotomy reservoir (“A.M.G. MODULE PMP NO TP STERILE”), - Venous Cardiotomy Reservoir 4500 PMP (“VCR 4500 PMP STERILE”). The device is used to temporarily substitute the functions of the lung as it supplies oxygen and removes carbon dioxide from the blood. The device can be use with adult patients.
More Information

No
The description focuses on the physical components and function of a traditional oxygenator and heat exchanger. There is no mention of AI/ML terms, data analysis, or algorithmic decision-making.

Yes
Explanation: The device is intended for extracorporeal gas exchange support and blood temperature control to temporarily substitute the functions of the lung, which are therapeutic actions.

No
The device is described as an oxygenator with an integral heat exchanger used to perform cardiopulmonary bypass, which provides extracorporeal gas exchange support and blood temperature control, indicating a therapeutic rather than diagnostic function.

No

The device description clearly outlines a physical medical device (oxygenator with integral heat exchanger and blood reservoir) used for extracorporeal gas exchange. There is no mention of software as the primary or sole component.

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

Here's why:

  • Intended Use: The intended use clearly states the device is for "extracorporeal gas exchange support and blood temperature control" during surgical procedures. This involves directly interacting with the patient's blood outside the body to perform a physiological function (gas exchange and temperature regulation).
  • Device Description: The description reinforces this by calling it a "microporous hollow-fiber oxygenator with an integral heat exchanger used to perform cardiopulmonary bypass." This is a life-support device that replaces the function of the lungs and heart during surgery.
  • IVD Definition: In vitro diagnostics are devices intended for use in the examination of specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device does not fit this definition as it is used to treat the patient by performing a physiological function, not to diagnose or monitor based on analyzing a specimen.

The device is a therapeutic device used in a surgical setting, not a diagnostic device used to analyze samples.

N/A

Intended Use / Indications for Use

The Advanced Membrane Gas Exchange PMP STERILE (A.M.G. PMP STERILE) is intended for use in adult Surgical procedures requiring extracorporeal gas exchange support and blood temperature control for periods of up to 6 hours.
The Advanced Membrane Gas Exchange PMP STERILE (A.M.G. PMP STERILE) for extracorporeal circulation is a microporous hollow-fiber oxygenator with an integral heat exchanger used to perform cardiopulmonary bypass. It includes a detachable 4.5 liter blood reservoir.

Product codes

DTZ

Device Description

The Advanced Membrane Gas Exchange and accessories PMP STERILE (A.M.G. PMP STERILE) is a microporous hollow-fiber oxygenator with an integral heat exchanger, used to perform cardiopulmonary bypass or surgical procedures requiring extracorporeal gas exchange support and blood temperature control for periods of up to 6 hours. It includes a detachable 4.5 liter blood reservoir.
The A.M.G. PMP STERILE is equipped with polymethyl pentene fibres, more hydrophobic than the polyethylene used for the predicate device and so considered a more reliable barrier between the blood pathway and gas pathway of the oxygenator.
The A.M.G. PMP STERILE is provided in different configurations:

  • microporous hollow-fiber oxygenator with temperature probe and pre-connected venous cardiotomy reservoir (“A.M.G. PMP STERILE”),
  • microporous hollow-fiber oxygenator with temperature probe and without pre-connected venous cardiotomy reservoir (“A.M.G. MODULE PMP STERILE”),
  • microporous hollow-fiber oxygenator without temperature probe and without pre-connected venous cardiotomy reservoir (“A.M.G. MODULE PMP NO TP STERILE”),
  • Venous Cardiotomy Reservoir 4500 PMP (“VCR 4500 PMP STERILE”).
    The device is used to temporarily substitute the functions of the lung as it supplies oxygen and removes carbon dioxide from the blood. The device can be use with adult patients.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

lung

Indicated Patient Age Range

adult

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)

In vitro bench testing was performed to support a determination of substantial equivalence (refer to performance testing below) between the new Advanced Membrane Gas Exchange PMP STERILE (A.M.G. PMP STERILE) and the predicate.
The results of these tests provide reasonable assurance that the proposed device has been designed and tested to assure conformance to the requirements for its intended use and performs comparably to the existing predicate devices.

In vitro bench tests were carried out to demonstrate equivalence, according to the requirements of FDAs document "Guidance for Cardiopulmunary Bypass Oxygenators 510(k) Submission", issued on November 13, 2000, the ISO 7199:2009 and of the EN 12022:1998 "Blood-gas exchangers".
The following areas have been tested and/or evaluated:

  • Gas Transfer and Pressure Drop,
  • Fiber Hydrophilization,
  • Cracking test external body,
  • Coating Uniformity,
  • Plasma hemoglobin concentration,
  • Heat exchanger Efficiency and Filling Volume,
  • Seal Connection,
  • Structural and Mechanical Integrity,
  • Bioburden tests,
  • Sterility tests,
  • LAL-test,
  • Validation of the EtO Sterilization process,
  • Sterility tests,
  • Packaging evaluation,
  • Labelling evaluation,
  • EtO Residual, according to EN ISO 10993-7,
  • Biocompatibility, according to ISO 10993 series requirements.
    The results from these performance evaluations demonstrated that the AMG PMP STERILE met the acceptarfce criteria defined in the product specification and performed comparably to the predicate device.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K102109, K082403

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.4350 Cardiopulmonary bypass oxygenator.

(a)
Identification. A cardiopulmonary bypass oxygenator is a device used to exchange gases between blood and a gaseous environment to satisfy the gas exchange needs of a patient during open-heart surgery.(b)
Classification. Class II (special controls). The special control for this device is the FDA guidance document entitled “Guidance for Cardiopulmonary Bypass Oxygenators 510(k) Submissions.”

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Public Health Service

Image /page/0/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized representation of three human profiles facing right, stacked on top of each other. The profiles are black and have a flowing, abstract design. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the left side of the logo.

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

February 6, 2015

EUROSETS s.r.1. % Mario Gennari Official Correspondent, Gemar s.r.1. Via G. Puccini, 1 Medolla, Modena, IT I-43036

Re: K141492

Trade/Device Name: Advanced Membrane Gas Exchange PMP Sterile (A.M.G. PMP Sterile) Regulation Number: 21 CFR 870.4350 Regulation Name: Cardiopulmonary Bypass Oxygenator Regulatory Class: Class II Product Code: DTZ Dated: December 4, 2014 Received: January 14, 2015

Dear Mario Gennari,

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. You must comply

1

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 of medical devicerelated 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 Industry and Consumer Education 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. 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 Industry and Consumer Education 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,

M.A. Hillebrenner

for

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

Enclosure

2

Indications for Use

510(k) Number (if known) K141492

Device Name

Advanced Membrane Gas Exchange PMP (A.M.G. PMP STERILE)

Indications for Use (Describe)

The Advanced Membrane Gas Exchange PMP STERILE (A.M.G. PMP STERILE) is intended for use in adult Surgical procedures requiring extracorporeal gas exchange support and blood temperature control for periods of up to 6 hours.

The Advanced Membrane Gas Exchange PMP STERILE (A.M.G. PMP STERILE) for extracorporeal circulation is a microporous hollow-fiber oxygenator with an integral heat exchanger used to perform cardiopulmonary bypass. It includes a detachable 4.5 liter blood reservoir.

Type of Use (Select one or both, as applicable)
Prescription Use (Part 21 CFR 801 Subpart D)Over-The-Counter Use (21 CFR 801 Subpart C)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

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510(K) SUMMARY, AS REQUIRED BY 21 CFR 807.92

Submitter's NameEurosets s.r.l.
AddressStrada Statale 12, nº143
41036 Medolla (MO) Italy
Establishment
Registration Number3003752502
Summary
Preparation DateFeruary 05, 2015
Contact Person
Telephone Number
Fax NumberDr. Katia Vescovini, Regulatory Affairs Manager
0039 0535660334
0039 0535 51248
Name of the DeviceAdvanced Membrane Gas Exchange PMP STERILE (A.M.G.
PMP STERILE)
Name of the
Oxygenating moduleA.M.G. MODULE PMP STERILE
A.M.G. MODULE PMP NO T.P. STERILE
Name of the
Cardiotomy
reservoirVCR 4500 PMP STERILE
Common name of
the deviceAdvanced Membrane Gas Exchange and Accessories A.M.G.
PMP STERILE
Common name of
the Oxygenating
moduleA.M.G. MODULE PMP STERILE
A.M.G. MODULE PMP NO T.P. STERILE
Common name of
the Cardiotomy
reservoirVenous Cardiotomy Reservoir 4500 PMP STERILE
Classification NameCardiopulmunary device
Classification Name: Advanced membrane gas exchange
Device Class: II
Product Code: DTZ
Regulation Number: 21 CFR §870.4350
Performance
StandardsNo performance standards applicable to Advanced Membrane
Gas Exchange PMP STERILE (A.M.G. PMP STERILE) have
been established by the FDA

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510(k) SUMMARY, continued

| DESCRIPTION: | The Advanced Membrane Gas Exchange and accessories PMP
STERILE (A.M.G. PMP STERILE) is a microporous hollow-fiber
oxygenator with an integral heat exchanger, used to perform
cardiopulmonary bypass or surgical procedures requiring
extracorporeal gas exchange support and blood temperature
control for periods of up to 6 hours. It includes a detachable 4.5
liter blood reservoir.
The A.M.G. PMP STERILE is equipped with polymethyl pentene
fibres, more hydrophobic than the polyethylene used for the
predicate device and so considered a more reliable barrier
between the blood pathway and gas pathway of the oxygenator.
The A.M.G. PMP STERILE is provided in different configurations:

  • microporous hollow-fiber oxygenator with temperature probe
    and pre-connected venous cardiotomy reservoir (“A.M.G. PMP
    STERILE”),
  • microporous hollow-fiber oxygenator with temperature probe
    and without pre-connected venous cardiotomy reservoir
    (“A.M.G. MODULE PMP STERILE”),
  • microporous hollow-fiber oxygenator without temperature
    probe and without pre-connected venous cardiotomy reservoir
    (“A.M.G. MODULE PMP NO TP STERILE”),
  • Venous Cardiotomy Reservoir 4500 PMP (“VCR 4500 PMP
    STERILE”).
    The device is used to temporarily substitute the functions of the |
    |-----------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
    | | lung as it supplies oxygen and removes carbon dioxide from the
    blood. The device can be use with adult patients. |
    | Indications for Use | The Advanced Membrane Gas Exchange PMP STERILE (A.M.G.
    PMP STERILE) is intended for use in adult Surgical procedures
    requiring extracorporeal gas exchange support and blood
    temperature control for periods of up to 6 hours.
    The Advanced Membrane Gas Exchange PMP STERILE (A.M.G.
    PMP STERILE) for extracorporeal circulation is a microporous
    hollow-fiber oxygenator with an integral heat exchanger used to
    perform cardiopulmonary bypass.
    It includes a detachable 4.5 liter blood reservoir. |
    | Identification of
    Predicate Device | Proprietary Name: AMG
    Classification Name: 21 CFR 870.4350, Oxygenator,
    Cardiopulmonary Bypass
    Registered Establishment Name:
    Eurosets srl
    Strada Statale 12, n. 143
    41036 Medolla (MO) Italy |
    | Registered Establishment Number: | 3003752502
    Owner/Operator: Eurosets srl
    Establishment Operations: Manufacturer
    510 (k): K102109
    Device Name: A.M.G. advanced membrane gas exchange and
    accessories
    Applicant: Eurosets srl |
    | | Please note that regarding the polymethyl pentene fibres used by
    the A.M.G. PMP STERILE, Eurosets will refer to the following
    predicate device: |
    | | Proprietary Name: MEDOS HILITE 7000 & 7000 LT Hollow Fiber
    Oxygenator |
    | | Classification Name: 21 CFR 870.4350, Oxygenator,
    Cardiopulmonary Bypass
    Registered Establishment Name: GISH BIOMEDICAL, INC. |
    | | Registered Establishment Number: 3002845651
    Owner/Operator: GISH BIOMEDICAL, INC.
    Owner/Operator Number: 3002845651
    Establishment Operations: Manufacturer 510 (k): K082403 |
    | | Device Name: 7000 LT Hollow Fiber Oxygenator (K082403) |
    | | Applicant: GISH BIOMEDICAL, INC. |
    | Common name of
    the predicate device
    for principles of
    operatations | A.M.G. advanced membrane gas exchange and accessories |
    | Classification Name
    of the device | Oxygenator, Cardiopulmonary Bypass |
    | Classification Name
    of the Oxygenating
    module | Device Class: II
    Product Code: DTZ
    Regulation Number: 21 CFR §870.4350
    Oxygenator cardiopulmonary bypass Cardiovascular
    Device Class: II
    Product Code: DTZ |
    | Classification Name
    of the Cardiotomy
    reservoir | Regulation Number: 21 CFR §870.4350
    Hard shell Venous/cardiotomy reservoir Cardiovascular
    Device Class: II
    Product Code: DTZ
    Regulation Number: 21 CFR §870.4350 |
    | Applicant name and
    address: | Eurosets s.r.l.
    Strada Statale 12, n°143
    41036 Medolla (MO) Italy |
    | | MEDOS MEDIZINTECHNIK AG
    Obere Steinfurt 8-10 |
    | Comparison of
    Technological
    Characteristics | In vitro bench testing was performed to support a determination of
    substantial equivalence (refer to performance testing below)
    between the new Advanced Membrane Gas Exchange PMP
    STERILE (A.M.G. PMP STERILE) and the predicate.
    The results of these tests provide reasonable assurance that the
    proposed device has been designed and tested to assure
    conformance to the requirements for its intended use and
    performs comparably to the existing predicate devices. |
    | Performance
    Testing (non-
    clinical) | In vitro bench tests were carried out to demonstrate equivalence,
    according to the requirements of FDAs document "Guidance for
    Cardiopulmunary Bypass Oxygenators 510(k) Submission",
    issued on November 13, 2000, the ISO 7199:2009 and of the EN
    12022:1998 "Blood-gas exchangers".
    The following areas have been tested and/or evaluated:
  • Gas Transfer and Pressure Drop,
  • Fiber Hydrophilization,
  • Cracking test external body,
  • Coating Uniformity,
  • Plasma hemoglobin concentration,
  • Heat exchanger Efficiency and Filling Volume,
  • Seal Connection,
  • Structural and Mechanical Integrity,
  • Bioburden tests,
  • Sterility tests,
  • LAL-test,
  • Validation of the EtO Sterilization process,
  • Sterility tests,
  • Packaging evaluation,
  • Labelling evaluation,
  • EtO Residual, according to EN ISO 10993-7,
  • Biocompatibility, according to ISO 10993 series
    requirements.
    The results from these performance evaluations demonstrated
    that the AMG PMP STERILE met the acceptarfce criteria defined
    in the product specification and performed comparably to the
    predicate device. |
    | SUBSTANTIAL
    EQUIVALENCE: | The A.M.G PMP STERILE are identical to the predicate device in
    terms of intended use, indications for use and surgical technique.
    Based on the safety and performance testing, technological
    characteristics and the indications for use for the device, the
    proposed A.M.G PMP STERILE has been demonstrated to be
    appropriate for its intended use and is considered substantially
    equivalent to the previously cleared A.M.G. advanced membrane
    gas exchange and accessories (K102109). |

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Stolberg, GERMANY 52222