K Number
K142367
Device Name
Hospira Primary Sets
Manufacturer
Date Cleared
2014-11-25

(92 days)

Product Code
Regulation Number
880.5440
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Hospira Primary sets are indicated for the delivery of fluids from a container to a patient's vascular system.
Device Description
The Hospira Primary Sets with Secure Lock are intended for use as gravity sets. Hospira infusion sets are disposable devices for single patient use.
More Information

Not Found

No
The summary describes a standard gravity infusion set and does not mention any AI or ML capabilities.

No
The device is described as an "infusion set" indicated for the "delivery of fluids from a container to a patient's vascular system." This describes an administration device, not a device that directly treats a disease or condition (therapeutic).

No
Explanation: The device is an infusion set used for delivering fluids, not for diagnosing medical conditions.

No

The device description clearly states it is a disposable hardware device (infusion sets) for delivering fluids, not a software application.

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

Here's why:

  • Intended Use: The intended use is for the "delivery of fluids from a container to a patient's vascular system." This describes a device used in vivo (within the body) for therapeutic or supportive purposes, not for testing samples in vitro (outside the body) to diagnose a condition.
  • Device Description: The description reinforces this by stating they are "infusion sets" for "single patient use" and "gravity sets." These are all terms associated with delivering substances directly into a patient's bloodstream.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting analytes, or providing diagnostic information.

Therefore, the Hospira Primary Sets are considered medical devices used for infusion, not for in vitro diagnostic testing.

N/A

Intended Use / Indications for Use

Hospira Primary sets are indicated for the delivery of fluids from a container to a patient's vascular system.

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

FPA

Device Description

The Hospira Primary Sets with Secure Lock are intended for use as gravity sets. Hospira infusion sets are disposable devices for single patient use.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

patient's 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 (study type, sample size, AUC, MRMC, standalone performance, key results)

Performance testing was conducted to ensure the device performs as intended in accordance with applicable standards. All testing is acceptable. The product Sterility Assurance Level is 10-6.

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.

LifeShield Vision Infusion Sets - K113683, Hospira Infusion Blood Sets – K101677

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

§ 880.5440 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.

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which is often associated with medicine and healthcare. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" are arranged in a circular pattern around the symbol.

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

November 25,2014

Hospira, Incorporated Dr. Catherine Kang Senior Associate. Global Regulatory Affairs 375 North Field Drive, D-393, Bldg. H3 Lake Forest, IL 60046

Re: K142367

Trade/Device Name: Hospira Primary Sets Regulation Number: 21 CFR 880.5440 Regulation Name: Intravascular Administration Set Regulatory Class: II Product Code: FPA Dated: August 26, 2014 Received: August 27, 2014

Dear Dr. Kang:

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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Page 2 - Dr. Kang

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,

Susan Runno DDS, MA

Erin I. 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

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Indications for Use

510(k) Number (if known) K142367

Device Name

Hospira Primary Set

Indications for Use (Describe)

Hospira Primary sets are indicated for the delivery of fluids from a container to a patient's vascular system.

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

2 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.

FOR FDA USE ONLY

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Image /page/3/Picture/1 description: The image shows the logo for Hospira. The logo consists of the word "Hospira" in a sans-serif font, with a stylized graphic above it. The graphic features three curved lines that converge at the top, resembling a stylized representation of a plant or a network. The logo is presented in grayscale.

Section 5: 510(k) Summary

A summary of 510(k) safety and effectiveness information in accordance with the requirements of 21 CFR 807.92 for Hospira Primary Sets.

Submitter Information
NameHospira, Incorporated
AddressD-393, Bldg. H3
375 North Field Drive
Lake Forest, IL. 60046
Phone number(224) 212-4421
Fax number(224) 212-5401
Establishment Registration Number3005579246 (Owner/Operator #9063339)
Name of contact personCatherine Kang, PhD, Senior Associate, Global Regulatory Affairs
Date preparedAugust 22, 2014
Name of device
Trade or proprietary nameHospira Primary Sets
Common or usual nameI.V Administration Sets
Classification nameIntravascular Administration Set, 21 CFR 880.5440, Class II
Product Code(s)FPA
Legally marketed device(s) to
which equivalence is claimedHospira Primary sets:
LifeShield Vision Infusion Sets - K113683
Hospira Infusion Blood Sets – K101677
Reason for 510(k) submissionThe changes addressed in this submission include:
• Modification to Secure Lock Male Luer
Device descriptionThe Hospira Primary Sets with Secure Lock are intended for use as gravity sets.
Hospira infusion sets are disposable devices for single patient use.
Intended Use of DeviceA Hospira Primary set is intended for the delivery of fluids from a container to a
patient's vascular system

CONFIDENTIAL

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Image /page/4/Picture/1 description: The image shows the logo for Hospira. The logo consists of the word "Hospira" in a sans-serif font, with a stylized graphic above it. The graphic appears to be three curved lines that converge at the top, resembling a stylized representation of a plant or a medical symbol. The logo is in grayscale.

Summary of the technological characteristics of the device compared to the predicate device
CharacteristicPredicateProposed Device
Indications for UseInfusion sets are intended for the
delivery of fluids including but not
limited to blood and blood products
from a container into a patient's
vascular system.Hospira Primary Set is intended for the
delivery of fluids from a container to a
patient's vascular system.
Materials of ContructionThe materials of construction for the proposed device are the same as the materials for
the predicate product.
Summary of non-clinical tests for
determination of substantial
equivalenceAll materials of construction for
Hospira Primary Sets meet the
applicable material test requirements
for ISO 10993.Same
Summary of Performance TestingPerformance testing was conducted to
ensure the device performs as intended
in accordance with applicable
standards. All testing is acceptable.
The product Sterility Assurance Level
is 10-6.Same

Conclusion

Hospira Primary Sets meet the functional claims and intended use as described in the product labeling. The safety and effectiveness are substantially equivalent to the LifeShield Vision Infusion Sets cleared under K113683 and Hospira Infusion Blood Sets cleared under K101677.