K Number
K142435
Device Name
3S Safety Syringe with/without Needle
Date Cleared
2015-02-20

(175 days)

Product Code
Regulation Number
880.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The 3S Safety Syringe with/without Needle is a sterile, single-use, disposable and non-reusable, manual retractable safety syringe intended for injection of fluids into the body, while reducing the risk of sharps injuries and the potential for syringe reuse.
Device Description
The 3S Safety Syringe with/without Needle is an integrated needle and piston syringe with an innovative anti-needle-stick mechanism. The design incorporates the ideal features desired in a safety syringe. No special techniques are required to use the safety mechanism. The mechanism allows clear visualization of the injection site at all times. The mechanism clearly shows the needle is contained within the syringe barrel. After standard techniques for injection, the plunger is withdrawn, snapped off and used syringe is discarded into a sharps container per regulatory provision.
More Information

Not Found

No
The device description and intended use focus on a mechanical safety mechanism for a syringe and do not mention any computational or data-driven features indicative of AI/ML.

No
Explanation: This device is a safety syringe intended for injection of fluids and reducing sharps injuries, not for treating a disease or condition itself.

No
Explanation: The device is described as a safety syringe intended for the "injection of fluids into the body," which indicates a therapeutic or procedural function, not a diagnostic one. There is no mention of it being used to detect, identify, or monitor medical conditions.

No

The device description clearly describes a physical syringe with an integrated needle and piston, indicating it is a hardware medical 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 clearly stated as "injection of fluids into the body." This is a therapeutic or procedural use, not a diagnostic one.
  • Device Description: The description focuses on the mechanical aspects of the syringe for safe injection and preventing reuse. There is no mention of analyzing samples from the body or performing any diagnostic tests.
  • Lack of Diagnostic Elements: There are no mentions of analyzing biological samples (blood, urine, tissue, etc.), reagents, or any processes related to determining the state of health or disease.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This syringe is used to introduce substances into the body, which is the opposite of what an IVD does.

N/A

Intended Use / Indications for Use

The 3S Safety Syringe with/without Needle is a sterile, single-use, disposable and non-reusable, manual retractable safety syringe intended for injection of fluids into the body, while reducing the risk of sharps injuries and the potential for syringe reuse.

Product codes

MEG

Device Description

The 3S Safety Syringe with/without Needle is an integrated needle and piston syringe with an innovative anti-needle-stick mechanism. The design incorporates the ideal features desired in a safety syringe. No special techniques are required to use the safety mechanism. The mechanism allows clear visualization of the injection site at all times. The mechanism clearly shows the needle is contained within the syringe barrel. After standard techniques for injection, the plunger is withdrawn, snapped off and used syringe is discarded into a sharps container per regulatory provision.

The 3S safety syringe with/without Needle will be available in numerous sizes and combinations between the smallest (0.5cc/ml + 28G x 1/2" to 20G x 1 1/2") and the largest (10cc/ml)

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

K040545

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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

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

February 20, 2015

Sincere Medical Device Company, Ltd. Mr. Garfield Wang RA Manager Room 218, 2F., No. 183, Zhouzi St. Taipei City, Taipei City 114 TAIWAN (R.O.C)

Re: K142435

Trade/Device Name: 3S Safety Syringe with/without needle Regulation Number: 21 CFR 880.5860 Regulation Name: Piston Syringe Regulatory Class: II Product Code: MEG Dated: August 15, 2015 Received: January 23, 2015

Dear Mr. Wang:

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.

1

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 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/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 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,

Tina Kiang
-s

for 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

Enclosure

2

Image /page/2/Picture/0 description: The image shows the logo of Sincere Medical Device Co., Ltd. The logo consists of a green circular emblem with the letter 'S' inside, surrounded by stylized green leaves. To the right of the emblem is the company name, 'Sincere Medical Device Co., Ltd.,' written in a clear, sans-serif font.

510(k) Submission

Rev 0.00 15/08/14

Section_004 Indications for Use

K142435 510(k) Number (if known):

Device Name: 3S SAFETY SYRINGE WITH/WITHOUT NEEDLE

Indications for Use

[3S Safety Syringe]

The 3S Safety Syringe with/without Needle is a sterile, single-use, disposable and non-reusable, manual retractable safety syringe intended for injection of fluids into the body, while reducing the risk of sharps injuries and the potential for syringe reuse.

Prescription Use V AND/OR Over-The-Counter Use (Part 21 CFR 801 Subpart D) (21 CFR 801 Subpart C) (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

3

Image /page/3/Picture/0 description: The image shows the logo of Sincere Medical Device Co., Ltd. The logo consists of a green circular emblem with the letter "S" inside, along with the company name written in black text to the right of the emblem. The text is clear and easy to read, and the overall design is simple and professional.

510(k) Submission

Rev 0.02

05/02/15

[3S Safety Syringe]

Section_005 510(K) Summary

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA and 21 CFR §807.92

Date Prepared: 15. 08.2014

1. Submitter Name and Address:

Owner Name:Sincere Medical Device Co., Ltd.
Address:Rm. 218, 2F., No. 183, Zhouzi St., Neihu Dist., Taipei City 114.
Taiwan(R.O.C)
Contactor Name:Garfield Wang, Vivian Lu
TEL:+86-13564751751
E-mail:wangxuebo_11@hotmail.com
Web:http://sincere-med.com
Fax:+886-2-2659-8698

US Agent:

US Agent:Benjamin Lee.
Address:8692 9th Street, unit 42, Rancho Cucamonga, ca 91730
TEL:1909-985-0648

2. Submission Devices Information:

Trade/Proprietary Name: 3S Safety Syringe with/without Needle Common Name: Syringe, Antistick Piston Syringe Classification name: Piston Syringe.. Class: 2. Panel: 80. Product codes: MEG Submission Type: 510(k) Requlation Number: 880.5860

3. Predicate Devices Information:

Trade Name:Otter Safety Syringe
510(K) Number:K040545

4. Devices Description:

The 3S Safety Syringe with/without Needle is an integrated needle and piston syringe with an innovative anti-needle-stick mechanism. The design incorporates the ideal features desired in a safety syringe. No special techniques are required to use the safety mechanism. The mechanism allows clear visualization of the injection site at all times. The mechanism clearly shows the needle is contained within the syringe barrel. After standard techniques for injection, the plunger is withdrawn, snapped off and used syringe is discarded into a sharps container per regulatory provision.

4

Image /page/4/Picture/0 description: The image shows the logo of Sincere Medical Device Co., Ltd. The logo consists of a green circular emblem with the letter 'S' inside, accompanied by the company name in a simple, sans-serif font. The text is in a dark gray color, providing a clear contrast against the white background.

510(k) Submission

[3S Safety Syringe]

Rev 0.02 05/02/15

The 3S safety syringe with/without Needle will be available in numerous sizes and combinations between the smallest (0.5cc/ml + 28G x 1/2" to 20G x 1 1/2") and the largest (10cc/ml)

5. Intended Use:

The 3S Safety Syringe with/without Needle is a sterile, single-use, disposable and nonreusable, manual retractable safety syringe intended for injection of fluids into the body, while reducing the risk of sharps injuries and the potential for syringe reuse.

6. Technological Characteristics:

Through comparisons between the submitted devices with the predicate devices as follows tables. We believe the applicant devices are substantially equivalent with the predicate devices.

| Element of Comparison | Submission Device | Predicate Device
K040545 |
|------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Intended Use | The 3S Safety Syringe is an
integrated needle and piston
syringe with an innovative anti-
needle-stick mechanism. The
design incorporates the ideal
features desired in a safety
syringe. No special techniques
are required to use the safety
mechanism. The mechanism
allows clear visualization of the
injection site at all times. The
mechanism clearly shows that
the needle has been crushed
within the syringe barrel. After
standard techniques for
injection, the plunger is
withdrawn completely into the
barrel. Snap off plunger and
discard used syringe in a sharp
container per regulatory
provision. | The Otter Safety Syringe is an
integrated needle and piston
syringe with an innovative anti-
needle-stick mechanism. The
design incorporates the ideal
features desired in a safety
syringe. No special techniques
are required to use the safety
mechanism. The mechanism
allows clear visualization of the
injection site at all times. The
mechanism clearly shows that
the needle has been crushed
within the syringe barrel. After
standard techniques for
injection, the plunger is
withdrawn completely into the
barrel. A forward compression
of the plunger again and the
needle is crushed within the
puncture-resistant barrel. This
renders the needle unusable
and safe from accidental
needle sticks. |
| Principle of Operation | Normal | Normal |
| Syringe Capacity | Various Sizes | Various Sizes |
| Nozzle Type | Luer Slip & Luer Lock | Luer Slip & Luer Lock |
| Lubricant for Barrel | Silicone Oil | Silicone Oil |
| Barrel Transparency | Transparent and Clear | Transparent and Clear |
| Gradations Legibility | Legible | Legible |

Safety Syringe Comparison Table

5

Image /page/5/Picture/0 description: The image shows a logo with a green circular design. Inside the circle is a stylized letter 'S' in brown. Below the circle, the words 'SINCERE MEDICAL' are written in a curved fashion, following the shape of the circle. The logo appears to be for a medical organization or company.

Sincere Medical Device Co., Ltd.

510(k) Submission

[3S Safety Syringe]

Rev 0.02 05/02/15

Materials
BarrelPPPP
PlungerPPPP
PistonSILICONESILICONE
Needle HubPPPP
NeedleStainless SteelStainless Steel
Needle SheathPPPP
Needle Gauge and LengthVarious SizesVarious Sizes
Lubricant for NeedleSilicone OilSilicone Oil
Sharps Injury Prevention FeaturesManual RetractableManual Retractable
PerformancesConforms to ISO7864 ISO7886Conforms to ISO7864 ISO7886
BiocompatibilityConforms to ISO10993Conforms to ISO10993
LabelingMeet the requirements of 21 CFR Part 801Meet the requirements of 21 CFR Part 801

7. Conclusion:

The materials, performance, and operational features of both the submitted device and the predicate device are substantially equivalent.

END