K Number
K142539
Device Name
EnteraLite Infinity Enteral Pump Delivery Set, 1200 mL Enteral Feeding Delivery Set
Manufacturer
Date Cleared
2015-01-08

(121 days)

Product Code
Regulation Number
876.5980
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The devices in this product family are used to dispense liquid nutrients (feeding solution) at a preprogrammed pump or user controlled rate. These enteral feeding sets interface with the patient's feeding tube and may use gravity or an enteral feeding pump to dispense feeding solution. The devices may include a bag to contain the feeding solution and/or a spike to connect to a prefilled container.
Device Description
These enteral feeding sets are designed to be used with or without an enteral feeding pump, (pump is not in scope for this 510k) model specific. Refer to diagrams below for explanation of components. The enteral sets terminate in a bonded conical connector, the ENFit connector; that is designed to be incompatible with ISO 594-1/2 and other non-enteral feeding connections. The ENFit connector is a new connector and it is anticipated that not all patient feeding tubes will be compatible with it, so the administration sets include an adapter that connects to the ENFit connector on one end while providing the traditional "Christmas Tree" shaped transitional stepped connector on the other.
More Information

No
The description focuses on the mechanical and fluid dispensing aspects of the device, with no mention of AI or ML capabilities. The performance studies are also related to physical properties and safety, not algorithmic performance.

No

Explanation: The device is used to dispense liquid nutrients, not to treat or diagnose a disease or condition. It acts as an administration set for feeding solutions.

No
The device is described as an enteral feeding set, which is used to dispense liquid nutrients. Its function relates to delivery of sustenance, not to the identification or analysis of a medical condition.

No

The device description and performance studies clearly indicate a physical medical device (enteral feeding sets) with hardware components and associated testing (bond strength, leak testing, dimensional analysis, etc.). 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 is to "dispense liquid nutrients (feeding solution) at a preprogrammed pump or user controlled rate." This describes a device used for delivering substances into the body, not for examining specimens from the body to diagnose conditions.
  • Device Description: The description focuses on the physical components and how the device interfaces with a feeding tube and feeding solution containers. It does not mention any components or processes related to analyzing biological samples.
  • Lack of IVD Indicators: There is no mention of analyzing blood, urine, tissue, or any other biological specimen. There is no mention of diagnostic purposes, measuring analytes, or providing information for diagnosis, monitoring, or prognosis.

The device is clearly described as an enteral feeding set, which is used for delivering nutrition directly into the gastrointestinal tract. This falls under the category of medical devices used for patient care and treatment, not in vitro diagnostics.

N/A

Intended Use / Indications for Use

The devices in this product family are used to dispense liquid nutrients (feeding solution) at a preprogrammed pump or user controlled rate. These enteral feeding sets interface with the patient's feeding tube and may use gravity or an enteral feeding pump to dispense feeding solution. The devices may include a bag to contain the feeding solution and/or a spike to connect to a prefilled container.

Product codes

PIF, PIO

Device Description

These enteral feeding sets are designed to be used with or without an enteral feeding pump, (pump is not in scope for this 510k) model specific. Refer to diagrams below for explanation of components. The enteral sets terminate in a bonded conical connector, the ENFit connector; that is designed to be incompatible with ISO 594-1/2 and other non-enteral feeding connections. The ENFit connector is a new connector and it is anticipated that not all patient feeding tubes will be compatible with it, so the administration sets include an adapter that connects to the ENFit connector on one end while providing the traditional "Christmas Tree" shaped transitional stepped connector on the other.

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 testing has been performed to support substantial equivalence:

  • Bond Strength - Passed
  • Leak Testing - Passed
  • Volumetric accuracy testing Passed ●
  • Biocompatibility - Passed
  • Misconnection assessment - Passed
  • Dimensional analysis — Passed
  • Enteral Connector Risk Management Report Acceptable ●
  • Human Factors Testing – Acceptable
  • Failure Modes and Effects Analysis (FMEA) – Acceptable
  • Accelerated Aging - Passed
  • ISO 80369-3 Testing as follows:
    • . Falling drop positive pressure liquid leakage - Passed
    • Stress cracking - Passed
    • Resistance to separation from axial load – Passed
    • Resistance to unscrewing – Passed
    • Resistance to overriding - Passed
    • Disconnection by unscrewing - Passed
    • Falling drop positive pressure liquid leakage after 20 cycles of connection and separation - Passed
      The Enteral Feeding Sets meets all the requirements for overall design, functionality, biocompatibility, and confirms that the output meets the design inputs and specifications. The Enteral Feeding Sets passed all testing stated above as shown by the acceptable results obtained.
      The Enteral Feeding Sets along with the ENFit connector and adapter complies with the applicable voluntary standards for biocompatibility. The devices passed all the testing in accordance with national and international standards.

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

Not Found

Predicate Device(s)

K012147

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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

Image /page/0/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" arranged around the perimeter. Inside the circle is a stylized image of three human profiles facing right, with flowing lines beneath them, possibly representing water or movement.

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

January 8, 2015

Zevex, Inc. Dianne Batch Director, RA/QA 4314 Zevex Park Lane Salt Lake City, UT 84123

Re: K142539

Trade/Device Name: Enteralite Infinity Enteral Pump Delivery Set, 1200 ML Enteral Feeding Delivery Set Regulation Number: 21 CFR 876.5980 Regulation Name: Gastrointestinal Tube and Accessories Regulatory Class: Class II Product Code: PIF, PIO Dated: November 28, 2014 Received: November 28, 2014

Dear Dianne Batch,

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 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

1

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/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,

Image /page/1/Picture/8 description: The image shows the name "Benjamin R. Fisher -A" in a large, bold font. The text is black and appears to be centered on a white background. The letters are clearly legible, and the overall impression is clean and professional.

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

Enclosure

2

Indications for Use

510(k) Number (if known) K142539

Device Name

Enteralite Infinity Enteral Pump Delivery Set, 1200 ML Enteral Feeding Delivery Set

Indications for Use (Describe)

The devices in this product family are used to dispense liquid nutrients (feeding solution) at a preprogrammed pump or user controlled rate. These enteral feeding sets interface with the patient's feeding tube and may use gravity or an enteral feeding pump to dispense feeding solution. The devices may include a bag to contain the feeding solution and/or a spike to connect to a prefilled container.

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

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

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:

Department of Health and Human Services Food and Druq Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

3

510(k) Summary

for

Enteral Feeding Sets

1. Submission Sponsor

Zevex, Inc. 4314 Zevex Park Lane Salt Lake City, Utah 84123 USA Phone: 801.201.6928 Fax: 801.264.1051 Contact: Dianne Batch, Director, RA/QA

2. Date Prepared

September 5, 2014

3. Device Identification

Trade/Proprietary Name:EnteraLite Infinity Enteral Pump Delivery Sets
1200 mL Enteral Feeding Delivery Set
Common/Usual Name:Enteral Feeding Sets
Classification Name:Gastrointestinal Tubes and Accessories
Classification Regulation:876.5980
Feeding Set Product Code: PIF
Transition Connector
Product Code:PIO
Device Class:Class II
Classification Panel:Gastroenterology/Urology

4. Legally Marketed Predicate Device(s)

K012147, Zevex, Inc., Enteral Feeding Sets for Gravity and Pump Use

5. Device Description

These enteral feeding sets are designed to be used with or without an enteral feeding pump, (pump is not in scope for this 510k) model specific. Refer to diagrams below for explanation of components. The enteral sets terminate in a bonded conical connector, the ENFit connector; that is designed to be incompatible with ISO 594-1/2 and other non-enteral feeding connections. The ENFit connector is a new connector and it is anticipated that not all patient feeding tubes will be compatible with it, so the administration sets include an adapter that connects to the ENFit connector on one end while providing the traditional "Christmas Tree" shaped transitional stepped connector on the other.

6.

Indication for Use Statement

The devices in this product family are used to dispense liquid nutrients (feeding solution) at a preprogrammed pump or user controlled rate. These enteral feeding sets interface with

4

the patient's feeding tube and may use gravity or an enteral feeding pump to dispense feeding solution. The devices may include a bag to contain the feeding solution and/or a spike to connect to a prefilled container.

7. Substantial Equivalence Discussion

The following table compares the Enteral Feeding Sets to the predicate device with respect to intended use, technological characteristics and principles of operation, providing more detailed information regarding the basis for the determination of substantial equivalence.

In the 'Significant Differences' column of the table, list the differences between the device and the predicate and briefly justify why these differences do not raise safety and effectiveness concerns.

ManufacturerMoog Medical DevicesMoog Medical DevicesSignificant
GroupGroupDifferences
Trade NameEnteral Feeding SetsZevex, Inc., Enteral
Feeding Sets For Gravity
And Pump Use
510(k) NumberK142539K012147N/A
Product CodePIF, PIOKNTUpdated Codes from FDA
Regulation876.5980876.5980Same
Number
Regulation NameGastrointestinal TubesTubes, GastrointestinalSame
and Accessories(and Accessories)
Indications forThe devices in thisThe devices in this productThe difference is in the
Useproduct family are usedfamily are used todistal (or patient) end of
to dispense liquiddispense liquid nutrientsthe device. Where the
nutrients (feeding(feeding solution) at apredicate terminates
solution) at apreprogrammed pump oronly in a traditional
preprogrammed pump oruser controlled rate.stepped connector, the
user controlled rate.These enteral feeding setsproposed device
These enteral feedinginterface with theterminates in a bonded
sets interface with thepatient's feeding tube andENFit connector which is
patient's feeding tubemay use gravity or andesigned to be
and may use gravity or anenteral feeding pump toincompatible with all
enteral feeding pump todispense feeding solution.other defined connectors
dispense feedingThe devices may include aavailable. The ENFit
solution. The devicesbag to contain the feedingconnector is designed to
may include a bag tosolution and/or a spike tocomply with ISO 80369-3.
contain the feedingconnect to a prefilledGI Tubes that are
solution and/or a spike tocontainer.compatible with the ISO
connect to a prefilled80369-3 compliant
container.design will be able to
ManufacturerMoog Medical Devices
GroupMoog Medical Devices
GroupSignificant
Differences
Trade NameEnteral Feeding SetsZevex, Inc., Enteral
Feeding Sets For Gravity
And Pump Use
connect directly to the
ENFit connector. Non
ISO 80369-3 compliant GI
tubes will be able to
connect to the
transitional stepped
connector which is
designed to adapt to the
ENFit connector.
MaterialNon-DEHP PVC tubing,
extruded film (bags), inlet
port and outlet port;
Polyethylene inlet port
cap; polycarbonate
connector/pump
interface (cassette);
silicone pump tubing
segment; ABS distal
(stepped) connector.Non-DEHP PVC tubing,
extruded film (bags), inlet
port and outlet port;
Polyethylene inlet port
cap; polycarbonate
connector/pump interface
(cassette); silicone pump
tubing segment; ABS distal
(stepped) connector.Similar; the differences
between them are that
the ABS formulation (HF
  1. and color of the
    ENFit connector (purple,
    Remofin Violet
    PE43076356-ZT)) are
    different from the ABS
    formulation (CYCOLAC
    HMG47MD 6H3C106,
    pre-colored) used in the
    current stepped adapter. |
    | Sterile | Non-sterile | Non-sterile | Same |
    | Overall Design | | | |
    | Length | Set length varies, tubing
    lengths same as
    predicate; connector is
    slightly shorter (~ 0.82"
    vs. ~2.0") than the
    current stepped adapter,
    but with the adapter
    (~1.74") the overall set
    length will be less than
    1/4" different. | Set length varies
    depending on
    configuration. | Same
    The EnFit connector has a
    slightly larger ID, which
    has shown no negative
    impact on flow rates. |
    | Diameter | EnFit connector ID is
    0.116". | Distal connector ID is
    0.10". | |
    | Single-Use | Yes | Yes | Same |
    | Shelf Life | 1 yr. | 1 yr. (minimum) | Same |
    | Manufacturer | Moog Medical Devices | Moog Medical Devices | Significant |
    | | Group | Group | Differences |
    | Trade Name | Enteral Feeding Sets | Zevex, Inc., Enteral | |
    | | | Feeding Sets For Gravity | |
    | | | And Pump Use | |
    | Latex Free | Yes | Yes | Same |
    | Complies with ISO | Yes | Yes | Same |
    | 10993-1 | | | |

Table 5A – Comparison of Characteristics

5

6

8. Non-Clinical Performance Data

The following testing has been performed to support substantial equivalence:

  • Bond Strength - Passed
  • Leak Testing - Passed
  • Volumetric accuracy testing Passed ●
  • Biocompatibility - Passed
  • Misconnection assessment - Passed
  • Dimensional analysis — Passed
  • Enteral Connector Risk Management Report Acceptable ●
  • Human Factors Testing – Acceptable
  • Failure Modes and Effects Analysis (FMEA) – Acceptable
  • Accelerated Aging - Passed
  • ISO 80369-3 Testing as follows:
    • . Falling drop positive pressure liquid leakage - Passed
    • Stress cracking - Passed
    • Resistance to separation from axial load – Passed
    • Resistance to separation from unscrewing – Passed
    • Resistance to overriding - Passed
    • Disconnection by unscrewing - Passed
    • Falling drop positive pressure liquid leakage after 20 cycles of connection and separation - Passed

As part of demonstrating safety and effectiveness of Enteral Feeding Sets and in showing substantial equivalence to the predicate devices that are subject to this 510(k) submission, Zevex completed a number of tests. The Enteral Feeding Sets meets all the requirements for overall design, functionality, biocompatibility, and confirms that the output meets the design inputs and specifications. The Enteral Feeding Sets passed all testing stated above as shown by the acceptable results obtained.

The Enteral Feeding Sets along with the ENFit connector and adapter complies with the applicable voluntary standards for biocompatibility. The devices passed all the testing in accordance with national and international standards.

9. Clinical Performance Data

There was no clinical testing required to support the medical device as the indications for use is equivalent to the predicate device. These types of devices, including the predicate devices, have been on the market for many years with a proven safety and efficacy for the use of the device. The non-clinical testing detailed in this submission supports the substantial equivalence of the device.

7

10. Statement of Substantial Equivalence

It has been shown in this 510(k) submission that the difference between the Enteral Feeding Sets and the predicate devices do not raise any questions regarding its safety and effectiveness. The Enteral Feeding Sets, as designed and manufactured, is determined to be substantially equivalent to the referenced predicate devices.