K Number
K143015
Device Name
Hospira Primary Sets
Manufacturer
Date Cleared
2015-02-25

(128 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. Primary Sets are comprised of a variety of components, at a minimum including a male luer adapter with spin collar, a piercing pin assembly, a cap on each adapter, injection site assembly, dial-a-flo assembly and tubing. In addition to these components, a set may contain one or more of the following components: flow control device, drip chamber assembly and air inlet. Hospira Primary sets are intended for the delivery of fluids from a container to a patient's vascular system. Hospira infusion sets are disposable devices for single patient use.
More Information

Not Found

No
The device description and performance studies focus on mechanical components and fluid delivery, with no mention of AI or ML technologies.

No
Explanation: The device is indicated for the delivery of fluids, which is a supportive function and not a direct therapeutic action to treat a disease or condition. It facilitates therapy but is not therapeutic itself.

No

This device is an infusion set designed for delivering fluids, not for diagnosing conditions or diseases. Its purpose is therapeutic delivery, not diagnostic assessment.

No

The device description clearly outlines physical components such as a male luer adapter, piercing pin assembly, tubing, etc., 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 for the "delivery of fluids from a container to a patient's vascular system." This describes a device used for administering substances directly into the body, not for testing samples taken from the body.
  • Device Description: The description details components like luer adapters, piercing pins, tubing, and flow control devices, all consistent with an infusion set used for delivering fluids intravenously. There is no mention of components or functions related to analyzing biological samples.
  • Lack of IVD Characteristics: An IVD device is typically used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. This device does not perform any such analysis.

Therefore, the Hospira Primary Sets are medical devices used for fluid delivery, 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

FPA

Device Description

The Hospira Primary Sets with Secure Lock are intended for use as gravity sets. Primary Sets are comprised of a variety of components, at a minimum including a male luer adapter with spin collar, a piercing pin assembly, a cap on each adapter, injection site assembly, dial-a-flo assembly and tubing. In addition to these components, a set may contain one or more of the following components: flow control device, drip chamber assembly and air inlet. Hospira Primary sets are intended for the delivery of fluids from a container to a patient's vascular system. 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. New performance data has been generated to ensure the device performs as intended in accordance with ISO 594-1, ISO 594-2 and ISO 8536-4. All testing is acceptable. The product Sterility Assurance Level is 10-6.

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

Not Found

Predicate Device(s)

K142367

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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.

0

Image /page/0/Picture/1 description: The image shows the seal of the U.S. Department of Health and Human Services. The seal features the department's name in a circular arrangement around a stylized image of three human profiles. The profiles are stacked on top of each other, creating a sense of unity and collaboration. The seal is simple, yet recognizable, and represents the department's mission to protect the health of all Americans.

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

February 25, 2015

Hospira, Inc. Ms. Anju Kurian Associate, Regulatory Affairs D- 0393 Bldg. H3 375 N. Field Drive Lake Forest, Illinois 60045

Re: K143015

Trade/Device Name: Hospira Primary Sets Regulation Number: 21 CFR 880.5440 Regulation Name: Intravascular Administration Sets Regulatory Class: II Product Code: FPA Dated: January 23, 2015 Received: January 26, 2015

Dear Ms. Kurian:

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

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Indications for Use Statement

K143015 510(k) Number:

Device Name: Hospira Primary Set

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

Prescription Use x (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (Part 21 CFR 807 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

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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. 60045
Phone number(224) 212-6141
Fax number(224) 212-5401
Establishment
Registration Number3005579246 (Owner/Operator #9063339)
Name of contact
personAnju Kurian, Associate, Global Regulatory Affairs
Date prepared10/17/2014
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 - K142367
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. Primary Sets are comprised of a variety of components, at a minimum including a male luer adapter with spin collar, a piercing pin assembly, a cap on each adapter, injection site assembly, dial-a-flo assembly and tubing. In addition to these components, a set may contain one or more of the following components: flow control device, drip chamber assembly and air inlet. Hospira Primary sets are intended for the delivery of fluids from a container to a patient's vascular system. 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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| Summary of the technological characteristics of the device compared to the predicate

device
CharacteristicPredicate 510 (k) : K142367Proposed Device
Indications for UseHospira Primary Sets are indicated
for the delivery of fluids from a
container to a patient's vascular
system.Hospira Primary Sets are indicated for the
delivery of fluids from a container to a
patient's vascular system.
Design and Materials of
ConstructionThe materials of construction for the
proposed device are exactly the same
as the materials for the predicate
productThe design and materials of construction
remain the same as 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.All materials of construction for Hospira
Primary Sets meet the applicable material
test requirements for ISO 10993.
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. | New performance data has been generated
to ensure the device performs as intended
in accordance with ISO 594-1, ISO 594-2
and ISO 8536-4. All testing is acceptable.

The product Sterility Assurance Level
is 10-6. |

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 Hospira Primary Sets cleared under K142367.

CONFIDENTIAL