K Number
K143234
Device Name
MaxZero Administration Sets
Manufacturer
Date Cleared
2014-11-20

(10 days)

Product Code
Regulation Number
880.5440
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The MaxZero Intravascular Administration set with needleless connector(s) is a device used to administer fluids from a container to a patient's vascular system. The administration set is for single patient use only. The administration set can be used for direct injection, intermittent infusion or continuous infusion.
Device Description
The CareFusion MaxZero Administration Sets are intravascular administration sets intended for single patient use, including pediatrics and immunocompromised patients, for direct injection, intermittent infusion continuous infusion of drugs, blood and fluids. All MaxZero Administration Sets include the previously cleared zero reflux MZ1000 Needleless Connector (K132413) bonded to the extension set tubing. The MZ1000 needleless connector allows thorough and easy disinfection due to a solid, flat smooth surface and eliminates the risk of needlestick injuries. The MaxZero Administration Sets are sterile single patient devices. All extension sets included in this submission are not made from material containing natural rubber latex or DEHP.
More Information

No
The document describes a standard intravascular administration set and its components, with no mention of AI or ML capabilities.

No
The device is used for administering fluids, drugs, and blood into a patient's vascular system, which is a supportive function and not a direct therapeutic treatment of a disease or condition.

No

Explanation: The device is an administration set used to deliver fluids to a patient's vascular system. Its purpose is to administer, not to diagnose.

No

The device description clearly outlines a physical medical device (intravascular administration set with needleless connector) and the performance studies focus on physical characteristics and testing (microbial ingress, shelf life, biocompatibility, etc.), not software validation.

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

Here's why:

  • Intended Use: The intended use is to "administer fluids from a container to a patient's vascular system." This is a direct therapeutic or supportive action on the patient's body, not a test performed on a sample taken from the body to diagnose a condition.
  • Device Description: The description reinforces the administration of fluids and highlights features related to that function (needleless connector, sterile, single patient use).
  • Lack of IVD Indicators: There is no mention of analyzing samples, detecting substances, or providing diagnostic information.

IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. This device's function is entirely focused on delivering substances into the body.

N/A

Intended Use / Indications for Use

The MaxZero Intravascular Administration set with needleless connector(s) is a device used to administer fluids from a container to a patient's vascular system. The administration set is for single patient use only. The administration set can be used for direct injection, intermittent infusion or continuous infusion.

Product codes

FPA

Device Description

The CareFusion MaxZero Administration Sets are intravascular administration sets intended for single patient use, including pediatrics and immunocompromised patients, for direct injection, intermittent infusion continuous infusion of drugs, blood and fluids. All MaxZero Administration Sets include the previously cleared zero reflux MZ1000 Needleless Connector (K132413) bonded to the extension set tubing. The MZ1000 needleless connector allows thorough and easy disinfection due to a solid, flat smooth surface and eliminates the risk of needlestick injuries. The MaxZero Administration Sets are sterile single patient devices. All extension sets included in this submission are not made from material containing natural rubber latex or DEHP.

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

pediatrics

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)

CareFusion performed design verification performance testing to verify, demonstrate and support the claim of substantial equivalence to the predicate devices. All test results met their acceptance criteria and support that the MaxZero Administration Sets are appropriately designed for their intended use.

Testing performed included:

  • Microbial ingress and barrier testing
  • Design verification testing
  • Shelf life performance testing
  • Harsh Infusates testing
  • Priming volume/flow rate testing
  • Biocompatibility
  • Sterilization

The results of the non-clinical testing exhibited that no new issues of safety and efficacy are raised with the proposed introduction of the MaxZero Administration Sets. The device met the acceptance criteria for all functional, microbial ingress, sterility, biocompatibility and other performance criteria, which verify it to be substantially equivalent to the predicate devices. The conclusion drawn from the performance testing demonstrate that the CareFusion MaxZero Administration Sets are as safe as effective and performs at least as safe and effectively as the legally marketed predicate devices.

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

Not Found

Predicate Device(s)

K051499, K132413

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.

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

November 20,2014

CareFusion c/o Mark Job Regulatory Technology Services LLC 1394 25th Street N.W. Buffalo, Minnesota 55313

Re: K143234

Trade/Device Name: MaxZero Administration Set Regulation Number: 21 CFR 880.5440 Regulation Name: Intravascular administration set Regulatory Class: II Product Code: FPA Dated: November 7, 2014 Received: November 10, 2014

Dear Mark Job:

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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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,

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

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K143234

Device Name MaxZero Administration Sets

Indications for Use (Describe)

The MaxZero Intravascular Administration set with needleless connector(s) is a device used to administer fluids from a container to a patient's vascular system. The administration set is for single patient use only. The administration set can be used for direct injection, intermittent infusion or continuous infusion.

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

X 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)

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510(k) Summary

Submitter Information

A. Company Name:CareFusion
B. Company Address:10020 Pacific Mesa Blvd.
San Diego, CA 92121
C. Company Phone:(858) 617-3042
D. Company Fax:(858) 617-5982
E. Contact Person:Larry Walker
F. Date Summary Prepared:October 14, 2014

Device Identification

A. Trade NameMaxZero Administration Sets
B. Common Name:IV Administration Sets
C. Classification:IV Administration Set, Needleless Connector,
Closed Access, 21 CFR 880.5440, (Product code FPA)

Legally Marketed Predicate Device for Substantial Equivalence

Predicate DeviceManufacturer510(k) #Date Cleared
(Primary) Medegen
Intravascular Administration
Set and Extension SetCareFusion (formerly
Medegen)K051499June 22, 2005
MZ1000 Needleless ConnectorCareFusionK132413August 29, 2013

Rational for Substantial Equivalence

The information provided in the premarket notification demonstrates that the subject CareFusion MaxZero Administration Sets are substantially equivalent to the legally marketed predicated devices. The subject MaxZero Administration Sets and the primary predicate Medeqen Administration Sets are intended to be used for the delivery of fluids to an IV catheter in a hospital environment. The subject and the predicate devices are similar in physical properties, materials, and configuration. Each device includes connectors that allow for needleless access to the IV line during IV therapy eliminating the risk of needle injury. The subject device incorporates the predicate MZ1000 Needleless Connector bonded directly to IV tubing. Components of the subject devices are made of materials that are substantial equivalent to the predicate devices listed above and this submission includes comprehensive biocompatibility testing for all device materials included in this submission.

Device Description

The CareFusion MaxZero Administration Sets are intravascular administration sets intended for single patient use, including pediatrics and immunocompromised patients, for direct

1 of 3 Section 5- 510(K) Summary

5

injection, intermittent infusion continuous infusion of drugs, blood and fluids. All MaxZero Administration Sets include the previously cleared zero reflux MZ1000 Needleless Connector (K132413) bonded to the extension set tubing. The MZ1000 needleless connector allows thorough and easy disinfection due to a solid, flat smooth surface and eliminates the risk of needlestick injuries. The MaxZero Administration Sets are sterile single patient devices. All extension sets included in this submission are not made from material containing natural rubber latex or DEHP.

The following model numbers are subject to this submission:

| Model
Number | Description | Tubing
ID | Tubing
OD |
|-----------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------|--------------|
| MZXT4001 | MaxZero administration set, microbore tubing, amber tubing, IV
connector, 20 drop drip chamber, filter, check valve, T-connector, ≈95
inch I | 0.020" | 0.079" |
| MZ8001 | MaxZero Administration set, microbore tubing, 3 MaxZero connectors, 20
drop drip chamber, 0.2 micron filter, check valve, anti-siphon valve, 3
colored pinch clamps, spin male luer. ≈ 95 inches | 0.020" | 0.079" |

Intended Use

The MaxZero intravascular administration set with needleless connector(s) is a device used to administer fluids from a container to a patient's vascular system. The administration set is for single patient use only. The administration set can be used for direct injection, intermittent infusion or continuous infusion.

Substantial Equivalence Table

DeviceCareFusion MaxZero Administration SetsCareFusion (formerly Medegen) Intravascular Administration Set and Extension Set
510(k) #TBD Subject deviceK051499
Fluid contacting materialsNeedleless Connector:
Polycarbonate, silicone rubber
Drip Chamber: PVC, ABS
Polyethylene, Gelman Vespar
Tubing: PVC
Bi-F Connector: Rigid PVC
Back Check Valve: MABS, silicon rubber
Male Luer Adapter: ABS
Male Spinloc: ABS
Female Luer: Copolyester
Filter: Acrylic, Gulman SuporNeedleless Connector:
Polycarbonate. Liquid silicone rubber
Drip Chamber: ABS, Polyethylene, PTFE
Tubing: PVC
Rotating luer lock: ABS
Female luer lock: Copolyester
Male luer lock: Acrylic
Bi-F Connector: ABS
Check Valve: ABS, silicone rubber
Stopcock: Polycarbonate
Flow Controller: ABS, silicon rubber
Manifold: ABS, LDPE, silicon rubber, Copolyester
Filter: Acrylic, Gore-Tex
Needleless ConnectorCareFusion MZ1000
(K132413)CareFusion NAC Plus Needleless Connector
(K011193)
Functional UseDirect Injection, intermittent infusion, continuous infusionDirect Injection, intermittent infusion, continuous infusion, aspiration
PackagingTyvek/polymer pouchTyvek/ polymer pouch
Sterilization MethodE-BeamIrradiation
Usable LifePer facility protocol or in accordance with current recognized guidelines for IV therapy.Per CDC guidelines

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Technical Characteristics

Technological Characteristics
Zero Reflux Needleless Connector
Designed to prevent microbial ingress
Needleless connector can be disinfected with 3 sec scrub with 70% IPA
Non-hemolytic
Not made with DEHP
Safe for use in MRI environment
Not made with natural latex rubber
Sets can be used with harsh infusates

Clinical Data

There is no clinical data included in this submission.

Non-Clinical Data

CareFusion performed design verification performance testing to verify, demonstrate and support the claim of substantial equivalence to the predicate devices. All test results met their acceptance criteria and support that the MaxZero Administration Sets are appropriately designed for their intended use.

Testing performed included:

  • Microbial ingress and barrier testing ●
  • . Design verification testing
  • Shelf life performance testing .
  • Harsh Infusates testing
  • . Priming volume/flow rate testing
  • . Biocompatibility
  • Sterilization

For complete list of non-clinical testing please see the following sections.

  • . Sterilization: Section 14
  • Biocompatibility: Section 15
  • Performance Bench: Section 18

Conclusion

The results of the non-clinical testing exhibited that no new issues of safety and efficacy are raised with the proposed introduction of the MaxZero Administration Sets. The device met the acceptance criteria for all functional, microbial ingress, sterility, biocompatibility and other performance criteria, which verify it to be substantially equivalent to the predicate devices. The conclusion drawn from the performance testing demonstrate that the CareFusion MaxZero Administration Sets are as safe as effective and performs at least as safe and effectively as the legally marketed predicate devices.