K Number
K143437
Device Name
Droplet Pen Needles
Manufacturer
Date Cleared
2015-06-25

(206 days)

Product Code
Regulation Number
880.5570
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Droplet® Pen Needles are intended for use with pen injector device for the subcutaneous injection of insulin.
Device Description
The Droplet® Pen Needles are sterile, single use needles designed to be used with commercially available pen-injectors for the subcutaneous injection of insulin. Pen needles are used by consumers, caregivers and healthcare professionals. The pen needle assembly consists of a double-ended cannula that is assembled into an injection molded hub using adhesive. The hub has internal threads, which allow it to be screwed onto the pen injector device. This allows the cartridge end of the cannula to penetrate through the rubber septum of the cartridge. The patient end and the cartridge end of the cannula are lubricated using a silicone based lubricant for ease of injection and rubber septum penetration. There is an inner needle shield assembled over the patient end of the cannula to protect the needle point from damage and accidental needle sticks. There is also an outer protective container. Each pen needle assembly is protected with a peel away seal to provide a sterility barrier. To use a pen needle, the user needs to remove the seal, remove the outer protective cap and attach it to the pen injector. Then the user removes the inner protective cap to expose the needle and make an injection. Following the injection the user inserts the used pen needle into the outer cap to remove the pen needle from the pen injector and dispose of it immediately. The pen needle is individually packaged and sterilized with Gamma radiation. It is intended for single use only. Droplet® Pen Needles are available in the following lengths and gauges: 4 mm x 32G, 5 mm x 32G, 6 mm x 32G, 8 mm x 32G, 5 mm x 31G, 6 mm x 31G, 8 mm x 31G, 10 mm x 29G, 12 mm x 29G.
More Information

No
The device description and performance studies focus on the physical characteristics and functionality of a pen needle for insulin injection, with no mention of AI or ML.

No.
This device is a pen needle, which is used for the delivery of a therapeutic substance (insulin) but does not itself provide a therapeutic effect. It is an accessory to a drug delivery system.

No

The device is a pen needle intended for the injection of insulin, which is a therapeutic action, not a diagnostic one.

No

The device description clearly outlines a physical medical device (pen needles) with hardware components (cannula, hub, shields, packaging) and manufacturing processes (injection molding, adhesive, lubrication, sterilization). There is no mention of software as a component or function of the device.

Based on the provided information, the Droplet® Pen Needles are not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use is for the subcutaneous injection of insulin using a pen injector device. This is a direct administration of a substance into the body, not a test performed on a sample taken from the body.
  • Device Description: The description details a needle designed for injection, not for collecting or analyzing biological samples.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Testing of biological samples (blood, urine, tissue, etc.)
    • Detection or measurement of analytes
    • Diagnosis, monitoring, or screening of diseases or conditions based on sample analysis

IVD devices are used to perform tests outside of the body on samples taken from the body to provide information about a person's health. The Droplet® Pen Needles are used to deliver a substance into the body.

N/A

Intended Use / Indications for Use

The Droplet® Pen Needles are intended for use with pen injector device for the subcutaneous injection of insulin.

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

FMI

Device Description

The Droplet® Pen Needles are sterile, single use needles designed to be used with commercially available pen-injectors for the subcutaneous injection of insulin. Pen needles are used by consumers, caregivers and healthcare professionals. The pen needle assembly consists of a double-ended cannula that is assembled into an injection molded hub using adhesive. The hub has internal threads, which allow it to be screwedonto the pen injector device. This allows the cartridge end of the cannula to penetrate through the rubber septum of the cartridge. The patient end and the cartridge end of the cannula are lubricated using a silicone based lubricant for ease of injection and rubber septum penetration. There is an inner needle shield assembled over the patient end of the cannula to protect the needle point from damage and accidental needle sticks. There is also an outer protective container. Each pen needle assembly is protected with a peel away seal to provide a sterility barrier. To use a pen needle, the user needs to remove the seal, remove the outer protective cap and attach it to the pen injector. Then the user removes the inner protective cap to expose the needle and make an injection. Following the injection the user inserts the used pen needle into the outer cap to remove the pen needle from the pen injector and dispose of it immediately. The pen needle is individually packaged and sterilized with Gamma radiation. It is intended for single use only. Droplet® Pen Needles are available in the following lengths and gauges: 4 mm x 32G, 5 mm x 32G, 6 mm x 32G, 8 mm x 32G, 5 mm x 31G, 6 mm x 31G, 8 mm x 31G, 10 mm x 29G, 12 mm x 29G.

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

consumers, caregivers and healthcare professionals

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)

Verification/Validation testing was done according to the requirements of ISO 11608-2:2012. All testing met the applicable requirements, including tests for materials, dimensions, flow rate, bond between hub and needle tube, freedom from defects, lubrication, dislocation of measuring point at patient end, functional compatibility with needle-based injection systems, ease of assembly and disassembly, and pre-conditioning of needles. Biocompatibility testing (Cytotoxicity, Sensitization, Intracutaneous Reactivity, Haemocompatibility, System toxicity (acute), Subchronic toxicity (subacute toxicity)) was conducted based on ISO 10993-1 and successfully passed. Sterility testing ensured the device's sterility over its shelf life.

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.

K031200, K100005

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.

K133738, K013782

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

§ 880.5570 Hypodermic single lumen needle.

(a)
Identification. A hypodermic single lumen needle is a device intended to inject fluids into, or withdraw fluids from, parts of the body below the surface of the skin. The device consists of a metal tube that is sharpened at one end and at the other end joined to a female connector (hub) designed to mate with a male connector (nozzle) of a piston syringe or an intravascular administration set.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of three human profiles facing to the right, stacked on top of each other.

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

June 25, 2015

HTL-Strefa S.A. Ms. Aleksandra Prazmowska-Wilanowska QA/RA/ Director Adamówek 7 95-035 Ozorków Poland

Re: K143437

Trade/Device Name: Droplet® Pen Needles Regulation Number: 21 CFR 880.5570 Regulation Name: Hypodermic Single Lumen Needle Regulatory Class: II Product Code: FMI Dated: May 21, 2015 Received: May 26, 2015

Dear Ms. Prazmowska-Wilanowska:

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

Page 2 - Ms. Prazmowska-Wilanowska

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,

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

Indications for Use

510(k) Number (if known) K143437

Device Name Droplet® Pen Needles

Indications for Use (Describe)

The Droplet® Pen Needles are intended for use with pen injector device for the subcutaneous injection of insulin.

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

Prescription Use (Part 21 CFR 801 Subpart D)

|X | Over-The-Counter Use (21 CFR 801 Subpart C)

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3

510(k) Summary - K143437

As required by the Safe Medical Devices Act of 1990 and in accordance with 21 CFR ട്ല807.92(a).

[807.92 (a)(1,2)]

Date Summary Prepared:June 11, 2015
Submitted By:HTL-STREFA S.A.
Adamówek 7,
95-035 Ozorków
POLAND
Phone: +48 42 270 00 10
Fax: +48 42 270 00 20
Contact Person:Aleksandra Prazmowska-Wilanowska
QA/RA Director
ola.prazmowska-wilanowska@htl-strefa.pl
Trade Name:Droplet® Pen Needles
Models:4mm x 32G, 5mm x 32G, 6mm x 32G, 8mm x 32G, 5mm x 31G, 6mm x 31G, 8mm x 31G, 10mm x 29G, 12mm x 29G
Common Name:Insulin Pen Needle
Classification name:Hypodermic Single Lumen Needle
Device Classification:Class II, 21 CFR § 880.5570
Product Code: FMI
Review Panel:80 General Hospital

Predicate Devices: [807.92(a)(3)]

The legally marketed devices to which substantial equivalence is claimed are:

ManufacturerTrade Name510(k) Number
Becton Dickson & Co.BD Ultra-FineK031200
Becton Dickson & Co.BD Ultra-FineK100005

Reference devices:

ManufacturerTrade Name510(k) Number
Novo Nordisk Inc.Novofine® PlusK133738
Disetronic Medical SystemsPenfine® Insulin Injection
Pen NeedleK013782

4

Description of Device: [807.92(a)(4)]

The Droplet® Pen Needles are sterile, single use needles designed to be used with commercially available pen-injectors for the subcutaneous injection of insulin. Pen needles are used by consumers, caregivers and healthcare professionals. The pen needle assembly consists of a double-ended cannula that is assembled into an injection molded hub using adhesive. The hub has internal threads, which allow it to be screwed onto the pen injector device. This allows the cartridge end of the cannula to penetrate through the rubber septum of the cartridge. The patient end and the cartridge end of the cannula are lubricated using a silicone based lubricant for ease of injection and rubber septum penetration. There is an inner needle shield assembled over the patient end of the cannula to protect the needle point from damage and accidental needle sticks. There is also an outer protective container. Each pen needle assembly is protected with a peel away seal to provide a sterility barrier. To use a pen needle, the user needs to remove the seal, remove the outer protective cap and attach it to the pen injector. Then the user removes the inner protective cap to expose the needle and make an injection. Following the injection the user inserts the used pen needle into the outer cap to remove the pen needle from the pen injector and dispose of it immediately. The pen needle is individually packaged and sterilized with Gamma radiation. It is intended for single use only. Droplet® Pen Needles are available in the following lengths and gauges: 4 mm x 32G, 5 mm x 32G, 6 mm x 32G, 8 mm x 32G, 5 mm x 31G, 6 mm x 31G, 8 mm x 31G, 10 mm x 29G, 12 mm x 29G.

Indications for Use: [807.92(a)(5)]

The Droplet® Pen Needles are intended for use with pen injector device for the subcutaneous injection of insulin.

Technological Characteristics: [807.92(a)(6)]

A comparison of characteristics of Droplet pen needles and the predicate devices is shown in the table below:

| Device Name | Subject Device | Predicate
Device #1 | Predicate Device
#2 |
|---------------|-----------------|------------------------|------------------------|
| Manufacturer | HTL STREFA S.A. | Becton Dickinson | Becton Dickinson |
| 510(k) Number | Pending | K031200 | K100005 |

5

| Intended use | | intended for use
with pen injector
device for the
subcutaneous
injection of insulin | intended for use
with pen injector
device for
the subcutaneous
injection of insulin | intended for use
with pen injector
device for
the subcutaneous
injection of drugs,
including insulin
and exenatide |
|--------------|-------------------------------------------------|-----------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------|
| | Operation principle | Manual | Manual | Manual |
| | Design | Needle assembly –
cannula, needle hub,
inner protective cap,
outer protective cap,
seal | Needle assembly –
cannula, needle
hub, inner
protective cap,
outer protective
cap, seal | Needle assembly –
cannula, needle
hub, inner
protective cap, outer
protective cap, seal |
| | Product Code | FMI | FMI | FMI |
| | Length | 4mm, 5mm,
6mm,
8mm,10mm,
12mm | 5mm, 8mm,
12.7mm | 4mm |
| Materials | Needle
tube | AISI 304
Grade Stainless
Steel | AISI 304
Grade Stainless
Steel | AISI 304
Grade Stainless
Steel |
| | Hub | Polypropylene | Polypropylene | Polypropylene |
| | Primary
Container
and
Needle
Shield | Polypropylene | Polypropylene | Polypropylene |
| | Biocompatibility | Conforms to
ISO10993-1 | Conforms to
ISO10993-1 | Conforms to
ISO10993-1 |
| | Sterilization | Gamma radiation
(validated in
accordance with
ISO 11137-1 to
achieve SAL 10-
6) | Gamma radiation | Gamma radiation |

6

Size characteristics of the reference devices:

ManufacturerTrade NameSize
Disetronic Medical SystemsPenfine® Insulin Injection
Pen Needle29G x 6mm
30G x 6mm
31G x 6mm
29G x 10mm
30G x 10mm
31G x 10mm
29G x 12mm
30G x 12mm
31G x 12 mm
Novo Nordisk Inc.Novofine® Plus32G x 6mm

The reference devices are provided for purposes of sizes and lengths that are not available with the predicate devices. The reference devices have same or similar IFUs as the subject device.

Non-Clinical Performance Data: [(807.92(b)(1)]

Verification/Validation testing was done according to the requirements of ISO 11608-2:2012 as summarized below. All testing met the applicable requirements.

Test ParameterRequirement – ISO 11608-2:2012Result
MaterialsThe needle shall be made of tubing
materials specified in ISO 9626.Meets standard
DimensionsThe needles shall fit the test apparatus
specified in item 7.3 of ISO 11608-2.Meets standard
Determination of flow rate
through the needleThe needle was tested in accordance with
Annex A to ISO 11608-2 to determine
flow rate through the needle.Meets standard
Bond between hub and needle
tubeThe union of the hub and needle tube
shall not break when tested in accordance
with Clause 9 of ISO 11608-2.Meets standard
Freedom from defectsThe needle tube shall fulfill the
requirements of ISO 7864, 11.3.Meets standard
LubricationThe needle tube should be lubricated at
both the patient end and the cartridge end.
The lubricant shall not, under normal orMeets standard

7

Test ParameterRequirement – ISO 11608-2:2012Result
corrected-to-normal vision, be visible as droplets of fluid on the outside surface of the needle tube.
Dislocation of measuring point at patient endDislocation of the cannula point at the patient end shall be in accordance with Table 2 below when tested as per Clause 8 (of ISO 11608-2).Meets standard
Determination of functional compatibility with needle-based injection systemsCompatibility with any NIS shall be claimed only after testing in accordance with Clause 11.Meets standard
Ease of assembly and disassemblyAttachment of the needle shall be possible without removing the needle from its opened unit packaging. Compliance is checked according to the requirements of Clause 11.Meets standard
Pre-conditioning of needlesAll requirements of the standard related to preconditioning of needles were met.Meets standard

Biocompatibility testing

The following biocompatibility testing has been conducted on the Droplet® Pen Needles. The selection of biocompatibility tests was made based on the requirements of ISO 10993-1. All the tests have been successfully passed.

TestResult
CytotoxicityPassed
SensitizationPassed
Intracutaneous ReactivityPassed
HaemocompatibilityPassed
System toxicity (acute)Passed
Subchronic toxicity (subacute toxicity)Passed

8

Sterility testing

Droplet® Pen Needles are sterilized with Gamma radiation. To ensure sterility of the device over its shelf life, relevant sterility testing is conducted. Droplet® Pen Needles have passed all relevant sterility tests successfully.

Clinical Performance Data: [(807.92(b)(2)] Clinical data were not provided.

Conclusion: [(807.92(b)(3)]

Droplet® Pen Needles are substantially equivalent in the intended use, technology/principle of operation, materials and performance to the predicate devices and do not raise any new questions of safety and effectiveness.