K Number
K150333
Device Name
MedSource Sharps Dart
Date Cleared
2015-05-08

(87 days)

Product Code
Regulation Number
880.5570
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The MedSource Sharps Datt is a non-sterile single-use disposable sharps container with a permanent closure system for a contaminated 1 ml or smaller syringe. Its intended use is by health care professionals in a setting where standard sharps containers are not accessible such as EMS, home healthcare, and laboratories. Its permanent closure system protects the user prior to disposal by incineration or decontamination by autoclave.
Device Description
The MedSource Sharps Dart (MSD) sharps container consists of two injected molded parts-a tubular tapered cone and a polypropylene closure. Its small size of 0.6 L qualifies it as a pocket sharps container as defined by ISO 23907 First Edition 2012-09-01, Sharps injury protection-Requirements and test methods-Sharps containers. It is designed for the storage, such sharps as small syringes, blood needles, lancets, and angio-caths prior to disposal consideration. It's intended to be used in remote settings for sharps containers are not convenient and accessible such as EMS, home healthcare, etc. It is a single use device.
More Information

Not Found

No
The device description and intended use clearly define a physical sharps container with no mention of software, algorithms, or data processing capabilities.

No.
The device is a sharps container designed for the safe disposal of contaminated sharps, not for treating a disease or condition.

No
The device is described as a sharps container for safe disposal of contaminated syringes and needles, not for diagnostic purposes.

No

The device description clearly indicates it is a physical sharps container made of injected molded parts, not software.

Based on the provided information, the MedSource Sharps Dart is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • IVD Definition: In vitro diagnostic devices are used to examine specimens (like blood, urine, or tissue) taken from the human body to provide information about a person's health. They are used outside of the body (in vitro) to diagnose, monitor, or screen for diseases or conditions.
  • MedSource Sharps Dart Function: The MedSource Sharps Dart is a container designed for the safe disposal of contaminated sharps (like syringes and needles). Its purpose is to protect users from injury and facilitate proper waste management. It does not perform any diagnostic testing or analysis of biological specimens.

The description clearly states its function is for the "storage, such sharps as small syringes, blood needles, lancets, and angio-caths prior to disposal consideration." This is a waste management and safety function, not a diagnostic one.

N/A

Intended Use / Indications for Use

The MedSource Sharps Datt is a non-sterile single-use disposable sharps container with a permanent closure system for a contaminated 1 ml or smaller syringe. Its intended use is by health care professionals in a setting where standard sharps containers are not accessible such as EMS, home healthcare, and laboratories. Its permanent closure system protects the user prior to disposal by incineration or decontamination by autoclave.

MedSource Sharps Dart Model No. MS-64250 Color-Clear/translucent with red closure Length-17cm (6.7 in.) Diameter-3cm (1.2 in.) Empty Weight- 255 gm ( 0.9 oz)

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

MMK

Device Description

The MedSource Sharps Dart (MSD) sharps container consists of two injected molded parts-a tubular tapered cone and a polypropylene closure. Its small size of 0.6 L qualifies it as a pocket sharps container as defined by ISO 23907 First Edition 2012-09-01, Sharps injury protection-Requirements and test methods-Sharps containers. It is designed for the storage, such sharps as small syringes, blood needles, lancets, and angio-caths prior to disposal consideration. It's intended to be used in remote settings for sharps containers are not convenient and accessible such as EMS, home healthcare, etc. It is a single use device.

The MSD sharps container was designed using the above standard, ISO 23907, and its design includes the required features specified in the standard. It meets the performance requirements for the standard. In addition, it has also been tested by an independent laboratory to meet the requirements for puncture resistance specified in ASTM F2132-01 (Re-approved in 2008). Both standards are FDA recognized.

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

health care professionals in a setting where standard sharps containers are not accessible such as EMS, home healthcare, and laboratories.

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 MedSource Sharps Dart was tested internally and by an independent laboratory to meet the requirements of ISO 23907 and ASTM F2132-01 (Re-approved in 2008).

  • ISO 23907 First edition 2012-09-01—Sharps injury protection— Requirements and test methods—Sharps containers: Summary report prepared demonstrating compliance to the standard for pocket sharps container. Testing was conducted for puncture resistance and leak resistance and product met the testing criteria.
  • ASTM F2132- 01 (2008) Standard Specification for Puncture Resistance of Materials Used in Containers for Discarded Medical Needles and Other Sharps: See revised standards Summary report prepared demonstrating compliance to standard.

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.

K972279, K140285

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.

Not Found

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 text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of three faces in profile, stacked on top of each other.

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

May 8, 2015

MedSource International, LLC c/o Mr. Howard Cooper Principal Consultant EQACT INC. 11715 Fox Road Indianapolis, IN 46236

Re: K150333

Trade/Device Name: MedSource Sharps Dart Regulation Number: 21 CFR 880.5570 Regulation Name: Hypodermic single lumen needle Regulatory Class: II Product Code: MMK Dated: March 10, 2015 Received: March 12, 2015

Dear Mr. Cooper:

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 - Mr. Cooper

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,

Tejashri Purohit-Sheth, M.D.

Tejashri Purohit-Sheth, M.D. Clinical Deputy Director DAGRID/ODE/CDRH 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) K150333

Device Name

MedSource Sharps Dart

Indications for Use (Describe)

The MedSource Sharps Datt is a non-sterile single-use disposable sharps container with a permanent closure system for a contaminated 1 ml or smaller syringe. Its intended use is by health care professionals in a setting where standard sharps containers are not accessible such as EMS, home healthcare, and laboratories. Its permanent closure system protects the user prior to disposal by incineration or decontamination by autoclave.

MedSource Sharps Dart Model No. MS-64250 Color-Clear/translucent with red closure Length-17cm (6.7 in.) Diameter-3cm (1.2 in.) Empty Weight- 255 gm ( 0.9 oz)

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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Image /page/3/Picture/0 description: The image shows the logo for MedSource. The logo consists of a red cross made up of horizontal lines that appear to be moving quickly to the right. To the right of the cross is the word "MedSource" in large, bold, blue letters. The logo is simple and modern, and the use of red and blue gives it a professional look.

Toll Free: 800-876-8264 Phone: 952-472-0131 Fax: 952-472-0136 www.gomedsource.com

Medical Supplies for the Healthcare Professional

4201 Norex Drive Chaska, MN 55318 USA

Image /page/3/Picture/4 description: The image shows the text '510 (k) Summary'. The text is written in a simple, sans-serif font and is gray. The text is likely a title or heading for a document or section of a document.

SECTION 5

Date Prepared: May 8, 2015

1. General Information

Submission SponsorSubmission Correspondent
MedSource International
4201 Norex Drive
Chaska, MN 55318Howard T. Cooper
EQACT, INC.
11715 Fox Rd.
Suite 400
Indianapolis, IN 46236
317-826-4398 office
Device IdentificationPredicate identification
CharacteristicSubmission DevicePredicate APredicate B
Trade nameMedSource Sharps DartCovidien Sharps Shuttle
/Sharps Shuttle with
Locking Mechanism*B Travel Savvy Sharps
Container
510(K)K150333K972279K140285
Regulatory NameHypodermic Single-
Lumen NeedleHypodermic Single-
Lumen NeedleHypodermic Single-
Lumen Needle
Common nameSharps ContainerSharps ContainerSharps Container
Product CodeMMKFMIMMK
ClassificationClass IIClass IIClass II
CFR reference880.5570880.5570880.8570
Classification PanelGeneral HospitalGeneral HospitalGeneral Hospital
Catalog No.MS-64250Model 8801BTS-702
*Covidien Sharps Shuttle, formerly Kendall P2 Shuttle Sharps Container manufactured by Sage Products

2. Device Description

The MedSource Sharps Dart (MSD) sharps container consists of two injected molded parts-a tubular tapered cone and a polypropylene closure. Its small size of 0.6 L qualifies it as a pocket sharps container as defined by ISO 23907 First Edition 2012-09-01, Sharps injury protection-Requirements and test

4

methods-Sharps containers. It is designed for the storage, such sharps as small syringes, blood needles, lancets, and angio-caths prior to disposal consideration. It's intended to be used in remote settings for sharps containers are not convenient and accessible such as EMS, home healthcare, etc. It is a single use device.

The MSD sharps container was designed using the above standard, ISO 23907, and its design includes the required features specified in the standard. It meets the performance requirements for the standard. In addition, it has also been tested by an independent laboratory to meet the requirements for puncture resistance specified in ASTM F2132-01 (Re-approved in 2008). Both standards are FDA recognized.

The predicate device, Covidien Sharps Shuttle, was selected because of its tubular-conical configuration with a polypropylene hinge-closure , which is very similar to the construction of the MedSource Sharps Dart. They are also similar in their weight and dimensions. When comparing such factors as Indications for Use, Performance, Technology, and method of manufacture, the data shows substantial equivalence between both the Covidein Sharps Shuttle and the MedSource Sharps Dart.

Although both devices are considered to be substantially equivalent, they have been or are being cleared at different periods of regulation. At the time that the predicate device was approved, there was not an FDA recognized standard for sharps container. However, Medsource Sharps Dart was designed following FDA recognized standards for the products with respect to puncture resistance testing and leak testing.

3. Standards

| Standard | Summary of Compliance to
Standard |
|-----------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| ISO 23907 First edition 2012-09-01—Sharps injury
protection— Requirements and test methods—
Sharps containers | Medsource Sharps Dart compliance
to the definition of the pocket
sharps container.

  1. Summary report prepared
    demonstrating compliance
    to the standard for pocket
    sharps container
  2. Testing was conducted for
    puncture resistance and leak
    resistance and product met
    the testing criteria |
    | ASTM F2132- 01 (2008) Standard Specification for
    Puncture Resistance of Materials Used in Containers
    for Discarded Medical Needles and Other Sharps | See revised standards Summary
    report prepared demonstrating
    compliance to standard.
    See Section 18. Performance Testing |

The following FDA recognized standards were used in the preparation of this 510K:

5

| FDA OSHA | 29 CFR 1910.1030 | Meets requirements by compliance
to applicable parts of ISO 23907 |
|----------|------------------|----------------------------------------------------------------------|
| | | (Impact Test) and
ASTM F 2132 (Puncture Resistance) |

4. Device Comparison

Predicate IDSubmission DevicePredicate APredicate B
TradeMedSource Sharps DartCovidien Sharps
Shuttle With LockingB Travel Savvy Sharps
Container
NameK150333K972279K140285
Indications for
UseThe MedSource Sharps
Dart is a non-sterile
single-use disposable
sharps container with a
permanent closure
system for a
contaminated 1ml or
smaller syringe. Its
intended use is by health
care professionals in a
setting where standard
sharps containers are not
accessible such as EMS,
home healthcare and
laboratories. Its
permanent closure
system protects the user
prior to disposal by
incineration or
decontamination by
autoclave.

MedSource Sharps Dart
Model No. MS-64250

Color-Clear/translucent
with red closure | The Sharps Shuttle
and Sharp Shuttle
with Locking
Mechanism are
single use, non-
sterile, disposable,
sharps transport
containers intended
for use in any setting
where standard
sharps containers are
not conveniently
accessible, such as
EMS home health
care, etc | The Travel Savvy
Sharps Container is a
single-use device
intended for disposal
of sharps waste by a
single user in a
private site of use.
When mounted with
the appropriate
bracket, the Travel
Savvy Sharps
Container can be
used for sharps
disposal in vehicles.
The B Travel Savvy
Sharps container
color is red. The
length of the device
is 6.5 inches, the
width is 2.1 inches
and the height is 2.3
inches. The aperture
opening is 1.5 inches
wide and the length
is 2.5 inches. |

6

| Length-17cm (6.7 in.)
Diameter-3cm (1.2 in.)
Empty Weight- 255 gm (

0.9 oz)
RX or OTCOTCOTCOTC
MaterialPolypropylenePolypropylenePolypropylene
Sharps AccessTop openingTop OpeningTop Opening
Sharps ClosureHinged closureHinged closureHinged closure
Dimensions & WeightLength-17cm (6.7 in.)
Diameter-3cm (1.2 in.)
Empty Weight- 255 gm (
0.9 oz)Approximately 6in. long & 1 in. diameter
Empty weight not
availableThe length of the device is 6.5 inches,
the width is 2.1 inches and the height
is 2.3 inches. The aperture opening is
1.5 inches wide and the length is 2.5
inches.
Single useYesYesYes
Non-sterileYesYesYes
TranslucentYesYesYes
Impact and
leak resistanceYesYesYes
Needle
Penetration
Resistance-YesYesYes

5. Comparison Results

Category of comparisonResults
1.Regulatory Requirements
CharacteristicsEquivalent
2.Indications for Use & RX/OTCEquivalent
3.Design & Construction and Method of
ManufactureEquivalent
4.TechnologyEquivalent
5.Product FeaturesEquivalent

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6. Test Methods

Test MethodsStandards
Puncture ResistanceISO 23907- Section 4.2.4
Resistance to LeakageISO 23907- Section 4.2.5
Puncture ResistanceASTM- F2132-01

7. Conclusion

The MedSource Sharps Dart sharps container was compared to the above predicate devices in such areas as technology, indications for use, materials of construction, performance testing, product testing, and product features. Based on the review of this data, the data supports the conclusion that the subject device is substantially equivalent to the predicate devices. No new questions of safety or effectiveness are raised by the introduction this device. Therefore, we conclude that the subject device is as safe, as effective, and performs as well as the legally marketed predicate devices [Covidien Sharps Shuttle/ Sharps Shuttle with Locking Mechanism (K972279) and B Travel Savvy Sharps Container (K140285)].