K Number
K151303
Device Name
AirLife Infant Heated Wire Circuit
Manufacturer
Date Cleared
2016-01-21

(248 days)

Product Code
Regulation Number
868.5270
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The heated breathing circuit is intended to deliver and warm breathing gases before they enter the patient's airway. The heated breathing circuit is used with Fisher and Paykel MR850 humidifier. The AirLife Infant Heated Wire Circuit is used with pediatic population. specifically the neonate (birth to 1 month of age) and infant (greater than 1 month to 2 vears of age) pediatric subgroups. The product is single use device, non-sterile and used in professional healthcare environments and intra-hospital transport environments under a doctor's supervision and by skilled clinicians. The AirLife Infant Heated Wire Circuit is used for flow rates greater than 4 LPM.
Device Description
The heated breathing circuit is intended to deliver and warm breathing gases before they enter the patient's airway. It is provided non sterile for single patient use. The heated breathing circuit is used with Fisher and Paykel heated humidifiers.
More Information

Not Found

No
The document describes a heated breathing circuit and its intended use, device description, and performance testing. There is no mention of AI or ML technology in the provided text.

Yes
The device is intended to deliver and warm breathing gases to the patient's airway, which is a therapeutic intervention for medical conditions or procedures.

No

The device is a heated breathing circuit for delivering and warming breathing gases, not for diagnosing medical conditions. Its function is therapeutic/supportive.

No

The device description clearly states it is a "heated breathing circuit," which is a physical hardware component used to deliver and warm breathing gases. It also mentions testing for physical properties like length, resistance to flow, and electrical safety.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health.
  • Device Function: The description clearly states the device's purpose is to "deliver and warm breathing gases before they enter the patient's airway." This is a therapeutic and supportive function, not a diagnostic one involving testing bodily samples.
  • Lack of Diagnostic Language: The text does not mention any diagnostic tests, analysis of biological samples, or providing information about a patient's disease state or condition based on such analysis.

The device is a component of a respiratory support system, designed to improve the delivery of breathing gases to the patient.

N/A

Intended Use / Indications for Use

The heated breathing circuit is intended to deliver and warm breathing gases before they enter the patient's airway. The heated breathing circuit is used with Fisher and Paykel MR850 humidifier. The AirLife Infant Heated Wire Circuit is used with pediatic population. specifically the neonate (birth to 1 month of age) and infant (greater than 1 month to 2 vears of age) pediatric subgroups. The product is single use device, non-sterile and used in professional healthcare environments and intra-hospital transport environments under a doctor's supervision and by skilled clinicians. The AirLife Infant Heated Wire Circuit is used for flow rates greater than 4 LPM.

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

BZE

Device Description

The heated breathing circuit is intended to deliver and warm breathing gases before they enter the patient's airway. It is provided non sterile for single patient use. The heated breathing circuit is used with Fisher and Paykel heated humidifiers.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

patient's airway

Indicated Patient Age Range

pediatric population, specifically the neonate (birth to 1 month of age) and infant (greater than 1 month to 2 years of age) pediatric subgroups.

Intended User / Care Setting

professional healthcare environments and intra-hospital transport environments under a doctor's supervision and by skilled clinicians.

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 proposed device was tested to ensure compliance to the following standards: Biocompatibility (Cytotoxicity, Sensitization, Irritation, Muscle Implantation, Genotoxicity and Extractables/Leachables), Electrical safety (Patient Leakage Current, Dielectric Strength Means, Insulation), Length, Resistance to Flow/Rated Flow, Resistance to Flow @ 2.5 LPM, Increase in Flow Resistance w/Bending @ Rated Flow (10 LPM), Increase in Flow Resistance w/Bending @ 2.5 LPM, Conical Connectors, Security of Attachment, Leakage, Compliance per Meter, Humidity Output (Invasive Mode), Humidity Output (Non-Invasive Mode), Corrugate Melt (100% Duty Cycle, Zero Gas Flow), Security of engagement temperature sensor, Leakage from sensing port, Specific enthalpy, Surface temperature, Steady state noise, Duration of Use (30 days), Longitudinal Temperature Profile, Patient End Temperature Profile. The test results demonstrate that the device is as safe and effective as the predicate and therefore substantially equivalent to the predicate device.

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.

K020332, K000697

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

§ 868.5270 Breathing system heater.

(a)
Identification. A breathing system heater is a device that is intended to warm breathing gases before they enter a patient's airway. The device may include a temperature controller.(b)
Classification. Class II (performance standards).

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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" around the perimeter. Inside the circle is a stylized image of three human profiles facing to the right, with flowing lines representing hair or clothing.

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

January 21, 2016

CareFusion 2200, Inc. Erika Fernandez Regulatory Affairs Manager 75 North Fairway Drive Vernon Hills, Illinois 60061

Re: K151303

Trade/Device Name: AirLife Infant Heated Wire Circuit Regulation Number: 21 CFR 868.5270 Regulation Name: Breathing System Heater Regulatory Class: Class II Product Code: BZE Dated: December 20, 2015 Received: December 23, 2015

Dear Ms. Fernandez,

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 devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in

1

the quality systems (OS) 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,

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

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Indications for Use

510(k) Number (if known)

Device Name AirLife Infant Heated Wire Circuit

Indications for Use (Describe)

The heated breathing circuit is intended to deliver and warm breathing gases before they enter the patient's airway. The heated breathing circuit is used with Fisher and Paykel MR850 humidifier. The AirLife Infant Heated Wire Circuit is used with pediatic population. specifically the neonate (birth to 1 month of age) and infant (greater than 1 month to 2 vears of age) pediatric subgroups. The product is single use device, non-sterile and used in professional healthcare environments and intra-hospital transport environments under a doctor's supervision and by skilled clinicians. The AirLife Infant Heated Wire Circuit is used for flow rates greater than 4 LPM.

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

Prescription Use (Part 21 CFR 801 Subpart D)

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

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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Image /page/3/Picture/0 description: The image shows the CareFusion logo. The logo consists of an orange circle with a white shield inside, and the text "CareFusion" in gray. Below the text, there is a smaller text that says "has joined BD".

Summary of Safety and Effectiveness

510k summary complying with 21 CFR 807.92

1. SUBMITTER

CareFusion 2200, Inc. 75 N Fairway Drive, Vernon Hill, IL 60061

Phone: 847 362-8097 Fax: 312 949-0731

Contact Person: Erika Fernandez

Date Prepared: January 20, 2016

2. Device

Product Name:AirLife Infant Heated Wire Circuit
Device Name:Heated Breathing Circuit
Common Name:Heater, breathing system w/wo controller (not humidifier or
nebulizer)
Classification Name:Breathing system heater (21 CFR 868.5270)
Regulatory Class:II
Product Code:BZE

3. Predicate Device

This submission demonstrates substantial equivalence to the Fisher and Paykel Heated Breathing Circuit K020332 cleared on July 700, 2003 and AirLife Heated Ventilator and Anesthesia Breathing Circuits, K000697 cleared on March 30, 2000. The predicate devices have not been subject to a design-related recall.

4. Device Description

The heated breathing circuit is intended to deliver and warm breathing gases before they enter the patient's airway. It is provided non sterile for single patient use. The heated breathing circuit is used with Fisher and Paykel heated humidifiers.

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Image /page/4/Picture/0 description: The image shows the CareFusion logo. The logo consists of an orange circle with a white shield inside, followed by the text "CareFusion" in gray. Below the text, there is a smaller text that says "has joined BD".

5. Indication for use

The heated breathing circuit is intended to deliver and warm breathing gases before they enter the patient's airway. The heated breathing circuit is used with Fisher and Paykel MR850 humidifier. The AirLife Infant Heated Wire Circuit is used with pediatric population, specifically the neonate (birth to 1 month of age) and infant (greater than 1 month to 2 years of age) pediatric subgroups. The product is single use device, non-sterile and used in professional healthcare environments and intra-hospital transport environments under a doctor's supervision and by skilled clinicians. The AirLife Infant Heated Wire Circuit is used for flow rates greater than 4 LPM.

6. Comparison of technological characteristics with the predicate device

The fundamental scientific technology is the same for both proposed and predicate devices. It is based on acting as an airway conduit between a breathing machine and the patient (typically attached to an endotracheal or tracheal tube previously insert into the patient's airway). The differences in the design do not raise any different questions of safety and effectiveness.

| Element of comparison | Predicate Device 1
Fisher and Paykel heated
wire breathing circuit
RT131 with flow rate

4L/min | Predicate Device 2
AirLife Heated and
Anesthesia Breathing
Circuits
with flow rate >3L/min | Proposed Device
AirLife Infant Heated
Wire Circuit
with flow rate
4L/min |
|----------------------------------------------------|-------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------|
| Principal of Operation | Resistance wires within
the tubing generate heat
to maintain
temperatures and
humidity | Resistance wires within
the tubing generate heat
to maintain
temperatures and
humidity | Resistance wires
within the tubing
generate heat to
maintain
temperatures and
humidity |
| Circuit Characteristics | | | |
| Infant Inspiratory Limb with
Unheated Extension | 5 ft | 5 ft | 5 ft |
| Dryline Length | 2 ft | 2 ft | 2 ft |
| Inspiratory Limb Length | 4 ft | 4 ft | 4 ft |
| Heated wire | Present | Present | Present |
| Expiratory Limb Length | 5ft 6in | 4 ft 3 in | 4 ft 5in |
| Water trap | Present | Not Present | Not Present |
| Heated Wire | Not Present | Present | Present |
| Patient population | Neonates | Infants, pediatric and
Adults | Infants and Neonates |
| Usage | Disposable | Disposable | Disposable |

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Image /page/5/Picture/0 description: The image shows the CareFusion logo. The logo consists of an orange circle with a white shield inside. The shield has a yellow accent on the top right. To the right of the circle is the text "CareFusion" in gray. Below the text is the phrase "has joined BD" in a smaller, lighter gray font.

| Element of comparison | Predicate Device 1
Fisher and Paykel heated
wire breathing circuit
RT131 with flow rate

4L/min | Predicate Device 2
AirLife Heated and
Anesthesia Breathing
Circuits
with flow rate >3L/min | Proposed Device
AirLife Infant Heated
Wire Circuit
with flow rate
4L/min |
|----------------------------------|-------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|
| Design | Dual Limb | Dual Limb | Dual Limb |
| Tube Specifications | | | |
| ID | 0.44in-0.45in | 0.394in | 0.45in-0.46in |
| Design | Corrugate | Corrugate | Corrugate |
| Wire Design | | | |
| Minimum Resistance at
ambient | 22 Ω | 27 Ω | 22 Ω |
| Wire Total Length | 115in | 99in | 121in |
| Constant Power | 22W | 16W | 22W |
| Typical Wattage/foot of
wire | 2 | 1.9 | 2 |
| Typical Watt/ foot of
circuit | 6 | 4 | 6 |
| Conductor | Copper | Copper/Ni alloy | 304 Steel |
| Anchor Position of Wire | 19 cm | 5-10 cm | 19 cm |
| Compatible Humidifier | Fisher and Paykel MR850 | Fisher and Paykel MR850 | Fisher and Paykel
MR850 |

7. Performance Data

The proposed device was tested to ensure compliance to the following standards:

Biocompatibility

Tests for an externally communicating, tissue by way of gas path and direct mucosal contact with prolonged contact (greater than 24 hours but less than 30 days): Cytotoxicity, Sensitization, Irritation, Muscle Implantation, Genotoxicity and Extractables/Leachables

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Standards

Performance CharacteristicStandard
Biological Evaluation of Medical Devices Part 1: Evaluation and
Testing
FDA Guidance: Use of International Standard ISO- 10993,
"Biological Evaluation of Medical Devices Part 1: Evaluation
and Testing"ISO 10993-1:2009
Biological Evaluation of Medical Devices Part 3: Tests for
genotoxicity, carcinogenicity and reproductive toxicityISO 10993-3:2014
Biological Evaluation of Medical Devices Part 5: Tests for in
vitro cytotoxicityISO 10993-5:2009
Biological Evaluation of Medical Devices Part 6: Tests for local
effects after implantationISO 10993-6:2007
Biological Evaluation of Medical Devices Part 10: Tests for
irritation and skin sensitizationISO 10993-10:2010
Biological Evaluation of Medical Devices Part 17:
Establishment of allowable limits for leachable substancesISO 10993-17:2002
Biological Evaluation of Medical Devices Part 18: Chemical
characterization of materialsISO 10993-18:2005

Performance

The following tests were performed for the proposed device to support the substantial equivalence decision.

TestDescriptionRelevant Standard
Electrical safety
Patient Leakage CurrentTo ensure, under normal system
operating conditions, that
excessive current does not
reach the patientIEC 60601-1:2005, 3rd
Edition (Equivalent to
AAMI ES60601-1:2005)
Electrical safety
Dielectric Strength MeansTo check the integrity of the
wire insulation under excessive
power conditions.IEC 60601-1:2005, 3rd
Edition (Equivalent to
AAMI ES60601-1:2005)
Electrical Safety
InsulationTo ensure IEC requirements for
creepage and clearance were
met.IEC 60601-1:2005, 3rd
Edition (Equivalent to
AAMI ES60601-1:2005)
LengthTo ensure that the actual length
of the device is within ±10% of
the labeled lengthISO 5367:2000, 4th Edition
TestDescriptionRelevant Standard
Resistance to Flow/Rated
FlowTo ensure, when tested per the
standard, that the pressure
increase at the rated flow
through the breathing tube does
not exceed 0.2 kPaISO 5367:2000, 4th Edition
Resistance to Flow @ 2.5
LPMTo ensure, when tested per the
standard, that the flow
resistance at 2.5 LPM through
the breathing tube does not
exceed 0.74 cmH2O/l/minISO 5367:2014, 5th Edition
Increase in Flow Resistance
w/Bending @ Rated Flow
(10 LPM)To ensure, when tested per the
standard, that the pressure at
the rated flow when the
breathing tube is suspended
over a metal cylinder does not
exceed 150% of the value
obtained with the tube straight.ISO 5367:2000, 4th Edition
Increase in Flow Resistance
w/Bending @ 2.5 LPMTo ensure, when tested per the
standard, that the pressure at
2.5 LPM when the breathing
tube is suspended over a metal
cylinder does not exceed 150%
of the value obtained with the
tube straight.ISO 5367:2014, 5th Edition
Conical ConnectorsTo ensure, when tested per the
standard, that required ports are
correctly sized.ISO 5367:2000, 4th Edition
ISO 5356-1:2004, 3rd Edition
ISO 8185:2008, 3rd Edition
(Corrected Version)
Security of AttachmentTo ensure, when tested per the
standard, that the adaptor shall
not become detached from the
tube at a force greater than 45N.ISO 5367:2000, 4th Edition
LeakageTo ensure, when tested per the
standard, that the system
supplied ready to use does not
leak at a rate greater than 50
ml/min.ISO 5367:2000, 4th Edition
Compliance per MeterTo ensure, when tested per the
standard, that the compliance
per meter at a pressure of 6 kPa
does not exceed 10 ml*kPa-1
per meter length of tube.ISO 5367:2000, 4th Edition
ISO 8185:2008, 3rd Edition
(Corrected Version)
TestDescriptionRelevant Standard
Humidity Output (Invasive
Mode)To ensure, when tested per the
standard, that the system
delivers at least the minimum
humidity of at least 33 mg/L to
the patient.ISO 8185:2008, 3rd Edition
(Corrected Version)
Humidity Output (Non-
Invasive Mode)To ensure, when tested per the
standard, that the system
delivers at least the minimum
humidity of at least 10 mg/L to
the patient.ISO 8185:2008, 3rd Edition
(Corrected Version)
Corrugate Melt (100% Duty
Cycle, Zero Gas Flow)To ensure that the breathing
tubes do not collapse on
bending, occlude, or otherwise
cause a safety hazard at the
maximum output of the
humidification system.ISO 8185:2008, 3rd Edition
(Corrected Version)
Security of engagement
temperature sensorTo ensure that the temperature
probes that accompany the
circuit do not become
disconnected under the
condition of no flow or
maximum rated flow.ISO 8185:2008, 3rd Edition
(Corrected Version)
Leakage from sensing portTo ensure, when tested per the
standard, that the sensing port
does not leak more than 5
ml/min.ISO 8185:2008, 3rd Edition
(Corrected Version)
Specific enthalpyTo ensure under normal and
single fault conditions, a thermal
overshoot at the patient
connection port shall not exceed
an energy equivalent to 43C and
100% relative humidity (a
specific enthalpy not to exceed
194 kJ/kg dry gas) when
averaged over 30 seconds.ISO 8185:2008, 3rd Edition
(Corrected Version)
Surface temperatureTo ensure that the accessible
temperature within 25 cm of the
patient port connection does
not exceed 44°CISO 8185:2008, 3rd Edition
(Corrected Version)
Steady state noiseTo ensure, when tested per the
standard, that the noise at any
point within 1 m of the system
does not exceed 50 dB.ISO 8185:2008, 3rd Edition
(Corrected Version)
TestDescriptionRelevant Standard
Duration of Use (30 days)To assess the circuit use over a
30 day time periodN/A
Longitudinal Temperature
ProfileTo assess the temperature range
of the wire once a nominal
voltage is induced across it.N/A
Patient End Temperature
ProfileTo assess the temperature of the
airway gas delivered to the
patient when a given humidified
circuit is used with a ventilator
and the Fisher & Paykel MR850
heater base.N/A

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Image /page/8/Picture/0 description: The image shows the CareFusion logo, which includes an orange circle with a white shield-like shape inside. To the right of the logo is the text "CareFusion" in a dark gray, sans-serif font. Below the company name, in a smaller, lighter font, is the phrase "has joined BD".

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8. Conclusion

The test results demonstrate that the device is as safe and effective as the predicate and therefore substantially equivalent to the predicate device.