K Number
K152201
Device Name
MedActive Oral Gel and Spray
Date Cleared
2015-12-30

(146 days)

Product Code
Regulation Number
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
1. Provides symptom relief from Dry Mouth and low saliva including: - Oral discomfort - Mucosal soft tissue dryness - Oral side effects of illness, therapies, and medications 2. Soothes moistens and lubricates 3. Hydrates soft tissue
Device Description
MedActive Oral Gel and Spray are liquid delivery systems for ingredients that coat the inside of the mouth for a period of time and create relief from dry mouth symptoms in those who suffer oral malodor, discomfort, difficulties eating or speaking from dry mouth complications. They are applied by either a spray or gel to the user's mouth. MedActive Oral Gel and Spray are nonsterile ready to use devices to be used as needed or directed by a health care professional.
More Information

No
The device description and performance studies focus on the physical and chemical properties of the gel and spray, with no mention of AI or ML.

Yes
The device is intended to provide symptom relief and soothe, moisten, and lubricate the oral cavity, which are therapeutic functions.

No

The device is intended to provide symptom relief and hydrate the oral cavity, not to diagnose a condition.

No

The device description clearly states that the device is a "liquid delivery system" applied by "spray or gel," indicating a physical product, not software.

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

Here's why:

  • Intended Use: The intended use is to provide symptom relief from dry mouth and low saliva by soothing, moistening, and lubricating the oral cavity. This is a therapeutic or palliative function, not a diagnostic one.
  • Device Description: The device is described as a liquid delivery system that coats the inside of the mouth. It does not involve analyzing samples from the body (like blood, urine, or tissue) to diagnose a condition.
  • Lack of Diagnostic Claims: There are no claims about diagnosing, monitoring, or screening for any disease or condition.
  • Performance Studies: The performance studies focus on physical properties (desorption, rheology, shelf life, biocompatibility, pH) and comparison to predicate devices with similar symptomatic relief functions. There are no studies related to diagnostic accuracy (sensitivity, specificity, etc.).

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information for the diagnosis, monitoring, or screening of diseases or conditions. This device does not fit that description.

N/A

Intended Use / Indications for Use

    1. Provides symptom relief from Dry Mouth and low saliva including:
    • Oral discomfort
    • Mucosal soft tissue dryness
    • Oral side effects of illness, therapies, and medications
    1. Soothes moistens and lubricates
    1. Hydrates soft tissue

Product codes

LFD

Device Description

MedActive Oral Gel and Spray are liquid delivery systems for ingredients that coat the inside of the mouth for a period of time and create relief from dry mouth symptoms in those who suffer oral malodor, discomfort, difficulties eating or speaking from dry mouth complications. They are applied by either a spray or gel to the user’s mouth. MedActive Oral Gel and Spray are nonsterile ready to use devices to be used as needed or directed by a health care professional.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Oral Cavity

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Over-The-Counter Use

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

The submission includes summaries of the following physical tests:

  • Desorption Testing: Measured moisture desorption degree by weighing samples before and after incubation at 37 degrees Celsius for 2 hours. Results showed that MedActive Oral Relief Gel and Spray performed similarly to predicate devices.
  • Rheology Testing: Established similarity in viscosity and rheological behavior between MedActive Oral Relief Gel and Spray and predicate devices.
  • Shelf Life Testing: Evaluated physical characteristics using rheology and desorption testing methods. Results indicated similar form and function after three years of real-time aging, supporting a three-year shelf life.
  • Biocompatibility Testing: Although not required for limited exposure mucosal membrane devices, Biocompatibility testing was completed for MedActive Oral Gel. Results from Acute Toxicity, Oral, Eye, and skin Irritation testing showed biocompatibility in accordance with ISO 10993.
  • pH Testing: Tested pH using a Fischer Scientific Accumet AB15 pH meter with a Thomas Scientific Orion Ross Sure Flow Electrode. Results showed MedActive Oral Relief Gel and Spray performed similarly to predicate devices, with a pH range of 5.35-5.78.

Key Metrics

  • Desorption Test Mean Percent Loss:
    • Biotene Spray (U4E291): 38.1%, 35.0%
    • GC Gel (040109M): 17.4%, 13.9%
    • MedActive Spray (4077): 56.9%, 57.8%
    • MedActive Gel (2661015): 34.3%, 33.5%
  • pH Results:
    • MedActive Samples (Spray VM 4077-1): 5.78
    • MedActive Samples (Spray VM 4077-2): 5.76
    • MedActive Samples (Gel OC266-1): 5.35
    • MedActive Samples (Gel OC266-2): 5.36
    • Biotene Moisturizing Mouth Spray Predicate: 6.2-7.1
    • GC Moisturizing Gel Predicate: 7.2
    • Laclede Oral Balance Liquid/ Gel Predicate: 5.6

Predicate Device(s)

K123731, K101346, K061331

Reference Device(s)

K101346, K061331

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

N/A

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 two main elements: a circular text element and a symbol. The text element reads "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement. The symbol is a stylized representation of a human figure, with three profiles overlapping to create a sense of depth and connection.

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

December 30, 2015

MedActive Oral Pharmaceuticals, LLC Mr. Brian Walker Purchasing and Quality Manager 6293 West Linebaugh Avenue Tampa, FL 33625

Re: K152201

Trade/Device Name: MedActive Oral Gel, MedActive Oral Spray Regulation Number: Unclassified Regulation Name: Unclassified Regulatory Class: Unclassified Product Code: LFD Dated: December 1, 2015 Received: December 2, 2015

Dear Mr. Walker:

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

Tina Kiang

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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K152201/S002

4. Indications for Use Statement

Indications for Use

510(k) Number (if known): K152201

Device Name: MedActive Oral Gel and MedActive Oral Spray

Indications for Use:

    1. Provides symptom relief from Dry Mouth and low saliva including:
  • Oral discomfort ●
  • Mucosal soft tissue dryness ●
  • Oral side effects of illness, therapies, and medications
    1. Soothes moistens and lubricates
    1. Hydrates soft tissue
Prescription Use_________________________
(Part 21 CFR 801 Subpart D)

AND/OR

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

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Page

3

5. 510(k) Summary

Submitter:

Company:MedActive Oral Pharmaceuticals, LLC
Street:6293 W Linebaugh Ave
City, State Zip:Tampa, Fl. 33625
Country:USA
Estab. Registration #:Unknown
Correspondent:Brian Walker
Purchasing and Quality Manager
Phone:813-792-5335 x 108
Fax:813-792-5445
Email:brianw@medactive.com
Date:December 29, 2015

Name of Device

Proprietary Name:MedActive Oral Gel, MedActive Oral Spray
Classification Name:Saliva, Artificial
Unclassified, pre-amendment
Common Name:Saliva, Artificial
Product Code:LFD

Predicate Devices

Primary Device510(k)
Biotene Moisturizing Mouth SprayK123731
Reference Devices510(k)
GC Moisturizing GelK101346
Laclede Oral Balance Liquid/ GelK061331

Description

MedActive Oral Gel and Spray are liquid delivery systems for ingredients that coat the inside of the mouth for a period of time and create relief from dry mouth symptoms in those who suffer oral malodor, discomfort, difficulties eating or speaking from dry mouth complications. They are applied by either a spray or gel to the user's mouth. MedActive Oral Gel and Spray are nonsterile ready to use devices to be used as needed or directed by a health care professional.

MedActive Oral Gel and Spray are equivalent to Boitene Moisturizing Mouth Spray and GC Moisturizing Gel in their intended use. All products are artificial saliva agents designed for relief from dry mouth symptoms.

Indications for Use

Primary Predicate Device - Biotene Moisturizing Mouth Spray

  • . The Biotene Oral Balance Gel, Biotene Dry Mouth Oral Rinse and Biotene Moisturizing Mouth Spray intended use is to relieve the symptoms of dry mouth, refresh, moisturize, clean, soothe oral irritation and lubricate oral dryness.

4

Reference Predicate Device - GC Moisturizing Gel

  • GC Oral Moisturizing Gel is designed to provide comfort for individuals suffering . from dry mouth. It is recommended to be used for people who may experience difficulties in eating, speaking or are suffering from discomfort due to dry mouth. GC Oral Moisturizing Gel is indicated for the relief of dry mouth symptoms, to provide a protective coating inside the mouth, and help to control bad breath.
    Reference Predicate Device - Laclede Oral Balance Liquid/Gel

  • . Laclede Oral Balance Liquid/ Gel is a refreshing Gel and Liquid that quickly diminishes dry discomfort, mouth odors and other symptoms of a dry mouth.
    MedActive Oral Gel and Spray

  1. Provides symptom relief from Dry Mouth and low saliva including:
  • Oral discomfort
  • Mucosal soft tissue dryness
  • . Oral side effects of illness, therapies, and medications
    1. Soothes moistens and lubricates
    1. Hydrates soft tissue

All claims of all three devices are similar in nature and are for the relief of dry mouth symptoms and/or oral malodor.

Technological Characteristics

The chemical compositions of MedActive Oral Gel and Spray are similar to the predicate devices. These products contain ingredients such as water, VP/VA copolymer, sodium carboxymethylcellulose, flavorings, sweeteners, glycerol and various thickening agents. The combination of these ingredients provides a pleasant flavor, lubrication of the oral environment when used.

The mode of action of MedActive Oral Gel and Spray are substantially equivalent to the predicate devices.

Summary of Physical Tests

Desorption Testing:

1.4g of each product was placed on a weighing dish and weighed followed by incubation at 37 degrees Celsius for 2 hours. A value obtained by dividing the weight change by the initial weight in terms of percentage was designated as moisture desorption degree. The result of the desorption testing shows that MedActive Oral Relief Gel and MedActive Oral Relief Spray perform similar to the predicate devices.

5

Mean Percent Loss

| Product | Original Weight (g) -
Exp 1, 2 | Weight Loss (g) - 1,
2 | Percent
Moisture
Desorbed (%)- 1, 2 |
|-------------------------|-----------------------------------|---------------------------|-------------------------------------------|
| Biotene Spray (U4E291) | 0.399, 0.400 | 0.152, 0.140 | 38.1, 35.0 |
| GC Gel (040109M) | 0.390, 0.404 | 0.068, 0.056 | 17.4, 13.9 |
| MedActive Spray (4077) | 0.394, 0.396 | 0.224, 0.229 | 56.9, 57.8 |
| MedActive Gel (2661015) | 0.411, 0.397 | 0.141, 0.133 | 34.3, 33.5 |

Rheology Testing:

A Rheology study was performed to establish the similarity in the viscosity and rheological behavior of predicate devices compared to MedActive Oral Relief Gel and Spray. The results of the rheological evaluation demonstrate the MedActive Oral Relief Gel and Spray exhibits viscosity and rheological behavior in equivalence to the predicate devices.

Shelf Life Testing:

MedActive Oral Relief Gel and Spray were evaluated for physical characteristics using rheology and desorption testing methods to determine shelf life. The results of these rheology and desorption tests show that MedActive Oral Relief Gel and Spray exhibit similar form and function after three years of real time aging and result in a three year shelf life.

Biocompatibility Testing:

Although MedActive Oral Gel and Spray are limited exposure mucosal membrane devices and do not require biocompatibility testing, Biocompatibility was completed for MedActive Oral Gel. The results from Acute Toxicity, Oral, Eye, and skin Irritation testing show biocompatibility results in accordance with ISO 10993.

pH Testing:

MedActive Oral Relief Gel and Spray were tested for pH using a Fischer Scientific Accumet AB15 pH meter paired with a Thomas Scientific Orion Ross Sure Flow Electrode. The electrode was specifically chosen to provide faster stable readings for gel type samples. The electrode was prepared according to manufacturer's specifications and standardized with VWR standard buffers at pH = 4. 7, 10. All samples were transferred (4 - 7 ml) into polypropylene 10 ml bottles from their original containers. All MedActive samples came from previously unopened containers. The results of the pH testing shows that MedActive Oral Relief Gel and MedActive Oral Relief Spray perform similar to the predicate devices.

6

| Spray | MedActive
Samples | pH
Results | Predicate Devices | pH
Stated |
|-------|----------------------|---------------|-------------------------------------|--------------|
| | VM 4077-1 | 5.78 | Biotene Moisturizing Mouth
Spray | 6.2-7.1 |
| | VM 4077-2 | 5.76 | | |
| Gel | | | | |
| | OC266-1 | 5.35 | GC Moisturizing Gel | 7.2 |
| | OC266-2 | 5.36 | Laclede Oral Balance Liquid/
Gel | 5.6 |

Discussion of Differences

In particular, the variations in formula/composition for MedActive Oral Gel and Spray from the predicate devices are as follows:

  • . Solvent: The main solvent in the current devices are water and a smaller quantity of propylene glycol (a GRAS ingredient) ore EDTA. The predicate devices use water, PEG- 60 and polyglycerol. The predicate devices use PEG-60 or Polyglycerol as a solvent but these ingredients also serve as humectants and rheology modifiers.
  • Mucoadhesive Agents: Poloxamer 407 and dimethicone emulsions (Ultramulsion ®) was used as the mucoadhesive over Polyvinyl Alcohol (VP/VA), due to its specific development as a surfactant by its manufacturer Whitehill Technologies. Ultramulsion (poloxamer 407 and dimethicone) works as a surfactant that can be retained in the mouth for a period of time to create a smooth, slick feeling. Carboxymethylcelulose (CMC) is also used as a mucoadhesive, as in some predicate devices. While present, these combinations will act as a lubricant and maintain a moist mouth feel for the patient as shown by desorption testing.
  • . Rheology Modifiers: Cellulose gum (carboxymethylcellulose, or CMC) was chosen as a thickener/theology modifier for the gel based on its significant history of use in dental, oral care and food products. Xanthan gum was chosen for the spray for similar reasons. The resulting viscosity in MedActive Gel and Spray are similar in nature to the predicate devices.
  • Flavoring, Aromas, Sweeteners: The flavorings in MedActive Gel and Spray are similar in nature to the predicate devices although the specific flavor may differ based on stated label flavor. All devices use aqueous solutions and a sweetener such as xylitol, sorbitol or sodium saccharin as the sweetener.
  • . Preservatives: Potassium sorbate and methylparaben are used as preservatives in MedActive Gel while predicate devices GC Gel and Laclede Gel used ethyl phydroxybenzoatepotassium, soduim citrate and sorbic acid, benzoic acid, lactoperoxidase and lyzome, as preservatives respectively. Potassium sorbate and xylitol are used in MedActive Spray as preservatives and reference device Biotene Spray uses sodium Benzoate, methylparaben, polyparaben, and cetyl- pyridiniumchloride. These ingredients are GRAS and commonly used in dental, oral and food products as

7

preservatives. In addition, Xylitol, sugar and other sugar substitutes have been shown to act as preservatives in high concentrations (Int J Cosmet Sci._2011 Oct; 33(5):391-7).

  • . pH - The pH of artificial saliva products in category LFD range from neutral to slightly acidic depending upon the device. The normal pH range for saliva is considered to be 5.6 to 7.9, according to the International Journal of Drug Testing. MedActive has chosen to use preservatives which result in slightly more acidic pH than the predicate devices, and has done so in order to maintain the integrity of its gel and spray against any adventitious organisms. MedActive Gel and Spray have a pH range of 5.35-5.78. Although this pH is slightly more acidic than some predicate devices (and within the range of one reference device) both have low titratable acidity.

| Function | GC Moisturizing
Gel
Ingredient
K101346 | Biotene
Moisturizing
Mouth Spray
Ingredient
K123731 | Laclede Oral
Balance Gel
K061331 | MedActive
Oral Relief Gel | MedActive
Oral Relief Spray |
|----------------------------------|---------------------------------------------------|---------------------------------------------------------------------------------|---------------------------------------------------------------|-------------------------------------------------|--------------------------------------------|
| Solvent | Water | Purified Water | Butylene glycol,
water | Water,
Propylene glycol | Water, EDTA |
| Mucoadhesives | Sodium
carboxymethyl

  • cellulose | VP/VA
    copolymer | Hydroxyethylcellul
    ose, Sodium
    polyacrylate | Poloxamer 407,
    Dimethicone,
    Cellulose gum | Poloxamer 407,
    Dimethicone |
    | Rheology
    Modifiers | Carrageenan | Glycerin,
    hydrogenated
    castor oil, xanthan
    gum,PEG-60 | Polyacrylic acid,
    Hydroxyethylcellulose | Cellulose gum | Xanthan gum,
    glycerin |
    | Humectant | Polyglycerol | Glycerin | Sodium polyacrylate | Glycerin | Glycerin |
    | Flavoring, aromas,
    sweeteners | Xylitol, Flavoring | Xylitol,
    sodium
    saccharin, Flavoring | Xylitol,
    Hydrogenated Starch
    Hydrolysate,
    Glycerol | Sorbitol, sodium
    saccharin,
    flavoring | Xylitol, Sodium
    Saccharin,
    Flavoring |
    | Preservatives | Ethyl
    p-
    hydroxybenzoate,
    sodium citrate | Sodium Benzoate,
    methylparaben,
    polyparaben, cetyl-
    pyridiniumchloride | Sorbic acid,
    Benzoic acid,
    Lactoperoxidase,
    Lysozyme | Potassium Sorbate,
    methylparabn | Xylitol,
    potassium
    sorbate |
    | Delivery
    method | Tube with orifice for
    dispensing | Bottle with spray
    nozzle | Tube with orifice for
    dispensing | Tube with orifice
    for dispensing | Bottle with Spray
    nozzle |
    | Packaging size | 40 g tube | 1.5 fl oz | 1.5 oz tube | 0.5 oz | 1 fl oz |
    | pH | 7.2 | 6.2-7.1 | 5.6 | 5.35-5.36 | 5.76-5.78 |

• All other variations in the formula/composition are concentration and volume variations of common ingredients to allow proper dispensing and use of the product and do not affect the function, indications, or equivalency of the product.

In summary, these differences in formulation to the predicate devices do not alter the function, indications, or substantial equivalency of the products.

In addition:

8

  • . Any new components/ingredients are designated GRAS ingredients, food additives or have a significant history of use in dental & medical or food applications.
  • All components of the product have been manufactured using standardized and industry accepted state of the art production methods.
  • . All components of the product have been tested using standardized and industry accepted state of the art test methods.
  • . The products have been tested using standardized and industry accepted state of the art test methods.

Description of Substantial Equivalence

The chemical components in MedActive Oral Gel and Spray have been used in predicate devices, are listed as GRAS ingredients, are approved food additives/ingredients, or a combination these conditions. We believe these facts well support the compatibility of MedActive Oral Gel and Spray, and that the applicant devices are substantially equivalent to the predicate devices properties, intended use and composition.

| Product Name | PREDICATE DEVICE
Biotene® moisturizing
mouth Spray
(K123731) | PREDICATE DEVICE
GC® oral
moisturizing
GEL (K10134) | Predicate Device
Laclede® Oral
Balance Gel
(K061331) | MedActive®
Oral Relief
GEL | MedActive® Oral
Relief Spray |
|---------------------------|-----------------------------------------------------------------------|--------------------------------------------------------------|---------------------------------------------------------------|--------------------------------------------------|--------------------------------------------------|
| Method of Use | Ready to Use | Ready to Use | Ready to Use | Ready to Use | Ready to Use |
| No. of
Application/day | Take as needed | Take as needed | Take as needed | Take as needed | Take as needed |
| Claim | Symptomatic
Relief/treatment of
Xerostomia | Symptomatic
Relief/treatment of
Xerostomia | Symptomatic
Relief/treatment of
Xerostomia | Symptomatic
Relief/treatment of
Xerostomia | Symptomatic
Relief/treatment of
Xerostomia |
| Area of Use | Oral Cavity | Oral Cavity | Oral Cavity | Oral Cavity | Oral Cavity |
| Disease State | Xerostomia | Xerostomia | Xerostomia | Xerostomia | Xerostomia |
| Type of Product | Spray | Gel | Liquid/ Gel | Gel | Spray |
| Presentation | Non-sterile | Non-sterile | Non-sterile | Non-sterile | Non-sterile |

Substantial Equivalence Comparison Chart

Information provided in this submission confirms the substantial equivalence to the predicate devices with common indications.

Conclusion Statement

MedActive Oral Gel and Spray are a mouth gel and a mouth spray respectively for use in patients that are suffering from dry mouth symptoms. They will coat the inside of the mouth for a short period of time and help create relief from oral malodor, difficulty speaking or eating or general discomfort caused by dry mouth. Their semi viscous formulas create a smooth moist coating on oral tissues as well as providing a pleasant flavor to the user. When compared to the predicate devices and other existing mouth moisturizers and dry mouth products, MedActive Gel and Spray are substantially equivalent.

This 510(k) summary is being submitted in accordance with the requirements of 21 CFR 807.