K Number
K153084
Device Name
Nephros S100
Manufacturer
Date Cleared
2016-04-08

(165 days)

Product Code
Regulation Number
876.5665
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The S100 Point of Use Filter is intended to be used to filter EPA quality drinking water. The filter retains bacteria. By retaining bacteria in water for washing and drinking, the filter may aid in infection control. The filter produces water that is suitable for cleaning of equipment used in medical procedures and washing of surgeon's hands. The filter is not intended to provide water that can be used as a substitute for USP sterile water.

Device Description

The S100 Point of Use Filter is a hollow fiber microfilter that retains bacteria from water used for washing and drinking.

AI/ML Overview

Here's a breakdown of the acceptance criteria and study information for the Nephros S100 Point of Use Filter, based on the provided document:

1. Table of Acceptance Criteria and Reported Device Performance

Performance CharacteristicAcceptance Criteria (Predicate Device)Reported Device Performance (S100 Filter)
Bacteria Removal> 10^11 reduction> 10^9 reduction
Flow Rate vs. Pressure Drop4.5 L/min at 20 psi (SSU-H) 4 L/min at 20 psi (DSU-H)4 L/min at 20 psi
Maximum Inlet Pressure75 psi (SSU-H) 100 psi (DSU-H)75 psi
Use LifeUp to 3 Months (SSU-H) Up to 6 Months (DSU-H)Up to 3 months

Note: The document directly compares the S100 filter to the DSU-H and SSU-H Ultrafilters (K141731) as predicate devices. The "Acceptance Criteria" here are derived from the performance specifications of these predicate devices as presented in the "SUBJECT TO PREDCATE DEVICE COMPARISON TABLE." The S100's performance is considered "substantially equivalent" to these predicates.

2. Sample Size Used for the Test Set and Data Provenance

The document does not explicitly state the sample size for the test set (number of S100 filters tested for performance). It only mentions "The S100 Point of Use Filter has been tested for performance."

The data provenance (country of origin, retrospective/prospective) is not specified in the provided text.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications of Those Experts

This information is not provided in the document. The testing described for the filter's performance (Flow Rate, Simulated Use Life, Bacteria Challenge, Biocompatibility) are typically lab-based tests with objective measurements, not requiring expert consensus for "ground truth" in the way a clinical study for diagnosis might.

4. Adjudication Method for the Test Set

This information is not applicable/provided as the performance tests described are objective, laboratory-based measurements rather than subjective assessments requiring adjudication.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

An MRMC study is not applicable to this type of device. The S100 Point of Use Filter is a physical water filter, not an AI-powered diagnostic tool. The document describes performance testing for filtration capabilities.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) was done

This is not applicable to this device. As mentioned, the S100 Point of Use Filter is a physical filter, not an algorithm or AI system.

7. The Type of Ground Truth Used

The ground truth for the performance testing (e.g., bacteria removal, flow rate) would be established through laboratory-based measurements and validated testing methods. For example:

  • Bacteria Removal: Direct enumeration of bacteria in the influent and effluent water (e.g., colony-forming units, turbidity measurements) using standard microbiological laboratory practices.
  • Flow Rate: Direct measurement of water volume passed over time at a given pressure.
  • Use Life: Controlled flow and pressure conditions over an extended period, with periodic performance checks for bacteria removal and flow.

8. The Sample Size for the Training Set

This is not applicable/provided. As the S100 Point of Use Filter is a physical device and not an AI/machine learning model, there is no "training set" in the computational sense.

9. How the Ground Truth for the Training Set Was Established

This is not applicable as there is no training set for this type of device.

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Image /page/0/Picture/1 description: The image is a logo for the U.S. Department of Health & Human Services. The logo features the department's name in a circular arrangement around a symbol. 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

April 8, 2016

Nephros, Inc. James Summerton Director Product Development 41 Grand Ave River Edge, NJ 07661

Re: K153084

Trade/Device Name: S100 Point of Use Filter Regulation Number: 21 CFR§ 876.5665 Regulation Name: Water Purification System for Hemodialysis Regulatory Class: II Product Code: NHV Dated: March 7, 2016 Received: March 10, 2016

Dear James Summerton,

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.

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You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/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,

Joyce M. Whang -S

for Benjamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known): K153084 Device Name: S100 Point of Use Filter

Indications For Use:

The S100 Point of Use Filter is intended to be used to filter EPA quality drinking water. The filter retains bacteria. By retaining bacteria in water for washing and drinking, the filter may aid in infection control. The filter produces water that is suitable for cleaning of equipment used in medical procedures and washing of surgeon's hands. The filter is not intended to provide water that can be used as a substitute for USP sterile water.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ AND/OR (Part 21 CFR 801 Subpart D)

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

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Submitter:Nephros Inc.41 Grand AveRiver Edge, NJ 07661Establishment Registration # 3003337893Subject DevicePredicate DeviceSubject DevicePredicate Device
Contact PersonJim Summerton, Director Product Development41 Grand AveRiver Edge, NJ 07661201-343-5202 (p)201-343-5207 (f)summerton@nephros.com510(k)NumberK153084K141731Materials
Date PreparedMarch 8, 2016ManufacturerNameNephros Inc.Nephros Inc.CasingABSABS
Trade NameS100 Point of Use FilterIndicationsfor UseThe S100 Point of Use Filter isintended to be used to filter EPAquality drinking water. The filterretains bacteria. By retainingbacteria in water for washing anddrinking, the filter may aid ininfection control. The filterproduces water that is suitable forcleaning of equipment used inmedical procedures and washingof surgeon's hands. The filter isnot intended to provide water thatcan be used as a substitute forUSP sterile water.The DSU-H and SSU-H Ultrafiltersare intended to be used to filter EPAquality drinking water. The filtersretain bacteria, viruses andendotoxin. By providing ultrapurewater for washing and drinking, thefilters aid in infection control. Thefilters produce water that is suitablefor wound cleansing, cleaning ofequipment used in medicalprocedures and washing ofsurgeon's hands. The filters are notintended to provide water that can beused as a substitute for USP sterilewater.FilterPolysulfone MicrofiltrationPolysulfone Ultrafiltration Hollow
Proposed ClassClass IIOperationElement(s)Hollow FiberFiber
Classification Nameand Number21 CFR Part 876.5665 Water Purification Device, GeneralMedical UseFeed WaterSourceMunicipal tap waterMunicipal tap waterRemoval
Product CodeNHVUse LifeUp to 3 monthsUp to 3 Months (SSU-H)Up to 6 Months (DSU-H)Bacteria> 109> 1011
Predicate DeviceDSU-H and SSU-H Ultrafilters – K141731MaximumInlet Pressure75 psi75 psi (SSU-H)100 psi (DSU-H)Reduction
Device DescriptionThe S100 Point of Use Filter is a hollow fiber microfilter thatretains bacteria from water used for washing and drinking.Flow Rate vs.Pressure Drop4 L/min at 20 psi4.5 L/min at 20 psi (SSU-H)4 L/min at 20 psi (DSU-H)Virus removaln/a> 108
Intended UseThe S100 Point of Use Filter is intended to be used to filter EPAquality drinking water. The filter retains bacteria. By retainingbacteria in water for washing and drinking, the filter may aid ininfection control. The filter produces water that is suitable forcleaning of equipment used in medical procedures and washingof surgeon's hands. The filter is not intended to provide waterthat can be used as a substitute for USP sterile water.Endotoxinn/a> 105
Summary of theTechnologicalThe proposed device contains a polysulfone hollow fibermembrane encased in an ABS housing that retains bacteria.Reduction
CharacteristicsRemoval of contaminants is through size exclusion.
Assessment of Non-clinical PerformanceData / SubstantialEquivalenceThe S100 Point of Use Filter has been tested for performance.The tests conducted include Flow Rate versus Pressure Drop,Simulated Use Life, Bacteria Challenge Test andBiocompatibility. The filters were found to be substantiallyequivalent to the predicate DSU-H and SSU-H Ultrafilters(K141731).

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SUBJECT TO PREDCATE DEVICE COMPARISON TABLE

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§ 876.5665 Water purification system for hemodialysis.

(a)
Identification. A water purification system for hemodialysis is a device that is intended for use with a hemodialysis system and that is intended to remove organic and inorganic substances and microbial contaminants from water used to dilute dialysate concentrate to form dialysate. This generic type of device may include a water softener, sediment filter, carbon filter, and water distillation system.(b)
Classification. Class II (special controls). The device, when it is a water purification subsystem disinfectant, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.