K Number
K160450
Manufacturer
Date Cleared
2016-10-31

(256 days)

Product Code
Regulation Number
870.5050
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Pleural Catheter Kits are indicated for intermittent, long term drainage of symptomatic, recurrent, pleural effusion, including malignant pleural effusion and other recurrent effusions that do not respond to medical management of the underlying disease. The devices are indicated for 1) the palliation of dyspnea effusion and 2) providing pleurodesis (resolution of the pleural effusion). The Pleural Catheter Kits are indicated for adults only.

The Pleur X Lockable Drainage Line is used to drain fluid using standard wall suction, water seal drainage system, vacuum bottle, or other appropriate method.

The Pleur X Access Valve attaches only to the PleurX Valve Kit is intended to repair the Pleur X Catheter and replace the PleurX Valve. The PleurX Valve Kit is indicated for adults only.

The Pleur X LP Catheter Mini Kit is indicated for intermittent, long term drainage of symptomatic, recurrent, pleural effusion, including malignant pleural effusion and other recurrent effusions that do not respond to medical management of the underlying disease. The devices are indicated for the palliation of dyspnea effusion and providing pleurodesis (resolution of the pleural effusion). The PleurX Low Profile Catheter is indicated for adults only.

Device Description

The Pleurx Pleural Catheter System provides patients with a convenient method to relieve pleural effusion symptoms at home. The primary components of the Pleurx Catheter System are the Pleurx Pleural Catheter and the Pleurx Drainage Kits.

AI/ML Overview

The CareFusion Pleurx Pleural Catheter System, cleared under K160450, is a medical device for draining symptomatic, recurrent pleural effusion. The provided text indicates this 510(k) submission is for a change in material formulation and concentration, and minor design modifications to the devices previously cleared under K141965. No clinical studies were conducted for this submission. The device's acceptance criteria and performance are based on a series of non-clinical, in-vitro performance tests and biocompatibility studies.

1. Table of Acceptance Criteria and Reported Device Performance:

CharacteristicAcceptance Criteria (Standard/Test/FDA Guidance)Reported Device Performance
BiocompatibilityAAMI/ANSI/ISO 10993-1:2009 Biological evaluation of Medical Devices Part 1: Evaluation and TestingThe results of the non-clinical tests show that the CareFusion Pleural Catheter System is as safe, as effective, and performs as well as the legally marketed predicate devices. (This general statement applies to all biocompatibility tests listed, indicating successful completion and meeting established criteria for safety.)
BiocompatibilityAAMI/ANSI/ISO 10993-5: 2009 Biological Evaluation of Medical Devices – Part 5 Tests for In Vitro CytotoxicityIbid.
BiocompatibilityAAMI/ANSI/ISO 10993-6: 2007 (R) 2010 Biological Evaluation of Medical Devices – Part 6 Tests for Local Effects After ImplantationIbid.
Residuals (Ethylene Oxide)AAMI/ANSI/ISO 10993-7:2008 Biological evaluation of Medical Devices Part 7: Ethylene Oxide Sterilization ResidualsIbid.
Biocompatibility (Irritation/Sensitivity)AAMI/ANSI/ISO 10993-10: 2010 Biological Evaluation of Medical Devices – Part 10 Tests for Irritation and Skin SensitivityIbid.
Biocompatibility (Leachable Substances)ISO 10993-17:2002 Biological evaluation of medical devices – Establishment of allowable limits for leachable substancesIbid.
Biocompatibility (Chemical Characterization)ISO 10993-18:2005 Biological evaluation of medical devices – Chemical characterization of materialsIbid.
PerformanceEN 1617:1997 Sterile Drainage Catheters and Accessory Devices for Single UseThe results of the non-clinical tests show that the CareFusion Pleural Catheter System is as safe, as effective, and performs as well as the legally marketed predicate devices. (This general statement applies to all performance tests, indicating successful completion and meeting established criteria for functionality and safety.)
PerformanceEN 1618:1997 Catheters Other Than Intravascular Catheters - Test Methods for Common PropertiesIbid.
Performance (Packaging)ANSI/AAMI/ISO 11607-1:2006/(R)2010 Packaging for Terminally Sterilized Medical Devices- Part 1:Requirements For Materials, Sterile Barrier Systems And Packaging Systems [Including: Amendment 1 (2014)]Ibid.
Performance (Packaging Validation)ANSI/AAMI/ISO 11607-2:2006/(R)2010 Packaging for Terminally Sterilized Medical Devices- Part 2: Validation Requirements For Forming, Sealing And Assembly Processes [Including: Amendment 1 (2014)]Ibid.
Performance (Accelerated Aging)ASTM F1980-07 Accelerated Aging of Sterile Barrier SystemsIbid.
Performance (Biological Indicators)ISO 11138-1, 2nd Ed Sterilization of healthcare products - Biological Indicators - Part 1: General RequirementsIbid.
Performance (Microbiological Methods)ISO 11737-1 2nd Ed Sterilization of Medical Devices – Microbiological Methods Part 1Ibid.
Performance (EO Sterilization)ISO 11135 2nd Ed Sterilization of Health-Care Products -Ethylene Oxide – Requirements for the Development, Validation and Routine Control of a Sterilization Process for Medical DevicesIbid.
Performance (EO Sterilization Adoption)AAMI TIR28:2009(R)2013 Product Adoption and Process Equivalency for Ethylene Oxide SterilizationIbid.
Performance (Surgical Implants)ISO 14630 Non-active Surgical Implants - General RequirementsIbid.
Performance (MRI Safety - Displacement)ASTM F2052 Measurement of Magnetically Induced Displacement Force on Medical Devices in the MR EnvironmentIbid.
Performance (MRI Safety - Artifacts)ASTM F2119 Evaluation of MR Image Artifacts from Passive ImplantsIbid.
Performance (MRI Safety - Heating)ASTM F2182 A Measurement of Radiofrequency Induced Heating on or Near Passive Implants During MRIIbid.
Performance (MRI Safety - Torque)ASTM F2213 Measurement of Magnetically Induced Torque on Medical Devices in the Magnetic Resonance EnvironmentIbid.

2. Sample size used for the test set and the data provenance:

The document states "No clinical tests were conducted for this submission." Therefore, there is no test set in the context of clinical data. The performance was evaluated through non-clinical laboratory testing against recognized standards. The provenance of the data is from these laboratory tests, which are typically conducted in a controlled environment, not on human subjects or patient data.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

This information is not applicable as no clinical tests were conducted and thus no expert-established ground truth from a test set in a clinical context. The "ground truth" for non-clinical tests is established by adherence to the specified standards and the objective measurement of device performance against the requirements of those standards.

4. Adjudication method for the test set:

Not applicable, as no clinical test set was used requiring expert 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:

Not applicable. The Pleurx Pleural Catheter System is a physical medical device, not an AI-powered diagnostic or interpretive tool that would involve human readers or AI assistance in the way typically associated with MRMC studies.

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

Not applicable. This device is not an algorithm or AI system.

7. The type of ground truth used:

The ground truth for the device's performance is based on the objective measurements and pass/fail criteria defined by the internationally recognized standards (e.g., ISO, AAMI, ASTM, EN) listed in the "Performance Test Summary" section. For example, biocompatibility is evaluated against the requirements of ISO 10993 standards, and physical performance against specific EN standards.

8. The sample size for the training set:

Not applicable, as no clinical or AI-based training set was used. The submission is about modifications to an existing device and relies on non-clinical testing.

9. How the ground truth for the training set was established:

Not applicable, as no training set was used.

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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 features a stylized caduceus symbol, which is a staff with two snakes coiled around it. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the caduceus symbol.

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

October 31, 2016

CareFusion Tamara Brey Advisor, Regulatory Management 75 North Fairway Drive Vernon Hills, Illinois 60061

Re: K160450

Trade/Device Name: Pleurx Pleural Catheter System Regulation Number: 21 CFR 870.5050 Regulation Name: Patient Care Suction Apparatus Regulatory Class: Class II Product Code: DWM Dated: September 26, 2016 Received: September 28, 2016

Dear Tamara Brey:

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 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.

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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

Tina Kiang, Ph.D. Acting 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) K160450

Device Name Pleurx Pleural Catheter System

Indications for Use (Describe)

The Pleural Catheter Kits are indicated for intermittent, long term drainage of symptomatic, recurrent, pleural effusion, including malignant pleural effusion and other recurrent effusions that do not respond to medical management of the underlying disease. The devices are indicated for 1) the palliation of dyspnea effusion and 2) providing pleurodesis (resolution of the pleural effusion). The Pleural Catheter Kits are indicated for adults only.

The Pleur X Lockable Drainage Line is used to drain fluid using standard wall suction, water seal drainage system, vacuum bottle, or other appropriate method.

The Pleur X Access Valve attaches only to the PleurX Valve Kit is intended to repair the Pleur X Catheter and replace the PleurX Valve. The PleurX Valve Kit is indicated for adults only.

The Pleur X LP Catheter Mini Kit is indicated for intermittent, long term drainage of symptomatic, recurrent, pleural effusion, including malignant pleural effusion and other recurrent effusions that do not respond to medical management of the underlying disease. The devices are indicated for the palliation of dyspnea effusion and providing pleurodesis (resolution of the pleural effusion). The PleurX Low Profile Catheter is indicated for adults only.

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)

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510(k) SUMMARY K160450

A summary of 510(k) safety and effectiveness information in accordance with 21 CFR 807.92.

SUBMITTER INFORMATION
NameCareFusion
Address75 North Fairway Drive, Vernon Hills, IL 60061 USA
Phone number(847) 362-9485
Fax number(312) 949-9245
Establishment RegistrationNumber1423507
Name of contact personTamara Brey
Date preparedFebruary 15, 2016
DESCRIPTION OF DEVICE
Trade or proprietary namePleurx Pleural Catheter System
Common or usual namePleural Drainage Catheter
Classification namePatient Care Suction Apparatus
Classification panelAnesthesiology
RegulationClass II per 21CFR §870.5050, Procode DWM
Product Code(s)Multiple
Legally marketed device(s) towhich equivalence is claimedCareFusion Pleurx Catheter System: K141965, andBard Aspira Pleural Drainage System: K110409
Reason for 510(k) submissionThis 510(k) submission is for a change in material formulation andconcentration, and minor design modifications to the devices clearedunder K141965.
Device descriptionThe Pleurx Pleural Catheter System provides patients with a convenientmethod to relieve pleural effusion symptoms at home. The primarycomponents of the Pleurx Catheter System are the Pleurx PleuralCatheter and the Pleurx Drainage Kits.
Intended use of the deviceThe PleurX Pleural Catheter Kits are indicated for intermittent, long termdrainage of symptomatic, recurrent, pleural effusion, including malignantpleural effusion and other recurrent effusions that do not respond tomedical management of the underlying disease. The devices are indicatedfor 1) the palliation of dyspnea due to pleural effusion and 2) providingpleurodesis (resolution of the pleural effusion). The PleurX PleuralCatheter Kits are indicated for adults only.The PleurX Lockable Drainage Line is used to drain fluid using standardwall suction, water seal drainage system, vacuum bottle, or otherappropriate method.The PleurX Access Valve attaches only to the PleurX Catheter. ThePleurX Valve Kit is intended to repair the PleurX Catheter.
Catheter and replace the PleurX Valve. The PleurX Valve Kit is indicatedfor adults only.
The PleurX LP Catheter Mini Kit is indicated for intermittent, long termdrainage of symptomatic, recurrent, pleural effusion, including malignantpleural effusion and other recurrent effusions that do not respond tomedical management of the underlying disease. The devices are indicatedfor the palliation of dyspnea due to pleural effusion and providingpleurodesis (resolution of the pleural effusion). The PleurX Low ProfileCatheter is indicated for adults only.

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SUMMARY OF THE TECHNOLOGICAL CHARACTERISTICS OF THE DEVICE COMPARED TO THE PREDICATE DEVICE

CharacteristicNew DevicePredicate
Catheter DescriptionInternal: fenestrations,radiopaque markings & cuffExternal: valveSame as predicate: CareFusion PleurxCatheter Systems: K141965
MethodPercutaneously tunneled -indwellingSame as predicate: CareFusion PleurxCatheter Systems: K141965
Access Valve DescriptionUnique access tip, valved closedsystem to inject and withdrawfluids.Same as predicate: Bard Aspira DrainageSystem: K110409
Materials of ConstructionSilicone, Barium Sulfate,Polyester, Polyisoprene,Polypropylene, Colorant, ABS,Ink, AdhesiveSame as predicate: CareFusion PleurxCatheter Systems: K141965
CONCLUSION OF DEVICE COMPARISON

The technological characteristics of the proposed devices are substantially equivalent to the predicates.

PERFORMANCE DATA

SUMMARY OF NON-CLINICAL TESTS CONDUCTED FOR DETERMINATION OF SUBSTANTIAL EQUIVALENCE

Performance Test Summary

CharacteristicStandard/Test/FDA Guidance
BiocompatibilityAAMI/ANSI/ISO 10993-1:2009 Biological evaluation of Medical Devices Part 1:Evaluation and Testing
BiocompatibilityAAMI/ANSI/ISO 10993-5: 2009 Biological Evaluation of Medical Devices – Part 5Tests for In Vitro Cytotoxicity
BiocompatibilityAAMI/ANSI/ISO 10993-6: 2007 (R) 2010 Biological Evaluation of Medical Devices –Part 6 Tests for Local Effects After Implantation
ResidualsAAMI/ANSI/ISO 10993-7:2008 Biological evaluation of Medical Devices Part 7:Ethylene Oxide Sterilization Residuals
BiocompatibilityAAMI/ANSI/ISO 10993-10: 2010 Biological Evaluation of Medical Devices – Part 10Tests for Irritation and Skin Sensitivity
BiocompatibilityISO 10993-17:2002 Biological evaluation of medical devices --Establishment ofallowable limits for leachable substances
BiocompatibilityISO 10993-18:2005 Biological evaluation of medical devices -- Chemicalcharacterization of materials
PerformanceEN 1617:1997 Sterile Drainage Catheters and Accessory Devices for Single Use

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PerformanceEN 1618:1997 Catheters Other Than Intravascular Catheters - Test Methods forCommon Properties
PerformanceANSI/AAMI/ISO 11607-1:2006/(R)2010 Packaging for Terminally Sterilized MedicalDevices- Part 1:Requirements For Materials, Sterile Barrier Systems And PackagingSystems [Including: Amendment 1 (2014)]
PerformanceANSI/AAMI/ISO 11607-2:2006/(R)2010 Packaging for Terminally Sterilized MedicalDevices- Part 2: Validation Requirements For Forming, Sealing And AssemblyProcesses [Including: Amendment 1 (2014)]
PerformanceASTM F1980-07 Accelerated Aging of Sterile Barrier Systems
PerformanceISO 11138-1, 2nd Ed Sterilization of healthcare products - Biological Indicators - Part1: General Requirements
PerformanceISO 11737-1 2nd Ed Sterilization of Medical Devices – Microbiological Methods Part1
PerformanceISO 11135 2nd Ed Sterilization of Health-Care Products -Ethylene Oxide –Requirements for the Development, Validation and Routine Control of a SterilizationProcess for Medical Devices
PerformanceAAMI TIR28:2009(R)2013 Product Adoption and Process Equivalency for EthyleneOxide Sterilization
PerformanceISO 14630 Non-active Surgical Implants - General Requirements
PerformanceASTM F2052 Measurement of Magnetically Induced Displacement Force on MedicalDevices in the MR Environment
PerformanceASTM F2119 Evaluation of MR Image Artifacts from Passive Implants
PerformanceASTM F2182 A Measurement of Radiofrequency Induced Heating on or NearPassive Implants During MRI
PerformanceASTM F2213 Measurement of Magnetically Induced Torque on Medical Devices inthe Magnetic Resonance Environment
SUMMARY OF CLINICAL TESTS CONDUCTED FOR DETERMINATION OF SUBSTANTIALEQUIVALENCE AND/OR OF CLINICAL INFORMATION

N/A – No clinical tests were conducted for this submission

CONCLUSIONS DRAWN FROM NON-CLINICAL AND CLINICAL DATA

The results of the non-clinical tests show that the CareFusion Pleural Catheter System is as safe, as effective, and performs as well as the legally marketed predicate devices.

§ 870.5050 Patient care suction apparatus.

(a)
Identification. A patient care suction apparatus is a device used with an intrathoracic catheter to withdraw fluid from the chest during the recovery period following surgery.(b)
Classification. Class II (performance standards).