K Number
K161812
Device Name
Freedom Syringe
Date Cleared
2017-03-27

(269 days)

Product Code
Regulation Number
880.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Freedom™ Syringe is intended to inject fluids into, or withdraw fluids from, the body.
Device Description
The Freedom™ Syringe is a single-use medical device consisting of a calibrated hollow barrel and movable plunger (piston). The plunger contains a rubber stopper on the end that is positioned within the syringe barrel. A small amount of medical-grade silicone is used as a lubricant. The lubricant, stopper on the end of the plunger, and the syringe barrel are the components which make contact with the fluid path of the device. The syringe barrel contains a standard male luer lock connector that is compatible with standard female luer hubs. Freedom™ Syringes have a nominal capacity of 10ml, and are available sterile or non-sterile for further processing. The syringe is available in 5 different plunger colors: white, blue, red, yellow, or green.
More Information

Not Found

No
The device description and performance studies focus on the mechanical and material properties of a standard syringe, with no mention of AI or ML capabilities.

No
A syringe is a delivery device for substances, not a therapeutic device itself. Its intended use is for injecting or withdrawing fluids, which can include therapeutic agents, but the syringe itself does not provide therapy.

No

The device is a syringe, intended to inject or withdraw fluids from the body. Its function is to administer or extract substances, not to provide diagnostic information about a patient's condition.

No

The device description clearly outlines physical components (barrel, plunger, stopper, lubricant, luer lock connector) and mentions testing against hardware standards (ISO 7886-1, ISO 594-1, etc.), indicating it is a physical medical device, not software-only.

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

Here's why:

  • Intended Use: The intended use is to "inject fluids into, or withdraw fluids from, the body." This describes a direct interaction with the human body for therapeutic or diagnostic purposes within the body, not for examining specimens outside the body.
  • Device Description: The description details a standard syringe for fluid handling in a clinical setting. There is no mention of components or functions related to analyzing biological specimens.
  • Lack of IVD Characteristics: IVD devices are typically used to examine specimens such as blood, urine, tissue, etc., to provide information about a person's health. The Freedom™ Syringe does not perform any such analysis.

Therefore, the Freedom™ Syringe is a medical device, but it falls under a different classification than an IVD.

N/A

Intended Use / Indications for Use

The Freedom™ Syringe is intended to inject fluids into, or withdraw fluids from, the body.

Product codes

FMF

Device Description

The Freedom™ Syringe is a single-use medical device consisting of a calibrated hollow barrel and movable plunger (piston). The plunger contains a rubber stopper on the end that is positioned within the syringe barrel. A small amount of medical-grade silicone is used as a lubricant. The lubricant, stopper on the end of the plunger, and the syringe barrel are the components which make contact with the fluid path of the device. The syringe barrel contains a standard male luer lock connector that is compatible with standard female luer hubs. Freedom™ Syringes have a nominal capacity of 10ml, and are available sterile or non-sterile for further processing. The syringe is available in 5 different plunger colors: white, blue, red, yellow, or green.

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

Not Found

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)

Freedom™ Syringes have been tested to ensure conformance to all applicable performance requirements within the following standards: ISO 7886-1, ISO 594-1, ISO 594-2, ISO 11135-1, ISO 10993-1, ISO 10993-4, ISO 10993-5, ISO 10993-7, ISO 10993-10, ISO 10993-11, ANSI/AAMI ST72.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K103736

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 880.5860 Piston syringe.

(a)
Identification. A piston syringe is a device intended for medical purposes that consists of a calibrated hollow barrel and a movable plunger. At one end of the barrel there is a male connector (nozzle) for fitting the female connector (hub) of a hypodermic single lumen needle. The device is used to inject fluids into, or withdraw fluids from, the body.(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 an abstract symbol that resembles a stylized caduceus or a series of human profiles.

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

March 27, 2017

Procedure Products, Inc. Mr. Doug Rowley QA Manager 1801 W. 4th Plain Blvd. Vancouver, Washington 98660

Re: K161812

Trade/Device Name: Freedom™ Syringe Regulation Number: 21 CFR 880.5860 Regulation Name: Piston Syringe Regulatory Class: Class II Product Code: FMF Dated: February 17, 2017 Received: February 21, 2017

Dear Mr. Doug Rowley:

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. Isting 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.

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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 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" (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 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,

Image /page/1/Picture/8 description: The image contains a signature and the name "Tina Kiang". There is also a "-s" below the name. The signature is a complex series of loops and lines, and it is placed to the left of the name.

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

2

Change Control Table, Change History

Change Control Table

VersionDocument AuthorDocument ApproverDate Approved
1.00Name, Title, OfficeName, Title, OfficeMM/DD/YYYY

Complete Change Control Table (all versions) retained in SWIFT Docs.

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Indications for Use

510(k) Number (if known) K161812

Device Name Freedom™ Syringe

Indications for Use (Describe)

The Freedom™ Syringe is intended to inject fluids into, or withdraw fluids from, the body.

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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PROCEDURE PRODUCTS INC. 1801 WEST FOURTH PLAIN BLVD. VANCOUVER, WASHINGTON 98660 360.693.1832 TELEPHONE 360.690.4473 FAX WWW.PROCEDUREPRODUCTS.COM

Image /page/4/Picture/1 description: The image contains the logo for Procedure Products Inc. The logo is in blue text, with the words "Procedure Products Inc." stacked on top of each other. To the left of the text is a square made up of four smaller squares in yellow, blue, green, and red. Below the main text is the phrase "Safety Color TM" in a smaller font.

Page 1/4

510(k) Summary

K161812 510(k) Number:

General Provisions

Address:

Fax Number:

Procedure Products, Inc. Submitter's Name:

1801 W 4th Plain Blvd. Vancouver, WA 98660

Doug Rowley

(360) 693-1832 or (888) 532-3396

Telephone Number:

(360) 690-4473

Contact Person:

(360) 693-1832

Date of Preparation: 03/09/2017

Subject Device

Freedom™ Svringe Trade Name: 21 CFR 880.5860 Regulation Number: Regulation Name: Piston Syringe Requlatory Class: = FMF Product Code: Classification Panel: General Hospital

Predicate Device

Trade Name: Requlation Number: Requlation Name: Regulatory Class: Product Code: Classification Panel: Premarket Notification #:

DMC Medical Single-Use Polycarbonate Syringe 21 CFR 880.5860 Piston Syringe = FMF General Hospital K103736

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PROCEDURE PRODUCTS INC. 1801 WEST FOURTH PLAIN BLVD. VANCOUVER, WASHINGTON 98660 360.693.1832 TELEPHONE 360.690.4473 FAX WWW.PROCEDUREPRODUCTS.COM

Image /page/5/Picture/1 description: The image shows the logo for Procedure Products Inc. The logo consists of the words "Procedure" and "Products Inc." in blue font. To the left of the words is a square made up of four smaller squares in the colors yellow, blue, green, and red. Below the words "Products Inc." is the phrase "Safety Color TM" in a smaller blue font.

Page 2/4

Indications for Use

The Freedom™ Syringe is intended to inject fluids into, or withdraw fluids from, the body.

Device Description

The Freedom™ Syringe is a single-use medical device consisting of a calibrated hollow barrel and movable plunger (piston). The plunger contains a rubber stopper on the end that is positioned within the syringe barrel. A small amount of medical-grade silicone is used as a lubricant. The lubricant, stopper on the end of the plunger, and the syringe barrel are the components which make contact with the fluid path of the device. The syringe barrel contains a standard male luer lock connector that is compatible with standard female luer hubs. Freedom™ Syringes have a nominal capacity of 10ml, and are available sterile or non-sterile for further processing. The syringe is available in 5 different plunger colors: white, blue, red, yellow, or green.

Principles of Operation

Freedom™ Syringes are manually operated by the user through the advancement and/or withdrawal of the syringe plunger within the barrel. Syringe content volume is measured by the user through the printed scale on the outside of the syringe barrel. These operating principles are identical to that of the predicate device and the vast majority of piston syringes currently on the market.

Comparison to Predicate Device

The indications for use, technological characteristics, and principles of operation of the Freedom™ Syringe are substantially equivalent to those of the DMC Medical Single-Use Polycarbonate Syringe product line (predicate device). Both devices have been designed and tested to ensure compliance with the same set of consensus standards. The table on the following page provides additional comparison between the subject device (Freedom™ Syringe) and the predicate device (the DMC Medical Single-Use Polycarbonate Syringe).

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PROCEDURE PRODUCTS INC. 1801 WEST FOURTH PLAIN BLVD. VANCOUVER, WASHINGTON 98660 360.693.1832 TELEPHONE 360.690.4473 FAX WWW.PROCEDUREPRODUCTS.COM

Image /page/6/Picture/1 description: The image is a logo for Procedure Products Inc. The logo features the company name in blue, with the words "Procedure" stacked on top of "Products Inc." To the left of the company name is a plus sign made up of four squares, each in a different color: yellow, blue, green, and red. Below the company name is the phrase "Safety Color TM" in a smaller, blue font.

| Component / Characteristic | DMC Medical Single-Use
Polycarbonate Syringe
(Predicate Device) | Freedom™ Syringe
(Subject Device) |
|-------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------|
| Barrel | Polycarbonate | Triton® MX731 Copolyester |
| Plunger | ABS | ABS |
| Stopper | Elastomer | Polyisoprene Elastomer |
| Lubricant | Medical Grade Silicone | Medical Grade Silicone |
| Sterilization Method
(when applicable) | Ethylene Oxide (EtO) | Ethylene Oxide (EtO) |
| Syringe Size(s) (nominal capacity) | Various, including 10ml | 10ml |
| ISO 10993-1 Compliance | Yes | Yes |
| ISO 7886-1 Compliance | Yes | Yes |
| ISO 594-1 & 594-2 Compliance | Yes | Yes |
| FDA 510(k) Numbers | K103736 | K161812 |
| Intended Use / Indications for Use | DMC Medical piston type
syringes are single use
syringes, intended for injecting
fluids into or withdrawing fluids
from the body. | The Freedom™™ Syringe is
intended to inject fluids into, or
withdraw fluids from, the body. |
| Commentary regarding Indications for Use | As seen within the row above, the Indications for Use for the predicate
device are not identical to the Indications for Use of the Freedom™™
Syringe. However, the Freedom™™ Syringe is a piston type, single use
syringe, and as such the differences between the two Indications for
Use are not considered to impact substantial equivalence. | |

Technological Differences between Predicate and Subject Device

The only known technological difference between the Freedom™ Syringe and the predicate device is the differing materials that make up the syringe barrel (as noted in the table above). The Copolyester material utilized in the Freedom™ Syringe has been tested according to all applicable standards and found to be equivalent to the polycarbonate syringe barrel used by the predicate device with respect to function and compliance with these standards.

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Image /page/7/Picture/1 description: The image shows the logo for Procedure Products Inc. The logo features the company name in blue, with the word "Procedure" stacked on top of "Products Inc." To the left of the company name is a colorful square made up of smaller squares in yellow, blue, green, white, and red. Below the company name is the phrase "Safety Color TM" in blue.

Freedom™ Syringes have been tested to ensure conformance to all applicable performance requirements within the following standards:

Standard NumberStandard Title
ISO 7886-1Sterile hypodermic syringes for single use – Part 1: Syringes for manual use
ISO 594-1Conical fittings with a 6% (Luer) taper for syringes, needles and certain other medical equipment –
Part 1: General Requirements
ISO 594-2ISO 594-2; Conical fittings with a 6% (Luer) taper for syringes, needles and certain other medical
equipment – Part 2: Lock fittings
ISO 11135-1Sterilization of health-care products - ethylene oxide - Requirements for the development,
validation and routine control of a sterilization process for medical devices
ISO 10993-1Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management
process
ISO 10993-4Biological evaluation of medical devices - Part 4: Selection of tests for interactions with blood
ISO 10993-5Biological evaluation of medical devices - Part 5: Tests for in vitro cytotoxicity
ISO 10993-7Biological evaluation of medical devices – Part 7: Ethylene oxide sterilization residuals
ISO 10993-10Biological evaluation of medical devices - Part 10, Tests for Irritation and Skin Sensitization
ISO 10993-11Biological evaluation of medical devices - Part 11, Tests for systemic toxicity
ANSI/AAMI ST72Bacterial endotoxin - Test methods, routine monitoring and alternatives to batch testing

Conclusions Drawn

Based on the indications for use, technological characteristics, testing performed and principles of operation, the Freedom™ Syringe meets all identified requirements and is considered to be substantially equivalent to the predicate device.