K Number
K170651
Device Name
Sterile Disposable Syringe with Safety Needle, Sterile Disposable Syringe with Needle, Sterile Disposable Syringe, Sterile Disposable Safety Needle, Sterile Disposable Needle
Date Cleared
2017-08-02

(152 days)

Product Code
Regulation Number
880.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Sterile Disposable Syringe with Safety Needle is intended for use in the aspiration of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks. The Sterile Disposable Syringe with Needle is intended for use in the aspiration of fluids for medical purpose. The Sterile Disposable Syringe is a sterile luer slip syringe which is intended to be used with a hypodermic needle for the aspiration and injection of fluids for medical purpose. The Sterile Disposable Safety Needle is intended to be used with a luer slip or luer lock syringe for aspiration and injection of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needlestick. The Sterile Disposable Needle is intended to be used with a luer lock syringe for aspiration and injection of fluids for medical purpose.
Device Description
The Sterile Disposable Syringe with Safety Needle is intended for manual and single use only, which consists of a hypodermic needle with a safety sheath attached to the needle hub and a luer slip or luer lock syringe. The proposed device is available in a variety combination of syringe volume and needle size. The safety sheath will be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks. The Sterile Disposable Syringe with Needle is intended for manual and single use only, which consists of a hypodermic needle and a luer slip or luer lock syringe. The proposed device is available in a variety combination of syringe volume and needle size. The Sterile Disposable Syringe is intended for manual and single use only, which consists of barrel, plunger and piston. The proposed device is available in a variety syringe volume. The syringe is available in luer slip and luer lock two connector types which are intended to be connected with a hypodermic needle. The Sterile Disposable Safety Needle is intended for manual and single use only, which consists of a hypodermic needle with a safety sheath attached to the connector hub. The proposed device is available in variety combination of needle gauge and needle length. The proposed device is compatible for use with a luer slip or luer lock syringe. The safety sheath will be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks. The Sterile Disposable Needle is intended for manual and single use only, which is compatible for use with a luer slip or luer lock syringe. The proposed device is available in variety combination of needle gauge and needle length.
More Information

Not Found

No
The device description and intended use clearly describe a manual, single-use syringe and needle with a manually activated safety shield. There is no mention of any computational or analytical capabilities that would suggest the use of AI or ML. The performance studies focus on physical and biological properties and a simulated clinical study of the manual safety mechanism.

No.
The device descriptions and intended uses clearly describe the product as a sterile disposable syringe and needle, or components thereof, designed for aspiration and injection of fluids, and minimizing the risk of accidental needle sticks. These are delivery or collection tools, not devices that deliver therapy themselves.

No

The device is a syringe and needle system intended for the aspiration and injection of fluids, and does not perform any diagnostic function.

No

The device description and intended use clearly describe physical medical devices (syringes and needles) with mechanical safety features. There is no mention of software as a component or function of the device.

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

Here's why:

  • Intended Use: The intended use clearly states the devices are for "aspiration of fluids for medical purpose" and "aspiration and injection of fluids for medical purpose." This describes a process of withdrawing or introducing substances into the body, which is a clinical procedure, not an in vitro diagnostic test.
  • Device Description: The descriptions detail the physical components of syringes and needles, which are tools for administering or collecting substances from the body.
  • Lack of IVD Language: There is no mention of analyzing samples outside the body, detecting specific analytes, or providing diagnostic information based on the analysis of biological specimens. IVD devices are designed to perform tests on samples like blood, urine, or tissue to diagnose conditions, monitor treatments, or screen for diseases.
  • Performance Studies: The performance studies focus on the physical and functional aspects of the syringes and needles (e.g., compliance with standards, safety mechanism effectiveness), not on the accuracy or reliability of a diagnostic test.

The devices described are medical devices used for clinical procedures involving the body, not for in vitro diagnostic testing of samples.

N/A

Intended Use / Indications for Use

The Sterile Disposable Syringe with Safety Needle is intended for use in the aspiration of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks.

The Sterile Disposable Syringe with Needle is intended for use in the aspiration of fluids for medical purpose.

The Sterile Disposable Syringe is a sterile luer slip syringe which is intended to be used with a hypodermic needle for the aspiration and injection of fluids for medical purpose.

The Sterile Disposable Safety Needle is intended to be used with a luer slip or luer lock syringe for aspiration and injection of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needlestick.

The Sterile Disposable Needle is intended to be used with a luer lock syringe for aspiration and injection of fluids for medical purpose.

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

MEG, FMF, FMI

Device Description

The Sterile Disposable Syringe with Safety Needle is intended for manual and single use only, which consists of a hypodermic needle with a safety sheath attached to the needle hub and a luer slip or luer lock syringe. The proposed device is available in a variety combination of syringe volume and needle size. The safety sheath will be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks.

The Sterile Disposable Syringe with Needle is intended for manual and single use only, which consists of a hypodermic needle and a luer slip or luer lock syringe. The proposed device is available in a variety combination of syringe volume and needle size.

The Sterile Disposable Syringe is intended for manual and single use only, which consists of barrel, plunger and piston. The proposed device is available in a variety syringe volume. The syringe is available in luer slip and luer lock two connector types which are intended to be connected with a hypodermic needle.

The Sterile Disposable Safety Needle is intended for manual and single use only, which consists of a hypodermic needle with a safety sheath attached to the connector hub. The proposed device is available in variety combination of needle gauge and needle length. The proposed device is compatible for use with a luer slip or luer lock syringe. The safety sheath will be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks.

The Sterile Disposable Needle is intended for manual and single use only, which is compatible for use with a luer slip or luer lock syringe. The proposed device is available in variety combination of needle gauge and needle length.

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)

Non clinical tests were conducted to verify that the proposed device met all design specifications as was Substantially Equivalent (SE) to the predicate device. The test results demonstrated that the proposed device complies with the following standards:

Cleanliness (Clause 5 of ISO 7886-1:1993, Clause 4 of ISO 7864:1993)
Limits for acidity or alkalinity (Clause 6 of ISO 7886-1:1993, Clause 5 of ISO 7864:1993)
Limits for extractable metals (Clause 7 of ISO 7886-1:1993, Clause 6 of ISO 7864:1993)
Lubricant (Clause 8 of ISO 7886-1:1993)
Tolerance on graduated capacity (Clause 9 of ISO 7886-1:1993)
Graduated scale (Clause 10 of ISO 7886-1:1993)
Barrel (Clause 11 of ISO 7886-1:1993)
Piston/ plunger assembly (Clause 12 of ISO 7886-1:1993)
Nozzle (Clause 13 of ISO 7886-1:1993)
Performance (Clause 14 of ISO 7886-1:1993, Clause 13 of ISO 7864:1993)

Size designation (Clause 7 of ISO 7864:1993)
Colour coding (Clause 8 of ISO 7864:1993)
Needle hub (Clause 9 of ISO 7864:1993)
Sheath (Clause 10 of ISO 7864:1993)
Needle tube (Clause 11 of ISO 7864:1993)
Needle point (Clause 12 of ISO 7864:1993)

Gauging (Clause 4.1 of ISO 594-1:1986, Clause 4.1 of ISO 594-2:1998)
Liquid leakage (Clause 4.2 of ISO 594-1:1986)
Air leakage (Clause 4.3 of ISO 594-1:1986)
Separation force (Clause 4.4 of ISO 594-1:1986, Clause 4.3 of ISO 594-2:1998)
Stress cracking (Clause 4.5 of ISO 594-1:1986, Clause 4.7 of ISO 594-2:1998)
Leakage (Clause 4.2 of ISO 594-2:1998)
Unscrewing torque (Clause 4.4 of ISO 594-2:1998)
Ease of assembly (Clause 4.5 of ISO 594-2:1998)
Resistance to overriding (Clause 4.6 of ISO 594-2:1998)

Materials (Clause 3 of ISO 9626:1991/AMD-1:2001)
Surface finish (Clause 4 of ISO 9626:1991/AMD-1:2001)
Size designation (Clause 5 of ISO 9626:1991/AMD-1:2001)
Resistance to breakage (Clause 6 of ISO 9626:1991/AMD-1:2001)
Resistance to corrosion (Clause 7 of ISO 9626:1991/AMD-1:2001)
Limits for acidity and alkalinity (Clause 8 of ISO 9626:1991/AMD-1:2001)
Cleanliness (Clause 9 of ISO 9626:1991/AMD-1:2001)
Dimensions (Clause 10 of ISO 9626:1991/AMD-1:2001)
Stiffness (Clause 11 of ISO 9626:1991/AMD-1:2001)

Sterile Barrier Packaging Testing:
Seal strength (ASTM F88/F88-09)
Internal pressure (ASTM F1140/F1140M-13)
Dye penetration (ASTM F1929-12)

Sterilization and Shelf Life Testing:
EO residue (ISO 10993-7:2008)
ECH residue (ISO 10993-7:2008)
Bacteria Endotoxin Limit (USP 38-NF 33 )
Shelf Life Evaluation (Physical, Mechanical, Chemical, Package Tests were performed on aging samples to verify the claimed shelf life of the device)

Biocompatibility Testing:
In Vitro Cytotoxicity (ISO 10993-5:2009)
Intracutaneous Reactivity (ISO 10993-10:2010)
Skin Sensitization (ISO 10993-10:2010)
Acute Systemic Toxicity (ISO 10993-11:2006)
Hemolysis (ASTM F756-13)
Pyrogen (USP)
Complement Activation (ISO 10993-4:2002/A12006)
In Vivo Thrombogenicity (ISO 10993-4:2002/A12006)

Simulated Clinical Study:
A simulated clinical study was performed on proposed device according to FDA Guidance, Guidance for Industry and FDA Staff: Medical Device with Sharps Injury Prevention Feature, issued on August 9, 2005 to evaluate the safety mechanism of the proposed device. The results demonstrated that the proposed device met the pre-established criteria.

Safety Feature Test:
The safety feature test was performed on both proposed device and predicate device to determine its safety feature. The results demonstrated that the proposed device did not show a significant difference from predicate device.

No clinical study is included in this submission.
Based on the bench performance testing, comparison and analysis above, the proposed devices are determined to be Substantially Equivalent (SE) to the predicate devices.

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.

K113422, K083514

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

§ 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).

0

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 entwined around it. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the symbol.

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

August 2, 2017

Yangzhou Medline Industry Co., Ltd. c/o Ms. Diana Hong Mid-Link Consulting Co., Ltd. P.O. Box 120-119 Shanghai 200120 CHINA

Re: K170651

Trade/Device Name: Sterile Disposable Syringe With Safety Needle, Sterile Disposable Syringe With Needle, Sterile Disposable Syringe, Sterile Disposable Safety Needle, Sterile Disposable Needle Regulation Number: 21 CFR 880.5860 Regulation Name: Piston Syringe Regulatory Class: Class II Product Code: MEG, FMF, FMF, FMI Dated: July 3, 2017 Received: July 5, 2017

Dear Ms. Diana Hong:

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 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,

Tara A. Ryan -S

for Michael Ryan 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.

3

Indications for Use

510(k) Number (if known)

K170651

Device Name

Sterile Disposable Syringe with Safety Disposable Syringe with Needle, Sterile Disposable Syringe, Sterile Disposable Safety Needle, Sterile Disposable Needle

Indications for Use (Describe)

The Sterile Disposable Syringe with Safety Needle is intended for use in the aspiration of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks.

The Sterile Disposable Syringe with Needle is intended for use in the aspiration of fluids for medical purpose.

The Sterile Disposable Syringe is a sterile luer slip syringe which is intended to be used with a hypodermic needle for the aspiration and injection of fluids for medical purpose.

The Sterile Disposable Safety Needle is intended to be used with a luer slip or luer lock syringe for aspiration and injection of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needlestick.

The Sterile Disposable Needle is intended to be used with a luer lock syringe for aspiration and injection of fluids for medical purpose.

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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4

510(k) Summary

This 510(k) Summary is being submitted in accordance with requirements of Title 21, CFR Section 807.92.

The assigned 510(k) Number: K170651

    1. Date of Preparation: 8/2/2017
  • Sponsor Identification 2.

Yangzhou Medline Industry Co., Ltd.

No. 108, Jinshan Road, Economic Development Zone Yangzhou, China 225000

Establishment Registration Number: Not yet registered

Contact Person: Jianzhong Qi Position: General Manager Tel: +86-514-87525631 Fax: +86-514-87525631 Email: President@cnmedical.net

    1. Designated Submission Correspondent
      Ms. Diana Hong (Primary Contact Person) Ms. Ying Xu (Alternative Contact Person)

Mid-Link Consulting Co., Ltd

P.O. Box 120-119, Shanghai, 200120, China

Tel: +86-21-22815850, Fax: 240-238-7587 Email: info@mid-link.net

5

  1. Identification of Proposed Device

Trade Name: Sterile Disposable Syringe with Safety Needle

Sterile Disposable Syringe with Needle Sterile Disposable Syringe Sterile Disposable Safety Needle Sterile Disposable Needle

Regulatory Information Classification Name: Syringe Antistick Classification: II Product Code: MEG Regulation Number: 21 CFR 880.5860 Review Panel: General Hospital

Classification Name: Piston Syringe Classification: II Product Code: FMF Regulation Number: 21 CFR 880.5860 Review Panel: General Hospital

Additional Product Code: FMI, Hypodermic single lumen needle

Indications for Use Statement:

The Sterile Disposable Syringe with Safety Needle is intended for use in the aspiration and injection of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needlesticks.

The Sterile Disposable Syringe with Needle is intended for use in the aspiration and injection of fluids for medical purpose.

The Sterile Disposable Syringe is a sterile luer lock or luer slip syringe which is intended to be used with a hypodermic needle for the aspiration and injection of fluids for medical purpose.

The Sterile Disposable Safety Needle is intended to be used with a luer slip or luer lock syringe for aspiration and injection of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needlesticks.

6

The Sterile Disposable Needle is intended to be used with a luer slip or luer lock syringe for aspiration and injection of fluids for medical purpose.

Device Description

The Sterile Disposable Syringe with Safety Needle is intended for manual and single use only, which consists of a hypodermic needle with a safety sheath attached to the needle hub and a luer slip or luer lock syringe. The proposed device is available in a variety combination of syringe volume and needle size. The safety sheath will be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks.

The Sterile Disposable Syringe with Needle is intended for manual and single use only, which consists of a hypodermic needle and a luer slip or luer lock syringe. The proposed device is available in a variety combination of syringe volume and needle size.

The Sterile Disposable Syringe is intended for manual and single use only, which consists of barrel, plunger and piston. The proposed device is available in a variety syringe volume. The syringe is available in luer slip and luer lock two connector types which are intended to be connected with a hypodermic needle.

The Sterile Disposable Safety Needle is intended for manual and single use only, which consists of a hypodermic needle with a safety sheath attached to the connector hub. The proposed device is available in variety combination of needle gauge and needle length. The proposed device is compatible for use with a luer slip or luer lock syringe. The safety sheath will be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks.

The Sterile Disposable Needle is intended for manual and single use only, which is compatible for use with a luer slip or luer lock syringe. The proposed device is available in variety combination of needle gauge and needle length.

The syringe barrel sizes and needle gauges/ lengths of the subject device are provided in following table. Table 1 Syringe barrel sizes and needle gauges/ lengths

Syringe volumeNeedle GaugeNeedle Length
Sterile Disposable Syringe with Safety Needle1ml, 2ml, 3ml, 5ml, 10ml, 20ml, 30ml, 50ml, 60ml16G,18G, 19G, 20G, 21G, 22G, 23G, 24G, 25G, 26G, 27G, 28G, 29G, 30G5/16", 1/2", 5/8", 3/4", 1", 1-1/4", 1-1/2"
Sterile Disposable Syringe with Needle1ml, 2ml, 3ml, 5ml, 10ml, 20ml, 30ml16G,18G, 19G, 20G, 21G, 22G, 23G, 24G5/16", 1/2", 5/8", 3/4", 1", 1-1/4", 1-1/2"

7

| | | 50ml, 60ml | 25G, 26G, 27G, 28G,
29G, 30G | |
|---------|-----------------------------|--------------------------------------------------------|------------------------------------------------------------------------------|------------------------------------------------|
| Sterile | Disposable
Syringe | 1ml, 2ml, 3ml, 5ml,
10ml, 20ml, 30ml,
50ml, 60ml | N.A. | N.A. |
| Sterile | Disposable
Safety Needle | N.A. | 16G,18G, 19G, 20G,
21G, 22G, 23G, 24G,
25G, 26G, 27G, 28G,
29G, 30G | 5/16", 1/2", 5/8", 3/4",
1", 1-1/4", 1-1/2" |
| Sterile | Disposable
Needle | N.A. | 16G,18G, 19G, 20G,
21G, 22G, 23G, 24G,
25G, 26G, 27G, 28G,
29G, 30G | 5/16", 1/2", 5/8", 3/4",
1", 1-1/4", 1-1/2" |

5. Identification of Predicate Device

Predicate Device 1 510(k) Number: K113422 Product Name: TERUMO® SurGuard® 3 Safety Needle TERUMO® SurGuard® 3 Hypodermic Syringe with Safety Needle

Predicate Device 2 510(k) Number: K083514 Product Name: TERUMO® Syringe with/without Needle

б. Non-Clinical Test Conclusion

Non clinical tests were conducted to verify that the proposed device met all design specifications as was Substantially Equivalent (SE) to the predicate device. The test results demonstrated that the proposed device complies with the following standards:

CleanlinessClause 5 of ISO 7886-1:1993
Limits for acidity or alkalinityClause 6 of ISO 7886-1:1993
Limits for extractable metalsClause 7 of ISO 7886-1:1993
LubricantClause 8 of ISO 7886-1:1993
Tolerance on graduated capacityClause 9 of ISO 7886-1:1993
Graduated scaleClause 10 of ISO 7886-1:1993
BarrelClause 11 of ISO 7886-1:1993
Piston/ plunger assemblyClause 12 of ISO 7886-1:1993
NozzleClause 13 of ISO 7886-1:1993
PerformanceClause 14 of ISO 7886-1:1993

8

Cleanliness Clause 4 of ISO 7864:1993 Limits for acidity or alkalinity Clause 5 of ISO 7864:1993 Limits for extractable metals Clause 6 of ISO 7864:1993 Size designation Clause 7 of ISO 7864:1993 Colour coding Clause 8 of ISO 7864:1993 Needle hub Clause 9 of ISO 7864:1993 Sheath Clause 10 of ISO 7864:1993 Needle tube Clause 11 of ISO 7864:1993 Needle point Clause 12 of ISO 7864:1993 Performance Clause 13 of ISO 7864:1993

Clause 3 of ISO 9626:1991/AMD-1:2001 Clause 4 of ISO 9626:1991/AMD-1:2001 Clause 5 of ISO 9626:1991/AMD-1:2001 Clause 6 of ISO 9626:1991/AMD-1:2001 Clause 7 of ISO 9626:1991/AMD-1:2001 Clause 8 of ISO 9626:1991/AMD-1:2001 Clause 9 of ISO 9626:1991/AMD-1:2001 Clause 10 of ISO 9626:1991/AMD-1:2001 Clause 11 of ISO 9626:1991/AMD-1:2001

Gauging Liquid leakage Air leakage Separation force Stress cracking

Gauging Leakage Separation force Unscrewing torque Ease of assembly Resistance to overriding Stress cracking

Materials

Surface finish

Size designation

Resistance to breakage

Resistance to corrosion

Limits for acidity and alkalinity

Cleanliness

Dimensions

Stiffness

Clause 4.1 of ISO 594-1:1986 Clause 4.2 of ISO 594-1:1986 Clause 4.3 of ISO 594-1:1986 Clause 4.4 of ISO 594-1:1986 Clause 4.5 of ISO 594-1:1986

Clause 4.1 of ISO 594-2:1998 Clause 4.2 of ISO 594-2:1998 Clause 4.3 of ISO 594-2:1998 Clause 4.4 of ISO 594-2:1998 Clause 4.5 of ISO 594-2:1998 Clause 4.6 of ISO 594-2:1998 Clause 4.7 of ISO 594-2:1998

Sterile Barrier Packaging Testing performed on the proposed device:

Seal strengthASTM F88/F88-09
Internal pressureASTM F1140/F1140M-13
Dye penetrationASTM F1929-12

9

Sterilization and Shelf Life Testing performed on the proposed device:
EO residueISO 10993-7:2008
ECH residueISO 10993-7:2008
Bacteria Endotoxin LimitUSP 38-NF 33
Shelf Life EvaluationPhysical, Mechanical, Chemical, Package Tests
were performed on aging samples to verify the
claimed shelf life of the device
Biocompatibility Testing:
In Vitro CytotoxicityISO 10993-5:2009
Intracutaneous ReactivityISO 10993-10:2010
Skin SensitizationISO 10993-10:2010
Acute Systemic ToxicityISO 10993-11:2006
HemolysisASTM F756-13
PyrogenUSP
Complement ActivationISO 10993-4:2002/A12006

Sterilization and Shelf Life Testing performed on the proposed device:

Simulated Clinical Study

In Vivo Thrombogenicity

A simulated clinical study was performed on proposed device according to FDA Guidance, Guidance for Industry and FDA Staff: Medical Device with Sharps Injury Prevention Feature, issued on August 9, 2005 to evaluate the safety mechanism of the proposed device. The results demonstrated that the proposed device met the pre-established criteria.

ISO 10993-4:2002/A12006

Safety Feature Test

The safety feature test was performed on both proposed device and predicate device to determine its safety feature. The results demonstrated that the proposed device did not show a significant difference from predicate device.

    1. Clinical Test Conclusion
      No clinical study is included in this submission.

10

Substantially Equivalent (SE) Comparison 8.

Table 2 Comparison of Technology Characteristics of Proposed device & Predicate Devices
ITEMProposed DevicePredicate Device 1Predicate Device 2
K170651K113422K083514
Product CodeMEG, FMF, FMIMEG, FMFFMF, FMI
Regulation No.21 CFR 880.5860, 21 CFR880.557021 CFR 880.5860, 21 CFR 880.557021 CFR 880.5860
ClassCLASS IICLASS IICLASS II
Intended UseThe Sterile Disposable Syringe with Safety Needle is intended
for use in the aspiration and injection of fluids for medical
purpose. After withdrawal of the needle from the body, the
attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks.
The Sterile Disposable Syringe with Needle is intended for use in the aspiration and injection of fluids for medical purpose.
The Sterile Disposable Syringe is a sterile luer lock or luer slip syringe which is intended to be used with a hypodermic needle for the aspiration and injection of fluids for medical purpose.
The Sterile Disposable Safety Needle is intended to be used with a luer slip or luer lock syringe for aspiration and injection of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needlestick.
The Sterile Disposable Needle is intended to be used with a luerThe TERUMO® SurGuard® 3
Hypodermic Syringe with Safety Needle is intended for use in the aspiration and injection of fluids for medical purposes. The TERUMO® SurGuard® 3 Hypodermic Syringe with Safety Needle is compatible for use with standard luer slip and luer lock syringes. Additionally, after withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needlestick.The Terumo Syringe with
without needle is a sterile hypodermic syringe for single use, intended for the aspiration of fluids and blood, or for the injection of fluids immediately after filling.

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slip or luer lock syringe for aspiration and injection of fluids for medical purpose.
Configuration and materialBarrelPolypropylene (PP)BarrelBarrel
PlungerPolypropylene (PP)PlungerPlunger
PistonPolyisoprenePistonPiston
Needle hubPolypropylene (PP)Needle hubUnknownNeedle hubUnknown
Protective capPolypropylene (PP)Protective capProtective cap
Needle tubeStainless Steel (SUS304)Needle tubeNeedle tube
Safety sheathPolypropylene (PP)Safety sheath
Operation ModeFor manual use onlySameSame
Label/LabelingComplied with 21 CFR part 801Complied with 21 CFR part 801Complied with 21 CFR part 801
Syringe Volume1ml, 2ml, 3ml, 5ml, 10ml, 20ml, 30ml, 50ml, 60ml3ml, 5ml, 10ml1ml, 2ml, 5ml, 10ml, 50ml
Connector TypeLuer Lock/ Luer slipLuer Lock/ Luer slipLuer Lock/ Luer slip
Syringe performanceComplied with ISO 7886-1: 1993Complied with ISO 7886-1: 1993Complied with ISO 7886-1: 1993
Needle Gauge and length16G,18G, 19G, 20G, 21G, 22G, 23G, 24G, 25G, 26G, 27G, 28G, 29G, 30G
Available in 5/16", 1/2", 5/8", 3/4", 1", 1-1/4", 1-1/2"18G~25G
Available in 1" to 2"20G~26G
BiocompatibilityIn Vitro CytotoxicityNo cytotoxicitySameSame
Intracutaneous ReactivityNo intracutaneous reactivity
Skin SensitizationNo skin sensitization
Acute Systemic ToxicityNo systemic toxicity
HemolysisNo Hemolysis

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PyrogenNo Pyrogen
Complement AcitivationNot show potentials to activate
complete system
In Vivo ThrombogenicityNo thrombogenicity
SterilizationEO SterilizationSameSame
SAL$10^{-6}$SameSame
Single UseYesSameSame
Label/LabelingComplied with 21 CFR part 801SameSame

The Sterile Disposable Syringe with Safety Needle, Sterile Disposable Needle are similar to the predicate device K113422 in device design, Indications for use, materials, sterlization, method of operation and technological characteristics. The proposed device Sterile Disposable Syringe with Needle, Syringe are similar to the predicate device K083514 in device design, Indications for use, materials, sterilization, method of operation and technological characteristics. The differences and barrel sizes. Through performance testing comparison the subject device and predicate device have demonstrated substantial equivalence.

Substantially Equivalent (SE) Conclusion 9.

Based on the Based on the bench performance testing, comparison and analysis above, the proposed devices are determined to be Substantially Equivalent (SE) to the predicate devices.