K Number
K170988
Manufacturer
Date Cleared
2017-12-12

(253 days)

Product Code
Regulation Number
880.5570
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The DropSafe Safety Pen Needles are sterile, single-use safety needles intended for use with pen injector devices for the injection of drugs.

Device Description

DropSafe Safety Pen Needles are sterile, single-use safety needles intended for use with pen injector devices for the injection of drugs. DropSafe Safety Pen Needles are OTC devices intended to be used by clinical and non-clinical users. DropSafe Safety Pen Needles are offered in one gage - 31 G and in two lengths: 6mm and 8 mm. DropSafe Safety Pen Needles are gamma sterilized, non-toxic single use devices.

The device is designed to minimize the risk from accidental needle sticks with a used needle by application of a sharps injury prevention feature. Following use, the needle is locked out preventing reuse. The shield also serves to hide the needle before and after injection.

Each DropSafe safety pen needle is individually packaged in a sealed container. The DropSafe safety pen needle is used by removing the seal and attaching it to the pen injector device to administer a drug subcutaneously. While inserting the needle into the skin at a 90° angle, the slides into the shield. While the slider glides into the shield, the safety feature is activated. Following injection, the slider glides back into its initial position, completely covering the needle where it remains locked.

The red safety lock indicator tells the user that the safety lock has been activated. Once the safety pen needle is in the locked mode, it cannot be reused. The safety pen needle is detached from the pen injector device and disposed of into a sharps container.

The pen needle assembly consists of a double-ended cannula that is assembled into an injection molded hub using an adhesive. The hub has internal threads which allows it to be screwed onto the pen injector device. This allows the cartridge end of the needle to penetrate through the rubber septum of the cartridge. The patient-end and the cartridge end of the cannula are lubricated using a silicone-based lubricant for ease of injection and rubber septum penetration. An injection molded inner shield is assembled over the patient end of the cannula to prevent needle point damage and accidental needle-sticks. This needle assembly is inserted into a protective injection molded container and sealed with a peel away medical grade paper tab which provides a sterility barrier and tamper evident seal.

AI/ML Overview

The provided text describes a 510(k) premarket notification for a medical device called "DropSafe Safety Pen Needles." This type of submission focuses on demonstrating substantial equivalence to a legally marketed predicate device, rather than proving novel safety and effectiveness through extensive clinical trials. Therefore, the information provided primarily addresses design verification and validation testing of the device's physical properties and safety features, and not a study proving the device meets high-level acceptance criteria through, for instance, a multi-reader multi-case clinical study or algorithm-only performance.

Based on the provided text, here's a breakdown of the requested information, highlighting what is present and what is not applicable or not detailed for this type of submission:

1. A table of acceptance criteria and the reported device performance:

The document lists "Non-Clinical Performance Data" and "Clinical Performance Data" which serve as acceptance criteria based on established standards and guidance.

Test parameterRequirement – ISO 11608-2:2012 / FDA GuidanceReported Device Performance (Result)
Non-Clinical Performance Data (ISO 11608-2:2012)
MaterialsThe needle shall be made of tubing materials specified in ISO 9626.Meets standard
DimensionsThe needles shall fit the test apparatus specified in clause 7.3 of ISO 11608-2.Meets standard
Determination of flow rate through the needleThe needle was tested in accordance with Annex A to ISO 11608-2 to determine flow rate through the needle.Meets standard
Bond between hub and needle tubeThe union of the hub and needle tube shall not break when tested in accordance with Clause 9 of ISO 11608-2.Meets standard
Freedom from defectsThe needle tube shall fulfill the requirements of ISO 7864, clause 11.3.Meets standard
LubricationThe needle tube should be lubricated at both the patient end and the cartridge end. The lubricant shall not, under normal or corrected-to-normal vision, be visible as droplets of fluid on the outside surface of the needle tube.Meets standard
Dislocation of measuring point at patient endDislocation of the cannula point at the patient end shall be in accordance with Table 2 [not included in excerpt] when tested in accordance with Clause 8 (of ISO 11608-2).Meets standard
Determination of functional compatibility with needle-based injection systemsCompatibility with any NIS shall be claimed only after testing in accordance with Clause 11.Meets standard
Ease of assembly and disassemblyAttachment of the needle shall be possible without removing the needle from its opened unit packaging. Compliance is checked according to the requirements of clause 11.Meets standard
Pre-conditioning of needlesAll requirements of the standard related to preconditioning of needles were met.Meets standard
Clinical Performance Data (FDA GUIDANCE Medical Devices with Sharps Injury Prevention Features, August 9, 2005)
Function of safety feature in simulated clinical environmentEvaluate the function of the safety feature with participation of both clinical and non-clinical users."As evidenced in the study, the use of this device does not affect the injection technique or the functionality of the pen injector and is safe and effective when used as per the Instructions for Use."
Validation of Instructions For Use (IFU)Validate IFU with participation of clinical and non-clinical users."As evidenced in the study, the use of this device does not affect the injection technique or the functionality of the pen injector and is safe and effective when used as per the Instructions for Use."

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

  • Test Set Sample Size: The document does not specify the numerical sample sizes for the non-clinical performance tests (e.g., number of needles tested for flow rate, bond strength, etc.) nor for the "Simulated Use Study" involving clinical and non-clinical users. It merely states that "Testing was performed" and "All testing met the applicable requirements."
  • Data Provenance: The tests are described as being conducted in compliance with ISO standards and FDA guidance. The manufacturer, HTL-Strefa S.A., is located in Poland. The text doesn't explicitly state the location of the testing, but it can be inferred to have been conducted by or for the manufacturer. The studies described are likely prospective tests performed specifically for this 510(k) submission.

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 and not provided. For this type of device (a hypodermic needle), "ground truth" is established through engineering and performance testing against objective standards (ISO 11608-2:2012) and simulated user studies. Expert consensus or ground truth derived from a panel of medical specialists (like radiologists) is not relevant for this device's validation. The "Simulated Use Study" involved "clinical and non-clinical users," but their number or specific qualifications (beyond being "clinical users") are not detailed.

4. Adjudication method (e.g., 2+1, 3+1, none) for the test set:

Not applicable. Adjudication methods are typically used in studies where human readers are interpreting images or data, and their disagreements need to be resolved to establish ground truth. For the physical and functional tests of a pen needle, objective measurements against established standards are the norm, not 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. This device is a mechanical medical device (a safety pen needle), not an AI-powered diagnostic tool. Therefore, an MRMC comparative effectiveness study involving human readers and AI assistance is not relevant or performed for this product.

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. Its performance is inherent to its physical design, manufacturing, and user interaction.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):

The "ground truth" for this device's performance is established by:

  • Compliance with international standards (ISO 11608-2:2012) for physical and functional properties (e.g., materials, dimensions, flow rate, bond strength, lubrication, compatibility).
  • Compliance with FDA guidance for sharps injury prevention features, validated through a "Simulated Use Study" to confirm the safety feature's function and IFU effectiveness with users.
  • The primary ground truth is the ability of the device to meet specified engineering and performance requirements for safe and effective use, rather than a clinical diagnosis.

8. The sample size for the training set:

Not applicable. This is a mechanical device, not an AI model requiring a training set.

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

Not applicable, as there is no training set for a mechanical device.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo in blue. Underneath the FDA logo is the text "ADMINISTRATION".

December 12, 2017

HTL-Strefa S.A. Aleksandra Prazmowska-Wilanowska Ouality Assurance & Regulatory Affairs Director Adamowek 7 Ozorkow. 95-035 POLAND

Re: K170988

Trade/Device Name: DropSafe Safety Pen Needle Regulation Number: 21 CFR 880.5570 Regulation Name: Hypodermic Single Lumen Needle Regulatory Class: Class II Product Code: FMI Dated: November 07, 2017 Received: November 13, 2017

Dear Aleksandra Prazmowska-Wilanowska:

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.

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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 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.

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.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely.

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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510(k) Summary ُ K170988

As required by the Safe Medical Devices Act of 1990 and in accordance with 21 CFR §807.92(a).

[807.92 (a)(1,2)]

Date SummaryPrepared:December 5, 2017
Submitted By:HTL-STREFA S.A.ul. Adamówek 795-035 OzorkówPOLANDPhone: +48 42 270 00 10Fax: +48 42 270 00 20
Primary Contact:Aleksandra Prażmowska-WilanowskaQA/RA Directorola.prazmowska-wilanowska@htl-strefa.pl
Secondary Contact:Izabela BanaśSenior RA Specialistizabela.banas@htl-strefa.pl
Trade Name:DropSafe Safety Pen Needles
Models:31G x 6mm, 31G x 8 mm
Common Name:Insulin Pen Needle
Regulation Number:21 CFR § 880.5570
Product Code:FMI
Device Classification:II
Review Panel:80 General Hospital

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Predicate Device [807.92(a)(3)]

The legally marketed devices to which substantial equivalence is claimed is:

Predicate Device:

ManufacturerTrade Name510(k) Number
Becton Dickson & Co.BD AUTOSHIELDK110703
DUOTM PEN NEEDLE

Secondary Predicate Device

Manufacturer NameTrade Name510(k) Number
HTL-Strefa S.A.Droplet Pen NeedleK143437

The secondary predicate device has been included in this submission to cover the gage and lengths of the New Device - 31G x 6mm and 31G x 8mm. The difference between the New Device and the Secondary Predicate Device is the sharps prevention feature which was added to the New Device. Otherwise, the Secondary Predicate Device and the New Device are identical with regard to raw materials, sterilization method and biocompatibility requirements. The New Device is manufactured in identical production conditions as the secondary predicate device cleared under K143437.

Description of Device: [807.92(a)(4)]

Device description

DropSafe Safety Pen Needles are sterile, single-use safety needles intended for use with pen injector devices for the injection of drugs. DropSafe Safety Pen Needles are OTC devices intended to be used by clinical and non-clinical users. DropSafe Safety Pen Needles are offered in one gage - 31 G and in two lengths: 6mm and 8 mm. DropSafe Safety Pen Needles are gamma sterilized, non-toxic single use devices.

The device is designed to minimize the risk from accidental needle sticks with a used needle by application of a sharps injury prevention feature. Following use, the needle is locked out preventing reuse. The shield also serves to hide the needle before and after injection.

Each DropSafe safety pen needle is individually packaged in a sealed container. The DropSafe safety pen needle is used by removing the seal and attaching it to the pen injector device to administer a drug subcutaneously. While inserting the needle into the skin at a 90° angle, the slides into the shield. While the slider glides into the shield, the safety feature is activated. Following injection, the slider glides back into its initial position, completely covering the needle where it remains locked.

{5}------------------------------------------------

The red safety lock indicator tells the user that the safety lock has been activated. Once the safety pen needle is in the locked mode, it cannot be reused. The safety pen needle is detached from the pen injector device and disposed of into a sharps container.

The pen needle assembly consists of a double-ended cannula that is assembled into an injection molded hub using an adhesive. The hub has internal threads which allows it to be screwed onto the pen injector device. This allows the cartridge end of the needle to penetrate through the rubber septum of the cartridge. The patient-end and the cartridge end of the cannula are lubricated using a silicone-based lubricant for ease of injection and rubber septum penetration. An injection molded inner shield is assembled over the patient end of the cannula to prevent needle point damage and accidental needle-sticks. This needle assembly is inserted into a protective injection molded container and sealed with a peel away medical grade paper tab which provides a sterility barrier and tamper evident seal.

Indications for Use: [807.92(a)(5)]

The DropSafe Safety Pen Needles are sterile, single-use safety needles intended for use with pen injector devices for the injection of drugs.

Technological Characteristics: [807.92(a)(6)]

A comparison of characteristics of DropSafe Safety Pen Needles and the predicate device and the secondary predicate device is shown in the table below:

Device NameNew DevicePredicate DeviceSecondary PredicateDevice
ManufacturerHTL-STREFA S.A.BD AutoShield™ Duo PenNeedleDroplet Pen Needle
510(k) NumberPendingK110703K143437
Intended useIntended for use withpen injector devices forthe injection of drugsIntended for use with peninjector devices for theinjection of drugsIntended for use withpen injector device forthe subcutaneousinjection of insulin
OperationprincipleManualManualManual
DesignNeedle assembly -cannula, hub, primarycontainer,seal, needle shield,slider, spring- operatedNeedle assembly -cannula, hub, primarycontainer,seal, needle shield, slider,spring- operatedNeedle assembly -cannula, hub, primarycontainer, seal, needleshield
Product CodeFMIFMIFMI

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Device NameNew DevicePredicate DeviceSecondary PredicateDevice
Length6mm, 8 mm5mm4mm, 5mm, 6mm,8mm, 10mm, 12mm
Gage31G31G29G, 31G, 32G
BiocompatibilityConforms toISO 10993-1Conforms to ISO10993-1Conforms toISO 10993-1
SterilizationGamma radiationGamma radiationGamma radiation
Needle tubeMedical GradeStainless SteelMedical GradeStainless SteelMedical GradeStainless Steel
Hub, PrimaryContainer andShieldPlastic resinPlastic resinPlastic resin
SpringStainless steel wireStainless steel wiren/a
Sharps PreventionfeatureYesYesn/a

The new device, the predicate device and the secondary predicate device are classified under 21 CFR 880.5570, which states: "A hypodermic single lumen needle is a device intended to inject fluids into, or withdraw fluids from, parts of the body below the surface of the skin." The indications for use of the new device and the predicate and the secondary predicate devices is identical / substantially equivalent (intended for use with pen injector devices for the injection of drugs / insulin, respectively).

The technological and design differences between the new device and the secondary predicate device do not raise any new or different questions of safety or effectiveness.

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Non-Clinical Performance Data:

[(807.92(b)(1)]

Verification/Validation testing was conducted in compliance with the requirements of ISO 11608- 2:2012 as summarized below. All testing met the applicable requirements.

Test parameterRequirement – ISO 11608-2:2012Result
MaterialsThe needle shall be made of tubing materials specified in ISO 9626.Meets standard
DimensionsThe needles shall fit the test apparatus specified in clause 7.3 of ISO 11608-2.Meets standard
Determination of flow rate through the needleThe needle was tested in accordance with Annex A to ISO 11608-2 to determine flow rate through the needle.Meets standard
Bond between hub and needle tubeThe union of the hub and needle tube shall not break when tested in accordance with Clause 9 of ISO 11608-2.Meets standard
Freedom from defectsThe needle tube shall fulfill the requirements of ISO 7864, clause 11.3.Meets standard
LubricationThe needle tube should be lubricated at both the patient end and the cartridge end. The lubricant shall not, under normal or corrected- to-normal vision, be visible as droplets of fluid on the outside surface of the needle tube.Meets standard
Dislocation of measuring point at patient endDislocation of the cannula point at the patient end shall be in accordance with Table 2 below when tested in accordance with Clause 8 (of ISO 11608-2).Meets standard
Determination of functional compatibility with needle-based injection systemsCompatibility with any NIS shall be claimed only after testing in accordance with Clause 11.Meets standard
Ease of assembly and disassemblyAttachment of the needle shall be possible without removing the needle from its opened unit packaging. Compliance is checked according to the requirements of clause 11.Meets standard
Pre-conditioning of needlesAll requirements of the standard related to preconditioning of needles were met.Meets standard

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DropSafe Safety Pen Needle & pen injector compatibility - pen injectors available and cleared in the USA:

Manufactured byBrand:
Eli LillyHumaPen® L U X U R A HD
Eli LillyHumaPen® L U X U R A
Eli LillyHumaPen® savvio
Eli LillyHumaPen® Ergo
Eli LillyHumaPen® Ergo II
Owen MumfordAutopen®
HaselmeierTactiPen®
Novo NordiskNovoPen®

Clinical Performance Data: [(807.92(b)(2)]

FDA GUIDANCE Medical Devices with Sharps Injury Prevention Features (issued on August 9, 2005).

Testing was performed to evaluate the function of the safety feature in a simulated clinical environment with the participation of both clinical and non-clinical users. The Simulated Use Study was performed to validate the Instructions For Use (IFU) with the participation of clinical and non-clinical users. As evidenced in the study, the use of this device does not affect the injection technique or the functionality of the pen injector and is safe and effective when used as per the Instructions for Use.

Conclusion:

[(807.92(b)(3)]

DropSafe Safety Pen Needles are substantially equivalent in the intended use, technology/principle of operation, materials and performance to the predicate device and the secondary predicate and do not raise any new questions of safety and effectiveness.

§ 880.5570 Hypodermic single lumen needle.

(a)
Identification. A hypodermic single lumen needle is a device intended to inject fluids into, or withdraw fluids from, parts of the body below the surface of the skin. The device consists of a metal tube that is sharpened at one end and at the other end joined to a female connector (hub) designed to mate with a male connector (nozzle) of a piston syringe or an intravascular administration set.(b)
Classification. Class II (performance standards).