K Number
K171805
Device Name
Luer-Jack Slip 3 ml, Luer-Jack Slip 5 ml, Luer-Jack Slip 20 ml, Luer-Jack Lock 10 ml
Manufacturer
Date Cleared
2017-09-08

(81 days)

Product Code
Regulation Number
880.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The ConceptoMed Luer-Jack device is a sterile syringe without needle intended for single use by health care professionals for general purpose aspiration of fluids immediately after filling. The device is intended to be used only in combination with female 6% Luer connectors.
Device Description
The LuerJack is a five-piece, single use syringe without needle, with a male 6% (Luer) connector in 3 ml, 5 ml, 10ml, 20 ml Luer Slip and 10 ml Luer Lock syringe sizes. The device includes a three-piece slip syringe (the Reference Device) with a barrel with graduated volume scale, a stopper and a plunger rod. Onto the barrel is a single-handed hub release system in two pieces monunted. The hub release system provides a single-handed connector release system for all Subject Devices and the additional locking function for the LuerJack Lock syringe. The LuerJack is used as a general syringe except when disconnecting from a compatible female 6% (Luer) connector. The LuerJack is delivered sterilized by irradiation) in a syringe only configuration. The LuerJack is used as a general syringe except when disconnecting from a compatible female 6% (Luer) connector. For disconnection of an attached connector, the hub release system mounted onto the barrel is used.
More Information

No
The device description and intended use are purely mechanical, focusing on a syringe with a specific connector release system. There is no mention of any computational or data-driven components.

No
The device is described as a "sterile syringe without needle intended for single use by health care professionals for general purpose aspiration of fluids immediately after filling." It functions as a fluid transfer device and does not inherently treat or diagnose any medical condition.

No

Explanation: The device is described as a "sterile syringe without needle intended for single use by health care professionals for general purpose aspiration of fluids immediately after filling." There is no mention of it being used to analyze or interpret medical data for diagnostic purposes.

No

The device description clearly outlines a physical, five-piece syringe with a barrel, stopper, plunger rod, and a hub release system. It is a hardware device.

Based on the provided information, the ConceptoMed Luer-Jack device is not an In Vitro Diagnostic (IVD).

Here's why:

  • Intended Use: The intended use is for "general purpose aspiration of fluids immediately after filling" and for use with "female 6% Luer connectors." This describes a device used for manipulating fluids within the body or for delivering/removing substances from the body, not for testing samples in vitro (outside the body).
  • Device Description: The description details a syringe, which is a tool for fluid handling in a clinical setting. It does not describe a device designed to analyze biological samples.
  • Lack of IVD Characteristics: The description does not mention any components or functions related to:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances within samples
    • Providing diagnostic information based on sample analysis

In summary, the ConceptoMed Luer-Jack is a medical device used for fluid management in a clinical setting, not for performing diagnostic tests on samples outside the body.

N/A

Intended Use / Indications for Use

Indications and Intended Use:

The ConceptoMed Luer-Jack device is a sterile syringe without needle intended for single use by health care professionals for general purpose aspiration of fluids immediately after filling. The device is intended to be used only in combination with female 6% Luer connectors.

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

FMF

Device Description

The LuerJack is a five-piece, single use syringe without needle, with a male 6% (Luer) connector in 3 ml, 5 ml, 10ml, 20 ml Luer Slip and 10 ml Luer Lock syringe sizes. The device includes a three-piece slip syringe (the Reference Device) with a barrel with graduated volume scale, a stopper and a plunger rod. Onto the barrel is a single-handed hub release system in two pieces monunted. The hub release system provides a single-handed connector release system for all Subject Devices and the additional locking function for the LuerJack Lock syringe.

The LuerJack is used as a general syringe except when disconnecting from a compatible female 6% (Luer) connector. The LuerJack is delivered sterilized by irradiation) in a syringe only configuration. The LuerJack is used as a general syringe except when disconnecting from a compatible female 6% (Luer) connector. For disconnection of an attached connector, the hub release system mounted onto the barrel is used.

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

healthcare professionals

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)

Design Verification tests were performed based on the risk analysis. The results of these tests demonstrate that the Subject Device performed in an equivalent manner to the Predicate Devices and is safe and effective when used as intended.

Design Verification testing included the following performance testing with "PASS" on all criteria:

  • System use: Valid sterilization documentation, Manufacturing and assembly in cleanroom (Cleanroom for ISO-class 8)
  • Safety functions: Functional catch mechanism, Designed to fit female 6% Luer connectors
  • Functional testing: Sustaining Force (ISO 7886-1:1997 - Annex G) (Per ISO 7886-1:1997), Break-Out Force (ISO 7886-1:1997 - Annex G) (Per ISO 7886-1:1997), Pump Sticktion/ Force (ISO 7886-2:1996 - Annex C) (Per ISO 7886-2:1997), Stopper Seal (ISO 7886-1:1997 - Annex D) (Per ISO 7886-1:1997), Autoclavability (ISO 7886-1:1997 - Annex D) (Per ISO 7886-1:1997)
  • Chemical testing (Extractables): Zinc (Per ISO 7886-1:1997), Lead, Tin, Iron (Per ISO 7886-1:1997), Cadmium (Per ISO 7886-1:1997), pH shift (Per ISO 7886-1:1997)
  • Biocompatibility: Cytotoxicity (Conformance to EN ISO 10993-5:2009), Sensitization (Conformance to EN ISO 10993-10:2010), Irritation or Intra cutaneous reactivity (Conformance to EN ISO 10993-10:2010), Acute Systemic Toxicity (Conformance to EN ISO 10993-11:2009), Material-Mediated Pyrogenicity (Conformance to EN ISO 10993-11:2009)
  • Packaging safe for sterilization: 1) Existence of Packaging and labelling specification. Compliance with Packforsk Std- 40-101 2001 Transport tests (including air transportation), 2) Packaging material intended for irradiation sterilization
  • Lifetime and reliability: Shelf life (Valid shelf life on blister and device)
  • Mechanical requirements: Drop test (No damage of the packages and full functionality of device), Mechanical strength (a) Full function of the Lever after 15 full cycles, b) A mechanical report shall conclude sufficient mechanical strength), Initial force level before Lever press down (Initial force of 2N needed before click and release activation), Complete functional performance requirements from ISO 80369-7 (Leakage, separation force, unscrewing and overriding torque)

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.

K162057

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.

K110771

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 seal of the U.S. Department of Health and Human Services. The seal features the department's name in a circular arrangement around a stylized caduceus symbol. The caduceus is depicted with three intertwined figures, representing health, services, and humanity. The text reads "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA".

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

September 8, 2017

ConceptoMed AS Marit Martinsen Director QA & Regulatory Hattvikveien 2 Ballstad N-8373 NORWAY

Re: K171805

Trade/Device Name: Luer-Jack Slip 3 ml, Luer-Jack Slip 5 ml, Luer-Jack Slip 20 ml, Luer-Jack Lock 10 ml Regulation Number: 21 CFR 880.5860 Regulation Name: Piston syringe Regulatory Class: Class II Product Code: FMF Dated: August 3, 2017 Received: August 10, 2017

Dear Marit Martinsen:

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.

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/Resourcesfor You/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 Lori A. Wiggins, MPT, CLT 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

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known)

K171805

Device Name LuerJack Slip 3 ml. 5 ml. 20 ml LuerJack Lock 10 ml

Indications for Use (Describe)

Indications and Intended Use:

The ConceptoMed Luer-Jack device is a sterile syringe without needle intended for single use by health care professionals for general purpose aspiration of fluids immediately after filling. The device is intended to be used only in combination with female 6% Luer connectors.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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"DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW."

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"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement below.

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510(K) Summary K171805

SUBMITTER'S NAME:ConceptoMed AS
ADDRESS:Hattvikveien 2
8373 Ballstad
Norway
CONTACT PERSON:Marit Martinsen, Director QA & Regulatory,
ConceptoMed AS
TELEPHONE NUMBER:+47 905 14 690
E-MAIL
DATE OF SUBMISSION:marit.martinsen@conceptomed.no
July 31, 2017
1. Subject DeviceTrade Name:
Common Name:
Regulation Number:
Regulation Name:
Regulatory Class:
Product Code:
Classification Panel:Subject Device 1 – LuerJack Slip 3 ml
Subject Device 2 – LuerJack Slip 5 ml
Subject Device 3 – LuerJack Slip 20 ml
Subject Device 4 – LuerJack Lock 10 ml
LuerJack Slip/ LuerJack Lock
21 CFR §880.5860
Piston syringe
II
FMF
General Hospital
2. Predicate
DevicesPredicate Device:
Trade Name:
510(k) Reference:
Common Name:
Regulation Number:
Regulation Name:
Regulatory Class:
Product Code:
Classification Panel:ConceptoMed Luer-Jack Slip 10 ml
K162057
Luer-Jack Slip 10 ml
21 CFR §880.5860
Piston syringe
II
FMF
General Hospital

5

Reference Device
Trade Name:BD Single use, Hypodermic Syringe
510(k) Reference:K110771
Common Name:BD Single use, Hypodermic Syringe
Regulation Number:21 CFR §880.5860
Regulation Name:Piston syringe
Regulatory Class:II
Product Code:FMF
Classification Panel:General Hospital

Description of the Device 3.

The LuerJack is a five-piece, single use syringe without needle, with a male 6% (Luer) connector in 3 ml, 5 ml, 10ml, 20 ml Luer Slip and 10 ml Luer Lock syringe sizes. The device includes a three-piece slip syringe (the Reference Device) with a barrel with graduated volume scale, a stopper and a plunger rod. Onto the barrel is a single-handed hub release system in two pieces monunted. The hub release system provides a single-handed connector release system for all Subject Devices and the additional locking function for the LuerJack Lock syringe.

The LuerJack is used as a general syringe except when disconnecting from a compatible female 6% (Luer) connector. The LuerJack is delivered sterilized by irradiation) in a syringe only configuration. The LuerJack is used as a general syringe except when disconnecting from a compatible female 6% (Luer) connector. For disconnection of an attached connector, the hub release system mounted onto the barrel is used.

4. Indications for use

The LuerJack device is a sterile syringe without needle intended for single use by healthcare professionals for general purpose aspiration or injection of fluids immediately after filling. The device is intended to be used only in combination with female 6% Luer connectors.

5. Technological characteristics; comparison to predicate device

The Subject Devices are equivalent to the Predicate Device (K162057) in intended use and performance characteristics.

The Subject Devices are assembled and sterilized under the same conditions as the Predicate Device.

Disconnection of attached devices is identical for both the Subject Devices and the Predicate Device.

Subject Device 1. 2 and 3 are equivalent to the Predicate Device in materials and design.

Subject Device 4 (LuerJack Lock 10 ml) is different from the Predicate in terms of materials. The difference is the added Petrolatum between the collar and lever.

Subject Device 4 (LuerJack Lock 10 ml) is different from the Predicate in terms of design. The difference in design is the added 205° protrusion with an integrated

6

locking mechanism.

| Element of
Comparison | Subject Device | Primary Predicate Device
(PD1) | |
|--------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------|
| Indications for
Use/ Intended Use | The LuerJack is a sterile
syringe without needle
intended for single use by
healthcare professionals for
general purpose aspiration or
injection of fluids immediately
after filling. The device is
intended to be used only in
combination with female 6%
Luer connectors. | The LuerJack is a sterile
syringe without needle
intended for single use by
healthcare professionals for
general purpose aspiration or
injection of fluids immediately
after filling. The device is
intended to be used only in
combination with female 6%
Luer slip connectors. | |
| Barrel size | 3 ml, 5 ml, 20 ml slip –
identical to reference device
K110771
10 ml – identical to predicate
device K162057 | 10 ml slip – identical to subject
device | |
| Syringe materials | Barrel | Polypropylene | Polypropylene |
| | Barrel
Lubricant | Silicone | Silicone |
| | Plunger Rod | Polypropylene | Polypropylene |
| | Stopper | Rubber | Rubber |
| | Stopper
Lubricant | Silicone | Silicone |
| | Only Subject
Device 4 –
Outside
Barrel
Lubricant | Petrolatum (Vaseline) | N/A |
| | Sterilization Method | E-Beam | E-Beam |
| SAL | 10-6 | 10-6 | |

Reference device K110771 used for comparison to the different syringe barrel sizes 3 ml, 5 ml, 20 ml slip - which are identical to the additional sizes of the subject device.

6. Summary of performance testing.

Design Verification tests were performed based on the risk analysis. The results of these tests demonstrate that the Subject Device performed in an equivalent manner to the Predicate Devices and is safe and effective when used as intended.

7

Design Verification testing included the following performance testing with "PASS" on all criteria:

Performance CharacteristicAcceptance Criteria
System use
SterilizationValid sterilization documentation
Manufacturing and assembly in cleanroomCleanroom for ISO-class 8
Safety functions
Catch mechanismFunctional catch mechanism
Connector compatibilityDesigned to fit female 6% Luer connectors
Functional testing
Sustaining Force (ISO 7886-1:1997 - Annex G)Per ISO 7886-1:1997
Break-Out Force (ISO 7886-1:1997 - Annex G)Per ISO 7886-1:1997
Pump Sticktion/ Force (ISO 7886-2:1996 - Annex C)Per ISO 7886-2:1997
Stopper Seal (ISO 7886-1:1997 - Annex D)Per ISO 7886-1:1997
Autoclavability (ISO 7886-1:1997 - Annex D)Per ISO 7886-1:1997
Chemical testing (Extractables)
ZincPer ISO 7886-1:1997
Lead, Tin, IronPer ISO 7886-1:1997
CadmiumPer ISO 7886-1:1997
pH shiftPer ISO 7886-1:1997
Biocompatibility
CytotoxicityConformance to EN ISO 10993-5:2009
SensitizationConformance to EN ISO 10993-10:2010
Irritation or Intra cutaneous reactivityConformance to EN ISO 10993-10:2010
Acute Systemic ToxicityConformance to EN ISO 10993-11:2009
Material-Mediated PyrogenicityConformance to EN ISO 10993-11:2009
Packaging safe for sterilization1) Existence of Packaging and labelling specification. Compliance with Packforsk Std-
40-101 2001 Transport tests (including air
transportation)
  1. Packaging material intended for irradiation sterilization |
    | Lifetime and reliability | |
    | Shelf life | Valid shelf life on blister and device |
    | Mechanical requirements | |
    | Drop test | No damage of the packages and full |

8

functionality of device
Mechanical strengtha) Full function of the Lever after 15 full cycles
b) A mechanical report shall conclude sufficient
mechanical strength
Initial force level beforeInitial force of 2N needed before click and
Lever press downrelease activation
Complete functional
performance requirements
from ISO 80369-7Leakage, separation force, unscrewing and
overriding torque

The Device will be marketed as a piston syringe with one-handed disconnection option.

7. Substantial Equivalence

The LuerJack Slip 3 ml, 5 ml and 20 ml and the LuerJack Lock 10 ml are equivalent to that of the Predicate ConceptoMed Luer-Jack Slip 10 ml in intended use, principles of operation, technology, materials and performance characteristics.

8. Conclusion

The LuerJack Slip 3 ml, 5 ml and 20 ml and the LuerJack Lock 10 ml has been verified to meet the established performance criteria above. The LuerJack Slip 3 ml, 5 ml and 20 ml and the LuerJack Lock 10 ml performs as intended and comparably to the legally marketed Predicate Device.