K Number
K172266
Device Name
Dynarex Three-Way Stopcock
Date Cleared
2018-03-14

(230 days)

Product Code
Regulation Number
880.5440
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Dynarex Three-Way Stopcock multiple port device is indicated to serve as a flow control and a conduit for I.V. fluid delivery to a patient's vascular system. This device is intended for delivering I.V. drug solutions or fluids, allowing gravity feed, sampling, bolus injection, and elimination or reflux of solutions and fluids during operation. The device may be used for a limited contact duration (24 hours or less).
Device Description
The Dynarex Three-Way Stopcock is a multiple port and needless access device that can be attached to other intravascular administration set devices by the user at the point of use during infusion therapy or sampling. The single-use disposable device intended for use on continuous or intermittent fluid administration or withdrawal of fluids. An in-line access site and can be connected to female luer adapters to allow needless access to fluid or vascular fluid path, and can control fluid flow by rotating flow control taps. The multiple access sites can be used for administration of drugs and solutions to a common fluid path or patient vascular system through a needle or catheter inserted into a vein.
More Information

Not Found

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

No.
The device acts as a control and conduit for fluid delivery to a patient's vascular system, but it does not directly treat a disease or condition.

No

The device is described as a flow control and conduit for IV fluid delivery, allowing for administration of drugs and fluids, and fluid sampling. It does not perform any diagnostic function.

No

The device description clearly indicates it is a physical, single-use disposable device with multiple ports and a needless access mechanism, designed for controlling fluid flow in an IV system. It is not software.

Based on the provided text, the Dynarex Three-Way Stopcock is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use clearly states the device is for "I.V. fluid delivery to a patient's vascular system" and for "delivering I.V. drug solutions or fluids, allowing gravity feed, sampling, bolus injection, and elimination or reflux of solutions and fluids during operation." This describes a device used in vivo (within the body) for administering or withdrawing fluids directly from a patient.
  • Device Description: The description reinforces this by mentioning it attaches to "intravascular administration set devices" and is used for "continuous or intermittent fluid administration or withdrawal of fluids" and "administration of drugs and solutions to a common fluid path or patient vascular system through a needle or catheter inserted into a vein."
  • Anatomical Site: The specified anatomical site is the "patient's vascular system," which is an in vivo location.

In Vitro Diagnostic (IVD) devices are used to examine specimens (like blood, urine, or tissue) outside of the body to provide information for diagnosis, monitoring, or screening. The Dynarex Three-Way Stopcock does not perform this function. It is a device used for managing fluid flow directly within a patient's circulatory system.

N/A

Intended Use / Indications for Use

The Dynarex Three-Way Stopcock multiple port device is indicated to serve as a flow control and a conduit for I.V. fluid delivery to a patient's vascular system. This device is intended for delivering I.V. drug solutions or fluids, allowing gravity feed, sampling, bolus injection, and elimination or reflux of solutions and fluids during operation. The device may be used for a limited contact duration (24 hours or less).

Product codes

FMG

Device Description

The Dynarex Three-Way Stopcock is a multiple port and needless access device that can be attached to other intravascular administration set devices by the user at the point of use during infusion therapy or sampling. The single-use disposable device intended for use on continuous or intermittent fluid administration or withdrawal of fluids. An in-line access site and can be connected to female luer adapters to allow needless access to fluid or vascular fluid path, and can control fluid flow by rotating flow control taps. The multiple access sites can be used for administration of drugs and solutions to a common fluid path or patient vascular system through a needle or catheter inserted into a vein.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

patient's vascular system

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 Testing:
Visual inspection (debris) - Free from foreign particles, Conclusion: Free from particles
Visual inspection (molding) - No molding defects, Conclusion: No defects
Male luer - 6% taper, Conclusion: Meets criteria
Female luer (main port) - 6% taper, Conclusion: Meets criteria
Female luer (side port) - 6% taper, Conclusion: Meets criteria
Air leakage from tap - No leakage, Conclusion: No leakage
Liquid leakage - No leakage at maximum 3.3 bar, Conclusion: No leakage
Tap rotation - Rotates freely without jerking, Conclusion: Rotates freely without jerking
Fitment with receptive component - Luers must fit securely without any jerk or damage, Conclusion: Meets criteria
Gravity Flow rate - 435 to 465 mL/min, Conclusion: Average 451.5 mL, range 445mL/min to 462 mL/min
Bisphenol A content - None, Conclusion: Undetectable (

§ 880.5440 Intravascular administration set.

(a)
Identification. An intravascular administration set is a device used to administer fluids from a container to a patient's vascular system through a needle or catheter inserted into a vein. The device may include the needle or catheter, tubing, a flow regulator, a drip chamber, an infusion line filter, an I.V. set stopcock, fluid delivery tubing, connectors between parts of the set, a side tube with a cap to serve as an injection site, and a hollow spike to penetrate and connect the tubing to an I.V. bag or other infusion fluid container.(b)
Classification. Class II (special controls). The special control for pharmacy compounding systems within this classification is the FDA guidance document entitled “Class II Special Controls Guidance Document: Pharmacy Compounding Systems; Final Guidance for Industry and FDA Reviewers.” Pharmacy compounding systems classified within the intravascular administration set are exempt from the premarket notification procedures in subpart E of this part and subject to the limitations in § 880.9.

0

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, which consists of the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

March 14, 2018

Dynarex Corporation Pablo Martinez Regulatory Affairs Manager 10 Glenshaw Street Orangeburg, New York 10962

Re: K172266

Trade/Device Name: Dynarex Three-Wav Stopcock Regulation Number: 21 CFR 880.5440 Regulation Name: Intravascular Administration Set Regulatory Class: Class II Product Code: FMG Dated: February 8, 2018 Received: February 12, 2018

Dear Pablo Martinez:

We have reviewed vour 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 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 mediation-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

Tina
Kiang-S

Tina Kiang, Ph.D. Acting Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control, and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K172266

Device Name Dynarex Three-Way Stopcock

Indications for Use (Describe)

The Dynarex Three-Way Stopcock multiple port device is indicated to serve as a flow control and a conduit for I.V. fluid delivery to a patient's vascular system. This device is intended for delivering I.V. drug solutions or fluids, allowing gravity feed, sampling, bolus injection, and elimination or reflux of solutions and fluids during operation. The device may be used for a limited contact duration (24 hours or less).

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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K172266

Section 5: Summary [As Required by 21 CFR 807.92]

Submitter's Information:

Name:Dynarex Corp.
Address:10 Glenshaw St.
Orangeburg, NY 10962
Phone Number:(845) 365-8200
Contact Person:Marc L. Somelofski
M.Somelofski@Dynarex.com
Date Prepared:March 9th, 2018

Subject Device:

Trade/Proprietary Name:Dynarex Three-Way Stopcock
Common/Usual Name:Three-Way Stopcock
Classification Name:Stopcock, I.v. Set
Classification Panel:General Hospital
Regulation Number:21 CFR 880.5440
Product Code:FMG
Device Class:2

Predicate Device:

K111016 Elcam Medical's SafePort Manifold™ (or Stopcock).

Regulation Number:21 CFR 880.5440
Product Code:FPA
Device Class:2

The predicate device has not been subject to a design related recall.

4

Description of the Device:

The Dynarex Three-Way Stopcock is a multiple port and needless access device that can be attached to other intravascular administration set devices by the user at the point of use during infusion therapy or sampling. The single-use disposable device intended for use on continuous or intermittent fluid administration or withdrawal of fluids. An in-line access site and can be connected to female luer adapters to allow needless access to fluid or vascular fluid path, and can control fluid flow by rotating flow control taps. The multiple access sites can be used for administration of drugs and solutions to a common fluid path or patient vascular system through a needle or catheter inserted into a vein.

Indications for Use:

The Dynarex Three-Way Stopcock multiple port device is indicated to serve as a flow control and a conduit for I.V. fluid delivery to a patient's vascular system. This device is intended for delivering I.V. drug solutions or fluids, allowing gravity feed, sampling, bolus injection, and elimination or reflux of solutions and fluids during operation. The device may be used for a limited contact duration (24 hours or less).

Comparison to Predicate Device:

CharacteristicSubject DevicePredicate DeviceEquivalency
Intended UseDynarex Three-Way
Stopcock is indicated to
serve as a flow control
and a conduit device for
I.V. fluid delivery to the
patient's vascular system.
The product is intended
for delivering of I.V. drugs
or fluids, allowing gravity
feed, sampling, bolus
injection and elimination
or reflux of fluid during
operation.SafePort Manifold or
Stopcock is indicated to
serve as a flow control
and a conduit device for
I.V. fluid delivery to the
patient's vascular system.
The product is intended
for delivering of I.V. drugs
or fluids, allowing gravity
feed, sampling, bolus
injection and elimination
or reflux of fluid during
operation.Same
BodyPolycarbonate lexanPolycarbonateEquivalent
Handle/TapHigh density polyethyleneHigh density polyethyleneSame
RotatorHigh density polyethyleneHigh density polyethyleneSame
Single UseYesYesSame
Body ColorClearClearSame
Dimensions2.125" X 1" X .8"SimilarEquivalent
SterilantEthylene oxideEthylene oxideSame
Sterility
Assurance
Level (SAL)$10^{-6}$$10^{-6}$Same

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CharacteristicSubject DevicePredicate DeviceEquivalency
Pressure ratingPressure up to 3 bars (44 psi)Pressure up to 3 bars (44 psi)Same
Performance parametersNot designed to withstand high pressure injectionsNot designed to withstand high pressure injectionsSame
Performance standardsISO 594-1, ISO 594-2ISO 80369-7Equivalent
Pouch PackagingBlister pack with medical grade paper coverSimilarEquivalent
Biocompatibility endpointsExternal communicating device with indirect blood contact for a limited duration (24 hours or less)SimilarEquivalent

Table 5-1: Equivalency of subject device and predicate device

Non-clinical Testing:

TestCriteriaConclusion
Visual inspection (debris)Free from foreign particlesFree from particles
Visual inspection (molding)No molding defectsNo defects
Male luer6% taperMeets criteria
Female luer (main port)6% taperMeets criteria
Female luer (side port)6% taperMeets criteria
Air leakage from tapNo leakageNo leakage
Liquid leakageNo leakage at maximum
3.3 barNo leakage
Tap rotationRotates freely without
jerkingRotates freely without
jerking
Fitment with receptive
componentLuers must fit securely
without any jerk or damageMeets criteria
Gravity Flow rate435 to 465 mL/minAverage 451.5 mL, range
445mL/min to 462 mL/min
Bisphenol A contentNoneUndetectable (