K Number
K172499
Device Name
NEOSHIELD
Date Cleared
2018-06-01

(287 days)

Product Code
Regulation Number
880.5440
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The NEOSHIELD System is an airtight and leak proof closed system drug transfer device (CSTD) that mechanically prohibits the transfer of environmental contaminants into the system and the escape of drug or vapor concentrations outside the system, thereby minimizing individual and environmental exposure to drug vapor, aerosols and spills.

The NEOSHIELD system also prevents microbial ingress for 3 days.

Device Description

NeoShield is a needle free closed system drug transfer device (CSTD). Neoshield prevents transfer of environmental contaminants into the system and also prevents the escape of drug or vapor from the system.

The ability to prevent microbial ingress for up to 3 days should not be interpreted as modifying, extending, or superseding a manufacturer labeling recommendations for the storage and expiration dating. Refer to drug manufacturer's recommendations and USP compounding guidelines for shelf life and sterility information.

AI/ML Overview

The provide text is a 510(k) summary for a medical device called NEOSHIELD, an intravascular administration set. It does not describe a study involving humans or AI, but rather a set of non-clinical (bench) performance tests to demonstrate substantial equivalence to a predicate device.

Here's the information extracted and formatted as requested:

1. Table of Acceptance Criteria and Reported Device Performance:

Test NameAcceptance Criteria (Implied by "No leak" or "Pass")Reported Device Performance
Leaking Pressure of Pre-Slit SeptumNo leakNo leak
Pressure Resistant Test (Liquid Tightness)No leakNo leak
Pressure Resistant Test (Air tightness)No leakNo leak
Pressure Resistant Test (Connecting Part of Closed System)No leakNo leak
Airtight ConnectionNo leakNo leak
Leakproof ConnectionsNo leakNo leak
Microbial Ingress TestingNo ingress for 3 daysNo ingress for 3 days
Pyrogen testNon-pyrogenicNon-pyrogenic
Crack Test for drug compatibilityNo cracks (except for N, N-dimethylacetamide, which is an exclusion)No cracks except for N, N-dimethylacetamide
Sterility Testing (EO) (ISO 11135)SterileSterile
Shelf Life TestingSterility kept for 3 yearsSterility kept for 3 years
Biocompatibility TestingAll materials are biocompatible (Cytotoxicity, Sensitization, Irritation or Intracutaneous Reactivity, Systematic Toxicity (Acute), Haemocompatibility, Pyrogen, Particulate Matter)All materials are biocompatible
Package Testing: Seal Strength/dye penetration testingPass/PassPass/Pass

2. Sample Size Used for the Test Set and Data Provenance:

The document does not specify the exact sample sizes for each non-clinical test. It states that "The following non-clinical tests were conducted," and then lists the tests and their results. The data provenance is from bench testing conducted by the manufacturer, JMS Co., Ltd / JMS Singapore Pte Ltd. This is a retrospective analysis of test results.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Their Qualifications:

Not applicable. This was a non-clinical (bench) testing study, not a study involving human interpretation or expert ground truth establishment in the traditional sense of clinical studies. The "ground truth" for these tests is based on objective laboratory measurements against defined standards or pass/fail criteria.

4. Adjudication Method for the Test Set:

Not applicable, as this was non-clinical bench testing. The results are typically objectively measured against pre-defined specifications.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and the Effect Size:

No, an MRMC comparative effectiveness study was not done. This submission focuses on non-clinical performance and substantial equivalence to a predicate device, not on comparing human reader performance with or without AI assistance.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done:

Not applicable. The device, NEOSHIELD, is an intravascular administration set (hardware), not an AI algorithm.

7. The Type of Ground Truth Used:

The ground truth used for these non-clinical tests is based on objective physical and chemical measurements against established engineering and regulatory standards (e.g., "no leak," "sterile," "non-pyrogenic," "biocompatible").

8. The Sample Size for the Training Set:

Not applicable. As a hardware device, there is no "training set" in the context of an AI algorithm. The device's design and manufacturing processes are developed through engineering and testing, but not machine learning training.

9. How the Ground Truth for the Training Set Was Established:

Not applicable, as there is no training set for this type of device.

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Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health and Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

June 1, 2018

JMS North America Corporation % Yolanda Smith Smith Associates 1468 Harwell Ave Crofton, Maryland 21114

Re: K172499

Trade/Device Name: NEOSHIELD Regulation Number: 21 CFR 880.5440 Regulation Name: Intravascular Administration Set Regulatory Class: Class II Product Code: ONB Dated: April 30, 2018 Received: May 2, 2018

Dear Yolanda Smith:

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.

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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 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
-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) K172499

Device Name

NEOSHIELD

Indications for Use (Describe)

The NEOSHIELD System is an airtight and leak proof closed system drug transfer device (CSTD) that mechanically prohibits the transfer of environmental contaminants into the system and the escape of drug or vapor concentrations outside the system, thereby minimizing individual and environmental exposure to drug vapor, aerosols and spills.

The NEOSHIELD system also prevents microbial ingress for 3 days.

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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Image /page/3/Picture/0 description: The image shows the logo for JMS North America Corporation. The logo is in blue and features the letters JMS in a stylized font. Below the letters is the text "North America Corporation".

MAIN OFFICE 22320 Foothill Blvd. Suite 350 Hayward, CA 94541 Tel. (510) 888-9090 Fax (510) 888-9099

SALES OFFICE 480 Sawgrass Corp. Pkwy. Suite 120 Sunrise, FL 33325 Tel. (954) 689-9280 Fax (954) 689-9289

K172499 Section 05: 510(k) Summary [807.92(c)]

Owner [807.92(a)1]:

Company Name:JMS North America Corp.
Company Address:22320 Foothill Blvd., Suite 350
Hayward, CA 94541
Telephone:510-888-9090
Fax:510-888-9099

Contact Person: Sho Hosoki Summary Preparation Date: 06/01/2018

Device of Submission [807.92(a)(2)]

Classification Name:Intravascular Administration Set
Common/Usual Name:Closed Antineoplastic and Hazardous DrugReconstitution and Transfer System
Proprietary Name:NEOSHIELD
Classification:Class II
Product Code:ONB
Code of Federal Regulations:21 CFR 880.5440

Predicate Device [807.92(a)(3)]

K NumberProductCompany
K123213(PrimaryPredicate)BD PhaSeal Closed System Drug Transfer DeviceProtector, injector, Luer connectorBecton Dickinson & Co.

Reference Device

K965027Vented IV SetJMS Co., Ltd
--------------------------------------

Device Description [807.92(a)(4)]

NeoShield is a needle free closed system drug transfer device (CSTD). Neoshield prevents transfer of environmental contaminants into the system and also prevents the escape of drug or vapor from the system.

The ability to prevent microbial ingress for up to 3 days should not be interpreted as modifying, extending, or superseding a manufacturer labeling recommendations for the storage and expiration dating. Refer to drug manufacturer's recommendations and USP compounding guidelines for shelf life and sterility information.

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Image /page/4/Picture/0 description: The image shows the logo for JMS North America Corporation. The logo is blue and features the letters JMS in a stylized font. Below the letters is the text "North America Corporation" in a smaller font, also in blue. The logo is simple and professional.

MAIN OFFICE 22320 Foothill Blvd. Suite 350 Hayward, CA 94541 Tel. (510) 888-9090 Fax (510) 888-9099

SALES OFFICE 480 Sawgrass Corp. Pkwy. Suite 120 Sunrise, FL 33325 Tel. (954) 689-9280 Fax (954) 689-9289

Device components:

Name of ComponentGeneral Description
NEOSHIELD TransferNEOSHIELD Transfer is used to transfer a solution from a vial container to another container such as an IV bag. It has a female connector, bag adaptor connector, and vial connector. It also has a stopcock to change the direction of flowDepending on the stopcock's position it can open the flow from female connector to/from NEOSHIELD Bag Adaptor or from female connector to/from vial. During usage, the NEOSHIELD Transfer keeps aerosol and liquid from being exposed to the outer environment to keep a closed system.
NEOSHIELD Bag AdaptorNEOSHIELD Bag Adaptor is connected to a liquid container such as IV bags for injection or extraction of liquid. The spike is used for the connection to liquid container and the injection port is used for injection or extraction of liquid in/out of container without leakage maintaining closed system.
NEOSHIELD Infusion SetThe NEOSHIELD Infusion Set is used for infusion of drug solutioninto a patient.
NEOSHIELD plugThe NEOSHIELD Plug is an optional accessory that can be connected with a female connector (such as one from NEOSHIELD Infusion Set) to inject/ extract solution without using needle in a closed system environment. The slit septum of the NEOSHIELD Plug opens upon connection with NEOSHIELD Lever Lock and the flow path opens. The slit septum of NEOSHIELD plug and the flow path closes once male portion of the NEOSHIELD Lever Lock is removed to keep a closed system.
NEOSHIELD Lever LockThe NEOSHIELD Lever Lock is used for injecting/extracting solution in a closed system by connecting a device such as syringe to the female connector.
NEOSHIELD Vial CoverNEOSHIELD Vial Cover is attached to drug vials in order to prevent leakage during extraction. The NEOSHIELD Vial Cover keeps the system closed to outer environment

Intended Use [807.92(a)(5)]

The NEOSHIELD System is an airtight and leak proof closed system drug transfer device (CSTD) that mechanically prohibits the transfer of environmental contaminants into the system and the escape of drug or vapor concentrations outside the system, thereby minimizing individual and environmental exposure to drug vapor, aerosols and spills.

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Image /page/5/Picture/0 description: The image shows the logo for JMS North America Corporation. The logo is blue and features the letters "JMS" stacked on top of each other. There are three horizontal lines going through the letters. Below the letters is the text "North America Corporation".

MAIN OFFICE 22320 Foothill Blvd. Suite 350 Hayward, CA 94541 Tel. (510) 888-9090 Fax (510) 888-9099

SALES OFFICE 480 Sawgrass Corp. Pkwy. Suite 120 Sunrise, FL 33325 Tel. (954) 689-9280 Fax (954) 689-9289

The NEOSHIELD system also prevents microbial ingress for 3 days.

Predicate Comparison [807.92(a)(6)]

DeviceModified DeviceCurrently Legally Marketed Predicate Device(Primary Predicate)
NeoShieldBD PhaSeal Closed System Transfer Device
ManufactureJMS Co., Ltd / JMS Singapore Pte LtdBecton Dickinson & Co.
510(K) #----K123213
ClassificationClass IIClass II
Product CodeONBONB
Intended UseThe Neoshield System is an airtight andleak proof closed system drug transferdevice (CSTD) that mechanically prohibitsthe transfer of environmentalcontaminants into the system and theescape of drug or vapor concentrationsoutside the system, thereby minimizingindividual and environmental exposure todrug vapor, aerosols and spills.The NEOSHIELD system also preventsmicrobial ingress for 3 days.The PhaSeal System is an airtight and leak proofclosed system drug transfer device (CSTD) thatmechanically prohibits the transfer ofenvironmental contaminants into the system andthe escape of drug or vapor concentrationsoutside the system, thereby minimizing individualand environmental exposure to drug vapor,aerosols and spills.The PhaSeal system also prevents microbialingress.
Equalizes VialPressurewhenAccessedYesYes
PreventsEscape ofDrug or VaporConcentrationYesYes
Closed DrugTransferMechanismElastomeric double membrane(non-ISO)Elastomeric double membrane(non-ISO)
ActivationMechanismPush-to connect(Non-ISO)Push-to connectwith bayonet lock (Non-ISO)
Needle FreeNeedle free18G needle with safety sleeve and /or steal spike
Connection toExternalEquipmentStandard ISO Luer Connections and Vial SpikesStandard ISO Luer Connections and Vial Spikes

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Image /page/6/Picture/0 description: The image shows the logo for JMS North America Corporation. The logo is in blue and features the letters "JMS" stacked on top of the words "North America Corporation". The letters "JMS" are stylized and bolded. The words "North America Corporation" are in a smaller font size.

MAIN OFFICE 22320 Foothill Blvd. Suite 350 Hayward, CA 94541 Tel. (510) 888-9090 Fax (510) 888-9099

SALES OFFICE 480 Sawgrass Corp. Pkwy. Suite 120 Sunrise, FL 33325 Tel. (954) 689-9280
Fax (954) 689-9289

Single Useyesyes
SterilizationMethodEOEO
Open orClosedSystemclosed systemFollowing tests were conducted:Leaking Pressure of Pre-Slit SeptumPressure Resistant Test (Liquid Tightness)Pressure Resistant Test (Air tightness)Pressure Resistant Test (Connecting Part ofClosed System)Airtight ConnectionLeakproof ConnectionsMicrobial Ingress Testingclosed system
FilterPTFE (NeoShield Transfer)PTFE (Protector)
MaterialContains plastics, elastomeric doublemembrane, PTFE filterPlastics, elastomeric double membrane, PTFEfilter, stainless steel
PerformancetestingLeak proof connectionsAirtight connectionsMicrobial IngressLeak proof connectionsAirtight connectionsMicrobial Ingress

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Image /page/7/Picture/0 description: The image contains the logo for JMS North America Corporation. The logo is blue and features the letters "JMS" in a stylized font with horizontal lines above the letters. Below the letters is the text "North America Corporation" in a smaller font.

MAIN OFFICE 22320 Foothill Blvd. Suite 350 Hayward, CA 94541 Tel. (510) 888-9090 Fax (510) 888-9099

SALES OFFICE 480 Sawgrass Corp. Pkwy. Suite 120 Sunrise, FL 33325 Tel. (954) 689-9280 Fax (954) 689-9289

Non-Clinical Performance Data [807.92(b)(1)]

The following non-clinical tests were conducted:

Performance test (bench testing)

Name of deviceResult
NeoShield TransferPass
NeoShield Bag Adaptor (Also includes testsfrom ISO 8536-4 : 2010)Pass
NeoShield Infusion Set (Also includes testsfrom ISO 8536-4 : 2010)Pass
NeoShield PlugPass
NeoShield Lever LockPass
NeoShield Vial CoverPass
Name of TestResult
Leaking Pressure of Pre-Slit SeptumNo leak
Pressure Resistant Test (Liquid Tightness)No leak
Pressure Resistant Test (Air tightness)No leak
Pressure Resistant Test (Connecting Part of Closed System)No leak
Airtight ConnectionNo leak
Leakproof ConnectionsNo leak
Microbial Ingress TestingNo ingress for 3 days

Other tests

Name of TestResult
Pyrogen testNon-pyrogenic
Crack Test for drug compatibility with:N, N-dimethylacetamide Polyethylene Glycol benzyl alcohol polysorbate 80 polyoxyethylene castor oil NaOH CH3COOHNo cracks except forN, N-dimethylacetamide

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Image /page/8/Picture/0 description: The image shows the logo for JMS North America Corporation. The logo is blue and features the letters JMS stacked on top of each other. There are also horizontal lines above the letters. The words "North America Corporation" are written below the letters.

MAIN OFFICE 22320 Foothill Blvd. Suite 350 Hayward, CA 94541 Tel. (510) 888-9090 Fax (510) 888-9099

SALES OFFICE 480 Sawgrass Corp. Pkwy. Suite 120 Sunrise, FL 33325 Tel. (954) 689-9280 Fax (954) 689-9289

Sterility Testing (EO)ISO 11135Sterile
Shelf Life TestingSterility kept for 3 years
Biocompatibility Testing:Cytotoxicity Sensitization Irritation or Intracutaneous Reactivity Systematic Toxicity (Acute) Haemocompatibility Pyrogen Particulate MatterAll materials are biocompatible
Package Testing: Seal Strength/dyepenetration testingPass/Pass

Note: Based on the crack test for drug compatibility results, DO NOT use NEOSHIELD system with anticancer drug or any solution that contains the plasticizer N, N-dimethylacetamide.

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

Not applicable as no clinical tests were referenced in this submission

Conclusion [807.92(b)(3)]

The device is equivalent to the predicate device K123213.

Through non-clinical performance testing the subject devices have demonstrated that they are substantially equivalent to the predicate device.

§ 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.