K Number
K172631
Device Name
Arisure Dry Spike
Manufacturer
Date Cleared
2017-09-29

(28 days)

Product Code
Regulation Number
880.5440
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Arisure™ Dry Spike allows for the addition of liquid medications to IV containers through a needle-free access port, and serves as a connector between an IV container and a standard IV set, while minimizing exposure to drug aerosols and spills.
Device Description
The Arisure™ Dry Spike connects between IV containers and standard IV sets for the addition or removal of fluids. A needle-free valve on the side of the device provides a swab-able female access port for connection with ISO standard male luers. The needlefree valve provides an alternative fluid path to the IV container, which is normally accessed via a dedicated lumen within the spike. A pierceable septum distal to the device's spike, incorporates a redundant seal ring to minimize or eliminate fluid leakage that might otherwise occur during the spiking of IV containers. Fluid within the bag is then administered through a second, primary lumen within the spike. A third, vented lumen incorporates a check valve with hydrophobic vent media to equalize vacuum created within rigid containers and glass bottles during the administration of fluids. The Arisure™ Dry Spike was designed to comply with ISO 8536-4:2010 as appropriate. The primary components of the Arisure Dry Spike include a vented lumen, handle, and needle-free valve, which are made of ABS, TPE, and PC/Silicone respectively. All materials were tested in accordance with ISO 10993-1.
More Information

Not Found

No
The device description and performance studies focus on mechanical and fluid dynamics, with no mention of AI or ML.

No.
The device is described as a connector and an access port for delivering liquid medications, not a device that itself provides a therapeutic effect.

No
The device is described as an accessory for administering liquid medications and fluids to patients via IV containers, focusing on fluid delivery and connection, not on diagnosing medical conditions.

No

The device description clearly details physical components (spike, valve, lumens, septum, handle) made of specific materials (ABS, TPE, PC/Silicone) and describes mechanical functions (connecting, piercing, venting, sealing). The performance studies focus on physical properties and functions like flow rate, leakage, retention force, and material biocompatibility, which are characteristic of a hardware device. There is no mention of software as part of the device itself.

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

Here's why:

  • Intended Use: The intended use clearly describes the device's function as a connector for adding liquid medications to IV containers and administering fluids. This is a direct interaction with the medication and the delivery system to the patient, not a test performed on a sample taken from the body.
  • Device Description: The description details the mechanical components and how they facilitate the flow of fluids. There is no mention of analyzing biological samples or providing diagnostic information.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Testing of biological samples (blood, urine, tissue, etc.)
    • Detection or measurement of analytes
    • Providing information for diagnosis, monitoring, or prognosis of a disease or condition
    • Use of reagents or assays

The device is designed to facilitate the safe and efficient delivery of medications to a patient, which falls under the category of a medical device used for therapeutic purposes, not diagnostic purposes.

N/A

Intended Use / Indications for Use

The Arisure™ Dry Spike allows for the addition of liquid medications to IV containers through a needle-free access port, and serves as a connector between an IV container and a standard IV set, while minimizing exposure to drug aerosols and spills.

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

LHI

Device Description

The Arisure™ Dry Spike connects between IV containers and standard IV sets for the addition or removal of fluids. A needle-free valve on the side of the device provides a swab-able female access port for connection with ISO standard male luers. The needlefree valve provides an alternative fluid path to the IV container, which is normally accessed via a dedicated lumen within the spike. A pierceable septum distal to the device's spike, incorporates a redundant seal ring to minimize or eliminate fluid leakage that might otherwise occur during the spiking of IV containers. Fluid within the bag is then administered through a second, primary lumen within the spike. A third, vented lumen incorporates a check valve with hydrophobic vent media to equalize vacuum created within rigid containers and glass bottles during the administration of fluids.

The Arisure™ Dry Spike was designed to comply with ISO 8536-4:2010 as appropriate. The primary components of the Arisure Dry Spike include a vented lumen, handle, and needle-free valve, which are made of ABS, TPE, and PC/Silicone respectively. All materials were tested in accordance with ISO 10993-1.

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 performance testing was performed to verify design requirements and to mitigate any potential risks. All testing was performed following maximum dose gamma irradiation sterilization to ensure the Arisure™ Dry Spike would still perform effectively under the harshest potential sterilization. The following requirements were tested and completed with passing results.

Bench Test Requirements:

  • Flow Rate from IV Container (per ISO 8536-4)
  • Flow Rate into IV Container (per ISO 8536-4)
  • Air Leakage (per ISO 8536-4)
  • Liquid Leakage (per ISO 8536-4)
  • Bag Retention Force (per ISO 8536-4)
  • Drip Chamber/IV Set Retention Force (per ISO 8536-4)
  • Device Disassembly (per ISO 8536-4)
  • Needle-free valve Detachment Torque (Bond Strength)
  • Microbial Ingress
  • Leak Pressure Tolerance for Pre-slit Septa

Additional Testing:

  • Biocompatibility (Cytotoxicity ISO MEM Elution L-929 Mouse Fibroblast Cells, Reactivity - ISO Intracutaneous Irritation Test, Sensitization - ISO Maximization Sensitization - Extraction Methodization Test, Systemic Toxicity (Acute) - ISO Acute Systemic Toxicity Test, Hemocompatibility - ASTM Method Hemolysis Test - Extraction Method, Pyrogen - ISO Materials Mediated Rabbit Pyrogen Testing)
  • Sterilization
  • Chemical Compatibility
  • Shelf Life
  • Distribution Testing

Package Integrity testing was completed in accordance with or satisfying the requirements for the following standards:

  • ISTA P2A (2011)
  • ASTM D4169-14 Standard Practice for Performance Testing of Shipping Containers and Systems DC-13
  • ASTM F88M-09 Standard Test Method for Seal Strength of Flexible Barrier Materials
  • ASTM F2096-11 Standard Test Method for Detecting Gross Leaks in Packaging by Internal Pressurization (Bubble Test)
  • ASTM F1886 Standard Test Method for Determining Integrity of Seals for Flexible Packaging by Visual Inspection

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.

K110023

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

§ 880.5440 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/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the top half of the circle. Inside the circle is a stylized image of a caduceus, which is a symbol of medicine. The caduceus is made up of three intertwined snakes and a staff.

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

September 29, 2017

Yukon Medical, LLC % Mark Job Responsible Third Party Official Regulatory Technology Services, LLC 1394 25th Street, NW Buffalo, Minnesota 55313

Re: K172631

Trade/Device Name: Arisure™ Dry Spike Regulation Number: 21 CFR 880.5440 Regulation Name: Intravascular Administration Set Regulatory Class: Class II Product Code: LHI Dated: October 13, 2016 Received: September 1, 2017

Dear Mark Job:

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 devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) 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 (DICE) 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" (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.

You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education (DICE) 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,

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

2

Indications for Use

510(k) Number (if known)

K172631

Device Name Arisure™ Dry Spike

Indications for Use (Describe)

The Arisure™ Dry Spike allows for the addition of liquid medications to IV containers through a needle-free access port, and serves as a connector between an IV container and a standard IV set, while minimizing exposure to drug aerosols and spills.

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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5.2.

5. 510(k) Summary

5.1. Submitter Information

Company Name:Yukon Medical, LLC
Company Address:4021 Stirrup Creek Drive
Suite 200
Research Triangle Park, NC 27703
Company Phone:(919) 595-8250
Company Fax:(919) 595-8251
Contact Person:Pam McNulty, Director QA and Compliance
Yukon Medical
Phone: 919-595-8253
Fax: 919-595-8251
Email: pmcnulty@yukonmedical.com
Prepared By:Brian Beach, Project Engineer
Yukon Medical
Phone: 984-234-5240
Fax: 919-595-8251
Email: bbeach@yukonmedical.com
Date Summary
Prepared:August 11, 2017
Device Identification
Trade/Proprietary Name:Arisure™ Dry Spike
Common Name:Infusion Access Device
Classification Name:Intravascular Administration Set
Regulation Number:21 CFR 880.5440
Class:II
Classification PanelGeneral Hospital
Product Code:LHI

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5.3. Predicate Device

The Arisure™ Dry Spike is substantially equivalent to the following predicate device:

DeviceManufacturer510(k)Date Cleared
PhaSeal® Infusion AdapterCarmel Pharma ABK11002304/12/2011

5.4. Device Description

The Arisure™ Dry Spike connects between IV containers and standard IV sets for the addition or removal of fluids. A needle-free valve on the side of the device provides a swab-able female access port for connection with ISO standard male luers. The needlefree valve provides an alternative fluid path to the IV container, which is normally accessed via a dedicated lumen within the spike. A pierceable septum distal to the device's spike, incorporates a redundant seal ring to minimize or eliminate fluid leakage that might otherwise occur during the spiking of IV containers. Fluid within the bag is then administered through a second, primary lumen within the spike. A third, vented lumen incorporates a check valve with hydrophobic vent media to equalize vacuum created within rigid containers and glass bottles during the administration of fluids.

The Arisure™ Dry Spike was designed to comply with ISO 8536-4:2010 as appropriate. The primary components of the Arisure Dry Spike include a vented lumen, handle, and needle-free valve, which are made of ABS, TPE, and PC/Silicone respectively. All materials were tested in accordance with ISO 10993-1.

5.5. Intended Use

Arisure™ Dry SpikePredicate Device
The intended use of the Arisure™ Dry Spike is to
allow the administration of a fluid from an IV
container to a patient's vascular system through a
needle or catheter inserted into a vein. The
Arisure Dry Spike provides needle-free access to
the infusion system through a female luer valve.The intended use of this device is to administer
fluids from a container to a patient's vascular
system through a needle or catheter inserted into a
vein.

The Arisure Dry Spike's intended use is equivalent to that of the PhaSeal Infusion Adapter.

5.6. Indications for Use

Arisure Dry SpikePredicate Device
The Arisure™ Dry Spike allows for the addition
of liquid medications to IV containers through a
needle-free access port, and serves as a connector
between an IV container and a standard IV set,
while minimizing exposure to drug aerosols and
spills.The indication for use is admixing of drug into an
IV container and administration/transfer of drug
from the container to an external IV line, while
minimizing exposure to potentially hazardous
drugs aerosols and spills that can occur during
admixing, administration and disposal process.

The Arisure™ Dry Spike's indications for use are equivalent to that of the PhaSeal Infusion Adapter.

5

Predicate Device Comparison – Technical Characteristics 5.7.

Equivalency of technical characteristics are demonstrated through a direct comparison of the Arisure™ Dry Spike and the predicate device listed in the table below.

| Technical
Characteristic | Arisure™ Dry Spike | PhaSeal Infusion
Adapter | Equivalence
(Y/N) |
|-----------------------------|----------------------------------------------------------------------------------------|------------------------------------------------------------------------------------|----------------------|
| Connections | • Rigid spike
• Handle
• Access port –
needle-free | • Rigid spike
• Handle
• Access port – double
membraned, sealed
needle | Y |
| Materials | • Rigid spike: ABS
• Handle: TPE
• Access port: PC/Silicone
• Spike cap: LDPE | • Rigid spike: ABS
• Handle: TPE
• Access port: ABS
• Spike cap: PP | Y |
| Vent | • Third lumen for pressure
equalization with check
valve | • N/A | N |

Same Technological Characteristics

Both the Arisure™ Dry Spike and PhaSeal Infusion Adapter have three connectors designed with the same use in mind. The rigid spikes' primary use is to pierce an IV container and are both made from ABS. The handles' primary use is to receive an external spike including an administration set, and they are both made from TPE. Both access ports aim to provide secure, safe access to the containers to which the device is connected to. Lastly, both spike caps add protection from the main spike when the device is not in use.

Different Technological Characteristics

A primary difference between the Arisure™ Dry Spike and the PhaSeal Infusion Adapter is that the latter does not have a vented lumen. This additional feature allows for pressure equalization when accessing rigid containers or glass bottles. This pressure equalization creates desirable fluid flow with these types of containers, especially when compared to non-vented alternatives such as the predicate device. This difference does not create an intended use different from the PhaSeal Infusion Adapter.

Another technical difference between the two devices is that the side port is needle-free for the Arisure™ Dry Spike and a double membraned, tightly sealed needle for the PhaSeal Infusion Adapter. Although the designs are different, both side ports have the same intended use. These differences between the devices do not raise different questions of safety and effectiveness.

5.8. Performance Testing

Non-clinical performance testing was performed to verify design requirements and to mitigate any potential risks. All testing was performed following maximum dose gamma irradiation sterilization to ensure the Arisure™ Dry Spike would still perform effectively

6

under the harshest potential sterilization. The following requirements were tested and completed with passing results.

Requirement IDBench Test Requirements
P1Flow Rate from IV Container (per ISO 8536-4)
P2Flow Rate into IV Container (per ISO 8536-4)
P3Air Leakage (per ISO 8536-4)
P4Liquid Leakage (per ISO 8536-4)
P5Bag Retention Force (per ISO 8536-4)
P6Drip Chamber/IV Set Retention Force (per ISO 8536-4)
P7Device Disassembly (per ISO 8536-4)
P8Needle-free valve Detachment Torque (Bond Strength)
P9Microbial Ingress
N/ALeak Pressure Tolerance for Pre-slit Septa

In addition to this bench testing biocompatibility testing, chemical testing, and package integrity testing was also conducted.

Requirement IDAdditional Testing
C2Biocompatibility
C3Sterilization
C7Chemical Compatibility
E1Shelf Life
E2Distribution Testing

For Biocompatibility the following tests from IS0-10993 were tested and completed with passing results:

  • Cytotoxicity ISO MEM Elution L-929 Mouse Fibroblast Cells ●
  • . Reactivity - ISO Intracutaneous Irritation Test
  • . Sensitization - ISO Maximization Sensitization - Extraction Methodization Test
  • . Systemic Toxicity (Acute) - ISO Acute Systemic Toxicity Test
  • . Hemocompatibility - ASTM Method Hemolysis Test - Extraction Method
  • . Pyrogen - ISO Materials Mediated Rabbit Pyrogen Testing

For Package Integrity the following tests were completed in accordance with or satisfying the requirements for the following standards:

  • ISTA P2A (2011)
  • ASTM D4169-14 Standard Practice for Performance Testing of Shipping ● Containers and Systems DC-13
  • . ASTM F88M-09 Standard Test Method for Seal Strength of Flexible Barrier Materials
  • . ASTM F2096-11 Standard Test Method for Detecting Gross Leaks in Packaging by Internal Pressurization (Bubble Test)

7

  • ASTM F1886 Standard Test Method for Determining Integrity of Seals for Flexible Packaging by Visual Inspection

5.9. Conclusion

Based on thorough comparison to the predicate device and performance testing, we have concluded that the Arisure Dry Spike is substantially equivalent to the previously cleared predicate device.