K Number
K172717
Device Name
Automatic Tissue Processing Unit
Manufacturer
Date Cleared
2018-05-25

(259 days)

Product Code
Regulation Number
878.5040
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Automatic Tissue Processing Unit is used in medical procedures involving the harvesting and transferring of autologous adipose tissue. The Automatic Tissue Processing Unit is used for concentrating adipose tissue harvested with a legally marketed lipoplasty system. The Automatic Tissue Processing Unit is intended for use in the following surgical specialties when the concentration of harvested adipose tissue is desired. - Neurosurgery Gastrointestinal Surgery Urological Surgery Plastic and Reconstructive Surgery General Surgery Orthopedic Surgery Gynecological Surgery Thoracic Surgery Laparoscopic Surgery Arthoscopic Surgery
Device Description
The fat harvested by liposuction, called as lipoaspirates, contains fat tissues, bloody impurities and tumescent solution. The harvested lipoaspirates are not appropriate for autologous fat transfer without removal of the bloody impurities and tumescent solution containing anesthetic agent, anti-coagulant agent, antibiotics etc. In addition, the harvested fat tissues are not homogenous and contain uneven fibrotic tissues. So, for the purpose of in autologous fat transfer surgical technique. ACPU kit is designed and developed for harvest of the fine homologous adipose tissue in a sterile and closed way. ACPU needs to be centrifuged by using exclusive centrifuge (ACS Combo-A-Centrifuge/Product code: JQC) and the kits are single-use only.
More Information

Not Found

No
The description focuses on mechanical processing (centrifugation) of adipose tissue and does not mention any computational or algorithmic components indicative of AI/ML.

No.
The device processes tissue for use in medical procedures but does not directly treat a disease or condition.

No

The device is an Automatic Tissue Processing Unit used for concentrating autologous adipose tissue by removing impurities and preparing it for transfer. Its function is to process tissue, not to diagnose a medical condition or disease.

No

The device description explicitly mentions a "ACPU kit" and the need to be "centrifuged by using exclusive centrifuge (ACS Combo-A-Centrifuge/Product code: JQC)". This indicates the device includes physical components and is not solely software.

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

Here's why:

  • Intended Use: The intended use is for processing adipose tissue for surgical procedures (autologous fat transfer). It's about preparing tissue for re-implantation into the patient, not for diagnosing a condition or providing information about a patient's health status based on in vitro analysis of a specimen.
  • Device Description: The description focuses on the mechanical processing of harvested fat tissue to remove impurities and create a homogenous product for surgical use. It's a tissue processing device, not a diagnostic test.
  • Lack of Diagnostic Claims: There are no claims or indications that the device is used to detect, measure, or analyze substances in a specimen to provide diagnostic information.
  • Performance Metrics: The performance metrics listed (Nucleated Cell Count, Viability, pH, etc.) are related to the quality and characteristics of the processed adipose tissue itself, not to diagnostic markers or indicators of disease.

IVD devices are typically used to examine specimens (like blood, urine, tissue samples) outside the body to provide information for diagnosis, monitoring, or screening. This device is used to prepare tissue for use within the body.

N/A

Intended Use / Indications for Use

The Automatic Tissue Processing Unit is used in medical procedures involving the harvesting and transferring of autologous adipose tissue. The Automatic Tissue Processing Unit is used for concentrating adipose tissue harvested with a legally marketed lipoplasty system. The Automatic Tissue Processing Unit is intended for use in the following surgical specialties when the concentration of harvested adipose tissue is desired.

  • Neurosurgery Gastrointestinal Surgery Urological Surgery Plastic and Reconstructive Surgery General Surgery Orthopedic Surgery Gynecological Surgery Thoracic Surgery Laparoscopic Surgery Arthoscopic Surgery

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

MUU

Device Description

The fat harvested by liposuction, called as lipoaspirates, contains fat tissues, bloody impurities and tumescent solution. The harvested lipoaspirates are not appropriate for autologous fat transfer without removal of the bloody impurities and tumescent solution containing anesthetic agent, anti-coagulant agent, antibiotics etc. In addition, the harvested fat tissues are not homogenous and contain uneven fibrotic tissues. So, for the purpose of in autologous fat transfer surgical technique. ACPU kit is designed and developed for harvest of the fine homologous adipose tissue in a sterile and closed way. ACPU needs to be centrifuged by using exclusive centrifuge (ACS Combo-A-Centrifuge/Product code: JQC) and the kits are single-use only.

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)

Bench test were performed. Bench testing included biocompatibility, mechanical testing,sterility testing including EO residues. The tests demonstrated that the device performs in a substantially equivalent manner to the predicate device. The following bench testing is performed to demonstrate the functionality is substantially equivalent.

Test itemRequirementsResults
AppearanceItshould not be defects inflaws, breakage or contamination of foreign objects.Pass
MeasurementWhen measuring with Vernier calipers, according to the dimension of 'shape and structure' part, the stated should be within ±5 %.Pass
LeakageWhen tested according to the test method, there should be no leakage.Pass
Residuals of cleaning liquidWhen tested accordingto the test method, the residuals of cleaning liquid should be less than 20 ml.Pass
PackagingAdhesive strength shall be tested by ASTM F-88 to be not less than 3NPass
Nucleated Cell CountNucleated cells should have more than 3.86x105 per ml of adipose tissuePass
Nucleated Cell ViabilityViability of nucleated cells should be more than 71.4%Pass
Extraction test
AppearanceWhen observe sample preparation extract with naked eyes, there should not be foreign material.Pass
pHDifference in pH S: 1.5Pass
KMn04 Reducing agentsDifference intitres S: 2.0 mlPass
Evaporating residueDifference in extractables S 1.0 mgPass
Heavy metal (as Pb)Not darker than standard solution.Pass
UV-vis SpectrumDifference inabsorbance (250nm-350nm) S:0.1Pass

Biocompatibility tests:

#TestitemTest method /Test criteriaTest result
1CytotoxicityISO 10993-5 Tests for in vitro cytotoxicityPass
2Skin Sensitization TestISO 10993-10 irritation and skin sensitizationPass
3Intracutaneous Reactivity TestISO 10993-10 Test for irritation and skin sensitization, maximization test for delayed hypersensitivityPass
4Acute Systemic Toxicity TestISO 10993-11 Test for systemic toxicity -Acute Systemic ToxicityPass
5Pyrogen TestISO 10993-11Tests for systemic toxicity, Annex(F) Information on material-mediated pyrogens.Pass
6Hemolysis TestISO 10993-4 Selection of tests for interactions with bloodPass

The performance tests demonstrated that Automatic Tissue Processing Unit performs in a substantially equivalent manner to the predicate device.

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.

K121005

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

§ 878.5040 Suction lipoplasty system.

(a)
Identification. A suction lipoplasty system is a device intended for aesthetic body contouring. The device consists of a powered suction pump (containing a microbial filter on the exhaust and a microbial in-line filter in the connecting tubing between the collection bottle and the safety trap), collection bottle, cannula, and connecting tube. The microbial filters, tubing, collection bottle, and cannula must be capable of being changed between patients. The powered suction pump has a motor with a minimum of1/3 horsepower, a variable vacuum range from 0 to 29.9 inches of mercury, vacuum control valves to regulate the vacuum with accompanying vacuum gauges, a single or double rotary vane (with or without oil), a single or double diaphragm, a single or double piston, and a safety trap.(b)
Classification. Class II (special controls). Consensus standards and labeling restrictions.

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, with the letters "FDA" in a blue square. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

May 25, 2018

BSL Co. % Peter Chung President Plus Global 300 Atwood Pittsburgh, Pennsylvania 15213

Re: K172717

Trade/Device Name: Automatic Tissue Processing Unit Regulation Number: 21 CFR 878.5040 Regulation Name: Suction lipoplasty system Regulatory Class: Class II Product Code: MUU Dated: April 25, 2018 Received: April 25, 2018

Dear Mr. Chung:

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.

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);

1

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,

David Krause -S

for Binita S. Ashar, M.D., M.B.A., F.A.C.S. Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K172717

Device Name Automatic Tissue Processing Unit

Indications for Use (Describe)

The Automatic Tissue Processing Unit is used in medical procedures involving the harvesting and transferring of autologous adipose tissue. The Automatic Tissue Processing Unit is used for concentrating adipose tissue harvested with a legally marketed lipoplasty system. The Automatic Tissue Processing Unit is intended for use in the following surgical specialties when the concentration of harvested adipose tissue is desired.

  • Neurosurgery Gastrointestinal Surgery Urological Surgery Plastic and Reconstructive Surgery General Surgery Orthopedic Surgery Gynecological Surgery Thoracic Surgery Laparoscopic Surgery Arthoscopic Surgery
    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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510(k)Summary [as required by 807.92(c)]

1Applicant

    1. Company: BSLCo.
  • Address: 6-13, Chilsan-ro 237beon-gil,Gimhae-si,Gyungsangnam-do, South Korea য
  • Tel:82-55-328-9235 3)
    1. Fax:82-55-328-9236
  • Prepared date: July 4, 2017 5)
    1. Contact person: Peter Chung,412-512-8802
  • Contact person address: 300 Atwood Street, Pittsburgh, PA, 15213, USA 7)
    1. Submission date: August 25, 2017

2. Device Information

    1. Trade name: Automatic Tissue Processing Unit
  • 2 Common name: Fat Concentration System
  • 3 Regulation name: Suction Lipoplasty System
  • 4 Product code: MUU
    1. Regulation number: 878.5040
  • റ്റം Class of device: Class II
    1. Panel: General and Plastic surgery
    1. The legally marketed device to which we are claiming equivalence K121005, AdiPrep™Adipose Transfer System

4. Device description

The fat harvested by liposuction, called as lipoaspirates, contains fat tissues, bloody impurities and tumescent solution. The harvested lipoaspirates are not appropriate for autologous fat transfer without removal of the bloody impurities and tumescent solution containing anesthetic agent, anti-coagulant agent, antibiotics etc. In addition, the harvested fat tissues are not homogenous and contain uneven fibrotic tissues. So, for the purpose of in autologous fat transfer surgical technique. ACPU kit is designed and developed for harvest of the fine homologous adipose tissue in a sterile and closed way. ACPU needs to be centrifuged by using exclusive centrifuge (ACS Combo-A-Centrifuge/Product code: JQC) and the kits are single-use only.

5. Intended Use:

The Automatic Tissue Processing Unit is used in medical procedures involvingthe harvesting and transferring of autologous adipose tissue. The Automatic Tissue Processing Unit is used for concentrating adipose tissue harvested with a legally marketed lipoplasty system. The Automatic Tissue Processing Unit is intended for

use in the following surgical specialties when the concentration of harvested adipose tissue is desired.

  • Neurosurgery
  • Gastrointestinal Surgery
  • Urological Surgery
  • -Plastic and Reconstructive Surgery
  • -General surgery
  • Orthopedic Surgery
  • Gynecological Surgery
  • Thoracic Surgery
  • Laparoscopic Surgery
  • Arthroscopic Surgery

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6. Performance data:

    1. Bench test were performed. Bench testing included biocompatibility, mechanical testing,sterility testing including EO residues. The tests demonstrated that the device performs in a substantially equivalent manner to the predicate device. The following bench testing is performed to demonstrate the functionality is substantially equivalent.
Test itemRequirementsResults
AppearanceItshould not be defects inflaws, breakage or contamination of foreign objects.
MeasurementWhen measuring with Vernier calipers, according to the dimension of 'shape and structure' part, the stated should be within ±5 %.
LeakageWhen tested according to the test method, there should be no leakage.
Residuals of cleaning liquidWhen tested accordingto the test method, the residuals of cleaning liquid should be less than 20 ml.Pass
PackagingAdhesive strength shall be tested by ASTM F-88 to be not less than 3N
Nucleated Cell CountNucleated cells should have more than 3.86x105 per ml of adipose tissue
Nucleated Cell ViabilityViability of nucleated cells should be more than 71.4%
Extraction test
AppearanceWhen observe sample preparation extract with naked eyes, there should not be foreign material.
pHDifference in pH S: 1.5
KMn04 Reducing agentsDifference intitres S: 2.0 mlPass
Evaporating residueDifference in extractables S 1.0 mg
Heavy metal (as Pb)Not darker than standard solution.
UV-vis SpectrumDifference inabsorbance (250nm-350nm) S:0.1

2Biocompatibility

#TestitemTest method /Test criteriaTest result
1CytotoxicityISO 10993-5 Tests for in vitro cytotoxicityPass
2Skin Sensitization
TestISO 10993-10 irritation and skin sensitizationPass
3Intracutaneous
Reactivity TestISO 10993-10 Test for irritation and skin sensitization, maximization test
for delayed hypersensitivityPass
4Acute Systemic
Toxicity TestISO 10993-11 Test for systemic toxicity -Acute Systemic ToxicityPass
5Pyrogen TestISO 10993-11Tests for systemic toxicity, Annex(F) Information on
material-mediated pyrogens.Pass
6Hemolysis TestISO 10993-4 Selection of tests for interactions with bloodPass

The performance tests demonstrated that Automatic Tissue Processing Unit performs ina substantially equivalent manner to the predicate device.

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7.ComparisonTable of ACPU-100/AC PU-200

ManufacturerBSL Co.AdiprepTMRemark
SIO(K) No.K121005N/A
Indication for
useThe Automatic Tissue Processing Unit is used in
medical procedures involving the harvesting and
transferring of autologous adipose tissue. The
Automatic Tissue Processing Unit is used for
concentrating adipose tissue harvested with a
legally marketed lipoplasty system.The
Automatic Tissue Processing Unit is intended for
use in the following surgical specialties when the
concentration of harvested adipose tissue is
desired.
  • Neurosurgery
  • Gastrointestinal Surgery
  • Urological Surgery
  • Plastic and Reconstructive Surgery
  • General surgery
  • Orthopedic Surgery
  • Gynecological Surgery
  • Thoracic Surgery
  • aparoscopic Surgery
  • Arthroscopic Surgery | The AdiPrep™ Adipose Transfer System isused
    in medical procedures involving the harvesting
    and transferring of autologous adipose tissue.
    The Adiprep system is used for concentrating
    adipose tissue harvested with a legally
    marketed lipoplasty system. AdiPrepTM Adipose
    Transfer system is intended for use in the
    following surgical specialties when the
    concentration of harvested adipose tissue is
    desired .
  • Neurosurgery
  • Gastrointestinal Surgery
  • Urological Surgery
  • Plastic and Reconstructive Surgery
  • Generalsurgery
  • Orthopedic Surgery
  • Gynecological Surgery
  • Thoracic Surgery
  • Laparoscopic Surgery
  • Arthroscopic Surgery | Same |
    | Model/type | ACPU-100/ACPU-200 | ADI-25-01 AdiPrep Procedure pack | N/A |
    | Appearance | Image: ACPU-100/ACPU-200 | Image: ADI-25-01 AdiPrep Procedure pack | Different |
    | Processing
    Pack:Materials | ACPU-100 kit / ACPU-200 kit | Components - Syringes with removable
    plunger, centrifuge tubes with filter, aspiration
    & fat injection cannula,fat injection syringes,
    skin puncture needles, and oil extraction
    syringe & needle. Cannula & syringes
    composed of medicalgrade plastics. | Different |
    | Fill volumes | 5 to 25ml | 5 to 25ml | same |
    | Sterilization
    Method | Ethylene-OxideGas(EtO) | Ethylene-Oxide Gas (EtO) | same |
    | Autologous Adipose Product | | | |
    | Nucleated cell
    count (x105 ml
    of product) | 3.86 over | Mean 1.848 | Similar |
    | Nucleated cell
    viability | 71.4% over | Mean 83.5 | Similar |
    | Processing capabilities | | | |
    | Volume | 5 to SOml | Sta 25ml | Similar |
    | Low-g-force | Centrifuge to spin for approximately 4 minutes at
    1250 g-force (ACPU-200 kit)
    Centrifuge to spin for approximately 5 minutes at
    375 g-force (ACPU-100 kit) | Centrifuge to spin for approximately 4 minutes
    at 1250 g-force | Same
    and
    different |
    | Laboratory
    centrifuge | ACS Combo-A Centrifuge
    CENTRIFUGES (MICRO, ULTRA, REFRIGERATED)
    FOR CLINICAL USE or laboratory centrifuge for
    clinical use | SmartPReP2 centrifuge isa general-purpose
    laboratory centrifuge for clinical use | N/A |

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Conclusion

The device is investigated for function and effectiveness to compare the operation of function between proposed device and predicate device (K121005). Comparison results demonstrate that the specifications and performance of the device are same as functional and effective as the legally marketed predicate device. Therefore, it is concluded that is Automatic Tissue Processing Unit of BSL Co. substantially equivalent to the legally marketed predicate device.