K Number
K180417
Device Name
Self-destruction Safety Syringes for Single Use; Sterile Hypodermic Syringes for Single Use; Sterile Hypodermic Needles for Single Use; Sterile Safety Hypodermic Needles for Single Use
Date Cleared
2018-08-09

(175 days)

Product Code
Regulation Number
880.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Self-destruction Safety Syringes for Single Use are intended to be used for medical purposes to inject fluid into or withdraw fluid from body. Its secondary intended use is to retract inside the safety barrel, contain the contaminated needle and aid in the prevention of accidental needle stick injuries. The Sterile Hypodermic Syringes for Single Use are intended to be used for medical purpose to inject fluid into or withdraw fluid from body. The Sterile Hypodermic Needles for Single Use are intended to be used with a luer slip syringe and injection devices for general purpose fluid injection/aspiration. The Sterile Safety Hypodermic Needles for Single Use are intended to be used with a luer slip or luer slip syringe for aspiration and injection of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needlestick.
Device Description
The Self-destruction Safety Syringes for Single Use are intended for single use only. The proposed device is available in 1mL, 3mL, 5mL, 10mL volumes with a 25 gauge, 25mm needle. The safety feature will be manually activated to retract the needle immediately after use to minimize risk of accidental needle sticks. The Sterile Hypodermic Syringes for Single Use are intended for single use only, which consists of barrel, plunger and piston. The proposed device is available in 1mL, 2mL, 5mL, 10mL, 20mL, 30mL and 50mL volumes. The syringe is available in luer lock connector types which are intended to be connected with a hypodermic needle. The Sterile Safety Hypodermic Needles for Single Use are intended for single use only, which consists of a hypodermic needle with a safety sheath attached to the needle hub. The proposed device is available in 18-27 gauge and 6-50 mm lengths. The safety sheath will be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks. The Sterile Hypodermic Needles for Single Use are intended for single use only. The proposed device is available in 14-30 gauge and 6-60 mm lengths.
More Information

No
The device description and performance studies focus on mechanical safety features and standard medical device testing, with no mention of AI or ML.

No
The devices listed are for injecting or withdrawing fluids and preventing needle stick injuries, not for treating any specific disease or condition.

No

The devices described are syringes and needles for injecting or withdrawing fluids, with features for safety and single use. Their purpose is drug delivery or fluid aspiration, not diagnosis.

No

The device description clearly outlines physical components such as barrels, plungers, pistons, needles, and safety sheaths, indicating it is a hardware medical device.

Based on the provided text, no, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly states the devices are for "inject[ing] fluid into or withdraw[ing] fluid from body." This describes a direct interaction with the patient's body for therapeutic or diagnostic purposes within the body, not for testing samples outside the body.
  • Device Description: The descriptions detail syringes and needles, which are instruments used for administering substances or collecting samples directly from a living organism.
  • Lack of IVD Characteristics: The text does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in samples
    • Providing information about a patient's health status based on sample analysis
    • Reagents or test kits

The devices described are standard medical devices used for injection and aspiration, with added safety features to prevent needlestick injuries. They are not designed to perform diagnostic tests on samples outside the body, which is the core function of an IVD.

N/A

Intended Use / Indications for Use

The Self-destruction Safety Syringes for Single Use are intended to be used for medical purposes to inject fluid into or withdraw fluid from body. Its secondary intended use is to retract inside the safety barrel, contain the contaminated needle and aid in the prevention of accidental needle stick injuries.

The Sterile Hypodermic Syringes for Single Use are intended to be used for medical purpose to inject fluid into or withdraw fluid from body.

The Sterile Hypodermic Needles for Single Use are intended to be used with a luer slip syringe and injection devices for general purpose fluid injection/aspiration.

The Sterile Safety Hypodermic Needles for Single Use are intended to be used with a luer slip or luer slip syringe for aspiration and injection of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needlestick.

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

MEG, FMF, FMI

Device Description

The Self-destruction Safety Syringes for Single Use are intended for single use only. The proposed device is available in 1mL, 3mL, 5mL, 10mL volumes with a 25 gauge, 25mm needle. The safety feature will be manually activated to retract the needle immediately after use to minimize risk of accidental needle sticks.

The Sterile Hypodermic Syringes for Single Use are intended for single use only, which consists of barrel, plunger and piston. The proposed device is available in 1mL, 2mL, 5mL, 10mL, 20mL, 30mL and 50mL volumes. The syringe is available in luer lock connector types which are intended to be connected with a hypodermic needle.

The Sterile Safety Hypodermic Needles for Single Use are intended for single use only, which consists of a hypodermic needle with a safety sheath attached to the needle hub. The proposed device is available in 18-27 gauge and 6-50 mm lengths. The safety sheath will be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks.

The Sterile Hypodermic Needles for Single Use are intended for single use only. The proposed device is available in 14-30 gauge and 6-60 mm lengths.

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 tests were conducted to verify that the proposed device met all design specifications and is Substantially Equivalent (SE) to the predicate device. The test results demonstrate conformance with the related standard requirements and include the following:
Physical, Mechanical, Chemical testing were performed on all syringe volumes of Self-destruction Safety Syringes for Single Use and Sterile Hypodermic Syringes for Single Use, the test items include: Cleanliness, Limits for acidity or alkalinity, Limits for extractable metals, Lubricant, Tolerance on graduated capacity, Graduated scale, Barrel, Piston/ plunger assembly, Nozzle, Performance, For Safety syringe: Safety Feature.
Physical, Mechanical, Chemical testing were performed on all needle gauges and lengths of Sterile Hypodermic Needles for and Single Use Sterile Safety Hypodermic Needles for Single Use, the test items include: Cleanliness, Limits for acidity or alkalinity, Limits for extractable metals, Size designation, Colour coding, Needle hub, Needle Cap, Needle tube, Needle point, Bond between hub and needle tube, Patency of lumen, Surface finish, Cleanliness, Limits for acidity and alkalinity, Size designation, Dimensions, Stiffness, Resistance to breakage, Resistance to corrosion.
For Safety needle: Safety Feature.
Sterile Barrier Packaging Testing performed on the proposed device: Seal strength, Dye penetration.
Sterilization and Shelf Life Testing performed on the proposed device: EO residue, ECH residue, Bacteria Endotoxin Limit, Shelf Life Evaluation.
1ml Self-destruction Safety Syringes for Single Use, 1ml Sterile Hypodermic Syringes for Single Use, 27G×20mm Sterile Safety Hypodermic Needles for Single Use and 30G×12mm Sterile Hypodermic Needles for Single Use are used for sterilization validation test.
The shelf life validation test was performed on syringe from 1ml to 50ml and needle gauge from 14G30G with 660mm length.
Biocompatibility Testing: The devices meet biocompatibility endpoints for cytotoxicity, irritation, systemic toxicity, hemolysis and material-mediated pyrogens. The data was supplied in the reference device submission, K162180, and the manufacturer certified that the devices, in their final finished form, are identical to the K162180 reference device (cleared 12/29/2016) in formulation, processing, sterilization, and geometry and no other chemicals have been added (e.g., plasticizers, fillers, cleaning agents, mold release agents).
Simulated Clinical Use: A simulated clinical use study was performed on 500 device samples each for the safety syringe and safety needles according to FDA Guidance, Guidance for Industry and FDA Staff: Medical Device with Sharps Injury Prevention Feature, issued on August 9, 2005 and ISO 23908 to evaluate the safety mechanism of the proposed device. The results demonstrated that the proposed device met the pre-established criteria.
No clinical study is included in this submission.

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.

K072739, K113422

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.

K162180

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/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 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.

August 9, 2018

Berpu Medical Technology Co., Ltd % Diana Hong General Manager Mid-Link Consulting Co., Ltd P.O. Box 120-119 Shanghai. 200120 CHINA

Re: K180417

Trade/Device Name: Self-destruction Safety Syringes for Single Use; Sterile Hypodermic Syringes for Single Use; Sterile Hypodermic Needles for Single Use; Sterile Safety Hypodermic Needles for Single Use

Regulation Number: 21 CFR 880.5860 Regulation Name: Piston Syringe Regulatory Class: Class II Product Code: MEG. FMF. FMI Dated: July 18, 2018 Received: July 30, 2018

Dear Diana Hong:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.htm); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; 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,

Alan M. Stevens -S

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

2

Indications for Use

510(k) Number (if known) K180417

Device Name

Seff-destruction Safety Syringes for Single Hypodermic Syringes for Single Use: Sterile Hypodermic Needles for Single Use; Sterile Safety Hypodermic Needles for Single Use

Indications for Use (Describe)

The Self-destruction Safety Syringes for Single Use are intended to be used for medical purposes to inject fluid into or withdraw fluid from body. Its secondary intended use is to retract inside the safety barrel, contain the contaminated needle and aid in the prevention of accidental needle stick injuries.

The Sterile Hypodermic Syringes for Single Use are intended to be used for medical purpose to inject fluid into or withdraw fluid from body.

The Sterile Hypodermic Needles for Single Use are intended to be used with a luer slip syringe and injection devices for general purpose fluid injection/aspiration.

The Sterile Safety Hypodermic Needles for Single Use are intended to be used with a luer slip or luer slip syringe for aspiration and injection of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needlestick.

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.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

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

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services

Department of Health and Human Services Food and Druq Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"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."

Tyne of Use (Select one or hoth, as annlicable)

3

510(k) Summary

This 510(k) Summary is being submitted in accordance with requirements of Title 21, CFR Section 807.92.

The assigned 510(k) Number: K180417

    1. Date of Preparation: 08/08/2018
    1. Sponsor Identification

BERPU MEDICAL TECHNOLOGY CO., LTD NO.14 Xingji Road, Yongxing Street, Longwan District, 325000, Wenzhou, Zhejiang Province

Establishment Registration Number: 3004496829

Contact Person: Jundong Tan Position: Management Representative Tel: +86-577-86651999 Fax: +86-577-86630389 Email: BERPU@BERPU.COM

    1. Designated Submission Correspondent
      Ms. Diana Hong (Primary Contact Person) Ms. Ying Xu (Alternative Contact Person)

Mid-Link Consulting Co., Ltd

P.O. Box 120-119, Shanghai, 200120, China

Tel: +86-21-22815850, Fax: 360-925-3199 Email: info@mid-link.net

4

4. Identification of Proposed Device

Trade Name: Self-destruction Safety Syringes for Single Use Sterile Hypodermic Syringes for Single Use Sterile Hypodermic Needles for Single Use Sterile Safety Hypodermic Needles for Single Use

Regulatory Information

Classification Name: Piston Syringe Classification: II Product Code: MEG (antistick syringe) Regulation Number: 21 CFR 880.5860 Review Panel: General Hospital

Classification Name: Piston Syringe Classification: II Product Code: FMF Regulation Number: 21 CFR 880.5860 Review Panel: General Hospital

Classification Name: Hypodermic single lumen needle Classification: II Product Code: FMI Regulation Number: 21 CFR 880.5570 Review Panel: General Hospital

Intended Use Statement:

The Self-destruction Safety Syringes for Single Use are intended to be used for medical purposes to inject fluid into or withdraw fluid from body. Its secondary intended use is to retract inside the safety barrel, contain the contaminated needle and aid in the prevention of accidental needle stick injuries.

The Sterile Hypodernic Syringes for Single Use are intended to be used for medical purpose to inject fluid into or withdraw fluid from body.

The Sterile Hypodermic Needles for Single Use are intended to be used with a luer slip or luer slip syringe and injection devices for general purpose fluid injection/aspiration.

The Sterile Safety Hypodermic Needles for Single Use are intended to be used with a luer slip or luer

5

slip syringe for aspiration and injection of fluids for medical purpose. After withdrawal of the needle from the body, the attached needle safety shield can be manually activated to cover the needle immediately after use to minimize risk of accidental needlestick.

Device Description

The Self-destruction Safety Syringes for Single Use are intended for single use only. The proposed device is available in 1mL, 3mL, 5mL, 10mL volumes with a 25 gauge, 25mm needle. The safety feature will be manually activated to retract the needle immediately after use to minimize risk of accidental needle sticks.

The Sterile Hypodermic Syringes for Single Use are intended for single use only, which consists of barrel, plunger and piston. The proposed device is available in 1mL, 2mL, 5mL, 10mL, 20mL, 30mL and 50mL volumes. The syringe is available in luer lock connector types which are intended to be connected with a hypodermic needle.

The Sterile Safety Hypodermic Needles for Single Use are intended for single use only, which consists of a hypodermic needle with a safety sheath attached to the needle hub. The proposed device is available in 18-27 gauge and 6-50 mm lengths. The safety sheath will be manually activated to cover the needle immediately after use to minimize risk of accidental needle sticks.

The Sterile Hypodermic Needles for Single Use are intended for single use only. The proposed device is available in 14-30 gauge and 6-60 mm lengths.

న్. Identification of Predicate and Reference Devices

Predicate Device 1 510(k) Number: K072739 Product Name: Retractable Auto-Disable Syringe for Single Use, with/without Needle Sterile Hypodermic Needle for Single Use Sterile Hypodermic Syringe for Single Use with/without Needle

Predicate Device 2 510(k) Number: K113422 Product Name: TERUMO® SurGuard® 3 Safety Needle

Reference Device 510(k) Number: K162180 Product Name: Disposable Insulin Syringe

6

6. Non-Clinical Test Conclusion

Non clinical tests were conducted to verify that the proposed device met all design specifications and is Substantially Equivalent (SE) to the predicate device. The test results demonstrate conformance with the related standard requirements and include the following:

Physical, Mechanical, Chemical testing were performed on all syringe volumes of Self-destruction Safety Syringes for Single Use and Sterile Hypodermic Syringes for Single Use, the test items include:

CleanlinessClause 5 of ISO 7886-1:1993
Limits for acidity or alkalinityClause 6 of ISO 7886-1:1993
Limits for extractable metalsClause 7 of ISO 7886-1:1993
LubricantClause 8 of ISO 7886-1:1993
Tolerance on graduated capacityClause 9 of ISO 7886-1:1993
Graduated scaleClause 10 of ISO 7886-1:1993
BarrelClause 11 of ISO 7886-1:1993
Piston/ plunger assemblyClause 12 of ISO 7886-1:1993
NozzleClause 13 of ISO 7886-1:1993
PerformanceClause 14 of ISO 7886-1:1993
For Safety syringe:
Safety FeatureISO 23908

Physical, Mechanical, Chemical testing were performed on all needle gauges and lengths of Sterile Hypodermic Needles for and Single Use Sterile Safety Hypodermic Needles for Single Use, the test items include:

7

CleanlinessClause 4.3 of ISO 7864:2016
Limits for acidity or alkalinityClause 4.4 of ISO 7864:2016
Limits for extractable metalsClause 4.5 of ISO 7864:2016
Size designationClause 4.6 of ISO 7864:2016
Colour codingClause 4.7 of ISO 7864:2016
and ISO 6009
Needle hubClause 4.8 of ISO 7864:2016
Needle CapClause 4.9 of ISO 7864:2016
Needle tubeClause 4.10 of ISO 7864:2016
Needle pointClause 4.11 of ISO 7864:2016
Bond between hub and needle tubeClause 4.12 of ISO 7864:2016
Patency of lumenClause 4.13 of ISO 7864:2016
Surface finishClause 5.2 of ISO 9626:2016
CleanlinessClause 5.3 of ISO 9626:2016
Limits for acidity and alkalinityClause 5.4 of ISO 9626:2016
Size designationClause 5.5 of ISO 9626:2016
DimensionsClause 5.6 of ISO 9626:2016
StiffnessClause 5.8 of ISO 9626:2016
Resistance to breakageClause 5.9 of ISO 9626:2016
Resistance to corrosionClause 5.10 of ISO 9626:2016

For Safety needle: Safety Feature

ISO 23908

Sterile Barrier Packaging Testing performed on the proposed device:

Seal strengthASTM F88/F88-15
Dye penetrationASTM F1929-15

Sterilization and Shelf Life Testing performed on the proposed device:

EO residueISO 10993-7:2008
ECH residueISO 10993-7:2008
Bacteria Endotoxin LimitUSP 38-NF 33
Shelf Life EvaluationPhysical, Mechanical, Chemical, Package Tests were performed on aging samples to verify the claimed shelf life of the device

8

1ml Self-destruction Safety Syringes for Single Use, 1ml Sterile Hypodermic Syringes for Single Use, 27G×20mm Sterile Safety Hypodermic Needles for Single Use and 30G×12mm Sterile Hypodermic Needles for Single Use are used for sterilization validation test.

The shelf life validation test was performed on syringe from 1ml to 50ml and needle gauge from 14G30G with 660mm length

Biocompatibility Testing:

The devices meet biocompatibility endpoints for cytotoxicity, irritation, systemic toxicity, hemolysis and material-mediated pyrogens. The data was supplied in the reference device submission, K162180, and the manufacturer certified that the devices, in their final finished form, are identical to the K162180 reference device (cleared 12/29/2016) in formulation, processing, sterilization, and geometry and no other chemicals have been added (e.g., plasticizers, fillers, cleaning agents, mold release agents).

Simulated Clinical Use

A simulated clinical use study was performed on 500 device samples each for the safety syringe and safety needles according to FDA Guidance, Guidance for Industry and FDA Staff: Medical Device with Sharps Injury Prevention Feature, issued on August 9, 2005 and ISO 23908 to evaluate the safety mechanism of the proposed device. The results demonstrated that the proposed device met the pre-established criteria.

7. Clinical Test Conclusion

No clinical study is included in this submission.

9

8. Substantially Equivalent (SE) Comparison

ITEMProposed DevicePredicate Device 1
Product CodeMEGK072739
Regulation No.21 CFR 880.5860Same
ClassCLASS IISame
Intended UseThe Self-destruction Safety Syringes for Single Use are intended to be used for medical purposes to inject fluid into or withdraw fluid from body. Its secondary intended use is to retract inside the safety barrel, contain the contaminated needle and aid in the prevention of accidental needle stick injuries.The Retractable Auto-Disable Syringe for single use with/without needle is intended to be used for medical purposes to inject fluid into or withdraw fluid from body. Its secondary intended use is to retract inside the safety barrel, contain the contaminated needle and aid in the prevention of accidental needle stick injuries.
Configuration
and materialBarrelPolypropylene (PP)Barrel
PlungerPolypropylene (PP)Plunger
PistonPolyisoprenePistonPP, Stainless Steel
Needle hubPolypropylene (PP)Needle hub
Needle tubeStainless SteelNeedle tube
Operation ModeFor manual use onlySame
Safety FeatureRetractedSame
Label/LabelingComply with 21 CFR part 801Same
Syringe Volume1ml, 3ml, 5ml, 10ml3ml, 5ml, 10ml
Connector TypeLuer LockSame
Needle Gauge25GUnknown
BiocompatibilityComply with ISO 10993Same
SterilizationEO SterilizationSame
SAL10-6Same
Single UseYesSame
Label/LabelingComplied with 21 CFR part 801Same

Table 1 Comparison of Technology Characteristics of Self-destruction Safety Syringes for Single Use

10

| ITEM | Proposed Device | Predicate Device 1
K072739 |
|-------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Product Code | FMF | Same |
| Regulation No. | 21 CFR 880.5860 | Same |
| Class | CLASS II | Same |
| Intended Use | The Sterile Hypodermic Syringes for Single Use are intended to be used for medical purpose to inject fluid into or withdraw fluid from body. | The Sterile Hypodermic Syringe for Single Use with/without needle is intended to be used for medical purpose to inject fluid into or withdraw fluid from body |
| Configuration
and material | Barrel | Barrel |
| | Plunger | Polypropylene (PP) |
| | Piston | Polyisoprene |
| Operation Mode | For manual use only | Same |
| Label/Labeling | Complied with 21 CFR part 801 | Same |
| Syringe Volume | 1ml, 2ml, 3ml, 5ml, 10ml, 20ml, 30ml, 50ml | 1ml, 2ml, 3ml, 5ml, 10ml, 20ml, 30ml, 50ml, 100ml |
| Connector Type | Luer Lock/ Luer slip | Same |
| Biocompatibility | Comply with ISO 10993 | Same |
| Sterilization | EO Sterilization | Same |
| SAL | 10-6 | Same |
| Single Use | Yes | Same |
| Label/Labeling | Comply with 21 CFR part 801 | Same |

Table 2 Comparison of Technology Characteristics of Sterile Hypodermic Syringes for Single Use

11

ITEMProposed DevicePredicate Device 1
K072739
Product CodeFMISame
Regulation No.21 CFR 880.5570Same
ClassCLASS IISame
Intended UseThe Sterile Hypodermic Needles for Single Use are intended to be used with a luer slip or luer slip syringe and injection devices for general purpose fluid injection/aspiration.The Sterile Hypodermic Needle for single use is intended for use with syringes and injection devices for general purpose fluid injection/aspiration.
Needle hub Polypropylene (PP)Needle hub
Protective cap Polypropylene (PP)Protective cap PP, Stainless Steel
Needle Stainless SteelNeedle tube
Operation ModeFor manual use onlySame
Label/LabelingComplied with 21 CFR part 801Same
Needle GaugeAvailable in14G, 15G, 16G, 17G, 18G, 19G, 20G, 21G, 22G, 23G, 24G, 25G, 26G, 27G, 29G, 30GAvailable in 16G, 18G, 19G, 20G, 21G, 22G, 23G, 24G, 25G, 26G, 27G, 29G
BiocompatibilityComply with ISO 10993Same
SterilizationEO SterilizationSame
SAL10-6Same
Single UseYesSame
Label/LabelingComply with 21 CFR part 801Same
Table 3 Comparison of Technology Characteristics of Sterile Hypodermic Needles for Single Use

12

| ITEM | Proposed Device | Predicate Device 1
K113422 |
|------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Product Code | FMI | Same |
| Regulation No. | 21 CFR 880.5570 | Same |
| Class | CLASS II | Same |
| Intended Use | The Sterile Safety Hypodermic Needles
for Single Use are intended to be used
with a luer slip or luer slip syringe for
aspiration and injection of fluids for
medical purpose. After withdrawal of the
needle from the body, the attached
needle safety shield can be manually
activated to cover the needle
immediately after use to minimize risk
of accidental needlestick. | The TERUMO® SurGuard® 3 Safety
Needle is intended for use in the aspiration
and injection of fluids for medical
purposes. The TERUMO® SurGuard® 3
Safety Needle is compatible for use with
standard luer slip and luer lock syringes. |
| Needle hub | Polypropylene (PP) | Needle hub |
| Protective cap | Polypropylene (PP) | Protective cap |
| Needle | Stainless Steel | Needle tube |
| Safety sheath | Polypropylene (PP) | Safety sheath |
| Operation Mode | For manual use only | Same |
| Safety Feature | Slide over the needle to prevent from
needle sticks | Same |
| Label/Labeling | Comply with 21 CFR part 801 | Same |
| Needle Gauge | Available in 18G, 19G, 20G, 21G, 22G,
23G, 24G, 25G, 26G, 27G | 18G~25G |
| Biocompatibility | Comply with ISO 10993 | Same |
| Sterilization | EO Sterilization | Irradiation Sterilization |
| SAL | 10-6 | Same |
| Single Use | Yes | Same |
| Label/Labeling | Complied with 21 CFR part 801 | Same |

Table 4 Comparison of Technology Characteristics of Sterile Safety Hypodermic Needles for Single Use

Substantially Equivalent (SE) Conclusion 9.

Based on the comparison and analysis above, the proposed devices are determined to be Substantially Equivalent (SE) to the predicate devices.