K Number
K181150
Device Name
ProtekDuo Mini Veno-Venous Cannula Set
Manufacturer
Date Cleared
2018-05-25

(24 days)

Product Code
Regulation Number
870.4210
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The ProtekDuo Mini Veno-Venous Cannula Set is intended for use as a single cannula for both venous drainage and reinfusion of blood via an internal jugular vein during extracorporeal life support procedures.
Device Description
The ProtekDuo Mini Veno-Venous Cannula Set consists of two components: a 31 Fr. Dual Lumen Veno-Venous Cannula and a 15.5 Fr. Introducer is designed to accept a standard 0.038 inch guidewire. The ProtekDuo Mini Veno-Venous Cannula Set is intended as a single patient, single use, sterile device. The ProtekDuo Mini Veno-Venous Cannula (Figure 5-1) consists of two distinct lumens with a wire-reinforced cannula body. The inner lumen is located entirely within the outer lumen forming two concentric channels. The distal section (inner lumen/cannula) of the cannula body has six side holes near the distal tip opening. The proximal sections of each lumen are clear and not wire-reinforced to allow visualization of blood and to enable clamping to prevent blood flow during setup and removal of the cannula from the extracorporeal circulatory support equipment (see Figure 5-1). A non-vented barbed connector is affixed to both proximal ends (inner/distal and outer/proximal lumens) of the cannula and allow for connection of standard 3/8 inch blood circuit tubing for subsequent connection to extracorporeal circulatory support equipment. The introducer (Figure 5-2) consists of a tube with a luer hub. The introducer fits inside the inner lumen of the cannula during insertion of the cannula/introducer assembly. The introducer is used to advance the cannula over a guidewire and facilitate cannula placement within the target vessel. The introducer has a luer hub at its proximal end to manage introducer insertion and removal from the cannula. The luer hub can also enable contrast injection, if necessary, to facilitate placement and final positioning of the cannula within the target vessel. The hemostasis cap minimizes blood loss when the cannula/introducer assembly is inserted into the target vessel. The introducer body is constructed from radiopaque material for visualization under fluoroscopy.
More Information

Not Found

No
The description focuses solely on the physical components and mechanical performance of a cannula set. There is no mention of software, algorithms, or data processing that would indicate the presence of AI/ML.

No.
The device is a cannula set used during extracorporeal life support procedures, which is a supportive intervention, not a therapeutic treatment itself. It facilitates blood drainage and reinfusion but does not directly treat a disease or condition.

No

The device is a cannula set used for veno-venous cannulation during extracorporeal life support procedures, facilitating the drainage and reinfusion of blood. It is an interventional device, not a diagnostic one.

No

The device description clearly details physical components (cannula, introducer) and their material properties and mechanical testing, indicating it is a hardware device.

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

Here's why:

  • Intended Use: The intended use is for "venous drainage and reinfusion of blood via an internal jugular vein during extracorporeal life support procedures." This describes a procedure performed on the patient's body, not a test performed on a sample taken from the body.
  • Device Description: The device is a cannula and introducer designed for insertion into a blood vessel. This is a surgical/interventional device, not a device used to analyze biological samples.
  • Lack of IVD Characteristics: There is no mention of analyzing blood or other biological samples, detecting specific analytes, or providing diagnostic information based on laboratory testing.

IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for the diagnosis, prevention, monitoring, treatment, or alleviation of disease. This device's function is to facilitate blood flow during a medical procedure, not to perform diagnostic testing on a sample.

N/A

Intended Use / Indications for Use

The ProtekDuo Mini Veno-Venous Cannula Set is intended for use as a single cannula for both venous drainage and reinfusion of blood via an internal jugular vein during extracorporeal life support procedures.

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

DWF

Device Description

The ProtekDuo Mini Veno-Venous Cannula Set consists of two components: a 31 Fr. Dual Lumen Veno-Venous Cannula and a 15.5 Fr. Introducer is designed to accept a standard 0.038 inch guidewire. The ProtekDuo Mini Veno-Venous Cannula Set is intended as a single patient, single use, sterile device.

The ProtekDuo Mini Veno-Venous Cannula (Figure 5-1) consists of two distinct lumens with a wire-reinforced cannula body. The inner lumen is located entirely within the outer lumen forming two concentric channels.

The distal section (inner lumen/cannula) of the cannula body has six side holes near the distal tip opening. The proximal sections of each lumen are clear and not wire-reinforced to allow visualization of blood and to enable clamping to prevent blood flow during setup and removal of the cannula from the extracorporeal circulatory support equipment (see Figure 5-1). A non-vented barbed connector is affixed to both proximal ends (inner/distal and outer/proximal lumens) of the cannula and allow for connection of standard 3/8 inch blood circuit tubing for subsequent connection to extracorporeal circulatory support equipment.

The introducer (Figure 5-2) consists of a tube with a luer hub. The introducer fits inside the inner lumen of the cannula during insertion of the cannula/introducer assembly. The introducer is used to advance the cannula over a guidewire and facilitate cannula placement within the target vessel. The introducer has a luer hub at its proximal end to manage introducer insertion and removal from the cannula. The luer hub can also enable contrast injection, if necessary, to facilitate placement and final positioning of the cannula within the target vessel. The hemostasis cap minimizes blood loss when the cannula/introducer assembly is inserted into the target vessel. The introducer body is constructed from radiopaque material for visualization under fluoroscopy.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

internal jugular vein

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Non-clinical testing included:

  • Comparative Hemolysis: Side-by-side comparison with predicate of bench top hemolysis levels over 6 hours. Conclusion: No difference in hemolysis levels between test articles and predicate controls.
  • Pressure-Flow: Measure pressure losses across cannula at different flow rates. Conclusion: Measured flow rates exceed the longer predicate at all levels of pressure difference across the cannula. Design specifications were met.
  • Tensile Strength: Pull testing of both cannula and introducer. Conclusion: Acceptance criteria were identical to those of the predicate and were met in all tests.
  • Pathway Integrity: Pressure testing. Conclusion: Acceptance criterion was identical to that of the predicate and was met in all tests.
  • Kink Radius: Flow rate reduction caused by specified minimum bend radius was measured. Conclusion: Acceptance criterion was identical to that of the predicate and was met in all tests.
  • Stiffness: Deflection testing to measure force required to bend cannula a specified distance. Conclusion: The cannula, the introducer, and the cannula/introducer assembly met acceptance criteria established to ensure the cannula is stiff enough to insert while remaining flexible enough to avoid vessel injury.

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.

K160257

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

§ 870.4210 Cardiopulmonary bypass vascular catheter, cannula, or tubing.

(a)
Identification. A cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to cannulate the vessels, perfuse the coronary arteries, and to interconnect the catheters and cannulas with an oxygenator. The device includes accessory bypass equipment.(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). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo features the letters 'FDA' in a blue square, followed by the words 'U.S. FOOD & DRUG ADMINISTRATION' in blue text.

May 25, 2018

CardiacAssist Inc Greg Johnson VP, Regulatory Affairs and Quality Assurance 240 Alpha Drive Pittsburg, Pennsylvania 15238

Re: K181150

Trade/Device Name: ProtekDuo Mini Veno-Venous Cannula Set Regulation Number: 21 CFR 870.4210 Regulation Name: Cardiopulmonary Bypass Vascular Catheter, Cannula, Or Tubing Regulatory Class: Class II Product Code: DWF Dated: April 30, 2018 Received: May 1, 2018

Dear Greg Johnson:

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 (OS) 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,

Nicole G. Ibrahim -S

for Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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| DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration
Form Approved: OMB No. 0910-0120
Expiration Date: 06/30/2020
See PRA Statement below.

Indications for Use

510(k) Number (if known)K181150
Device NameProtekDuo Mini Veno-Venous Cannula Set
Indications for Use (Describe)The ProtekDuo Mini Veno-Venous Cannula Set is intended for use as a single cannula for both venous drainage and reinfusion of blood via an internal jugular vein during extracorporeal life support procedures.
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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Company of the country of the country of the country of the

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TANDEM LIFE

Section 5 510(k) Summary 510(k) Special

Date: 30 April 2018

Applicant

CardiacAssist, Inc. dba TandemLife 240 Alpha Drive Pittsburgh, PA 15238 Telephone: 412-963-7770 Fax: 412-963-0800

Contact person

Greg Johnson, PhD Title: VP, Regulatory Affairs and Quality Assurance Phone: 412-963-7770 x266 e-mail: gjohnson@tandemlife.com

Device

Trade/Proprietary Name:ProtekDuo Mini Veno-Venous Cannula Set
Common Name:Veno-Venous Cannula Set
Classification Name:Cardiopulmonary bypass vascular catheter, cannula, or tubing (21 CFR 870.4210 Product Code DWF)

Predicate Device

TandemHeart 31 Fr. (31 Fr. ProtekDuo) Veno-Venous Cannula Set (K160257) (marketed under Trade Name: 31 Fr. ProtekDuo)

Device Description

The ProtekDuo Mini Veno-Venous Cannula Set consists of two components: a 31 Fr. Dual Lumen Veno-Venous Cannula and a 15.5 Fr. Introducer is designed to accept a standard 0.038 inch guidewire. The ProtekDuo Mini Veno-Venous Cannula Set is intended as a single patient, single use, sterile device.

Image /page/3/Figure/13 description: The image shows a technical drawing of a medical device. The device has barbed connectors on one end and insertion depth markers labeled 36, 34, and 32. There are also tantalum markers and a wire-reinforced area labeled with numbers 18, 16, and 14.

Figure 5-1. ProtekDuo Mini Veno-Venous Cannula

4

TANDEM LIFE

Section 5 510(k) Summary 510(k) Special

The ProtekDuo Mini Veno-Venous Cannula (Figure 5-1) consists of two distinct lumens with a wire-reinforced cannula body. The inner lumen is located entirely within the outer lumen forming two concentric channels.

The distal section (inner lumen/cannula) of the cannula body has six side holes near the distal tip opening. The proximal sections of each lumen are clear and not wire-reinforced to allow visualization of blood and to enable clamping to prevent blood flow during setup and removal of the cannula from the extracorporeal circulatory support equipment (see Figure 5-1). A non-vented barbed connector is affixed to both proximal ends (inner/distal and outer/proximal lumens) of the cannula and allow for connection of standard 3/8 inch blood circuit tubing for subsequent connection to extracorporeal circulatory support equipment.

The introducer (Figure 5-2) consists of a tube with a luer hub. The introducer fits inside the inner lumen of the cannula during insertion of the cannula/introducer assembly. The introducer is used to advance the cannula over a guidewire and facilitate cannula placement within the target vessel. The introducer has a luer hub at its proximal end to manage introducer insertion and removal from the cannula. The luer hub can also enable contrast injection, if necessary, to facilitate placement and final positioning of the cannula within the target vessel. The hemostasis cap minimizes blood loss when the cannula/introducer assembly is inserted into the target vessel. The introducer body is constructed from radiopaque material for visualization under fluoroscopy.

Image /page/4/Figure/5 description: The image shows a medical device, specifically an introducer needle, with labels pointing to its components. The "Introducer Hub" is labeled at the left end of the needle, which is the part that connects to other medical equipment. The "Hemostasis Cap" is labeled near the hub, indicating a component that helps control bleeding during insertion.

Figure 5-2: 15.5 Fr. Introducer

Indications for Use

The ProtekDuo Mini Veno-Venous Cannula Set is intended for use as a single cannula for both venous drainage and reinfusion of blood via an internal jugular vein during extracorporeal life support procedures.

Comparison of Technological Characteristics

ProtekDuo Mini Veno-Venous Cannula Set is an extension to the ProtekDuo Veno-Venous Cannula Family. It is identical to the TandemHeart 31 Fr. (31 Fr. ProtekDuo) Veno-Venous Cannula Set, except the distal lumen is approximately 14.2 cm shorter in length. The introducer is also approximately 14.2 cm shorter. It is designed for the same

5

TANDEM LIFE

Section 5 510(k) Summary 510(k) Special

intended use as the TandemHeart 31 Fr. (31 Fr. ProtekDuo) Veno-Venous Cannula Set. All materials and methods of manufacture are identical.

Summary of Non-clinical Testing

Testing of the ProtekDuo Mini Veno-Venous Cannula Set included comparative hemolysis, pressure-flow testing, tensile strength, pathway integrity, kink radius, and stiffness.

TestMethodConclusion
Comparative
HemolysisSide-by-side comparison with
predicate of bench top
hemolysis levels over 6 hours.No difference in hemolysis levels
between test articles and predicate
controls.
Pressure-FlowMeasure pressure losses across
cannula at different flow rates.Measured flow rates exceed the
longer predicate at all levels of
pressure difference across the
cannula. Design specifications
were met.
Tensile StrengthPull testing of both cannula and
introducerAcceptance criteria were identical
to those of the predicate and were
met in all tests.
Pathway IntegrityPressure testingAcceptance criterion was identical
to that of the predicate and was met
in all tests.
Kink RadiusFlow rate reduction caused by
specified minimum bend radius
was measuredAcceptance criterion was identical
to that of the predicate and was met
in all tests.
StiffnessDeflection testing to measure
force required to bend cannula
a specified distanceThe cannula, the introducer, and the
cannula/introducer assembly met
acceptance criteria established to
ensure the cannula is stiff enough to
insert while remaining flexible
enough to avoid vessel injury.

Conclusion

The ProtekDuo Mini Veno-Venous Cannula Set is made from the same materials, using the same manufacturing processes and sterilization techniques as the predicate device. Testing demonstrated that hemolysis, tensile strength, pathway integrity, and kink radius are identical to the predicate. Stiffness and pressure-flow properties differed as expected for the shorter length cannula and met established acceptance criteria. The ProtekDuo Mini Veno-Venous Cannula Set is determined to be substantially equivalent to the predicate TandemHeart 31 Fr. (31 Fr. ProtekDuo) Veno-Venous Cannula Set.

{End of Section}