K Number
K183584
Device Name
JO H2O Jelly Original Personal Lubricant
Manufacturer
Date Cleared
2019-04-17

(117 days)

Product Code
Regulation Number
884.5300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
JO H2O Jelly Original Personal Lubricant is a personal lubricant for penile, anal and/or vaginal application, intended to lubricate and moisturize, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is compatible with natural rubber latex and polyisoprene condoms. This product is not compatible with polyurethane condoms.
Device Description
JO H2O Jelly Original Personal Lubricant is a clear/water white, viscous gel-type personal lubricant that is compatible with condoms made of natural rubber latex and polyisoprene. This product is not compatible with polyurethane condoms. This device is a non-sterile personal lubricant for penile, anal and/or vaginal application, to lubricate and moisturize, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is provided in clear, polyethylene (PE) tubes. These 4 oz. size tubes are capped with silver, glossy, polypropylene (PP) flip tops. The individual tubes are hermetically sealed during the production process.
More Information

Not Found

No
The device is a personal lubricant and the description focuses on its physical properties, intended use, and compatibility with condoms. There is no mention of any computational or analytical capabilities that would suggest the use of AI or ML.

Yes.
This device is described as a personal lubricant intended to enhance comfort during intimate sexual activity and supplement natural lubrication, which aligns with the definition of a therapeutic device designed to alleviate or improve a condition or function.

No

Explanation: The device is a personal lubricant intended to enhance comfort during intimate activity, not to diagnose any medical condition.

No

The device description clearly states it is a "viscous gel-type personal lubricant" and is provided in "polyethylene (PE) tubes," indicating it is a physical product, not 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 "personal lubricant for penile, anal and/or vaginal application, intended to lubricate and moisturize, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication." This describes a topical application for physical lubrication, not a test performed in vitro (outside the body) on biological samples to diagnose a condition.
  • Device Description: The description details a "viscous gel-type personal lubricant" for direct application to the body. This aligns with a personal lubricant, not an IVD.
  • Lack of IVD Characteristics: The description does not mention any components or processes typically associated with IVDs, such as reagents, assays, analysis of biological samples (blood, urine, tissue, etc.), or diagnostic purposes.

Therefore, JO H2O Jelly Original Personal Lubricant is a personal lubricant, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

JO H2O Jelly Original Personal Lubricant is a personal lubricant for penile, anal and/or vaginal application, intended to lubricate and moisturize, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is compatible with natural rubber latex and polyisoprene condoms. This product is not compatible with polyurethane condoms.

Product codes

NUC

Device Description

JO H2O Jelly Original Personal Lubricant is a clear/water white, viscous gel-type personal lubricant that is compatible with condoms made of natural rubber latex and polyisoprene. This product is not compatible with polyurethane condoms. This device is a non-sterile personal lubricant for penile, anal and/or vaginal application, to lubricate and moisturize, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is provided in clear, polyethylene (PE) tubes. These 4 oz. size tubes are capped with silver, glossy, polypropylene (PP) flip tops. The individual tubes are hermetically sealed during the production process.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

penile, anal and/or vaginal

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)

Biocompatibility studies were performed in accordance with ISO 10993-1:2009 and the 2016 FDA guidance document. Testing included Acute Systemic Toxicity, Vaginal Irritation Testing, Penile Irritation Testing, Cytotoxicity and Sensitization testing. The results demonstrated that the lubricant is biocompatible.

Shelf-Life: An accelerated and real-time aging study supported a two-year shelf-life. All device specifications (Table 1) were tested at 0, 1, and 2 years and met the criteria at all time points.

Condom Compatibility: Compatibility with natural rubber latex, polyisoprene, and polyurethane condoms was evaluated per ASTM D7661-10. Results indicated compatibility with natural rubber latex and polyisoprene condoms, but not with polyurethane condoms.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K171021

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 884.5300 Condom.

(a)
Identification. A condom is a sheath which completely covers the penis with a closely fitting membrane. The condom is used for contraceptive and for prophylactic purposes (preventing transmission of sexually transmitted infections). The device may also be used to collect semen to aid in the diagnosis of infertility.(b)
Classification. (1) Class II (special controls) for condoms made of materials other than natural rubber latex, including natural membrane (skin) or synthetic.(2) Class II (special controls) for natural rubber latex condoms. The guidance document entitled “Class II Special Controls Guidance Document: Labeling for Natural Rubber Latex Condoms Classified Under 21 CFR 884.5300” will serve as the special control. See § 884.1(e) for the availability of this guidance document.

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Image /page/0/Picture/0 description: The image contains the logos of the U.S. Department of Health & Human Services and the U.S. Food & Drug Administration (FDA). The Department of Health & Human Services logo is on the left and features a stylized human figure. The FDA logo is on the right and includes the FDA acronym in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

April 17, 2019

United Consortium Stephanie Morris Global Regulatory Specialist 29000 N. Hancock Pkwy. Valencia, CA 91355

Re: K183584

Trade/Device Name: JO H2O Jelly Original Personal Lubricant Regulation Number: 21 CFR§ 884.5300 Regulation Name: Condom Regulatory Class: II Product Code: NUC Dated: March 15, 2019 Received: March 18, 2019

Dear Stephanie Morris:

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.

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.

1

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.html; good manufacturing practice requirements as set forth in the quality systems (QS) 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 mediation-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,

Jason Roberts -S 2019.04.17 15:32:11 -04'00'

for

Benjamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K183584

Device Name JO H2O Jelly Original Personal Lubricant

Indications for Use (Describe)

JO H2O Jelly Original Personal Lubricant is a personal lubricant for penile, anal and/or vaginal application, intended to lubricate and moisturize, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is compatible with natural rubber latex and

polyisoprene condoms. This product is not compatible with polyurethane condoms.

Prescription Use (Part 21 CFR 801 Subpart D)

X Over-The-Counter Use (21 CFR 801 Subpart C)

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510 (k) Summary - K183584

1. Submitter Information

Applicant:United Consortium
Contact:Stephanie Morris
Global Regulatory Specialist

Bruce Albert Head of Technical Services Address: 29000 N. Hancock Parkway Valencia. CA 91355 Phone: (661) 295-1700, ext. 232 Phone: (661) 295-1700, ext. 231 FAX: (661) 295-1800

2. Correspondent Information

Contact:Stephanie Morris
Address:29000 N. Hancock Parkway
Valencia, CA 91355
Phone:(661) 295-1700, ext. 232
Fax:(661) 295-1800
Email:smorris@systemjo.com

3. Date prepared: April 16, 2019

4. Device Information

Device Name:JO H2O Jelly Original Personal Lubricant
Common Name:Personal Lubricant
Regulation Number:21 CFR 884.5300
Regulation Name:Condom
Regulatory Class:Class II
Product Code:NUC (lubricant, personal)

5. Predicate Device Information

Device Name:JO Agapé Personal Lubricant
510(k) Number:K171021
Manufacturer:United Consortium
Regulatory Class:Class II
Product Code:NUC (lubricant, personal)

The predicate device has not been subject to a design-related recall.

6. Device Description

JO H2O Jelly Original Personal Lubricant is a clear/water white, viscous gel-type personal lubricant that is compatible with condoms made of natural rubber latex and polyisoprene. This product is not compatible with polyurethane condoms. This device is a non-sterile personal lubricant for penile, anal and/or vaginal application, to lubricate and moisturize, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is provided in clear, polyethylene (PE) tubes. These 4 oz. size tubes are capped with silver, glossy, polypropylene (PP) flip tops. The individual tubes are hermetically sealed during the production process. The device specifications are listed in the table below:

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PropertySpecification
AppearanceViscous gel
ColorClear, water white
OdorOdorless
Viscosity (cps)15,500 cps to 35,000 cps
pH4.00 to 5.00
Specific Gravity1.000 to 1.200
Osmolality1050 to 1250 mOsm/kg
Antimicrobial effectiveness per USPMeets US acceptance criteria for
Category 2 products
Total aerobic microbial count (TAMC) per
USP andLess than 10 cfu/g
Total yeast and mold count (TYMC) per
USP andLess than 10 cfu/g
Presence of Pathogens per USPSpecification
Pseudomonas aeruginosaAbsent
Staphylococcus aureusAbsent
Salmonella/ShigellaAbsent
Escherichia coliAbsent
Candida albicansAbsent

Table 1: Device Specifications for JO H2O Jelly Original Personal Lubricant

7. Indications for Use

JO H2O Jelly Original Personal Lubricant is a personal lubricant for penile, anal and/or vaginal application, intended to lubricate and moisturize, to enhance the ease and comfort of intimate sexual activity and supplement the body's natural lubrication. This product is compatible with natural rubber latex and polyisoprene condoms. This product is not compatible with polyurethane condoms.

    1. Comparison of Intended Use and Technological Characteristics with the Predicate Device The table below lists the comparative indications for use and technological characteristics of the subject and predicate device.

Table 2: Comparator Table for Subject Device - JO H2O Jelly Original Personal Lubricant and Predicate Device JO Agapé Personal Lubricant

| Feature | JO H2O Jelly Original
Personal Lubricant | JO Agapé Personal
Lubricant (K171021) |
|-------------------------------|---------------------------------------------|------------------------------------------|
| Device Classification
Name | Lubricant, Personal | Lubricant, Personal |
| Product Code | NUC | NUC |

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| Feature | JO H2O Jelly Original
Personal Lubricant | JO Agapé Personal
Lubricant (K171021) |
|-------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Indications for Use | JO H2O Jelly Original Personal
Lubricant is a personal lubricant
for penile, anal and/or vaginal
application, intended to lubricate
and moisturize, to enhance the
ease and comfort of intimate
sexual activity and supplement
the body's natural lubrication.
This product is compatible with
natural rubber latex and
polyisoprene condoms.
This product is not compatible
with polyurethane condoms. | JO Agapé Personal Lubricant is
a water-based personal
lubricant for penile and/or
vaginal application, intended to
lubricate and moisturize, to
enhance the
ease and comfort of intimate
sexual activity and supplement
the body's natural lubrication.
This product is compatible with
natural rubber latex and
polyisoprene condoms. This
product is
not compatible with
polyurethane condoms. |
| Water soluble | Yes | Yes |
| Contains water | Yes | Yes |
| Primary ingredients | Glycerine USP, Natrosol 250
HHX, Aqualon Sodium
Carboxymethyl Cellulose 7H
35F, Water (Aqua), Norsene
100, Sodium Benzoate,
Potassium Sorbate, PREMIX
Citric
Acid 50% Blend | Propanedile,
Hydroxyethylcellulose,
Water (Aqua),
Gluconolactone, Sodium
Benzoate, Citric Acid |
| Over the counter use | Yes | Yes |
| Sterile | No | No |
| Condom Compatibility | Natural Rubber Latex,
Polyisoprene | Natural Rubber
Latex, Polyisoprene |
| Biocompatibility Tested | Yes | Yes |
| Antimicrobial Tested | Yes | Yes |
| Shelf life | 2 years | 3 years |

The subject and predicate device have similar indications for use. The indication for the subject device has been expanded to also include anal use. This change does not represent a new intended use as the intended use of this device is the same as the predicate device, i.e., lubrication of an orifice during intimate sexual activity. The subject and predicate device have similar technological characteristics, including similar formulation. The different technological characteristics of the subject device do not raise different types of safety and effectiveness questions.

9. Summary of Non-Clinical Performance Testing

Biocompatibility

Biocompatibility studies, including Acute Systemic Toxicity, Vaginal Irritation Testing, Penile Irritation Testing, Cytotoxicity and Sensitization testing were performed in accordance with the 2016 FDA guidance document Use of International Standard ISO 10993-1, "Biological Evaluation of Medical Devices - Part 1: Evaluation and testing within a risk management process" and ISO 10993- 1:2009 as follows:

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  • Cytotoxicity (ISO 10993-5:2009) ●
  • Sensitization (ISO 10993-10:2010) ●
  • Vaginal Irritation (ISO 10993-10:2010)
  • Penile Irritation (ISO 10993-10:2010)
  • Acute Systemic Toxicity (ISO 10993-11:2006)

The results of this testing demonstrated that the subject lubricant is biocompatible.

Shelf-Life

The subject device is a non-sterile personal lubricant with a two-year shelf-life in accordance with the results of a real time and accelerated aging study. All device specifications listed in Table 1 were tested at 0, 1 and 2 years. The subject device met the device specifications at all time points.

Condom Compatibility

The compatibility of the subject device with natural rubber latex, polyisoprene and polyurethane condoms was evaluated in accordance with ASTM D7661-10 Standard Test Method for Determining Compatibility of Personal Lubricants with Natural Rubber Latex Condoms. The results of this test indicated that JO H2O Jelly Original Personal Lubricant is compatible with natural rubber latex and polyisoprene condoms. This device is not compatible with polyurethane condoms.

10. Conclusion

The results of the performance testing described above demonstrate that the JO H2O Jelly Original Personal Lubricant is as safe and effective as the predicate device and supports a determination of substantial equivalence.