K Number
K191246
Device Name
Paragon Adult Maxi PMP Oxygenator (Model: XCMOP405PMP)
Date Cleared
2020-02-28

(295 days)

Product Code
Regulation Number
870.4350
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Paragon Adult Maxi PMP oxygenator is a hollow fiber membrane oxygenator intended for physiologic gas exchange in adults and small adults undergoing cardopulmonary bypass surgery. The integrated heat exchanger makes it possible to regulate the blood temperature. The Paragon Adult Maxi PMP Oxygenator is intended for up to 6 hours.
Device Description
The Paragon Adult Maxi PMP oxygenator (Paragon Maxi) is a hollow fiber membrane oxygenator with an integrated heat exchanger. The Paragon Maxi facilitates the gas exchange into and out of the blood, and the regulation of blood temperature during cardiopulmonary bypass. The Paragon Maxi is supplied with a Rheopak surface coating that reduces platelet adhesion to coated surfaces. The gas exchanger part of the Paragon Maxi is formed of plasma tight hollow fiber membranes. The gas flow takes place through the inner lumen of the fibers. Blood is in contact with the outer side of the membranes, so that oxygen can diffuse into the venous blood, while carbon dioxide diffuses out of the blood. The heat exchanging part of the Paragon Maxi is made of non-porous hollow fiber membranes. Water flows through the inner lumen of the fibers, so that blood temperature flowing outside is regulated.
More Information

Sorin Group Italia Inspire 8M (K122254)

Not Found

No
The summary describes a mechanical device for gas exchange and temperature regulation during cardiopulmonary bypass, with no mention of AI or ML capabilities.

Yes
The device is intended for physiologic gas exchange and regulation of blood temperature during cardiopulmonary bypass surgery, directly treating a physiological condition.

No

Explanation: The device is an oxygenator and heat exchanger used during cardiopulmonary bypass surgery for gas exchange and temperature regulation, not for diagnosing medical conditions.

No

The device description clearly details a physical medical device with hardware components (hollow fiber membranes, heat exchanger, surface coating) designed for physiological gas exchange and temperature regulation during cardiopulmonary bypass surgery. It is not a software-only device.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used to provide information for diagnosis, monitoring, or screening.
  • Device Function: The Paragon Adult Maxi PMP oxygenator is a medical device used during cardiopulmonary bypass surgery. Its function is to perform physiological gas exchange (oxygen and carbon dioxide) and regulate blood temperature within the patient's circulatory system. It is not analyzing samples taken from the body.
  • Intended Use: The intended use clearly states it's for "physiologic gas exchange in adults and small adults undergoing cardopulmonary bypass surgery." This describes a therapeutic intervention, not a diagnostic test.
  • Device Description: The description details how the device interacts with blood in vivo (within the body) to facilitate gas exchange and temperature regulation.

Therefore, the Paragon Adult Maxi PMP oxygenator is a therapeutic medical device used during surgery, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Paragon Adult Maxi PMP oxygenator is a hollow fiber membrane oxygenator intended for physiologic gas exchange in adults and small adults undergoing cardopulmonary bypass surgery. The integrated heat exchanger makes it possible to regulate the blood temperature. The Paragon Adult Maxi PMP Oxygenator is intended for up to 6 hours.

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

DTZ, DTR

Device Description

The Paragon Adult Maxi PMP oxygenator (Paragon Maxi) is a hollow fiber membrane oxygenator with an integrated heat exchanger. The Paragon Maxi facilitates the gas exchange into and out of the blood, and the regulation of blood temperature during cardiopulmonary bypass. The Paragon Maxi is supplied with a Rheopak surface coating that reduces platelet adhesion to coated surfaces.

The gas exchanger part of the Paragon Maxi is formed of plasma tight hollow fiber membranes. The gas flow takes place through the inner lumen of the fibers. Blood is in contact with the outer side of the membranes, so that oxygen can diffuse into the venous blood, while carbon dioxide diffuses out of the blood. The heat exchanging part of the Paragon Maxi is made of non-porous hollow fiber membranes. Water flows through the inner lumen of the fibers, so that blood temperature flowing outside is regulated.

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

Adults and small adults

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)

Performance testing has been planned and conducted in accordance with the requirements of the following:

  • . FDA's Guidance for Cardiopulmonary Bypass Oxygenators (2000),
  • . ISO 7199:2016 Cardiovascular implants and artificial organs — Blood-gas exchangers (oxygenators),
  • ISO 15676:2016 Cardiovascular implants and artificial organs --. Requirements for single-use tubing packs for cardiopulmonary bypass and extracorporeal membrane oxygenation (ECMO),

The following performance characteristics were evaluated for the Paragon Maxi:

TestMethodConclusion
Blood Pathway IntegrityNon-comparativeAcceptance criteria met by the devices.
Heat Exchanger Fluid Pathway IntegrityNon-comparativeAcceptance criteria met by the devices.
Gas Pathway IntegrityNon-comparativeAcceptance criteria met by the devices.
Connector securityNon-comparativeAcceptance criteria met by the devices.
Coating CharacterizationNon-comparativeAcceptance criteria met by the devices.
Oxygen Transfer RatesComparativeNo statistically significant difference in the O2 transfer rates of the Paragon Maxi oxygenator and the predicate.
Carbon Dioxide Transfer RatesComparativeNo statistically significant difference in the CO2 transfer rates of the Paragon Maxi oxygenator and the predicate.
Blood Side Pressure DropComparativeThe Paragon Maxi has a lower blood side pressure drop than the predicate oxygenator as a consequence of slight differences in the oxygenator design.
Heat Exchanger Performance FactorComparativeNo statistically significant difference in the heat exchanger performance of the Paragon Maxi oxygenator and the predicate.
Blood cell damageComparativeNo statistically significant difference in the blood cell damage test results (e.g. hemolysis, white blood cell count, platelet count) of the Paragon Maxi oxygenator and the predicate.

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.

Sorin Group Italia Inspire 8M (K122254)

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

§ 870.4350 Cardiopulmonary bypass oxygenator.

(a)
Identification. A cardiopulmonary bypass oxygenator is a device used to exchange gases between blood and a gaseous environment to satisfy the gas exchange needs of a patient during open-heart surgery.(b)
Classification. Class II (special controls). The special control for this device is the FDA guidance document entitled “Guidance for Cardiopulmonary Bypass Oxygenators 510(k) Submissions.”

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February 28, 2020

Chalice Medical Ltd Carol Middleton Quality Manager Manton Wood Enterprise Park, Worksop. S80 2RS Gb

Re: K191246

Trade/Device Name: Paragon Adult Maxi PMP Oxygenator (Model: XCMOP405PMP) Regulation Number: 21 CFR 870.4350 Regulation Name: Cardiopulmonary Bypass Oxygenator Regulatory Class: Class II Product Code: DTZ, DTR Dated: January 2, 2020 Received: January 6, 2020

Dear Carol Middleton:

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. 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

1

https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

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/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Fernando Aguel for Assistant Director DHT2B: Division of Circulatory Support, Structural and Vascular Devices OHT2: Office of Cardiovascular Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K191246

Device Name

Paragon Adult Maxi PMP Oxygenator (Model: XCMOP405PMP)

Indications for Use (Describe)

The Paragon Adult Maxi PMP oxygenator is a hollow fiber membrane oxygenator intended for physiologic gas exchange in adults and small adults undergoing cardopulmonary bypass surgery. The integrated heat exchanger makes it possible to regulate the blood temperature. The Paragon Adult Maxi PMP Oxygenator is intended for up to 6 hours.

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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Image /page/3/Picture/1 description: The image is a logo for Chalice. The logo consists of a circular symbol on the left and the word "chalice" in blue on the right. Below the word "chalice" is the phrase "operate your way" in a smaller, red font. The circular symbol is made up of several concentric circles.

2. 510(k) Summary

Date Prepared:21st February 2020
Submitter's Name
and AddressChalice Medical Ltd
Manton Wood Enterprise Park,
Worksop, Nottinghamshire,
S80 2RS,
United Kingdom
Contact Person:Carol Middleton
Quality Manager, Chalice Medical Ltd
Phone: +44 1909 470 777
Email: cmiddleton@chalicemedical.com
Alternate Contact:Stephen Horan
Project Manager
Phone: +44 1909 470 777
Email: shoran@chalicemedical.com
Proprietary Name:Paragon Adult Maxi PMP Oxygenator (Model:
XCMOP405PMP)
Common Name:Hollow fiber membrane oxygenator with an
integrated heat exchanger.
Requlation Name:Cardiopulmonary Bypass Oxygenator
Regulation Number:870.4350, 870.4240
Product Code:DTZ, DTR
Regulatory Class:Class II
510(k) Review PanelCardiovascular
Predicate DeviceSorin Group Italia Inspire 8M (K122254)

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5.1 Device Description

The Paragon Adult Maxi PMP oxygenator (Paragon Maxi) is a hollow fiber membrane oxygenator with an integrated heat exchanger. The Paragon Maxi facilitates the gas exchange into and out of the blood, and the regulation of blood temperature during cardiopulmonary bypass. The Paragon Maxi is supplied with a Rheopak surface coating that reduces platelet adhesion to coated surfaces.

The gas exchanger part of the Paragon Maxi is formed of plasma tight hollow fiber membranes. The gas flow takes place through the inner lumen of the fibers. Blood is in contact with the outer side of the membranes, so that oxygen can diffuse into the venous blood, while carbon dioxide diffuses out of the blood. The heat exchanging part of the Paragon Maxi is made of non-porous hollow fiber membranes. Water flows through the inner lumen of the fibers, so that blood temperature flowing outside is regulated.

5.2 Indications for Use

Paragon Adult Maxi PMP Oxygenators (Model: XCMOP405PMP)

The Paragon Adult Maxi PMP oxygenator is a hollow fiber membrane oxygenator intended for physiologic gas exchange in adults and small adults undergoing cardiopulmonary bypass surgery. The integrated heat exchanger makes it possible to regulate the blood temperature. The Paragon Adult Maxi PMP Oxygenator is intended for clinical use for up to 6 hours.

5.3 Technological Characteristics

The Paragon Maxi has been compared with a predicate device and found to be substantially equivalent. The devices have the following similarities:

  • Same intended use, ●
  • Same operating principle, ●
  • Same fundamental technological characteristics, .
  • . Same biological status (i.e. sterile, non-pyrogenic),
  • . Similar base materials,
  • Similar packaging materials and configurations,
  • Same methods of sterilisation. ●

The Paragon Maxi is a single use disposable product, supplied sterile, sterilised by ethylene oxide, non-toxic and non-pyrogenic. The shelf life of the Paragon

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Maxi has been substantiated using products that have been subjected to simulated distribution conditions and aged prior to performance testing.

5.4 In Vitro Test Results

Performance testing has been planned and conducted in accordance with the requirements of the following:

  • . FDA's Guidance for Cardiopulmonary Bypass Oxygenators (2000),
  • . ISO 7199:2016 Cardiovascular implants and artificial organs — Blood-gas exchangers (oxygenators),
  • ISO 15676:2016 Cardiovascular implants and artificial organs --. Requirements for single-use tubing packs for cardiopulmonary bypass and extracorporeal membrane oxygenation (ECMO),

The following performance characteristics were evaluated for the Paragon Maxi:

TestMethodConclusion
Blood Pathway
IntegrityNon-comparativeAcceptance criteria met by the
devices.
Heat Exchanger
Fluid Pathway
IntegrityNon-comparativeAcceptance criteria met by the
devices.
Gas Pathway
IntegrityNon-comparativeAcceptance criteria met by the
devices.
Connector
securityNon-comparativeAcceptance criteria met by the
devices.
Coating
CharacterizationNon-comparativeAcceptance criteria met by the
devices.
Oxygen Transfer
RatesComparativeNo statistically significant difference
in the O2 transfer rates of the
Paragon Maxi oxygenator and the
predicate.
Carbon Dioxide
Transfer RatesComparativeNo statistically significant difference
in the CO2 transfer rates of the
Paragon Maxi oxygenator and the
predicate.
Blood Side
Pressure DropComparativeThe Paragon Maxi has a lower blood
side pressure drop than the
predicate oxygenator as a

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| | | consequence of slight differences in
the oxygenator design. |
|-----------------------------------------|-------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Heat Exchanger
Performance
Factor | Comparative | No statistically significant difference
in the heat exchanger performance
of the Paragon Maxi oxygenator and
the predicate. |
| Blood cell
damage | Comparative | No statistically significant difference
in the blood cell damage test results
(e.g. hemolysis, white blood cell
count, platelet count) of the Paragon
Maxi oxygenator and the predicate. |

5.5 Non-Clinical Test Results

The biological safety of the Paragon Maxi has been evaluated in accordance with the process defined in ISO 10993-1:2009. Biological risk assessments and the applicable biocompatibility testing demonstrate the biocompatibility and biological safety of the device.

The Paragon Maxi is sterilised by ethylene oxide gas to achieve a SAL of 10-6. The pyrogen levels of the devices were determined following ANSI/AAMI ST72:2011 – Bacterial Endotoxins Test Methods, Routine Monitoring and Alternatives to Batch Testing. The Bacterial Endotoxin Testing validation confirmed that the endotoxin recoveries were all below the 'Endotoxin Release Limit' of