K Number
K192770
Device Name
S dispensing line
Manufacturer
Date Cleared
2020-12-17

(444 days)

Product Code
Regulation Number
880.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The S Dispensing Line is intended for transfer of liquid drug from bag to syringes through the APOTECAsyringe automated system. The device is used inside an automatic system APOTEC Asyringe that tightens the tube with the syringe, while the connection with the bag is done manually. The transfer of liquid takes place by depression through the mechanical action on the piston of the syringe of a manipulator equipped with a gripping device.
Device Description
Sdispensinglineisadevice for the transferofiquids, with the purpose of preparation of in drugs. The device is intended to be used with APOTECAsyringe automatic compoundingsystem. Thedeviceissingleuse, sterilizedbyEOandsingle-packagedinablister. The device is not manufactured with natural rubber latex. Medical grade plastics are used, according to ISO 10993 series standards. Sdispensingline is a non-vented infusion setused as a connecting part be rock syringe without hypodermic needle. The tip in contact with the syringe must perfectly by means of a pressure connector (not by screwind). in ordertoavoidloss ofmedication; the connectoris to be assembled atthe endof the line. The short line enables the transfer of drug from a bag to a luer lock syringe through the APOTECAsyringe automated system. The line is intended for the connection of the spike perforator; a check valve prevents the flow back towards thebag.
More Information

Not Found

No
The description focuses on the mechanical function of a dispensing line for liquid transfer within an automated system, with no mention of AI or ML capabilities.

No
This device is for the transfer of liquid drug from a bag to syringes, specifically for the "preparation of in drugs" through an automated compounding system. It does not directly provide therapy to a patient.

No

The device is described as being for "transfer of liquid drug from bag to syringes" and the "preparation of in drugs," indicating a function in drug compounding and administration, not in identifying or characterizing a disease or condition.

No

The device description clearly outlines a physical medical device (dispensing line, tubing, connectors, check valve) made of medical-grade plastics, intended for single use and sterilization. It is a hardware component used within an automated system.

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

Here's why:

  • Intended Use: The intended use is for the transfer of liquid drug from a bag to syringes for the preparation of in-drugs. This is a process related to drug preparation and administration, not the diagnosis of a disease or condition.
  • Device Description: The device is described as a "device for the transfer of liquids, with the purpose of preparation of in drugs." It's a non-vented infusion set used as a connecting part. This aligns with drug preparation and transfer, not diagnostic testing.
  • Lack of Diagnostic Purpose: There is no mention of the device being used to analyze samples (blood, urine, tissue, etc.) or to provide information for the diagnosis, monitoring, or treatment of a disease or condition.
  • Predicate Devices: The predicate devices listed (Rapid-Fill™ Tubeset, Exacta-Mix Administration Set) are also devices used in the preparation and administration of medications, not for in vitro diagnostic testing.

In vitro diagnostics are devices intended for use in the collection, preparation, and examination of specimens taken from the human body for the purpose of providing information for the diagnosis, monitoring, or treatment of a disease or condition. This device's function falls outside of that definition.

N/A

Intended Use / Indications for Use

The S Dispensing Line is intended for transfer of liquid drug from bag to syringes through the APOTECAsyringe automated system. The device is used inside an automatic system APOTEC Asyringe that tightens the tube with the syringe, while the connection with the bag is done manually. The transfer of liquid takes place by depression through the mechanical action on the piston of the syringe of a manipulator equipped with a gripping device.

Product codes

LHI

Device Description

Sdispensinglineisadevice for the transferofiquids, with the purpose of preparation of in drugs. The device is intended to be used with APOTECAsyringe automatic compoundingsystem.

Thedeviceissingleuse, sterilizedbyEOandsingle-packagedinablister. The device is not manufactured with natural rubber latex.

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

Non-Clinical Testing: AEA srl has performed non-clinicalion testing based on the risk analysis conducted, as summarized in the following tables. The favourable outcome of this testing demonstrates that the AEA proposed device performs in an equivalent manner to the predicate devices.
Performance Characteristics:

  • Right connection/absence of ruptures between syringe tip and connector after 100 usages
  • Absence of leakage during filling after 100 usages
  • Right disconnection/absence of ruptures between syringe tip and connector after 100 usages
  • Absence of spilling after the disconnection
  • Performance testing after real aging (ongoing)
  • Test for particulate contamination (ISO 8536-4:2010)
  • Test for leakage (ISO 8536-4:2010)
  • Test for tensile strength (ISO 8536-4:2010)
  • Test for the closure-piercing device (ISO 8536-4:2010)
  • Test for transparency (ISO 8536-4:2010)
    Biocompatibility Testing:
  • Cytotoxicity MEM (ISO 10993-5:2009, ISO 10993-12:2012)
  • Elution test
  • Sensitization (ISO 10993-10:2010, ISO 10993-12:2012)
  • Guinea Pig Sensitization Test
  • Irritation or Intracutaneous Reactivity Rabbit Intracutaneous reactivity (ISO 10993-10:2010, ISO 10993-12:2012)
  • Acute Systemic Toxicity (ISO 10993-11:2017, ISO 10993-12:2012)
  • Material-Mediated Pyrogenicity Pyrogen Test (USP Rabbit Test) (USP 41-NF36:2018 Pyrogen Test (USP Rabbit Test))
  • Hemocompatibility Haemolysis test indirect contact (ISO 10993-4:2017, ISO 10993-12:2012)
  • Particulate matters testing (USP 788)
    Sterilization and Shelf Life:
  • Sterilization Validation (ISO 11135:2014)
  • Packaging Validation
  • Shelf life - 3 years
  • 3 year Real Time Study (Ongoing)
  • Accelerated Ageing Study completed

Clinical Testing: Clinical testing was not required for this submission.

Key Metrics

Not Found

Predicate Device(s)

K022523, K002705

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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).

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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 in blue, with the words "U.S. FOOD & DRUG" stacked on top of the word "ADMINISTRATION".

December 17, 2020

AEA srl Michele Mengoni Quality & Regulatory via Fiume 16 Angeli di Rosora, 60030 It

Re: K192770

Trade/Device Name: S dispensing line Regulation Number: 21 CFR 880.5440 Regulation Name: Intravascular administration set Regulatory Class: Class II Product Code: LHI Dated: December 10, 2020 Received: December 16, 2020

Dear Michele Mengoni:

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

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devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); 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 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,

CAPT Alan Stevens Acting Director DHT3C: Division of Drug Delivery and General Hospital Devices. and Human Factors OHT3: Office of GastroRenal, ObGyn, General Hospital and Urology 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) K192770

Device Name S Dispensing Line

Indications for Use (Describe)

The S Dispensing Line is intended for transfer of liquid drug from bag to syringes through the APOTECAsyringe automated system. The device is used inside an automatic system APOTEC Asyringe that tightens the tube with the syringe, while the connection with the bag is done manually. The transfer of liquid takes place by depression through the mechanical action on the piston of the syringe of a manipulator equipped with a gripping device.

Type of Use (Select one or both, as applicable)
☒ Prescription Use (Part 21 CFR 801 Subpart D)
☐ Over-The-Counter Use (21 CFR 801 Subpart C)

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510(k) Summary

Thefollowing510(k)summaryhasbeenpreparedpursuanttorequirementsspecifiedin21 CFR807.92.

I SUBMITTER

AEA SRL ViaFiume, 16AngelidiRosa60030AnconaItaly Phone: 0039-0731-816689 Contact Person: Michele Mengoni Date prepared: December 10th , 2020

II DEVICE

TradeNames:S dispensing line
CommonorUsualNames:Intravascular administration set
Classification Names:Set, IV Fluid Transfer
Regulation Numbers:Sdispensingline: 880.5440-Intravascularadministrationset
Regulatory Class:II
ProductCodes:S dispensing line: LHI
PanelIdentification:General Hospital

III PREDICATE DEVICES

S dispensing linePredicate devicePredicate device
Trade Name:Rapid-Fill™ TubesetExacta-Mix
Administration Set
510(k) number:K022523K002705

IV DEVICE DESCRIPTION

Sdispensinglineisadevice for the transferofiquids, with the purpose of preparation of in drugs. The device is intended to be used with APOTECAsyringe automatic compoundingsystem.

Thedeviceissingleuse, sterilizedbyEOandsingle-packagedinablister. The device is not manufactured with natural rubber latex.

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Image /page/4/Picture/0 description: The image shows the word "LOCCIONI" in a bold, sans-serif font. The color of the text is a dark red. The letters are evenly spaced and appear to be a logo or brand name.

Medical grade plastics are used, according to ISO 10993 series standards.

The device has the same intended use and the same technological characteristics as its predicate devices.

Sdispensingline is a non-vented infusion setused as a connecting part be rock syringe without hypodermic needle. The tip in contact with the syringe must perfectly by means of a pressure connector (not by screwind). in ordertoavoidloss ofmedication; the connectoris to be assembled atthe endof the line.

The short line enables the transfer of drug from a bag to a luer lock syringe through the APOTECAsyringe automated system.

The line is intended for the connection of the spike perforator; a check valve prevents the flow back towards thebag. Components and materials are reported in the following table.

COMPONENTMATERIAL
Vented spike with protective capABS (vented spike), LDPE (protective cap), Polyethylene (vent)
TubingPVC D.E.H.P. Free
Check valveSilicone (internal part), Acrylic (upper and lower parts)
Straight connectorABS
Elbow connectorPVC D.E.H.P. Free
Female luer slip connectorPolycarbonate

V INTENDED USE AND INDICATIONS FOR USE

The S dispensing line is intended for transfer of liquid drug from a bag to syringes through the APOTECAsyringe automated system.

The device is used inside an automatic system APOTECAsyringe that tightens the tube with the connection with the bagis done manually. The transfer of liquid takes place by depression through the piston of the syringe of a manipulator equipped with a gripping device.

VI comparison of technological characteristics with The Predicate devices

S dispensing line has the intended use and the same technological characteristics of its predicate devices:

  • . The S dispensing line has the same intended use of the predicated devices (K022523 and K002705).
  • The S dispensing line and the predicate devices (K022523 and K002705) component materials comply with ISO 10993 ● as applicable to the intended use of the device.
  • The S dispensing line hasvery similar design and materials of predicated devices (K022523 and K002705). .

The differences between the predicate devices and the subject devices include:

  • The proximal end connector of the S dispensing line has been appropriately designed to be managed by APOTECAsyringe . compoundingsystemandatthesametimetofitwiththeluerlockofthesyringe used inside the automaticsystem.

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AEA srl Via Fiume 16,60030 Angelidi Rosora, AN (Italy) R.I. - C.F. - P. Iva 00686250424 info@loccioni.com

  • The sterilization method for the proposed device S dispensing line is ethylene oxide whereas the sterilization method . for the predicate device is gamma irradiation.
    The differences between proposed device and predicate devices do not raise any issues of safety and effectiveness.

VII. PERFORMANCE DATA

Non-Clinical Testing

AEA srl has performed non-clinicalion testing based on the risk analysis conducted, as summarized in the following tables. The favourable outcome of this testing demonstrates that the AEA proposed device performs in an equivalent manner to the predicate devices.

Performance CharacteristicAcceptance Criteria/Standard
Performance Testing Ref.
Section 018
"Performance Testing-
Bench"Right connection/absence of
ruptures between syringe tip and
connector after 100 usagesRight connection, no ruptures
Absence of leakage during filling after
100 usagesNo leakage
Right disconnection/absence of
ruptures between syringe tip and
connector after 100 usagesRight disconnection, no ruptures
Absenceofspillingafterthe
disconnectionNo spilling
Performance testing after real aging
(ongoing)No change in performances after 3 years
Test for particulate contaminationISO 8536-4:2010
Test for leakageISO 8536-4:2010
Test for tensile strengthISO 8536-4:2010
Test for the closure-piercing deviceISO 8536-4:2010
Test for transparencyISO 8536-4:2010
Biocompatibility Testing Ref.
Section 015
"Biocompatibility"Cytotoxicity MEMISO 10993-5:2009, ISO 10993-12:2012
Elution test
SensitizationISO 10993-10:2010, ISO 10993-12:2012

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Image /page/6/Picture/0 description: The image shows the word "LOCCIONI" in a bold, sans-serif font. The letters are all capitalized and are a dark red color. The background is white, which makes the text stand out.

AEA srl Via Fiume 16,60030 Angelidi Rosora, AN (Italy) R.I. - C.F. - P. Iva 00686250424 info@loccioni.com

Performance CharacteristicAcceptance Criteria/Standard
Guinea Pig Sensitization Test
Irritation or Intracutaneous Reactivity
Rabbit Intracutaneous reactivityISO 10993-10:2010, ISO 10993-12:2012
Acute Systemic ToxicityISO 10993-11:2017, ISO 10993-12:2012
Material-Mediated Pyrogenicity
Pyrogen Test (USP Rabbit Test)USP 41-NF36:2018 Pyrogen Test
(USP Rabbit Test)
Hemocompatibility
Haemolysis test indirect contactISO 10993-4:2017, ISO 10993-12:2012
Particulate matters testingUSP 788
Sterilization ValidationISO 11135:2014
Sterilization and Shelf Life
Ref. Section 014
"Sterilization and Shelf Life"Packaging ValidationEffective microbiological barrier, product sterility and
integrity preservation
Shelf life - 3 yearsSterility and product integrity maintained over the
entire shelf life
Sterility and product integrity maintained over 3 year
shelf life
3 year Real Time Study (Ongoing)
Accelerated Ageing Study completed

Clinical Testing

Clinical testing was not required for this submission.

Substantial Equivalence

The S dispensing line is substantially equivalent to the predicate devices in intended use, principles of operation, technology, design, materials and performance.

VII CONCLUSION

Results of performance and biocompatibility testing conducted on the proposed devices demonstrate that the is substantially equivalent to the predicate devices.