K Number
K192937
Device Name
3M Comply Hydrogen Peroxide Chemical Indicator
Manufacturer
Date Cleared
2019-11-16

(29 days)

Product Code
Regulation Number
880.2800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Use the 3M™ Comply™ Hydrogen Peroxide Chemical Indicator 1248 as an internal pack process indicator to verify exposure to vaporized hydrogen peroxide in the STERRAD® 100S, STERRAD® NX (Standard and Advanced cycles), STERRAD® 100NX (Standard, Flex , Express and Duo cycles), STERRAD® NX with ALLClear™ Technology (Standard and Advanced cycles), STERRAD® 100NX with ALLClear™ Technology (Standard, Flex , Express and Duo cycles), AMSCO® V PRO® 1 (Lumen cycle), AMSCO® V PRO® 1 Plus (Lumen and Non Lumen cycles), AMSCO® V PRO® maX Low Temperature Sterilization System (Lumen , Non Lumen, and Flexible cycles), AMSCO® V-PRO® 60 Low Temperature Sterilization System (Lumen , Flexible cycles), and AMSCO® V-PROTM maX 2 Low Temperature Sterilization System (Lumen, Flexible, and Fast Non Lumen cycles) sterilizers. The chemical indicator bar turns from blue toward pink after exposure to vaporized hydrogen peroxide.
Device Description
The 3M™ ComplyTM Hydrogen Peroxide Chemical Indicator 1248 consists of a noncellulosic plastic material onto which a chemical indicator bar is printed. A comparison color match is also printed on the product to aid in color interpretation.
More Information

No
The device is a chemical indicator that changes color based on exposure to hydrogen peroxide. There is no mention of any computational processing, learning, or AI/ML components in the description or performance studies.

No.
This device is an internal pack process indicator used to verify exposure to vaporized hydrogen peroxide in sterilizers, not a therapeutic device for treating medical conditions.

No

This device is an internal pack process indicator to verify exposure to vaporized hydrogen peroxide in sterilizers, not a diagnostic device for medical conditions.

No

The device description explicitly states it consists of a "noncellulosic plastic material onto which a chemical indicator bar is printed," indicating it is a physical, hardware-based device, 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 to verify exposure to vaporized hydrogen peroxide in specific sterilization systems. This is a quality control measure for the sterilization process, not a diagnostic test performed on a biological sample to diagnose a disease or condition.
  • Device Description: The device is a chemical indicator that changes color based on exposure to a chemical (vaporized hydrogen peroxide). It does not interact with biological samples.
  • Lack of Biological Sample Interaction: IVD devices are designed to be used in vitro (outside the body) to examine specimens derived from the human body (like blood, urine, tissue). This device does not use or analyze any biological samples.
  • Purpose: The purpose is to confirm that a sterilization cycle has reached the necessary conditions, not to provide information about a patient's health status.

Therefore, the 3M™ Comply™ Hydrogen Peroxide Chemical Indicator 1248 is a sterilization process indicator, not an IVD.

N/A

Intended Use / Indications for Use

Use the 3M™ Comply™ Hydrogen Peroxide Chemical Indicator 1248 as an internal pack process indicator to verify exposure to vaporized hydrogen peroxide in the STERRAD® 1 00S, STERRAD® NX (Standard and Advanced cycles), STERRAD® 100NX (Standard, Flex , Express and Duo cycles), STERRAD® NX with ALLClear™ Technology (Standard and Advanced cycles), STERRAD® 100NX with ALLClear™ Technology (Standard, Flex, Express and Duo cycles), AMSCO® V PRO® 1 (Lumen cycle), AMSCO® V PRO® 1 Plus (Lumen and Non Lumen cycles), AMSCO® V PRO® maX Low Temperature Sterilization System (Lumen , Non Lumen, and Flexible cycles), AMSCO® V-PRO® 60 Low Temperature Sterilization System (Lumen , Flexible cycles), and AMSCO® V-PROTM maX 2 Low Temperature Sterilization System (Lumen, Flexible, and Fast Non Lumen cycles) sterilizers. The chemical indicator bar turns from blue toward pink after exposure to vaporized hydrogen peroxide.

Product codes

JOJ

Device Description

The 3M™ ComplyTM Hydrogen Peroxide Chemical Indicator 1248 consists of a noncellulosic plastic material onto which a chemical indicator bar is printed. A comparison color match is also printed on the product to aid in color interpretation.

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

Nonclinical testing was performed in accordance with the FDA Guidance for Industry and Staff: Premarket Notification [510(k)] Submissions for Chemical Indicators, issued December 19, 2003.

Test Method / Name: Color Change in Health Care Facility Cycle
Purpose: To demonstrate the color change of the device when used in the AMSCO® V-PRO™ maX 2 Low Temperature Sterilization System
Acceptance Criteria: Color change from blue toward pink
Result: Pass

Test Method / Name: Minimum Exposure Parameters
Purpose: To determine the minimum time required for the color change of the device when used in the AMSCO® V-PROTM maX 2 Low Temperature Sterilization System
Acceptance Criteria: Determination of the minimum time for color to change from blue toward pink
Result: Pass

Test Method / Name: End Point Color Stability
Purpose: To demonstrate the post-sterilization color stability of the device after use in the AMSCO® V-PROTM maX 2 Low Temperature Sterilization System
Acceptance Criteria: No significant color change after exposure to fluorescent light for a minimum of 1 month (4 weeks).
Result: Pass

Key Metrics

Not Found

Predicate Device(s)

K183211

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 880.2800 Sterilization process indicator.

(a)
Biological sterilization process indicator —(1)Identification. A biological sterilization process indicator is a device intended for use by a health care provider to accompany products being sterilized through a sterilization procedure and to monitor adequacy of sterilization. The device consists of a known number of microorganisms, of known resistance to the mode of sterilization, in or on a carrier and enclosed in a protective package. Subsequent growth or failure of the microorganisms to grow under suitable conditions indicates the adequacy of sterilization.(2)
Classification. Class II (performance standards).(b)
Physical/chemical sterilization process indicator —(1)Identification. A physical/chemical sterilization process indicator is a device intended for use by a health care provider to accompany products being sterilized through a sterilization procedure and to monitor one or more parameters of the sterilization process. The adequacy of the sterilization conditions as measured by these parameters is indicated by a visible change in the device.(2)
Classification. Class II (performance standards).

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November 16, 2019

3M Company Mary Fretland Senior Regulatory Affairs Associate 3M Center, Building 275-5W-06 St. Paul, Minnesota 55144

Re: K192937

Trade/Device Name: 3M Comply Hydrogen Peroxide Chemical Indicator Regulation Number: 21 CFR 880.2800 Regulation Name: Sterilization Process Indicator Regulatory Class: Class II Product Code: JOJ Dated: October 17, 2019 Received: October 18, 2019

Dear Mary Fretland:

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

1

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/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,

Elizabeth Claverie, M.S. Assistant Director for THT4B2 Acting Assistant Director for THT4B1 DHT4B: Division of Infection Control and Plastic Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K192937

Device Name

3MTM ComplyTM Hydrogen Peroxide Chemical Indicator 1248

Indications for Use (Describe)

Use the 3M™ Comply™ Hydrogen Peroxide Chemical Indicator 1248 as an internal pack process indicator to verify exposure to vaporized hydrogen peroxide in the STERRAD® 1 00S, STERRAD® NX (Standard and Advanced cycles), STERRAD® 100NX (Standard, Flex , Express and Duo cycles), STERRAD® NX with ALLClear™ Technology (Standard and Advanced cycles), STERRAD® 100NX with ALLClear™ Technology (Standard, Flex , Express and Duo cycles), AMSCO® V PRO® 1 (Lumen cycle), AMSCO® V PRO® 1 Plus (Lumen and Non Lumen cycles), AMSCO® V PRO® maX Low Temperature Sterilization System (Lumen , Non Lumen, and Flexible cycles), AMSCO® V-PRO® 60 Low Temperature Sterilization System (Lumen , Flexible cycles), and AMSCO® V-PROTM maX 2 Low Temperature Sterilization System (Lumen, Flexible, and Fast Non Lumen cycles) sterilizers. The chemical indicator bar turns from blue toward pink after exposure to vaporized hydrogen peroxide.

Type of Use (Select one or both, as applicable)

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 for 3M™ Comply™ Hydrogen Peroxide Chemical Indicator 1248 K192937

Sponsor Information:

3M Health Care 3M Center, Bldg. 275-5W-06 St. Paul, MN 55144-1000

Contact: Mary Fretland Senior Regulatory Affairs Associate Phone Number: (651) 737-2296 Fax Number: (651) 737-5320

Date of Summary: November 04, 2019

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PREMARKET NOTIFICATION [510(k)] 3M™ ComplyTM Hydrogen Peroxide Chemical Indicator 1248

1. Device Name and Classification:

Common or Usual Name:Chemical Indicator
Proprietary Name:3M™ Comply™ Hydrogen Peroxide Chemical Indicator
1248
Classification Name:Indicator, physical/chemical sterilization process
Device Classification:Class II, 21 CFR § 880.2800
Product Code:JOJ

2. Predicate Device:

K183211 3M™ Comply™ Hydrogen Peroxide Chemical Indicator 1248

3. Description of Device:

The 3M™ ComplyTM Hydrogen Peroxide Chemical Indicator 1248 consists of a noncellulosic plastic material onto which a chemical indicator bar is printed. A comparison color match is also printed on the product to aid in color interpretation.

4. Indications for Use

Use the 3M™ Comply™ Hydrogen Peroxide Chemical Indicator 1248 as an internal pack process indicator to verify exposure to vaporized hydrogen peroxide in the STERRAD® 100, STERRAD® 100S, STERRAD® NX (Standard and Advanced cycles). STERRAD® 100NX (Standard, Flex, Express and Duo cycles), STERRAD® NX with ALLClear™ Technology (Standard and Advanced cycles), STERRAD® 100NX with ALLClear™ Technology (Standard, Flex, Express and Duo cycles), AMSCO® V-PRO® 1 (Lumen cycle), AMSCO® V-PRO® 1 Plus (Lumen and Non Lumen cycles), AMSCO® V-PRO® maX Low Temperature Sterilization System (Lumen, and Flexible cycles), AMSCO® V-PRO® 60 Low Temperature Sterilization System (Lumen, Non Lumen, Flexible cycles) and AMSCO® V-PRO™ maX 2 Low Temperature Sterilization System (Lumen, Non-Lumen, Flexible, and Fast Non-Lumen cycles) sterilizers. The chemical indicator bar turns from blue toward pink after exposure to vaporized hydrogen peroxide.

5

PREMARKET NOTIFICATION [510(k)] 3M™ Comply™ Hydrogen Peroxide Chemical Indicator 1248

5. Technological Characteristic Comparison Table
FeatureSubmission Device (K192937):
3M™ Comply™ Hydrogen
Peroxide Chemical Indicator 1248Predicate Device (K183211):
3M™ Comply™ Hydrogen
Peroxide Chemical Indicator 1248Comparison
Indications for
useUse the 3M™ Comply™ Hydrogen
Peroxide Chemical Indicator 1248 as
an internal pack process indicator to
verify exposure to vaporized
hydrogen peroxide in the
STERRAD® 100, STERRAD®
100S, STERRAD® NX (Standard
and Advanced cycles), STERRAD®
100NX (Standard, Flex, Express and
Duo cycles), STERRAD® NX with
ALLClear™ Technology (Standard
and Advanced cycles), STERRAD®
100NX with ALLClear™
Technology (Standard, Flex, Express
and Duo cycles), AMSCO® V-
PRO® 1 (Lumen cycle), AMSCO®
V-PRO® 1 Plus (Lumen and Non
Lumen cycles), AMSCO® V-PRO®
maX Low Temperature Sterilization
System (Lumen, Non Lumen, and
Flexible cycles), AMSCO® V-
PRO® 60 Low Temperature
Sterilization System (Lumen, Non
Lumen and Flexible cycles) and
AMSCO® V-PRO™ maX 2 Low
Temperature Sterilization System
(Lumen, Non-Lumen, Flexible, and
Fast Non-Lumen cycles) sterilizers.
The chemical indicator bar turns
from blue toward pink after exposure
to vaporized hydrogen peroxide.Use the 3M™ Comply™ Hydrogen
Peroxide Chemical Indicator 1248 as
an internal pack process indicator to
verify exposure to vaporized
hydrogen peroxide in the
STERRAD® 100, STERRAD®
100S, STERRAD® NX (Standard
and Advanced cycles), STERRAD®
100NX (Standard, Flex, Express and
Duo cycles), STERRAD® NX with
ALLClear™ Technology (Standard
and Advanced cycles), STERRAD®
100NX with ALLClear™
Technology (Standard, Flex, Express
and Duo cycles), AMSCO® V-
PRO® 1 (Lumen cycle), AMSCO®
V-PRO® 1 Plus (Lumen and Non
Lumen cycles), AMSCO® V-PRO®
maX Low Temperature Sterilization
System (Lumen, Non Lumen, and
Flexible cycles) and AMSCO® V-
PRO® 60 Low Temperature
Sterilization System (Lumen, Non
Lumen and Flexible cycles)
sterilizers. The chemical indicator bar
turns from blue toward pink after
exposure to vaporized hydrogen
peroxide.Similar
Sterilizers and
Sterilization
CyclesSTERRAD® 100
STERRAD® 100S
STERRAD® NX (Standard and
Advanced cycles)
STERRAD® NX with ALLClear™
Technology (Standard and Advanced
cycles)
STERRAD® 100NX (Standard, Flex,
Express, and Duo cycles)
STERRAD® 100NX with
ALLClear™ Technology (Standard,
Flex, Express, and Duo cycles)
AMSCO® V-PRO™ 1 (Lumen
cycle)
AMSCO® V-PRO™ 1 Plus (Lumen
and Non Lumen cycles)
AMSCO® V-PRO™ maX Low
Temperature Sterilization System
(Lumen, Non Lumen and Flexible
cycles)STERRAD® 100
STERRAD® 100S
STERRAD® NX (Standard and
Advanced cycles)
STERRAD® NX with ALLClear™
Technology (Standard and Advanced
cycles)
STERRAD® 100NX (Standard, Flex,
Express, and Duo cycles)
STERRAD® 100NX with
ALLClear™ Technology (Standard,
Flex, Express, and Duo cycles)
AMSCO® V-PRO™ 1 (Lumen
cycle)
AMSCO® V-PRO™ 1 Plus (Lumen
and Non Lumen cycles)
AMSCO® V-PRO™ maX Low
Temperature Sterilization System
(Lumen, Non Lumen and Flexible
cycles)Similar
Submission Device (K192937):Predicate Device (K183211):Comparison
Feature3M™ Comply™ Hydrogen
Peroxide Chemical Indicator 12483M™ Comply™ Hydrogen
Peroxide Chemical Indicator 1248
AMSCO® V-PRO™ 60 (Lumen,
Non Lumen and Flexible cycles)
AMSCO® V-PRO™ maX 2 Low
Temperature Sterilization System
(Lumen, Non-Lumen, Flexible, and
Fast Non-Lumen cycles)AMSCO® V-PRO™ 60 (Lumen,
Non Lumen and Flexible cycles)
SubstratePolyethylenePolyethyleneIdentical
BiocompatibilityThe exposure to health care
professionals is minimal and well
below any identified toxic thresholds
for the compounds.The exposure to health care
professionals is minimal and well
below any identified toxic thresholds
for the compounds.Identical
Color ChangeBlue toward pinkBlue toward pinkIdentical
DetectionHydrogen PeroxideHydrogen PeroxideIdentical
Stability of the
endpoint
reactionAt least one month (4 weeks)At least one month (4 weeks)Identical
Shelf lifeTwo (2) yearsTwo (2) yearsIdentical

5. Technological Characteristic Comparison Table

6

PREMARKET NOTIFICATION [510(k)] 3MTM ComplyTM Hydrogen Peroxide Chemical Indicator 1248

The 3M™ Comply™ Hydrogen Peroxide Chemical Indicator 1248 is identical to the previously cleared device of the same model number (the predicate) which is sold under the tradename 3M™ Comply™ Hydrogen Peroxide Chemical Indicator 1248 (K18321). As no change has been made to the device materials, performance specifications, or fundamental technology, the biocompatibility and nonclinical testing provided in K183211 was referenced in this submission to support performance of the device in the claimed sterilizers.

6. Summary of Nonclinical Testing

To demonstrate performance in the newly claimed sterilizers and cycles, nonclinical testing was performed in accordance with the FDA Guidance for Industry and Staff: Premarket Notification [510(k)] Submissions for Chemical Indicators, issued December 19, 2003. Reference Table 6.1 for testing completed in AMSCO® V-PRO™ maX 2 Low Temperature Sterilization System (Lumen, Non-Lumen, Flexible, and Fast Non-Lumen cycles) sterilizer.

Test Method / NamePurposeAcceptance CriteriaResult
Color Change in
Health Care
Facility CycleTo demonstrate the color change of
the device when used in the
AMSCO® V-PRO™ maX 2 Low
Temperature Sterilization SystemColor change from blue toward
pinkPass
Minimum
Exposure
ParametersTo determine the minimum time
required for the color change of the
device when used in the AMSCO®Determination of the minimum
time for color to change from
blue toward pinkPass

Table 6.1 Summary of Nonclinical Testing

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PREMARKET NOTIFICATION [510(k)] 3M™ ComplyTM Hydrogen Peroxide Chemical Indicator 1248

| Test Method /

NamePurposeAcceptance CriteriaResult
End Point Color
StabilityV-PROTM maX 2 Low
Temperature Sterilization SystemNo significant color change after
exposure to fluorescent light for a
minimum of 1 month (4 weeks).Pass
To demonstrate the post-
sterilization color stability of the
device after use in the AMSCO®
V-PROTM maX 2 Low
Temperature Sterilization System

7. Conclusion

Based on the non-clinical testing performance data, the 3MTM Comply™ Hydrogen Peroxide Chemical Indicator 1248 is as safe, as effective, and performs as well as or better than the legally marketed predicate device, the 3MTM Comply™ Hydrogen Peroxide Chemical Indicator 1248 cleared under K183211, Class II (21 CFR 880.2800), product code JOJ.