K Number
K201284
Device Name
Sterile Hypodermic Syringe for Single Use, with/without needle, luer/luer-lock, Sterile Insulin Syringe for Single Use, with needle, Sterile Hypodermic needle for Single use
Date Cleared
2020-12-14

(215 days)

Product Code
Regulation Number
880.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Sterile Hypodermic Syringe for Single Use with/without needle is intended to be used for medical purposes to inject fluid into or withdraw fluid from body. The sterile insulin syringe for single use with the calibration unit of insulin for U-100, is a device intended for medical purposes for the manual aspiration of insulin, and for the injection of insulin into parts of the body below the surface skin. The sterile insulin syringe for single use with the calibration unit of insulin for U-40 is a device intended for medical purposes for the manual aspiration of insulin, and for the injection of insulin into parts of the body below the surface skin. The Sterile Hypodermic Needle for single use is intended for use with syringes and injection devices for general purpose fluid injection/aspiration.
Device Description
The Sterile Hypodermic Syringe for Single use, with/without needle; luer/luer-lock consists of a Piston, Plunger, and Barrel. It is EO Sterilized and intended for Prescription use by Medical professionals and trained care givers. It is for single use and operates by pulling and pushing the plunger along inside the barrel to take in and expel fluids. It comes in various lengths, diameters, tip types, needle tip configurations, nozzle types, barrel marking specs, volumes, sizes, and needle lengths. Materials include Isoprene Rubber, PP, PE, and SUS304. The Sterile Insulin Syringe for Single use, with needle consists of a Needle Cap, Needle, Piston, Plunger, Barrel, and End Cap. It is EO Sterilized and intended for Prescription use by patients. It is for single use and operates by pulling and pushing the plunger along inside the barrel to take in and expel fluids. It comes in 0.3ml, 0.5ml, and 1ml volumes with fixed needles of 8mm and 13mm lengths. Materials include Isoprene Rubber, PP, PE, and SUS304. The Sterile Hypodermic needle for Single use consists of a Protective cap, Needle, Adhesives, and Needle hub. It is EO Sterilized and intended for Prescription use by Medical professionals and trained care givers. It is for single use and for Manual Use Only. It comes in various sizes and needle lengths. Materials include PP, Epoxy resin, and SUS304.
More Information

Not Found

No
The device description and performance studies focus on the physical, chemical, and biological properties of standard syringes and needles, with no mention of AI or ML capabilities.

No.
The devices are used for injecting or withdrawing fluids, which are instrumental actions in medical procedures but do not inherently provide therapeutic effect themselves.

No
The devices are described as syringes and needles intended for injecting or withdrawing fluids (like insulin) from the body. Their function is therapeutic/delivery, not to diagnose a condition.

No

The device description clearly outlines physical components made of materials like Isoprene Rubber, PP, PE, and SUS304, and the performance studies focus on physical, chemical, and biological standards for these hardware components (syringes and needles). There is no mention of software as the primary or sole component.

Based on the provided information, no, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use of all the described devices (hypodermic syringes, insulin syringes, and hypodermic needles) is for the injection or withdrawal of fluids from the body. This is a direct interaction with the patient's body for therapeutic or procedural purposes.
  • IVD Definition: In Vitro Diagnostics are devices intended for use in the examination of specimens derived from the human body (such as blood, urine, or tissue) to provide information for diagnostic, monitoring, or screening purposes. They are used outside the body (in vitro).
  • Device Description: The description focuses on the physical components and operation of syringes and needles, which are tools for administering or collecting substances from the body, not for analyzing those substances in vitro.
  • Performance Studies: The performance studies described focus on the physical, chemical, and biological properties of the devices themselves (sterility, biocompatibility, etc.), not on their ability to accurately detect or measure substances in a specimen. The key metrics mentioned are related to compliance with standards for medical devices, not diagnostic performance metrics like sensitivity or specificity.

In summary, these devices are intended for direct interaction with the human body for medical procedures, which is the definition of a general medical device, not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The Sterile Hypodermic Syringe for Single Use with/without needle is intended to be used for medical purposes to inject fluid into or withdraw fluid from body.

The sterile insulin syringe for single use with the calibration unit of insulin for U-100, is a device intended for medical purposes for the manual aspiration of insulin, and for the injection of insulin into parts of the body below the surface skin.

The sterile insulin syringe for single use with the calibration unit of insulin for U-40 is a device intended for medical purposes for the manual aspiration of insulin, and for the injection of insulin into parts of the body below the surface skin.

The Sterile Hypodermic Needle for single use is intended for use with syringes and injection devices for general purpose fluid injection/aspiration.

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

FMF, FMF, FMI

Device Description

Sterile Hypodermic Syringe for Single use, with/without needle; luer/luer-lock:
Configuration: Piston, Plunger, Barrel
Sterility condition: EO Sterilized
Single use: Yes
Operation mode: The plunger of syringe can be pulled and pushed along inside the barrel, allowing the syringe to take in and expel the fluids through the connector to the patient.
length: 64-182mm
diameter: 6,6mm-31,6mm
tip type: luer/ luer lock/catheter/perfusion
needle tip configuration: Back bevel needle
nozzle type: Luer / Lock, %6 conical, 1,2 mm
barrel marking specs: 0,05ml-1ml
graduation legibility: Legible
needle cover dimensions: L: 35-55mm, D: 6-9mm
needle cover color: Transparent
lubricant composition: Silicone
barrel transparency: Transparent/ UV resistant/ opaque
needlecover strength: min. 2N max. 20N
hub/ needle bond strength: min. 22-69N
Volume: 2ml, 2,5ml, 3ml, 5ml, 6ml, 10ml, 12ml, 20ml, 24ml, 50ml and 60 ml
Sizes: 14G,15G,16G,18G,19G,20G,21G,22G,23G,24G,25G,26G,27G,28G,29G,30G
Needle Lengths: 4–50 mm
Piston material: Isoprene Rubber
Barrel material: PP
Plunger material: PP/PE
Needle material: PP, SUS304
SAL: 10-6
Endotoxin Limit: 20 EU per device
Biocompatibility: Complied with ISO 10993-4/5/10/11 (Cytotoxicity, Irritation, Sensitization Acute Systemic Toxicity. Hemolytical effect)

Sterile Insulin Syringe for Single use, with needle:
Configuration: Needle Cap, Needle, Piston, Plunger, Barrel, End Cap
Sterility condition: EO Sterilized
Single use: Yes
Operation mode: The plunger of syringe can be pulled and pushed along inside the barrel, allowing the syringe to take in and expel the fluids through the connector to the patient.
Volume: 0.3ml, 0.5ml, 1ml volumes with fixed needle
Needle Lengths: 8mm, 13mm
Piston material: Isoprene Rubber
Barrel material: PP
Plunger material: PP
Needle material: SUS304
Needle Cap material: PP
End Cap material: PP
SAL: 10-6
Endotoxin Limit: 20 EU per device
Biocompatibility: Complied with ISO 10993-4/5/10/11 (Cytotoxicity, Irritation, Sensitization Acute Systemic Toxicity, Subchronic Toxicity, Hemolytic effect)

Sterile Hypodermic needle for Single use:
Configuration: Protective cap, Needle, Adhesives, Needle hub
Sterility condition: EO Sterilized
Single use: Yes
Operation mode: For Manual Use Only, For Single Use only
Sizes: 14G,15G,16G,18G,19G,20G,21G,22G,23G,24G,25G,26G,27G,28G,29G,30G
Needle Lengths: 4–50 mm
Protective cap material: PP
Adhesive material: Epoxy resin
Needle Hub material: PP
Needle material: SUS304
SAL material: 10-6
Endotoxin Limit material: 20 EU per device
Biocompatibility: Complied with ISO 10993-4/5/10/11 (Cytotoxicity, Irritation, Sensitization Acute Systemic Toxicity, Hemolytical effect)

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

Sterile Hypodermic Syringe for Single use, with/without needle; luer/luer-lock: Medical professionals and trained care givers, Prescription use
Sterile Insulin Syringe for Single use, with needle: Patient use, Prescription use
Sterile Hypodermic needle for Single use: Medical professionals and trained care givers, Prescription use

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 was conducted to demonstrate conformance with FDA recognized standards:

  • Sterile, single lumen hypodermic needles: ISO 9626, ISO 7886-1, ISO 7864, ISO 10993-4, ISO 10993-5, ISO 10993-10, ISO 10993-11, USP 788, ISO 10993-7, ISO 10993-12, ISO 11135, ISO 11607-2. Biocompatibility studies based on ISO 10993 (cytotoxicity, irritation, sensitization, acute systemic toxicity, hemocompatibility, pyrogenicity) were performed.
  • Sterile, insulin syringe: ISO 8537, ISO 10993-4, ISO 10993-5, ISO 10993-10, ISO 10993-11, USP 788, ISO 10993-7, ISO 10993-12, ISO 11135, ISO 11607-2. Biocompatibility studies based on ISO 10993 (cytotoxicity, irritation, sensitization, acute systemic toxicity, sub-acute systemic toxicity, sub-chronic systemic toxicity, hemocompatibility, pyrogenicity) were performed.
  • Sterile, needle: ISO 9626, ISO 7864, ISO 10993-4, ISO 10993-5, ISO 10993-10, ISO 10993-11, USP 788, ISO 10993-7, ISO 10993-12, ISO 11135, ISO 11607-2. Biocompatibility studies based on ISO 10993 (cytotoxicity, irritation, sensitization, acute systemic toxicity, hemocompatibility, pyrogenicity) were performed.

Key results: The devices complied with all relevant standards and regulations, demonstrating substantial equivalence to the predicate device.

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.

K190002

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

§ 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).

0

Build Correspondence

Image /page/0/Picture/2 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, which is a blue square with the letters "FDA" in white. To the right of the FDA logo is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

December 14, 2020

Set Medikal Sanayi Ve Ticaret Anonim Sirketi % Mehmet Fatih Ormeci Consultant Medcer Uluslararasi Medikal Belgelendirme Anonim Sirketi Taspinar Mahallesi 2800. Caddesi A-2 Apt. No:6 B/49 Ankara, 06830 Turkey

Re: K201284

Trade/Device Name: Sterile Hypodermic Syringe for Single Use, with/without needle, luer/luer-lock, Sterile Insulin Syringe for Single Use, with needle, Sterile Hypodermic needle for Single use Regulation Number: 21 CFR 880.5860 Regulation Name: Piston Syringe Regulatory Class: Class II Product Code: FMF, FMF, FMI Dated: November 11, 2020

Received: November 16, 2020

Dear Mehmet Fatih Ormeci:

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.

1

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 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,

Rumi Young Acting Assistant 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

2

Indications for Use

510(k) Number (if known)

Device Name

Sterile Hypodermic Syringe for Single use, with/without needle; luer/luer-lock

Indications for Use (Describe)

The Sterile Hypodermic Syringe for Single Use with/without needle is intended to be used for medical purposes to inject fluid into or withdraw fluid from body.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

3

Indications for Use

510(k) Number (if known)

Device Name

Sterile Insulin Syringe for Single use, with needle

Indications for Use (Describe)

The sterile insulin syringe for single use with the calibration unit of insulin for U-100, is a device intended for medical purposes for the manual aspiration of insulin, and for the injection of insulin into parts of the body below the surface skin.

The sterile insulin syringe for single use with the calibration unit of insulin for U-40 is a device intended for medical purposes for the manual aspiration of insulin, and for the injection of insulin into parts of the body below the surface skin.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

4

Indications for Use

510(k) Number (if known)

Device Name

Sterile Hypodermic needle for Single use

Indications for Use (Describe)

The Sterile Hypodermic Needle for single use is intended for use with syringes and injection devices for general purpose fluid injection/aspiration.

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

X Prescription Use (Part 21 CFR 801 Subpart D)

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

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

5

Image /page/5/Picture/0 description: The image contains the logo for "SET MEDIKAL". The logo consists of a blue square with a stylized "S" inside it on the left, followed by the text "SET MEDIKAL" in a gray, sans-serif font. The "S" in the square is also stylized, with a gap in the middle.

K201284 510(k) Summary

510(k) Submitter NameSET MEDIKAL SANAYI VE TICARET ANONIM SIRKETI
510(k) Submitter AddressOsmangazi Mahallesi Maresal Fevzi Cakmak Caddesi No:18 Esenyurt
İstanbul/TURKEY
510(k) Submitter Telephone No+90-212-622-0400
Primary Correspondent Contact InformationMehmet Fatih Ormeci (Consultant)
+90-532-397-3043
mformeci@gmail.com
Fax Number: +90 (212) 689 4 828
Summary Preparation Date11/24/2020

| Trade Or Proprietary Name | Sterile Hypodermic Syringe for Single use, with/without needle;
luer/luer-lock |
|---------------------------|-----------------------------------------------------------------------------------|
| | Sterile Insulin Syringe for Single use, with needle |
| | Sterile Hypodermic needle for Single use |
| Common Name | Hypodermic Syringe |
| | Insulin Syringe |
| | Hypodermic needle |
| Classification Name | Piston Syringe |
| | Piston Syringe |
| | Hypodermic Single Lumen Needle |
| Regulation Number | 21 CFR 880.5860 |
| | 21 CFR 880.5860 |
| | 21 CFR 880.5570 |
| Product Code | FMF |
| | FMF |
| | FMI |

| | Subject Device 510k No | Predicate Device 510k
No | Predicate Device
Manufacturer |
|-----------------------------------------------------------------------------------------|------------------------|-----------------------------|------------------------------------------------|
| Sterile Hypodermic
Syringe for Single use,
with/without needle;
luer/luer-lock | K201284 | K190002 | Shanghai Kohope
Medical Devices Co.,
Ltd |
| Sterile Insulin Syringe
for Single use, with
needle | K201284 | K190002 | Shanghai Kohope
Medical Devices Co.,
Ltd |
| Sterile Hypodermic
needle for Single use | K201284 | K190002 | Shanghai Kohope
Medical Devices Co.,
Ltd |

6

Image /page/6/Picture/0 description: The image contains the logo for SER Medikal. The logo features a blue diamond shape with a stylized "S" inside. To the right of the diamond is the text "SER medikal" in a gray, sans-serif font. The text is all lowercase and has a modern, slightly futuristic appearance.

Device Description

Table 5.1. Device Description Summary for Hypodermic Syringe

ITEMSubject Device
Product nameSterile Hypodermic Syringe for Single use, with/without needle; luer/luer-lock
Indications for useThe Sterile Hypodermic Syringe for Single Use with/without needle is
intended to be used for medical purposes to inject fluid into or withdraw fluid
from body.
ConfigurationPiston, Plunger, Barrel
Sterility conditionEO Sterilized
Environment of usePrescription use
Intended usersMedical professionals and trained care givers
Single useYes
Operation modeThe plunger of syringe can be pulled and pushed along inside the barrel, allowing
the syringe to take in and expel the fluids through the connector to the patient.
length64-182mm
diameter6,6mm-31,6mm
tip typeluer/ luer lock/catheter/perfusion
needle tip configurationBack bevel needle
nozzle typeLuer / Lock, %6 conical, 1,2 mm
barrel marking specs0,05ml-1ml
graduation legibilityLegible
needle cover dimensionsL: 35-55mm, D: 6-9mm
needle cover colorTransparent
lubricant compositionSilicone
barrel transparencyTransparent/ UV resistant/ opaque
needlecover strengthmin. 2N max. 20N
hub/ needle bond strengthmin. 22-69N
Product
performanceComplied with ISO 7886-1, ISO 7864, ISO 9626
Volume2ml, 2,5ml, 3ml, 5ml, 6ml, 10ml, 12ml, 20ml, 24ml, 50ml and 60 ml
Sizes14G,15G,16G,18G,19G,20G,21G,22G,23G,24G,25G,26G,27G,28G,29G,30G
Needle Lengths4–50 mm
Piston materialIsoprene Rubber
Barrel materialPP
Plunger materialPP/PE
Needle materialPP, SUS304
SAL$10^{-6}$
Endotoxin Limit20 EU per device
BiocompatibilityComplied with ISO 10993-4/5/10/11 (Cytotoxicity, Irritation, Sensitization
Acute Systemic Toxicity. Hemolytical effect)

7

Image /page/7/Picture/0 description: The image shows the logo for SER Medikal. The logo consists of a blue square with a white "S" inside of it. To the right of the square is the text "SER MEDIKAL" in a gray, sans-serif font. The logo is simple and modern, and the colors are clean and professional.

Table 5.2. Device Description Summary for Insulin Syringe

ITEMSubject Device
Product nameSterile Insulin Syringe for Single use, with needle
Indications for useThe sterile insulin syringe for single use with needle, with the calibration unit of
insulin for U-100, is a device intended for medical purposes for the manual
aspiration of insulin, and for the injection of insulin into parts of the body
below the surface skin.
The sterile insulin syringe for single use with needle, with the calibration unit of
insulin for U-40 is a device intended for medical purposes for the manual
aspiration of insulin, and for the injection of insulin into parts of the body
below the surface skin.
ConfigurationNeedle Cap, Needle, Piston, Plunger, Barrel, End Cap
Sterility conditionEO Sterilized
Environment of usePrescription use
Intended usersPatient use
Single useYes
Operation modeThe plunger of syringe can be pulled and pushed along inside the barrel,
allowing the syringe to take in and expel the fluids through the connector to
the patient.
Product
performanceComplied with ISO 8537
Volume0.3ml, 0.5ml, 1ml volumes with fixed needle
Needle Lengths8mm, 13mm
Piston materialIsoprene Rubber
Barrel materialPP
Plunger materialPP
Needle materialSUS304
Needle Cap materialPP
End Cap materialPP
SAL10-6
Endotoxin Limit20 EU per device
BiocompatibilityComplied with ISO 10993-4/5/10/11 (Cytotoxicity, Irritation, Sensitization
Acute Systemic Toxicity, Subchronic Toxicity, Hemolytic effect)

8

Image /page/8/Picture/0 description: The image contains the logo for SER Medikal. The logo consists of a blue square with a white "S" inside, followed by the text "SER medikal" in a gray, sans-serif font. The logo is simple and modern, and the use of blue and gray gives it a professional look.

Table 5.3. Device Description Summary for Needle
ITEMSubject Device
Product nameSterile Hypodermic needle for Single use
Indications for useThe Sterile Hypodermic Needle for single use is intended for use with syringes and injection devices for general purpose fluid injection/aspiration.
ConfigurationProtective cap, Needle, Adhesives, Needle hub
Sterility conditionEO Sterilized
Environment of usePrescription use
Intended usersMedical professionals and trained care givers
Single useYes
Operation modeFor Manual Use Only, For Single Use only
Product performanceComplied with ISO 7864, ISO 9626
Sizes14G,15G,16G,18G,19G,20G,21G,22G,23G,24G,25G,26G,27G,28G,29G,30G
Needle Lengths4–50 mm
Protective cap materialPP
Adhesive materialEpoxy resin
Needle Hub materialPP
Needle materialSUS304
SAL material10-6
Endotoxin Limit material20 EU per device
BiocompatibilityComplied with ISO 10993-4/5/10/11 (Cytotoxicity, Irritation, Sensitization Acute Systemic Toxicity, Hemolytical effect)

Technological Characteristics

Table 5.4 Sterile Hypodermic Syringe for Single use, with/without needle; luer/luer-lock Predicate Comparison

Sterile Hypodermic Syringe for Single use, with/without needle; luer/luer-lock
ITEMSubject DevicePredicate Device
K190002Comparison
Product nameSterile Hypodermic Syringe
for Single use, with/without
needle; luer/luer-lockSterile Hypodermic Syringe
for Single use, with/without
needleSimilar
Product codeFMFFMFSame
Regulation No.21 CFR 880.586021 CFR 880.5860Same
ClassIIIISame
Sterile Hypodermic Syringe for Single use, with/without needle; luer/luer-lock
ITEMSubject DevicePredicate Device
K190002Comparison
Indications for useThe Sterile Hypodermic
Syringe for Single Use
with/without needle is
intended to be used for
medical purposes to inject
fluid into or withdraw fluid
from body.The Sterile Hypodermic
Syringe for Single Use
with/without needle is
intended to be used for
medical purposes to inject
fluid into or withdraw fluid
from body.Same
ConfigurationPiston
Plunger
BarrelPiston
Plunger
BarrelSame
Sterility conditionEO SterilizedEO SterilizedSame
Environment of usePrescription usePrescription useSame
Intended usersMedical professionals and
trained care giversMedical professionals and
trained care giversSame
Single useYesYesSame
Operation modeThe plunger of syringe can be
pulled and pushed along inside
the barrel, allowing the syringe
to take in and expel the fluids
through the connector to the
patient.The plunger of syringe can be
pulled and pushed along
inside the barrel, allowing
the syringe to take in and
expel the fluids through the
connector to the patient.Same
Label/labelingComplied with 21 CFR part
801Complied with 21 CFR part
801Same
Product
performanceComplied with
ISO 7886-1
ISO 7864
ISO 9626Complied with
ISO 7886-1
ISO 7864
ISO 9626Same
Volume2ml, 2,5ml, 3ml, 5ml, 6ml, 10ml,
12ml, 20ml, 24ml, 50ml1ml, 3ml, 5ml, 6ml, 10ml,
20ml, 30ml, 35ml, 50ml and
60 mlDifference 1
Sizes14G,15G,16G,18G,19G,20G,
21G,22G,23G,24G,25G,26G,27G,
28G,29G,30G18G,19G,20G,21G,22G,23G,
24G,25G,26G,27G,28G,29G,
30GDifference 2
Needle Lengths4-50 mm4-38 mmDifference 3
Patient contact component and material
PistonIsoprene RubberIsoprene RubberSame
BarrelPPPPSame
PlungerPP/PEPPDifference 4
NeedlePP, SUS304PP, SUS304Same
Sterile Hypodermic Syringe for Single use, with/without needle; luer/luer-lock
ITEMSubject DevicePredicate Device
K190002Comparison
SAL$10^{-6}$$10^{-6}$Same
Endotoxin Limit20 EU per device20 EU per deviceSame

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Image /page/9/Picture/0 description: The image shows the logo for SER Medikal. The logo consists of a blue square with rounded corners and a white "S" inside. To the right of the square is the text "SER MEDIKAL" in a gray, futuristic-looking font. The logo is simple and modern, and the colors are clean and professional.

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Image /page/10/Picture/0 description: The image shows the logo for "SER MEDIKAL". The logo consists of a blue square with a white "S" inside on the left. To the right of the square is the company name, "SER MEDIKAL", in a gray, futuristic-looking font. The logo is simple and modern.

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Table 5.5. Sterile Insulin Syringe for Single use, with needle Predicate Comparison

Sterile Insulin Syringe for Single use, with needle
ITEMSubject DevicePredicate Device
K190002Comparison
Product nameSterile Insulin Syringe for
Single use, with needleSterile Insulin Syringe for
Single use, with needleSame
Product codeFMFFMFSame
Regulation No.21 CFR 880.586021 CFR 880.5860Same
ClassIIIISame
Indications for
useThe sterile insulin syringe for single
use with needle, with the calibration
unit of insulin for U-100, is a device
intended for medical purposes for
the manual aspiration of insulin, and
for the injection of insulin into parts
of the body below the surface skin.
The sterile insulin syringe for single
use with needle, with the calibration
unit of insulin for U-40 is a device
intended for medical purposes for
the manual aspiration of insulin, and
for the injection of insulin into parts
of the body below the surface skin.The sterile insulin syringe for single
use with needle, with the calibration
unit of insulin for U-100, is a device
intended for medical purposes for the
manual aspiration of insulin, and for
the injection of insulin into parts of
the body below the surface skin.
The sterile insulin syringe for single
use with needle, with the calibration
unit of insulin for U-40 is a device
intended for medical purposes for the
manual aspiration of insulin, and for
the injection of insulin into parts of
the body below the surface skin.Same
ConfigurationNeedle Cap
Needle
Piston
Plunger
Barrel
End CapNeedle Cap
Needle
Piston
Plunger
Barrel
End CapSame
Sterility
conditionEO SterilizedEO SterilizedSame
Environment
of usePrescription usePrescription useSame
Intended usersPatient usePatient useSame
Single useYesYesSame
Operation
modeThe plunger of syringe can be pulled
and pushed along inside the barrel,
allowing the syringe to take in andThe plunger of syringe can be pulled
and pushed along inside the barrel,
allowing the syringe to take in andSame

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Image /page/11/Picture/0 description: The image shows the logo for SER Medikal. The logo consists of a blue square with rounded corners and a white "S" inside. To the right of the square is the text "SER MEDIKAL" in a gray, sans-serif font. The logo is simple and modern, and the colors are clean and professional.

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T

Sterile Insulin Syringe for Single use, with needle
ITEMSubject DevicePredicate Device
K190002Comparison
expel the fluids through the
connector to the patient.expel the fluids through the
connector to the patient.
Label/labelingComplied with 21 CFR part
801Complied with 21 CFR part
801Same
Product
performanceComplied with ISO 8537Complied with ISO 8537Same
Volume0.3ml, 0.5ml, 1ml volumes
with fixed needle0.3ml, 0.5ml, 1ml volumes
with fixed needleSame
Needle
Lengths8mm, 13mm8mm, 13mmSame
Patient contact component and material
PistonIsoprene RubberIsoprene RubberSame
BarrelPPPPSame
PlungerPPPPSame
NeedleSUS304SUS304Same
Needle CapPPPPSame
End CapPPPPSame
Sterilization
SAL$10^{-6}$$10^{-6}$Same
Endotoxin
Limit20 EU per device20 EU per deviceSame

Table 5.6. Sterile Hypodermic needle for Single use Predicate Comparison

Sterile Hypodermic needle for Single use
ITEMSubject DevicePredicate Device
K190002Comparison
Product nameSterile Hypodermic needle
for Single useSterile Hypodermic needle
for Single useSame
Product codeFMIFMISame
Regulation No.21 CFR 880.557021 CFR 880.5570Same
ClassIIIISame
Indications for useThe Sterile Hypodermic Needle for single
use is intended for use with syringes and
injection devices for general purpose
fluid injection/aspiration.The Sterile Hypodermic Needle
for single use is intended for
use with syringes and injection
devices for general purpose
fluid injection/aspiration.Same

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Image /page/12/Picture/0 description: The image contains the logo for SER Medikal. The logo consists of a blue square with a stylized white "S" inside, followed by the text "SER MEDIKAL" in a gray, sans-serif font. The logo appears to be for a medical company.

Sterile Hypodermic needle for Single use
ITEMSubject DevicePredicate Device
K190002Comparison
ConfigurationProtective cap
Needle
Adhesives
Needle hubProtective cap
Needle
Adhesives
Needle hubSame
Sterility conditionEO SterilizedEO SterilizedSame
Environment of
usePrescription usePrescription useSame
Intended usersMedical professionals and
trained care giversMedical professionals and
trained care giversSame
Single useYesYesSame
Operation modeFor Manual Use Only, For
Single Use onlyFor Manual Use Only, For
Single Use onlySame
Label/labelingComplied with 21 CFR part
801Complied with 21 CFR part
801Same
Product
performanceComplied with:
ISO 7864
ISO 9626Complied with:
ISO 7864
ISO 9626Same
Sizes14G,15G,16G,18G,19G,20G,21G,22G,23G,
24G,25G,26G,27G,28G,29G,30G18G,19G,20G,21G,22G,23G,
24G,25G,26G,27G,28G,29G,30GDifference
1
Needle Lengths4–50 mm4 – 38 mmDifference
2
Patient contact component and material
Protective capPPPPSame
AdhesiveEpoxy resinEpoxy resinSame
Needle HubPPPPSame
NeedleSUS304SUS304Same
Sterilization
SAL$10^{-6}$$10^{-6}$Same
Endotoxin Limit20 EU per device20 EU per deviceSame

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Substantial Equivalence Discussion

Hypodermic Syringe Discussion

The indications for use statement for the hypodermic syringe subject device is identical to the predicate device. There are no technological differences between the predicate and subject devices except for the following: syringe volumes, needle lengths, and plunger material.

  • . Difference 1: The subject device includes different syringe volumes compared to the predicate. The subject device includes 2ml, 2.5ml, 12ml and 24 ml volume syringes while the predicate does not include these sizes. The predicate device includes 1 ml, 30 ml, 35 ml and 60 ml syringe volumes which the subject device does not include. These slight differences have no adverse effect on clinical safety and performance. All of the subject device hypodermic syringes are tested in accordance with ISO 7886-1 standard. The requirements of the standards are met.
  • . Difference 2: The subject device includes additional needle gauges compared to the predicate. The subject device includes larger needle gauges, including 14G, 15G, and 16G. The needles are tested in accordance with ISO 7864 and ISO 9626 and released in accordance with the standards compliance. This was verified by performance testing according to ISO 7864 and ISO 9626.
  • Difference 3: The subject device includes additional needle lengths compared to the predicate. The subject device includes the following additional needle lengths: 39 mm - 50 mm. The needles are tested in accordance to ISO 7864 and ISO 9626 and released in accordance with the standards compliance. This was verified by performance testing according to ISO 7864 and ISO 9626.
  • Difference 4: The plunger material of the subject device is PP/PE, while the predicate device plunger material is PP. Biocompatibility studies are carried out in according to ISO 10993-1. Biological safety was demonstrated.

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The intended use, principle of operation, and sterilization for the subject device are the same as the predicate device. The differences between the predicate and the subject device do not raise any new or different questions of safety or effectiveness. Therefore, it can be determined that the proposed device is substantially equivalent to the predicate device.

Insulin Syringe Discussion

The indications for use statement for the subject device is identical to the predicate device. There are no technological differences between the subject and the predicate device. This was verified by performance testing according to ISO 8537. The intended use, principle of operation, materials, specifications and sterilization information for the subject device are the same as for the predicate device. Therefore, it can be determined that the proposed device is substantially equivalent to the predicate device.

Needle Discussion

The indications for use statement for the subject device is identical to the predicate device. There are no technological differences between the subject and the predicate device except for the following: needle gauge sizes and needle length.

  • . Difference 1: The subject device includes additional needle gauges compared to the predicate. The subject device includes larger needle gauges, including 14G, 15G, and 16G. The needles are tested in accordance with ISO 7864 and ISO 9626 and released in accordance with the standards compliance. This was verified by performance testing according to ISO 7864 and ISO 9626.
  • Difference 2: The subject device includes additional needle lengths compared to the predicate. The subject device includes the following additional needle lengths: 39 mm - 50 mm. The needles are tested in accordance to ISO 7864 and ISO 9626 and released in accordance with

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the standards compliance. This was verified by performance testing according to ISO 7864 and ISO 9626.

The intended use, principle of operation, materials, and sterilization information for the subject device are the same as the predicate device. The differences between the predicate and the subject device do not raise any new or different questions of safety or effectiveness. Therefore, it can be determined that the proposed device is substantially equivalent to the predicate device.

Performance Testing

The sterile, single lumen hypodermic needles described in this summary were tested and demonstrated to be in conformance with the following FDA recognized standards:

  • ISO 9626 Second edition: Stainless steel needle tubing for the manufacture of medical devices - Requirements and test methods
  • . ISO 7886-1 Second edition 2017-05 Sterile hypodermic syringes for single use - Part 1: Syringes for manual use
  • . ISO 7864:2016 Fourth Edition: Sterile hypodermic needles for single use — Requirements and test methods
  • ISO 10993-4:2017 Biological Evaluation Of Medical Devices — Part 4: Selection Of Tests For Interactions With Blood
  • . ISO 10993-5:2009 Biological Evaluation Of Medical Devices — Part 5: Tests For In Vitro Cytotoxicity
  • ISO 10993-10:2010 Biological Evaluation Of Medical Devices — Part 10: Tests For Irritation And Skin Sensitization
  • . ISO 10993-11:2017 Biological Evaluation Of Medical Devices — Part 11: Tests For Systemic Toxicity
  • . USP 788 Particulate Matter in Injections
  • . ISO 10993-7:2008 Biological evaluation of medical devices — Part 7: Ethylene oxide sterilization residuals
  • . ISO 10993-12:2012 Biological evaluation of medical devices — Part 12: Sample preparation and reference materials

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  • . ISO 11135:2014 Sterilization of health-care products — Ethylene oxide — Requirements for the development, validation and routine control of a sterilization process for medical devices
  • . ISO 11607-2:2019 Packaging for terminally sterilized medical devices — Part 2: Validation requirements for forming, sealing and assembly processes

The sterile, single lumen hypodermic needle is considered in the category of "External Communicating Devices" and are accepted to be in contact for a period less than 24 hours with "Tissue/Bone/Dentin". Thus, cytotoxicity (ISO 10993-5:2009, irritation and sensitization (ISO 10993-10:2010), acute systemic toxicity (ISO 10993-11:2017), hemocompatibility (EN ISO 10993-4:2017) and pyrogenicity (European Pharmacopoeia 9.0 (2.6.8)) were carried out for the device in question.

The sterile, insulin syringe described in this summary were tested and demonstrated to be in conformance with the following FDA recognized standards:

  • . ISO 8537 Third edition 2016-03-15 Sterile single-use syringes, with or without needle, for insulin
  • . ISO 10993-4:2017 Biological Evaluation Of Medical Devices — Part 4: Selection Of Tests For Interactions With Blood
  • ISO 10993-5:2009 Biological Evaluation Of Medical Devices — Part 5: Tests For In Vitro Cytotoxicity
  • . ISO 10993-10:2010 Biological Evaluation Of Medical Devices — Part 10: Tests For Irritation And Skin Sensitization
  • . ISO 10993-11:2017 Biological Evaluation Of Medical Devices — Part 11: Tests For Systemic Toxicity
  • USP 788 Particulate Matter in Injections
  • ISO 10993-7:2008 Biological evaluation of medical devices Part 7: Ethylene oxide ● sterilization residuals
  • ISO 10993-12:2012 Biological evaluation of medical devices — Part 12: Sample preparation and reference materials
  • ISO 11135:2014 Sterilization of health-care products — Ethylene oxide — Requirements for the development, validation and routine control of a sterilization process for medical devices

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  • . ISO 11607-2:2019 Packaging for terminally sterilized medical devices — Part 2: Validation requirements for forming, sealing and assembly processes
    The sterile, insulin syringe is considered in the category of "External Communicating Devices" and are accepted to be in contact for a period between 24 hours - 30 days because of repetitive use of patient with "Tissue/Bone/Dentin". Thus, cytotoxicity (ISO 10993-5:2009, irritation and sensitization (ISO 10993-10:2010), acute systemic toxicity (ISO 10993-11:2017), sub-acute systemic toxicity (ISO 10993-11:2017), sub-chronic systemic toxicity (ISO 10993-11:2017), hemocompatibility (EN ISO 10993-4:2017) and pyrogenicity (European Pharmacopoeia 9.0 (2.6.8)) were carried out for the device in question.

The sterile, needle described in this summary were tested and demonstrated to be in conformance with the following FDA recognized standards:

  • ISO 9626 Second edition: Stainless steel needle tubing for the manufacture of medical devices - Requirements and test methods
  • ISO 7864:2016 Fourth Edition: Sterile hypodermic needles for single use — Requirements and test methods
  • . ISO 10993-4:2017 Biological Evaluation Of Medical Devices — Part 4: Selection Of Tests For Interactions With Blood
  • ISO 10993-5:2009 Biological Evaluation Of Medical Devices — Part 5: Tests For In Vitro Cytotoxicity
  • . ISO 10993-10:2010 Biological Evaluation Of Medical Devices — Part 10: Tests For Irritation And Skin Sensitization
  • ISO 10993-11:2017 Biological Evaluation Of Medical Devices — Part 11: Tests For Systemic Toxicity
  • USP 788 Particulate Matter in Injections
  • ISO 10993-7:2008 Biological evaluation of medical devices — Part 7: Ethylene oxide sterilization residuals
  • ISO 10993-12:2012 Biological evaluation of medical devices — Part 12: Sample preparation and reference materials
  • ISO 11135:2014 Sterilization of health-care products — Ethylene oxide — Requirements for the development, validation and routine control of a sterilization process for medical devices

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  • . ISO 11607-2:2019 Packaging for terminally sterilized medical devices — Part 2: Validation requirements for forming, sealing and assembly processes
    The sterile, needle is considered in the category of "External Communicating Devices" and are accepted to be in contact for a period less than 24 hours with "Tissue/Bone/Dentin". Thus, cytotoxicity (ISO 10993-5:2009, irritation and sensitization (ISO 10993-10:2010), acute systemic toxicity (ISO 10993-11:2017), hemocompatibility (EN ISO 10993-4:2017) and pyrogenicity (European Pharmacopoeia 9.0 (2.6.8)) were carried out for the device in question.

Conclusion

The differences between the predicate and the subject device do not raise any new or different questions of safety or effectiveness. The subject devices are substantially equivalent to the predicate devices with respect to the indications for use, target populations, treatment method, and technological characteristics.