K Number
K201930
Device Name
Nanum Syringe
Date Cleared
2021-01-17

(191 days)

Product Code
Regulation Number
880.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Nanum Syringe is the plastic syringe for Single use, with/without needle is intended to be used for medical purposes to inject fluid into or withdraw fluid from body.
Device Description
A sterile device consisting of a calibrated barrel (cylinder) with plunger intended to be used for injection/withdrawal of fluids/gas (e.g., medication) to/from a medical device or the body (i.e., capable of both); a needle is not included. It is intended for various medical applications and is not dedication administration. At the distal end of the barrel is a male connector (typically Luer-lock/slip type) for the attachment to a hypodermic needle or an administration set. It is typically made of plastic and silicone materials and may have anti-stick plunger allowing smooth plunger movement, either manually or by a syringe pump. This is a single-use device.
More Information

Not Found

No
The device description and intended use are for a standard plastic syringe, and there is no mention of AI, ML, image processing, or any other technology typically associated with AI/ML in medical devices. The performance studies are standard bench tests for mechanical and biocompatibility properties.

No
The device is a syringe used for injecting or withdrawing fluids, which is a delivery mechanism, not a therapeutic treatment itself.

No
The device description states it is a "plastic syringe for Single use" intended "to inject fluid into or withdraw fluid from body." This describes an instrument for administration, not for diagnosis.

No

The device description explicitly states it is a physical, sterile device made of plastic and silicone materials, intended for injecting/withdrawing fluids. It is a hardware device.

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

Here's why:

  • Intended Use: The intended use is to "inject fluid into or withdraw fluid from body." This describes a direct interaction with the human body for therapeutic or diagnostic purposes within the body, not for testing samples outside the body.
  • Device Description: The description details a device for injecting/withdrawing fluids/gas to/from a medical device or the body. This aligns with the intended use and does not mention any components or functions related to analyzing biological samples.
  • Lack of IVD Characteristics: There is no mention of analyzing samples, reagents, or any other elements typically associated with in vitro diagnostics.

IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. The Nanum Syringe's function is purely mechanical for fluid transfer to or from the body.

N/A

Intended Use / Indications for Use

Nanum Syringe is the plastic syringe for Single use, with/without needle is intended to be used for medical purposes to inject fluid into or withdraw fluid from body.

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

FMF

Device Description

A sterile device consisting of a calibrated barrel (cylinder) with plunger intended to be used for injection/withdrawal of fluids/gas (e.g., medication) to/from a medical device or the body (i.e., capable of both); a needle is not included. It is intended for various medical applications and is not dedication administration. At the distal end of the barrel is a male connector (typically Luer-lock/slip type) for the attachment to a hypodermic needle or an administration set. It is typically made of plastic and silicone materials and may have anti-stick plunger allowing smooth plunger movement, either manually or by a syringe pump. This is a single-use device.

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

Bench test were performed. Bench testing included biocompatibility and mechanical testing. The tests demonstrated that the device performs in a substantially equivalent manner to the predicate device. The following bench testing is performed to demonstrate the functionality is substantially equivalent.
Test item: Appearance and Structure, Requirements: MFDA Notification No. 2018-72, The standards for the medical device
Test item: Nozzle, Requirements: ISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use, Results: Pass — MTK-2019-000829
Test item: Scale, Requirements: ISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Test item: Piston/Plunger Assembly, Requirements: ISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Test item: Tightness, Requirements: ISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Test item: Extraction test : pH, Requirements: ISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Test item: Extraction test : Heavy metal, Requirements: ISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Test item: Extraction test : Potassium permanganate-reducible substances, Requirements: ISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Test item: Extraction test : Residue on evaporation, Requirements: ISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Test item: Quantity of silicone oil, Requirements: ISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Test item: Shelf life test, Requirements: ASTM1980-07: 2011 Standard guide for Accelerated Aging of Sterile Barrier System for Medical Device ISO11607-1:2006 Packaging for terminally sterilized medical devices, Results: NC-SLR-1902
Test item: Performance test of Real time and accelerated aged devices, Results: NC-060-F0729 NC-060-F0421

Biocompatibility tests:

Test item: Cytotoxicity, Test method / Test criteria: ISO 10993-5(2009) Biological evaluation of medical devices - Part 5: Tests for in vitro cytotoxicity, Test result: Pass

Test item: Acute systemic toxicity test, Test method / Test criteria: ISO 10993-11(2009) Biological evaluation of medical devices - Part 11: Tests for systemic toxicity, Test result: Pass

Test item: Pyrogen test, Test method / Test criteria: ISO 10993-11 Test for systemic toxicity, pyrogen test, Test result: Pass

Test item: Sensitization test, Test method / Test criteria: ISO 10993-10 (2010), Test result: Pass

Test item: Hemolytic test, Test method / Test criteria: ISO 10993-4:2017, ASTM F756-17, Test result: Pass

Test item: Intracutaneous reactivity test, Test method / Test criteria: ISO 10993-10 (2010), Test result: Pass

Test item: LAL Test, Test method / Test criteria: ISO 10993-11 Test for systemic toxicity, pyrogen test, Test result: Pass MSK-2020-002259

The performance tests demonstrated that the subject device performs in a substantially equivalent manner 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).

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Image /page/0/Picture/0 description: The image contains two logos. On the left is the Department of Health & Human Services logo. On the right is the FDA logo, which includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

January 17, 2021

Nanum Company Co., Ltd % Peter Chung President Plus Global 300 Atwood St. Pittsburgh, Pennsylvania 15213

Re: K201930

Trade/Device Name: Nanum Syringe Regulation Number: 21 CFR 880.5860 Regulation Name: Piston Syringe Regulatory Class: Class II Product Code: FMF Dated: June 24, 2020 Received: July 10, 2020

Dear Mr. Chung:

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

1

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 (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 mediation-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,

Cindy Chowdhury, Ph.D., M.B.A. Assistant Director DHT4B: Division of Infection Control and Plastic Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K201930

Device Name Nanum Syringe

Indications for Use (Describe)

Nanum Syringe is the plastic 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)

X Prescription Use (Part 21 CFR 801 Subpart D)

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

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3

510(k) Summary

1. Applicant

  • Company : NANUM COMPANY Co., Ltd 1)
  • Address : 4th floor, 40, Siji-ro, Suseong-gu, Daegu, Korea 2)
  • Tel : 82-53-795-7076 3)
    1. Fax : 82-53-795-7078
    1. Prepared date : June 24, 2020
  • ୧) Contact person : Peter Chung, 412-512-8802
    1. Contact person address : 300, Atwood Street, Pittsburgh, PA, 15213, USA
    1. Submission date : Nov. 20, 2020

2. Device Information

    1. Trade name : Nanum Syringe
    1. Common name : Piston Syringe
  • Regulation name : Syringe, Piston 2)
    1. Product code : FMF
    1. Regulation number : 880.5860
  • Class of device : Class II 5)
    1. Panel : General Hospital

3. The legally marketed device to which we are claiming equivalence

K190002, Shanghai Kohope Medical Devices Co., Ltd. / Sterile Hypodermic Syringe for Single use, with/without needle

4. Device description

A sterile device consisting of a calibrated barrel (cylinder) with plunger intended to be used for injection/withdrawal of fluids/gas (e.g., medication) to/from a medical device or the body (i.e., capable of both); a needle is not included. It is intended for various medical applications and is not dedication administration. At the distal end of the barrel is a male connector (typically Luer-lock/slip type) for the attachment to a hypodermic needle or an administration set. It is typically made of plastic and silicone materials and may have anti-stick plunger allowing smooth plunger movement, either manually or by a syringe pump. This is a single-use device.

5. Intended Use

Nanum Syringe is the plastic syringe for Single use, with/without needle is intended to be used for medical purposes to inject fluid into or withdraw fluid from body.

6. Performance data:

    1. Bench test were performed. Bench testing included biocompatibility and mechanical testing. The tests demonstrated that the device performs in a substantially equivalent manner to the predicate device. The following bench testing is performed to demonstrate the functionality is substantially equivalent.
Test itemRequirementsResults
Appearance and StructureMFDA Notification No. 2018-72, The standards for the medical device
NozzleISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes
for manual usePass — MTK-
2019-
000829
ScaleISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes
for manual use
Piston/Plunger AssemblyISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes
for manual use

4

TightnessISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Extraction test : pHISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Extraction test : Heavy metalISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Extraction test : Potassium
permanganate-reducible
substancesISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Extraction test : Residue on
evaporationISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
Quantity of silicone oilISO 7886-1:2017 Sterile hypodermic syringes for single use — Part 1: Syringes for manual use
ASTM1980-07: 2011 Standard guide for Accelerated Aging of Sterile
Barrier System for Medical Device
ISO11607-1:2006 Packaging for terminally sterilized medical devicesNC-SLR-
1902
Shelf life testPerformance test of Real time and accelerated aged devicesNC-060-
F0729
NC-060-
F0421

2) Biocompatibility

#Test itemTest method / Test criteriaTest result
1CytotoxicityISO 10993-5(2009) Biological evaluation of medical devices - Part 5: Tests for in vitro cytotoxicityPass
2Acute systemic toxicity testISO 10993-11(2009) Biological evaluation of medical devices - Part 11: Tests for systemic toxicityPass
3Pyrogen testISO 10993-11 Test for systemic toxicity, pyrogen testPass
4Sensitization testISO 10993-10 (2010)Pass
5Hemolytic testISO 10993-4:2017, ASTM F756-17Pass
6Intracutaneous reactivity testISO 10993-10 (2010)Pass
7LAL TestISO 10993-11 Test for systemic toxicity, pyrogen testPass
MSK-2020-
002259

The performance tests demonstrated that the subject device performs in a substantially equivalent manner to the predicate device.

7. Predicate device comparison table

ManufacturerNANUM COMPANY Co., LtdShanghai Kohope Medical Devices Co., Ltd.Remark
510(k) No.N/AK190002N/A
Indication for useNanum Syringe is the plastic 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.Similar
Classification
nameSyringe, PistonSyringe, PistonSame

5

ManufacturerNANUM COMPANY Co., LtdShanghai Kohope Medical Devices Co., Ltd.Remark
Trade nameNanum SyringeSterile Hypodermic Syringe for Single use,
with/without needle, Sterile Insulin Syringe
for Single use, with needle, Sterile
Hypodermic needle for Single useN/A
Model/typeNS-10, NS-20, NS-50N/AN/A
ComponentsCylinder, Plunger, Gasket, ClipBarrel, Plunger, PistonSimilar
Nozzle typeLock type, Lock clip typeLock and Slip typeSimilar
Materials
Barrel
Plunger
PistonPP
PP
RubberPP
PP
RubberSame
Capacity10mL, 20mL, 50mL1mL, 2mL, 3mL, 5mL, 10mL, 20mL, 30mL,
35mL, 50mL, 60mLSimilar
Principle of
operationManualManualSame
PerformancesComplies with ISO 7886-1 : 2017 Sterile
hypodermic syringes for single use – Part 1 :
Syringes for manual useComplies with ISO 7886-1 : 2017 Sterile
hypodermic syringes for single use - Part 1 :
Syringes for manual useSame
BiocompatibilityCytotoxicity
Acute systemic toxicity
Pyrogenicity
Sensitization
Hemolysis
Intracutaneous test
Endotoxin (LAL) testCytotoxicity
Acute systemic toxicity
Pyrogenicity
Sensitization
Irritation
Subacute toxicitySimilar
Principle of
OperationThe 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

8. Conclusion

The device is investigated for function to compare the operation of function between Nanum Syringe and predicate devices.

Comparison results demonstrate that the specifications and performance of the device are substantially equivalent to the legally marketed predicate device.

Therefore, it is concluded that Nanum Syringe are substantially equivalent to the legally marketed predicate device.