K Number
K210748
Date Cleared
2022-05-25

(439 days)

Product Code
Regulation Number
880.5570
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

This device is intended for use with pen injector devices for the subcutaneous injection of insulin.

Device Description

The Well-life™ Safety Pen Needles and Well-life™ Pen Needles are single use, sterile, disposable medical devices intended to be used with compatible insulin pen injectors. The pen needles are intended for use by adults and pediatrics in a home, clinical, or hospital environment. The devices are sterilized by Ethylene Oxide (EO) to a sterility assurance level of 10 °. The Well-life™ Pen Needles consist of a Needle, Hub, Needle Cap, and Sterile Cap. The Well-life™ Safety Pen Needles consist of a Needle, Hub, Needle Cap, Sterile Cap, Guide, Safety Cap, and Spring. To use the devices, the Needle Hub is screwed onto a compatible pen injector. The Well-life™ Safety Pen Needle (i.e., S type) is designed to reduce occurrence of accidental needle sticks from patient end of the needle by providing a shield that covers and locks the needle after use. As the user proceeds with inserting the needle into the skin, the Needle Cap will retract. After the injection is completed and needle is removed from the skin, the safety cap will automatically extend to cover the needle. Once the pen needle is locked out, it can no longer be used.

AI/ML Overview

The provided text describes the 510(k) premarket notification for "Well-life™ Pen Needles" and "Well-life™ Safety Pen Needles." This submission focuses on establishing substantial equivalence to legally marketed predicate devices through performance data (bench testing and biocompatibility) and a comparison of device characteristics.

However, the provided document DOES NOT describe an AI/ML-driven medical device. Therefore, it is not possible to extract information related to:

  • Acceptance criteria for an AI/ML model
  • A study proving an AI/ML device meets acceptance criteria
  • Sample size for a test set or its provenance for an AI/ML model
  • Number of experts for ground truth establishment for an AI/ML model
  • Adjudication methods for an AI/ML model's test set
  • Multi-reader multi-case (MRMC) comparative effectiveness study for AI assistance
  • Standalone performance of an algorithm (AI only)
  • Type of ground truth used for an AI/ML model
  • Sample size for the training set of an AI/ML model
  • How ground truth for the training set was established for an AI/ML model

The document details the physical and biological testing of the pen needles to ensure they meet established standards and are substantially equivalent to the predicate devices. The "performance data" section (page {5}) lists various tests and their requirements, predominantly referencing ISO standards for physical characteristics, material properties, and sterility. The "biocompatibility" section (page {5} - {6}) lists tests related to the device's interaction with the human body. These are physical device performance evaluations, not AI/ML model performance evaluations.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA acronym along with the full name of the agency on the right. The Department of Health & Human Services logo features a stylized human figure, while the FDA part includes the acronym in a blue square and the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

W. L. Med Co., Ltd. % Peter Chung President Plus Global 300. Atwood Street Pittsburgh, Pennsylvania 15213

Re: K210748

Trade/Device Name: Well-life™ Pen Needles, Well-life™ Safety Pen Needles Regulation Number: 21 CFR 880.5570 Regulation Name: Hypodermic single lumen needle Regulatory Class: Class II Product Code: FMI Dated: April 25, 2022 Received: April 27, 2022

Dear Peter 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 requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part

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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 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,

For CAPT Alan Stevens 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

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Indications for Use

510(k) Number (if known) K210748

Device Name Well-life™ Safety Pen Needles Well-life™ Pen Needles

Indications for Use (Describe) This device is intended for use with pen injector devices for the subcutaneous injection of insulin.

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 K210748

1. Applicant

    1. Company : W. L. MED Co., Ltd.
  • Address : 246, Geumgwangosan-ro, Geumgwang-yeon, Anseong-si, Gyeonggi-do, Korea 2)
    1. Tel : 82-31-8057-2162
    1. Fax : 82-31-8057-2163
  • Prepared date : Feb 26, 2021 ട്)
  • Contact person : Peter Chung, 412-512-8802 ()
  • Contact person address : 300, Atwood Street, Pittsburgh, PA, 15213, USA 7)
    1. Submission date : May. 20, 2022

2. Device Information

    1. Trade name : Well-life™ Safety Pen Needles and Well-life™ Pen Needles
  • Common name : Hypodermic single lumen needle 2)
  • Regulation name : Needle, hypodermic, Single Lumen 3)
    1. Product code : FMI
  • Regulation number : 880.5570 5)
  • ର) Class of device : Class II
  • Panel : General Hospital 7)
    1. Model Types
G-type
G2904G2905G2906G2908G2910G2912G3004G3005
G3006G3008G3010G3012G3104G3105G3106G3108
G3110G3112G3204G3205G3206G3208G3210G3304
G3305G3306G3308G3310G3404G3405G3406G3408
P-type
P2904P2905P2906P2908P2910P2912P3004P3005
P3006P3008P3010P3012P3104P3105P3106P3108
P3110P3112P3204P3205P3206P3208P3210P3304
P3305P3306P3308P3310P3404P3405P3406P3408
S-type
S2904S2905S2906S2908S2910S2912S3004S3005
S3006S3008S3010S3012S3104S3105S3106S3108
S3110S3112S3204S3205S3206S3208S3210S3304
S3305S3306S3308S3310S3404S3405S3406S3408

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

Predicate Device #1: K113186, ShinaPen / SHINA CORPORATION

Predicate Device #2: K172095, Autokeeper / MedExel Co., Ltd.

4. Device description

The Well-life™ Safety Pen Needles and Well-life™ Pen Needles are single use, sterile, disposable medical devices intended to be used with compatible insulin pen injectors. The pen needles are intended for use by adults and pediatrics in a home, clinical, or hospital environment. The devices are sterilized by Ethylene Oxide (EO) to a sterility assurance level of 10 °.

The Well-life™ Pen Needles consist of a Needle, Hub, Needle Cap, and Sterile Cap. The Well-life™ Safety Pen Needles consist of a Needle, Hub, Needle Cap, Sterile Cap, Guide, Safety Cap, and Spring. To use the devices, the Needle Hub is screwed onto a compatible pen injector.

The Well-life™ Safety Pen Needle (i.e., S type) is designed to reduce occurrence of accidental needle sticks from patient end of the needle by providing a shield that covers and locks the needle after use. As the user proceeds

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with inserting the needle into the skin, the Needle Cap will retract. After the injection is completed and needle is removed from the skin, the safety cap will automatically extend to cover the needle. Once the pen needle is locked out, it can no longer be used.

ModelGaugeLengthWall TypeModelGaugeLengthWall Type
G29044P29044
G290529G5P290529G5
G29066RWP29066RW
G29088P29088
G291010P291010
G291212.7P291212.7
G30044P30044
G300530G5P300530G5
G30066P30066
G30088P30088
G301010P301010
G301212.7P301212.7
G31044P31044
G310531G5P310531G5
G31066P31066
G31088P31088
G311010P311010
G311212.7P311212.7
G320432G4TWP320432G4TW
G32055P32055
G32066P32066
G32088P32088
G321010P321010
G33044P33044
G33055P33055
G330633G6P330633G6
G33088P33088
G331010P331010
G34044P34044
G340534G5P340534G5
G34066P34066
G34088P34088
S29044S311031G10
S290529G5S311212.7
S29066RWS32044
S29088S32055TW
S291010S320632G6
S291212.7S32088
S300430G4TWS321010

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S30055S33044
S30066S33055
S30088S330633G 6
S301010S33088
S301212.7S331010
S31044S34044
S310531G 5S340534G 5
S31066S34066
S31088S34088

5. Intended Use

This device is intended for use with pen injector devices for the subcutaneous injection of insulin.

6. Performance data:

  • Bench testing was performed for the Well-life™ Safety Pen Needle and Well-life™ Pen Needle. The tests, shown 1) below, demonstrated that the device performs in a substantially equivalent manner to the predicate device.
Test itemRequirements
DimensionISO 11608-2:2012 Dimension, General, Dimension for needles
Flow rateISO 11608-2:2012 Determination of flow rate through the needle
Bond between hub and needle tubeISO 11608-2:2012 Bond between hub and needle tube
Needle point freedom from defectslubrication testISO 11608-2:2012 Needle point, Freedom from defects, Lubrication
Dislocation of measuring point atpatient endISO 11608-2:2012 Dislocation of measuring point at patient end
Compatibility of needles and injectorsystemISO 11608-2:2012 Determination of functional compatibility with needle-basedinjection systems
Ease of assembly and disassemblyISO 11608-2:2012 Ease of assembly and disassembly
MaterialsISO 9626:2016 Stainless steel needle tubing for the manufacture of medical devices.
Surface finish and visual appearanceISO 9626:2016 Stainless steel needle tubing for the manufacture of medical devices.
CleanlinessISO 9626:2016 Stainless steel needle tubing for the manufacture of medical devices.
Limits for acidity and alkalinityISO 9626:2016 Stainless steel needle tubing for the manufacture of medical devices.
Size DesignationISO 9626:2016 Stainless steel needle tubing for the manufacture of medical devices.
DimensionISO 9626:2016 Stainless steel needle tubing for the manufacture of medical devices.
StiffnessISO 9626:2016 Stainless steel needle tubing for the manufacture of medical devices.
Resistance to breakageISO 9626:2016 Stainless steel needle tubing for the manufacture of medical devices.
Resistance to corrosionISO 9626:2016 Stainless steel needle tubing for the manufacture of medical devices.
Simulated Clinical Use testReferenced with ISO23908:2011
ElasticityMFDS Notification No 2020-20 "Needle, aspiration/injection, single-use"
Flexural rigidity testMFDS Notification No 2020-20 "Needle, aspiration/injection, single-use"
Draw testOver 11N
Safety device operation testThe Safety cap should work after injection
Extraction testMFDS Notification No 2020-20 "Needle, aspiration/injection, single-use"
SterilityKorean Pharmacopeia / General Requirements for tests and assays / Sterility test
EO gas residualsISO 10993-7:2008 Ethylene oxide sterilization residuals

2) Biocompatibility

#Test itemTest method / Test criteria
1CytotoxicityISO 10993-5(2009) Biological evaluation of medical devices - Part 5: Tests for invitro cytotoxicity
2Acute systemic toxicity testISO 10993-11(2009) Biological evaluation of medical devices - Part 11: Tests forsystemic toxicity
3Pyrogen testISO 10993-11 Test for systemic toxicity, pyrogen test
4Sensitization testISO 10993-10 (2010)

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5Hemolytic testISO 10993-4:2017, ASTM F756-17
6Intracutaneous reactivity testISO 10993-10 (2010)
7Endotoxin testISO 10993-11 Tests for systemic toxicity

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

7. Predicate device comparison table Well-life™ Pen Needle

Device NameSubject DevicePredicate Device #1RemarkDevice NameSubject DevicePredicate Device #2Remark
ManufacturerW.L. MEDSHINA CORPORATIONN/AManufacturerW.L. MEDMedExelN/A
510(k) NumberN/AK113186N/A510(k) NumberN/AK172095N/A
Product CodeFMIFMISameProduct CodeFMIFMISame
DesignSterile CapImage: Sterile Cap Subject DeviceImage: Sterile Cap Predicate DeviceSimilarDesignPrimary containerImage: Primary container of Subject DeviceImage: Primary container of Predicate Device #2Similar
Needle CapImage: Needle Cap Subject DeviceImage: Needle Cap Predicate DeviceSimilarIntended UseThe Well-life safety pen needle is designed for use with a pen injector for the subcutaneous injection of insulin.The MedExel Autokeeper is intended for use with insulin pens for the subcutaneous injection of insulin.Additionally, the attached safety shield automatically locks in place and reduces the occurrence of accidental needle sticks form the patient end of the needle. The shield also serves to hide the needle before and after injection.Similar
Needle And HubImage: Needle and Hub Subject DeviceImage: Needle and Hub Predicate DeviceSimilarLength4mm, 5mm, 6mm, 8mm, 10 mm , 12.7mm4mm, 5mm, 6mm, 8mmSame
Intended UseThe Well-life pen needle is designed for use with a pen injector for the subcutaneous injection of insulin.The ShinaPen® is designed for use with a pen injector for the subcutaneous injection of insulin.SimilarGauge29G 30G 31G 32G, 33G, 34G29G, 30G, 31G, 32G, 33G, 34GSimilar
Length4mm, 5mm, 6mm, 8mm, 10 mm , 12.7mm4mm, 6mm, 8mm, 12.7mmDifferentBiocompatibilityConform ISO 10993-1Conform ISO 10993-1Same
Gauge29G 30G 31G 32G, 33G, 34G29G 30G 31G 32GDifferentMaterialsNeedle tubeSTS304STS304Same
BiocompatibilityConform ISO 10993-1Conform ISO 10993-1SameHub1-Propene polymer with ethenePolypropyleneDifferent
MaterialsNeedleSTS304STS304SamePrimary containerPolyethylenePolyethyleneSame
Hub1-Propene polymer with ethenePolypropyleneSameSiliconPoly di-methyl siloxanePoly di-methyl siloxaneSame
Needle capPolypropylenePolyethyleneDifferentSterilitySterilized by ethyleneoxide gas SAL = 10-6Sterilized by ethyleneoxide gas SAL = 10-6Same
SiliconPoly di-methyl siloxanePoly di-methyl siloxaneSame
SterilitySterilized by ethyleneSterilized by ethyleneSame
oxide gasSAL = 10-6oxide gasSAL = 10-6
Type of useSingle use, DisposableSingle use, DisposableSame

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The subject device and predicate device outlined above consist of the same materials for each component. The difference in needle length does not impact substantial equivalence as the subject devices needle lengths are in range of the predicate. The difference in needle gauge does not impact substantial equivalence based on the performed bench testing. The difference in Hub material does not impact substantial equivalence based on performed biocompatibility testing.

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Well-life™ Safety Pen Needle

The subject device and predicate device outlined above consist of the same materials for each component. The difference in needle length does not impact substantial equivalence as the subject devices needle lengths are in range of the predicate. The difference in needle gauge does not impact substantial equivalence based on the performed bench testing. The difference in Hub material does not impact substantial equivalence based on performed biocompatibility testing.

8. Conclusion

Comparison results demonstrate that the specifications and performance of the device are substantially equivalent to the legally marketed predicate devices. Therefore, it is concluded that Well-life™ Pen Needles and Well-life™ Safety Pen Needles are substantially equivalent to the legally marketed predicate devices.

§ 880.5570 Hypodermic single lumen needle.

(a)
Identification. A hypodermic single lumen needle is a device intended to inject fluids into, or withdraw fluids from, parts of the body below the surface of the skin. The device consists of a metal tube that is sharpened at one end and at the other end joined to a female connector (hub) designed to mate with a male connector (nozzle) of a piston syringe or an intravascular administration set.(b)
Classification. Class II (performance standards).