K Number
K213146
Device Name
Safety butterfly type blood collection needle, Butterfly type blood collection needle, Pen type blood collection needle, Safety pen
Date Cleared
2023-10-27

(760 days)

Product Code
Regulation Number
862.1675
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Safety pen type blood Collection needle is intended to be used with vacuum blood collection tube for multiple collections of venous blood. The Safety butterfly type blood Collection needle is intended to be used with vacuum blood collection tube for multiple collections of venous blood. The pen type blood Collection needle is intended to be used with vacuum blood collection of venous blood. The butterfly type blood Collection needle is intended to be used with vacuum blood collection tube for multiple collections of venous blood.
Device Description
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More Information

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No
The 510(k) summary describes a blood collection needle, a purely mechanical device, and contains no mention of AI, ML, image processing, or data analysis that would suggest the use of such technologies.

No
The device is a blood collection needle, which is used for diagnostic purposes (collecting blood for testing), not for treating a disease or condition.

No
Explanation: The device is a blood collection needle, which is used for obtaining samples, not for diagnosing conditions.

No

The intended use clearly describes physical blood collection needles, which are hardware devices, not software.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD devices are used to examine specimens from the human body to provide information for diagnosis, monitoring, or treatment. This device is used to collect the specimen (blood).
  • The intended use clearly states the purpose is for "multiple collections of venous blood" or "collection of venous blood". This describes a sample collection tool, not a diagnostic test performed on the sample.

While the collected blood will likely be used for IVD testing, the needle itself is a medical device used for specimen collection, not an IVD.

N/A

Intended Use / Indications for Use

The Safety pen type blood Collection needle is intended to be used with vacuum blood collection tube for multiple collections of venous blood.

The Safety butterfly type blood Collection needle is intended to be used with vacuum blood collection tube for multiple collections of venous blood.

The pen type blood Collection needle is intended to be used with vacuum blood collection of venous blood.

The butterfly type blood Collection needle is intended to be used with vacuum blood collection tube for multiple collections of venous blood.

Product codes

JKA, FMI

Device Description

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Mentions image processing

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Mentions AI, DNN, or ML

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Input Imaging Modality

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Anatomical Site

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Indicated Patient Age Range

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Intended User / Care Setting

Prescription Use (Part 21 CFR 801 Subpart D)

Description of the training set, sample size, data source, and annotation protocol

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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)

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Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

Not Found

Reference Device(s)

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Predetermined Change Control Plan (PCCP) - All Relevant Information

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§ 862.1675 Blood specimen collection device.

(a)
Identification. A blood specimen collection device is a device intended for medical purposes to collect and to handle blood specimens and to separate serum from nonserum (cellular) components prior to further testing. This generic type device may include blood collection tubes, vials, systems, serum separators, blood collection trays, or vacuum sample tubes.(b)
Classification. Class II.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food & Drug Administration (FDA). On the left, there is a symbol representing the Department of Health & Human Services. To the right of the symbol, the acronym "FDA" is displayed in a blue box, followed by the words "U.S. FOOD & DRUG" in a larger, bold font. Below that, the word "ADMINISTRATION" is written in a smaller font.

October 27, 2023

Jiangsu Rongye Technology Co., Ltd. Tina Jiang Sales Manager Touqiao Town, Yangzhou City Jiangsu, 225109 China

Re: K213146

Trade/Device Name: Safety butterfly type blood collection needle, Butterfly type blood collection needle, Pen type blood collection needle, Safety pen type blood collection needle Regulation Number: 21 CFR 862.1675 Regulation Name: Blood Specimen Collection Device Regulatory Class: Class II Product Code: JKA, FMI Dated: September 25, 2023 Received: September 27, 2023

Dear Tina Jiang:

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 (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 available at https://www.accessdata.fda.gov/scripts/cdrb/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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device"

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(https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30, Design controls; 21 CFR 820.90, Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review. the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 Part 803) for devices or postmarketing safety reporting (21 CFR Part 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 Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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,

David Walloschek

David Wolloscheck, Ph.D. Assistant Director DHT3C: Division of Drug Delivery and General Hospital Devices. and Human Factors

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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) K213146

Device Name

Safety butterfly type blood collection needle, Butterfly type blood collection needle, Safety pen type blood collection needle

Indications for Use (Describe)

The Safety pen type blood Collection needle is intended to be used with vacuum blood collection tube for multiple collections of venous blood.

The Safety butterfly type blood Collection needle is intended to be used with vacuum blood collection tube for multiple collections of venous blood.

The pen type blood Collection needle is intended to be used with vacuum blood collection of venous blood.

The butterfly type blood Collection needle is intended to be used with vacuum blood collection tube for multiple collections of venous blood.

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)

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