K Number
K220185
Device Name
Sterile Safety Insulin Syringes for Single Use
Date Cleared
2022-07-11

(168 days)

Product Code
Regulation Number
880.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Sterile Safety Insulin Syringes For Single Use are a sterile, single-use, disposable and non-reusable, manual retractable safety insulin syringe intended for injection of U40 or U100 insulin into the body, the sliding sleeve helps protect against needle puncture once activated.
Device Description
KDL Sterile safety insulin syringes have a sliding sleeve which is designed to shield the injection needle to protect the user from needle puncture and the sliding sleeve helps protect against needle puncture once activated. The sliding sleeve can be activated manually.
More Information

Not Found

No
The device description and performance studies focus on mechanical safety features and standard compliance, with no mention of AI or ML.

No
The device is described as an insulin syringe for injection, which is a delivery mechanism for a drug (insulin), not a therapeutic device in itself. Its safety features are for preventing needle-stick injuries, not for providing therapy.

No
The device is described as an insulin syringe intended for injecting insulin into the body, which is a therapeutic rather than a diagnostic function.

No

The device is a physical syringe with a safety mechanism, not a software application.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used outside the body (in vitro).
  • Device Intended Use: The intended use of this device is for the "injection of U40 or U100 insulin into the body." This is an action performed on the body (in vivo), not a test performed on a sample taken from the body.
  • Device Description: The description focuses on the physical features of the syringe and its safety mechanism for injection, not on any diagnostic testing capabilities.

Therefore, based on the provided information, the Sterile Safety Insulin Syringes are a medical device used for administering medication, not for in vitro diagnostic testing.

N/A

Intended Use / Indications for Use

The Sterile Safety Insulin Syringes For Single Use are a sterile, single-use, disposable and non-reusable, manual retractable safety insulin syringe intended for injection of U40 or U100 insulin into the body, the sliding sleeve helps protect against needle puncture once activated.

Product codes

MEG, FMF, FMI

Device Description

KDL Sterile safety insulin syringes have a sliding sleeve which is designed to shield the injection needle to protect the user from needle puncture and the sliding sleeve helps protect against needle puncture once activated. The sliding sleeve can be activated manually.

Models of Sterile safety insulin syringes for single use shown in Table 1-1 are available in various models according to different insulin concentration and syringe volume.

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

Non-clinical tests were conducted to verify that the proposed device met all design specifications as was Substantially Equivalent (SE) to the predicate device. The test results demonstrated that the proposed device complies with the following standards: ISO 8537: 2016, ISO 7864:2016, ISO 9626:2016, ISO 23908:2011, Guidance for Industry and FDA Staff: Medical Devices with Sharps Injury Prevention Features, ISO 10993-1:2018, ISO 10993-4:2017, ISO 10993-5:2009, ISO 10993-7:2008, ISO 10993-10: 2010, ISO 10993-11:2017, and USP . No clinical study is included in this submission.

Key Metrics

Not Found

Predicate Device(s)

K191639

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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 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 blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

July 11, 2022

Shanghai Kindly Enterprise Development Group Co., Ltd. % Amy Li Technical Director Shanghai Mind-link Consulting Co., Ltd. Room A08, Floor 14th, No 699, Jiaozhou Road, Jingan District Shanghai, 200040 China

Re: K220185

Trade/Device Name: Sterile Safety Insulin Syringes for Single Use Regulation Number: 21 CFR 880.5860 Regulation Name: Piston Syringe Regulatory Class: Class II Product Code: MEG, FMF, FMI Dated: June 10, 2022 Received: June 13, 2022

Dear Amy Li:

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

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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,

CAPT Alan M. 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) K220185

Device Name Sterile Safety Insulin Syringes For Single Use

Indications for Use (Describe)

The Sterile Safety Insulin Syringes For Single Use are a sterile, single-use, disposable and non-reusable, manual retractable safety insulin syringe intended for injection of U40 or U100 insulin into the body, the sliding sleeve helps protect against needle puncture once activated.

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)

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This 510(k) summary is being submitted in accordance with the requirements of Title 21, CFR Section 807.92.

The assigned 510(k) Number: K220185

    1. Date of preparation: July 8, 2022
    1. Sponsor Identification

Shanghai Kindly Enterprise Development Group Co., Ltd. 658 Gaochao Road, Shanghai, 201803, China

Contact Person: Hualong Liu Position: Technology Director Tel: +86 02169118232 Email: henry liu@kdlchina.net

    1. Designated submission correspondent
      Ms.Amy Li (Primary Contact Person) Mind-Link Consulting Co., Ltd. Tel: +86 15721449974 Email: amy.li@mind-link.net
    1. Identification of Proposed Device
      Trade Name: Sterile safety insulin syringes for single use Regulation Number: 21 CFR 880.5860 Regulation Name: Piston syringe Regulatory Class: Class II Product Code: MEG, FMF, FMF, FMI Regulation Number: 21 CFR 880.5860 Review Panel: General hospital
    1. Indication for use statement
      The Sterile Safety Insulin Syringes for single use are a sterile, single-use, disposable and non-reusable, manual retractable safety insulin syringe intended for injection of U40 or U100 insulin into the body, the sliding sleeve helps protect against needle puncture once activated.

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6. Device description

KDL Sterile safety insulin syringes have a sliding sleeve which is designed to shield the injection needle to protect the user from needle puncture and the sliding sleeve helps protect against needle puncture once activated. The sliding sleeve can be activated manually.

Models of Sterile safety insulin syringes for single use shown in Table 1-1 are available in various models according to different insulin concentration and syringe volume.

| Syringe
volume(ml) | Insulin
concentration | Needle
gauge(G) | Needle
length(mm) | Needle wall
type | Bevel |
|-----------------------|--------------------------|--------------------|----------------------|---------------------|--------|
| 0.5ml | U40 | 27G | 13 | RW | 11°±2° |
| | | 28G | 13 | RW | 11°±2° |
| | | 29G | 13 | RW | 11°±2° |
| | | 30G | 8、13 | TW | 11°±2° |
| | | 31G | 6、8 | TW | 11°±2° |
| 0.5ml | U100 | 27G | 13 | RW | 11°±2° |
| | | 28G | 13 | RW | 11°±2° |
| | | 29G | 13 | RW | 11°±2° |
| | | 30G | 8、13 | TW | 11°±2° |
| | | 31G | 6、8 | TW | 11°±2° |
| 1ml | U40 | 27G | 13 | RW | 11°±2° |
| | | 28G | 13 | RW | 11°±2° |
| | | 29G | 13 | RW | 11°±2° |
| | | 30G | 8、13 | TW | 11°±2° |
| | | 31G | 6、8 | TW | 11°±2° |
| 1ml | U100 | 27G | 13 | RW | 11°±2° |
| | | 28G | 13 | RW | 11°±2° |
| | | 29G | 13 | RW | 11°±2° |
| | | 30G | 8、13 | TW | 11°±2° |
| | | 31G | 6、8 | TW | 11°±2° |

Table 1-1 Models of Sterile safety insulin syringes for single use

7. Identification of predicate device

510(k) Number: K191639 Product name: TK Insulin Syringe with/without Safety Retractable Device

8. Non-clinical test conclusion

Non-clinical tests were conducted to verify that the proposed device met all design specifications as was Substantially Equivalent(SE) to the predicate device. The test results demonstrated that the proposed device complies with the following standards:

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ISO 8537: 2016 Third edition, Sterile single-use syringes, with or without needle, for A insulin.

ISO 7864:2016 Fourth edition, Sterile hypodermic needles for single use-Requirements and test method.

ISO 9626:2016 Second edition 2016-08-01 Stainless steel needle tubing for A manufacture of medical device-Requirements and test method.

ISO 23908:2011 First edition 2011-06-11 Sharps Injury Protection- Requirements A and test methods-Sharps protection features for single-use hypodermic needles, introducers for catheters and needles used for blood sampling.

Guidance for Industry and FDA Staff: Medical Devices with Sharps Injury A Prevention Features

ISO 10993-1:2018 Biological evaluation of medical devices - Part 1: Evaluation A and testing within a risk management process

A 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 A cytotoxicity

ISO 10993-7:2008 Biological evaluation of medical devices - Part 7: Ethylene oxide sterilization residuals

ISO 10993-10: 2010 Biological evaluation of medical devices - Part 10: Tests for A irritation and skin sensitization

ISO 10993-11:2017 Biological evaluation of medical devices - Part 11: Tests for A systemic toxicity

USP : Particulate Matter for injection A

    1. Clinical test conclusion
      No clinical study is included in this submission.
  1. Substantially Equivalent(SE) comparison

| Items | Proposed device | Predicate device
K191639 | Comment |
|--------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------|
| Produce name | Sterile safety insulin syringes
for single use | TK Insulin Syringe
with/without Safety
Retractable Device | Same |
| Product code | MEG, FMF,FMI | MEG, FMF | Same |
| Regulation number | 21 CFR 880.5860 | 21 CFR 880.5860 | Same |
| Class | Class II | Class II | Same |
| Intended use | The Sterile Safety Insulin Syringes for Single Use are
sterile, single-use, disposable, | The TK Insulin Syringe
with Safety Retractable
Device is a sterile, single-use, | Different.
Please
refer to |
| | non-reusable and manually
retractable safety insulin
syringes intended for injection
of insulin into the body. The
sliding sleeve helps protect
against needle puncture once
activated | disposable and non-reusable, manual
retractable safety
insulin syringe intended for
injection of U-100 insulin into
the body, while reducing the
risk of sharps injuries and
the potential for insulin
syringe reuse.
The TK Insulin Syringe is a
sterile, single-use, disposable
and non-reusable, insulin
syringe intended for injection
of U-100 insulin into the
body. | Analysis 1. |
| Principle of Operation | Normal. | Normal. | Same |
| Syringe Capacity | 1ml Needle 27Gx1/2"
1ml Needle 28Gx1/2"
1ml Needle 29Gx1/2"
1ml Needle 30Gx1/2"
1ml Needle 30Gx5/16"
1ml Needle 31Gx5/16"
1ml Needle 31Gx15/64"
0.5ml Needle 27Gx1/2"
0.5ml Needle 28Gx1/2"
0.5ml Needle 29Gx1/2"
0.5ml Needle 30Gx1/2"
0.5ml Needle 30Gx5/16"
0.5ml Needle 31Gx5/16"
0.5ml Needle 31Gx15/64" | TK Insulin Syringe:
0.3cc/ml Needle 27G x1/"
0.3cc/ml Needle 28G x1/2"
0.3cc/ml Needle 29G x1/2"
0.3cc/ml Needle 30G x1/2"
0.3cc/ml Needle 31G x3/8"
0.5cc/ml Needle 27G x1/2"
0.5cc/ml Needle 28G x1/2"
0.5cc/ml Needle 29G x1/2"
0.5cc/ml Needle 30G x1/2"
0.5cc/ml Needle 31G x3/8"
1cc/ml Needle 27G x1/2"
1cc/ml Needle 28G x1/2"
1cc/ml Needle 29G x1/2"
1cc/ml Needle 30G x1/2"
1cc/ml Needle 31G x3/8"
TK Insulin Syringe with
Safety Retractable Device:
0.5cc/ml Needle 27G x1/2"
0.5cc/ml Needle 28G x1/2"
0.5cc/ml Needle 29G x1/2"
0.5cc/ml Needle 30G x1/2"
0.5cc/ml Needle 31G x3/8"
1cc/ml Needle 27G x1/2"
1cc/ml Needle 28G x1/2"
1cc/ml Needle 29G x1/2" | Different.
Please
refer
to
Analysis 2. |
| | | 1cc/ml Needle 30G ×1/2"
1cc/ml Needle 31G ×3/8" | |
| Nozzle Type | N.A | N.A | Same |
| Lubricant for Barrel | Silicone oil | Silicone oil | Same |
| Barrel Transparency | Transparency and clear | Transparency and clear | Same |
| Gradations Legibility | Legible | Legible | Same |
| Materials | | | Different.
Please
refer
to
Analysis 3. |
| Barrel | PP | PP | |
| Plunger | PP | PP | |
| Piston | Rubber | Rubber | |
| Lubricant for Barrel | DC 360 | HC-SS36 | |
| Needle hub | PP | PP | |
| Needle tube | Stainless | Stainless | |
| Sliding sleeve | PP | PP | |
| Needle gauge and
needle length | Varies sizes | Various sizes | Same |
| Lubricant for needle | Silicone oil | Silicone | Same |
| Sterile safety insulin
syringes for single
use: sharps injury
prevention features | Manual Retractable
Conforms to ISO 23908. | Manual Retractable
Conforms to ISO 23908. | Same |
| Performances | Conforms to ISO 8537,
ISO 7864 and ISO 9626. | Conforms to ISO 8537
and ISO 7864. | Same |
| Biocompatibility | Complies with:
ISO 10993-1: Evaluation and
Testing;
Part 4: Selection of tests for
interactions with blood;
Part 5: Tests for in vitro
cytotoxicity;
Part 7: Ethylene oxide
sterilization residuals;
Part 10: Tests for irritation and
delayed-type hypersensitivity;
Part 11: Tests for systemic
toxicity, tests for Bacterial
endotoxins, Tests for
Pyrogenicity
And Conforms to USP :
Particulate Matter for injection | Conforms to ISO10993
(Part1: Evaluation and
testing, Part 4: Selection of
tests for interactions with
blood, Part 5: Tests for in
vitro cytotoxicity, Part 7:
Ethylene oxide sterilization
residuals, Part 10: Tests for
irritation and
delayed-type hypersensitivity,
Part 11: Tests for systemic
toxicity, tests for Bacterial
endotoxins, Tests for
Pyrogenicity)
Conforms to USP :
Particulate Matter
for injection | Same |
| Labeling | Meet the requirements of 21
CER Part 801 | Meet the requirements of 21
CER Part 801 | Same |

Table 1-2 Comparison of Technology Characteristics

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SE Analysis 1: Indication for use

The proposed device and the predicate device have the same indication, that is, for insulin injection. The proposed device has another syringe type for U-40 insulin injection. However, the differences between U-40 insulin syringes and U-100 insulin syringes do not raise any new questions of safety and effectiveness. The difference between U-40 insulin syringe and U-100 insulin syringe is the insulin concentration delivery. The U-40 insulin syringe has red protective cap for color marking in accordance with ISO 8537 to distinguish the insulin concentration. In addition, the tolerance on graduated capacity has been validated in accordance with ISO 8537 Annex H. Therefore, this difference does not affect the Substantially Equivalency (SE) between the proposed and predicate devices.

SE Analysis 2: Syringe Capacity

The Syringe Capacity of the proposed device is covered by the predicate device.

The difference is that the proposed device doesn't include a 0.3ml syringe. This difference does not to affect the Substantially Equivalency (SE) between the proposed and predicate devices.

SE Analysis 3: Materials

The material of the lubricant is different between the proposed device and predicate device. The biocompatibility test of proposed device has been conducted to demonstrate that the proposed device met the biocompatibility requirements. The difference does not raise new questions of safety and effectiveness.

11. Conclusion

The conclusion drawn from the nonclinical tests demonstrates that the subject device, Sterile Safety Insulin Syringes for Single Use are substantially equivalent to the legally marketed predicate device TK Insulin Syringe with/without Safety Retractable Device(K191639).