K Number
K220258
Manufacturer
Date Cleared
2022-07-14

(164 days)

Product Code
Regulation Number
862.1675
Panel
HO
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Ally device is attached to a PIV catheter system for blood sampling into a vacuum tube or syringe.

Device Description

The Ally device by Avia Vascular is intended to be attached to a peripheral intravenous (PIV) catheter system for use as a needleless blood draw device into a vacuum tube or syringe. Once attached to a PIV catheter system, the Ally device functions by extending a conduit tube through the internal lumen of the PIV catheter so that the distal tip of the Ally conduit extends beyond the tip of the PIV catheter, allowing for sampling of blood. The Ally device is a sterile, single use device.

AI/ML Overview

This document is a 510(k) summary for the Ally Blood Collection Device, a blood specimen collection device. It outlines the device's technical characteristics, its comparison to a predicate device, and the performance testing conducted to demonstrate its safety and effectiveness.

1. Table of Acceptance Criteria and Reported Device Performance

The document lists performance tests conducted, but it does not specify quantitative acceptance criteria or detailed numerical results for each test. Instead, it broadly states that "The subject Ally device met all predetermined acceptance criteria." The table below summarizes the listed performance tests:

Acceptance Criteria (Implied)Reported Device Performance
Physical/Mechanical Performance
Flow Conduit Inner DiameterMet predetermined criteria
Flow Conduit Outer DiameterMet predetermined criteria
Flow Conduit Effective Length and Flow Conduit Exposure LengthMet predetermined criteria
Open-System Introducer LengthMet predetermined criteria
Extension Tubing Inner DiameterMet predetermined criteria
Flow Conduit-to-Extension Tubing Assembly TensileMet predetermined criteria
Extension Leg-to-Stop Ring Assembly TensileMet predetermined criteria
Extension Tubing-to-Proximal Luer Assembly TensileMet predetermined criteria
Guide Cannula-to-Introducer Assembly TensileMet predetermined criteria
Introducer to Housing RetentionMet predetermined criteria
Sheathing Cannula Tensile TestingMet predetermined criteria
Kink DiameterMet predetermined criteria
Aspiration Flow RateMet predetermined criteria
Leak DecayMet predetermined criteria
Housing Seal Leak Decay TestingMet predetermined criteria
Particulate testing per USPMet predetermined criteria
**Biocompatibility (per ISO 10993-1 for external communicating device, limited (

§ 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.