K Number
K240164
Date Cleared
2024-06-28

(158 days)

Product Code
Regulation Number
876.5820
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The NovaLine SP-C35 Transducer Protector is a single-use, disposable, prescription device intended for use as a protective device for pressure monitors and to help prevent contamination of the fluid pathway in hemodialysis delivery systems.

Device Description

The NovaLine SP-C35 Transducer Protector consists of a plastic housing that contains a hydrophobic filter with a reference pore size of 0.2 µ m. The housing has male and female luer lock connectors that allow its attachment between a blood tubing set and the pressure monitor on a hemodialysis machine.

The NovaLine SP-C35 Transducer Protector is to be used as protective device for pressure monitors as well as to help maintain the sterility of the blood tubing fluid pathway. The 0.2 ↓ m hydrophobic filter helps prevent cross-contamination by viruses, bacterial and particulate matter while preventing the flow of fluids to the hemodialysis machine pressure monitor.

The devices are packaged sterile and labeled for single use only.

The proposed devices are provided in sterile condition, it is subject to e-beam radiation sterilization prior to release to achieve a Sterility Assurance Level (SAL) of 10-6.

AI/ML Overview

Here's a breakdown of the acceptance criteria and study information for the NovaLine SP-C35 Transducer Protector based on the provided FDA 510(k) summary.

Note: This document describes a medical device, not an AI or software-based medical device. Therefore, many of the requested fields related to AI performance, ground truth, and expert evaluation are not applicable.


1. Table of Acceptance Criteria and Reported Device Performance

Device: NovaLine SP-C35 Transducer Protector

Acceptance Criteria CategorySpecific Test / CharacteristicAcceptance Criteria (Target)Reported Device Performance (Result)Relevant Standard (if applicable)
Physical PerformanceAppearanceComplies with specificationsComplies with specifications---
Structural IntegrityMaintainedMaintained---
DimensionComplies with standardComplies with standardISO 80369-7:2021
SterilitySAL of 10^-6Achieved SAL of 10^-6---
Positive Pressure Limitation500 mmHg500 mmHg (matches predicate)---
Negative Pressure Limitation-500 mmHg-500 mmHg (matches predicate)---
Connections ConformanceConforms to standardConforms to standardISO 80369-7:2016
BiocompatibilityCytotoxicityNon-toxicComplies with ISO 10993-5ISO 10993-5
SensitizationNon-sensitizingComplies with ISO 10993-10ISO 10993-10
Irritation/Intradermal ReactivityNon-irritatingComplies with ISO 10993-23ISO 10993-23
Systemic Toxicity/Acute Systemic ToxicityNon-toxicComplies with ISO 10993-11ISO 10993-11
Pyrogens/Material-mediated PyrogensNon-pyrogenicComplies with ISO 10993-11ISO 10993-11
In Vitro HemolysisNon-hemolyticComplies with ISO 10993-4ISO 10993-4
Complement ActivityNo adverse complement activityComplies with ISO 10993-4ISO 10993-4
Partial Thromboplastin TimeNo adverse effectComplies with ISO 10993-4ISO 10993-4
Platelet CountNo adverse effectComplies with ISO 10993-4ISO 10993-4
HematologyNo adverse effectComplies with ISO 10993-4ISO 10993-4
SterilizationSterility Assurance LevelSAL of 10^-6Achieved SAL of 10^-6---
PackagingSeal StrengthComplies with standardComplies with standardASTM F88/F88-15
Dye PenetrationComplies with standardComplies with standardASTM F1929-15
Shelf LifePackaging Performance (aged samples)Complies with acceptance criteriaComplies with acceptance criteriaISO 80369-7 (for connections)
Performance Tests (aged samples)Complies with acceptance criteriaComplies with acceptance criteria---
MicrobiologicalBacterial Endotoxin<20 USP EUComplies with limitUSP <85>
Microbial ChallengeSterile Barrier IntegrityMaintains sterile barrierComplies with standardsASTM F1671/F1671M-2022, YYT1497-2016, ASTM F838-2020
Distribution SimulationWithstands distribution stressesComplies with standardComplies with standardASTM D4169-22
Comparative PerformanceOverall performance vs. predicateEquivalentEquivalent to predicate device---

2. Sample Size Used for the Test Set and Data Provenance

The document does not specify exact sample sizes for each test within the finished product performance, packaging, or shelf-life evaluations. It mentions "proposed devices" were tested, implying a statistical sample was used according to the relevant standards, but the specific number is not provided.

Data Provenance: The tests were conducted by Bain Medical Equipment (Guangzhou) Co., Ltd. in China. The data is retrospective in the sense that the testing was performed on manufactured devices to support the 510(k) submission.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Their Qualifications

Not Applicable. This is a medical device (transducer protector) and not an AI/software device. The "ground truth" here refers to the physical and biological properties of the device, established through standardized laboratory testing, not human expert interpretation of data.

4. Adjudication Method for the Test Set

Not Applicable. As this is not an AI/software device involving human interpretation, there is no adjudication method in the traditional sense. Device performance is determined by objective, measurable laboratory tests against pre-defined specifications and standards.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

No. An MRMC study is relevant for imaging or diagnostic AI, comparing human readers with and without AI assistance. This device is a component of a hemodialysis system, and its performance is assessed through physical, chemical, and biological testing.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

Not Applicable. This device is hardware, not an algorithm or software.

7. The Type of Ground Truth Used

The "ground truth" for this device's performance is established by:

  • Standardized Test Results: Objective measurements from various laboratory tests (e.g., dimensional measurements, sterile barrier integrity, biocompatibility assays).
  • Compliance with Recognized Standards: Adherence to international and national standards such as ISO 80369-7, ISO 10993 series, ASTM F88, ASTM F1929, ASTM D4169, USP <85>, ASTM F1671, etc.
  • Predicate Device Equivalence: Direct comparison to the performance characteristics of a legally marketed predicate device (Nipro Transducer Protector TP-SURE, K072988) where applicable.

8. The Sample Size for the Training Set

Not Applicable. This is a physical medical device, not an AI/machine learning model, so there is no training set.

9. How the Ground Truth for the Training Set Was Established

Not Applicable. See response to #8.

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Image /page/0/Picture/0 description: The image contains the logo for 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 consists of the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

June 28, 2024

Bain Medical Equipment (Guangzhou) Co., Ltd. Zoe Zeng Regulatory Supervisor No.10 Juncheng Road, No.10, Juncheng Road, Eastern Area, Economic and Technological Development Guangzhou, Guangdong 510760 China

Re: K240164

Trade/Device Name: NovaLine SP-C35 Transducer Protector Regulation Number: 21 CFR§ 876.5820 Regulation Name: Hemodialysis system and accessories Regulatory Class: II Product Code: FIB Dated: May 31, 2024 Received: May 31, 2024

Dear Zoe Zeng:

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 (the 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/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.

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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" (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 QS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 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.

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3

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,

Maura Rooney -S

Maura Rooney Assistant Director DHT3A: Division of Renal, Gastrointestinal, Obesity and Transplant Devices 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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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K240164

Device Name NovaLine SP-C35 Transducer Protector

Indications for Use (Describe)

The NovaLine SP-C35 Transducer Protector is a single-use, disposable, prescription device intended for use as a protective device for pressure monitors and to help prevent contamination of the fluid pathway in hemodialysis delivery systems.

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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Tab #29 510(k) Summary

This 510(k) Summary is being submitted in accordance with requirements of SMDA 1990 and Title 21, CFR Section 807.92.

The assigned 510(k) Number: K240164

    1. Date of Preparation: 05/31/2024
    1. Sponsor Identification

Bain Medical Equipment (Guangzhou) Co., Ltd.

No.10, Juncheng Road, Eastern Area, Economic and Technological Development District, 510760, Guangdong, P.R.China

Establishment Registration Number: 3013217742

Contact Person: Sophia Shao Position: Management Representative Tel: +86-20-66856868 ext. 218 Fax: +86-20-32067500 Email: sophia@baingz.com

3. Designated Submission Correspondent

Bain Medical Equipment (Guangzhou) Co., Ltd

No.10, Juncheng Road, Eastern Area, Economic and Technological Development District, 510760, Guangdong, P.R.China

Ms. Zoe Zeng (Primary Contact Person) Tel: +86-20-66856868 ext.290 Fax: +86 20 3206 7500 Email: zoe@baingz.com

Ms. Sophia Shao (Alternative Contact Person) Tel: +86-20-66856868 ext.218 Fax: +86 20 3206 7500 Email: sophia@baingz.com

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Trade Name: NovaLine SP-C35 Transducer Protector Common Name: Transducer Protector Models: 956007

Regulatory Information

Regulation Name: Hemodialysis system and accessories Classification: II Product Code: FIB Regulation Number: CFR 876.5820 Review Panel: Gastroenterology/Urology

Indications for Use:

The NovaLine SP-C35 Transducer Protector is a single-use, disposable, prescription device intended for use as a protective device for pressure monitors and to help prevent contamination of the fluid pathway in hemodialysis delivery systems.

Device Description

The NovaLine SP-C35 Transducer Protector consists of a plastic housing that contains a hydrophobic filter with a reference pore size of 0.2 µ m. The housing has male and female luer lock connectors that allow its attachment between a blood tubing set and the pressure monitor on a hemodialysis machine.

The NovaLine SP-C35 Transducer Protector is to be used as protective device for pressure monitors as well as to help maintain the sterility of the blood tubing fluid pathway. The 0.2 ↓ m hydrophobic filter helps prevent cross-contamination by viruses, bacterial and particulate matter while preventing the flow of fluids to the hemodialysis machine pressure monitor.

The devices are packaged sterile and labeled for single use only.

The proposed devices are provided in sterile condition, it is subject to e-beam radiation sterilization prior to release to achieve a Sterility Assurance Level (SAL) of 10-6.

ComponentsMaterialType of ContactContact DurationApplicable standard
CapPolyethyleneSurface device (skin)<24 hoursISO 10993
Female luer lock connectorPolyvinylchlorideExternal communication device (blood path, indirect)<24 hoursISO 10993
Male luer lockPolyvinylchlorideExternal communication device (blood path, indirect)<24 hoursISO 10993

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Filter paperPTFE compositemembraneExternal communication device(blood path, indirect)<24 hoursISO 10993
-------------------------------------------------------------------------------------------------------------------------

ട. Identification of Predicate Device

Predicate Device

510(k) Number: K072988

Product Name: Nipro Transducer Protector TP-SURE Manufacturer: NIPRO MEDICAL CORPORATION

6. 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.

Finished Product Performance Test

The proposed devices were tested with appearance, structural integrity, Dimension(ISO 80369-7:2021) and sterility and the test results demonstrated that the proposed device complies with the standards requirements. A side-by-side parallel test with the predicate device demonstrate that the proposed device performs equivalent to the predicate device and is safe and effective when used as intended. A human factors assessment was conducted to demonstrate its safe and effective use.

Product Packaging

Tests were performed on sterilized product packages according to ASTM F88/F88-15 and ASTM F1929-15 to support compliance with pre-established acceptance criteria.

Simulated Distribution Test

Tests were conducted according to ASTM D4169-22 to support compliance with pre-established acceptance criteria.

Shelf life

Packaging performance(Seal Strength and Dye Penetration) and Performance Tests were conducted, including tests per ISO 80369-7. The test resulted demonstrated that the accelerated aged samples complied with the pre-established acceptance criteria.

Bacterial Endotoxin Testing

Endotoxin limit is established as 20 USP Endotoxin Unit (EU) for the proposed device. Test has been conducted by Limulus Amebocyte Lysate (LAL) method according to USP <85> Bacterial Endotoxin Limit.

Biocompatibility Tests

The following tests were conducted to support the biological safety of the proposed device: cytotoxicity(ISO10993-5), sensitization(ISO 10993-10), irritation(ISO 10993-23), systemic

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toxicity(ISO10993-11), pyrogen(ISO10993-11), complement activity (ISO10993-4), partial thromboplastin time(ISO 10993-4), platelet count(ISO 10993-4) and hematology(ISO 10993-4).

Microbial Challenge Testing

Tests were conducted to support the sterile barrier according to ASTM F1671/F1671M-2022, YYT1497-2016 and ASTM F838-2020.

Electrical Safety and EMC Not applicable.

Software Verification and Validation Testing Not applicable.

Animal Studies No animal studies were performed.

7. Clinical Test Conclusion

No clinical study is included in this submission.

Substantially Equivalent (SE) Comparison 8.

ItemProposed DevicePredicate DeviceK072988
Model956007/
Device ClassIIII
Product CodeFIBFIB
Regulation Number21CFR part 876.582021CFR part 876.5820
Indications for UseThe NovaLine SP-C35 Transducer Protectoris a single-use, disposable, prescription deviceintended for use as a protective device forpressure monitors and to help preventcontamination of the fluid pathway inhemodialysis delivery systems.The Nipro Transducer ProtectorTP-SURE is a single-use,disposable, prescription deviceintended for use as a protectivedevice for pressure monitorsand to help preventcontamination of the fluidpathway in hemodialysisdelivery systems.
FeatureSterileNon-pyrogenicSingle UsePrescription DeviceSterileNon-pyrogenicSingle UsePrescription Device
Main ConfigurationFilter PaperMale Luer Lock ConnectorFilter PaperMale Luer Lock Connector

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ItemProposed DevicePredicate DeviceK072988
CapCap
PhysicalperformancePositivepressureLimitation(mmHg)500500
NegativePressureLimitation(mmHg)-500-500
PerformanceConforms toISO 80369-7:2016Conforms toISO 80369-7:2016
MaterialsPVC, PTFE, PET, PEPP, PTFE, PET
BiocompatibilityCytotoxicity;Skin Sensitization;Intradermal Reactivity;Acute Systemic Toxicity;Material-mediated Pyrogens;In Vitro Hemolysis;Bacterial endotoxin testing;Complement Activity;Partial Thromboplastin Time;Platelet Count;HematologyCytotoxicity;PyrogenicityAcute Toxicity;Intracutaneous Reactivity;Hemolysis Testing;Implantation Testing;Bacterial Endotoxin Testing
SterilizationEbeam, SAL(10-6)EO, SAL(10-6)
LabelingDirection for UseIntended UseDescriptionWarnings and CautionsDirection for UseIntended UseDescriptionWarnings and Cautions

The proposed device has the similar configuration, indication for use and safety feature as the predicated device. The non-clinical testing demonstrates the product performance of proposed device is similar as that of the predicate device or the product performance of proposed device is acceptable. The biocompatibility of the proposed device comply with ISO 10993 series standards.

9. Substantially Equivalent (SE) Conclusion

Based on the comparison and analysis above, the proposed devices are determined to be Substantially Equivalent (SE) to the predicate devices.

§ 876.5820 Hemodialysis system and accessories.

(a)
Identification. A hemodialysis system and accessories is a device that is used as an artificial kidney system for the treatment of patients with renal failure or toxemic conditions and that consists of an extracorporeal blood system, a conventional dialyzer, a dialysate delivery system, and accessories. Blood from a patient flows through the tubing of the extracorporeal blood system and accessories to the blood compartment of the dialyzer, then returns through further tubing of the extracorporeal blood system to the patient. The dialyzer has two compartments that are separated by a semipermeable membrane. While the blood is in the blood compartment, undesirable substances in the blood pass through the semipermeable membrane into the dialysate in the dialysate compartment. The dialysate delivery system controls and monitors the dialysate circulating through the dialysate compartment of the dialyzer.(1) The extracorporeal blood system and accessories consists of tubing, pumps, pressure monitors, air foam or bubble detectors, and alarms to keep blood moving safely from the blood access device and accessories for hemodialysis (§ 876.5540) to the blood compartment of the dialyzer and back to the patient.
(2) The conventional dialyzer allows a transfer of water and solutes between the blood and the dialysate through the semipermeable membrane. The semipermeable membrane of the conventional dialyzer has a sufficiently low permeability to water that an ultrafiltration controller is not required to prevent excessive loss of water from the patient's blood. This conventional dialyzer does not include hemodialyzers with the disposable inserts (Kiil type) (§ 876.5830) or dialyzers of high permeability (§ 876.5860).
(3) The dialysate delivery system consists of mechanisms that monitor and control the temperature, conductivity, flow rate, and pressure of the dialysate and circulates dialysate through the dialysate compartment of the dialyzer. The dialysate delivery system includes the dialysate concentrate for hemodialysis (liquid or powder) and alarms to indicate abnormal dialysate conditions. This dialysate delivery system does not include the sorbent regenerated dialysate delivery system for hemodialysis (§ 876.5600), the dialysate delivery system of the peritoneal dialysis system and accessories (§ 876.5630), or the controlled dialysate delivery system of the high permeability hemodialysis system § 876.5860).
(4) Remote accessories to the hemodialysis system include the unpowered dialysis chair without a scale, the powered dialysis chair without a scale, the dialyzer holder set, dialysis tie gun and ties, and hemodialysis start/stop tray.
(b)
Classification. (1) Class II (performance standards) for hemodialysis systems and all accessories directly associated with the extracorporeal blood system and the dialysate delivery system.(2) Class I for other accessories of the hemodialysis system remote from the extracorporeal blood system and the dialysate delivery system, such as the unpowered dialysis chair, hemodialysis start/stop tray, dialyzer holder set, and dialysis tie gun and ties. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.