K Number
K250836
Date Cleared
2025-08-12

(145 days)

Product Code
Regulation Number
876.5540
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Duo-Flow® Side X Side double lumen catheter is intended for short-term central venous access for hemodialysis, apheresis and infusion.

Device Description

The Duo-Flow® Side X Side double lumen catheter is a radiopaque, polyurethane tube with two D-shaped lumina. The lumina can be distinguished by the color-coded luers:

  • Red Adaptor = proximal lumen
  • Blue Adaptor = distal lumen
    The proximal lumen provides "arterial" outflow from the patient; the distal lumen provides "venous" return.
    The catheter comes in a variety of sizes and is offered with curved or straight extensions.
    The Duo-Flow® Side x Side Catheter removes and returns blood through two segregated lumen passages. Each lumen is connected to an extension line with color-coded female luer connectors. The transition between lumen and extension is housed within a molded hub. Both arterial and venous lumens contain side-holes. The catheter incorporates Barium Sulphate to facilitate visualization under fluoroscopy or Xray. All sizes of the Duo-Flow® Side x Side Catheter are available in a Basic Set intended to be used in an Interventional Radiology or Operating Suite. The Set includes primary insertion componentry for the Modified Seldinger Insertion Technique.
AI/ML Overview

The provided FDA 510(k) clearance letter describes the 14F Duo-Flow® Side X Side Double Lumen Catheter and its substantial equivalence to a predicate device. However, this document does not detail an AI/algorithm-based medical device performance study.

The submission is for a physical medical device (a catheter) and focuses on demonstrating substantial equivalence through non-clinical (bench) testing and comparison of technical specifications with a previously cleared predicate device. Therefore, many of the requested details regarding AI/algorithm performance (e.g., sample size for test/training sets, expert qualifications, adjudication methods, MRMC studies, standalone performance) are not applicable to this particular FDA clearance.

Here's an analysis based on the information provided, highlighting the acceptance criteria and how the device meets them within the context of a physical device submission and not an AI/algorithm study:


Acceptance Criteria and Reported Device Performance (Non-AI/Algorithm Device)

The acceptance criteria for this physical medical device are derived from establishing substantial equivalence to a predicate device (Duo-Flow® Side x Side Double Lumen Catheter, K192807) through a combination of identical intended use, similar technological characteristics, and satisfactory non-clinical performance testing. The "performance" here refers to physical and mechanical attributes, not diagnostic or predictive accuracy.

Table of Acceptance Criteria and Reported Device Performance (Focus on Substantial Equivalence and Bench Testing):

Acceptance Criteria CategorySpecific Criteria (Implicitly Met for Substantial Equivalence)Reported Device Performance (Subject Device - 14F Duo-Flow)Supporting Information/Evidence
Intended UseIdentical to predicate device"The Duo-Flow® Side X Side double lumen catheter is intended for short-term central venous access for hemodialysis, apheresis and infusion." (Identical to predicate)Form 4, Page 6. Confirmed identical to predicate in Table 1.
Technological CharacteristicsSimilar to predicate device; no changes affecting safety or effectivenessRadiopaque, polyurethane tube with two D-shaped lumina (red/blue adaptors for proximal/distal). Both arterial and venous lumens contain side-holes. Incorporates Barium Sulphate. Available in various sizes and with curved/straight extensions.Page 6 ("Summary of Technological Characteristics") and Page 7 (Table 1). The key difference is the larger French size (14F) compared to predicate (9F, 11F, 12F), necessitating verification of performance for this new size. Other aspects like material (polyurethane, Barium Sulphate), lumen design, and side-holes are similar.
BiocompatibilityDevice materials are biocompatibleEvaluated in accordance with FDA Guidance 'Use of International Standard ISO 10993-1'. Leveraged from the predicate device.Page 8 ("Summary of Non-Clinical Testing: Biocompatibility"). No new testing performed as it relied on predicate data.
Physical/Mechanical PerformanceMeets established performance standards for catheters (e.g., leakage, flow rates, durability)Passed a suite of bench tests: Dimensional Analysis, Air Leakage, Liquid Leakage, % Lumen Elongation, ISO 80369-7 Stress Cracking, ISO 80369-7 Luer Testing, Kink Resistance, Gravity Flow Rate, Flow vs Pressure, Priming Volume, Clamp Cycle, Simulated Use, Electrical Conductivity, Force at Break, Packaging Validation.Page 9 ("Summary of Non-Clinical Testing: Performance Testing"). Specific values for flow rate and priming volume are provided (Pages 7-8) for various lengths, demonstrating performance for the 14F size.
Sterilization MethodIdentical to predicate device1x and/or 2x EO Sterilized (Identical to predicate)Page 6, Table 1.
Target PopulationIdentical to predicate deviceAdult (Identical to predicate)Page 6, Table 1.
Duration of UseIdentical to predicate deviceShort-Term (Identical to predicate)Page 6, Table 1.
Principles of OperationSimilar to predicate deviceInsertion Site: Jugular, femoral or subclavian vein (Identical to predicate)Page 8, Table.

Details Not Applicable to this Submission (as it's not an AI/Algorithm Device):

The following information requested in the prompt is not applicable to this 510(k) submission, as it pertains to AI/algorithm-based medical devices or clinical studies that were explicitly stated as "not required nor performed":

  1. Sample size used for the test set and the data provenance: Not applicable. This is a physical device clearance based on bench testing. No "test set" in the context of diagnostic data was used.
  2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. No diagnostic ground truth was established.
  3. Adjudication method (e.g. 2+1, 3+1, none) for the test set: Not applicable. No diagnostic test set or adjudication was involved.
  4. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance: Not applicable. This is not an AI-assisted device. The document explicitly states "Clinical testing was not required nor performed to support the substantial equivalence of these devices."
  5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not applicable. This is a physical device, not an algorithm.
  6. The type of ground truth used (expert consensus, pathology, outcomes data, etc.): Not applicable. "Ground truth" concept does not apply to the physical and mechanical performance testing of a catheter.
  7. The sample size for the training set: Not applicable. This is a physical device, not an AI model.
  8. How the ground truth for the training set was established: Not applicable. This is a physical device, not an AI model.

In summary, the FDA 510(k) K250836 clearance for the 14F Duo-Flow® Side X Side Double Lumen Catheter is for a physical medical device. The "acceptance criteria" and "study" described in the document are focused on demonstrating substantial equivalence to a predicate device through comparison of intended use, technological characteristics, and comprehensive non-clinical (bench) performance testing. There is no information regarding AI/algorithm performance or clinical studies in this submission.

FDA 510(k) Clearance Letter - K250836

Page 1

U.S. Food & Drug Administration
10903 New Hampshire Avenue
Silver Spring, MD 20993
www.fda.gov

Doc ID # 04017.08.00

August 12, 2025

Medical Components, Inc.
Danielle Mckinney
Senior Regulatory Affairs Specialist
1499 Delp Drive
Harleysville, PA 19438

Re: K250836
Trade/Device Name: 14F Duo-Flow® Side X Side Double Lumen Catheter
Regulation Number: 21 CFR§ 876.5540
Regulation Name: Blood Access Device and Accessories
Regulatory Class: II
Product Code: MPB
Dated: July 21, 2025
Received: July 21, 2025

Dear Danielle Mckinney:

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.

Page 2

K250836 - Danielle Mckinney Page 2

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 (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-reporting-combination-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.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rule"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-devices/device-advice-comprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

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-devices/medical-device-safety/medical-device-reporting-mdr-how-report-medical-device-problems.

Page 3

K250836 - Danielle Mckinney Page 3

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medical-devices/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-devices/device-advice-comprehensive-regulatory-assistance/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

Page 4

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120
Expiration Date: 07/31/2026
See PRA Statement below.

Submission Number (if known)
K250836

Device Name
14F Duo-Flow® Side X Side Double Lumen Catheter

Indications for Use (Describe)
The Duo-Flow® Side X Side double lumen catheter is intended for short-term central venous access for hemodialysis, apheresis and infusion.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.
DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

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"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

Page 5

- Proprietary and Confidential -

U.S. Food and Drug Administration
Center for Devices and Radiological Health
Document Control Center (DCC) – W066-G609
10903 New Hampshire Avenue
Silver Spring, MD 20993-0002

Traditional 510(k): 510(k) Summary

Submitter Information:

510(k) Submitted By: Medical Components, Inc. (dba MedComp)
1499 Delp Drive
Harleysville, PA 19438
United States of America

Primary Correspondent: Danielle McKinney, Senior Regulatory Affairs Specialist
regulatory@medcompnet.com
843-467-5661

Date Prepared: February 25, 2025

Subject Device Information:

Trade Name: 14F Duo-Flow® Side x Side Double Lumen Catheter
Common Name: Short-Term Hemodialysis Catheter
Classification Regulation: Blood access device and accessories, 21 CFR 876.5540
Device Class: Class II
Classification Panel: Gastroenterology/Urology
Product Code: MPB

Predicate Device Information:

Trade Name (predicate): Duo-Flow® Side x Side Double Lumen Catheter
Common Name (predicate): Short-Term Hemodialysis Catheter
Classification Regulation: Blood access device and accessories, 21 CFR 876.5540
Device Class: Class II
Classification Panel: Gastroenterology/Urology
Product Code: MPB
Predicate 510(k) Number: K192807
Predicate 510(k) Owner: Medical Components, Inc. (dba MedComp)

Page 1 of 5
K250836

Page 6

K250836
Page 2 of 5

Device Description:

The Duo-Flow® Side X Side double lumen catheter is a radiopaque, polyurethane tube with two D-shaped lumina. The lumina can be distinguished by the color-coded luers:

  • Red Adaptor = proximal lumen
  • Blue Adaptor = distal lumen

The proximal lumen provides "arterial" outflow from the patient; the distal lumen provides "venous" return.

The catheter comes in a variety of sizes and is offered with curved or straight extensions.

Intended Use:

The Duo-Flow® Side X Side double lumen catheter is intended for short-term central venous access for hemodialysis, apheresis and infusion.

Summary of Technological Characteristics:

The subject device has similar technological characteristics as the predicate device. The Duo-Flow® Side x Side Catheter removes and returns blood through two segregated lumen passages. Each lumen is connected to an extension line with color-coded female luer connectors. The transition between lumen and extension is housed within a molded hub. Both arterial and venous lumens contain side-holes. The catheter incorporates Barium Sulphate to facilitate visualization under fluoroscopy or Xray. All sizes of the Duo-Flow® Side x Side Catheter are available in a Basic Set intended to be used in an Interventional Radiology or Operating Suite. The Set includes primary insertion componentry for the Modified Seldinger Insertion Technique. Based on the similarity of these technological characteristics, there are no changes that affect the safety or effectiveness of the 14F Duo-Flow Side x Side Double Lumen Catheter.

Substantial Equivalence Discussion:

The Substantial Equivalence Comparison Table below provides evidence to facilitate the substantial equivalence determination between the 14F Duo-Flow® Side x Side Double Lumen Catheter to the predicate device Duo-Flow® Side x Side Double Lumen Catheter.

Table 1 - Substantial Equivalence

DescriptionSubject DevicePredicate Device
Device Trade Name14F Duo-Flow® Side x Side Double Lumen CatheterDuo-Flow® Side x Side Double Lumen Catheter
510(k) submitter/holderMedical Components Inc. (dba MedComp)Medical Components Inc. (dba MedComp)
510(k) NumberK250836K192807, cleared on April 23, 2020
Intended UseThe Duo-Flow® Side X Side double lumen catheter is intended for short-term central venous access for hemodialysis, apheresis and infusion.The Duo-Flow® Side X Side double lumen catheter is intended for short-term central venous access for hemodialysis, apheresis and infusion.
Prescription/Over-the-Counter UsePrescriptionPrescription
Target PopulationAdultAdult
Duration of UseShort-TermShort-Term
Sterilization Method1x and/or 2x EO Sterilized1x and/or 2x EO Sterilized

Page 2 of 5

Page 7

- Proprietary and Confidential -

Table 1 - Substantial Equivalence (continued)

DescriptionSubject DevicePredicate Device
Technical Specifications
French Size14F9F, 11F, 12F
Inner Diameters (in)14F - .140±.0039F – .097" ±.00211F – .114" ±.00312F - .114" ±.003
Outer Diameters (in)14F - .190±.0039F - .125" ±.00211F - .160" ±.00312F - .160" ±.003
Number of LumensTwo (2)Two (2)
Catheter Lengths14F Straight - 15cm, 20cm, 24cm14F Curved - 15cm, 20cm, 24cm9F Straight – 10cm, 12cm, 15cm, 20cm9F Curved – 7.5cm, 12cm, 15cm11F Straight – 12cm, 15cm, 20cm, 24cm11F Curved – 10cm, 12cm, 15cm, 20cm12F Straight - 15cm, 20cm, 24cm12F Curved – 13cm, 15cm, 20cm
Priming Volume (cc)
14F Subject DeviceLengthArterial
14F Straight15cm1.5
20cm1.7
24cm2.0
14F Curved15cm1.5
20cm1.7
24cm2.0
Predicate Device Priming VolumesLengthArterialVenous
9F Straight10cm0.81.0
12cm0.91.0
15cm1.01.1
20cm1.11.2
9F Curved7.5cm0.91.0
12cm1.01.1
15cm1.11.2
11F Straight12cm1.11.2
15cm1.21.4
20cm1.41.5
24cm1.51.6
11F Curved10cm1.11.2
12cm1.21.3
15cm1.31.4
20cm1.51.6
12F Straight15cm1.21.3
20cm1.41.5
24cm1.51.6
12F Curved13cm1.11.2
15cm1.21.3
20cm1.41.5

Page 3 of 5
K250836

Page 8

- Proprietary and Confidential -

Flow (ml/min) vs Pressure (mmHg)

Subject Device - 14FFlow Rate (ml/min)200300400450500
14F Straight
15cmV204467N/A96
A-20-31-51N/A-69
20cmV27.74871N/A102
A-20-35-50N/A-74
24cmV22.349.377.3N/A111.3
A-20-40-59N/A-81
14F Curved
15cmV21.342.765.7N/A95
A-20-35-51N/A-71
20cmV3860.792.7N/A126
A-20.7-39.7-60N/A-86
24cmV22.360.788.6107.1126.4
A-20-30.7-53.6-65-80.7
Predicate DeviceFlow Rate (ml/min)200300400450500
9F Straight
10cmV4092109N/A147
A-34-63-99N/A-139
12cmV4783124144166
A-41-72-110-129-148
15cmV5288131150173
A-48-80-119-139-160
20cmV60104154177N/A
A-59-96-141-162N/A
9F Curved
7.5cmV4675113N/A154
A-33-53-86N/A-123
12cmV4989131153171
A-52-87-134-158-180
15cmV61103158175199
A-43-81-129-152-176
11F Straight
12cmV315991N/A129
A-30-50-80N/A-110
15cmV285483N/A119
A-32-52-78N/A-108
20cmV4472105124141
A-29-49-76-91-108
24cmV3971116N/A167
A-40-63-101N/A-141
11F Curved
10cmV305485N/A120
A-21-42-69N/A-95
12cmV305485N/A120
A-21-42-69N/A-95
15cmV4168101N/A112
A-20-42-70N/A-101
20cmV4472105124141
A-29-49-76-91-108
12F Straight
15cmV305790N/A130
A-27-49-74N/A-106
20cmV3262101N/A150
A-30-55-89N/A-122
24cmV4070114N/A166
A-37-62-99N/A-137
12F Curved
13cmV326096N/A138
A-31-52-81N/A-113
15cmV4068101N/A141
A-22-43-70N/A-101
20cmV4069107N/A153
A-31-59-90N/A-126
Principles of Operation
Insertion SiteJugular, femoral or subclavian veinJugular, femoral or subclavian vein

Summary of Non-Clinical Testing:

Biocompatibility:

A biocompatibility evaluation was performed in accordance with the FDA Guidance 'Use of International Standard ISO 10993-1, "Biological evaluation of medical devices – Part 1:

Page 4 of 5
K250836

Page 9

- Proprietary and Confidential -

Evaluation and testing within a risk management process"'. Biocompatibility testing was leveraged from the predicate device manufactured by Medical Components, Inc. Clinical testing was not required nor performed to support the substantial equivalence of these devices.

Performance Testing:

Design Verification and Validation performance testing was performed in accordance with Design Controls as per 21 CFR 820.30. Bench testing was performed to evaluate the performance of the subject device on:

  • Dimensional Analysis
  • Air Leakage
  • Liquid Leakage
  • % Lumen Elongation
  • ISO 80369-7 Stress Cracking
  • ISO 80369-7 Luer Testing
  • Kink Resistance
  • Gravity Flow Rate
  • Flow vs Pressure
  • Priming Volume
  • Clamp Cycle
  • Simulated Use
  • Electrical Conductivity
  • Force at Break
  • Packaging Validation

Clinical testing was not required nor performed to support the substantial equivalence of these devices.

Conclusion

In conclusion, based on the non-clinical testing performed, the subject device 14F Duo-Flow® Side x Side Double Lumen Catheter is substantially equivalent to the predicate device Duo-Flow® Side x Side Double Lumen Catheter (K192807) and does not raise any concern for the safety and effectiveness of the subject device.

Page 5 of 5
K250836

§ 876.5540 Blood access device and accessories.

(a)
Identification. A blood access device and accessories is a device intended to provide access to a patient's blood for hemodialysis or other chronic uses. When used in hemodialysis, it is part of an artificial kidney system for the treatment of patients with renal failure or toxemic conditions and provides access to a patient's blood for hemodialysis. The device includes implanted blood access devices, nonimplanted blood access devices, and accessories for both the implanted and nonimplanted blood access devices.(1) The implanted blood access device is a prescription device and consists of various flexible or rigid tubes, such as catheters, or cannulae, which are surgically implanted in appropriate blood vessels, may come through the skin, and are intended to remain in the body for 30 days or more. This generic type of device includes various catheters, shunts, and connectors specifically designed to provide access to blood. Examples include single and double lumen catheters with cuff(s), fully subcutaneous port-catheter systems, and A-V shunt cannulae (with vessel tips). The implanted blood access device may also contain coatings or additives which may provide additional functionality to the device.
(2) The nonimplanted blood access device consists of various flexible or rigid tubes, such as catheters, cannulae or hollow needles, which are inserted into appropriate blood vessels or a vascular graft prosthesis (§§ 870.3450 and 870.3460), and are intended to remain in the body for less than 30 days. This generic type of device includes fistula needles, the single needle dialysis set (coaxial flow needle), and the single needle dialysis set (alternating flow needle).
(3) Accessories common to either type include the shunt adaptor, cannula clamp, shunt connector, shunt stabilizer, vessel dilator, disconnect forceps, shunt guard, crimp plier, tube plier, crimp ring, joint ring, fistula adaptor, and declotting tray (including contents).
(b)
Classification. (1) Class II (special controls) for the implanted blood access device. The special controls for this device are:(i) Components of the device that come into human contact must be demonstrated to be biocompatible. Material names and specific designation numbers must be provided.
(ii) Performance data must demonstrate that the device performs as intended under anticipated conditions of use. The following performance characteristics must be tested:
(A) Pressure versus flow rates for both arterial and venous lumens, from the minimum flow rate to the maximum flow rate in 100 milliliter per minute increments, must be established. The fluid and its viscosity used during testing must be stated.
(B) Recirculation rates for both forward and reverse flow configurations must be established, along with the protocol used to perform the assay, which must be provided.
(C) Priming volumes must be established.
(D) Tensile testing of joints and materials must be conducted. The minimum acceptance criteria must be adequate for its intended use.
(E) Air leakage testing and liquid leakage testing must be conducted.
(F) Testing of the repeated clamping of the extensions of the catheter that simulates use over the life of the device must be conducted, and retested for leakage.
(G) Mechanical hemolysis testing must be conducted for new or altered device designs that affect the blood flow pattern.
(H) Chemical tolerance of the device to repeated exposure to commonly used disinfection agents must be established.
(iii) Performance data must demonstrate the sterility of the device.
(iv) Performance data must support the shelf life of the device for continued sterility, package integrity, and functionality over the requested shelf life that must include tensile, repeated clamping, and leakage testing.
(v) Labeling of implanted blood access devices for hemodialysis must include the following:
(A) Labeling must provide arterial and venous pressure versus flow rates, either in tabular or graphical format. The fluid and its viscosity used during testing must be stated.
(B) Labeling must specify the forward and reverse recirculation rates.
(C) Labeling must provide the arterial and venous priming volumes.
(D) Labeling must specify an expiration date.
(E) Labeling must identify any disinfecting agents that cannot be used to clean any components of the device.
(F) Any contraindicated disinfecting agents due to material incompatibility must be identified by printing a warning on the catheter. Alternatively, contraindicated disinfecting agents must be identified by a label affixed to the patient's medical record and with written instructions provided directly to the patient.
(G) Labeling must include a patient implant card.
(H) The labeling must contain comprehensive instructions for the following:
(
1 ) Preparation and insertion of the device, including recommended site of insertion, method of insertion, and a reference on the proper location for tip placement;(
2 ) Proper care and maintenance of the device and device exit site;(
3 ) Removal of the device;(
4 ) Anticoagulation;(
5 ) Management of obstruction and thrombus formation; and(
6 ) Qualifications for clinical providers performing the insertion, maintenance, and removal of the devices.(vi) In addition to Special Controls in paragraphs (b)(1)(i) through (v) of this section, implanted blood access devices that include subcutaneous ports must include the following:
(A) Labeling must include the recommended type of needle for access as well as detailed instructions for care and maintenance of the port, subcutaneous pocket, and skin overlying the port.
(B) Performance testing must include results on repeated use of the ports that simulates use over the intended life of the device.
(C) Clinical performance testing must demonstrate safe and effective use and capture any adverse events observed during clinical use.
(vii) In addition to Special Controls in paragraphs (b)(1)(i) through (v) of this section, implanted blood access devices with coatings or additives must include the following:
(A) A description and material characterization of the coating or additive material, the purpose of the coating or additive, duration of effectiveness, and how and where the coating is applied.
(B) An identification in the labeling of any coatings or additives and a summary of the results of performance testing for any coating or material with special characteristics, such as decreased thrombus formation or antimicrobial properties.
(C) A Warning Statement in the labeling for potential allergic reactions including anaphylaxis if the coating or additive contains known allergens.
(D) Performance data must demonstrate efficacy of the coating or additive and the duration of effectiveness.
(viii) The following must be included for A-V shunt cannulae (with vessel tips):
(A) The device must comply with Special Controls in paragraphs (b)(1)(i) through (v) of this section with the exception of paragraphs (b)(1)(ii)(B), (b)(1)(ii)(C), (b)(1)(v)(B), and (b)(1)(v)(C), which do not apply.
(B) Labeling must include Warning Statements to address the potential for vascular access steal syndrome, arterial stenosis, arterial thrombosis, and hemorrhage including exsanguination given that the device accesses the arterial circulation.
(C) Clinical performance testing must demonstrate safe and effective use and capture any adverse events observed during clinical use.
(2) Class II (performance standards) for the nonimplanted blood access device.
(3) Class II (performance standards) for accessories for both the implanted and the nonimplanted blood access devices not listed in paragraph (b)(4) of this section.
(4) Class I for the cannula clamp, disconnect forceps, crimp plier, tube plier, crimp ring, and joint ring, accessories for both the implanted and nonimplanted blood access device. The devices subject to this paragraph (b)(4) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.