K Number
K972712
Device Name
CORE RESISTANT HUBER INFUSION SETS
Manufacturer
Date Cleared
1997-10-01

(72 days)

Product Code
Regulation Number
880.5440
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The ICU Medical, Inc. Core Resistant Huber Needle Infusion Set, Core Resistant Huber Infusion Set with Y Site and Core Resistant Huber Infusion Set with Y Site and Clave are intended for use to deliver solutions and drugs through vascular implant ports. The ICU Medical, Inc. Core Resistant Huber Infusion Set, Core Resistant Huber Infusion Set with Y Site and Core Resistant Huber Infusion Set with Y Site and CLAVE® are used to deliver solutions and drugs into vascular implant ports.
Device Description
The ICU Medical Core Resistant Huber Infusion Sets are single use, sterile and non pyrogenic devices intended for use as an accessory to deliver solutions and drugs into a patient's vascular implant port. Components used in the sets may be either manufactured by ICU Medical or purchased from approved contract manufacturers. Components will be assembled into standard configurations or configurations specified by the customer and packaged.
More Information

Not Found

Not Found

No
The summary describes a standard infusion set and does not mention any AI or ML components or functionalities.

No
This device is an infusion set used to deliver solutions and drugs, which functions as an accessory. It does not inherently provide therapy, but rather facilitates the delivery of therapeutic substances.

No

The device is described as an "infusion set" intended "to deliver solutions and drugs." This function is therapeutic/delivery, not diagnostic.

No

The device description clearly states it is a physical infusion set with components and assembly, not a software-only device.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is to "deliver solutions and drugs through vascular implant ports" and "deliver solutions and drugs into vascular implant ports." This describes a device used for administering substances into the body, not for examining specimens from the body to diagnose or monitor a condition.
  • Device Description: The description reinforces this by stating it's an "accessory to deliver solutions and drugs into a patient's vascular implant port."
  • Lack of IVD Characteristics: There is no mention of analyzing biological specimens (blood, urine, tissue, etc.), detecting analytes, or providing diagnostic information.

IVD devices are used to perform tests on samples taken from the human body to provide information about a person's health. This device's function is purely for the delivery of substances into the body.

N/A

Intended Use / Indications for Use

The ICU Medical, Inc. Core Resistant Huber Needle Infusion Set, Core Resistant Huber Infusion Set with Y Site and Core Resistant Huber Infusion Set with Y Site and Clave are intended for use to deliver solutions and drugs through vascular implant ports.

The ICU Medical, Inc. Core Resistant Huber Infusion Set, Core Resistant Huber Infusion Set with Y Site and Core Resistant Huber Infusion Set with Y Site and CLAVE® are used to deliver solutions and drugs into vascular implant ports.

Product codes (comma separated list FDA assigned to the subject device)

FPA

Device Description

The ICU Medical Core Resistant Huber Infusion Sets are single use, sterile and non pyrogenic devices intended for use as an accessory to deliver solutions and drugs into a patient's vascular implant port. Components used in the sets may be either manufactured by ICU Medical or purchased from approved contract manufacturers. Components will be assembled into standard configurations or configurations specified by the customer and packaged.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

vascular implant ports

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

Not Found

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

Not Found

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 880.5440 Intravascular administration set.

(a)
Identification. An intravascular administration set is a device used to administer fluids from a container to a patient's vascular system through a needle or catheter inserted into a vein. The device may include the needle or catheter, tubing, a flow regulator, a drip chamber, an infusion line filter, an I.V. set stopcock, fluid delivery tubing, connectors between parts of the set, a side tube with a cap to serve as an injection site, and a hollow spike to penetrate and connect the tubing to an I.V. bag or other infusion fluid container.(b)
Classification. Class II (special controls). The special control for pharmacy compounding systems within this classification is the FDA guidance document entitled “Class II Special Controls Guidance Document: Pharmacy Compounding Systems; Final Guidance for Industry and FDA Reviewers.” Pharmacy compounding systems classified within the intravascular administration set are exempt from the premarket notification procedures in subpart E of this part and subject to the limitations in § 880.9.

0

ICU Medical Inc. Core Resistant Huber Infusion Sets 510(k) Notification Page 20 of 24

OCT - 1 1997

Appendix F. 510(k) Summary of Safety and Effectiveness 15.

The following section is included as required by the Safe Medical Device Act (SMDA) of 1990.

Name: Arlene Dutchik Address: 951 Calle Amanecer San Clemente, CA 92673

Contact Person:Arlene Dutchik
Phone Number:(714)366-2183
Fax Number:(714)366-8368

510(k) Summary of Safety and Effectiveness

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

The assigned 510(k) number is:

Applicant Information:

Date Prepared:July 17, 1997
Name:ICU Medical, Inc.
Address:951 Calle Amanecer.
San Clemente, Ca 92673

Contact Person: Arlene Dutchik Phone Number: (714)366-2183 Fax Number: (714)366-8368

Device Information:

Trade Name: Intravascular Administration Set Common Name: Core Resistant Huber Needle Sets Classification Name: Intravascular Administration Set

Equivalent Device:

Micro Med/Core-Resistant Huber Infusion Set with and without Y-Site

1

Device Description:

The ICU Medical Core Resistant Huber Infusion Sets are single use, sterile and non pyrogenic devices intended for use as an accessory to deliver solutions and drugs into a patient's vascular implant port. Components used in the sets may be either manufactured by ICU Medical or purchased from approved contract manufacturers. Components will be assembled into standard configurations or configurations specified by the customer and packaged.

Intended Use:

The ICU Medical, Inc. Core Resistant Huber Needle Infusion Set, Core Resistant Huber Infusion Set with Y Site and Core Resistant Huber Infusion Set with Y Site and Clave are intended for use to deliver solutions and drugs through vascular implant ports.

Comparison To Predicate Device:

| CHARACTERISTIC
COMPARED | ICU MEDICAL CORE
RESISTANT HUBER
INFUSION SET | MICRO MED, CORE
RESISTANT HUBER
NEEDLE INFUSION SET
WITH OR WITHOUT Y SITE |
|--------------------------------|------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------|
| Product Labeling | Sterile Use, Non Pyrogenic in
unopened, undamaged, package.
Directions for Use on label. | Sterile Use, Non Pyrogenic in
unopened, undamaged,
package. |
| Intended Use | Deliver solutions and drugs
through vascular implant ports. | Deliver solutions and drugs
through vascular implant ports. |
| Needle Gauges | 19, 20, 22 gauge | 19, 20, 22 gauge |
| Needle Lengths | 1/2", 3/4", 1", 11/2" | 1/2", 3/4", 1", 11/2" |
| Tubing Size | Macrobore and Minibore | Macrobore and Minibore |
| Color Coded Wings | Yes | Yes |
| Wing Assembly | Fixed | Fixed |
| CLAVE® Needleless
Connector | Yes | No |
| Luer Lock | Yes | Yes |

15.1. Comparative Information

2

Image /page/2/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo is circular in shape, with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter of the circle. In the center of the circle is a stylized image of a human figure with three wavy lines emanating from it.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

OCT - 1 1997

Ms. Arlene Dutchik Requlatory Affairs Specialist ICU Medical, Incorporated 951 Calle Amanecer San Clemente, California 92673

Re: K972712 Core resistant Huber Infusion Sets Trade Name: Requlatory Class: II Product Code: FPA Dated: July 17, 1997 Received: July 21, 1997

Dear Ms. Dutchik:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). "You may, therefore, market the device, subject to the general controls provisions The general controls provisions of the Act of the Act. include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major requlations affecting your device can be found in the Code of Federal Requlations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory In addition, FDA may publish further announcements action. concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531

3

Page 2 - Ms. Dutchik

through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin marketing your device as described in your 510 (k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4618. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,
K. Autrust

Timo Director Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

:

:

12. Appendix C. Indications for Use

The ICU Medical, Inc. Core Resistant Huber Infusion Set, Core Resistant Huber Infusion Set with Y Site and Core Resistant Huber Infusion Set with Y Site and CLAVE® are used to deliver solutions and drugs into vascular implant ports.

Patrici Crescenti

(Division Slets (11) (Division Status (1)
Division of Desta), infection of Democracy Division of General Finspilal Devices 1972212

510(k) Number

Prescription Use
(Per 21 CFR 801.109)