K Number
K980935
Device Name
CAPIOX SX HARDSHELL RESERVOIR
Date Cleared
1998-05-14

(63 days)

Product Code
Regulation Number
870.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The CAPIOX SX Hardshell Reservoir is a hardshell reservoir used to store blood during extracorporeal circulation from both the venous line and the cardiotomy line. The reservoir contains filters to remove particulate matter and defoamers to facilitate air bubble removal. The Hardshell Reservoir is also used for post-operative chest drainage and autotransfusion procedures to aseptically return the blood to the patient for blood volume replacement.
Device Description
CAPIOX® SX hardshell reservoir has a rotatable venous blood inlet port to permit minimizing tubing lengths which could result in lower circuit priming volumes. The Hardshell reservoir contains a defoamer and a screen filter in the venous blood inlet section. The defoamer resides in the upper part of the reservoir permitting blood to reside in the lower section of the reservoir while not in constant contact with the defoamer. The total capacity of the reservoir is 4,000 mL. The cardiotomy section of the hardshell reservoir contains a defoamer and a cardiotomy filter to facilitate gas bubble removal and the removal of particulates/emboli from suctioned blood entering the reservoir.
More Information

Not Found

No
The description focuses on the physical components and function of a blood reservoir, with no mention of AI or ML capabilities.

No.
The device stores and filters blood during extracorporeal circulation and post-operative chest drainage, but it does not directly treat or diagnose a disease or condition. Its function is supportive in a medical procedure.

No
The device is used to store and filter blood during extracorporeal circulation and for autotransfusion, focusing on blood handling and volume replacement rather than detecting or identifying a medical condition.

No

The device description clearly details a physical hardshell reservoir with filters, defoamers, and ports for blood storage and processing, indicating it is a hardware device, not software.

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

Here's why:

  • Intended Use: The intended use describes the device as being used to store and filter blood during extracorporeal circulation and for post-operative chest drainage and autotransfusion. These are procedures performed directly on or with the patient's blood outside the body, but the purpose is to return the blood to the patient or manage it during a medical procedure.
  • Device Description: The description focuses on the physical components and function of the reservoir for handling blood flow and filtration.
  • Lack of IVD Characteristics: There is no mention of the device being used to analyze or test biological samples (like blood, urine, tissue, etc.) to provide information about a patient's health status, diagnose a condition, or monitor treatment. IVDs are typically used for diagnostic purposes, not for managing blood during a surgical or post-operative procedure.

Therefore, the CAPIOX SX Hardshell Reservoir is a medical device used in extracorporeal circulation and blood management procedures, but it does not fit the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The CAPIOX SX Reservoir is a hardshell reservoir used to store blood during extracorporeal circulation from both the venous line and the cardiotomy line. The reservoir contains filters to remove particulate matter and defoamers to facilitate air bubble removal.

The Hardshell Reservoir is also used for post-operative chest drainage and autotransfusion procedures to aseptically return the blood to the patient for blood volume replacement.

Product codes

DTN

Device Description

CAPIOX® SX hardshell reservoir has a rotatable venous blood inlet port to permit minimizing tubing lengths which could result in lower circuit priming volumes.

The Hardshell reservoir contains a defoamer and a screen filter in the venous blood inlet section. The defoamer resides in the upper part of the reservoir permitting blood to reside in the lower section of the reservoir while not in constant contact with the defoamer. The total capacity of the reservoir is 4,000 mL.

The cardiotomy section of the hardshell reservoir contains a defoamer and a cardiotomy filter to facilitate gas bubble removal and the removal of particulates/emboli from suctioned blood entering the reservoir.

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

Not Found

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

Not Found

Predicate Device(s)

K961836

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.4400 Cardiopulmonary bypass blood reservoir.

(a)
Identification. A cardiopulmonary bypass blood reservoir is a device used in conjunction with short-term extracorporeal circulation devices to hold a reserve supply of blood in the bypass circulation.(b)
Classification. Class II (special controls), except that a reservoir that contains a defoamer or filter is classified into the same class as the defoamer or filter. The device, when it is a cardiopulmonary bypass blood reservoir that does not contain defoamers or blood filters, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 870.9.

0

MAY | 4 1998

K980935

SUMMARY OF SAFETY AND EFFECTIVENESS INFORMATION PERTAINING TO SUBSTANTIAL EQUIVALENCE

Proprietary Device Name: CAPIOX® SX Hardshell Reservoir

Classification Name: Cardiopulmonary bypass blood reservoir, defoamer, cardiotomy suction line filter

Reason for Submission:

Addition of postoperative chest drainage and autotransfusion to the intended use of the hardshell reservoir.

Intended Use:

The CAPIOX SX Reservoir is a hardshell reservoir used to store blood during extracorporeal circulation from both the venous line and the cardiotomy line. The reservoir contains filters to remove particulate matter and defoamers to facilitate air bubble removal.

The Hardshell Reservoir is also used for post-operative chest drainage and autotransfusion procedures to aseptically return the blood to the patient for blood volume replacement.

Description

CAPIOX® SX hardshell reservoir has a rotatable venous blood inlet port to permit minimizing tubing lengths which could result in lower circuit priming volumes.

The Hardshell reservoir contains a defoamer and a screen filter in the venous blood inlet section. The defoamer resides in the upper part of the reservoir permitting blood to reside in the lower section of the reservoir while not in constant contact with the defoamer. The total capacity of the reservoir is 4,000 mL.

The cardiotomy section of the hardshell reservoir contains a defoamer and a cardiotomy filter to facilitate gas bubble removal and the removal of particulates/emboli from suctioned blood entering the reservoir.

1

II - Summary and Certification Summary of Safety and Effectiveness

Substantial Equivalence

The CAPIOX® SX Reservoir is substantially equivalent to the Maxima Forte (Medtronic, K961836) as follows:

Intended use: same as described on previous page.

Design and Materials

· Design: Both devices are constructed from a clear plastic casing. Both contain filter and defoamer elements. Venous and cardiotomy blood flow through the same filter and defoamer in the Maxima Forte. In the CAPIOX SX reservoir the venous blood flows through a separate channel containing a separate defoamer element from the cardiotomy section.

·Materials:

ComponentCAPIOX SX ReservoirMAXIMA Forte
HousingPolycarbonatePolycarbonate
DefoamerPolyurethanePolyurethane
FilterPolyethylene terephthalate
nonwoven fabricPolyester felt filter 20 um

This difference in filter material does not have a significant clinical impact.

Technology and Principles of Operation

Both devices utilize gravity and/or external vacuum (cardiotomy) for blood collection into the reservoir. Air removal is facilitated by defoamers and the tendency of air to rise through liquid. Particulate removal is facilitated by the blood flow pathway through filters contained in the reservoirs.

The CAPIOX SX Hardshell Reservoir and the Maxima Forte are substantially equivalent in technology and principles of operation.

2

II - Summary and Certification Summary of Safety and Effectiveness

Specifications

Table 2
ItemCAPIOX SX18/25 ReservoirMaxima Forte
Reservoir volume
Maximum4,000 mL4,000 mL
Minimum operating volume200 mL500 mL
Blood flow rate duringCardiotomy inlet: 0.5-5LPMCardiotomy inlet: 1-5LPM
cardiopulmonary bypassVenous flow: 0.5-7 LPMVenous flow: 1-7 LPM
Cardiotomy FiltrationGreater than 90% efficiency95% efficient for particles
Efficiencyfor particles ≥20u≥20u

The specifications of the CAPIOX SX Hardshell Reservoir and the Maxima Forte are substantially equivalent.

In summary, the CAPIOX® SX Reservoir and the Maxima Forte are substantially equivalent in intended use, design and materials, technology/principles of operation, specifications and performance. Differences as described above do not raise new issues of safety or effectiveness.

Terumo's statement that this device is substantially equivalent to any other device is done solely to comply with the requirements of the Federal Food, Drug and Cosmetic Act and is not intended whatsoever to be the basis for a patent infringement action.

Additional Safety Information

· Pyrogen Testing

·Sterilization conditions have been validated to provide a Sterility Assurance Level (SAL) of 10-6.

· Ethylene oxide residuals will not exceed the maximum residue limits proposed for Part 821 of Title 21 in the Federal Register of June 23, 1978 (or as finalized or amended).

· Manufacturing control testing

· Blood contacting materials were tested in accordance with the FDA General Program Memorandum #G95-1 (5/1/95): Use of International Standard ISO-10993, " Biological Evaluation of Medical Devices Part 1: Evaluation and Testing (External communicating devices/Circulating Blood/Limited contact duration).

3

  • II Summary and Certification Summary of Safety and Effectiveness
    Date Prepared February 23, 1998

.'

Prepared by: Sandi Hartka, Manager Regulatory Affairs

  • for: Terumo Medical Corporation 2101 Cottontail Lane Somerset, NJ 08873

4

Image /page/4/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three human profiles incorporated into its design. The eagle is positioned to the right of a circular text that reads "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA".

MAY 1 4 1998

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Ms. Sandi Hartka Manager Regulatory Affairs Terumo Medical Corporation Regulatory Affairs Department 125 Blue Ball Road Elkton, MD 21921

Re : K980935 CAPIOX® SX Hardshell Reservoir Regulatory Class: II (Two) Product Code: DTN Dated: April 28, 1998 Received: May 4, 1998

Dear Ms. Hartka:

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 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, Druq, and Cosmetic Act (Act). You may, therefore, market the device, subject to the general controls provisions of the Act. 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.

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 regulations 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 reguirements, as set forth in the Quality System Requlation (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 requlation may result in requlatory action. In addition, FDA may publish further announcements 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 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations .

5

Page 2 - Ms. Sandi Hartka

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) 594-4648. 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 requlation 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/dsma/dsmamain.html".

Sincerely yours
Thomas J. Callahon

Thomas J. Callahan, Ph.D. Director Division of Cardiovascular, Respiratory, and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

6

510(k) Number (if known): 980935 ﻠ

Device Name: CAPIOX® SX Hardshell Reservoir

Indications For Use:

The CAPIOX SX Hardshell Reservoir is a hardshell reservoir used to store blood during extracorporeal circulation from both the venous line and the cardiotomy line. The reservoir contains filters to remove particulate matter and defoamers to facilitate air bubble removal.

The Hardshell Reservoir is also used for post-operative chest drainage and autotransfusion procedures to aseptically return the blood to the patient for blood volume replacement.

Bete L. Semperle
(Division Sign-Off)

Division of Cardiovascular, Respiratory, and Neurological Devices

510(k) Number ________________________________________________________________________________________________________________________________________________________________ K 980934

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

OR

Over-The-Counter Use

(Optional Format 1-2-96)