K Number
K981035
Device Name
PRO-VENT, PULSATOR ARTERIAL BLOOD SAMPLING SYRINGES
Manufacturer
Date Cleared
1998-04-21

(33 days)

Product Code
Regulation Number
862.1675
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The arterial blood sampling syringe is intended for sampling of arterial blood for the measurement of p02, pCO2, pH, CO-oximetry, electrolytes (Ca++, Na++, K+, Cl+, and Mg++), Total Magnesium, and the metabolites (Glucose and Lactate).
Device Description
A commercially available hypodermic needle is modified by dispensing sodium heparin into the hub and cannula and then drying the heparin. The total recoverable volume of the heparin is approximately 5 U.S.P. units. The needle is then attached to a Pro-Vent® or Pulsator® Arterial Blood Sampling Syringe, which contains approximately 25 U.S.P. units of Calcium Neutralized Dry Lithium Heparin. The device is packaged and sterilized by Ethylene Oxide.
More Information

Not Found

No
The device description and performance studies focus on the physical components and chemical properties of the syringe and heparin, with no mention of AI or ML.

No.
The device is strictly for sampling arterial blood for diagnostic measurements and does not provide any treatment or therapy to the patient.

Yes
The device is used for sampling arterial blood for the measurement of various analytes (e.g., pO2, pCO2, pH, electrolytes, metabolites), which are then used to diagnose or monitor medical conditions.

No

The device description clearly outlines a physical medical device (syringe, needle, heparin) used for collecting arterial blood samples. There is no mention of software as the primary or sole component.

Based on the provided information, this device is an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use explicitly states that the device is for "sampling of arterial blood for the measurement of p02, pCO2, pH, CO-oximetry, electrolytes... and the metabolites...". This indicates that the device is used to collect a biological specimen (arterial blood) for subsequent testing in vitro (outside the body) to obtain diagnostic information.
  • Device Description: The device is a syringe designed specifically for collecting arterial blood, which is a sample used in laboratory tests.
  • Performance Studies: The performance studies involve testing the collected blood samples for various analytes (p02, pCO2, pH, etc.) and comparing the results. This further supports the device's role in the diagnostic process.

While the device itself is a collection tool, its intended use is directly tied to in vitro diagnostic testing. Therefore, it falls under the definition of an IVD.

N/A

Intended Use / Indications for Use

The arterial blood sampling syringe is intended for sampling of arterial blood for the measurement of p02, pCO2, pH, CO-oximetry, electrolytes (Ca++, Na+, K+, Cl+, and Mg++), Total Magnesium, and the metabolites (Glucose and Lactate).

Product codes

JKA

Device Description

A commercially available hypodermic needle is modified by dispensing sodium heparin into the hub and cannula and then drying the heparin. The total recoverable volume of the heparin is approximately 5 U.S.P. units. The needle is then attached to a Pro-Vent® or Pulsator® Arterial Blood Sampling Syringe, which contains approximately 25 U.S.P. units of Calcium Neutralized Dry Lithium Heparin. The device is packaged and sterilized by Ethylene Oxide.

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

Non-clinical data: The proposed syringes were tested in a side-by-side comparison to our current Arterial Blood Sampling Syringes with Calcium Neutralized Dry Lithium Heparin. The testing consisted of the sampling of arterial blood and the subsequent measurement of p02, pCO2, pH, CO-oximetry, Ca++, Mg++, Na+, K+, C1-, Total Magnesium, Glucose, and Lactate. The results of the measurements were compared. There was no statistical difference between the proposed syringes and the predicate device.

Key Metrics

There was no statistical difference between the proposed syringes and the predicate device.

Predicate Device(s)

K952516

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

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K981035

Image /page/0/Picture/1 description: The image shows the logo for Smiths Industries Medical Systems. The logo is divided into two parts. The left side of the logo has the letters "SIMS" in a bold, stylized font. The right side of the logo has the words "SMITHS INDUSTRIES" in a bold, sans-serif font, with the words "Medical Systems" in a smaller, serif font below.

J: 510(K) SUMMARY OF SAFETY AND EFFECTIVENESS

APR 21 1998

510(K) SUMMARY:

COMPANY INFORMATION:

SIMS Portex Inc 10 Bowman Drive Keene, NH 03431 (603) 352-3812 Contact: Timothy J. Talcott Manager, Regulatory Affairs

PREPARATION DATE OF SUMMARY:

March 13, 1998

TRADE NAME:

Pro-Vent® and Pulsator® Arterial Blood Sampling Syringes

COMMON NAME:

Arterial Blood Sampling Syringes

PRODUCT CLASS/CLASSIFICATION:

Class II, 75 GJE, 21 CFR 862.1675.

PREDICATE DEVICE(S):

Our Arterial Blood Sampling syringes with Calcium Neutralized Dry Lithium Heparin (K952516).

SIMS Portex Inc.

10 Bowman Drive PO Box 0724 Keene NH 03431 USA Telephone: 603-352-3812 Fax: 603-352-3703

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DESCRIPTION:

A commercially available hypodermic needle is modified by dispensing sodium heparin into the hub and cannula and then drying the heparin. The total recoverable volume of the heparin is approximately 5 U.S.P. units. The needle is then attached to a Pro-Vent® or Pulsator® Arterial Blood Sampling Syringe, which contains approximately 25 U.S.P. units of Calcium Neutralized Dry Lithium Heparin. The device is packaged and sterilized by Ethylene Oxide.

INDICATIONS FOR USE:

The arterial blood sampling syringe is intended for sampling of arterial blood for the measurement of p02, pCO2, pH, CO-oximetry, electrolytes (Ca++, Na+, K+, Cl+, and Mg++), Total Magnesium, and the metabolites (Glucose and Lactate).

TECHNICAL CHARACTERISTICS:

The proposed syringe with heparinized needle has dry calcium neutralized lithium heparin in the syringe and dried sodium heparin in the needle. Calcium Neutralized Dry Lithium Heparin is used in our Arterial Blood Gas Sampling Syringes, currently legally marketed (K952516). Sodium Heparin is used in our liquid filled Arterial Blood Gas Sampling Syringes, currently marketed (K952516). Materials of the svringe and needle are unchanged from our current Arterial Blood Gas Sampling Syringes. Sterilization is by the same methods employed in our existing Arterial Blood Gas Sampling Syringes, as authorized by FDA in 510(k) K952516.

NON-CLINICAL DATA:

The proposed syringes were tested in a side-by-side comparison to our current Arterial Blood Sampling Syringes with Calcium Neutralized Dry Lithium Heparin. The testing consisted of the sampling of arterial blood and the subsequent measurement of p02, pCO2, pH, CO-oximetry, Ca++, Mg++, Na+, K+, C1-, Total Magnesium, Glucose, and Lactate. The results of the measurements were compared. There was no statistical difference between the proposed syringes and the predicate device.

2

CONCLUSION:

The testing performed and comparison to the predicate device demonstrate that the proposed device is safe and effective and is substantially equivalent to the predicate device.

Very truly yours,

SIMS Portex Inc dba Concord/Portex

Timothy J. Ickes

Timothy J. Talcott Manager, Regulatory Affairs

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Image /page/3/Picture/1 description: The image shows the seal for the Department of Health & Human Services - USA. The seal is circular and contains the department's name around the perimeter. In the center of the seal is a stylized image of a human figure.

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

APR 2 1 1998

Timothy J. Talcott . Manager, Regulatory Affairs SIMS Portex Inc. 10 Bowman Drive P.O. Box 0724 Keene, New Hampshire 03431

K981035 Re : Pro-Vent® and Pulsator® Arterial Blood Sampling Syringes Regulatory Class: II Product Code: JKA Dated: March 13, 1998 Received: March 19, 1998

Dear Mr. Talcott:

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 reqistration, listing of devices, good manufacturing practice, labelinq, 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 requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General requlation (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 requlatory 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 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or requlations.

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Page 2

Under the Clinical Laboratory Improvement Amendments of 1988 (CLIA-88), this device may require a CLIA complexity categorization. To determine if it does, you should contact the Centers for Disease Control and Prevention (CDC) at (770) 488-7655.

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) 594-4588. 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,
Steven Bitman

Steven I. Gutman, M.D., M.B.A. Director Division of Clinical Laboratory Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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B: INTENDED USE OF DEVICE

PROPOSED INDICATIONS FOR USE:

The arterial blood sampling syringe is intended for sampling of arterial blood for the measurement of p02, pCO2, pH, CO-oximetry, electrolytes (Ca++, Na+, K+, Cl+, and Mg++), Total Magnesium, and the metabolites (Glucose and Lactate).

Patricia Bernhart (for A. Montgomery)

(Division Sign-Off) Division of Clinical Laboratory Devices 510(k) Number.

prescription use. ✓