K Number
K991916
Device Name
VIRGINIA WATER SYSTEMS' WATER PURIFICATION SYSTEM FOR HEMODIALYSIS
Date Cleared
2000-01-14

(221 days)

Product Code
Regulation Number
876.5665
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Virginia Water Systems' Water Purification for Hemodialysis is intended to remove organic, inorganic, and microbial contaminants from water used to make dialysate and reprocess dialyzers as well as rinsing and disinfection of the dialysis equipment. When used as a medical device, Federal law restricts this device to sale by or on the order of a physician.
Device Description
Virginia Water Systems' Water Purification for Hemodialysis is complete water treatment system used in the production of ultrapure water used in hemodialysis facilities. The components consist of the following: Blend Valve, Inlet Booster Pump, Multimedia Filter, Softener, Carbon Tanks, Reverse Osmosis Unit, Water Storage Tank, Repressure Pumps, Deionizer, Ultraviolet Light, Submicron Filter, Hollow Fiber Filter.
More Information

K931595B, K945559, K974899, K981680

Not Found

No
The document describes a standard water purification system with physical components and does not mention any AI or ML capabilities.

No
This device purifies water for hemodialysis, which is used in the treatment, but it is not a therapeutic device itself.

No

Explanation: The device is described as a water purification system intended to remove contaminants from water used in hemodialysis. Its function is to treat water, not to diagnose a medical condition.

No

The device description lists numerous hardware components (Blend Valve, Inlet Booster Pump, Multimedia Filter, Softener, Carbon Tanks, Reverse Osmosis Unit, Water Storage Tank, Repressure Pumps, Deionizer, Ultraviolet Light, Submicron Filter, Hollow Fiber Filter), indicating it is a physical system, not software-only.

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

Here's why:

  • Intended Use: The intended use clearly states that the device is for purifying water used in hemodialysis. This is a process that prepares a substance (water) for use in a medical procedure (hemodialysis), but it does not involve testing or analyzing a sample from the human body to diagnose, monitor, or treat a condition.
  • Device Description: The description lists components that are part of a water purification system (filters, pumps, RO unit, etc.). These are physical components designed to treat water, not to perform in vitro diagnostic tests.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, detecting analytes, or providing diagnostic information about a patient's health status.

Therefore, while it is a medical device used in a clinical setting, it falls under the category of a water purification system for medical use, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

Virginia Water Systems' Water Purification for Hemodialysis is intended to remove organic, inorganic, and microbial contaminants from water used to make dialysate and reprocess dialyzers as well as rinsing and disinfection of the dialysis equipment. When used as a medical device, Federal law restricts this device to sale by or on the order of a physician.

Product codes

78 FIP

Device Description

Virginia Water Systems' Water Purification for Hemodialysis is complete water treatment system used in the production of ultrapure water used in hemodialysis facilities. The components consist of the following:

Blend Valve - used to temper the incoming water to 77°F.
Inlet Booster Pump - increases incoming water pressure to the pre-treatment and RO unit.
Multimedia Filter - removes incoming particles to a level of ten (10) microns.
Softener - reduces hardness constituants in incoming water.
Carbon Tanks - two (2) tanks in series that remove chlorine, chloramine, and organics. Ten (10) minutes empty bed time ensures complete chloramine removal.
Reverse Osmosis Unit - removes 95-98% of incoming minerals and 99% of organics. This is the primary treatment in most instances.
Water Storage Tank - retains product water from reverse osmosis unit as well as water recirculated through dialysis loop.
Repressure Pumps - supply pressure of water out of storage tank to the post-treatment equipment and the loop.
Deionizer - removes remaining minerals in RO product water as well as functions as a back-up to the reverse osmosis unit during periods of pre-teatment or RO problems.
Ultraviolet Light - kills bacteria in product water of RO, DI, or from the recirculation loop.
Submicron Filter - removes bacteria and particles greater than .2 micron from the product water and loop.
Hollow Fiber Filter - provides pyrogen removal with .05 micron filtration.

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)

K931595B, K945559, K974899, K981680

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.5665 Water purification system for hemodialysis.

(a)
Identification. A water purification system for hemodialysis is a device that is intended for use with a hemodialysis system and that is intended to remove organic and inorganic substances and microbial contaminants from water used to dilute dialysate concentrate to form dialysate. This generic type of device may include a water softener, sediment filter, carbon filter, and water distillation system.(b)
Classification. Class II (special controls). The device, when it is a water purification subsystem disinfectant, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.

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SECTION 8

510(K) SUMMARY OF SAFETY AND EFFECTIVENESS

May 25, 1999

Hemodialysis

Submitted by: VIRGINIA WATER SYSTEMS, INC. 7433 Whitepine Road Richmond, VA 23237 (804) 743-0034

Contact: William G. Garrahan

Dated :

Classification Name:

Proprietary Name:

Claiming Substantial _Equivalence To:

Osmonics Osmo 23G Series Reverse Osmosis / K931595B

Water Purification System for

Virginia Water Systems' Water Purification for Hemodialysis

MarCor Complete Water Treatment System for Kidney Dialysis / K945559

Gambro Central Water Treatment System CWP100-W / K974899

Dayton Water Systems Ultrapure Water Treatment System for Hemodialysis K981680

Device Description:

Virginia Water Systems' Water Purification for Hemodialysis is complete water treatment system used in the production ਰ of ultrapure water used in hemodialysis facilities. The components consist of the following:

Blend Valve - used to temper the incoming water to 77°F.

1

991916 p. 2/3

CHARACTERISTICS

| | Design | Material | Chemical
Composition | Energy
Source |
|-----------|--------------------|----------------------------------------|-------------------------|------------------|
| Va. Water | Complete
System | Pretreatment
RO, Post-
treatment | FRP, PVC, SS
Polypro | 110/220V |
| Osmonics | RO only | Exact RO
unit | Same | 110/220V |
| MarCor | Complete
System | Same | Same | 110/220V |
| Gambro | Complete
System | Same | Same | 110/220V |
| Dayton | Complete
System | Same | Same | 110/220V |

Statement of Intended Use:

Virginia Water Systems' Water Purification for Hemodialysis is intended to remove organic, inorganic, and microbial contaminants from water used to make dialysate and reprocess dialyzers as well as rinsing and disinfection of the dialysis equipment. When used as a medical device, Federal law restricts this device to sale by or on the order of a physician.

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K991916

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Device Description (cont'd)

Inlet Booster Pump - increases incoming water pressure to the pre-treatment and RO unit.

Multimedia Filter - removes incoming particles to a level of ten (10) microns.

Softener - reduces hardness constituants in incoming water.

Carbon Tanks - two (2) tanks in series that remove chlorine, chloramine, and organics. Ten (10) minutes empty bed time ensures complete chloramine removal.

Reverse Osmosis Unit - removes 95-98% of incoming minerals and 99% of organics. This is the primary treatment in most instances.

Water Storage Tank - retains product water from reverse osmosis unit as well as water recirculated through dialysis loop.

Repressure Pumps - supply pressure of water out of storage tank to the post-treatment equipment and the loop.

Deionizer - removes remaining minerals in RO product water as well as functions as a back-up to the reverse osmosis unit during periods of pre-teatment or RO problems.

Ultraviolet Light - kills bacteria in product water of RO, DI, or from the recirculation loop.

Submicron Filter - removes bacteria and particles greater than .2 micron from the product water and loop.

Hollow Fiber Filter - provides pyrogen removal with .05 micron filtration.

Technological Characteristics - Virginia Water systems claims equivalence in terms of technological characteristics, including design, material, chemical composition, and energy source as the predicate devices. A summary is as follows:

3

Image /page/3/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the top half of the circle. Inside the circle is a stylized image of three human profiles facing to the right, stacked on top of each other.

JAN 1 4 2000

Mr. William G. Garrahan Virginia Water Systems, Inc. 7433 Whitepine Road Richmond, VA 23237

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Re: K991916

Virginia Water Systems' Water Purification System for Hemodialysis Dated: October 13, 1999 Received: October 20,1999 Requiatory Class: II 21 CFR §876.5665/Procode: 78 FIP

Dear Mr. Garrahan:

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, Drug, 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 Regulations, 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 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 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.

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) 594-4613. 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/dsma/dsmamain.html".

Sincerely yours,

CAPT Daniel G. Schultz, M.D. Acting Director, Division of Reproductive, Abdominal, Ear, Nose and Throat, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

SECTION 7

INDICATION FOR USE STATEMENT

from water used to make dialysate and reprocess dialyzers as well as rinsing and disinfection of the dialysis equipment. When used as a medical device, Federal law restricts this device to sale by or on the order of a physician.

Prescription Use . (Per 21 CFR 801.109)

David A. Bergman

(Division Sign-Off) Division of Reproductive, Abdominal, EN and Radiological D 510(k) Number