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510(k) Data Aggregation

    Why did this record match?
    Applicant Name (Manufacturer) :

    Koru Medical Systems

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Freedom60 Infusion System is specifically indicated for the subcutaneous infusion of the following human plasma-derived immunoglobulins when used according to the FDA approved biologic labeling: Cutaquig®, Immune Globulin Subcutaneous (Human) 16.5% Solution (manufactured by Octapharma®); Cuvitru®, Immune Globulin Infusion (Human) 20% (manufactured by Takeda®); Gammagard Liquid®. Immune Globulin Infusion (Human) 10% (manufactured by Takeda®); Hizentra®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®); and Xembify®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by Grifols®) in the home, hospital, or ambulatory settings when administered according to the approved biologic or drug product labeling.

    The Freedom60 Infusion System with the Freedom60® Infusion Pump and Precision Flow Rate Tubing™ is specifically indicated for the intravenous infusion of the following antibiotics when used according to the FDA approved drug product labeling: ertapenem, oxacillin, and tobramycin.

    The Freedom60 Infusion System consists of the following devices:

    • Freedom60® Infusion Pump

    • Precision Flow Rate Tubing

    • High-Flo Subcutaneous Needle Sets

    • HigH-Flo Super26™ Subcutaneous Needle Sets are specifically indicated for the subcutaneous infusion of the following human plasma-derived immunoglobulins: Cutaquig®, Immune Globulin Subcutaneous (Human) 16.5% Solution (manufactured by Octapharma®); Cuvitru®, Immune Globulin Infusion (Human) 20% (manufactured by Takeda®); Hizentra®, lmmune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®); and Xembify®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®)

    The Freedom60 Infusion System is indicated for use with the following syringes:

    • · BD® 50 ml syringe
    • · Medline® 60 ml Syringe
    • · Hizentra® 50 ml Prefilled Syringe
    Device Description

    The Freedom60 Infusion System is a non-powered infusion system that includes a mechanical infusion pump, subcutaneous needle sets, and tubing sets. The infusion pump exerts a constant force on the medication through the tubing. The tubing set and needle set produce a certain amount of resistance, which moderates the flow rate. The tubing sets and needle sets are provided in a range of sizes and device options (number of needle gauge, tubing diameter, etc). The healthcare provider prescribes the tubing/needle sets based on the intended flow rate and dosage of the drug being administered.

    The infusion pump is compatible with specific syringe types. An adapter is included as part of this submission to enable compatibility with certain pre-filled syringes that are compatible for use with the Freedom60 infusion system are the BD 50ml syringe, the Medline 60 ml syringe, and the Hizentra 50 ml pre-filled syringe.

    The infusion pump and pre-filled syringe adapter are reusable. The infusion sets are are terminally sterilized via gamma radiation. The Freedom60 Infusion System is manufactured from materials with an established history of biological safety, and is not manufactured with latex or natural rubber.

    AI/ML Overview

    The provided text is a 510(k) Summary for a medical device (Freedom60 Infusion Pump and associated components). It describes the device, its intended use, and the non-clinical testing performed to establish substantial equivalence to a predicate device. However, it does not contain information about the specific acceptance criteria, reported device performance in a table, sample sizes for test/training sets, expert qualifications, ground truth establishment, MRMC studies, or standalone algorithm performance, as these typically relate to AI/ML device submissions.

    The document refers to mechanical/fluidic performance testing for an infusion pump, not an AI/ML diagnostic system. Therefore, I cannot extract the requested information regarding AI/ML device acceptance criteria and study details from this document.

    For context, I will outline the information that would be present if this were an AI/ML device submission, and then explain why it's not applicable here based on the provided text.

    Information NOT available in the provided document (as it's not an AI/ML device):

    1. Table of acceptance criteria and reported device performance: This document refers to flow rate verification, reliability/use life verification, dose accuracy, and fitment. It does not provide a table with specific numerical acceptance criteria (e.g., minimum sensitivity, specificity) and corresponding achieved performance metrics (e.g., actual sensitivity, specificity values), which are common for AI/ML diagnostic devices.
    2. Sample sizes used for the test set and data provenance: The document mentions "non-clinical testing" and "verification and validation testing" but does not specify sample sizes in terms of patient cohorts or image sets, nor does it mention data provenance (e.g., country of origin, retrospective/prospective), as would be detailed for AI/ML models.
    3. Number of experts used to establish the ground truth for the test set and their qualifications: This is irrelevant here because the device is a mechanical infusion pump. Ground truth for an AI/ML diagnostic device usually involves expert annotations (e.g., radiologists, pathologists).
    4. Adjudication method for the test set: Not applicable, as there's no diagnostic ground truth being established by experts.
    5. If a multi reader multi case (MRMC) comparative effectiveness study was done, and its effect size: Not applicable, as this is a mechanical device, not an AI-assisted diagnostic tool. MRMC studies evaluate the impact of AI on human reader performance.
    6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done: Not applicable, as there is no standalone AI algorithm.
    7. The type of ground truth used: For this device, the "ground truth" would be established through engineering measurements of flow rates, dose accuracy, and mechanical reliability against design specifications, not clinical outcomes, pathology, or expert consensus on medical images/data.
    8. The sample size for the training set: Not applicable, as this describes a device that undergoes physical manufacturing and testing based on engineering principles, not an AI/ML model that is trained on a dataset.
    9. How the ground truth for the training set was established: Not applicable for the same reason as above.

    What the document does state about testing:

    The "Non-Clinical and/or Clinical Tests Summary & Conclusions" section (Page 7) states:

    • Testing Performed:
      • Flow rate verification
      • Reliability/use life verification
      • Dose accuracy and fitment
      • Human factors validation (per IEC 62366-1 and FDA Guidance)
    • Clinical Testing: "Clinical testing is not applicable for this submission." This further confirms it's not an AI/ML diagnostic.
    • Conclusion: "All verification and validation testing was successfully completed. The non-clinical testing performed demonstrates that the device is as safe and effective as the legally marketed predicate device meets that the device meets the performance requirements set out as part of the design control process."

    In summary, the provided document details the regulatory clearance of a mechanical infusion system, not an AI/ML-driven device. Therefore, the specific acceptance criteria and study details relevant to AI/ML performance (such as sensitivity, specificity, expert ground truth, MRMC studies) are not present and cannot be extracted.

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    K Number
    K214045
    Date Cleared
    2022-04-29

    (123 days)

    Product Code
    Regulation Number
    880.5725
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Repro-Medical System, Inc., dba Koru Medical Systems

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The FreedomEdge® Syringe Infusion System is intended for the intravenous or subcutaneous infusion of medications and fluids in the home, hospital, or ambulatory settings when administered according to the approved biologic or drug product labeling.

    Intended population: adults and pediatrics.

    The FreedomEdge® Syringe Infusion System consists of the following components:

    • FreedomEdge® Syringe Driver
    • Precision Flow Rate Tubing™
    • HIgH-Flo Subcutaneous Safety Needle Sets™
    • HIgH-Flo Super26™ Subcutaneous Needle Sets are specifically indicated for the subcutaneous infusion of the following human plasma-derived immunoglobulins: Cuvitru®, Immune Globulin Infusion (Human) 20% (manufactured by Takeda®); Hizentra®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®); Hizentra®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®) Single-use pre-filled syringe for subcutaneous administration.

    The FreedomEdge® Syringe Infusion System is indicated for use with the BD® 20 ml syringe (US Reference number: 302830), BD 30 ml syringe (US Reference number: 302832) and Hizentra® 20 ml prefilled syringe (NDC 44206-458-96).

    For Immunoglobulin Administration:
    The Freedom Integrated Syringe Infusion System is specifically indicated for the subcutaneous infusion of the following human plasma-derived immunoglobulins when used according to the FDA approved biologic labeling: Cuvitru®, Immune Globulin Infusion (Human) 20% (manufactured by Takeda®); Gammagard Liquid®, Immune Globulin Infusion (Human) 10% (manufactured by Takeda®); Hizentra®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®) and Hizentra®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®) Single-use pre-filled syringe for subcutaneous administration in the home, hospital, or ambulatory settings when administered according to the approved biologic or drug product labeling.

    For EMPAVELI™ (pegcetacoplan) Administration:
    The Freedom Integrated Syringe Infusion System is specifically indicated for the subcutaneous infusion with EMPAVELI™ (pegcetacoplan) in the home, hospital, or ambulatory setting when administered according to the approved drug product labeling.

    For Intravenous Antibiotic Administration:
    The Freedom Integrated Syringe Infusion System with the FreedomEdge® Syringe Driver and Precision Flow Rate Tubing™, is specifically indicated for the intravenous infusion of the following antibiotics when used according to the FDA approved drug product labeling:

    Ertapenem, Meropenem, Oxacillin, and Tobramycin.

    Device Description

    The FreedomEdge® Syringe Infusion System is a single-channel, volumetric infusion pump. The FreedomEdge® Syringe Infusion System consists of four primary components:

      1. FreedomEdge® Syringe Driver,
      1. Precision Flow Rate Tubing™ and
      1. HIgH-Flo Subcutaneous Safety Needle Set™, or
      1. HIgH-Flo Super26TM Subcutaneous Safety Needle Set
    1. FreedomEdge® Syringe Driver:
      The FreedomEdge® Syringe Driver (non-sterile) in combination with Precision Flow Rate Tubing™ (sterile) and HIgH-Flo Safety Needle Sets (sterile) makes up the FreedomEdge® Syringe Infusion System. The FreedomEdge® Syringe Driver is a nonsterile, reusable non-electric driver that infuses immunoglobulins and Pegcetacoplan subcutaneously and antibiotic solutions intravenously to patients.

    The FreedomEdge® driver is an ambulatory device designed to accommodate a BD Luer-Lok™ 20mL syringe. Catalog No.: 302830 and 301031. BD Luer-Lok™ 30mL syringe, Catalog No.: 301033 and Hizentra® 20 ml prefilled syringe. The pump uses a constant force spring mechanism to apply pressure to the plunger-end syringe.

    The FreedomEdge® Syringe Infusion System is assembled by loading the syringe with tubing into the FreedomEdge® driver.

    1. Precision Flow Rate Tubing™:
      The FreedomEdge® Syringe Infusion System includes a range of Freedom Precision Flow Rate Tubing™ (provided sterile). The tubing ranges from F0.5 to F2400. Each Fnumber provides a different level of flow restriction, which, when combined with the viscosity of the medication, provides a controlled delivery in an all-mechanical system. The tubing sets connect at one end to the syringe being used and on the other end to the Subcutaneous Safety Needle Sets or directly on venous catheters for intravenous infusions as needed.

    2. HIgH-Flo Needles Sets:
      The HIgH-Flo Subcutaneous Safety Needle Sets™
      The HIgH-Flo Subcutaneous Safety Needle Sets™ (provided sterile) are used to administer drugs to the subcutaneous layers using small needles attached to the skin. Subcutaneous needles come in different lengths to administer immunoglobulins, pegcetacoplan, and antibiotics.

    Subcutaneous Safety Needle Sets come in multiple configurations (1, 2, 3, 4, 5, 6 needle sites). Needles are available in 4mm, 6mm, 9mm, 12mm, and 14mm lengths combined with 24 or 26 Gauge. Using the Y-Connector, the patient can have up to 8 sites for drug delivery.

    The HIgH- Flo Subcutaneous Safety Needle Sets™ also allow each needle to be enclosed between the wings after use.

    The HIgH-Flo Super26TM Subcutaneous Needle Sets
    The HIgH-Flo Super26TM Subcutaneous Needle Sets are sterile, non-pyrogenic, single use, Subcutaneous Administration Sets, comprised of a Super 26-gauge needle assembly, combined with 24-gauge needle tubing and are intended for the delivery of medication to the subcutaneous tissue. Each set consists of a sterile infusion set and a commercially available adhesive dressing used to hold the device in place. The infusion set is a 90degree, 26-gauge stainless steel needle, mounted to a butterfly winged safety closure on one end which is used to close the set upon completion. The other end consists of a luer lock which connects to PVC medical grade tubing. Additionally, each tubing set is equipped with a slide clamp used to stop flow, immediately as needed. HIgH-Flo Super 26TM Subcutaneous Needle Sets are available as a single set, as well as 2-needle, 3needle, 4-needle, 5-needle, 6-needle, sets; through use of a Y-connector, 7-needle and 8 needle sets may also be assembled.

    AI/ML Overview

    The provided text describes a 510(k) premarket notification for a medical device called the FreedomEdge® Syringe Infusion System. This submission aims to expand the indications for use of an existing predicate device (K211206) to include the subcutaneous infusion of EMPAVELI™ (pegcetacoplan) in addition to already cleared immunoglobulins and antibiotics.

    Here's an analysis of the acceptance criteria and the study that proves the device meets them, based on the provided text:

    1. A table of acceptance criteria and the reported device performance

    The document does not explicitly present a "table of acceptance criteria" in the traditional sense of numerical targets that the device needs to meet for each performance metric. Instead, it outlines performance data collected to demonstrate safety and effectiveness. The primary "acceptance criterion" for this 510(k) is demonstrating substantial equivalence to the predicate device, especially for the new indication (EMPAVELI™ infusion). The performance data cited are studies designed to ensure the device performs safely and effectively for its intended use, matching the existing predicate's performance and supporting the new use.

    Here's a summary of the reported device performance and how it relates to general acceptance in a 510(k) context:

    Acceptance Criteria (Inferred from 510(k) Requirements)Reported Device Performance
    Flow Rate Accuracy for EMPAVELI™Tables provided for "HIgH-Flo 26G with Precision Tubing - Max-Min Flow Rate Per Site (ml/hr/site)" and "HIgH-Flo 26G with Precision Tubing - Max-Min Flow Rate Total (ml/hr)" for various tubing configurations (F500 to F2400) and 1-2 needles.

    The "HIgH-Flo 26G with Precision Tubing – Min-Max Infusion Times (minutes)" table is also provided. The text states: "The EMPAVELI™ label states that typical infusion time is approximately 30 minutes (if using 2 infusion sites) or approximately 60 minutes (if using one infusion site). Based on assessment of EMPAVELI™ labeling there is no identified patient risk for going faster or slower than this approximate infusion time." This implies the device's flow rates (and thus infusion times) for EMPAVELI™ fall within a clinically acceptable range. |
    | Flow Rate Accuracy for Immunoglobulins (Hizentra®, Cuvitru®, Gammagard® Liquid) | Multiple tables for "Selected Flow Rate Combinations" with HIgH-Flo Subcutaneous Safety Needle Sets (Standard 26G and 24G) and Precision Flow Rate Tubing for different drug volumes (e.g., 10ml, 20ml, 40ml, 50ml, 60ml, 100ml) and number of sites (1, 2, 3, 4). These tables provide "Total Flow Rate (ml/hr)", "Flow rate/site (ml/hr)", "Vol/site (ml)", and "Time" for various configurations. They include notes like "Suggested start Peds", "Suggested start Adult", and "6th Infusion of biologic and beyond", indicating the device can achieve desired infusion rates for various clinical scenarios.

    Separate comprehensive tables are provided for Hizentra® 20 ml Prefilled Syringe with HIgH-Flo 26G, HIgH-Flo Super26, and HIgH-Flo 24G at various precision tubing settings and 1-8 needles, showing min-max flow rates per site (ml/hr/site). |
    | Biocompatibility | Materials comply with ISO 10993-1 and FDA Blue Book Memorandum #G95-1. Testing was conducted for Cytotoxicity, Sensitization, and Irritation. |
    | Human Factors and Usability | Studies conducted per FDA Guidance "Applying Human Factors and Usability Engineering to Medical Devices" (February 3, 2016) with intended user population, use environment, and scenarios. Results demonstrate device validation for intended use. |
    | Reprocessing, Cleaning | Compliance/testing with AAMI TIR12:2010, AAMI TIR30:2011(R)2016, FDA guidance "Reprocessing Medical Devices in Health Care Settings", ISO 17664:2017, ANSI/AAMI/ISO 11737-1:2018. NAMSA Technical Memorandum US033689 Rev. 1 was reviewed. |
    | Packaging | Compliance with 11607-1:2019 "Packaging for terminally sterilized medical devices - Part 1: Requirements for materials, sterile barrier systems and packaging systems." Tubing and needle sets are packaged sterile using a nylon pouch. |
    | Sterility | Compliance with ISO 11137-2:2013 "Sterilization of health care products - Radiation - Part 2: Establishing the sterilization dose." Needle sets and tubing are sterilized via Gamma SAL 10-6. |
    | MR Safety | Compliance with ASTM F2503-13, "Standard Practice for Marking Medical Devices and Other Items for Safety in the Magnetic Resonance Environment." |
    | Overall Safety and Effectiveness | A safety assurance case was provided, addressing device requirements, risk identification/mitigation, and reliability over service life, as recommended by FDA guidance. Non-clinical data supports safety, and performance testing demonstrates the device meets specifications, performing "as safely and as effectively as the predicate device". |

    2. Sample size used for the test set and the data provenance (e.g., country of origin of the data, retrospective or prospective)

    The document extensively discusses performance testing, particularly for flow rates. However, it does not specify the sample size used for the various tests (e.g., how many syringe infusion systems were tested, how many individual flow rate measurements were taken).

    The provenance of the data (country of origin, retrospective/prospective) is not explicitly stated. The testing was conducted "in accordance with the intended use of the device and in accordance with the FDA Guidance 'Infusion Pumps Total Product Life Cycle'," suggesting it was likely laboratory-based performance testing, prospectively designed to meet regulatory requirements.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g., radiologist with 10 years of experience)

    This section is not applicable as the device is an infusion system, not an AI or diagnostic device that relies on expert interpretation to establish a ground truth for a test set. The "ground truth" here is the physical performance (e.g., flow rate, biocompatibility) measured against engineering specifications and regulatory standards.

    4. Adjudication method (e.g., 2+1, 3+1, none) for the test set

    This section is not applicable for the same reasons as point 3. The performance testing of a physical medical device does not typically involve expert adjudication of results in the way image interpretation or AI diagnosis does.

    5. 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

    This section is not applicable as the device is not an AI-assisted diagnostic or decision support system. It is a physical medical device (infusion system), and therefore, MRMC studies are not relevant.

    6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done

    This section is not applicable as the device is not an algorithm. It is a physical infusion system that operates with a human user in the loop (for setup, drug preparation, monitoring, etc.) but its core function (drug delivery) is mechanical.

    7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

    For this device, the "ground truth" for performance testing is established by:

    • Engineering specifications and regulatory standards: Flow rates are measured against predicted values and in consideration of drug manufacturer's labeling.
    • Biocompatibility standards: ISO 10993-1 and FDA guidelines are used.
    • Human factors guidance: FDA guidance for human factors and usability engineering is applied.
    • Reprocessing/Sterility standards: ISO and AAMI standards define acceptable levels.
    • Drug labeling: The performance data correlates the device's flow rates with the parameters specified in the FDA-approved labeling for the indicated drugs (immunoglobulins, EMPAVELI, antibiotics).

    The "ground truth" is therefore a combination of validated technical performance measurements against established engineering and regulatory benchmarks, informed by drug-specific dosing and infusion parameters.

    8. The sample size for the training set

    This section is not applicable as the device is not an AI or machine learning system that requires a "training set."

    9. How the ground truth for the training set was established

    This section is not applicable for the same reasons as point 8.

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    K Number
    K200176
    Date Cleared
    2021-12-15

    (691 days)

    Product Code
    Regulation Number
    880.5725
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Repro-Med Systems, Inc., dba KORU Medical Systems

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Freedom Integrated Syringe Infusion System is specifically indicated for the subcutaneous infusion of the following human plasma-derived immunoglobulins when used according to the FDA approved biologic labeling: Cutaquig®, Immune Globulin Subcutaneous (Human) 16.5% Solution (manufactured by Octapharma®); Cuvitru®, Immune Globulin Infusion (Human) 20% (manufactured by Takeda®); Gammagard Liquid®, Immune Globulin Infusion (Human) 10% (manufactured by Takeda®); Hizentra®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®); and Xembify®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by Grifols®) in the home, hospital, or ambulatory settings when administered according to the approved biologic or drug product labeling.

    The FREEDOM Integrated Syringe Infusion System with the FREEDOM60® Syringe Driver and Precision Flow Rate Tubing™, is specifically indicated for the intravenous infusion of the following antibiotics when used according to the FDA approved drug product labeling: ertapenem, meropenem, oxacillin, and tobramycin.

    The Freedom Integrated Syringe Infusion System consists of the following components:

    • FREEDOM60® Syringe Driver
    • Precision Flow Rate Tubing™M
    • HIgH-Flo Subcutaneous Safety Needle SetsTM
    • HIgH-Flo Super26™ Subcutaneous Needle Sets are specifically indicated for the subcutaneous infusion of the following human plasma-derived immunoglobulins: Cutaquig®, Immune Globulin Subcutaneous (Human) 16.5% Solution (manufactured by Octapharma®); Cuvitru®, Immune Globulin Infusion (Human) 20% (manufactured by Takeda®); Hizentra®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®); and Xembify®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®).

    The FREEDOM60® Syringe Driver is indicated for use with the BD® 50 ml syringe (US Reference number 309653).

    Device Description

    The FREEDOM® Integrated Syringe Infusion System is a single-channel, volumetric infusion pump. The FREEDOM60® Integrated Syringe Infusion System consists of four primary components:

      1. FREEDOM60® Syringe Driver,
      1. Precision Flow Rate Tubing™ and
      1. HIgH-Flo Subcutaneous Safety Needle Set™, or
      1. HIgH-Flo Super26TM Subcutaneous Safety Needle Set
    1. FREEDOM60® Syringe Driver:
      The FREEDOM60® Syringe Driver in combination with Precision Flow Rate Tubing™ (sterile) and HIgH-Flo Subcutaneous Safety Needle Sets (sterile) makes up the Freedom Integrated Syringe Infusion system. The FREEDOM60® Syringe Driver is a non- sterile, reusable non-electric driver that infuses immunoglobulins subcutaneously and antibiotic solutions intravenously to patients.

    The FREEDOM60® Syringe Driver is an ambulatory device designed to accommodate a BD Luer- Lok™ 50mL Syringe (Catalog No.: 8881-560125, BD 309653), and fluid volumes ranging from 10cc to 60cc may be used. The pump uses a constant force spring mechanism to apply pressure to the plunger-end syringe.

    The Freedom Integrated Syringe System is assembled by loading the syringe with tubing into the Freemdom60® driver.

    1. Precision Flow Rate Tubing™:
      The Freedom Integrated Syringe System includes a range of Freedom Precision Flow Rate Tubing™ (provided sterile). The tubing ranges from F0.5 to F2400. Each F-number provides a different level of flow restriction, which, when combined with the viscosity of the medication, provides a controlled delivery in an all-mechanical system. The tubing sets connect at one end to the syringe being used and on the other end to the Subcutaneous Safety Needle Sets or directly on venous catheters for intravenous infusions as needed.

    2. HIgH-Flo Needles Sets:
      The HIgH-Flo Subcutaneous Safety Needle SetsTM
      The HIgH-Flo Subcutaneous Safety Needle Sets™ (provided sterile) are used to administer drugs to the subcutaneous layers using small needles attached to the skin. Subcutaneous needles come in different lengths to administer immunoglobulins and antibiotics.

    Subcutaneous Safety Needle Sets comes in multiple configurations (1, 2, 3, 4, 5, 6 needle sites). Needles are available in 4mm, 6mm, 9mm, 12mm, and 14mm lengths combined with 24 or 26 Gauge. Using the Y-Connector, the patient can have up to 8 sites for drug delivery.

    The HIgH- Flo Subcutaneous Safety Needle Sets™ also allow each needle to be enclosed between the wings after use.

    The HIgH-Flo Super26TM Subcutaneous Needle Sets
    The HIgH-Flo Super26TM Subcutaneous Needle Sets are sterile, non-pyrogenic, single use, Subcutaneous Administration Sets, comprised of a Super 26-gauge needle assembly, combined with 24-gauge needle tubing and are intended for the delivery of medication to the subcutaneous tissue. Each set consists of a sterile infusion set and a commercially available adhesive dressing used to hold the device in place. The infusion set is a 90degree, 26-gauge stainless steel needle, mounted to a butterfly winged safety closure on one end which is used to close the set upon completion. The other end consists of a luer lock which connects to PVC medical grade tubing. Additionally, each tubing set is equipped with a slide clamp used to stop flow, immediately as needed. HIgH-Flo Super 26TM Subcutaneous Needle Sets are available as a single set, as well as 2-needle, 3needle, 4-needle, 5-needle, 6-needle, sets; through use of a Y-connector, 7-needle and 8 needle sets may also be assembled.

    AI/ML Overview

    Here's a breakdown of the acceptance criteria and the study information presented in the provided text:

    1. Table of Acceptance Criteria and Reported Device Performance:

    The document primarily focuses on demonstrating substantial equivalence to a predicate device and provides performance data for flow rates with different configurations. It doesn't explicitly state "acceptance criteria" in a singular table, but rather details the performance characteristics that were measured and compared. The key performance aspect is the flow rate accuracy.

    Acceptance Criteria (Implied)Reported Device Performance
    Flow Rate AccuracyPredicate Device (K162613): +/- 8% of predicted flow rates.

    Subject Device (K200176): Flow rates will fall between the minimum and maximum predicted values as specified in the Instructions for Use (IFU). The document then provides extensive tables of min-max predicated flow rates per site for various drugs (Cutaquig®, Xembify®, Cuvitru®, Gammagard Liquid®, Hizentra® PI, Hizentra® CIDP) across different needle sets (HIgH-Flo 26G, HIgH-Flo Super26, HIgH-Flo 24G) and tubing types (F120-F2400). |
    | Biocompatibility | Materials comply with ISO 10993-1 and FDA Blue Book Memorandum #G95-1. Testing included Cytotoxicity, Sensitization, and Irritation. |
    | Human Factors | Human factors studies were conducted per FDA Guidance "Applying Human Factors and Usability Engineering to Medical Devices" (February 3, 2016). Results demonstrate validation of the device per its intended use. |
    | Reprocessing/Cleaning | Compliance with AAMI TIR12:2010, AAMI TIR30:2011(R)2016, "Reprocessing Medical Devices in Health Care Settings," and ISO 17664:2017. Worst-case design for cleaning and low-level disinfection efficacy studies were reviewed and compared. |
    | Packaging | Compliance with ISO 11607-1:2019 (Packaging for terminally sterilized medical devices). The nylon film pouch maintains sterile barrier. |
    | Sterility | Compliance with ISO 11137-2:2013 (Sterilization of health care products - Radiation). |
    | MR Safety | Compliance with ASTM F2503-13 ("Standard Practice for Marking Medical Devices and Other Items for Safety in the Magnetic Resonance Environment"). |
    | Safety Assurance | A safety assurance case was provided, addressing: device requirements, risk identification/mitigation, and device reliability. |

    2. Sample Size Used for the Test Set and Data Provenance:

    The document does not explicitly state a sample size for a "test set" in the context of an accuracy study with patient data. The performance data presented (flow rate combinations) appears to be derived from bench testing and theoretical calculations, rather than a clinical trial or a test set of patient data.

    • Provenance: This is bench testing data, not human or animal data. The origin would be the testing laboratories where the physical measurements were taken. No country of origin is specified for the testing. It is not retrospective or prospective clinical data.

    3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications:

    Not applicable. The "ground truth" for the flow rate performance is established through direct measurement on the physical device during bench testing, not through expert consensus on medical images or patient outcomes.

    4. Adjudication Method for the Test Set:

    Not applicable. There is no human adjudication process described, as the evaluation is based on physical device performance measurements.

    5. 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 a medical device for infusion, not an AI-powered diagnostic tool. Therefore, MRMC studies and AI assistance for human readers are not relevant.

    6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done:

    Not applicable. This is a mechanical infusion system, not an algorithm.

    7. The Type of Ground Truth Used:

    The ground truth for the flow rate performance is based on direct physical measurements (bench testing) of the device under various configurations and theoretical calculations. This is supplemented by compliance with recognized international standards and FDA guidance documents for biocompatibility, sterility, packaging, human factors, and reprocessing.

    8. The Sample Size for the Training Set:

    Not applicable. This is a mechanical infusion system, not an AI model that requires a training set.

    9. How the Ground Truth for the Training Set Was Established:

    Not applicable, as there is no training set for an AI model.

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    K Number
    K211206
    Date Cleared
    2021-11-09

    (201 days)

    Product Code
    Regulation Number
    880.5725
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Repro-Medical System, Inc., dba Koru Medical Systems

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The FreedomEdge® Syringe Infusion System is indicated for the intravenous or subcutaneous infusion of medications and fluids in the home, hospital, or ambulatory settings when administered according to the approved biologic or drug product labeling. The FreedomEdge® Syringe Infusion System is specifically indicated for the subcutaneous infusion of the following human plasma-derived immunoglobulins when used according to the FDA approved biologic labeling: Cuvitru®, Immune Globulin Infusion (Human) 20% (manufactured by Takeda®); Gammagard Liquid®, Immune Globulin Infusion (Human) 10% (manufactured by Takeda®); Hizentra®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®) and Hizentra®. Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®) Single-use pre-filled syringe for subcutaneous administration.

    The FreedomEdge® Syringe Infusion System with the FreedomEdge® Syringe Driver and Precision Flow Rate Tubing™, is specifically indicated for the intravenous infusion of the following antibiotics when used according to the FDA approved drug product labeling: ertapenem, oxacillin, and tobramycin.

    The FreedomEdge® Syringe Infusion System consists of the following components:

    • FreedomEdge® Syringe Driver ●
    • Precision Flow Rate Tubing™ ●
    • HIgH-Flo Subcutaneous Safety Needle SetsTM ●
    • HIgH-Flo Super26™ Subcutaneous Needle Sets are specifically indicated for the subcutaneous infusion ● of the following human plasma-derived immunoglobulins: Cuvitru®, Immune Globulin Infusion (Human) 20% (manufactured by Takeda®); Hizentra®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®); Hizentra®, Immune Globulin Subcutaneous (Human) 20% Liquid (manufactured by CSL Behring®) Single-use pre-filled syringe for subcutaneous administration.

    The FreedomEdge® Syringe Infusion System is indicated for use with the BD® 20 mL syringe (US Reference number: 302830), BD 30 mL syringe (US Reference number: 302832), and Hizentra® 20 mL single-use prefilled syringe (NDC 442096-458-96).

    Device Description

    The FreedomEdge® Syringe Infusion System is a single-channel, volumetric infusion pump. The FreedomEdge® Syringe Infusion System consists of four primary components:

      1. FreedomEdge® Syringe Driver,
      1. Precision Flow Rate Tubing™ and
      1. HIgH-Flo Subcutaneous Safety Needle Set™, or
      1. HIgH-Flo Super26TM Subcutaneous Safety Needle Set

    FreedomEdge® Syringe Driver: 1.
    The FreedomEdge® Syringe Driver (non-sterile) in combination with Precision Flow Rate Tubing™ (sterile) and HIgH-Flo Safety Needle Sets (sterile) makes up the FreedomEdge® Syringe Infusion System. The FreedomEdge® Syringe Driver is a nonsterile, reusable non-electric driver that infuses certain immunoglobulins subcutaneously and antibiotic solutions intravenously to patients.

    The FreedomEdge® driver is an ambulatory device designed to accommodate a BD Luer-Lok™ 20mL syringe, Catalog No.: 302830 and 301031, BD Luer-Lok™ 30mL syringe. Catalog No.: 301033 and Hizentra® 20 ml prefilled syringe. The pump uses a constant force spring mechanism to apply pressure to the plunger-end syringe.

    The FreedomEdge® Syringe Infusion System is assembled by loading the syringe with tubing into the Freemdom60® driver.

    Precision Flow Rate Tubing™: 2.
    The Freedom Integrated Syringe System includes a range of Freedom Precision Flow Rate Tubing™ (provided sterile). The tubing ranges from F0.5 to F2400. Each F-number provides a different level of flow restriction, which, when combined with the viscosity of the medication, provides a controlled delivery in an all-mechanical system. The tubing sets connect at one end to the syringe being used and on the other end to the Subcutaneous Safety Needle Sets or directly on venous catheters for intravenous infusions as needed.

    1. HIgH-Flo Needles Sets:

    The HIgH-Flo Subcutaneous Safety Needle SetsTM
    The HIgH-Flo Subcutaneous Safety Needle Sets™ (provided sterile) are used to administer drugs to the subcutaneous layers using small needles attached to the skin. Subcutaneous needles come in different lengths to administer immunoglobulins and antibiotics per the indications for use.

    Subcutaneous Safety Needle Sets comes in multiple configurations (1, 2, 3, 4, 5, 6 needle sites). Needles are available in 4mm. 6mm. 9mm. 12mm. and 14mm lengths combined with 24 or 26 Gauge. Using the Y -Connector, the patient can have up to 8 sites for drug delivery.

    The HIgH- Flo Subcutaneous Safety Needle Sets™ also allow each needle to be enclosed between the wings after use.

    The HIgH-Flo Super26TM Subcutaneous Needle Sets
    The HIgH-Flo Super26™ Subcutaneous Needle Sets are sterile, non-pyrogenic, single use. Subcutaneous Administration Sets, comprised of a Super 26-gauge needle assembly, combined with 24-gauge needle tubing and are intended for the delivery of medication to the subcutaneous tissue in accordance with the indication for use statement. Each set consists of a sterile infusion set and a commercially available adhesive dressing used to hold the device in place. The infusion set is a 90- degree, 26-gauge stainless steel needle, mounted to a butterfly winged safety closure on one end which is used to close the set upon completion. The other end consists of a luer lock which connects to PVC medical grade tubing. Additionally, each tubing set is equipped with a slide clamp used to stop flow, immediately as needed. HIgH-Flo Super 26™ Subcutaneous Needle Sets are available as a single set, as well as 2-needle, 3-needle, 5-needle, 6-needle, sets; through use of a Y-connector, 7-needle and 8 needle sets may also be assembled.

    AI/ML Overview

    Here's an analysis of the acceptance criteria and supporting study details based on the provided document:

    1. Table of Acceptance Criteria and Reported Device Performance:

    Acceptance Criteria CategoryReported Device PerformanceComments
    Flow Rate AccuracyFlow rates will fall between the minimum and maximum predicted values as specified in the IFU.This is a change from the predicate device, which had an accuracy of +/- 8%. The new approach provides a range based on theoretical calculations for each combination of needle and tubing set, ensuring it falls within biologic labeling requirements.
    Material BiocompatibilityComplies with ISO 10993-1, including Cytotoxicity, Sensitization, and Irritation testing.Ensures materials in contact with fluids/tissue are safe.
    Human FactorsStudies conducted with intended user population, use environment, and scenarios; results demonstrate validation per intended use.Confirms user interface and device design are intuitive and safe for users.
    Reprocessing/CleaningComplies with AAMI TIR12, AAMI TIR30, FDA guidance on reprocessing, and ISO 17664, ISO 11737-1.Ensures the device can be safely reprocessed (for reusable components) and sterilized.
    Packaging IntegrityComplies with ISO 11607-1:2019.Confirms that packaging maintains sterility. The material was changed from LDPE to nylon, but this was supported by testing.
    SterilityComplies with ISO 11137-2:2013 (Gamma SAL 10-6).Verifies the sterility of the disposable components.
    MR SafetyComplies with ASTM F2503-13.Ensures the device is safe for use in a Magnetic Resonance environment.
    Functionality with Hizentra Prefilled SyringePerformance testing verified compatibility and safety.Supports the expanded indication for use with this specific prefilled syringe.
    Functionality with HIgH-FLO Super26™ Subcutaneous Needle SetBench testing confirmed substantial equivalence in performance to the predicate device.Supports the expanded indication for use with this new needle set, demonstrating it does not raise new safety or effectiveness questions despite differences in tubing diameter.

    2. Sample Size Used for the Test Set and Data Provenance:

    The document explicitly states that "Clinical evaluation was not required to support submission and determination of substantial equivalence." Therefore, there is no test set of patient data and consequently, no sample size or data provenance related to patient cases. All testing mentioned is non-clinical performance testing.

    3. Number of Experts Used to Establish Ground Truth and Qualifications:

    Since no clinical outcome data was used, no experts were used to establish ground truth in a clinical context for a test set. The "ground truth" for performance seems to have been established through engineering and laboratory testing protocols adhering to relevant industry standards and FDA guidance.

    4. Adjudication Method for the Test Set:

    Not applicable, as no clinical test set requiring adjudication was used.

    5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:

    Not applicable. This type of study would involve human interpretation of medical images or data, with and without AI assistance, which is not relevant for an infusion pump system.

    6. Standalone (Algorithm Only) Performance:

    Not applicable. The device is a mechanical infusion system without "algorithm-only" performance in the sense of a diagnostic AI system predicting outcomes. Its performance is assessed through its mechanical and flow characteristics.

    7. Type of Ground Truth Used:

    The ground truth used is primarily engineering specifications, regulatory standards (e.g., ISO, AAMI, ASTM), and theoretical calculations. For instance, flow rate accuracy is compared against predicted minimum and maximum values derived from physical principles and drug product labeling. Biocompatibility relies on established biological evaluation standards.

    8. Sample Size for the Training Set:

    Not applicable. As a mechanical medical device, it does not involve machine learning algorithms that require a "training set" in the computational sense. Development and testing are based on engineering principles and prototypes.

    9. How the Ground Truth for the Training Set was Established:

    Not applicable, as there is no training set for a machine learning algorithm. The "ground truth" for the device's design and performance specifications would have been established through a combination of engineering design principles, regulatory requirements, risk analysis, and material science, all validated through non-clinical performance testing.

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