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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).

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,
• 2. Precision Flow Rate Tubing™ and
• 3. HIgH-Flo Subcutaneous Safety Needle Set™, or
• 4. 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.

2. 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.

3. 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.

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.

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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