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510(k) Data Aggregation

    K Number
    K033099
    Date Cleared
    2003-10-16

    (17 days)

    Product Code
    Regulation Number
    880.5440
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The ADR THINSet Infusion Set is intended for the subcutaneous infusion of medicine, including insulin, from an external infusion pump. The set is not intended nor indicated for use with blood or blood products.

    Device Description

    The ADR THINSet Insulin Infusion Set facilitates the flow of medication from an infusion pump reservoir into the subcutaneous tissue of the user. The infusion set consists of a female luer, tubing, Needle Grip with introducer needle and Base Assembly. The Base Assembly consists of three components: the Needle Grip, Connector and Base. The Needle Grip contains the 26 guage introducer needle that penetrates the subcutaneous tissue. The infusion set tubing attaches to the Connector. The Connector may be removed from the Base. The Base houses the 24 gauge Cannual and has a medical grade adhesive dressing attached to the bottom. The infusion set is packaged sterile in a Tray Pack. The infusion set is available with 23 and 43 inch tubing lines and 6 and 9 mm Cannulas.

    AI/ML Overview

    The provided 510(k) summary for the ADR THINSet Insulin Infusion Set (K033099) describes the device, its intended use, and the testing performed to demonstrate substantial equivalence to a predicate device. However, it does not contain specific acceptance criteria values or detailed performance metrics in a quantified format as requested by the user for a comprehensive table.

    Instead, the document primarily focuses on qualifying the testing performed and stating that the device "meets the requirements" or that "differences were insignificant." It also lacks details about ground truth establishment, expert qualifications, sample sizes for specific tests, or a multi-reader multi-case (MRMC) study.

    Therefore, the response below will reconstruct the information available as closely as possible to the requested format, clearly indicating where specific numerical data is absent in the original document.


    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance Criteria CategorySpecific Test/RequirementAcceptance Criteria (Stated or Implied)Reported Device Performance/Conclusion
    BiocompatibilityCytotoxicityMeet requirements of ISO-FDA Modified Matrix, FDA/ODE G95-1, ANSI/AAMI/ISO 10993-1:1997 for an External communicating device, Blood path, indirect for < 30 days.Biocompatibility testing included Cytotoxicity, Intracutaneous Reactivity, Maximization Sensitization Study, In Vitro Hemolysis Study, USP and ISO Systemic Toxicity Studies and USP Prorogen Study. All these tests were performed, and the implication is that the device met the requirements.
    Intracutaneous Reactivity(Same as above)(See above)
    Maximization Sensitization Study(Same as above)(See above)
    In Vitro Hemolysis Study(Same as above)(See above)
    USP and ISO Systemic Toxicity Studies(Same as above)(See above)
    USP Pyrogen Study(Same as above)(See above)
    Material CompatibilityInsulin Compatibility(Implied to be compatible with insulin)Insulin compatibility testing was performed. The implication is that the device demonstrated compatibility.
    Luer Lock PerformanceGaugingMeet requirements of ISO 594-2, "Conical fittings with 6% (Luer) taper for reservoirs, needles and certain other medical equipment - Part 2: Lock fittings."The Female Luer lock shall meet the requirements of Gauging, Leakage, Separation force, Unscrewing torque, Ease of assembly, Resistance to overriding, and Stress cracking tests detailed in ISO 594-2. The implication is that the device met these requirements.
    Leakage(Same as above)(See above)
    Separation force(Same as above)(See above)
    Unscrewing torque(Same as above)(See above)
    Ease of assembly(Same as above)(See above) ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
    Resistance to overriding(Same as above)(See above) ----------
    Stress cracking(Same as above)(See above) -----
    Flow PerformanceDose accuracy (of flow rates)(Implied to be accurate/meet acceptable limits for infusion sets)The accuracy of the flow rates through the ADR THINSet Insulin Infusion Set was verified by dose accuracy testing. The implication is that the accuracy was found to be acceptable.
    Mechanical IntegrityFirst Article InspectionsAll components meet specifications.First Article Inspections were conducted on all components.
    Material VerificationAll materials meet specifications.Material verification was performed on all components.

    2. Sample size used for the test set and the data provenance

    The document does not specify the numerical sample sizes for any of the tests (biocompatibility, luer lock, or flow rate testing). It only states that tests were "performed" or "conducted."

    The data provenance is not explicitly stated in terms of country of origin or whether it was retrospective or prospective. It is implied to be data collected specifically for the regulatory submission of this new device.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

    This information is not provided. The study involves laboratory-based testing of the device's physical and biological properties against established standards (ISO, USP, FDA guidance), rather than clinical studies requiring expert ground truth for diagnostic or clinical outcomes.

    4. Adjudication method for the test set

    This information is not applicable and not provided. The testing described is objective, standards-based verification, not subjective interpretation requiring adjudication among experts.

    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 is not applicable and no such study was conducted or mentioned. The device is an insulin infusion set, not an AI-powered diagnostic or assistive tool for human readers.

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

    This is not applicable. The device is a medical device (infusion set), not an algorithm. Performance testing was done on the physical device itself.

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

    The "ground truth" for the tests performed is the established requirements and specifications outlined in the referenced standards (e.g., ISO 594-2, ISO-FDA Modified Matrix, ANSI/AAMI/ISO 10993-1, USP). The device's performance was measured against these objective, predefined criteria.

    8. The sample size for the training set

    This is not applicable as the device is a physical medical device and does not involve AI or machine learning models that require training sets. The testing performed is physical and chemical verification.

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

    This is not applicable for the same reason as in point 8.

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