K020966 · Replacement Parts Industries, Inc. · FMT · Jun 13, 2002 · General Hospital
Device Facts
Record ID
K020966
Device Name
RPI REPLACEMENT HEATING ELEMENTS
Applicant
Replacement Parts Industries, Inc.
Product Code
FMT · General Hospital
Decision Date
Jun 13, 2002
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 880.5130
Device Class
Class 2
Attributes
Therapeutic, Pediatric
Indications for Use
The RPI heating elements are used to emit infrared radiant heat in an infant radiant warmer to maintain an infant's body temperature. The heating elements are identical to those supplied as original equipment as part of the infant radiant warmer.
Device Story
RPI Replacement Heating Elements serve as replacement parts for Hill-Rom Air-Shields infant radiant warmers; emit infrared radiant heat to maintain infant body temperature; identical in design, form, and materials to original equipment manufacturer (OEM) components; provided nonsterile; available in various wattages and terminations; installed by clinical engineering or maintenance personnel as a direct replacement for failed heating elements in existing radiant warmer systems.
Clinical Evidence
No clinical data. Bench testing only.
Technological Characteristics
Infrared radiant heating element; nonsterile; various wattage and termination configurations; identical design and materials to OEM predicate devices.
Indications for Use
Indicated for use in infant radiant warmers to maintain an infant's body temperature.
Regulatory Classification
Identification
The infant radiant warmer is a device consisting of an infrared heating element intended to be placed over an infant to maintain the infant's body temperature by means of radiant heat. The device may also contain a temperature monitoring sensor, a heat output control mechanism, and an alarm system (infant temperature, manual mode if present, and failure alarms) to alert operators of a temperature condition over or under the set temperature, manual mode time limits, and device component failure, respectively. The device may be placed over a pediatric hospital bed or it may be built into the bed as a complete unit.
Special Controls
*Classification.* Class II (Special Controls):(1) The Association for the Advancement of Medical Instrumentation (AAMI) Voluntary Standard for the Infant Radiant Warmer;
(2) A prescription statement in accordance with § 801.109 of this chapter (restricted to use by or upon the order of qualified practitioners as determined by the States); and
(3) Labeling for use only in health care facilities and only by persons with specific training and experience in the use of the device.
Predicate Devices
RPI Models AIH039 and AIH100; Infant Care System, Narco Air-Shields (K790137)
RPI Models AIH040 and AIH094; Infant Intensive Care System, Free-Standing Infant Warmer, Air-Shields Inc. (K875270)
RPI Model AIH097; Resuscitaire Radiant Warmer, Hill-Rom Air-Shields (K003355 and K940951)
RPI Model AIH099; Stabilet Infant Radiant Warmer, Hill-Rom, Inc. (K94904)
RPI Model AIH098; Stabilet Infant Radiant Warmer, Hill-Rom, Inc. (K913945)
Related Devices
K021531 — RPI REPLACEMENT PHOTOTHERAPY LIGHTS · Replacement Parts Industries, Inc. · May 31, 2002
K071977 — TARRY MEDICAL TEMPERATURE PROBES · Tarry Medical Products, Inc. · May 23, 2008
K033040 — PHOENIX INFANT RADIANT WARMER, MODEL 100NWS · International Hospital Supply Co. · Dec 17, 2003
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TO20966
# JUN 1 3 2002
## 510(k) SUMMARY
This 510(k) summary is being submitted in accordance with the requirements of SMDA and21CFR \$ 807.92
#### I. NAME OF SUBMITTER
#### RPI
Replacement Parts Industries, Inc. P.O. Box 5019 Chatsworth, California 91313-5019
Phone Number: (818) 882-8611
Contact Person: Ira Lapides, President/CEO
### Date Prepared:
March 19, 2002
## II. DEVICE NAME AND CLASSIFICATION
Proprietary Name: RPI Replacement Heating Elements Common or Usual Name: Replacement Heating Elements Class II, 21 CFR 880.5130, Infant Radiant Warmers FMT Classification:
### III. PREDICATE DEVICES
The RPI replacement Heating Elements are substantially equivalent in design and indications for use to the following devices currently in commercial distribution:
- RPI Models AIH039 and AIH100; Infant Care System. Narco Air-Shields: K790137 .
- RPI Models AIH040 and AIH094: Infant Intensive Care System, Free-Standing Infant Warmer, . Air-Shields Inc., Hatboro, PA 19040; K875270
- RPI Model AIH097: Resuscitaire Radiant Warmer, Hill-Rom Air-Shields, Hatboro, PA 19040; . K003355 and K940951
- . RPI Model AIH099: Stabilet Infant Radiant Warmer, Hill-Rom, Inc. Batesville, IN 47006; K94904
- RPI Model AIH098: Stabilet Infant Radiant Warmer, Hill-Rom, Inc., Batesville, TN 47006: . K913945
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#### IV. DESCRIPTION
ﺮﺓ ﺍﻟﻘﺪﻡ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘ
The RPI Replacement Heating Elements are intended to be used as replacement parts for the Hill-Rom Air Shields infant radiant warmers. The RPI heating elements are used to emit infrared radiant heat in an infant radiant warmer to maintain an infant's body temperature.
The Replacement Heating Elements are available in different outputs (wattage) and terminations. The heating elements are provided nonsterile.
## V. INTENDED USE
The RPI heating elements are used to emit infrared radiant heat in an infant radiant warmer to maintain an infant's body temperature. The heating elements are identical to those supplied as original equipment as part of the infant radiant warmer.
## VI. TECHNOLOGICAL CHARACTERISTICS
No new technology, materials, or change in efficacy have been introduced by RPI in the manufacture of the RPI Replacement Heating Elements. The design, form, and materials of the probes are identical to their predicate devices. All devices are provided nonsterile to the user.
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Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle with three lines representing its wings or feathers.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
JUN 1 3 2002
Mr. Ira Lapides President Replacement Parts Industries, Incorporated P.O. Box 5019 Chatsworth, California 91313-5019
Re: K020966
Trade/Device Name: RPI Replacement Heating Elements Regulation Number: 880.5130 Regulation Name: Infant Radiant Warmer Accessory Regulatory Class: II Product Code: FMT Dated: March 21, 2002 Received: March 25, 2002
Dear Mr. Lapides:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and 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) that do not require approval of a premarket approval application (PMA). 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 (PMA), it may be subject to such additional controls. Existing major regulations affecting vour device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies.
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Page 2 - Mr. Lapides
You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act): 21 CFR 1000-1050.
This letter will allow you to begin marketing your device as described in your Section 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 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4618. 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" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers. International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.qov/cdrh/dsma/dsmamain.html
Sincerely vours.
Susan Runne
£
Timothy A. Ulatowski Director Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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Include the following "Indications For Use" page that contains the applicant's name, name of the device and the intended use of the device. The information, data and labeling claims in the entire the 510(k) submission must support and agree with the "indications for use" statement. *For a new submission, do NOT fill in the 510(k) number blank.
#### INDICATIONS FOR USE
Applicant: Replacement Parts Industries, Inc. (RPI, Inc.)
510(k) Number (if known): N/A* 14020966
Device Name: RPI Replacement Heating Elements
Indications For Use:
The RPI heating elements are used to emit infrared radiant heat in an infant radiant warmer to maintain an infant's body temperature. The heating elements are identical to those supplied as original equipment as part of the infant radiant warmer.
## (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH Office of Device Evaluation (ODE)
Prescription Use
Per 21 CFR 801.109
OR
Over-the-Counter
Patricia Cuscinito
of Dental, Infection Contr ·neral Hospital De · Number _
10
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