SWABBABLE CAP, MODEL 60205

K070163 · Baxa Corp. · ODI · Aug 3, 2007 · General Hospital

Device Facts

• Record ID: K070163
• Device Name: SWABBABLE CAP, MODEL 60205
• Applicant: Baxa Corp.
• Product Code: ODI · General Hospital
• Decision Date: Aug 3, 2007
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 880.5440
• Device Class: Class 2

Intended Use

The PadLock Swabbable Cap provides temporary aseptic closure of the male luer connector of the IV tubing while disconnected from the patient, replacing the need for disposable caps to maintain aseptic procedure. The device is permanently attached to IV tube sets for general hospital use and is used repeatedly for the life of the administration set.

Device Story

PadLock Swabbable Cap; permanently attached to IV administration sets; provides temporary aseptic closure of male luer connectors when disconnected from patient; replaces disposable caps; used repeatedly for life of administration set; intended for general hospital use; operated by clinicians; maintains aseptic procedure during IV therapy.

Clinical Evidence

No clinical data; bench testing only.

Technological Characteristics

Mechanical swabbable cap; permanently attached to IV administration sets; designed for repeated use; materials and specifications not detailed in provided text.

Indications for Use

Indicated for temporary aseptic closure of male luer connectors on IV administration sets for patients requiring IV therapy in a hospital setting.

Regulatory Classification

Identification

An intravascular administration set is a device used to administer fluids from a container to a patient's vascular system through a needle or catheter inserted into a vein. The device may include the needle or catheter, tubing, a flow regulator, a drip chamber, an infusion line filter, an I.V. set stopcock, fluid delivery tubing, connectors between parts of the set, a side tube with a cap to serve as an injection site, and a hollow spike to penetrate and connect the tubing to an I.V. bag or other infusion fluid container.

Special Controls

*Classification.* Class II (special controls). The special control for pharmacy compounding systems within this classification is the FDA guidance document entitled “Class II Special Controls Guidance Document: Pharmacy Compounding Systems; Final Guidance for Industry and FDA Reviewers.” Pharmacy compounding systems classified within the intravascular administration set are exempt from the premarket notification procedures in subpart E of this part and subject to the limitations in § 880.9.

Predicate Devices

• Dual Luer Lock Cap (K981318)

Submission Summary (Full Text)

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K070163

## SECTION 5: 510(k) SUMMARY

| Submitted by: | Baxa Corporation | | AUG - 3 2007 |
|-------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------|--------------|
| Contact Person: | Kimberly Zizik | [phone]<br>[phone] | |
| Phone:<br>Fax: | | | |
| Date Prepared: | | | |
| Manufacturing Facility: | Baxa Corporation<br>14445 Grasslands Drive<br>Englewood, CO 80112<br>Establishment registration number 1419106 | | |
| Submitted Device: | PadLock™ Swabbable Cap<br>Common Name: Set, Intravascular Administration (ODI) | | |
| Product Code: | ODI | | |
| Device Classification: | Class II<br>Classification: 21 CFR § 880.5440 Intravascular<br>administration set<br>(a) <i>Identification</i> . An intravascular administration set is a<br>device used to administer fluids from a container to a<br>patient's vascular system through a needle or catheter<br>inserted into a vein. The device may include the needle or<br>catheter, tubing, a flow regulator, a drip chamber, an infusion<br>line filter, an I.V. set stopcock, fluid delivery tubing,<br>connectors between parts of the set, a side tube with a cap<br>to serve as an injection site, and a hollow spike to penetrate<br>and connect the tubing to an I.V. bag or other infusion fluid<br>container.<br>(b) <i>Classification</i> . Class II (performance standards) | | |
| Predicate Device: | Trade Name: Dual Luer Lock Cap<br>Common Name: Set, Intravascular Administration<br>Classification Name: [880.5440] Intravascular Administration<br>Set (Class II) (FPA)<br>Manufacturer: Baxter Healthcare Corporation<br>510(k) Number: K981318 | | |
| Product Description: | Provides temporary aseptic closure of the male luer<br>connector of the IV tubing while disconnected from the<br>patient, replacing the need for disposable caps to maintain<br>aseptic procedure. | | |
| Intended Use: | The PadLock Swabbable Cap provides temporary aseptic<br>closure of the male luer connector of the IV tubing while<br>disconnected from the patient, replacing the need for<br>disposable caps to maintain aseptic procedure. The device<br>is permanently attached to IV tube sets for general hospital<br>use and is used repeatedly for the life of the administration<br>set. | | |

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Fax

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG - 3 2007

Ms. Kimberly Zizik Regulatory Assurance Supervisor Baxa, Corporation 14445 Grasslands Drive Englewood, Colorado 80112

Re: K070163

Trade/Device Name: Swabbable Cap Regulation Number: 880.5440 Regulation Name: Intravascular Administration Set Regulatory Class: II Product Code: ODI Dated: July 20, 2007 Received: July 23, 2007

Dear Ms. Zizik:

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 your 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.

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Page 2 - Ms. Zizik

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. 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), please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely vours.

Clur
Chiu Lin, Ph.D.

Chiu Lin, Ph.D. Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

## Enclosure

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510(k) Number: K070163

Device Name: Swabbable Cap

## Indications for use:

The Swabbable Cap provides temporary aseptic closure of the male luer connector of the IV tubing while disconnected from the patient, replacing the need for disposable caps to maintain aseptic procedure. The device is designed to be permanently attached to an IV administration set and used over the life of the administration set.

Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

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(Division Sign-Off) (Division Sign-On)
Division of Anesthesiology, General Hospital Division Control, Dental Devices

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K 974163 510(k) Number: __