PREFILLED CATHETER INFLATION SYRINGE

K112209 · Avail Medical Products, Inc. · KNY · Sep 8, 2011 · Gastroenterology, Urology

Device Facts

• Record ID: K112209
• Device Name: PREFILLED CATHETER INFLATION SYRINGE
• Applicant: Avail Medical Products, Inc.
• Product Code: KNY · Gastroenterology, Urology
• Decision Date: Sep 8, 2011
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 876.5130
• Device Class: Class 2

Indications for Use

The Avail Sterile Water Filled Syringe is intended to be used to provide a sterile liquid for catheter inflation after insertion.

Device Story

Sterile, water-filled, single-patient-use syringe; designed exclusively for catheter balloon inflation. Not for injection. Syringes are bulk-packaged for inclusion in urological kits; not sold as standalone devices. Operation involves removing the cap, connecting the luer tip to the catheter valve, expressing sterile water to inflate the balloon, then disconnecting and discarding the syringe. Used in clinical settings by healthcare providers during urological procedures. Provides a convenient, sterile delivery method for catheter maintenance, ensuring proper balloon inflation and catheter securement.

Clinical Evidence

No clinical data. Bench testing only, including biocompatibility and performance testing, was used to support substantial equivalence.

Technological Characteristics

Polypropylene syringe body; medical-grade butyl rubber plunger tip and cap. Terminally gamma-sterilized. Manual operation via luer tip connection. No electronic components, software, or energy sources.

Indications for Use

Indicated for use by medical health professionals to provide sterile liquid for inflation of Foley catheter balloons following insertion.

Regulatory Classification

Identification

A urological catheter and accessories is a flexible tubular device that is inserted through the urethra and used to pass fluids to or from the urinary tract. This generic type of device includes radiopaque urological catheters, ureteral catheters, urethral catheters, coudé catheters, balloon retention type catheters, straight catheters, upper urinary tract catheters, double lumen female urethrographic catheters, disposable ureteral catheters, male urethrographic catheters, and urological catheter accessories including ureteral catheter stylets, ureteral catheter adapters, ureteral catheter holders, ureteral catheter stylets, ureteral catheterization trays, and the gastro-urological irrigation tray (for urological use).

Predicate Devices

• Pre Filled Catheter Inflation Syringe (K90121)

Submission Summary (Full Text)

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AVAIL MEDICAL PRODUCTS, INC., Premarket Notification - Special 510(k), Pre-filled Catheter Inflation Syringe K112209

SEP - 8 2011

# LEX Medical

5950 Nancy Ridge Dr Suite 500 San Diego, CA 92121 858-457-1988 Main 858-558-7264 Fax www.flextronics.com

#### ATTACHMENT 3

#### SECTION 5:

# 510(K) Number; K112209

510(K) SUMMARY

| Requirement | Information |
|-----------------------------------|--------------------------------------------------------|
| 510(K) Owner | Avail Medical Products Inc. |
| Address | 5950 Nancy Ridge Road, Ste.500 |
| | San Diego |
| | CA 92121 |
| | USA |
| Telephone # | 858-457-1988 |
| Fax # | 858-558-7264 |
| Contact Person | Steven A.Howell |
| Summary Preparation Date | August 10, 2011 |
| Proprietary Name | Sterile, Water Filled Syringe |
| Common Name | Pre-filled Catheter Inflation Syringe |
| Classification Name | Urological Catheter & Accessories |
| | (21 CFR876.5130) Product Code KNY |
| Legally marketed predicate device | Pre Filled Catheter Inflation Syringe (K90121) |
| Device Description | A sterile, water filled, single patient use syringe |
| | designed for catheter inflation only. Not for |
| | injection. The syringes are bulk packaged for sale |
| | to customers for inclusion in urological kits. The |
| | syringes are not marketed or sold as separate |
| | devices from urological kits. The intended use of |
| | the device is to provide a sterile liquid for Foley |
| | catheter inflation after insertion. The syringe cap is |
| | removed, the syringe luer tip connects directly to |
| | the catheter valve. The sterile water is expressed |
| | to inflate the catheter. The syringe is disconnected |
| | and discarded after use. |
| Intended Use of the Device | Pre-filled catheter inflation syringe for catheter |
| | balloon inflation. The device is substantially |
| | equivalent to the predicate device. |

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AVAIL MEDICAL PRODUCTS, INC., Premarket Notification - Special 510(k), Pre-filled Catheter Inflation Syringe K112209 Jose 2 12

### АТТАСНМЕNT 3

| Requirement | Information |
|-------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Technological Characteristics of<br>the device compared to the<br>predicate device | The new device is substantially equivalent to the<br>predicate device. The new device has the same<br>technological characteristics as the predicate<br>device. Both devices utilize polypropylene<br>materials of construction with medical grade, butyl<br>rubber plunger tips and caps. Both devices are<br>terminally gamma sterilized and bulk packaged for<br>inclusion in customers urological kits. |
| Assessment of Non Clinical Tests<br>used to support substantial<br>equivalence | Sections 2 (standards testing), 15<br>(biocompatibility) and 19 (performance testing) of<br>this 510(k) submission identify the non clinical tests<br>and results used to support substantial equivalence<br>to the predicate device |
| Assessment of Clinical Tests used<br>to support substantial equivalence | Not Applicable. No Clinical tests were conducted |
| Conclusion of tests used to<br>support substantial equivalence to<br>the predicate device | A comparison of the acceptable results of the<br>testing completed on the new device and the<br>results of testing of the predicate device support a<br>claim of substantial equivalence between the new<br>device and the predicate device |

. Page 2 of 2

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Image /page/2/Picture/1 description: The image shows the logo for the Department of Health & Human Services USA. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" arranged around the perimeter. Inside the circle is an abstract image of an eagle with three lines representing its wings and tail feathers.

Food and Drug Administration 10903 New Hampshire Avenue Document Mail Center - WO66-G609 Silver Spring, MD 20993-0002

Mr. Steven A. Howell Senior Director - Quality Assurance Avail Medical Products Inc. 5950 Nancy Ridge Road. Suite 500 SAN DIEGO CA 92121

- 8 2011 ్లో గ్రామం

Re: K112209

Trade/Device Name: Avail Sterile Water Filled Syringe Regulation Number: 21 CFR\$ 876.5130 Regulation Name: Urological catheter and accessories Regulatory Class: II Product Code: KNY Dated: August 17, 2011 Received: August 19, 2011

Dear Mr. Howell:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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.

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); medical device reporting of medical device-related

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adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the au vitae ovents) (21 CFR 800); good and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please rr you desire spochlo advice 10. your le ntersOffices/CDRH/CDRHOffices/ucm11.5809.htm for go to mep. 11 with wilder and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part note the regalition interesarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportalProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Tou may obtain biller generational and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Herbert Lemun MD

Herbert P. Lerner, M.D., Director (Acting) Division of Reproductive, Gastro-Renal and Urological Devices Office of Device Evaluation Center for Devices and · Radiological Health.

Enclosure

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# ATTACHMENT 2 (continued)

#### SECTION 4:

# INDICATIONS FOR USE

K112209 510(k) Number:

Avail Sterile Water Filled Syringe Device Name:

Indications For Use:

The Avail Sterile Water Filled Syringe is intended to be used to provide a sterile liquid for catheter inflation after insertion.

Concurrence of CDRH, Office of Device Evaluation (ODE)

Over-the-Counter Use ______ (Per 21 CFR 801.109) Prescription Use _____________________________________________________________________________________________________________________________________________________________ or

For Professional Use Only (Medical Health Provider) _

Alh. Rogers
(Division Sign-Off) for H. Lehner

(Division Sign-Off)
Division of Reproductive, Gastro-Renal, and
Urological Devices
510(k) Number. K112209

CONFIDENTIAL

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