Infant Heel Warmer (Model 24401) and WarmGel Infant Heel Warmer (Model 20418)

K151845 · CooperSurgical, Inc. · MPO · Mar 18, 2016 · Physical Medicine

Device Facts

• Record ID: K151845
• Device Name: Infant Heel Warmer (Model 24401) and WarmGel Infant Heel Warmer (Model 20418)
• Applicant: CooperSurgical, Inc.
• Product Code: MPO · Physical Medicine
• Decision Date: Mar 18, 2016
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 890.5710
• Device Class: Class 1
• Attributes: Therapeutic, Pediatric

Intended Use

An instant warm pack intended to be used on an infant's heel to increase blood circulation to the area to aid in the drawing of blood for analysis. It is a single use, non-toxic, non-sterile, disposable warmer. The device is primarily used in hospitals, doctor's offices, and other healthcare facilities.

Device Story

Single-use, non-sterile, disposable instant warm pack; used in hospitals and clinics to increase blood circulation to infant heels for blood sampling. Device consists of biaxially oriented nylon/polyethylene pouch containing supersaturated sodium acetate solution (liquid version) or sodium acetate/water/hydroxyethylcellulose (gel version). Activation via flexing internal stainless steel disc initiates exothermic crystallization, generating heat (max peak 107°F). Adhesive tape secures device to infant heel. Healthcare providers apply device to patient; heat aids blood draw. Benefits include improved blood flow for easier sampling and reduced risk of thermal injury.

Clinical Evidence

No human clinical data. Bench testing included temperature profile comparisons against predicate (thermocouple measurements at 5-second intervals for 30 minutes) and shelf-life stability testing. Biocompatibility testing performed per AAMI/ANSI/ISO 10993-5:2003 and 10993-10:2010. Animal study (n=6 pigs) evaluated thermal insult and erythema; results showed no thermal injury and negligible erythema (scores 0-1).

Technological Characteristics

Pouch: Biaxially oriented nylon/polyethylene. Solution: Sodium acetate, water, hydroxyethylcellulose (gel version). Activation: Exothermic crystallization via stainless steel disc. Dimensions: 5" x 3.5". Attachment: Adhesive strap. Biocompatibility: AAMI/ANSI/ISO 10993-5:2003, 10993-10:2010. Non-sterile, single-use, disposable.

Indications for Use

Indicated for infants requiring increased blood circulation to the heel to facilitate blood collection for analysis.

Regulatory Classification

Identification

A hot or cold disposable pack is a device intended for medical purposes that consists of a sealed plastic bag incorporating chemicals that, upon activation, provides hot or cold therapy for body surfaces.

Predicate Devices

• Rapid Aid Instant Disposable Infant Heel Warmer - Disc (K150627)
• DeRoyal Industries Infant Heel Warmer (K954716)

Submission Summary (Full Text)

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

March 18, 2016

CooperSurgical Inc. c/o Roaida Johnson Associate Director, New Product Development 95 Corporate Drive Trumbull, CT 06611

Re: K151845

Trade/Device Name: Infant Heel Warmer (Model 24401) and WarmGel Infant Heel Warmer (Model 20418) Regulation Number: 21 CFR 890.5710 Regulation Name: Hot or cold disposable pack Regulatory Class: Class I Product Code: MPO Dated: February 16, 2016 Received: February 17, 2016

Dear Ms. Johnson:

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

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CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/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 Division of Industry and Consumer Education at its toll-free number [phone] or [phone] or at its Internet address

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

Sincerely yours,

# Michael J.Hoffmann -A

Carlos L. Peña, PhD, MS for Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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# Indications for Use

510(k) Number (if known) K151845

Device Name Infant Heel Warmer (Model 24401) WarmGel® Infant Heel Warmer (Model 20418)

#### Indications for Use (Describe)

An instant warm pack intended to be used on an infant's heel to increase blood circulation to the area to aid in the drawing of blood for analysis. It is a single use, non-toxic, non-sterile, disposable warmer.

The device is primarily used in hospitals, doctor's offices, and other healthcare facilities.

| Type of Use (Select one or both, as applicable) | |
|----------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|
| <span style="font-family: sans-serif;">☑</span> Prescription Use (Part 21 CFR 801 Subpart D) | <span style="font-family: sans-serif;">☐</span> Over-The-Counter Use (21 CFR 801 Subpart C) |

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## K151845

Image /page/3/Picture/1 description: The image shows the logo for CooperSurgical. The logo is in black and features the company name in a stylized font. The 'C' in Cooper is stylized with two concentric circles.

## 510(k) Summary WarmGel® Infant Heel Warmer (Model 20418) Infant Heel Warmer (Model 24401)

#### Submitter Information

| Company Name: | CooperSurgical Inc. |
|------------------|------------------------------------------|
| Company Address: | 95 Corporate Drive<br>Trumbull, CT 06611 |
| Telephone: | 203-601-5200 |
| Fax: | 203-601-9870 |

| Contact Person: | Roaida Johnson |
|-----------------|----------------|
| Date Prepared: | March 17, 2016 |

#### Device Information

| Trade Names: | The Infant Heel Warmer (Model 24401)<br>WarmGel® Infant Heel Warmer (Model 20418) |
|----------------------|-----------------------------------------------------------------------------------|
| Common Name: | Infant Heel Warmer |
| Classification: | Class I per 21 CFR 890.5710 |
| Classification Name: | Hot or cold disposable pack |
| Product Code: | MPO |

#### Predicate Device Information

The CooperSurgical Infant Heel Warmer is substantially equivalent to the following predicates:

Primary Predicate: Rapid Aid Instant Disposable Infant Heel Warmer - Disc (K150627) Additional Predicate: DeRoyal Industries Infant Heel Warmer (K954716)

### Device Description

The CooperSurgical Infant Heel Warmer, which is available in both a liquid version (The Infant Heel Warmer, Model 24401) and a gel version (WarmGel® Infant Heel Warmer, Model 20418), is a non-sterile, single-use, disposable device comprised of a biaxially oriented nylon (BON)/polyethylene outer pouch filled with a supersaturated solution of food grade sodium acetate and water (liquid version), or food grade sodium acetate, water, and hydroxyethylcellulose, a common thickener (gel version). An adhesive tape is attached to the pouch, which can hold the warmer in place if desired. The pouch also contains a stainless steel disc that, when flexed, initiates an exothermic crystallization of the sodium acetate, generating heat. When activated at 75° + 1° F, the maximum peak temperature of the CooperSurgical Infant Heel Warmer is 107° F, which is reached in approximately 40 seconds and then gradually decreases over time.

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## Indications for Use

An instant warm pack intended to be used on an infant's heel to increase blood circulation to the area to aid in the drawing of blood for analysis. It is a single use, non-toxic, disposable warmer.

The device is primarily used in hospitals, doctor's offices, and other healthcare facilities.

## Substantial Equivalence Analysis

The substantial equivalence of the CooperSurgical Infant Heel Warmer to the predicates is shown by similarity in intended use, indications for use, materials, and performance. The table below provides a comparison of the technological characteristics of the subject device to the predicates.

| Property | Subject Device<br>CooperSurgical<br>Infant Heel Warmer | Primary<br>Predicate<br>Instant<br>Disposable<br>Infant Heel<br>Warmer - Disc | Additional<br>Predicate<br>Infant Heel<br>Warmer | Comparison |
|------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------|--------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Manufacturer | CooperSurgical Inc. | Rapid Aid Corp. | DeRoyal<br>Industries | --- |
| 510(k)<br>Number | K151845 | K150627 | K954716 | --- |
| Pouch<br>Material | Poly/nylon | Poly/nylon | Unknown | Same as primary<br>predicate |
| Solution<br>Material | Liquid version -<br>Sodium acetate (food<br>grade) and water<br>Gel version - Sodium<br>acetate (food grade),<br>water, and<br>hydroxyethylcellulose | Sodium acetate<br>(food grade) and<br>water | Unknown | The<br>hydroxyethylcellulose<br>is a non-toxic<br>thickening agent. The<br>addition of the material<br>does not raise new<br>issues of safety and<br>effectiveness. |
| Activation<br>Method | Flexing metal disc | Flexing metal<br>disc | Squeeze to burst<br>inner pouch | Same as primary<br>predicate |
| Average<br>Maximum<br>Temperature | 104° F | 104° F | 105° F | Same as primary<br>predicate |
| Maximum<br>Peak<br>Temperature | 107° F | Unknown | Unknown | An animal study was<br>performed to confirm<br>no new issues of safety<br>and effectiveness. |
| Size of Pouch | 5" x 3.5" | 5.5" x 3.75" | 5" x 3.5" | Same as secondary<br>predicate |
| Method of<br>Attachment to<br>Heel | Adhesive strap | Adhesive strap | Adhesive strap | Same as both<br>predicates |
| Sterility.<br>Number of<br>Uses | Non-sterile, Single<br>Use, Disposable | Non-sterile,<br>Single Use,<br>Disposable | Non-sterile,<br>Single Use,<br>Disposable | Same as both<br>predicates |

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### Non-Clinical Performance Testing

Temperature profile testing was performed on the CooperSurgical Infant Heel Warmer and on the predicate DeRoyal Infant Heel Warmer, and the results of this testing were used to determine the substantial equivalence of the Infant Heel Warmer to the predicate. For each sample, a calibrated thermocouple was attached to the center, the device was activated to allow the exothermic reaction to begin, and temperature readings were taken at 5 second intervals for 30 minutes. The samples were activated at a temperature of 75° + 1° F. The temperature profiles were compared between the CooperSurgical Infant Heel Warmer and the predicate DeRoyal Infant Heel Warmer, and were found to be equivalent.

Stability testing was also performed on the CooperSurgical Infant Heel Warmer to confirm its shelf life. Biocompatibility was performed on the patient-contacting components of the device (outer pouch and adhesive tape) per AAMI/ANSI/ISO 10993-5:2003, and AAMI/ANSI/ISO 10993-10:2010.

An animal study was performed to determine the temperature of the skin after application of the device. The study consisted of three light-skinned and three dark-skinned pigs, aged 3 to 3.5 weeks. A WarmGel Infant Heel Warmer was placed on one side of the animal while the opposite side served as a control. Temperatures were measured using thermocouples adhered to the animal, one under the heel warmer and one on the control side, at 1-minute intervals for a total of 22 minutes. The animals were then graded against established criteria for both thermal insult and erythema. There was no evidence of thermal injury in any of the animals, and all but one animal received an erythema score of 0, with the one animal receiving a score of 1, which is barely perceptible.

## Conclusion

Based on the indications for use, technological characteristics, performance testing, and comparison to the predicates, the CooperSurgical Infant Heel Warmer has been shown to be substantially equivalent to the predicate devices identified, and does not present any new issues of safety or effectiveness.