CADD®- Solis Ambulatory Infusion Pump with Wireless Communication; CADD®-Solis Infusion Pump, Model 2110; PharmGuard® Administrator Medication Safety Software; CADD® Administration Sets; Wireless Communication Module (CM)

K170982 · Smiths Medical Ads, Inc. · MEA · Aug 24, 2017 · General Hospital

Device Facts

• Record ID: K170982
• Device Name: CADD®- Solis Ambulatory Infusion Pump with Wireless Communication; CADD®-Solis Infusion Pump, Model 2110; PharmGuard® Administrator Medication Safety Software; CADD® Administration Sets; Wireless Communication Module (CM)
• Applicant: Smiths Medical Ads, Inc.
• Product Code: MEA · General Hospital
• Decision Date: Aug 24, 2017
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 880.5725
• Device Class: Class 2
• Attributes: Therapeutic, Pediatric

Intended Use

CADD®- Solis Ambulatory Infusion Pump with Wireless Communication is intended to be used for patient care for adult and pediatric patients in multiple care areas, including but not limited to post-operative, trauma, critical care, oncology, and labor and delivery. The pump can be programmed with a protocol configuration consisting of a therapy. qualifier, and drug. Medication is delivered at a constant rate, and/or with an intermittent bolus, and/or with a patient dose. CADD®-Solis Infusion Pump, Model 2110 The CADD®-Solis Pump is indicated for intravenous, intra-arterial, subcutaneous, intraperitoneal, in close proximity to nerves, into an intraoperative site (soft tissue, body cavity/surgical wound site), epidural space. The pump is intended for therapies that require a continuous rate of infermittent bolus, and/or with patientcontrolled demand doses. PharmGuard® Administrator Medication Safety Software The PharmGuard® Administrator Medication Safety Software allows the use of a computer to create therapy-based protocol libraries to be used with the CADD®-Solis Infusion Pump. CADD® Administration Set The CADD® Administration Set is designed for use with the CADD® Infusion pumps (except CADD®-Micro) to allow medication delivery from a flexible container. Wireless Communication Module (CM) The Wireless Communication Module is intended to be used as an accessory to provide wireless capability and battery power to a CADD®-Solis Infusion Pump, Model 2110

Device Story

System comprises CADD-Solis Model 2110 infusion pump, Wireless Communication Module (CM), and PharmGuard Administrator Medication Safety Software. Pump uses linear peristaltic mechanism to deliver medication from flexible containers via administration sets. CM accessory attaches to pump battery compartment to enable wireless data transmission to PharmGuard server. Software allows clinicians to create therapy-based protocol libraries (drug, concentration, limits) for pump programming. Used in clinical settings (post-op, trauma, critical care, oncology, labor/delivery) by healthcare providers. Providers program pump via color LCD/keypad; software facilitates protocol management and CQI data collection. Wireless capability replaces/augments USB data transfer. System provides continuous, intermittent, or patient-controlled (PCA) delivery. Benefits include standardized medication delivery, reduced programming errors via safety software, and remote data connectivity.

Clinical Evidence

No clinical data. Substantial equivalence supported by bench testing, including electrical safety (IEC 60601-1), EMC (IEC 60601-1-2), software V&V, human factors evaluation, and GLP pre-clinical neurotoxicity studies for intrathecal administration.

Technological Characteristics

Linear peristaltic pump; color LCD (320x320 pixels); rechargeable battery (via CM) or AC power. Connectivity: USB and wireless (via CM). Software: PharmGuard Administrator (Windows-based). Sterilization: Not specified. Standards: IEC 60601-1, IEC 60601-1-2, IEC 62304, ISO 10993-1, ASTM D4169.

Indications for Use

Indicated for adult and pediatric patients in post-operative, trauma, critical care, oncology, and labor and delivery settings. Used for intravenous, intra-arterial, subcutaneous, intraperitoneal, perineural, intraoperative (soft tissue/body cavity/surgical wound), epidural, and subarachnoid space infusion. Supports continuous, intermittent bolus, and patient-controlled demand dose therapies.

Regulatory Classification

Identification

An infusion pump is a device used in a health care facility to pump fluids into a patient in a controlled manner. The device may use a piston pump, a roller pump, or a peristaltic pump and may be powered electrically or mechanically. The device may also operate using a constant force to propel the fluid through a narrow tube which determines the flow rate. The device may include means to detect a fault condition, such as air in, or blockage of, the infusion line and to activate an alarm.

Predicate Devices

• CADD-Solis Ambulatory Infusion Pump, Version 3.0 (K130394)
• CADD® Medication Cassette Reservoir with Flow Stop / CADD® Administration Set with Flow Stop (K040636)

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

August 24, 2017

Smiths Medical ADS, Inc. Breanna Fautsch Regulatory Affairs Specialist 6000 Nathan Lane North Minneapolis, Minnesota 55442

Re: K170982

Trade/Device Name: CADD®- Solis Ambulatory Infusion Pump with Wireless Communication; CADD®-Solis Infusion Pump, Model 2110; PharmGuard® Administrator Medication Safety Software; CADD® Administration Sets; Wireless Communication Module (CM) Regulation Number: 21 CFR 880.5725 Regulation Name: Infusion Pump Regulatory Class: Class II Product Code: MEA, MRZ, FPA, PYR Dated: July 24, 2017 Received: July 20, 2017

Dear Ms. Fautsch:

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.

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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 (reporting of medical devicerelated 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 (DICE) at its toll-free number [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 (DICE) at its toll-free number [phone] or [phone] or at its Internet address

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

Sincerely,

Tara A. Ryan -S

for Lori Wiggins, MPT, CLT Acting Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control, and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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# Indications for Use

510(k) Number (if known) K170982

#### Device Name

CADD®- Solis Ambulatory Infusion Pump with Wireless Communication; CADD®-Solis Infusion Pump, Model 2110; Pharm Guard® Administrator Medication Safety Software; CADD® Administration Sets; Wireless Communication Module (CM)

#### Indications for Use (Describe)

CADD®- Solis Ambulatory Infusion Pump with Wireless Communication

#### CADD®-Solis Infusion Pump, Model 2110

The CADD®-Solis Pump is indicated for intravenous, intra-arterial, subcutaneous, intraperitoneal, in close proximity to nerves, into an intraoperative site (soft tissue, body cavity/surgical wound site), epidural space. The pump is intended for therapies that require a continuous rate of infermittent bolus, and/or with patientcontrolled demand doses.

PharmGuard® Administrator Medication Safety Software

The PharmGuard® Administrator Medication Safety Software allows the use of a computer to create therapy-based protocol libraries to be used with the CADD®-Solis Infusion Pump.

CADD® Administration Set

The CADD® Administration Set is designed for use with the CADD® Infusion pumps (except CADD®-Micro) to allow medication delivery from a flexible container.

Wireless Communication Module (CM)

The Wireless Communication Module is intended to be used as an accessory to provide wireless capability and battery power to a CADD®-Solis Infusion Pump, Model 2110

| Type of Use (Select one or both, as applicable) |
|-------------------------------------------------------------------------------------------------|
| <label><input checked="" type="checkbox"/> Prescription Use (Part 21 CFR 801 Subpart D)</label> |
| <label><input type="checkbox"/> Over-The-Counter Use (21 CFR 801 Subpart C)</label> |

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#### K170982 510(K) SUMMARY

| Manufacturer's Name: | Smiths Medical |
|--------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Corresponding Official: | Breanna Fautsch, Regulatory Specialist<br>Smiths Medical ASD, Inc<br>6000 Nathan Lane North<br>Minneapolis, Minnesota 55442 |
| Telephone Number: | 763-383-3258 |
| E-mail: | [e-mail] |
| Preparation Date: | August 25, 2017 |
| Trade Name: | CADD®- Solis Ambulatory Infusion Pump with Wireless Communication<br>CADD®-Solis Infusion Pump, Model 2110<br>PharmGuard® Administrator Medication Safety Software<br>CADD® Administration Sets<br>Wireless Communication Module (CM) |
| Common or Usual Name: | Infusion Pump |
| Regulation Name:<br>Regulation Number:<br>Product Code:<br>Device Class: | Infusion Pump<br>21 CFR 880.5725<br>FRN - Infusion Pump<br>MRZ - Infusion Pump Accessories<br>FPA - Set, Administration, Intravascular<br>PYR- Neuraxial Administration Set - Intrathecal delivery<br>Class II |
| Primary Predicate Device: | K130394 |
| Secondary Predicate Device: | K040636 |

#### Device Description

The CADD®- Solis Ambulatory Infusion Pump with Wireless Communication, which includes the CADD®-Solis Infusion Pump, Model 2110, the Wireless Communication Module (CM), and the PharmGuard® Administrator Medication Safety Software, work together to provide wireless communication between the pump and the server and are similar to currently marketed products.

The CADD®-Solis Infusion Pump, Model 2110 has a microprocessor and linear peristaltic pumping mechanism, similar in design to the Smiths Medical ASD, Inc. CADD®-Solis Ambulatory Infusion Pump, Version 3.0 (K130394). The user activates CADD®-Solis Infusion Pump, Model 2110 via a color LCD screen and keypad user interface. Commands are issued to the microprocessor by activating the user interface. Microprocessor actions are controlled by a program, which is contained in the pump's memory.

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The CADD® Administration Set is designed for use with the CADD® Infusion pumps (except CADD®-Micro) to allow medication delivery from a flexible container. The Flow Stop feature is a set-based free flow protection component (i.e. Flow Stop) that is designed to occlude the tube if the set is accidentally placed onto the pump incorrectly or becomes detached from the pump. The Flow Stop is located on the set housing, which is attached to the pump.

# Intended Use

The CADD®- Solis Ambulatory Infusion Pump with Wireless Communication is intended to be used for patient care for adult and pediatric patients in multiple care areas, including but not limited to post-operative, trauma, critical care, oncology, and labor and delivery. The pump can be programmed with a protocol configuration consisting of a therapy. qualifier, and drug. Medication is delivered at a constant rate, and/or with an intermittent bolus, and/or with a patient dose.

## Indications for Use Statement

CADD®- Solis Ambulatory Infusion Pump with Wireless Communication

### CADD®-Solis Infusion Pump, Model 2110

The CADD®-Solis Pump is indicated for intravenous, intra-arterial, subcutaneous, intraperitoneal, in close proximity to nerves, into an intraoperative site (soft tissue, body cavity/surgical wound site), epidural space. The pump is intended for therapies that require a continuous rate of infermittent bolus, and/or with patientcontrolled demand doses.

### PharmGuard® Administrator Medication Safety Software

The PharmGuard® Administrator Medication Safety Software allows the use of a computer to create therapy-based protocol libraries to be used with the CADD®-Solis Infusion Pump.

## CADD® Administration Set

The CADD® Administration Set is designed for use with the CADD® Infusion pumps (except CADD®-Micro) to allow medication delivery from a flexible container.

## Wireless Communication Module (CM)

The Wireless Communication Module is intended to be used as an accessory to provide wireless capability and battery power to a CADD®-Solis Infusion Pump, Model 2110

# Substantial Equivalence Discussion

The CADD®- Solis Ambulatory Infusion Pump with Wireless Communication (pump and accessories) covered by this submission is the result of modifications to the FDA cleared CADD-Solis Ambulatory Infusion Pumps, Model 2110 Version 3.0 (K130394), CADD-Solis Medication Safety Software Version 3.1 (K130394) and CADD® Administration Set with Flow Stop, Medication Cassette Reservoir with Flow Stop (K040636).

The modifications include user interface updates to a software version 4.1 and the capability of the pump to support a new optional accessory device, the Wireless Communication Module (CM). The CM connects through the battery compartment on the CADD®-Solis Infusion Pump, Model 2110 in order to wirelessly connect the pump to the Smiths Medical PharmGuard® Server. The administration sets subject devices are the predicate devices with the exception of the indication which now includes intrathecal use when utilized with the CADD®-Solis Infusion Pump, Model 2110.

# Comparison of Indications for Use Statements

The tables below identifies and provides comparative assessments of the indications for use between the CADD®-Solis Infusion Pump. Model 2110, PharmGuard® Administrator Medication Safety Software, and CADD® Administration Sets subject device and predicate as required per 21 CFR 807.92.

| Indications for Use – Infusion Pump | |
|---------------------------------------|-------------------------------------------|
| Subject Device (K170982) | Predicate Device (K130394) |
| CADD®-Solis Infusion Pump, Model 2110 | The CADD®-Solis Ambulatory Infusion Pump, |

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| | Model2110, Version 3.0 |
|--------------------------------------------------------------|--------------------------------------------------------------|
| CADD®-Solis Infusion Pump, Model 2110 | The CADD® -Solis Ambulatory Infusion Pump, Model |
| The CADD®-Solis Version 4.1 Pump is indicated for | 2110, Version 3.0, is indicated for intravenous, intra- |
| intravenous, intra-arterial, subcutaneous, intraperitoneal, | arterial, subcutaneous, intraperitoneal, in close proximity |
| in close proximity to nerves, into an intraoperative site | to nerves, into an intraoperative site (soft tissue, body |
| (soft tissue, body cavity/surgical wound site), epidural | cavity/surgical wound site), epidural space, or |
| space or subarachnoid space. The pump is intended for | subarachnoid space infusion. The pump is intended for |
| therapies that require a continuous rate of infusion, and/or | therapies that require a continuous rate of infusion, and/or |
| an intermittent bolus, and/or with patient-controlled | an intermittent bolus, and/or with patient-controlled |
| demand doses. | demand doses. |

The indications for use statements are identical.

| Indications for Use – Medication Safety Software | |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Subject Device (K170982) | Predicate Device (K130394) |
| PharmGuard® Administrator Medication Safety<br>Software | The CADD®-Solis Medication Safety Software,<br>Version 3.1 |
| The PharmGuard® Administrator Medication Safety<br>Software allows the use of a computer to create therapy-<br>based protocol libraries to be used with the CADD®-Solis<br>Infusion Pump. | The CADD™-Solis Medication Safety Software-<br>Administrator allows use of a computer to create therapy-<br>based protocol libraries to be used with the CADD®-<br>Solis VIP Ambulatory Infusion Pump, CADD®-Solis<br>Ambulatory Infusion Pump, or CADD-Prizm® PCS II<br>Ambulatory Infusion Pump (software revision H or<br>higher).<br><br>The CADD™-Solis Medication Safety Software- Point of<br>Care allows use of a computer to send therapy-based<br>protocols develojed by the CADD™Solis Medication<br>Safety Software.- Administrator to the CADD -Solis<br>Ambulatory Infusion Pump and CADD-Prizm® PCS II<br>Ambulatory Infusion Pump (software revision H or<br>higher). |

# Discussion of Differences

The predicate device provides two statements, one for administrative users and one for point of care users to reflect the two separate software products. However, the subject device product and multiple user profiles within the software product. Therefore, a single indications statement is appropriate. There are no differences in the core language of the indications for use statements.

| Indications for Use – Administration Sets | |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Subject Device (K170982)<br>CADD® Administration Set | Predicate Device (K040636)<br>CADD® Medication Cassette Reservoir with Flow Stop<br>CADD® Administration Set with Flow Stop |
| The CADD® Administration Set is designed for use with<br>the CADD® Infusion pumps (except CADD®-Micro) to<br>allow medication delivery from a flexible container. | "The CADD® Medication Cassette Reservoir with Flow Stop is designed for use with the CADD® pumps (except CADD-Micro® and CADD-TPN®) for delivery of medications and fluids."<br>"The CADD® Administration Set with Flow Stop is |

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| | designed for use with the CADD® pumps (except CADD-<br>Microo and CADD-TPN) for delivery of medications and<br>fluids." |
|--|-------------------------------------------------------------------------------------------------------------------------|
|--|-------------------------------------------------------------------------------------------------------------------------|

Both statements imply medication delivery and therefore are identical in purpose.

### Comparison of Device Characteristics

The tables below identifies and provides comparative assessments of significant physical and performance characteristics between the CADD Solis Infusion Pump, Medication Safety Software, and Administration Sets subject device and predicate as required per 21 CFR 807.92.

## Infusion Pump

| Attribute | Subject Device (K170982)<br>CADD®-Solis Infusion Pump,<br>Model 2110 | Predicate Device (K130394)<br>The CADD®-Solis<br>Ambulatory Infusion Pump,<br>Model2110, Version 3.0 | Comparison |
|--------------------------------------|----------------------------------------------------------------------|------------------------------------------------------------------------------------------------------|--------------------------------------|
| Manufacturer | Smiths Medical ASD – Pump<br>Plexus Corp. – CM | Smiths Medical ASD | - |
| Pump Model Number | Model 2110 | Model 2110 | - |
| Pump Firmware version | Version 4.1 | Version 3.0 | See discussion of<br>differences (1) |
| Pump type/ principle of<br>operation | Linear peristaltic | Linear peristaltic | Identical |
| Materials of construction | Same for subject and predicate<br>CADD®-Solis Pumps | Same for subject and predicate<br>CADD®-Solis Pumps | Identical |
| Display | Color display with 320 x 320<br>pixels | Color display with 320 x 320<br>pixels | Identical |
| Wireless capability | Yes, with installed CM | No | See discussion of<br>differences (2) |
| Power requirements | Rechargeable CM<br>AC Adapter | 4 ("AA") batteries<br>AC adapter<br>Rechargeable battery pack | See discussion of<br>differences (3) |
| Pump packaging | Foam insert, hardboard box | Foam insert, hardboard box | Identical |
| CM Packaging | Foam insert, hardboard box | n/a | n/a |
| USB port | Yes | Yes | Identical |
| AC adapter | Yes | Yes | Identical |
| AC power cord | Yes | Yes | Identical |
| Remote dose cord | Yes | Yes | Identical |
| Pole mount adapter | Yes | Yes | Identical |
| Carrying pouch | Yes | Yes | Identical |
| Lockbox | Yes | Yes | Identical |
| Medication cassette<br>reservoir | Yes | Yes | Identical |
| Administration set | Yes | Yes | Identical |
| Extension set | Yes | Yes | Identical |
| Intermittent | Yes | Yes | Identical |

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| (programmed<br>intermittent bolus) | Yes | Yes | Identical |
|--------------------------------------------------------------------|--------------------------------------------------|--------------------------------------------------|-----------|
| Continuous infusion | Yes | Yes | Identical |
| Continuous infusion<br>with Bolus (PCA) | Yes | Yes | Identical |
| Intermittent<br>(programmed<br>intermittent bolus) | Yes | Yes | Identical |
| Continuous infusion | Yes | Yes | Identical |
| Maximum clinician<br>bolus | 50 mL | 50 mL | Identical |
| Programmable<br>maximum delivery rate<br>(continuous rate + bolus) | Yes<br>500 mL/hour, with high flow<br>disposable | Yes<br>500 mL/hour, with high flow<br>disposable | Identical |
| Patient controlled access<br>PCA (dosing) | Yes | Yes | Identical |
| Dose lockout time | Yes | Yes | Identical |
| Doses per hour limit | Yes | Yes | Identical |
| Delivery limit | Yes | Yes | Identical |
| Clinician bolus | Yes | Yes | Identical |
| Maximum clinician<br>bolus | 50 mL | 50 mL | Identical |
| Programmable<br>maximum delivery rate<br>(continuous rate+bolus) | Yes<br>500 mL/hour, with high flow<br>disposable | Yes<br>500 mL/hour, with high flow<br>disposable | Identical |
| Medication Safety<br>Software | Version 4.1 | Version 3.1 | Identical |

- (1) Pump Firmware Update: firmware version update to accommodate updates in software. This was verified with software testing in accordance with IEC 62304:2006 Medical device software life cycle process and the Agency's Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices.
- (2) Data Transmission: update in means of data transmission of USB to wireless connection using the CM optional accessory. Design Verification and Validation testing demonstrates the wireless data transmission as meeting the acceptance criteria and intended use as well as USB data transmission utilized in the predicate device.
- (3) Power Requirements: the CM accessory contains a rechargeable battery pack within the confines of the CM container, which provides a similar type of power source for the standalone rechargeable battery pack that is included as a cleared accessory for the predicate device. Performance of the CM accessory was verified and validated through bench testing.

| Attribute | Subject Device (K170982)<br>PharmGuard® Medication<br>Safety Software | Predicate Device (K130394)<br>The CADD®-Solis<br>Medication Safety Software,<br>Version 3.1 | Comparison |
|---------------------------------------------------------|--------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|--------------------------------------|
| Manufacturer | Smiths Medical ASD | Smiths Medical ASD | Identical |
| PC software | Windows 2000, XP, VISTA, | Windows 2000, XP, VISTA, | See discussion of |
| compatibility | Windows 7, Windows 8<br>Administrator only:<br>Windows Server 2003,<br>Server 2008, Server 2008R | Windows 7,<br>Administrator only:<br>Windows Server 2003,<br>Server 2008, Server 2008R | differences (1) |
| Protocol programming | Yes | Yes | Identical |
| Multi-line drug names | Yes | No | See discussion of<br>differences (2) |
| Profiles function | Yes | No | See discussion of<br>differences (3) |
| View reports | Yes | Yes | Identical |
| Print reports | Yes | Yes | Identical |
| Save reports | Yes | Yes | Identical |
| Event log viewing | Yes | Yes | Identical |
| Rx (pump<br>History/Settings<br>Viewing | Yes | Yes | Identical |
| CQI data collection and<br>retrieval | Yes | Yes | Identical |
| Wt based programming<br>(PCA mode) | Yes | Yes | Identical |
| BarCode printing | Yes | Yes | Identical |
| Password protected | Yes | Yes | Identical |
| Second nurse<br>verification | Yes | Yes | Identical |
| Drug ID verification | Yes | Yes | Identical |
| Units programming | Yes | Yes | Identical |
| Concentration<br>programming | Yes | Yes | Identical |
| Demand Dose<br>programming | Yes | Yes | Identical |
| Max patient weight<br>(ranges) | Yes | Yes | Identical |
| Epidural Mode on/off | Yes | Yes | Identical |
| New patient feature | Yes | Yes | Identical |
| Program limits (soft and<br>hard limits)<br>programming | Yes | Yes | Identical |
| Biomed infusion pump<br>programming | Yes | Yes | Identical |
| Pump/Module ID<br>Storage and retrieval | Yes | Yes | Identical |
| Date/Time format | Yes | Yes | Identical |
| Daylight Savings Time<br>feature | Yes | No | See discussion of<br>differences (4) |
| Asset ID Feature | Yes | No | See discussion of<br>differences (5) |
| Units programming | Yes | Yes | Identical |
| Concentration programming | Yes | Yes | Identical |
| Continuous rate programming | Yes | Yes | Identical |
| Demand dose programming | Yes | Yes | Identical |

Medication Safety Software

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- (1) PC Software Capability: the subject device supports Windows 8 PC Software capability. This was verified with software testing in accordance with IEC 62304:2006 Medical device software life cycle process and the Agency's Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices.
- (2) Multi-line Drug Names: the subject device software updates to the pump allow for multiple lines of drug names to appear on the pump screen compared to the single line drug name capability of the predicate device pump. This change enhances ease of use as the user can see the full drug name instead of having to scroll through lines. This feature was verified with software testing in accordance with IEC 62304:2006 Medical device software - software life cycle process and the Agency's Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices. This feature was validated with Human Factors testing.
- (3) Profiles Function: the subject device software updates to the pump allow for user defined optional profiles to allow the user for easier organization stored on the pump. This feature was verified with software testing in accordance with IEC 62304:2006 Medical device software – software life cycle process and the Agency's Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices. This feature was validated with Human Factors testing.
- (4) Daylight Savings Time Auto Adjust Feature: the subject device can be configured to automatically update the time to account for daylight savings where the predicate device allows for manual entry of time adjustment only. This feature was verified with software testing in accordance with IEC 62304:2006 Medical device software software life cycle process and the Agency's Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices.
- (5) Asset ID Feature: the subject device has the optional feature of allowing the customer to set up an asset pump ID for each pump as a means of additional pump identification. This feature was verified with software testing in accordance with IEC 62304:2006 Medical device software - software life cycle process and the Agency's Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices. This feature was validated with Human Factors testing.

#### Administration Sets

The CADD® Administration Sets do not have any feature or function changes and are similar in design, function, and intended use to the predicate CADD® Administration Sets (K040636). The CADD® Administration Sets included in this submission may now be used to delivery medication to the intrathecal space as established through pre-clinical GLP neurotoxicity studies, chemical characterization and a toxicology assessment.

#### Conclusion

The differences in the indications for use statements and device characteristics are supported through non-clinical performance testing and do not raise new or different questions of safety and effectiveness.

#### Summary of Non-Clinical Performance Testing

A safety assurance case was provided for the CADD®- Solis Ambulatory Infusion Pump with Wireless Communication, which includes the CADD®-Solis Infusion Pump, Model 2110, the Wireless Communication Module (CM), and the

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PharmGuard® Administrator Medication Safety Software, as recommended in the FDA guidance document, Infusion Pumps Total Product Life Cycle.

The stated goal of the safety assurance case is:

- . The CADD-Solis Ambulatory Infusion Pump System is reasonably safe for use in its intended environment by its intended users
The assurance case defined the device system, including the indications for use, system definition, operational description, patient populations, and use environments. The supporting assurance arguments covered the following attributes:

The device is properly identified and defined

- · The process used to define new products and establish their requirements build a foundation for safe products
- · Clinical requirements define a safe system for the intended indications for use
- · Requirements are driven by applicable standards for the intended use, and markets of distribution are identified

The device design is adequately verified and validated

- . The developmental processes used take the establish requirement them, resulting in safe products
The device risks are acceptably mitigated

- · Risk analysis process identifies and manages safety requirements by identifying all hazards to safety, causes of those hazards, controls to mitigate those hazards, and assessing the effectiveness of those controls
The device is adequately reliable to ensure its safety over its intended use life.

- · The production process results in the manufacturing of products which, when used alone or in combination, form a safe system
- · The post-launch processes are in place to maintain safe products once they have been shipped to the customer

The following evidence was included in the assurance case:

Performance Test Summary - System verification activities for CADD®- Solis Ambulatory Infusion Pump with Wireless Communication, which includes the CADD®-Solis Infusion Pump, Model 2110, the Wireless Communication Module (CM), and the PharmGuard® Administrator Medication Safety Software, confirmed that the system modifications meets user needs and design inputs. All the testing met the acceptance criteria.

- The infusion pump basic safety and essential performance verification was completed in accordance with IEC . 60601-1 General requirements for basic safety and essential performance.
- . Human factors evaluations have been conducted to validate the effectiveness of use error related mitigations in accordance with the Agency's Guidance Document, "Applying Human Factors and Usability Engineering to Medical Devices" and IEC 62366-1:2007 Application of usability engineering to medical devices
- . Electrical and Electromagnetic Compatibility testing were conducted. The CADD®- Solis Ambulatory Infusion Pump with Wireless Communication, which includes the CADD@-Solis Infusion Pump, Model 21 10, the Wireless Communication Module (CM), and the PharmGuard® Administrator Medication Safety Software, complies with following standards:
- Electrical Safety per IEC 60601-1 and IEC 60601-1-12 O
- O EMC testing per IEC 60601-1-2
- IEC 60601-1-6:2013 Medical electrical equipment Part 1-6: General requirements for safety: usability O
- 2054 UL Standard for Safety Household and Commercial Batteries Second Edition; Reprint with O revisions through and including September 14, 2011

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- IEC 62122 Secondary cells and batteries containing alkaline or other non-acid electrolytes Safety O requirements for portable sealed secondary cells, and for them, for use in portable applications
- Medical Electrical Equipment and System Electromagnetic Immunity Test for Exposure to Radio O Frequency Identification Readers" (catalog number 7351731)
- . Software Verification and Validation per the Agency's "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices," "Content of Premarket Submissions for Management of Cybersecurity in Medical Devices" and IEC 62304:2006 Medical device software - software life cycle process
- . Cleaning and Disinfection Validation for the CADD®- Solis Ambulatory Infusion Pump with Wireless Communication, which includes the CADD®-Solis Infusion Pump. Model 2110, the Wireless Communication Module (CM), and the PharmGuard® Administrator Medication Safety Software, confirmed that the new accessories meets the cleaning and disinfection requirements.
- . GLP pre-clinical studies were completed to demonstrate each of the CADD® Administration Sets proposed for delivery of fluids to the epidural and subarachnoid spaces are free from unacceptable neurotoxicological risk.
- . A Chemical Characterization, Toxicological Risk Assessment, and in vivo and in vitro Biocompatibility studies were completed in accordance with ISO 10993-1:2009/ (R) 2013 Biological Evaluation of medical devices - Part 1: Evaluation and testing within a risk management process.
- . Packaging and Shipping verification was conducted in accordance with ASTM D4169 Standard Practice for Performance Testing of Shipping Containers and Systems

# Conclusion

The testing conducted demonstrates that the CADD®- Solis Ambulatory Infusion Pump with Wireless Communication, which includes the CADD®-Solis Infusion Pump, Model 2110, the Wireless Communication Module (CM), and the PharmGuard® Administrator Medication Safety Software with changes described meet the design requirements of the cleared predicate devices. Therefore, the CADD®- Solis Ambulatory Infusion Pump with Wireless Communication, which includes the CADD®-Solis Infusion Pump, Model 2110, the Wireless Communication Module (CM), and the PharmGuard® Administrator Medication Safety Software that is this submission is substantially equivalent to its predicate.

# Clinical Tests

Not Applicable

# Conclusions

The modifications pertain to the software update, additional communication module accessory, and expansion of the administration sets to include intrathecal delivery when used with the CADD® Infusion Pump. There are no changes the basic infusion pump technology. The modifications are supported by non-clinical testing.

The evaluation of the CADD®- Solis Ambulatory Infusion Pump with Wireless Communications for use, comparative evaluation to the predicate devices, K1310394 and K040636, and non-clinical performance testing demonstrate that the device is substantially equivalent to the legally marketed predicate device in as required per 21 CFR 807.92(3). Device testing met pre-defined acceptance criteria and did not raise new or different question of safety or effectiveness.