Accucuff Cuff Pressure Indicator

K182548 · Tianjin Medis Medical Device Co., Ltd. · BSK · Jan 25, 2019 · Anesthesiology

Device Facts

• Record ID: K182548
• Device Name: Accucuff Cuff Pressure Indicator
• Applicant: Tianjin Medis Medical Device Co., Ltd.
• Product Code: BSK · Anesthesiology
• Decision Date: Jan 25, 2019
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 868.5750
• Device Class: Class 2
• Attributes: Pediatric

Indications for Use

The Accucuff Cuff Pressure Indicator is intended to monitor intra-cuff pressures of endotracheal, supraglottic airways or tracheostomy tubes. The device is indicated for the patients from pediatric to adult who have an artificial airway and for which the user would like to monitor cuff pressure.

Device Story

Accucuff Cuff Pressure Indicator monitors intra-cuff pressure of artificial airways (endotracheal, supraglottic, tracheostomy). Device features color-coded zones indicating normal, negative, and positive pressure ranges; internal black marker moves in response to pressure changes. Available in three models (10-20 cmH2O, 20-29 cmH2O, 40-60 cmH2O) to accommodate pediatric to adult populations. Used in clinical settings under medical supervision. Healthcare providers observe the position of the black marker relative to color-coded zones to assess cuff pressure status. Proper monitoring helps maintain appropriate cuff pressure, potentially reducing risks associated with over-inflation or under-inflation of artificial airways.

Clinical Evidence

No clinical data. Bench testing only. Testing included conical fitting performance, pressure accuracy, repeatability, temperature exposure, simulated transportation, package integrity, and accelerated aging. Biocompatibility testing performed per ISO 10993-1, -5, and -10.

Technological Characteristics

Materials: Polycarbonate (PC) and Silicone. Sensing: Mechanical pressure indicator with moving black marker. Energy: None (passive). Connectivity: Standalone. Sterilization: EO (10^-6). Standards: ISO 594-1 (conical fittings), ISO 10993 (biocompatibility), ASTM F88/F88M (seal strength), ASTM F1929 (seal leaks).

Indications for Use

Indicated for pediatric to adult patients with an artificial airway (endotracheal, supraglottic, or tracheostomy) requiring cuff pressure monitoring.

Regulatory Classification

Identification

An inflatable tracheal tube cuff is a device used to provide an airtight seal between a tracheal tube and a patient's trachea.

Predicate Devices

• Cuff Pilot (K142103)
• Easy Cuff (K102704)

Submission Summary (Full Text)

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Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: a symbol on the left and the text "FDA U.S. FOOD & DRUG ADMINISTRATION" on the right. The symbol on the left is a stylized representation of a human figure, while the text on the right is written in blue and white. The logo is commonly used to identify the FDA and its role in regulating food and drugs in the United States.

Tianjin Medis Medical Device Co., Ltd. % Diana Hong General Manager Mid-Link Consulting Co., Ltd P.O. Box 120-119 Shanghai, China, 200120

Re: K182548

Trade/Device Name: Accucuff Cuff Pressure Indicator Regulation Number: 21 CFR 868.5750 Regulation Name: Inflatable Tracheal Tube Cuff Regulatory Class: Class II Product Code: BSK Dated: September 7, 2018 Received: September 17, 2018

Dear Diana Hong:

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 mav, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be avare that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

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requirements, including, but not limited to: registration and listing (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.html; good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely.

# Todd D. Courtney -S

for Tina Kiang, Ph.D. 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) K182548

Device Name Accucuff Cuff Pressure Indicator

#### Indications for Use (Describe)

The Accucuff Cuff Pressure Indicator is intended to monitor intra-cuff pressures of endotracheal, supraglottic airways or tracheostomy tubes. The device is indicated for the patients from pediatric to adult who have an artificial airway and for which the user would like to monitor cuff pressure.

| Type of Use (Select one or both, as applicable) | |
|----------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------|
| <div> <span> <b> × </b> </span> <span>Prescription Use (Part 21 CFR 801 Subpart D)</span> </div> | |
| | <div> <span>Over-The-Counter Use (21 CFR 801 Subpart C)</span> </div> |

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## 510(k) Summary

This 510(k) Summary is being submitted in accordance with requirements of Title 21, CFR Section 807.92.

The assigned 510(k) Number: K182548

- 1. Date of Preparation: 12/26/2018
- 2. Sponsor Identification

#### Tianjin Medis Medical Device Co., Ltd.

No.15-A, Saida One Avenue, Xiqing Economic Development Area, Tianjin, P.R. China

Establishment Registration Number: 3004992992

Contact Person: Yongzhi Wu Position: Quality Manager Tel: [phone] Fax: [phone] Email: [e-mail]

- Designated Submission Correspondent 3.
Ms. Diana Hong (Primary Contact Person) Ms. Ying Xu (Alternative Contact Person)

Mid-Link Consulting Co., Ltd P.O. Box 120-119, Shanghai, 200120, China

Tel: [phone], Fax: [phone] Email: [e-mail]

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#### 4. Identification of Proposed Device

Trade Name: Accucuff™ Cuff Pressure Indicator Common Name: Cuff Pressure Indicator

#### Regulatory Information

Classification Name: Cuff, Tracheal Tube, Inflatable Classification: II; Product Code: BSK Regulation Number: 21CFR 868.5750 Review Panel: Anesthesiology

#### Device Description

The Accucuff™ Cuff Pressure Indicator is intended to monitor the cuff pressure of endotracheal, supraglottic airways or tracheostomy tubes. It is designed with different color coded zones to indicate the normal, negative and positive pressure. The black marker on the device will be moved when the cuff pressure is changed. The device is available in 10-20 cmH2O, 20-29 cmH2O and 40-60 cmH2O three different models to accommodate the intended populations from pediatric to adult.

Intended Use Statement:

The Accucuff™ Cuff Pressure Indicator is intended to monitor intra-cuff pressures of endotracheal, supraglottic airways or tracheostomy tubes. The device is indicated for the patients from pediatic to adult who have an artificial airway and for which the user would like to monitor cuff pressure.

- న. Identification of Predicate Devices
Predicate Device 1 510(k) Number: K142103 Trade Name: Cuff Pilot™

Predicate Device 2 510(k) Number: K102704 Trade Name: Easy Cuff™

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| | Table 1 Comparison of Technology Characteristics |
|--|--------------------------------------------------|
| | |

| Item | Proposed Device | Predicate Device 1 | Predicate Device 2 | method | pressure | | pressure |
|----------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------|---------------------------------|----------------------|---------------------|
| Product Code | BSK | K142103 | K102704 | Types of airways to which it can be used | Supraglottic airway | Supraglottic airway | Supraglottic airway |
| Regulation Number | 868.5750 | 868.5750 | 868.5750 | | Endotracheal tube | | Endotracheal tube |
| Class | CLASS II | CLASS II | CLASS II | | Tracheostomy tube | | Tracheostomy tube |
| Intended Use | The AccucuffTM Cuff Pressure Indicator is intended to monitor intra-cuff pressures of endotracheal, supraglottic airways or tracheostomy tubes. The device is indicated for the patients from pediatric to adult who have an artificial airway and for which the user would like to monitor cuff pressure. | To monitor intra-cuff pressures of supraglottic airways<br>Patient population:<br>Patients who have an artificial airway and for which the user would like to monitor cuff pressure, pediatric to adult.<br>Environment of Use<br>To be used under medical supervision in hospitals, pre-hospital (EMS), extended care facilities and outpatient clinics, where a patient may have an artificial airway. It may also be used in MRI suites when attached to airways that are MR conditional or MR Safe. | To inflate cuffs and to measure and monitor intra-cuff pressures of endotracheal, supraglottic airways, or tracheostomy tubes.<br>Patient population:<br>Patient who are intubated.<br>Environment of use<br>To be used under medical supervision in hospitals, pre-hospital (EMS), extended care facilities and outpatient clinics, where a patient may be intubated | Sterile | EO sterilization, 10-6 | Non-sterile, sterile | Non-sterile |
| Range of measured pressure | AC0100P: 10~20cm H2O<br>AC0100B: 20~29cm H2O<br>AC0100R: 40~60cm H2O | 0~80cm H2O | 0~30cm H2O | Single Use | Single Use | Single Use | Single Use |
| Pressure accuracy | 10~20cm H2O :+/-2cm H2O<br>20~29cm H2O: +/-2cm H2O<br>40~60cm H2O: +/-4cm H2O | +/-5cm H2O up to 80cm H2O | +/-5% H2O up to 30cm H2O<br>+/-0.5cm H2O up @ 10cm H2O<br>+/-1cm H2O up @ 20cm H2O<br>+/-1.5cm H2O up @ 30cm H2O | Material | Polycarbonate (PC);<br>Silicone | Unknown | Unknown |
| Pressure indication | Black mark that move with changes in | Bellows that move with changes in pressure | Bellows that move with changes in | Biocompatibility | | | |
| Cytotoxicity | No cytotoxicity | Conform with ISO 10993 requirements | Conform with ISO 10993 requirements | | | | |
| Skin Sensitization | No skin sensitization | | | | | | |
| Irritation | No irritation | | | | | | |

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Intended Use

The proposed device has the indication of monitoring in endotracheal and trachestomy in addition to monitoring the pressure of supraglotic airway compared with the predicate device K142103. However, the two additional indications are covered by predicate device K102704. Therefore, this difference does not raise different safety and effectiveness questions.

#### Pressure Range

The range of measured pressure for proposed devices individually compared. The proposed device is available in three different pressure ranges. However, pressure range compared with the specifications of the predications of the predicates cleared previously.

#### Pressure Accuracy

The pressure accuracy for proposed devices. Although the pressure accuracy for prossure accuracy for proposed device is less than

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predicate device K102704, the proposed device has a more than predicate device K142103. Therefore, the accuracy difference does not raise different safety and effectiveness questions.

#### Airway Type

The type of airway for which the proposed device is different from predicate device K142103. The proposed device has the additional airway of monitoring endotracheal tube and tracheostomy tube which are identical to predicate device K102704.

#### Sterilization

The proposed device is provided sterile which is different from the sterilization method is established and validated per ISO 11135, which ensures the effectiveness of sterilization.

#### Material

The biocompatibility test (per ISO 10993) has been performed on the results do not show any adverse effect, which demonstrates biocompatibility of the proposed device.

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- Non-Clinical Test Summary 6.
Non-clinical tests were conducted to verify that the proposed device met all the design specifications to establish Substantial Equivalence (SE) with the predicate devices. Test items include:

Conical fitting Performance Test Pressure Accuracy Test Repeatability Pressure Accuracy Test Pressure Accuracy Test exposure to cold and hot temperature Simulated Transportation Test Package Integrity Test Pressure Accuracy and Package Integrity after Accelerated Aging

The test results demonstrate that the proposed device complies with the following standards:

- A ISO 594-1:1986 Conical fittings with a 6% (Luer) taper for syringes, needles and certain other medical equipment-Part 1: General requirement
- > ISO 10993-1:2009 Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process
- > ISO 10993-5:2009 Biological evaluation of medical devices -- Part 5: Tests for In Vitro cytotoxicity;
- > ISO 10993-10:2010 Biological evaluation of medical devices - Part 10: Tests for irritation and skin sensitization;
- > ASTM F88/F88M-15 Standard Test Method for Seal Strength of Flexible Barrier Materials.
- > ASTM F1929-15 Standard Test Method for Detecting Seal Leaks in Porous Medical Packaging by Dye Penetration
- 7. Clinical Test Conclusion

No clinical study is included in this submission.

- 8. Substantially Equivalent (SE) Conclusion
Based on the comparison and analysis above, the proposed device is Substantially Equivalent (SE) to the predicate devices.