DEKA ACE Pump System

K233952 · Deka Research and Development · QFG · Mar 13, 2024 · Clinical Chemistry

Device Facts

Record IDK233952
Device NameDEKA ACE Pump System
ApplicantDeka Research and Development
Product CodeQFG · Clinical Chemistry
Decision DateMar 13, 2024
DecisionSESE
Submission TypeTraditional
Regulation21 CFR 880.5730
Device ClassClass 2
AttributesTherapeutic, Pediatric

Intended Use

The DEKA ACE Pump System is intended for the subcutaneous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin, ages six and above. The pump is able to reliably and securely communicate with compatible, digitally connected devices, including automated insulin dosing software, to receive, execute, and confirm commands from these devices. The pump is intended for single patient, home use and requires a prescription. The bolus calculator is indicated for use for aiding the user in determining the bolus insulin dosage for management of diabetes mellitus based on consumed carbohydrates, operator entered blood glucose, insulin sensitivity, insulin to carbohydrate ratio, target glucose values, and current insulin on board.

Device Story

Wearable alternate controller enabled (ACE) insulin infusion pump; delivers insulin subcutaneously at set/variable rates. System components: durable pump (rechargeable Li-ion battery), single-use cassette (microfluidic valves, reservoir, Acoustic Volume Sensing (AVS) for delivery accuracy), and iOS mobile app (DEKA Loop) for user interface. Integrates with Dexcom G6 iCGM via BLE for sensor data. Halo Cloud platform enables patient onboarding, prescription downloads, event log uploads, and remote OTA software updates. Physician prescribes device; patient operates via iPhone app. Pump receives/executes commands from automated insulin dosing software. Bolus calculator aids dosage determination using carbs, blood glucose, insulin sensitivity, I/C ratio, target glucose, and insulin-on-board. Benefits include automated insulin delivery management and improved glycemic control.

Clinical Evidence

No clinical trials performed. Evidence consists of bench testing, human factors validation, and electromagnetic/wireless coexistence testing. Human factors study validated usability for critical tasks across the intended user population. Software and cybersecurity verification performed per IEC 62304. Electrical safety verified per IEC 60601-1 and collateral standards.

Technological Characteristics

Wearable micro-dosing pump; AVS feedback for delivery accuracy. Rechargeable Li-ion battery. Connectivity: BLE (to iCGM), Cloud (OTA updates, logs). Materials: Biocompatible per ISO 10993. Standards: IEC 60601-1, 1-2, 1-6, 1-8, 1-10, 1-11, 2-24; IEC 62304; ISO 11137-1 (Gamma sterilization), ISO 14971. Software: iOS app interface, embedded firmware, iAGC (DEKA Loop) algorithm.

Indications for Use

Indicated for subcutaneous insulin delivery for diabetes mellitus management in patients ages 6 and older. Contraindicated for users unable to test blood glucose, maintain self-care skills, see healthcare providers regularly, or count carbohydrates; also contraindicated for users with visual, hearing, or cognitive impairments, or physical impairments preventing pump/iPhone operation.

Regulatory Classification

Identification

An alternate controller enabled infusion pump (ACE pump) is a device intended for the infusion of drugs into a patient. The ACE pump may include basal and bolus drug delivery at set or variable rates. ACE pumps are designed to reliably and securely communicate with external devices, such as automated drug dosing systems, to allow drug delivery commands to be received, executed, and confirmed. ACE pumps are intended to be used both alone and in conjunction with digitally connected medical devices for the purpose of drug delivery.

Special Controls

Alternate controller enabled infusion pumps must comply with the following special controls:

*Classification.* Class II (special controls). The special controls for this device are:(1) Design verification and validation must include the following: (i) Evidence demonstrating that device infusion delivery accuracy conforms to defined user needs and intended uses and is validated to support safe use under actual use conditions. (A) Design input requirements must include delivery accuracy specifications under reasonably foreseeable use conditions, including ambient temperature changes, pressure changes ( *e.g.,* head-height, backpressure, atmospheric), and, as appropriate, different drug fluidic properties.(B) Test results must demonstrate that the device meets the design input requirements for delivery accuracy under use conditions for the programmable range of delivery rates and volumes. Testing shall be conducted with a statistically valid number of devices to account for variation between devices. (ii) Validation testing results demonstrating the ability of the pump to detect relevant hazards associated with drug delivery and the route of administration ( *e.g.,* occlusions, air in line, etc.) within a clinically relevant timeframe across the range of programmable drug delivery rates and volumes. Hazard detection must be appropriate for the intended use of the device and testing must validate appropriate performance under the conditions of use for the device.(iii) Validation testing results demonstrating compatibility with drugs that may be used with the pump based on its labeling. Testing must include assessment of drug stability under reasonably foreseeable use conditions that may affect drug stability ( *e.g.,* temperature, light exposure, or other factors as needed).(iv) The device parts that directly or indirectly contact the patient must be demonstrated to be biocompatible. This shall include chemical and particulate characterization on the final, finished, fluid contacting device components demonstrating that risk of harm from device-related residues is reasonably low. (v) Evidence verifying and validating that the device is reliable over the ACE pump use life, as specified in the design file, in terms of all device functions and in terms of pump performance. (vi) The device must be designed and tested for electrical safety, electromagnetic compatibility, and radio frequency wireless safety and availability consistent with patient safety requirements in the intended use environment. (vii) For any device that is capable of delivering more than one drug, the risk of cross-channeling drugs must be adequately mitigated. (viii) For any devices intended for multiple patient use, testing must demonstrate validation of reprocessing procedures and include verification that the device meets all functional and performance requirements after reprocessing. (2) Design verification and validation activities must include appropriate design inputs and design outputs that are essential for the proper functioning of the device that have been documented and include the following: (i) Risk control measures shall be implemented to address device system hazards and the design decisions related to how the risk control measures impact essential performance shall be documented. (ii) A traceability analysis demonstrating that all hazards are adequately controlled and that all controls have been validated in the final device design. (3) The device shall include validated interface specifications for digitally connected devices. These interface specifications shall, at a minimum, provide for the following: (i) Secure authentication (pairing) to external devices. (ii) Secure, accurate, and reliable means of data transmission between the pump and connected devices. (iii) Sharing of necessary state information between the pump and any digitally connected alternate controllers ( *e.g.,* battery level, reservoir level, pump status, error conditions).(iv) Ensuring that the pump continues to operate safely when data is received in a manner outside the bounds of the parameters specified. (v) A detailed process and procedure for sharing the pump interface specification with digitally connected devices and for validating the correct implementation of that protocol. (4) The device must include appropriate measures to ensure that safe therapy is maintained when communications with digitally connected alternate controller devices is interrupted, lost, or re-established after an interruption ( *e.g.,* reverting to a pre-programmed, safe drug delivery rate). Validation testing results must demonstrate that critical events that occur during a loss of communications (*e.g.,* commands, device malfunctions, occlusions, etc.) are handled appropriately during and after the interruption.(5) The device design must ensure that a record of critical events is stored and accessible for an adequate period to allow for auditing of communications between digitally connected devices and to facilitate the sharing of pertinent information with the responsible parties for those connected devices. Critical events to be stored by the system must, at a minimum, include: (i) A record of all drug delivery (ii) Commands issued to the pump and pump confirmations (iii) Device malfunctions (iv) Alarms and alerts and associated acknowledgements (v) Connectivity events ( *e.g.,* establishment or loss of communications)(6) Design verification and validation must include results obtained through a human factors study that demonstrates that an intended user can safely use the device for its intended use. (7) Device labeling must include the following: (i) A prominent statement identifying the drugs that are compatible with the device, including the identity and concentration of those drugs as appropriate. (ii) A description of the minimum and maximum basal rates, minimum and maximum bolus volumes, and the increment size for basal and bolus delivery, or other similarly applicable information about drug delivery parameters. (iii) A description of the pump accuracy at minimum, intermediate, and maximum bolus delivery volumes and the method(s) used to establish bolus delivery accuracy. For each bolus volume, pump accuracy shall be described in terms of the number of bolus doses measured to be within a given range as compared to the commanded volume. An acceptable accuracy description (depending on the drug delivered and bolus volume) may be provided as follows for each bolus volume tested, as applicable: Number of bolus doses with volume that is <25 percent, 25 percent to <75 percent, 75 percent to <95 percent, 95 percent to <105 percent, 105 percent to <125 percent, 125 percent to <175 percent, 175 to 250 percent, and >250 percent of the commanded amount. (iv) A description of the pump accuracy at minimum, intermediate, and maximum basal delivery rates and the method(s) used to establish basal delivery accuracy. For each basal rate, pump accuracy shall be described in terms of the amount of drug delivered after the basal delivery was first commanded, without a warmup period, up to various time points. The information provided must include typical pump performance, as well as worst-case pump performance observed during testing in terms of both over-delivery and under-delivery. An acceptable accuracy description (depending on the drug delivered) may be provided as follows, as applicable: The total volume delivered 1 hour, 6 hours, and 12 hours after starting delivery for a typical pump tested, as well as for the pump that delivered the least and the pump that delivered the most at each time point. (v) A description of delivery hazard alarm performance, as applicable. For occlusion alarms, performance shall be reported at minimum, intermediate, and maximum delivery rates and volumes. This description must include the specification for the longest time period that may elapse before an occlusion alarm is triggered under each delivery condition, as well as the typical results observed during performance testing of the pumps. (vi) For wireless connection enabled devices, a description of the wireless quality of service required for proper use of the device. (vii) For any infusion pumps intended for multiple patient reuse, instructions for safely reprocessing the device between uses.

Predicate Devices

Related Devices

Submission Summary (Full Text)

{0} FDA U.S. FOOD &amp; DRUG ADMINISTRATION # 510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY ## I Background Information: A 510(k) Number K233952 B Applicant Deka Research and Development C Proprietary and Established Names DEKA ACE Pump System D Regulatory Information | Product Code(s) | Classification | Regulation Section | Panel | | --- | --- | --- | --- | | QFG | Class II | 21 CFR 880.5730 - Alternate Controller Enabled Infusion Pump | CH - Clinical Chemistry | | NDC | Class II | 21 CFR 868.1890 - Predictive pulmonary-function value calculator | CH - Clinical Chemistry | ## E Purpose for Submission Modification of the DEKA ACE Pump System cleared in K213536 by replacing the dedicated Android controller with an iOS application installed on the user's personal iPhone and by adding DEKA Loop (K234055) to the pump, which is a ported version of Tidepool Loop (K203689). ## II Intended Use/Indications for Use: A Intended Use(s): See Indications for Use below. B Indication(s) for Use: The DEKA ACE Pump System is intended for the subcutaneous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin, ages six and Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993-0002 www.fda.gov {1} above. The pump is able to reliably and securely communicate with compatible, digitally connected devices, including automated insulin dosing software, to receive, execute, and confirm commands from these devices. The pump is intended for single patient, home use and requires a prescription. The bolus calculator is indicated for use for aiding the user in determining the bolus insulin dosage for management of diabetes mellitus based on consumed carbohydrates, operator entered blood glucose, insulin sensitivity, insulin to carbohydrate ratio, target glucose values, and current insulin on board. ## C Special Conditions for Use Statement(s): Rx - For Prescription Use Only The DEKA ACE Pump System is not intended for anyone unable or unwilling to: - Test blood glucose (BG) levels as recommended by their healthcare provider. - Maintain sufficient diabetes selfcare skills. - See their healthcare provider regularly. - Demonstrate adequate carbohydrate-counting skills. The user must not: - Have difficulty seeing. - Have difficulty hearing. - Have deficient cognitive capabilities. - Have physical impairments which would make operating the pump or iPhone difficult. The DEKA ACE Pump System is intended for single-patient use and requires a prescription. The device is designed to use rapid-acting U-100 insulin. The DEKA ACE Pump System is compatible with the following U-100 insulins: Humalog. The system is Magnetic Resonance Unsafe. Disconnect the pump before entering an MRI scan room. Do not bring the iPhone or pump into an MRI scan room. Contact with, or being in proximity to, an MRI scanner can cause the pump and iPhone to move or lead to electric shocks and may result in severe injury. Do not expose the system to: X-ray, Computed Tomography (CT) scan, Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET) scan, Other exposure to radiation. Disconnect the pump and leave it outside the room prior to these procedures. Failure to do so may lead to harm. Do not expose the system to: Pacemaker/Automatic Implantable Cardioverter Defibrillator (AICD) placement or programming, Cardiac Catheterization, Nuclear Stress Test. Users must remove the systems and leave them outside the procedure room prior to these procedures. Failure to do so may lead to harm. K233952 - Page 2 of 6 {2} K233952 - Page 3 of 6 ## III Device/System Characteristics: ### A Device Description: The DEKA ACE Pump system is a modification of the previously cleared DEKA ACE Pump System. The DEKA ACE Pump System consists of the following components: - Pump: A durable pump embedded with the DEKA Loop, which incorporates fluid delivery algorithms and interfaces to a cassette, external wireless user interface, and iCGM. The pump is powered by a rechargeable lithium ion battery. - Cassette: A single-use pumping cassette that combines microfluidic valves, a pump chamber, insulin reservoir, and Acoustic Volume Sensing (AVS) measurement chamber. The cassette interfaces to a pump and off-the-shelf infusion sets. - User interface app: The DEKA ACE Pump is controlled by the DEKA Loop app, separately cleared under k234055. The DEKA Loop app is an Apple iOS-based Bring Your Own Device (BYOD) App available for user download in Apple's App store. The App is compatible with version 16 of iOS and communicates to the pump using secure BLE wireless communication. The DEKA Loop App is the primary user interface to operate the DEKA ACE Pump System. The DEKA ACE Pump system includes the following electronic interfaces: - Dexcom G6 iCGM: The DEKA ACE Pump System is compatible with the Dexcom G6 iCGM. The ACE Pump communicates with the iCGM transmitter at a regular interval to provide iCGM sensor data to the iAGC. - Halo Cloud: Halo Cloud is a digital platform that connects the DEKA ACE Pump system to a variety of cloud-related services. ## IV Substantial Equivalence Information: ### A Predicate Device Name(s): DEKA ACE Pump System ### B Predicate 510(k) Number(s): K213536 ### C Comparison with Predicate(s): | Device & Predicate Device(s): | K233952 | K213536 | | --- | --- | --- | | Device Trade Name | DEKA ACE Pump System | DEKA ACE Pump System | | General Device Characteristic Similarities | | | {3} | Intended Use/Indications For Use | The device is intended for the subcutaneous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin, ages six and above. The pump is able to reliably and securely communicate with compatible, digitally connected devices, including automated insulin dosing software, to receive, execute, and confirm commands from these devices. The pump is intended for single patient, home use and requires a prescription. The bolus calculator is indicated for use for aiding the user in determining the bolus insulin dosage for management of diabetes mellitus based on consumed carbohydrates, operator entered blood glucose, insulin sensitivity, insulin to carbohydrate ratio, target glucose values, and current insulin on board. | Same | | --- | --- | --- | | General Device Characteristic Differences | | | | Intended Use Population | Persons with Diabetes Mellitus ages 6 and above | Persons with Diabetes Mellitus ages 13 and above | V Standards/Guidance Documents Referenced: - Special controls established under 21 CFR 880.5730 for alternate controller enabled infusion pump - ISO 14971 Third Edition 2019-12, Medical devices - Application of risk management to medical devices - IEC 60601-1-8 Edition 2.2 2020-07 CONSOLIDATED VERSION, Medical electrical equipment - Part 1-8: General requirements for basic safety and essential performance - Collateral Standard: General requirements tests and guidance for alarm systems in medical electrical equipment and medical electrical systems - IEC 60601-1-6 Edition 3.2 2020-07 CONSOLIDATED VERSION, Medical electrical equipment - Part 1-6: General requirements for basic safety and essential performance - Collateral standard: Usability - IEC 60601-1-11 Edition 2.1 2020-07 CONSOLIDATED VERSION, Medical electrical equipment - Part 1-11: General requirements for basic safety and essential performance - Collateral Standard: Requirements for medical electrical equipment and medical electrical systems used in the home healthcare environment - IEC 60601-1-2 Edition 4.1 2020-09 CONSOLIDATED VERSION, Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral Standard: Electromagnetic disturbances - Requirements and tests K233952 - Page 4 of 6 {4} - IEC 62304 Edition 1.1 2015-06 CONSOLIDATED VERSION, Medical device software - Software life cycle processes - ISO 10993-1 Fifth edition 2018-08, Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process - IEC 60601-1 Edition 3.2 2020-08 CONSOLIDATED VERSION, Medical electrical equipment - Part 1: General requirements for basic safety and essential performance - ISO 11607-1 Second edition 2019-02, Packaging for terminally sterilized medical devices - Part 1: Requirements for materials, sterile barrier systems and packaging systems - ISO 11137-1 First edition 2006-04-15, Sterilization of health care products - Radiation - Part 1: Requirements for development, validation and routine control of a sterilization process for medical devices [Including: Amendment 1 (2013) and Amendment 2 (2018)] - IEC/TR 60601-4-2 Edition 1.0 2016-05, Medical electrical equipment - Part 4-2: Guidance and interpretation - Electromagnetic immunity: performance of medical electrical equipment and medical electrical systems - IEC 60601-1-10 Edition 1.2 2020-07 CONSOLIDATED VERSION, Medical electrical equipment - Part 1-10: General requirements for basic safety and essential performance - Collateral Standard: Requirements for the development of physiologic closed-loop controllers - AIM Standard 7351731 Rev. 3.00 2021-06-04, Medical Electrical Equipment and System Electromagnetic Immunity Test for Exposure to Radio Frequency Identification Readers - An AIM Standard - IEEE ANSI USEMCSC C63.27-2021, American National Standard for Evaluation of Wireless Coexistence ## VI Performance Characteristics (if/when applicable): ### A Other Supportive Instrument Performance Characteristics Data: #### 1. Risk analysis Risk management activities were reviewed, including identification of essential performance, relevant hazards, failure modes, causes, and risk controls to mitigate the identified failure modes and causes to those failure modes. Risk controls are denoted as requirements, which are verified in testing. The output of risk management activities includes a final risk summary report as well as traceability of hazards to associated risk controls and their verification in the final design. All risks are adequately controlled and all risk control measures have been validated in the final device. #### 2. Human Factors Additional human factors validation tests were conducted with the DEKA ACE Pump System. All study participants received training that was consistent with the training that patients would receive with the commercial product. Usability evaluations assessed comprehension and usability of the device for critical device tasks. Results of the study demonstrated that the DEKA ACE Pump System is validated for its intended use. K233952 - Page 5 of 6 {5} K233952 - Page 6 of 6 3. Electromagnetic Compatibility and Wireless Coexistence Additional electromagnetic compatibility, electromagnetic immunity and wireless coexistence testing was performed for the pump. All tests demonstrated that the device would perform as expected in the home healthcare environment. 4. Basic Safety and Essential Performance (Electrical Safety) The sponsor provided additional verification evidence for the DEKA ACE Pump App and Bring-Your-Own-Device updates in compliance with the IEC 60601-1 and applicable collateral standards. Verification results support the finding of substantial equivalent for this device. 5. Interoperability The plan and approach for interoperability with an iCGM remain unchanged from the predicate device. The device has an embedded iAGC algorithm in the Pump software, which eliminates the need for an additional secure digital connection. 6. Software and Cybersecurity Detailed Information on software and cybersecurity of the device was reviewed and found acceptable. VII Proposed Labeling: The labeling supports the finding of substantial equivalence for this device. VIII Conclusion: The submitted information in this premarket notification is complete and supports a substantial equivalence decision.
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