PERCUPUMP II WITH EDA

K974621 · E-Z-Em, Inc. · DSB · Jan 27, 1998 · Cardiovascular

Device Facts

• Record ID: K974621
• Device Name: PERCUPUMP II WITH EDA
• Applicant: E-Z-Em, Inc.
• Product Code: DSB · Cardiovascular
• Decision Date: Jan 27, 1998
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 870.2770
• Device Class: Class 2

Intended Use

The device is indicated for the administration of ionic and nonionic compounds in conjunction with computed tomography scanning of the body. The extravasation detecting electrode patch element of the device is indicated for contact with intact skin and single use only.

Device Story

PercuPump II is an infusion pump system designed for delivery of ionic and nonionic contrast media during CT imaging. System includes an Extravasation Detection Accessory (EDA) utilizing an electrode patch. Patch adheres to patient skin at injection site; monitors for fluid leakage (extravasation) into subcutaneous tissue. If extravasation occurs, EDA detects impedance changes; triggers alarm to alert clinician. Used in radiology/CT suites; operated by trained medical personnel. Provides automated monitoring during contrast injection; enhances patient safety by enabling rapid intervention if extravasation occurs, reducing risk of tissue damage.

Clinical Evidence

No clinical data provided. Substantial equivalence based on bench testing and design verification.

Technological Characteristics

Infusion pump system for contrast media. Includes electrode patch for extravasation detection. Sensing principle: impedance-based detection of fluid leakage. Single-use patch component. System designed for clinical CT environment integration.

Indications for Use

Indicated for patients undergoing computed tomography (CT) scanning requiring administration of ionic or nonionic contrast media. Extravasation detection patch is for single-use on intact skin.

Regulatory Classification

Identification

An impedance plethysmograph is a device used to estimate peripheral blood flow by measuring electrical impedance changes in a region of the body such as the arms and legs.

Special Controls

*Classification.* Class II (special controls). The device, when it is a body composition analyzer which is not intended to diagnose or treat any medical condition, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 870.9.

Submission Summary (Full Text)

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Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

## JAN 27 1998

Peter C. Aprile, R.Ph. Manager, Regulatory Affairs E-Z-EM, Inc. 717 Main St. Westbury, NY 11590

Re:

K974621 PercuPump II with EDA (Extravasation Detection Accessory) Dated: December 9, 1997 Received: December 11, 1997 Regulatory class: II 21 CFR 870.2770/Procode: 74 DSB

Dear Mr. Aprile:

: 11

We have reviewed your Section 5100k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent for the indications for use stated in the enclosure) to 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). You may, therefore, 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.

If your device is classified (see above) into either class II (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations. Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (OS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic OS inspections the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at [phone]. Additionally, for question and advertising of your device, please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

h.J.Liau Yu

Lillian Yin, Ph.D. Director, Division of Reproductive, Abdominal, Ear, Nose and Throat, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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510(k) Number (if known): K974621

PercuPump II (with extravasation detection accessory) Device Name:

Indications For Use:

The device is indicated for the administration of ionic and nonionic compounds in conjunction with computed tomography scanning of the body.

The extravasation detecting electrode patch element of the device is indicated for contact with intact skin and single use only.

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Concurrence of CDRH, Office of Device Evaluation (ODE)

Vernit C. Seymore

(Division Sign-Off) Division of Reproductive, Abdominal, ENT,

Prescription Use (Per 21 CFR 801.109)

OR

Over-The-Counter Use

(Optional Format 1-2-96)