STERRAD CYCLESURE BIOLOGICAL INDICATOR
Device Facts
| Record ID | K994055 |
|---|---|
| Device Name | STERRAD CYCLESURE BIOLOGICAL INDICATOR |
| Applicant | Advanced Sterilization Products |
| Product Code | FRC · General Hospital |
| Decision Date | Feb 13, 2002 |
| Decision | SESE |
| Submission Type | Traditional |
| Regulation | 21 CFR 880.2800 |
| Device Class | Class 2 |
Indications for Use
The STERRAD® CycleSure™ Biological Indicator is intended to be used as a standard method for frequent monitoring of the STERRAD® Sterilizer cycles.
Device Story
STERRAD® CycleSure™ Biological Indicator is a self-contained biological monitor for STERRAD® sterilization processes. Device consists of a plastic vial containing a glass fiber disc with >10^6 Bacillus stearothermophilus spores and a glass ampule of nutrient growth medium; a cap with diffusion-restricting openings allows hydrogen peroxide vapor entry. After sterilization, user presses cap to seal vial, crushes ampule to release medium, and incubates at 55°C–60°C for 48 hours. Growth is indicated by a color change from purple to yellow. A chemical indicator on the cap changes from red to yellow upon exposure to hydrogen peroxide, providing immediate throughput verification. Used in clinical settings to confirm sterilization cycle efficacy; provides healthcare providers with objective evidence of spore inactivation, ensuring medical instruments are safe for reuse.
Clinical Evidence
Bench testing only. Performance validated using BIER vessels per ISO 11138-1. Incubation time determined to be 48 hours per CDRH 1986 guidance. Bacteriostasis testing in STERRAD 100 and 50 systems confirmed no inhibitory effects. Chemical indicator stability validated for 24 months (unprocessed) and 7 months (processed). Growth media performance validated for growth promotion and color stability.
Technological Characteristics
Self-contained biological indicator; glass fiber disc with >10^6 Bacillus stearothermophilus spores; nutrient growth medium in glass ampule; plastic vial with diffusion-restricted cap; chemical indicator (red-to-yellow) on cap. Incubation: 55°C–60°C. Shelf-life: 18 months. No electronic components or software.
Indications for Use
Indicated for routine monitoring of STERRAD® Sterilizer cycles. Intended for use as a standard method for frequent monitoring of sterilization efficacy.
Regulatory Classification
Identification
Biological sterilization process indicator: A device intended for use by a health care provider to accompany products being sterilized through a sterilization procedure and to monitor adequacy of sterilization. The device consists of a known number of microorganisms, of known resistance to the mode of sterilization, in or on a carrier and enclosed in a protective package. Subsequent growth or failure of the microorganisms to grow under suitable conditions indicates the adequacy of sterilization. Physical/chemical sterilization process indicator: A device intended for use by a health care provider to accompany products being sterilized through a sterilization procedure and to monitor one or more parameters of the sterilization process. The adequacy of the sterilization conditions as measured by these parameters is indicated by a visible change in the device.
Predicate Devices
- 3M™ Attest™ Biological Indicator
- STERRAD® BI Test Pack
Submission Summary (Full Text)
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K 994055
#### ADVANCED STERILIZATION PRODUCTS® a Johnnon Johnson company REGULATORY AFFAIRS DEPARTMENT
FEB 1 3 2002
# 510(k) Summary
### Applicant's Name, Address, Telephone, FAX, Contact Person
Advanced Sterilization Products Division of Ethicon, Inc. 33 Technology Drive Irvine, CA 92618
#### Contact Person
Kevin Corrigan, R.A.C. Director of Regulatory Affairs Tel: (949) 453-6410 Fax: (949) 789-3900
### Submission Date
February 6, 2002
#### Trade Name
STERRAD® CycleSure™ Biological Indicator
#### Common Name
Biological Indicator
# Classification Name
Class II
#### Legally Marketed Equivalent Device Name(s)
3MTM Attest™ Biological Indicator STERRAD® BI Test Pack
DIVISION OF ETHICON, INC. • 33 TECHNOLOGY DRIVE • IRVINE, CA 92618 • (949) 581-5799 • FAX (949) 789-3900
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### Description of Device
The STERRAD® CycleSure™ Biological Indicator is a self-contained stand-alone biological monitor intended for the routine monitoring of the STERRAD® Sterilization Process. It consists of a glass fiber disc containing a minimum of 106 Bacillus stearothermophilus spores placed inside a plastic vial, a glass ampule containing nutrient growth medium also inside the vial, a cap and liner closing the vial and a chemical indicator on top of the cap. The cap contains two small circular openings that allow for diffusion of hydrogen peroxide vapor into the vial. The relatively small size of the circular openings serves as a restriction to this diffusion.
After exposure to the sterilization process, the cap is pressed down until firmly seated against the top of the vial in order to seal the vial is then placed into the supplied tube crusher and squeezed until the media ampule is crushed. The entire device is then placed into an incubator and incubated in an upright position at 55° C to 60° C. After incubation, the medium in the vial is observed for a change in color from purple (indicating no growth) to yellow (indicating growth).
The STERRAD® CycleSure™ Chemical Indicator (on the cap) serves as a chemical process indicator (throughput indicator) [Class A per EN867-1] for the STERRAD® Sterilizer cycle. Exposure of the chemical indicator to the STERRAD® Sterilizer cycle results in a recognizable color change from red to yellow.
#### Statement of Intended Use
The STERRAD® CycleSure™ Biological Indicator is intended to be used as a standard method for frequent monitoring of the STERRAD® Sterilizer cycles.
### Summary of Nonclinical Tests
#### Chemical Indicator Validation
Effects of a simulated heavy load, no load, presence of plasma, and absence of hydrogen peroxide on the performance of the chemical indicator component of the STERRAD® CycleSure™ Biological Indicator were evaluated by observing the color of the chemical indicators before and after processing in the STERRAD® Sterilization System.
The results of these performance studies indicate that the chemical indicator component of the STERRAD® CycleSure™ Biological Indicator successfully changes color from red to yellow when processed in the STERRAD® 100 Sterilization System under maximum and minimum exposure to hydrogen peroxide.
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Additionally, the chemical indicator did not change color when water was substituted for hydrogen peroxide in the injection phase of the cycle. This demonstrates that the color change of the chemical indicator is due to the chemical reaction between the dye and hydrogen peroxide molecules during the diffusion phase and not due to the plasma phase of the STERRAD® 100 Sterilization Process.
#### Chemical Indicator Stability Validation
Color stability of the chemical indicator component of the STERRAD® CycleSure™ Color stabling of has evaluated before and after processing in the STERRAD® Sterilization System. The results of stability studies indicate that the unprocessed chemical indicators maintain their red color for at least 24 months when stored at the storage temperatures specified in the product labeling (15°C to 25°C).
Post-processing color stability of the chemical indicator was also evaluated after processing in the STERRAD® Sterilization System. Stability results, based upon real time aging, demonstrate that the indicator color is stable for at least 7 months after processing in a STERRAD® Sterilizer.
In addition to the stability studies, functionality studies were conducted to evaluate the ability of the chemical indicator, following aging at 30°C/75% R.H., to change color when processed in the STERRAD® Sterilization Systems. Chemical indicators from three different lots, aged up to 24 months, successfully changed color from red to yellow upon processing.
# Population and Performance Characteristics Determination
The spore population and performance characteristics of the STERRAD® CycleSure™ Biological Indicators were determined using a Biological Indicator Evaluation Resistometer (BIER Vessel) following the in accordance with ISO 11138-1.
#### Incubation Time Determination
Testing was conducted using CDRH Guidance Document Guide For Validation Of Biological Indicator Incubation Time (1986). Three different lots of STERRAD® CycleSure™ Biological Indicator (each using a different spore crop and media lot), each consisting of one hundred samples, were tested to determine the required incubation time. The sterilization cycle parameters were reduced in order to obtain 30-80% surviving samples for each lot tested. Processed STERRAD® CycleSure™ Biological Indicators were incubated for 7 days at 55-60° C. Samples were observed and the results were recorded on a daily basis. Based on the results from this testing, the minimum incubation time required for the STERRAD® CycleSure™ Biological Indicator was determined to be 48 hours.
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#### Bacteriostasis
Bacteriostasis testing was performed in the STERRAD® 100 Sterilizer to represent the minimum hydrogen peroxide exposure conditions (6 mg/L injected) and in the STERRAD® 50 Sterilizer to represent the maximum hydrogen peroxide exposure conditions (two injections at 14.3 mg/L injected).
#### STERRAD® 100 Sterilizer
Twenty STERRAD® CycleSure™ Biological Indicator samples were prepared with uninoculated glass fiber discs. Ten samples were processed in the STERRAD®100 Sterilization System as test samples and ten were unprocessed as negative controls. Ten additional STERRAD® CycleSure™ Biological Indicator samples were prepared without the glass fiber discs for positive controls, this sample set also remained unprocessed. All samples were inoculated with <10 Bacillus stearothermophilus spores/10uL. Growth of the test organism was observed in all samples when incubated at 55°-60°C. No bacteriostatic effects due to the materials of the STERRAD® CycleSure™ Biological Indicator and the STERRAD® 100 Sterilization process were observed.
#### STERRAD® 50 Sterilizer
Twenty STERRAD® CycleSure™ Biological Indicator samples were prepared with uninoculated glass fiber discs. Ten samples were processed in the STERRAD®50 Sterilization System as test samples and ten were unprocessed as negative controls. Ten additional STERRAD® CycleSure™ Biological Indicator samples were prepared without the glass fiber discs for positive controls, this sample set also remained unprocessed. All samples were inoculated with <10 Bacillus stearothermophilus spores/10uL. Growth of the test organism was observed in all samples when incubated at 55° - 60°C. No bacteriostatic effects due to the materials of the STERRAD® CycleSure™ Biological Indicator and the STERRAD® 50 Sterilization process were observed.
#### Growth Media Validation
The growth media was tested for color reversion after growth and it was determined that the yellow color was stable for up to 7 days of total incubation.
Studies were conducted to confirm the performance and quality characteristics of the growth medium and to evaluate the suitability of the media for use in the STERRAD® CycleSure™ Biological Indicator. The performance characteristics of the media to be evaluated include: growth promotion and bacteriostasis of the pH indicator. The quality characteristics of the media to be evaluated include: pH, color, appearance, and stability.
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Media lots were prepared and aged at room temperature (20-25° C). ASP currently has data for 12 months real-time aging and the testing is ongoing.
The aged media was shown to promote growth, was not bacteriostatic and the evaluated quality characteristics met specification.
Additional studies, conducted on media ampuls stored at at 55° C accelerated aging conditions, were conducted to determine the performance and quality characteristics of the growth media and to evaluate the end of shelf-life suitability of the media for use in the STERRAD® CycleSure™ Biological Indicator. The performance characteristics of the media to be evaluated include: growth promotion and bacteriostasis of the pH indicator. The quality characteristics of the media to be evaluated include: pH, color, appearance, and stability. Media lots were prepared and aged at elevated temperature (55° C). ASP has data for 36 months shelf-life based on these accelerated aging studies.
The accelerated aged media was shown to promote growth, was not bacteriostatic and the evaluated quality characteristics met specification.
#### Performance Validation
The STERRAD® CycleSure™ Biological Indicator samples made with three different spore crops were used to evaluate the effect of varying concentrations of hydrogen peroxide on the STERRAD® CycleSure™ Biological Indicator performance at half cycle conditions in the STERRAD®100, 100S, and 50 Sterilizers.
The results indicated that the inactivation of the STERRAD® CycleSure™ Biological Indicator was consistently obtained after processing through a half cycle with a reduced injection volume of 59% nominal hydrogen peroxide in each of the STERRAD® Sterilizers. All the chemical indicators from STERRAD® CycleSure™ Biological Indicator changed color from red to yellow, indicating exposure to hydrogen peroxide.
#### STERRAD® CycleSure™ Biological Indicator Shelf-Life (Stability) Validation
An ongoing product stability testing program is currently underway. Three different manufacturing lots of STERRAD® CycleSure™ Biological Indicators (each made with a different spore crop, a different growth media lot and a different chemical indicator lot) were used. A portion of each lot was placed into the following storage conditions:
- 1 group from each lot at 2°C (+/- 2° C) refrigerated. .
- 1 group from each lot at 25°C/50%RH (+/-3° C & +/-5%RH) .
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Samples from each storage condition are periodically removed from storage and tested for spore population, D-value (fraction negative method), and chemical indicator functionality. Testing will continue up to 24 months.
ASP currently has completed testing for up to 4 months. All lots have shown to be within specifications for the labeled storage conditions (2° C - 25° C) when tested through 18 months of storage. These data demonstrate that the STERRAD® CycleSure™ Biological Indicator is stable for a shelf-life of up to 18 months. ASP will continue to collect data as part of ongoing stability studies and may extend the labeled shelf-life of the product based upon the same acceptance criteria used here.
# Overall Performance Conclusions
The nonclinical studies demonstrate that the STERRAD® CycleSure™ Biological Indicator is safe and effective for the routine monitoring of the STERRAD® Sterilization Systems and establish equivalence to the predicate device.
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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
FEB 1 3 2002
Mr. Kevin Corrigan Director of Regulatory Affairs Advanced Sterilization Products 33 Technology Drive Irvine, California 92618
Re: K994055
Trade/Device Name: STERRAD® CycleSure™ Biological Indicator Regulation Number: 880.2800 Regulation Name: Biological Indicator Regulatory Class: II Product Code: FRC Dated: December 20, 2001 Received: December 21, 2001
Dear Mr. Corrigan:
We have reviewed your Section 510(k) premarket notification of intent to market the device We have reviewed your booker or economined 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 Interstate conmisive prior to that have been reclassified in accordance with the provisions of Amendinens, of to devices that inst o Act (Act) that do not require approval of a premarket the rederal Pood, Drug, and Comment , therefore, market the device, subject to the general approvisions of the Act. The general controls provisions of the Act include controls provisions of the Feat - Feb - Feb Janual manufacturing practice, labeling, and prohibitions against misbranding and adulteration.
If your device is classified (see above) into either class II (Special Controls) or class III IT your device is classinod (So are additional controls. Existing major regulations affecting (1 MF), it may of back of Federal Regulations, Title 21, Parts 800 to 898. In your device ear of round the rannouncements 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 moan that I DA nas made a statutes and regulations administered by other Federal agencies.
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Page 2 - Mr. Corrigan
You must comply with all the Act's requirements, including, but not limited to: registration r ou inust comply war a807); labeling (21 CFR Part 801); good manufacturing practice and insting (21 CF read 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.
This letter will allow you to begin marketing your device as described in your Section 11ths teller will and w you've cogne FDA finding of substantial equivalence of your device to 9 rotty promanted 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 If you desire specific as now as a rear 809.10 for in vitro diagnostic devices), please contact the and additionally 21 OF N 7 an 1 694-4618. Additionally, for questions on the promotion and Office of Compania of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html
Sincerely yours,
Timothy A. Ulatowski Director Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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AS
ADVANCED STERILIZATION PRODUCTS® a Johnson Johnson company REGULATORY AFFAIRS DEPARTMENT
# Indications for Use
K994055 510(k) Number:
STERRAD® CycleSure™ Biological Indicator Device Name
Indications For Use:
The STERRAD® CycleSure™ Biological Indicator is intended to be used as a standard
e and the states that the considered to articles eveles The STERRAD "CycleSure" "Diological martines in and of the Sterilizer cycles.
method for frequent monitoring of the STERRAD® Sterilizer cycles.
Concurrence of CDRH, Office of Device Evaluation (ODE)
Prescription Use _____________________________________________________________________________________________________________________________________________________________
OR
Over-the-Counter Use √
(Optional Format 1-2-96)
Division Sign Off
Tivision Sign-Off Consion of Dental, Infection Contro · Ceneral Hospital Devices ്:: Number __
