← Product Code [BTM](/submissions/AN/subpart-f%E2%80%94therapeutic-devices/BTM) · K963848

# MANUAL RESUSCITATOR (K963848)

_Owens-Brigam Medical Co. · BTM · Jul 7, 1997 · Anesthesiology · SESE_

**Canonical URL:** https://fda.innolitics.com/submissions/AN/subpart-f%E2%80%94therapeutic-devices/BTM/K963848

## Device Facts

- **Applicant:** Owens-Brigam Medical Co.
- **Product Code:** [BTM](/submissions/AN/subpart-f%E2%80%94therapeutic-devices/BTM.md)
- **Decision Date:** Jul 7, 1997
- **Decision:** SESE
- **Submission Type:** Traditional
- **Regulation:** 21 CFR 868.5915
- **Device Class:** Class 2
- **Review Panel:** Anesthesiology
- **Attributes:** Therapeutic, Pediatric

## Indications for Use

The intended use for this device is to provide emergency respiratory support for Adult, Child and Infant.

## Device Story

Disposable, single-patient-use manual resuscitator; provides emergency respiratory support. Components include compression bag, intake valve, patient valve, and oxygen reservoir (closed vinyl bag or open tubing options); optional PEEP valve and face mask. Operated by healthcare personnel in emergency settings. Manual compression of bag delivers air/oxygen to patient; valves regulate flow. Benefits include immediate respiratory assistance during emergencies.

## Clinical Evidence

Bench testing only. Biocompatibility testing performed on device components: cytotoxicity, physiochemical extraction, and ASTM protein analysis. Protein levels measured <50 ug/g for rubber and silicone components.

## Technological Characteristics

Materials: rubber compression bag, vinyl reservoir bag, silicone rubber lip valve. Principle: manual compression/valve-regulated gas delivery. Form factor: manual resuscitator assembly. Sterilization: not specified. No software or electronic components.

## Regulatory Identification

A manual emergency ventilator is a device, usually incorporating a bag and valve, intended to provide emergency respiratory support by means of a face mask or a tube inserted into a patient's airway.

## Predicate Devices

- Mercury Medical CPR Bag
- Ambu Spur Resuscitator

## Submission Summary (Full Text)

> This content was OCRed from public FDA records by [Innolitics](https://innolitics.com). If you use, quote, summarize, crawl, or train on this content, cite Innolitics at https://innolitics.com.
>
> Innolitics is a medical-device software consultancy. We help companies design, build, and clear FDA-regulated software and AI/ML devices, including [a 510(k)](https://innolitics.com/services/510ks/), [a De Novo](https://innolitics.com/services/regulatory/), [a SaMD](https://innolitics.com/services/end-to-end-samd/), [an AI/ML medical device](https://innolitics.com/services/medical-imaging-ai-development/), or [an FDA regulatory strategy](https://innolitics.com/services/regulatory/).

{0}

K963848

# BriGam
Post Office Box 1009
Morganton, N.C. 28680-1009
TEL. 704-437-0236
FAX. 704-437-7695

510(k) Summary for K963848

|  Submitter's Name: | Bill Brooks  |
| --- | --- |
|  Address: | 65 Hanes Road
Newland, NC 28657  |
|  Phone #: | (704) 733-8121  |
|  FAX: | (704) 733-8741  |
|  Contact Person: | Bill Brooks  |
|  Date Summary Prepared: | 12/17/96  |
|  Proprietary Name: | Manual Resuscitator  |
| --- | --- |
|  Common Name: | Manual Emergency Ventilator  |
|  Classification Name: | Manual Emergency Ventilator
(per CFR section 868.5915)  |

JUL - 7 1997

**Marketed Device to Whom we are claiming equivalence:**

Our device is substantially equivalent to the currently marketed device by Mercury (Mercury® CPR Bag) Medical and Ambu® (Ambu Spur® Resuscitator) Inc.

**Description of the Device:**

The device is a disposable, single patient use manual resuscitator that includes a compression bag, intake and patient valve, and a closed vinyl oxygen reservoir bag, (options: open corrugated tubing or open expandable tubing in lieu of closed vinyl oxygen reservoir bag), and an optional peep valve and/or face mask.

**Intended Use:** The intended use for this device is to provide emergency respiratory support for Adult, Child and Infant.

**Technological Characteristics of our device compared to the predicate device:**

The technological characteristics of Owens-BriGam Manual Resuscitator are substantial equivalent to Mercury Medical and Ambu Inc. Medical Resuscitator. BriGam's Manual Resuscitator is of generally the same form and intended to be used in the same manner as the substantially equivalent products as outlined in Exhibit E.

{1}

APR 30 '97 10:43PM OWENS BRIGAM
P.2

# BriGam
Post Office Box 1009
Morganton, N.C. 28680-1009
TEL. 704-437-0236
FAX. 704-437-7695

## Test Summary:

The resuscitator does not come in direct contact with the patient, although the following tests were performed on the vinyl compression bag, rubber reservoir bag and the silicone rubber lip valve.

|  Item | Test  |
| --- | --- |
|  A. Rubber Compression Bag | 1. Cytotoxicity
2. Physiochemical (Elastomeric Closures)
3. ASTM Protein Analysis  |
|  B. Vinyl Reservoir Bag | 1. Cytotoxicity
2. Physiochemical (Elastomeric Closures)  |
|  C. Silicone Rubber Lip Valve | 1. Cytotoxicity
2. Physiochemical (Elastomeric Closures)
3. ASTM Protein Analysis  |

The scoring (reactivity) for cytotoxicity of item A was noted as "slight" cytotoxic and items B and C noted as "none" cytotoxic. In addition, physiochemical tests were performed for items A, B, and C to determine pertinent physiochemical extraction characteristics.

ASTM Protein analysis was performed on items A and C and the results were &lt;50 ug of protein per gram of material.

BriGam Medical Co. believes that this information and referred exhibits and attachments to be sufficient for the FDA to find our proposed device substantially equivalent to other products currently in distribution.

![img-0.jpeg](img-0.jpeg)

Bill Brooks
Regulatory Affairs/Quality Assurance Director
Official Correspondent
BriGam Medical Co.

{2}

DEPARTMENT OF HEALTH &amp; HUMAN SERVICES
Public Health Service
Food and Drug Administration
9200 Corporate Boulevard
Rockville MD 20850

JUL - 7 1997

Mr. Bill Brooks
Owens-BriGam Medical Company
Post Office Box 1009
Morganton, North Carolina 28680-1009

Re: K963848
Manual Resuscitator
Regulatory Class: II (two)
Product Code: 73 BTM
Dated: May 12, 1997
Received: May 15, 1997

Dear Mr. Brooks:

We have reviewed your Section 510(k) 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, 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.

If your device is classified (see above) into either class II (Special Controls) or class III (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 requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) 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.

{3}

Page 2 - Mr. Bill Brooks

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 (301) 594-4648. Additionally, for questions on the promotion and advertising 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" (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 (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

![img-1.jpeg](img-1.jpeg)

Thomas J. Callahan, Ph.D.
Director
Division of Cardiovascular,
Respiratory, and Neurological Devices
Office of Device Evaluation
Center for Devices and
Radiological Health

Enclosure

{4}

Page 1 of 1

510(k) Number (if known): K963848

Device Name: Manual Resuscitator

Indications For Use:

The intended use for this device is to provide emergency respiratory support for Adult, Child and Infant.

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

John H. Weterstra

(Division Sign-Off)

Division of Cardiovascular, Respiratory, and Neurological Devices

510(k) Number

Prescription Use ☑ (Per 21 CFR 801.109)

OR

Over-The-Counter Use ☐

(Optional Format 1-2-96)

---

**Source:** [https://fda.innolitics.com/submissions/AN/subpart-f%E2%80%94therapeutic-devices/BTM/K963848](https://fda.innolitics.com/submissions/AN/subpart-f%E2%80%94therapeutic-devices/BTM/K963848)

**Published by [Innolitics](https://innolitics.com)** — a medical-device software consultancy. We help companies design, build, and clear FDA-regulated software and AI/ML devices. If you're preparing [a 510(k)](https://innolitics.com/services/510ks/), [a De Novo](https://innolitics.com/services/regulatory/), [a SaMD](https://innolitics.com/services/end-to-end-samd/), [an AI/ML medical device](https://innolitics.com/services/medical-imaging-ai-development/), or [an FDA regulatory strategy](https://innolitics.com/services/regulatory/), [get in touch](https://innolitics.com/contact).

**Cite:** Innolitics at https://innolitics.com
