← Product Code [JKA](/submissions/CH/subpart-b%E2%80%94clinical-chemistry-test-systems/JKA) · K962931

# SIMS PRO-VENT 250 (500) PLUS ARTERIAL BLOOD SAMPLING KIT (K962931)

_Smiths Industries Medical Systems, Inc. · JKA · Oct 21, 1996 · Clinical Chemistry · SESE_

**Canonical URL:** https://fda.innolitics.com/submissions/CH/subpart-b%E2%80%94clinical-chemistry-test-systems/JKA/K962931

## Device Facts

- **Applicant:** Smiths Industries Medical Systems, Inc.
- **Product Code:** [JKA](/submissions/CH/subpart-b%E2%80%94clinical-chemistry-test-systems/JKA.md)
- **Decision Date:** Oct 21, 1996
- **Decision:** SESE
- **Submission Type:** Traditional
- **Regulation:** 21 CFR 862.1675
- **Device Class:** Class 2
- **Review Panel:** Clinical Chemistry
- **Attributes:** Pediatric

## Indications for Use

The SIMS Pro-Vent® 250 (500) Plus is intended for obtaining small volume samples of blood for the measurement of pH, pO2, pCO2, CO-oximetry, electrolytes (Ca++, Mg++, Na+, Cl-, K+) and the metabolites (Glucose and Lactate).

## Device Story

Device is a small volume arterial blood sampling kit; utilizes 25g needle attached to single cannula vented tube; collects 250μl or 500μl blood samples. Operates via arterial pressure to draw blood into the device. Contains Calcium Neutralized Dry Lithium Heparin (approx. 40 units/ml) to prevent coagulation. Used by clinicians in clinical settings to obtain samples for subsequent laboratory analysis of pH, pO2, pCO2, CO-oximetry, electrolytes, and metabolites. Facilitates diagnostic testing in pediatric, neonatal, and geriatric populations where small sample volumes are required.

## Clinical Evidence

Bench testing and side-by-side comparison with predicate device. Evaluated arterial blood samples for pO2, pCO2, pH, Ca++, Na+, K+, Cl-, and Glucose. Results showed no statistical difference between subject and predicate devices. CO-oximetry measurements showed no drift compared to baseline. Fill time and pressure performance were superior to the AVL Microsampler predicate.

## Technological Characteristics

Small volume sampling kit; 25g needle; single cannula vented tube; 250μl or 500μl capacity. Contains Calcium Neutralized Dry Lithium Heparin (approx. 40 units/ml). Operates via arterial pressure. Sterilization via established methods used in existing SIMS kits.

## Regulatory Identification

A blood specimen collection device is a device intended for medical purposes to collect and to handle blood specimens and to separate serum from nonserum (cellular) components prior to further testing. This generic type device may include blood collection tubes, vials, systems, serum separators, blood collection trays, or vacuum sample tubes.

## Predicate Devices

- SIMS Pro-Vent® Arterial Blood Sampling Kit with Calcium Neutralized Dry Lithium Heparin ([K952516](/device/K952516.md))
- AVL Scientific Corporation’s Microsampler Arterial Blood Gas Kit, 240μl and 500μl

## 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.
>
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SMITHS INDUSTRIES

Medical Systems

SIMS Inc.
15 Kit Street
Keene, NH 03431
Telephone: (603) 352-3812
Fax: (603) 352-3703

OCT 21 1996
K962931

# H: 510(K) SUMMARY OF SAFETY AND EFFECTIVENESS

## 510(K) SUMMARY

### COMPANY INFORMATION

Smiths Industries Medical Systems, Inc.
15 Kit Street
Keene, NH 03431
ph(603) 352-3812
FAX (603) 357-5038
Contact: Timothy J. Talcott
Manager, Regulatory Affairs

### PREPARATION DATE OF SUMMARY

July 26, 1996

### TRADE NAME

SIMS Pro-Vent® 250 (500) Plus

### COMMON NAME

Arterial Blood Sampling Kit

### CLASSIFICATION NAME

Class II, 75 GJE, 21 CFR 862.1675

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PREDICATE DEVICE

SIMS Pro-Vent® Arterial Blood Sampling Kit with Calcium Neutralized Dry Lithium Heparin.

AVL Scientific Corporation’s Microsampler Arterial Blood Gas Kit, 240μl and 500μl.

## DESCRIPTION

The SIMS Pro-Vent® 250 (500) Plus contains a precision small volume sampling device for obtaining an arterial blood sample. The device consists of a small gauge needle (25g) attached to a single cannula vented tube with a micro volume of 250μl or 500μl (.25 or .50cc). The SIMS Pro-Vent® 250 (500) Plus is ideal for obtaining blood samples from pediatric, neonatal and geriatric patients. Each device contains approximately 40 units of Calcium Neutralized Dry Lithium Heparin per ml. The 250μl device contains approximately 10 U.S.P. units of heparin and the 500μl device contains approximately 20 U.S.P. units of heparin.

## INDICATIONS FOR USE

The SIMS Pro-Vent® 250 (500) Plus is intended for obtaining small volume samples of blood for the measurement of pH, pO2, pCO2, CO-oximetry, electrolytes (Ca++, Mg++, Na+, Cl-, K+) and the metabolites (Glucose and Lactate).

## TECHNOLOGICAL CHARACTERISTICS

The proposed device has a calcium neutralized lithium heparin. Calcium Neutralized Dry Lithium Heparin is used in our Arterial Blood Gas Sampling Syringes, currently legally marketed (K952516). The proposed device draws a blood sample dependent on the arterial pressure in a similar manner as AVL Scientific Corporation’s Microsampler Arterial Blood Gas Kit, 240μl and 500μl. Sterilization is by the same methods employed in our existing Arterial Blood Gas Sampling Kit.

## SUMMARY OF PERFORMANCE DATA

The proposed device was compared to AVL Scientific Corporation’s Microsampler Arterial Blood Gas Kit, 240μl and 500μl, for fill time since both devices rely on arterial pressure for obtaining the sample. The results demonstrate that the proposed device fills under lower pressure and in less time than the predicate device.

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# SUMMARY OF NONCLINICAL AND CLINICAL TESTS

The proposed device was tested in a side-by-side comparison to the SIMS Pro-Vent® Arterial Blood Sampling Kit with Calcium Neutralized Dry Lithium Heparin. The testing consisted of the sampling of arterial blood and the subsequent measurement of pO2, pCO2, pH, Ca++, Na+, K+, Cl-, and Glucose. The results of the measurements were compared. There was no statistical difference between the proposed device and the predicate device. There was no drift in the measurement of CO-oximetry when compared to the baseline for the blood sampled.

# CONCLUSION OF NONCLINICAL AND CLINICAL TESTS

The testing performed and comparison to the predicate devices demonstrate that the proposed device is safe and effective and is substantially equivalent to the predicate devices.

# ADDITIONAL INFORMATION

None

Very truly yours,

Smiths Industries Medical Systems, Inc.
dba Concord/Portex

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

Timothy J. Talcott
Manager, Regulatory Affairs

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**Source:** [https://fda.innolitics.com/submissions/CH/subpart-b%E2%80%94clinical-chemistry-test-systems/JKA/K962931](https://fda.innolitics.com/submissions/CH/subpart-b%E2%80%94clinical-chemistry-test-systems/JKA/K962931)

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