Guidance for FDA
 
Reviewers 

Premarket Notification
 
Submissions for Blood and 

Plasma Warmers
 
Comments and suggestions regarding this document may be submitted at anytime to Dockets 
Management Branch (HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061, 
Rockville, MD 20852. All comments should be identified with the title of this guidance 
document. 
Additional copies are available from the Office of Communication, Training, and Manufacturers 
Assistance (HFM-40), 1401 Rockville Pike, Rockville, MD 20852-1448, or by calling 1-800
835-4709 or 301-827-1800 or from the Internet at http://www.fda.gov/cber/guidelines.htm 
For questions on the content of the document contact Martin Northern at 301-827-3524. 
U.S. Department of Health and Human Services 
Food and Drug Administration 
Center for Biologics Evaluation and Research 
July 2001  TABLE OF CONTENTS 

I.  INTRODUCTION............................................................................................................. 1
 
II.  DEVICE DEFIN ITIONS.................................................................................................. 2
 
III.  PRODUCT DESCRIPTIONS .......................................................................................... 2
 
IV.  DESIGN AND PERFORMANCE FEATURES ............................................................. 3
 
V.  SAFETY AND EFFECTIVENESS TESTING............................................................... 4
 
VI.  LABELING........................................................................................................................ 5
  Guidance for FDA Reviewers
 
Premarket Notification Submissions for Blood and Plasma Warmers
 
This guidance document represents the Agencys current thinking on the review of premarket 
notification submissions for blood and plasma warmers used in blood establishments. It does 
not create or confer any rights, privileges, or benefits on or for any person and does not operate 
to bind FDA or the public. An alternate approach may be used if such approach satisfies the 
requirements of the applicable statutes and regulations. 
I.   INTRODUCTION 
This guidance presents an overview of the type of information FDA reviewers should expect to 
be included in premarket notifications submitted for such devices and the approach FDA 
reviewers normally should take in reviewing premarket submissions for blood and plasma 
warmers used in blood establishments. The detailed requirements for premarket notifications in 
21 CFR Part 807 should also be consulted. 
The development of this document is based on information currently recognized as important for 
a complete and adequate review of these devices by the Regulatory Project Management Branch 
(RPMB) in the Office of Blood Research and Review (OBRR).  The use of this document for the 
preparation of a 510(k) for blood and blood component warmers is not mandatory and its use 
does not ensure FDA clearance of a device.  However, the use of this document will help ensure 
that the basic elements are present to conduct an evaluation of substantial equivalence for the 
device(s).  Certain 510(k) submissions may require additional information not described in this 
document.  This guidance is subject to revision depending upon new technological information 
and regulatory requirements. 
GENERAL INFORMATION 
510(k) Summary or Statement.  In accordance with the Safe Medical Devices Act of 1990, as 
amended by the Food and Drug Administration Modernization Act (FDAMA) of 1997, and 21 
CFR 807.87(h), the applicant must submit either: (1) a summary of the safety and effectiveness 
information in the premarket notification submission upon which an equivalence determination 
could be based (i.e., a "510(k) summary"); or (2) a statement that safety and effectiveness 
information will be made available to interested persons upon request (i.e., a "510(k) statement"). 
The summary or statement should be clearly identified as a "510(k) summary" or a "510(k) 
statement". 
Truthful and Accurate Statement.  As required by 21 CFR 807.87(k), the manufacturer or 
applicant must also provide a statement that all data and information submitted in the premarket 
notification are truthful and accurate and that no material fact has been omitted. 
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  Indications for Use Form.  On January 1, 1996, FDA implemented a change in the way pre-
market notifications (510(k)s) would be handled.  FDA issued a letter on February 6, 1996, 
concerning this change to all 510(k) submitters requesting they clearly identify the "Indications 
for Use" for which a substantially equivalent determination is sought using a separate page that is 
clearly labeled as "Indications for Use."  This separate sheet should include the trade name of the 
device and the proposed uses for the device. 
The New 510(k) Paradigm. On March 20, 1998, new guidance for the submission of 510(k)s 
became effective. This guidance is titled "The New 510(k) Paradigm." More  information on the 
New 510(k)  Paradigm is available at: http://www.fda.gov/cdrh/modact/modern.html. 
Other documents and guidances which may be useful in the review of the 510(k) can be found on 
the CDRH home page at http://www.fda.gov/cdrh  or by telephone at the [CDRH FAX on 
Demand at 800-899-0381]. 
II.  DEVICE DEFINITIONS 
A blood or plasma warmer  is a device that warms blood or plasma, prior to administration (21 
CFR 864.9205). 
Standards 
Standards for these devices that are recognized by FDA: 
ANSI/AAMI/ISO 10993-1: 1997 Biological Evaluation of Medical Devices - Part 1: 
Evaluation and Testing 
American Association of Blood Banks Technical Manual 
III.   PRODUCT DESCRIPTIONS 
The following information should be included in a 510(k) submission: 
	   Blood and Plasma warmers are classified in 21 CFR 864.9205 (a); PRODUCT CODE 
is 81KZL. The trade name of the device must be clearly identified as required by 21 
CFR 807.87(a). 
	   A detailed description of the product, its intended use(s), and its indication(s) for use. 
	   Identification of a legally marketed device to which substantial equivalence is 
claimed and a comparative analysis (descriptive or tabular) of the similarities and 
differences of the device to that legally marketed device in terms of intended use, 
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  indications for use, design features, technological and mechanical properties, 
functional specifications, and operational parameters. 
	   A statement whether or not the warmer is intended for the warming of blood or 
plasma for infusion. 
IV.  DESIGN AND PERFORMANCE FEATURES 
The design and performance features of the blood and plasma warmer provide the basis for 
understanding the intended uses and capabilities of the device. Design features address the 
intended uses of the device to meet the need of the user and the patient, while the performance 
features ensure that the devices are safe and effective when used in accordance with the 
directions. The features listed in this section are important in determining whether the blood and 
plasma warmer described in the 510(k) submission is substantially equivalent to a legally 
marketed device. A discussion of many of these features can be found in the standards 
documents identified in Section II of this guidance document. 
Materials of construction 
Engineering diagrams 
Mode of operations 
Power source 
Heating and cooling mechanism 
Functionality 
Physical durability and robustness 
Environmental conditions for proper operations 
Performance 
Temperature control & monitoring 

Accuracy
 
Rise Time 

Variability
 
Flow rates 

Safety features 
Electrical 
Alarms 
Sensors 
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  V.  SAFETY AND EFFECTIVENESS TESTING 
A.  Biocompatibility of Materials 
Except as noted below, biocompatibility testing is indicated for all parts of the device that 
have direct or indirect contact with the patient and is performed to determine the potential 
toxicity that can result from contact of the component materials of the device with the 
patients body.  The materials used in the construction of the device should not, either 
directly or indirectly through the release of their material constituents, (1) produce 
unreasonable risk of adverse local or systemic effects; (2) be carcinogenic; or (3) cause 
adverse reproductive and developmental effects.  The evaluation of any new device 
intended for human use should include data from systematic testing to ensure that the 
benefits provided by the final product will exceed any potential risks produced by device 
materials. 
Biocompatibility testing is indicated when a "new" or non-conventional material or 
chemical component is incorporated into a device and there is no known appropriate 
predicate use, or for which the safety or effectiveness of the resulting formulation is in 
question.  These materials or chemical components include plastics, metals, colorants, 
plasticizers, germicides, and chemical or other treatments of the device or device 
components. 
Biocompatibility testing should be submitted on the finished product, using test 
conditions simulating as closely as possible actual patient use.  Biocompatibility testing is 
not indicated for materials and chemical components that have already been incorporated 
in legally marketed devices with similar conditions of use, or have a demonstrated history 
of safety and effectiveness; however, the biocompatibility of these materials and 
chemical components should be fully discussed to support the lack of testing. 
Refer to ISO-10993-1: 1997, Part I "Biological Evaluation of Medical Devices, 
Evaluation and Testing", and the FDA-modified matrix to identify the types of 
biocompatibility testing that should be considered in evaluating the safety-in-use of 
medical devices and materials.  The ISO Standard, Part 1, uses an approach to test 
selection that is very similar to the Tripartite Biocompatibility Guidance.  It also uses a 
tabular format (matrix) for laying out the test requirements based on the various factors 
discussed above.  The matrix consists of two tables, "Initial Evaluation Tests for 
Consideration" and "Supplementary Evaluation Tests for Consideration."  To harmonize 
biological response testing with the requirements of other countries, FDA reviewers will 
apply the ISO Standard, Part 1, in the review process in lieu of the Tripartite 
Biocompatibility Guidance. 
Reviewers in OBRR should accept data developed according to ISO-10993-1: 1997, Part 
1, with the matrix as modified and presented in Blue Book Memorandum #G95-1 entitled 
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  "Use of International Standard ISO-10993, Biological Evaluation of Medical Devices 
Part-1: Evaluation and Testing." The manufacturer or applicant also has the option of 
providing a summary of the specific tests conducted in accordance with the standard. 
All testing performed should either conform with the recommended standard documents 
or be accompanied by an explanation as to how the testing or methodology is an 
acceptable alternative to that of the standard. FDA reviewers should advise manufacturers 
or applicants to initiate discussions with the RPMB prior to the initiation of expensive, 
long-term testing of any new device materials to ensure that the proper testing will be 
conducted and unnecessary testing will not be undertaken.  We also recognize that an 
ISO standard is a document that undergoes periodic review and is subject to revision. 
B.  Device Performance 
The submission would normally contain data to support the safe and effective operations 
of the device when used according to the directions for use.  However, the manufacturer 
or applicant now has the option of providing a declaration of conformance to a standard. 
A declaration of conformance to a standard obviates the need for the submission of 
protocols and raw data as called for by that standard. If the submission does not include a 
declaration of conformance to a standard, the submission should include performance 
data from bench testing.  Additional data may include results from testing under actual 
conditions or in a simulated environment in which the device is expected to be used.  As 
with the biocompatibility testing, functional testing should be performed in conformance 
with the recommended standards or be accompanied by a justification that the testing or 
methodology is an acceptable alternative to that particular standard. 
FDA reviewers should advise manufacturers or applicants to initiate discussions with the 
RPMB prior to the initiation of extensive performance testing to ensure that proper 
testing will be conducted.  Since standards are documents that undergo periodic review 
and are subject to revision, FDA reviewers should also notify manufacturers or applicants 
of any future revisions of any performance standards referenced here. 
VI.  LABELING 
It is important to the user that the labeling for the blood and plasma warmer bear clear, accurate, 
and complete information for use concerning any relevant indications for use, conditions and 
limitations of use, hazards, contraindications, and precautions in their use. 
The 510(k) should identify and discuss all known situations and events that could cause the 
device to malfunction or become a hazard to the user or patient when the device is being 
properly used.  The labeling should discuss these situations and hazards in a precaution, warning, 
or advisory statement as appropriate. 
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  A 510(k) submission for blood and plasma warmers should include the proposed package labels 
and labeling.  Labeling refers to the package label plus other written, printed, or graphic material 
that accompanies the device or that is placed on either the device or any of its wrappers or 
containers.  Advertising may be considered labeling, especially if it accompanies the device. 
The labeling must bear adequate directions for use and any warnings needed to ensure the safe 
use of the device. See sections 201(k) and 502(f)(1) and (2) of the Federal Food, Drug, and 
Cosmetic Act. 
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