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U.S. Department of Health and Human Services

510(k) Premarket Notification

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Device Classification Name Pump, Infusion, Enteral
510(k) Number K111381
Device Name MEDI-SIS SYRINGE INFUSION SYSTEM
Applicant
Acacia, Inc.
785 Challenger St.
Brea,  CA  92821
Applicant Contact FERGIE FERGUSON
Correspondent
Acacia, Inc.
785 Challenger St.
Brea,  CA  92821
Correspondent Contact FERGIE FERGUSON
Regulation Number880.5725
Classification Product Code
LZH  
Date Received05/17/2011
Decision Date 01/13/2012
Decision Substantially Equivalent (SESE)
Regulation Medical Specialty General Hospital
510k Review Panel General Hospital
Summary Summary
Type Traditional
Reviewed by Third Party No
Combination Product No
Predetermined Change
Control Plan Authorized
No
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