FDA.reportPublic FDA data

Insuflow Port

Primary DI
00852588007199
Brand
Insuflow Port
Company
LEXION MEDICAL, LLC
Model
4100-10B
Catalog number
4100-10B
Device description
10mm x 130mm Insuflow Port
Published
2020-11-05
Public version status
New
Distribution status
In Commercial Distribution
MRI safety
Labeling does not contain MRI Safety Information
Rx
true
Sterile
true
Single use
true

Product Codes#

Code, Name table
CodeName
GCJLaparoscope, General & Plastic Surgery
HIFInsufflator, Laparoscopic
OSVInsufflator, Endoscopic Vessel Harvesting

Product Code Classifications#

Code, Device, Specialty table
CodeDeviceSpecialtyClass
GCJLaparoscope, General & Plastic SurgeryGastroenterology, Urology2
HIFInsufflator, LaparoscopicObstetrics/Gynecology2
OSVInsufflator, Endoscopic Vessel HarvestingObstetrics/Gynecology2

Premarket Submissions#

Submission, Supplement table
SubmissionSupplement
K170799000

Premarket Details#

Submission, Supplement, Device table
SubmissionSupplementDeviceApplicantDecision dateProduct code
K170799000AP 50/30 Insufflator with Insuflow PortLexion Medical, LLC2017-11-14HIF

Identifiers And Packaging#

Identifier, Type, Agency table
IdentifierTypeAgencyPackage quantityStatus
00852588007199PrimaryGS10

Alternate GTIN / UPC / EAN Codes

Source identifier, GTIN-14 normalized, UPC-A table
Source identifierGTIN-14 normalizedUPC-AEAN-13
00852588007199008525880071998525880071990852588007199

GMDN Terms#

Term, Definition table
TermDefinition
Laparoscopic access cannula, single-useA single-lumen surgical device intended to be percutaneously inserted through the abdominal wall to create an access port for a laparoscope/laparoscopic instrument during laparoscopy. The cannula is provided with a shut-off valve for gas/fluid supply, and other sealing devices (e.g., dedicated seals/rings, caps, valves), to prevent insufflation gas leakage whilst allowing entry of instruments; it may additionally be intended for thoracoscopy whereby the valve may not be required. It may include a sharp or blunt trocar blade to assist introduction and/or puncture the abdominal wall; if the trocar is included it may be referred to as a trocar or trocar assembly. This is a single-use device.

Sterilization Methods#

Method table
Method
Ethylene Oxide

Regulatory Flags#

DUNS number
848693730
Device count
1
Lot or batch
true
Manufacturing date on label
true
Expiration date on label
true
No natural rubber latex
true
Sterilization required before use
true

Other Devices From This Company#

Primary DI, Brand, Model table
Primary DIBrandModelCatalogPublished
00852588007229AP50/30 410041002020-11-02
00852588007014Insuflow6198NS6198NS2017-02-15
00852588007021INSUFLOWPP1000NSPP1000NS2017-02-15
00852588007069VERYCLEAR151515152017-02-15
00852588007083INSUFLOW SYNERGY PORT199119912017-02-15
00852588007090INSUFLOW SYNERGY XL PORT 1991-81991-82017-02-15
00852588007106INSUFLOW SYNERGY XL PORT1991-101991-102017-02-15
00852588007113INSUFLOW SYNERGY XL PORT1991-121991-122017-02-15
00852588007120INSUFLOW SYNERGY XL PORT1991-8B1991-8B2017-02-15
00852588007137iNSUFLOW SYNERGY XL PORT1991-10B1991-10B2017-02-15
00852588007144INSUFLOW SYNERGY XL PORT1991-12B1991-12B2017-02-15
00852588007243Standard filtered tube set4100-SHT4100-SHT2020-11-05
00852588007151Insuflow Port4100-54100-52020-11-05
00852588007168Insuflow Port4100-84100-82020-11-05
00852588007175Insuflow Port4100-8B4100-8B2020-11-05
00852588007182Insuflow Port4100-104100-102020-11-05
00852588007205Insuflow Port4100-124100-122020-11-05
00852588007212Insuflow Port4100-12B4100-12B2020-11-05
00852588007236Insuflow Port4100-5B4100-5B2020-11-05
00852588007038INSUFLOW6198M6198M2017-02-15

Other Devices Sharing Product Codes#

Primary DI, Brand, Company table
Primary DIBrandCompanyProduct codePublished
00190776427931MillenniumAvalign Technologies, Inc.GCJ2026-08-27
00190776428051MillenniumAvalign Technologies, Inc.GCJ2026-08-27
00190776428303MillenniumAvalign Technologies, Inc.GCJ2026-08-27
00190776427429MillenniumAvalign Technologies, Inc.GCJ2026-08-26
04580826928451PENTAX MedicalPENTAX MEDICAL CORPORATIONGCJ2026-08-25
04580826928543PENTAX MedicalPENTAX MEDICAL CORPORATIONGCJ2026-08-25
04580826928581PENTAX MedicalPENTAX MEDICAL CORPORATIONGCJ2026-08-25
04580826928604PENTAX MedicalPENTAX MEDICAL CORPORATIONGCJ2026-08-25
08800035701499CORE-TrocarINCORE CO., LTDGCJ2026-08-25
08800035701505CORE-TrocarINCORE CO., LTDGCJ2026-08-25
08800035701512CORE-TrocarINCORE CO., LTDGCJ2026-08-25
08800035701529CORE-TrocarINCORE CO., LTDGCJ2026-08-25
08800035701536CORE-TrocarINCORE CO., LTDGCJ2026-08-25
08800035701543CORE-TrocarINCORE CO., LTDGCJ2026-08-25
08800035701949CORE-TrocarINCORE CO., LTDGCJ2026-08-25
08800035701956CORE-TrocarINCORE CO., LTDGCJ2026-08-25
08800035701963CORE-TrocarINCORE CO., LTDGCJ2026-08-25
B382SD13448970Surgical DirectSurgical Direct, Inc.GCJ2026-08-21
B382SD16008970Surgical DirectSurgical Direct, Inc.GCJ2026-08-21
B382SD161730Surgical DirectSurgical Direct, Inc.GCJ2026-08-21
B382SD77205052000Surgical DirectSurgical Direct, Inc.GCJ2026-08-21
B382SD77205082000Surgical DirectSurgical Direct, Inc.GCJ2026-08-21
B382SD7720508TS2000Surgical DirectSurgical Direct, Inc.GCJ2026-08-21
B382SD77205252000Surgical DirectSurgical Direct, Inc.GCJ2026-08-21
00190776425883MillenniumAvalign Technologies, Inc.GCJ2026-08-18
00190776425906MillenniumAvalign Technologies, Inc.GCJ2026-08-18
00190776425968MillenniumAvalign Technologies, Inc.GCJ2026-08-18
00190776425975MillenniumAvalign Technologies, Inc.GCJ2026-08-18
00190776426361MillenniumAvalign Technologies, Inc.GCJ2026-08-18
00190776426378MillenniumAvalign Technologies, Inc.GCJ2026-08-18