OXY-1 System OXY-1 PLU Disposable-US

GUDID 00860001797916

OXY-1 PLU Disposable

Breethe, Inc.

Extracorporeal membrane oxygenator

• Primary Device ID: 00860001797916
• NIH Device Record Key: 3eb109c2-b825-48b9-a544-6756eaf41ff2
• Commercial Distribution Status: In Commercial Distribution
• Brand Name: OXY-1 System
• Version Model Number: OXY-1 PLU Disposable
• Catalog Number: OXY-1 PLU Disposable-US
• Company DUNS: 079455574
• Company Name: Breethe, Inc.
• Device Count: 1
• DM Exempt: false
• Pre-market Exempt: false
• MRI Safety Status: Labeling does not contain MRI Safety Information
• Human Cell/Tissue Product: false
• Device Kit: true
• Device Combination Product: false
• Single Use: true
• Lot Batch: true
• Serial Number: false
• Manufacturing Date: true
• Expiration Date: true
• Donation Id Number: false
• Contains Natural Rubber Latex: false
• Labeled No Natural Rubber Latex: false
• RX Perscription: true
• OTC Over-The-Counter: false

Device Identifiers

Device Issuing Agency	Device ID
GS1	00860001797916 [Primary]

FDA Pre-market Approvals/Notifications & deNovo

• Premarket Notification: K200109
• Premarket Notification: K223161

FDA Product Code

• DTZ: Oxygenator, Cardiopulmonary Bypass

Sterilization

• Steralize Prior To Use: false
• Device Is Sterile: true

Device Entry Metadata

• Public Version Status: New
• Device Record Status: Published
• Public Version Number: 1
• Public Version Date: 2020-12-08
• Device Publish Date: 2020-11-30

On-Brand Devices [OXY-1 System]

• 00860001797954: OXY-1 E-drive
• 00860001797947: OXY-1 Pump Driver
• 00860001797930: OXY-1-Console
• 00860001797916: OXY-1 PLU Disposable
• 00860001797909: OXY-1 System
• 00860001797961: Console Intake Filter, 5pk
• 10860001797920: OXY-1 Condensate Tray