Summary of Safety and Clinical Performance

Duo-Flow® III Catheter

SSCP Document Number: SSCP-025
Revision Number: 4
Revision Date: 16-Sep-24

Important Information

This Summary of Safety and Clinical Performance (SSCP) is intended to provide public access to an updated summary of the main aspects of the safety and clinical performance of the device. The information presented below is intended for patients or lay persons. A more extensive summary of safety and clinical performance prepared for healthcare professionals is found in the first part of this document.

The SSCP is not intended to give general advice on the treatment of a medical condition. Please contact your healthcare professional in case you have questions about your medical condition or about the use of the device in your situation. This SSCP is not intended to replace an Implant Card or the Instructions for Use to provide information on the safe use of the device.

1. Device Identification and General Information

Device Trade Name(s): Duo-Flow® III Catheter

Manufacturer Name and Address: Medical Components, Inc. 1499 Delp Drive Harleysville, PA 19438 USA

Basic UDI-DI: 00884908299NY

Date First CE Certificate Was Issued for This Device: Jun-13

Device Grouping and Variants

This document talks about hemodialysis tube [catheter] sets. These tubes are used for a short time and come in different sets. These devices are distributed as procedure trays. Procedure trays come in different configurations

Variant Devices:

Variant Description Part Number(s)
13F x 15cm Curved Extensions Duo-Flow III 10652-815-001C 10652-815-005C
13F x 15cm Straight Duo-Flow III 10652-815-000 10652-815-001 10652-815-005
13F x 17.5cm Curved Extensions Duo-Flow III 10652-817-001C 10652-817-005C
13F x 17.5cm Straight Duo-Flow III 10652-817-001 10652-817-005
13F x 20cm Curved Extensions Duo-Flow III 10652-820-001C 10652-820-005C
13F x 20cm Straight Duo-Flow III 10652-820-000 10652-820-001 10652-820-005
13F x 25cm Curved Extensions Duo-Flow III 10652-825-001C 10652-825-005C
13F x 25cm Straight Duo-Flow III 10652-825-000 10652-825-001 10652-825-005
Variant Description Part Number(s)

Procedure Trays:

Configurations of Procedure Trays:
Catalog Code Part Number Description
AQUA1513ST 10652-815-000 13F X 15cm Nikkiso Duo-Flow® III Double Lumen Hemodialysis Catheter W/ Stylet Basic Set
AQUA2013ST 10652-820-000 13F X 20cm Nikkiso Duo-Flow® III Double Lumen Hemodialysis Catheter W/ Stylet Basic Set
AQUA2513ST 10652-825-000 13F X 25cm Nikkiso Duo-Flow® III Double Lumen Hemodialysis Catheter W/ Stylet Basic Set
DFST1310CEE 10652-825-001C 13F X 25cm Duo-Flow® III Double Lumen Curved Extension Hemodialysis Catheter W/ Stylet Basic Set
DFST1310MTE 10652-825-001 13F X 25cm Duo-Flow® III Double Lumen Hemodialysis Catheter W/ Stylet Basic Set
DFST136CEE 10652-815-001C 13F X 15cm Duo-Flow® III Double Lumen Curved Extension Hemodialysis Catheter W/ Stylet Basic Set
DFST136MTE 10652-815-001 13F X 15cm Duo-Flow® III Double Lumen Hemodialysis Catheter W/ Stylet Basic Set
DFST137CEE 10652-817-001C 13F X 17.5cm Duo-Flow® III Double Lumen Curved Extension Hemodialysis Catheter W/ Stylet Basic Set
DFST137MTE 10652-817-001 13F X 17.5cm Duo-Flow® III Double Lumen Hemodialysis Catheter W/ Stylet Basic Set
DFST138CEE 10652-820-001C 13F X 20cm Duo-Flow® III Double Lumen Curved Extension Hemodialysis Catheter W/ Stylet Basic Set
DFST138MTE 10652-820-001 13F X 20cm Duo-Flow® III Double Lumen Hemodialysis Catheter W/ Stylet Basic Set
JFST1310CEE 10652-825-005C 13F X 25cm Duo-Jet® III Double Lumen Curved Extension Hemodialysis Catheter W/ Stylet Basic Set
JFST1310MTE 10652-825-005 13F X 25cm Duo-Jet® III Double Lumen Hemodialysis Catheter W/ Stylet Basic Set
JFST136CEE 10652-815-005C 13F X 15cm Duo-Jet® III Double Lumen Curved Extension Hemodialysis Catheter W/ Stylet Basic Set
JFST136MTE 10652-815-005 13F X 15cm Duo-Jet® III Double Lumen Hemodialysis Catheter W/ Stylet Basic Set
JFST137CEE 10652-817-005C 13F X 17.5cm Duo-Jet® III Double Lumen Curved Extension Hemodialysis Catheter W/ Stylet Basic Set
JFST137MTE 10652-817-005 13F X 17.5cm Duo-Jet® III Double Lumen Hemodialysis Catheter W/ Stylet Basic Set
JFST138CEE 10652-820-005C 13F X 20cm Duo-Jet® III Double Lumen Curved Extension Hemodialysis Catheter W/ Stylet Basic Set
JFST138MTE 10652-820-005 13F X 20cm Duo-Jet® III Double Lumen Hemodialysis Catheter W/ Stylet Basic Set
Configurations of Procedure Trays:
Catalog Code Part Number Description

Configurations of Procedure Trays:

Configuration Type
Duo-Flow® III Basic Set:

2. Intended Use of the Device

Intended Purpose: Duo-Flow® III Catheters are intended for use in adult patients with Acute Kidney Injury (AKI) or Chronic Kidney Disease (CKD) for whom immediate central venous vascular access for short-term hemodialysis is deemed necessary based on the direction of a qualified, licensed physician. The catheter is intended to be used under the regular review and assessment of qualified health professionals. This catheter is for Single Use Only.

Indication(s): The Duo-Flow® III Catheter is indicated for short-term use where vascular access is required for less than 14 days for the purpose of hemodialysis.

Intended Patient Group(s): Duo-Flow® III Catheters are intended for use in adult patients with Acute Kidney Injury (AKI) or Chronic Kidney Disease (CKD) for whom immediate central venous vascular access for short-term hemodialysis is deemed necessary based on the direction of a qualified, licensed physician. The catheter is not intended for use in pediatric patients.

Contraindications and/or Limitations:

  • Known or suspected allergies to any of the components of the catheter or the kit.
  • This device is contraindicated for patients exhibiting severe, uncontrolled coagulopathy or thrombocytopenia.

3. Device Description

Device Image

Device Name: Duo-Flow® III Catheter

Description of Device: Duo-Flow® III Catheter:The Duo-Flow® III Catheter has two separate paths to move blood in and out of the body. Each path has a different colored tube. The tubes connect to a part that is shaped like a hub. Both paths have small holes to help the blood flow. The device contains a substance called Barium Sulphate to make it easier to see with X-rays. It comes in various sizes and shapes to fit the needs of the patient as determined by the doctor.

Device Image

Device Name: Duo-Jet® III Catheter

Description of Device: Duo-Jet® III Catheter:This Duo-Jet® III Catheter has two separate paths to move blood in and out of the body. Each path has a different colored tube. The tubes connect to a part that is shaped like a hub. Both paths have small holes to help the blood flow. The device contains a substance called Barium Sulphate to make it easier to see with X-rays. It comes in various sizes and shapes to fit the needs of the patient as determined by the doctor. The Nikkiso Duo-Flow® III Catheter has two separate paths to move blood in and out of the body. Each path has a different colored tube. The tubes connect to a part that is shaped like a hub. Both paths have small holes to help the blood flow. The device contains a substance called Barium Sulphate to make it easier to see with X-rays. It comes in various sizes and shapes to fit the needs of the patient as determined by the doctor.

Materials / Substances in Contact with Patient Tissue:

The percentage ranges below are based on catheter weights. The 15cm catheter weighs 10.22 grams. The 25cm catheter weighs 11.22 grams.

Duo-Flow® III Catheter
Material % Weight (w/w)
Polyurethane 48.46 - 51.48
Acetal co-polymer 21.37 - 23.46
Polyvinyl chloride 16.59 - 18.20
Acrylonitrile Butadiene Styrene 6.55 - 7.19
Barium sulfate 2.66 - 4.05

Duo-Jet® III Catheter
Material % Weight (w/w)

Note:The device should not be used if you are allergic to the above materials.

Information on Medicinal Substances in the Device:

How the Device Achieves its Intended Mode of Action: Hemodialysis tubes provide access through the vein or artery. The tube is thin and flexible and goes into a big vein near the center of the body. There are two openings in the tube. One opening takes out the blood and sends it to a machine that cleans it. The other opening puts the clean blood back into the body. This tube is used when someone needs to have their blood cleaned right away, and they can't use a different kind of tube. This tube is only used for a short time.

Cleaning (Sterilization) Information: Contents are clean and will not cause fever in unopened, undamaged package. Sterilized by Ethylene Oxide.

Accessories Intended for Use in Combination with the Device:

Name of Accessory Description of Accessory
Guidewire Acts as a path for other components.
Guidewire Advancer Helps guidewire introduction.
Introducer Needle Placed into the target vein to gain access.
Stylet Assists in catheter insertion.
Scalpel A cutting device.
Dilator Used to make the opening of a vessel larger.
End Cap To keep the catheter clean between treatments.
Syringe Helps get blood return once the needle punctures the vein.

4. Risks and Warnings

If you think something is wrong with how you feel after using the device or you're worried about any problems, talk to your healthcare professional. Remember, this information is not meant to take the place of talking to your doctor if you need to.

How Potential Risks Have Been Controlled or Managed

  • There have been 22,186 devices sold since January 2019. There are side effects and risks associated with the device. These include:
  • Infection
  • Bleeding
  • Tube Removal
  • Tube Replacement These risks are reduced to an acceptable level. The labeling describes the risks. The benefit of the device is access for hemodialysis when alternatives are not suitable. These benefits outweigh the risks.
  • Remaining Risks and Undesirable Effects

  • The Duo-Flow® III catheter is associated with risks. These include:
  • Procedural Delays
  • Blood clots in veins (Thrombosis)
  • Infections
  • Punctures in organs (Perforations)
  • Air bubbles in veins (Embolism)
  • Heart problems (Cardiac Event)
  • Feeling unhappy with the procedure (Dissatisfaction) The risks of using the Medcomp device are similar to other dialysis tubes. The most common problem is getting an infection. Infections can happen when someone has surgery or stays in the hospital. Infections are not always caused by use of the device.
  • Quantification of Residual Risks
    PMS Complaints 01 January 2017 – 31 December 2023 PMCF Events
    Units Sold: 22,186 Units Studied: 69
    Patient Residual Harm Category # of Cases Per Event # of Cases Per Event
    Allergic Reaction Not Reported. Not Reported.
    Bleeding Not Reported. Not Reported.
    Cardiac Event Not Reported. Not Reported.
    Embolism Not Reported. Not Reported.
    Infection Not Reported. 1 Event in 6 Cases.
    Perforation Not Reported. Not Reported.
    Stenosis Not Reported. Not Reported.
    Tissue Injury Not Reported. Not Reported.
    Thrombosis Not Reported. 1 Event in 23 Cases.

    Warnings and Precautions

  • The below are warnings, precautions, or measures to be taken by patient:
  • To keep germs away from the catheter, wear a mask over your nose and mouth every time the catheter is used.
  • Keep the catheter dressing clean and dry. The dressing should be changed by a medical professional at each dialysis session.
  • Avoid getting the catheter or catheter site wet. Moisture near the catheter site can cause infection.
  • Ask the doctor to explain the signs and symptoms of catheter infection.
  • Never remove the cap at the end of the catheter. The cap and clamps of the catheter must be kept closed when not being used for dialysis.
  • Summary of Any Field Safety Correction Action (FSCA)

    There were no recalls for the device between 01 January 2023 to 31 December 2023.

    5. Summary of Clinical Evaluation and Post-Market Clinical Follow-Up

    Clinical Background of Device

    The Duo-Flow® III catheter has been available since 2013. The CE Mark was received in June 2013. All models included are planned for distribution in the European Union.

    Clinical Evidence for CE-Marking

    The clinical literature review identified 0 articles relating to the safety and/or performance of the subject device when used as intended. Two patient level data activities received information on 69 catheters. 2 user surveys have been received relating to this device. Findings from the clinical literature and data activities support the performance of the subject device. All data on the Duo-Flow® III catheter has been evaluated. When you use the device as intended, the good things it does are more than the bad things it might cause. This device helps people who have kidney problems get hemodialysis when other treatments are not right for them.

    Safety

  • There is sufficient data to prove conformity to the applicable requirements. The device is safe and performs as intended and claimed by Medcomp. The device is state of the art for allowing short-term vascular access for hemodialysis in adult patients. Medcomp has reviewed:
  • Post-Market Data
  • Medcomp Information Materials
  • Risk Management Documentation The device's risks are displayed clearly and are acceptable for this type of product. Compared to the good things the device does, the risks are okay. There were 4 complaints for 22,186 units sold from 01 January 2019 to 31 December 2023. The complaint rate is 0.018%.
  • 6. Possible Therapeutic Alternatives

    When considering alternative treatments, it is recommended to contact your healthcare professional who can consider your individual situation. The Kidney Disease Outcomes Quality Initiative (KDOQI) 2019 clinical practice guidelines have been used to support the below recommendations for treatments.

    Therapy Benefits Disadvantages Key Risks
    • AV Fistula
    • Permanent solution.
    • Lower complication rate than catheter.
    • Requires time.
    • Patients must sometimes self-needle stick.
    • Narrowing of a vein (Stenosis)
    • Thrombosis
    • Bulge in a blood vessel (Aneurysm)
    • High blood pressure in the lungs (Pulmonary hypertension)
    • Lack of blood flow to an area (Steal Syndrome)
    • Blood infection (Septicemia)
    • Hemodialysis Catheter
    • Useful for quick access.
    • Can be used as a bridge between therapies.
    • Not permanent.
    • Catheter dysfunction can happen.
    • Benefit may not be the same for everyone.
    • Post-procedural bleeding
    • Infection
    • Thrombosis
    • Decreased blood flow in dysfunctional catheter
    • Cardiovascular events
    • Fibrin sheath formation around catheter
    • Septicemia
    • Peritoneal Dialysis
    • Less restrictive diet than hemodialysis.
    • Does not require hospitalization.
    • Clearance of impurities is limited by flow and space.
    • Infection of the abdomen (Peritonitis)
    • Septicemia
    • Fluid overload
    • Kidney Transplant
    • Better quality of life.
    • Lower risk of death.
    • Fewer food restrictions.
    • Requires a donor.
    • More risky for certain groups.
    • Patient must take medication for life.
    • Medication has side effects.
    • Thrombosis
    • Severe bleeding (Hemorrhage)
    • Blockage of the tubes that carry urine (Ureteral blockage)
    • Infection
    • Organ rejection
    • Death
    • Heart problem (Myocardial infarction)
    • Blocked blood flow to brain (Stroke)
    • Comprehensive Conservative Care
    • Less imposed symptom burden.
    • Preserves life satisfaction.
    • May aggravate clinical condition.
    • Not designed to treat.
    • Treatment may not actually minimize risks associated with CKD.

    7. Suggested Profile and Training for Users

    The catheter should be inserted, manipulated, and removed by a qualified, licensed physician or other qualified health care professional under the direction of a physician.

    Acronyms

    Abbreviation Definition
    AKI Acute Kidney Injury
    AV Arteriovenous
    CE Conformité Européenne (European Conformity)
    CKD Chronic Kidney Disease
    cm centimeter
    CMR Carcinogenic, mutagenic, reprotoxic
    CVC Central Venous Catheter
    EU European Union
    F French (thickness of catheter)
    FDA Food and Drug Administration
    FSCA Field Safety Corrective Action
    HD Hemodialysis
    KDOQI Kidney Disease Outcomes Quality Initiative
    PA Pennsylvania
    PMCF Post Market clinical follow-up
    PMS Post Market Surveillance
    SSCP Summary of Safety and Clinical Performance
    STHD Short-term Hemodialysis
    USA United States of America
    w/w Weight over Weight

    Version 5.00 of Medical Components, Inc. Template QA-CL-200-1