510(k) Report

510(k) · Cleared

Cleared

Air Safety Hepa, Model 3500

K040712510(k) TraditionalCleared Jun 3, 200477-day reviewClass II21 CFR 868.5895

Data to Oct 25, 2026 (FDA decisions) Oct 12, 2026 (recalls) Sep 30, 2026 (MAUDE) refreshed weekly, last Nov 3, 2026

Air Safety, Ltd. · MOD Accessory To Continuous Ventilator (Respirator)

Cleared on Jun 3, 2004 as substantially equivalent to K990177 (Nellcor Puritan Bennett, Inc., 1999) and 1 other predicate after a 77-day review. Its family tree reaches back 2 generations to 1989.

Decided
Jun 3, 2004
Review
77 days
Class
Class II
Product code
MOD
Recalls
None
Predicates
2

Its longest line of descent runs back 2 generations to K894316 (1989). 10 ancestors in all. No later device cites it as a predicate yet.

Other ancestors, by year cleared 2002: 1 other ancestor2001: 3 other ancestors1994: 3 other ancestors1990: 1 other ancestorK894316 · Amadeus Ventilator · Hamilton Medical, Inc. · 1989K990177 · Nellcor Puritan Bennett Achieva Ventilator and Report Generator · Nellcor Puritan Bennett, Inc. · 199919851990199520002005
Other ancestors, by generation 1 generation back: 1 other ancestor2 generations back: 7 other ancestors K990177 · Nellcor Puritan Bennett Achieva Ventilator and Report Generator · Nellcor Puritan Bennett, Inc. · 1999K894316 · Amadeus Ventilator · Hamilton Medical, Inc. · 19890
  1. Root · 2 generations backK894316 Amadeus VentilatorHamilton Medical, Inc. · 1989
  2. 1 generation backK990177 Nellcor Puritan Bennett Achieva Ventilator and Report GeneratorNellcor Puritan Bennett, Inc. · 1999
  3. This deviceK040712 Air Safety Hepa, Model 3500Air Safety, Ltd. · 2004
View FIG. 1 as a table

Line of descent and top descendants

GenerationNumberDeviceApplicantDecidedRecalls
−2K894316Amadeus VentilatorHamilton Medical, Inc.1989—
−1K990177Nellcor Puritan Bennett Achieva Ventilator and Report GeneratorNellcor Puritan Bennett, Inc.1999—
0 (this device)K040712Air Safety Hepa, Model 3500Air Safety, Ltd.2004—

Other ancestors by year cleared

Year clearedDevicesWith a Class I recall
199010
199430
200130
200210
FIG. 1 — Lineage of K040712, 1989–2004Source: FDA 510(k) summaries, read by 510(k) Report · How lineage is built

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Notable FDA decisions, review times and new Class I recalls. See an issue.

Sources: FDA 510(k) database (decision fields), the FDA summary (predicates and indications), FDA recall and enforcement reports, and MAUDE; processed by 510(k) Report. Verify on FDA.gov · Methodology and accuracy.

Planning a device in MOD? A 510(k) Report weighs predicate choices, recall history and review times for a new device like this one.

Top candidate predicates for a new MOD device

  1. #1 K261360 EasyCare Tx 2score 14.6 · 10 generations · no Class I recall
  2. #2 Held for the reportin the report
  3. #3 Held for the reportin the report
Get a 510(k) Report

What was it cleared against? (2)

Devices the submitter claimed this one is substantially equivalent to (*), and reference devices cited for a specific test or feature (†), as written in the FDA summary.

TypeNumberDeviceApplicantDecidedRecalls
*K990177Nellcor Puritan Bennett Achieva Ventilator and Report Generator
Summary page 1
…Inlet filter Classification Name: Accessory to a Continuous Ventilator (Respirator), MOD Predicate Devices: NPB Achieva ventilator - K990177 EMS filter- K013089 IDevice Description Model 3500/01 is a replacement part for the ventil…
Nellcor Puritan Bennett, Inc.1999—
*K013089Ems Hepa Filter and Hme Combinations
Summary page 1
…sory to a Continuous Ventilator (Respirator), MOD Predicate Devices: NPB Achieva ventilator - K990177 EMS filter- K013089 IDevice Description Model 3500/01 is a replacement part for the ventilator. The Inlet Filter removes particles of 0.3 micron si…
Engineered Medical Systems2002—

Also cleared against K990177: 1 other device →

What descends from it?

No later submission names this one as a predicate yet.

Has anything in its family been recalled? (0 Class I)

No FDA recall names this device.

No ancestor or descendant has a Class I recall.

What does this lineage say?

  • The line of descent spans 15 years and passes through 3 companies; a new generation was cleared every 10.2 years on median.
  • 2 of the 10 ancestors have a recall of any class.
  • 1 other device also cites its predicate K990177.

How does its category compare?

All MOD devices

MOD Accessory To Continuous Ventilator (Respirator): FDA decisions, review times, recalls and adverse event reports over 20 years.

FDA decisions per year · MOD

3so far in 2026, the most since 2007

2009: 12017: 12025: 12026 (partial year): 3
2007high 3 (2026) · low 0 (2007)2026

2026 to Oct 25, outlined.

Median 510(k) review, days · MOD

125in 2026

2026 (partial year): 125 days median
2007high 125 (2026)2026

Receipt to decision; years with fewer than 3 clearances left blank.

Recalls per year · MOD

1so far in 2026, the most since 2007

2026 (partial year): 1
2007high 1 (2026) · low 0 (2007)2026

Class I (0 since 2007) Class II/III not classified

Adverse event reports per year · MOD

1in 2022

2008: 22015: 32016: 12017: 12019: 62020: 22022: 1
2007high 6 (2019) · low 0 (2007)2025

MAUDE reports naming product code MOD, not matched to any one device; reports are not rates.

View these four charts as a table
YearDecisionsMedian 510(k) review, daysRecalls (Class I)MAUDE reports
20070—00
20080—02
20091—00
20100—00
20110—00
20120—00
20130—00
20140—00
20150—03
20160—01
20171—01
20180—00
20190—06
20200—02
20210—00
20220—01
20230—00
20240—00
20251—00
202631251—

What is it indicated for?

Model 3500/01 is a replacement part for the ventilator. The Inlet Filter removes particles of 0.3 micron size (or larger) from entering the ventilator.

It is a HEPA grade particulate filter for use with the NPB Achieva or LP 10 ventilators. The filter is in the gas flow pathway.

Indications for use as stated in the FDA summary.

Cite this page

510(k) Report. “K040712: Air Safety Hepa, Model 3500.” Lineage record from FDA 510(k) data and the FDA summary. Updated Nov 3, 2026. Accessed Nov 6, 2026. https://510kreport.com/device/K040712

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Record history
  • FDA decision record loaded May 2, 2026
  • Summary read Oct 13, 2026 (extraction version 9eaa42aa01ed)
  • Lineage and recalls computed Nov 3, 2026
  • Page last updated Nov 3, 2026