K Number
K112803

Validate with FDA (Live)

Device Name
PATIENT MONITOR
Date Cleared
2011-10-24

(27 days)

Product Code
Regulation Number
870.1025
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Patient Monitors, M8500, are intended to be used for monitoring, displaying, reviewing, storing and alarming of multiple physiological parameters including ECG, Heart Rate (HR), Respiration Rate (RESP), Pulse Oxygen Saturation (SpO2), Pulse Rate (PR), Non-invasive Blood Pressure (NIBP), carbon dioxide (CO2), and Temperature (TEMP) of adult, pediatric and neonatal patient. The monitors are to be used in healthcare facilities by clinical physicians or appropriate medical staff under the direction of physicians. They are not intended for helicopter transport or hospital ambulance.

Device Description

The proposed devices are intended to be used for monitoring, displaying, reviewing, storing and alarming of multiple physiological parameters including ECG, Heart Rate (HR), Respiration Rate (RESP), Pulse Oxygen Saturation (SpO2), Pulse Rate (PR), Non-invasive Blood Pressure (NIBP), carbon dioxide (CO2), and Temperature (TEMP) of adult, pediatric and neonatal patient. They have the alarming function with audio and visual alarming which may raise the user attention of system error and exceeding the pre-set limit of physiological parameter, and data storage function, which can replay the data and alarming event. The device is driven by AC or DC power supply.

AI/ML Overview

The provided text is a 510(k) summary for a Patient Monitor (Model M8500) and it does not contain the detailed study information typically requested for devices that employ AI/ML algorithms, especially regarding acceptance criteria, sample sizes for test/training sets, expert adjudication, or MRMC studies.

The document states: "Per the risk management during the design change control, the verification tests performed demonstrated that risks of each hazard are reduced to acceptable region." This is a very general statement and does not provide specific acceptance criteria or study details for performance.

The device described is a multi-parameter patient monitor (ECG, HR, RESP, SpO2, PR, NIBP, CO2, TEMP), which are traditional physiological monitoring measurements. These types of devices are typically cleared based on meeting established performance standards for each physiological parameter (e.g., accuracy, precision) rather than AI/ML performance metrics.

Therefore, I cannot extract the specific information requested in your prompt regarding acceptance criteria, sample sizes, expert ground truth, adjudication, or MRMC studies from the provided text, as it describes a conventional medical device and not one heavily reliant on AI/ML algorithms or image interpretation that would require such extensive validation details in a 510(k) summary.

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K112803
P1/2

OCT 2 4 2011

Premarket Notification
Special Section 510(k) Submission

Project No.: M0312011Bd

Section IX 510(k) Summary

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Section IX 510(k) Summary

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

The assigned 510(k) Number is: _______________________________________________________________________________________________________________________________________________

Date of PreparationSeptember 23, 2011
SponsorGuangdong Biolight Meditech Co., Ltd [Reg #:3007305624]Innovation First Road, Technology Innovation CoastZhuhai, Guangdong, 519085, ChinaContact Person: Mr. Tianbao Li, Chief EngineerTel: +86-756-3399963 Fax: +86-756-3399989 E-mail: li_tb@blt.com.cn
SubmissionMs. Diana Hong / Mr. Lee Fu
CorrespondentMid-Link Consulting Co., Ltd
P.O. BOX 237-023, Shanghai, 200237, China
Proposed DevicePatient Monitor, M8500
Modification to: M9000 Patient Monitor as cleared in K100046
21 CFR 870.1025 MHX Class II
Intended UsePatient Monitors, M8500, are intended to be used for monitoring, displaying,reviewing, storing and alarming of multiple physiological parameters includingECG, Heart Rate (HR), Respiration Rate (RESP), Pulse Oxygen Saturation (SpO2),Pulse Rate (PR), Non-invasive Blood Pressure (NIBP), carbon dioxide (CO2), andTemperature (TEMP) of adult, pediatric and neonatal patient. The monitors are tobe used in healthcare facilities by clinical physicians or appropriate medical staffunder the direction of physicians. They are not intended for helicopter transport orhospital ambulance.
Device DescriptionThe proposed devices are intended to be used for monitoring, displaying,reviewing, storing and alarming of multiple physiological parameters includingECG, Heart Rate (HR), Respiration Rate (RESP), Pulse Oxygen Saturation (SpO2),Pulse Rate (PR), Non-invasive Blood Pressure (NIBP), carbon dioxide (CO2), andTemperature (TEMP) of adult, pediatric and neonatal patient.
They have the alarming function with audio and visual alarming which may raise

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K112803
p2/2

Premarket Notification Project No.: M0312011Bd Special Section 510(k) Submission

Section IX 510(k) Summary

Image /page/1/Picture/3 description: The image shows a logo with the letters "BLT" in bold, followed by the word "BIOLIGHT". To the left of the letters is a symbol that looks like a plant with a circle above it. To the right of the letters are three Chinese characters. The logo is in black and white.

the user attention of system error and exceeding the pre-set limit of physiological parameter, and data storage function, which can replay the data and alarming event.

The device is driven by AC or DC power supply.

Test Summary

Conclusion

Per the risk management during the design change control, the verification tests performed demonstrated that risks of each hazard are reduced to acceptable region.

The proposed devices are Substantially Equiavlent (SE) to the predicate device, M9000 Patient Monitor as cleared in K100046, with respect of effectiveness and safety.

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Image /page/2/Picture/0 description: The image shows the logo for the Department of Health & Human Services - USA. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the top half of the circle. The bottom half of the circle contains a stylized image of an eagle.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

OCT 2 4 2011

Guangdong Biolight Meditech Co., Ltd. c/o Ms. Diana Hong General Manager Mid-Link Consulting Co., Ltd. P.O. Box 237-023 Shanghai 200237 CHINA

Re: K112803

Trade/Device Name: Patient Monitor, Model M8500 Regulatory Number: 21 CFR 870.1025 Regulation Name: Patient Physiological Monitor (with arrhythmia detection or alarms) Regulatory Class: II (two) Product Code: 74 MHX Dated: September 15, 2011 Received: September 17, 2011

Dear Ms. Hong:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or 10 devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

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Page 2 - Ms. Diana Hong

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/dcfault.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours

Bram D. Zuckerman, M.D.

Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Premarket Notification Special Section 510(k) Submission

Project No .: M0312011Bd

Section III Indication for Use Form

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Section III Indication for Use Form

510(k) NUMBER (if known):

DEVICE NAME: Patient Monitor

INDICATION FOR USE:

Patient Monitors; M8500, are intended to be used for monitoring, displaying, reviewing, storing and alarming of multiple physiological parameters including ECG, Heart Rate (HR), Respiration Rate (RESP), Pulse Oxygen Saturation (SpO2), Pulse Rate (PR), Non-invasive Blood Pressure (NIBP), carbon dioxide (CO2), and Temperature (TEMP) of adult, pediatric and neonatal patient.

The monitors are to be used in healthcare facilities by clinical physicians or appropriate medical staff under the direction of physicians. They are not intended for helicopter transport or hospital ambulance.

Prescription Use __ X (Part 21 CFR 801 Subpart D)

Over-The-Counter Use AND/OR (21 CFR 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

(Division Sign-Off)
Division of Cardiovascular Devices
510(k) NumberK112803
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§ 870.1025 Arrhythmia detector and alarm (including ST-segment measurement and alarm).

(a)
Identification. The arrhythmia detector and alarm device monitors an electrocardiogram and is designed to produce a visible or audible signal or alarm when atrial or ventricular arrhythmia, such as premature contraction or ventricular fibrillation, occurs.(b)
Classification. Class II (special controls). The guidance document entitled “Class II Special Controls Guidance Document: Arrhythmia Detector and Alarm” will serve as the special control. See § 870.1 for the availability of this guidance document.