K Number
K150137
Device Name
SpiroThor
Manufacturer
Date Cleared
2015-05-27

(125 days)

Product Code
Regulation Number
868.1840
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

SpiroThor spirometer is a freestanding laboratory instrument for performing basic lung function tests in adults and children over the age of four years.

It is intended to be used by physicians or professional medical personnel for testing in physicians' offices, industrial medical, and hospital settings.

Device Description

The Cohero Health SpiroThor Spirometer is a hand-held portable diagnostic spirometer for the measurement of patient breath flow and volume. The proposed device consists of a compact main unit and an ultrasonic flowmeter sensor used with a pulmonary function filter. The device uses an ultrasonic sensor that measures flow. Algorithms are used to determine values based on this flow measurement. Tabular and graphical data are displayed on the spirometer LCD display.

AI/ML Overview

The provided document is a 510(k) premarket notification for the SpiroThor spirometer, asserting its substantial equivalence to a predicate device, the SDI AstraSonic Spirometer (K092813).

Here's an analysis of the acceptance criteria and study information:

1. Table of Acceptance Criteria and Reported Device Performance

The document states that the SpiroThor is identical to the predicate device, the SDI AstraSonic Spirometer (K092813), with minor differences being a name change and the use of a different bacterial filter which was shown through comparative testing to have no performance differences. Therefore, the acceptance criteria and reported device performance are assumed to be the same as the predicate device, which are explicitly listed in Table 1 – Comparison to Predicate.

SpecificationAcceptance Criteria (Predicate K092813 / SpiroThor)Reported Device Performance (SpiroThor)
Indications for UseBasic lung function tests in adults and children over the age of four yearsMeets (Identical)
Environment of UsePhysicians' offices, industrial medical, and hospital settingsMeets (Identical)
Patient PopulationAdults and children over the age of four yearsMeets (Identical)
Temperature SensorSemiconductor (-25 °C - +85 °C)Meets (Identical)
DisplayGraphic Quarter VGA (320x240 pixels), 262K colorsMeets (Identical)
Keyboard20-key keyboardMeets (Identical)
Connection TypeUSB, BlueToothMeets (Identical)
Flow Tube DimensionsØ30 mm x 150 mmMeets (Identical)
Power SupplyInternal 3.7 V Li-Ion battery (Rechargeable via 5V 500mA mini USB charger)Meets (Identical)
Dimensions85x120x35 mm (Flow tube: 26 mm(ID)x150 mm)Meets (Identical)
Weight300gMeets (Identical)
Flow/Volume Measurement SystemBidirectional, ultrasound/Ultrasonic technology (WaveFront™ technology)Meets (Identical)
Volume Range± 20 L (BTPS)Meets (Identical)
Flow Range± 18 L/s (BTPS)Meets (Identical)
Volume Accuracy± 3% or 50 mLMeets (Identical)
Flow Accuracy± 3% or 20 mL/sMeets (Identical)
Dynamic Resistance at 14 L/s< 1.1 cmH2O/L/sMeets (Identical)
Disposable in-line filterAstraGuard - K062913 or Air Safety - K051712Meets (Uses Air Safety - K051712, with demonstrated equivalent performance)
Electrical ProtectionInternal battery powerMeets (Identical)
PrinterExternal printer via RS232 or BlueToothMeets (Identical)

Note: The document explicitly states "The proposed SpiroThor is identical to the AstraSonic Spirometer cleared under K092813 with these differences, name change and that another cleared bacterial filter may be used with the device." and "The SpiroThor and predicate, K092813 – SDI AstraSonic Diagnostic Spirometer, are identical devices with minor differences. Namely, both products are produced by Thormed ("THOR") and the only differences are the name of the device and that another bacterial filter may be used with the proposed device."
Therefore, the reported device performance is stated to be identical to the predicate for all listed specifications.

2. Sample size used for the test set and the data provenance

The document states that "For K092813, THOR performed a number of bench tests." and lists several standards and tests. It explicitly mentions:

  • American Thoracic Society (ATS) 24 standard waveforms
  • ISO 26782:2009
  • Accuracy of waveform generator
  • Flow resistance test
  • EN 60601-1:2006/AC:2010
  • EN 60601-1-2:2007/AC:2010
  • EN 60601-1-6:2010
  • Performance to specifications with each bacterial filter

While these indicate a test set was used, the specific sample size (number of devices, number of replicates, etc.) for the test set is not provided. The data provenance is also not specified (e.g., country of origin, retrospective or prospective), but given it's bench testing, it's likely a controlled laboratory environment. The tests were performed by "THOR," the manufacturer of both the predicate and proposed device.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

This information is not provided. The "ground truth" for the performance specifications would be established by the reference standards and calibrated equipment used in the bench tests, not by human experts interpreting results.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

This is not applicable as the evaluation involved objective measurements against established technical standards and specifications, not subjective interpretation requiring adjudication among experts.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

This is not applicable. The device is a spirometer for basic lung function tests, which measures physiological parameters. It is not an AI-assisted diagnostic imaging or interpretation device that would involve human readers.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

A form of "standalone" evaluation was performed as the device's technical specifications and accuracy (e.g., volume accuracy, flow accuracy, dynamic resistance) were tested through bench testing against objective standards without human intervention in the measurement process itself. The document states: "The testing demonstrated that the SpiroThor performed as intended and met its performance specifications". This indicates its standalone performance.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

The ground truth used for performance validation was based on established industry standards and physical measurements from a "waveform generator" and other calibrated laboratory equipment. Specifically, the "American Thoracic Society (ATS) 24 standard waveforms" and "ISO 26782:2009" are mentioned, which serve as the objective ground truth against which the spirometer's measurements were compared.

8. The sample size for the training set

This is not applicable. The SpiroThor is a measurement device, not an AI/ML algorithm that requires a training set. Its functionality is based on ultrasonic technology and algorithms for flow measurement, which are deterministic rather than learned from data.

9. How the ground truth for the training set was established

This is not applicable as there is no training set for this type of device.

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract image of three human profiles facing to the right, stylized to resemble a bird.

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

May 27, 2015

Cohero Health LLC c/o Mr. Paul Dryden Consultant 335 Madison Avenue, 3rd Floor New York, New York 10017

Re: K150137

Trade/Device Name: SpiroThor Regulation Number: 21 CFR 868.1840 Regulation Name: Spirometer, diagnostic Regulatory Class: II Product Code: BZG Dated: April 21, 2015 Received: April 22, 2015

Dear Mr. Dryden:

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 to 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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

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 - Mr. Dryden

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 contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. 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/default.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,

Teiashri Purohit-Sheth, M.D.

Tejashri Purohit-Sheth, M.D. Clinical Deputy Director DAGRID/ODE/CDRH FOR

Erin I. Keith, M.S. Division Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known)

K150137

Device Name

SpiroThor

Indications for Use (Describe)

SpiroThor spirometer is a freestanding laboratory instrument for performing basic lung function tests in adults and children over the age of four years.

It is intended to be used by physicians or professional medical personnel for testing in physicians' offices, industrial medical, and hospital settings.

Type of Use (Select one or both, as applicable)

XX Prescription Use (Part 21 CFR 801 Subpart D)
Over-The-Counter Use (21 CFR 801 Subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

Page 1 of 1

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510(k) Summary Page 1 of 5

Date Prepared:26-May-2015
Cohero Health LLC335 Madison Ave., 3rd FloorNew York, NY 10017Phone - 917.363.5408Fax - 212.423.2998
Official Contact:Melissa Manice, Ph.D., CEO
Proprietary or Trade Name:SpiroThor
Common/Usual Name:Spirometer
Classification Name:21CFR 868.184073 BZG – Spirometer, DiagnosticClass II
Predicate Devices:K092813 – AstraSonic SpirometerK051712 – Air Safety Model 2800 PFT Filter

Device Description:

The Cohero Health SpiroThor Spirometer is a hand-held portable diagnostic spirometer for the measurement of patient breath flow and volume. The proposed device consists of a compact main unit and an ultrasonic flowmeter sensor used with a pulmonary function filter. The device uses an ultrasonic sensor that measures flow. Algorithms are used to determine values based on this flow measurement. Tabular and graphical data are displayed on the spirometer LCD display.

We note that the proposed SpiroThor is identical to the AstraSonic Spirometer cleared under K092813 with these differences, name change and that another cleared bacterial filter may be used with the device.

Indications for Use:

SpiroThor spirometer is a freestanding laboratory instrument for performing basic lung function tests in adults and children over the age of four years.

It is intended to be used by physicians or professional medical personnel for testing in Physicians' offices, industrial medical, and hospital settings.

Substantial Equivalence Discussion:

The proposed device is substantially equivalent to the predicate device, manufactured by Thor Medical for SDI Diagnostics and cleared under the SDI name K092813 as the AstraSonic spirometer except as noted above, i.e. name change and another bacterial filter may be used.

Tables 1 and 2 compare the key features of the proposed SpiroThor with the identified predicate and demonstrate that the proposed device is substantially equivalent.

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510(k) Summary Page 2 of 5

26-May-2015

Table 1 – Comparison to Predicate

SpecificationK092813 - SDI AstraSonicDiagnostic SpirometerProposed DeviceSpiroThor
Indicationsfor UseThe SDI AstraSonic Spirometeris a freestanding laboratoryinstrument for performing basiclung function tests.The SpiroThor Spirometer is afreestanding laboratoryinstrument for performing basiclung function tests.
Environment of UsePhysicians' offices, industrialmedical and hospital settingsPhysicians' offices, industrialmedical and hospital settings
Patient PopulationAdults and children over the ageof four yearsAdults and children over the ageof four years
Temperature SensorSemiconductor(-25 °C - +85 °C)Semiconductor(-25 °C - +85 °C)
DisplayGraphic Quarter VGA (320x240pixels), 262K colorsGraphic Quarter VGA (320x240pixels), 262K colors
Keyboard20-key keyboard20-key keyboard
Connection TypeUSB, BlueToothUSB, BlueTooth
Flow TubeDimensionsØ30 mm x 150 mmØ30 mm x 150 mm
Power SupplyInternal 3.7 V Li-Ion battery(Rechargeable via 5V 500mAmini USB charger)Internal 3.7 V Li-Ion battery(Rechargeable via 5V 500mAmini USB charger)
Dimensions85x120x35 mm(Flow tube: 26 mm(ID)x150 mm)85x120x35 mm(Flow tube: 26 mm(ID)x150 mm)
Weight300g300g
Flow/VolumeBidirectional, ultrasoundBidirectional, ultrasound
Measurement SystemUltrasonic technology (referred toas "WaveFront™ technology"Ultrasonic technology (referredto as "WaveFront™ technology"
Volume Range± 20 L (BTPS)± 20 L (BTPS)
Flow Range± 18 L/s (BTPS)± 18 L/s (BTPS)
Volume Accuracy± 3% or 50 mL± 3% or 50 mL
Flow Accuracy± 3% or 20 mL/s± 3% or 20 mL/s
DynamicResistance at 14 L/s< 1.1 cmH2O/L/s< 1.1 cmH2O/L/s
Disposable in-linefilterAstraGuard - K062913Air Safety - K051712
ElectricalProtectionInternal battery powerInternal battery power
PrinterExternal printer via RS232 orBlueToothExternal printer via RS232 orBlueTooth

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510(k) Summary Page 3 of 5 26-May-2015

Table 2 - Comparison to Predicate

PredicateK092813SpiroThor
FVC (Forced Vital Capacity)YesYes
FEV.5 (Volume Expired in the first half second of test)NoNo
FEV 1 (Volume Expired in the first second of test)YesYes
FEV3 (Volume Expired in the first three second of test)YesYes
FEV6 (Volume Expired in the first six second of test)YesYes
FEV1/FEV6 - RatioNoNo
FEV.5/FVC - RatioNoNo
FEV1/FVC - RatioYesYes
FEV1/VC - RatioNoNo
PEF (Peak Expiratory Flow)YesYes
FEF25 (Maximum flow at 25% of FVC)YesYes
FEF50 (Maximum flow at 50% of FVC)YesYes
FEF75 (Maximum flow at 75% of FVC)YesYes
FEF25-75 (Average flow between 25% and 75% of FVC)YesYes
FEF75-85 (Average flow between 75% and 85% of FVC)NoNo
FET25-75 (Time between 25% and 75% of FVC)NoNo
FET100 (Forced Expiratory Time)YesYes
FIVC (Forced Inspiratory Vital Capacity)YesYes
*FVC (Best FVC)NoNo
IVC (Inspiratory Slow Vital Capacity)YesYes
MVV (Maximum Voluntary Ventilation)YesYes
PIF (Peak Inspiratory Flow)YesYes
Te (Expiratory Time)NoNo
Ti (Inspiratory Time)NoNo
Ti/Tt (Ratio of Inspiratory Time to Total Time)NoNo
TV (Tidal Volume)YesYes
TV/Ti RatioNoNo
VE (Minute Ventilation at Rest)NoNo
Vext (Extrapolated Volume)YesYes
VC (Slow Vital Capacity)YesYes

Differences:

The SpiroThor and predicate, K092813 – SDI AstraSonic Diagnostic Spirometer, are identical devices with minor differences. Namely, both products are produced by Thormed ("THOR") and the only differences are the name of the device and that another bacterial filter may be used with the proposed device. THOR produced the SDI AstraSonic that was cleared in 2009, under the SDI AstraSonic name K092813.

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510(k) Summary Page 4 of 5 26-May-2015

There are no changes in technology, materials, design, performance, or any other difference that would render the device not substantially equivalent except as noted above.

In summary, one can conclude that substantial equivalence is met based upon the following:

Indications for Use -

The indications for use are identical for the proposed device when compared to the predicate -K092813 - SDI AstraSonic Diagnostic Spirometer.

Discussion – Each device is indicated for use as a freestanding laboratory instrument for performing basic lung function tests in adults and children over the age of four years.

Technology and construction -

The design, components, shape, size, etc. are identical to the predicate, K092813 - SDI AstraSonic Diagnostic Spirometer.

Discussion - The technology and construction are identical to the predicate, K092813 - SDI AstraSonic Diagnostic Spirometer. It is noted that the proposed SpiroThor uses a different bacterial filter than the predicate, but comparative testing demonstrated that there is no differences in the performance of the SpiroThor with either filter.

Environment of Use -

The environments of use are identical to the predicate, K092813 - SDI AstraSonic Diagnostic Spirometer.

Discussion - physicians' offices, industrial medical and hospital settings.

Patient Population -

The patient population of adults and children over 4 years old.

Discussion - The patient populations are equivalent to the predicate, K092813 - SDI AstraSonic Diagnostic Spirometer.

Non-Clinical Testing Summary -

For K092813, THOR performed a number of bench tests.

These included:

  • । American Thoracic Society (ATS) 24 standard waveforms
  • -ISO 26782:2009
  • Accuracy of waveform generator -
  • -Flow resistance test
  • EN 60601-1:2006/AC:2010 -
  • EN 60601-1-2:2007/AC:2010 -
  • -EN 60601-1-6:2010
  • Performance to specifications with each bacterial filter -

The testing demonstrated that the SpiroThor performed as intended and met its performance specifications and was found to be substantially equivalent to the predicate K092813 - SDI AstraSonic Diagnostic Spirometer.

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510(k) Summary Page 5 of 5 26-May-2015

Materials:

The materials for each component, patient contact and predicate for the material per G95-1 and ISO 10993-1:2009 would be considered as both:

  • External Communicating (Indirect gas pathway),
  • . Tissue contacting
  • Duration of Use limited (< 24 hours) .

And

  • Surface Contact
  • Mucosal contacting
  • Duration of Use limited (< 24 hours) ●

The following tests would be required if a material certification cannot be provided.

  • Cytotoxicity ●
  • Sensitization
  • Intracutaneous / Irritation

The materials are identical to the predicates and we have provided a material certification.

Clinical Testing -

No clinical testing was required or performed.

Discussion of Differences -

There are no significant differences between the proposed device and the predicate except that the proposed device may utilize the Air Safety PFT filter and a name change, but we have demonstrated that there are no functional performance differences between the AstraGuard and Air Safety filters.

Substantial Equivalence Conclusion -

All testing demonstrated that the proposed device is substantially equivalent to the predicate device.

§ 868.1840 Diagnostic spirometer.

(a)
Identification. A diagnostic spirometer is a device used in pulmonary function testing to measure the volume of gas moving in or out of a patient's lungs.(b)
Classification. Class II (performance standards).