K Number
K151013

Validate with FDA (Live)

Manufacturer
Date Cleared
2015-04-30

(15 days)

Product Code
Regulation Number
870.2920
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Diagnostic evaluation of patients with asymptomatic disturbances of cardiac rhythm such as: -Dizziness -Heart race -Palpitation -Syncopesof unknown cause

Device Description

The ECG monitoring devices are post-event recorders, also called tele-ECG devices, which realize one-channel (100BT) or three- channel (300BT) recordings of short ECG sections, their memorization as well as the preparation of the transmission. Therefore, the purpose of the recorders is the derivation and memorization of an ECG section in combination with a compatible telemedicine system. The recorder provides physicians with information used for the diagnosis of cardiac arrhythmias. The Post Event 300BT device is a modification to Vitaphone's previously cleared Post Event 110BT device cleared pursuant to K100383. The modification consists of the availability of three recording channels rather than one recording channel. There is no change to intended use, patient contact materials or core technology. The hardware of the 100BT and the 300BT is basically the same. The differences between both devices is the activation of the channels by the software. The device supports the transmission of the data. The recorders are battery operated devices. The recorders do not possess a separate on/off switch.

AI/ML Overview

The provided document is a 510(k) summary for the Vitaphone Post-Event Recorder 300 BT. This document focuses on demonstrating substantial equivalence to a predicate device (Vitaphone Post Event Recorder 100BT - K100383) rather than defining specific performance acceptance criteria for a new AI/algorithm-driven device and a study to prove it.

The Vitaphone Post-Event Recorder 300 BT is a cardiac event recorder, not an AI or algorithm-driven diagnostic device in the sense of image analysis or complex pattern recognition. Its function is to record ECG signals and transmit them. The "performance data" section indicates compliance with safety and essential performance standards for medical electrical equipment.

Therefore, many of the requested points regarding AI/algorithm performance (e.g., sample size for test/training sets, ground truth establishment methods, expert adjudication, MRMC studies, standalone performance) are not applicable to this type of device and its 510(k) submission as presented.

Based on the provided text, here is what can be extracted and what cannot:

1. A table of acceptance criteria and the reported device performance

The document does not explicitly present a table of "acceptance criteria" in the typical sense of diagnostic performance metrics (sensitivity, specificity, AUC). Instead, it relies on compliance with established medical device standards and functional equivalence to the predicate device.

Feature / StandardAcceptance Criteria (Implied by compliance)Reported Device Performance (Implied by compliance)
Safety and Essential PerformanceCompliance with IEC 60601-1 (2005, MOD)"Every specification of the modified device has been validated... Results of performance testing demonstrated that the 300BT model... meets all performance specifications."
Electromagnetic Compatibility (EMC)Compliance with IEC 60601-1-2"Verification and validation testing included testing to applicable standards..."
Ambulatory ECG System SafetyCompliance with IEC 60601-2-47"Verification and validation testing included testing to applicable standards..."
Risk ManagementCompliance with ISO 14971"Verification and validation testing were completed in accordance with the company's design control process in compliance with 21 CFR Part 820.30."
Functional EquivalenceTo Vitaphone 100BT (K100383) in intended use, materials, and core technology (except for number of ECG channels)"The 300BT model is substantially equivalent to the 100BT and that the 300BT meets all performance specifications."
Physical/Technical SpecificationsMatching or improved over predicate (e.g., 3 ECG channels vs. 1)The comparison table (page 6) shows identical specifications for most parameters (sampling rate, A/D converter, memory, battery life, etc.), with the key difference being 3 ECG channels for the subject device compared to 1 for the predicate.

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

  • Not applicable / Not provided. The document describes engineering validation and verification testing against standards, not a clinical study with a "test set" of patient data for diagnostic algorithm performance.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

  • Not applicable / Not provided. This is not an AI/algorithm for diagnostic interpretation. Ground truth for ECG signal quality would be assessed through technical means, not expert consensus on diagnoses.

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

  • Not applicable / Not provided. No such adjudication for diagnostic performance is mentioned.

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

  • No. This is not an AI-assisted diagnostic device; therefore, no MRMC study or AI-assistance effect size is relevant or provided.

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

  • Not applicable / No. The device is a recorder, not a standalone diagnostic algorithm. It enables healthcare professionals to acquire ECGs for later diagnostic evaluation.

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

  • Not applicable / Not provided. For a simple ECG recorder, the "ground truth" relates to the accurate acquisition and transmission of the electrical signals from the heart, which is verified against known electrical inputs and validated against performance standards rather than clinical ground truth like pathology for a diagnostic algorithm.

8. The sample size for the training set

  • Not applicable / Not provided. This device is hardware with firmware, not a machine learning model that requires a "training set."

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

  • Not applicable / Not provided. As above, no training set for a machine learning model is involved.

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

April 30, 2015

Vitasystems Gmbh % Mr. Mark Job Regulatory Technology Services LLC 1394 25th Street, NW Buffalo, Minnesota 55313

Re: K151013

Trade/Device Name: Vitaphone Post-Event Recorder 300 BT Regulation Number: 21 CFR 870.2920 Regulation Name: Telephone Electrocardiograph Transmitters and Receivers Regulatory Class: II (two) Product Code: DXH Dated: April 13, 2015 Received: April 15, 2015

Dear Mr. Mark Job,

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.

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 devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in

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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 Industry and Consumer Education 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. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 Industry and Consumer Education 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 vours,

Mitchell Stein

for 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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K151013

Page 1 of__1__1__

510(k) Number (if known): ______________________________________________________________________________________________________________________________________________________________________________

Device Name : ___ Vitaphone Post-Event Recorder 300 BT________________________________________________________________________________________________________________________

Indications For Use:

Diagnostic evaluation of patients with asymptomatic disturbances of cardiac rhythm such as: -Dizziness -Heart race -Palpitation -Syncopesof unknown cause

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

OR

Over-The-Counter Use

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510(k) Summary Prepared June 30, 2014

Sponsor:Vitasystems GmbH
Address:Staderstralle 14D-09126 Chemnitz, Germany
Contact Person:Michael Rothhaar
Telephone:49 621 178918174
Fax:49 621 178918101
Submission Date:June 30, 2014
Device Name:Vitaphone Post-Event Recorder 300BT
Common Name:Tele-ECG System, Cardiac Event Recorder
Classification:
Regulatory Class:II
Review Category:Tele-ECG System, Cardiac Event Recorder21CFR 870.2920 (DXH)
Classification Panel:Cardiology

A. Legally Marketed Predicate Devices

The Post Event 300BT device is substantially equivalent to Vitaphone's Post Event Recorder 100BT (K100383) with regard to both its intended use and its core technological characteristics. The 300BT represents a modification to the predicate device.

B. Device Description:

The ECG monitoring devices are post-event recorders, also called tele-ECG devices, which realize one-channel (100BT) or three- channel (300BT) recordings of short ECG sections, their memorization as well as the preparation of the transmission. Therefore, the purpose of the recorders is the derivation and memorization of an ECG section in combination with a compatible telemedicine system. The recorder provides physicians with information used for the diagnosis of cardiac arrhythmias. The Post Event 300BT device is a modification to Vitaphone's previously cleared Post Event 110BT device cleared pursuant to K100383.

The modification consists of the availability of three recording channels rather than one recording channel. There is no change to intended use, patient contact materials or core

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technology. The hardware of the 100BT and the 300BT is basically the same. The differences between both devices is the activation of the channels by the software. The device supports the transmission of the data. The recorders are battery operated devices. The recorders do not possess a separate on/off switch.

C. Intended Use

Diagnostic evaluation of patients with asymptomatic and symptomatic disturbances of the cardiac rhythm such as:

-Dizziness

-Heart race

-Palpatations

-Syncopes of unknown cause

D. Substantial Equivalence

The Post Event 300BT device is substantially equivalent to Vitaphone's previously cleared Post Event 100BT device cleared pursuant to K100383. There is only one difference between the original and the modified device: the 300BT provides 3 recording channels whereas the 100BT had only one recording channel. There is not change to the intended use, materials or core technology. A comparison between the predicate and the modified device and an analysis of the differences demonstrated that the devices are substantially equivalent.

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FeaturePredicate DeviceVitaphone 100BT Event Recorder(K100383)Subject DeviceVitaphone 300BT Event Recorder
Intended useDiagnostic evaluation of patients withasymptomatic andsymptomatic disturbances of thecardiac rhythmsuch as:– Dizziness– Racing heart beat– Palpitations– Syncopes of unknown causeDiagnostic evaluation of patients withasymptomatic and symptomaticdisturbances of the cardiac rhythm suchas:– Dizziness– Racing heart beat– Palpitations– Syncopes of unknown cause
Intended UsersHealthcare ProfessionalsHealthcare Professionals
ClassIIII
RegulationnumberCode21CFR 870.292021CFR 870.2920
DeviceDescriptionThe Vitaphone 100 BT device is a onechannel cardiac event recorder fortransmitting multiple ECG recordingsvia land-line or GSM telephonynetworks to a compatible ECGreceiving system, such as REMOSECG Receiving Software (510(k)K050670) or compatible ECGreceivers.The Vitaphone 100 BT device isintended for patient activated eventrecordings. It is battery operated andUtilizes a Flash memory to store ECGdata with and adjustable event time.The Vitaphone 300 BT device is a threechannel cardiac event recorder fortransmitting multiple ECG recordingsvia land-line or GSM telephonynetworks to a compatible ECGreceiving system, such as REMOSECG Receiving Software (510(k)K050670) or compatible ECGreceivers.The Vitaphone 300 BT device isintended for patient activated eventrecordings. It is battery operated andutilizes a Flash memory to store ECGdata with an adjustable event time.

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K151013

Page 4 of 5

Comparison Table – Technological Characteristics
FeaturePredicate DeviceVitaphone 100BT Event Recorder(K100383)Subject DeviceVitaphone 300BT Event Recorder
ECG Channels13
SafetyCompliant with ISO 60601-1Compliant with ISO 60601-1
DisplayYesYes
Buttons22
Audible feedbackYesYes
SetupUse of buttons and displayUse of buttons and display
Transmission methodBluetooth / GSM; transtelephonicBluetooth / GSM; transtelephonic
Audio triggerNoNo
Arythmia detectionNoNo
Auto sendYesYes
Electrode typeMetalMetal
Looping memoryNoNo
Pacemaker detectionYesYes
Applied part classBFBF
ECG memory10800s10800s
Max events120120
Batteries2 x AAA2 x AAA
Battery lifetime100 ECG transmissions100 ECG transmissions
Backup batteryYesYes
Weight95 gr95 gr
Width74 mm74mm
Thickness23mm23mm
Cover materialMolded plasticMolded plastic
Operating temperature5-45°C5-45°C
Storage temperature-20 - +60° C-20 - +60° C
Relative humidity10-95%10-95%
Memory typeFlashFlash
Data retention10 years10 years
Sampling rate200 Hz200 Hz
A/D Converter12 bit12 bit
Input impedance10 MOhm10 MOhm
Frequency range0.5 - 40 Hz0.5 - 40 Hz
Signal input range AC+/- 3mV+/- 3mV
Signal input range DC+/- 300 mV+/- 300 mV
Common mode ejection80dB80dB
Amplitude1 mV1 mV
calibration
Minimum featuresize50μV p-v@10Hz50μV p-v@10Hz

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E. Performance Data

Every specification of the modified device has been validated according to the documented development and test procedures. The verification and validation testing included testing to applicable standards including:

  • Medical electrical equipment – Part 1: General requirements for basic safety and essential performance (IEC 60601-1; 2005, MOD)
  • Medical electrical equipment Part 1-2: General requirements for basic safety ● and essential performance - Collateral standard: Electromagnetic compatibility Requirements and tests
  • Medical electrical equipment-Part 2-47; Particular requirements for the safety , ● including essential performance; of ambulatory electrocardiographic systems

ISO 14971 Medical devices - application of risk management to medical devices . Verification and validation testing were completed in accordance with the company's design control process in compliance with 21 CFR Part 820.30. Results of performance testing demonstrated that the 300BT model is substantially equivalent to the 100BT and that the 300BT meets all performance specifications.

§ 870.2920 Telephone electrocardiograph transmitter and receiver.

(a)
Identification. A telephone electrocardiograph transmitter and receiver is a device used to condition an electrocardiograph signal so that it can be transmitted via a telephone line to another location. This device also includes a receiver that reconditions the received signal into its original format so that it can be displayed. The device includes devices used to transmit and receive pacemaker signals.(b)
Classification. Class II (performance standards).