K Number
K983832
Date Cleared
1999-01-25

(87 days)

Product Code
Regulation Number
874.1090
Reference & Predicate Devices
N/A
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Interacoustics MT10 Handheld Impedance Audiometer is an easy to use handheld diagnostic middle ear analyzer that is well suited for providing quick and reliable results in both diagnostic and screening settings. The tympanometry test features a user selectable extended pressure range that is capable of -600daPa. Four ipsilateral reflexes at different frequencies may be tested at each ear. Reflex testing operates either at a user defined fixed level or uses an automatic intensity search function. It assists in the diagnosis of now sible otologic disorders.

Device Description

Our device, the Model MT10 Handheld Impedance Audiometer is an easy to use handheld diagnostic middle ear analyzer that is well suited for providing quick and reliable results in both diagnostic and screening settings. The tympanometry test features a user selectable extended pressure range that is capable of -600daPa. Four ipsilateral reflexes at different frequencies may be tested at each ear. Reflex testing operates either at a user defined fixed level or uses an automatic intensity search function. It assists in the diagnosis of possible otologic disorders.

AI/ML Overview

The provided text describes the Interacoustics Model MT10 Handheld Impedance Audiometer and its similarity to a predicate device, the Grason Stadler GSI-37 Auto Tymp, for the purpose of 510(k) clearance.

However, the document does not contain information about specific "acceptance criteria" in terms of performance metrics (e.g., sensitivity, specificity, accuracy) for the device, nor does it detail a study that proves the device meets such criteria. Instead, the submission focuses on demonstrating substantial equivalence to a legally marketed predicate device based on technical specifications and adherence to relevant standards.

Therefore, many of the requested sections about acceptance criteria, device performance, and details of a performance study cannot be filled from the provided text.

Here's an attempt to answer the questions based on the available information:


Acceptance Criteria and Device Performance

The submission does not specify quantitative acceptance criteria in terms of clinical performance metrics, nor does it present detailed study results in that format. The "acceptance criteria" in this context appear to be compliance with established performance and safety standards, and demonstrating substantial equivalence to a predicate device.

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance Criteria (Implied)Reported Device Performance (vs. Predicate/Standards)
(Functional/Technical Specifications - Implicit criteria are that the device performs comparably to or better than the predicate, and meets relevant standards)
Display TypeDigital (Equivalent to Predicate)
Form FactorLightweight, handheld (Equivalent to Predicate)
Hardcopy PrintoutProvides objective documentation of otitis media and other middle ear disorders (Equivalent to Predicate)
Intensity Range10dBHL to 50dBHL (Predicate: Not applicable)
Pressure Range+300 -600 daPa/sec. (Predicate: +200 -400 daPa/sec.) - Range is broader than predicate.
Compliance Range.0 to 2.5 cc displayed; .0 to 5.0 cc numeric (Predicate: .0 to 1.5 cm³ displayed) - Range is broader than predicate.
Tests PerformedTympanometry, acoustic reflex and screening audiometry (Predicate: Tympanometry) - More tests than predicate.
Software CompatibilityCompatible Windows Software: laBase 95 database program; Printview for on-line PC monitoring and printing; NOAH hearing aid fitting software (Predicate: None) - Additional functionality.
Applicable StandardsMeets or exceeds IEC 1027-1995, ANSI 3.60 -1989, ANSI 3.60-1985, Safety IEC 601-1-1988. Approved for Medical CE-marking by Danish Notified Body D.G.M. Identification No. 0543, Quality System Certificate DGM 016 (CE 0543) (Predicate: Meets ANSI S3.39 - 1987 for Type 4 Instrument and IEC 601-1-1988) - Meets specified performance and safety standards.
Available Frequencies.5kHz, 1kHz, 2kHz, 3kHz & 4kHz (Predicate: Not applicable)
Probe Tone Frequency226 Hz, +/-3% (Equivalent to Predicate)
Probe Tone Amplitude85dB SPL +/-3dB (Predicate: 85.5 dB SPL, +/-2.0 dB) - Comparable.
Power SourceNiMH batteries or Standard AA NiCa batteries (Predicate: NiCad batteries) - Similar.
Direction of Pressure SweepPositive to negative (Equivalent to Predicate)
Size and Weight (Probe)4" x 10" x 5"; 1 lb. (Predicate: 2.4" x 8.3" x 4.3"; 10.5 oz) - Differences in physical dimensions.
External Power Supply(optional) 1.8 lbs (recharger power supply EPS11 power transformer-11 volts) (Predicate: (optional) 1.5 lbs. (recharger power supply -9 volts)) - Similar.

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

The document does not describe a clinical or performance study with a test set of data or human subjects. The submission relies on technical comparisons and adherence to standards rather than clinical data for demonstrating substantial equivalence.

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

Not applicable, as no clinical test set requiring ground truth established by experts is described.

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

Not applicable, as no clinical test set requiring adjudication is described.

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

Not applicable. This device is an impedance audiometer, providing objective measurements, not an AI-assisted diagnostic tool that would involve human readers interpreting results in conjunction with AI.

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

This is an impedance audiometer providing objective measurements. The concept of "standalone algorithm performance" as typically applied to AI/imaging diagnostics does not directly apply here. The device itself performs the measurements. Its "standalone" performance is dictated by its technical specifications and adherence to standards, which are detailed in the comparison table.

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

Not applicable, as no clinical performance study with defined ground truth is described. The "ground truth" for this type of device's regulatory submission is its capability to meet technical specifications and established standards, and its equivalence to a predicate device in performing its intended function.

8. The sample size for the training set

Not applicable, as this device would not typically involve a "training set" in the context of machine learning or AI.

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

Not applicable, for the same reasons as above.


Summary of Device Approval Approach:

The provided 510(k) summary indicates that the Interacoustics Model MT10 Handheld Impedance Audiometer received clearance based on:

  • Substantial Equivalence: Demonstrating that it is as safe and effective as a legally marketed predicate device (Grason Stadler GSI-37 Auto Tymp) through a comparison of technical specifications and indications for use.
  • Compliance with Standards: Meeting recognized national and international performance and safety standards (IEC 1027-1995, ANSI 3.60 -1989, ANSI 3.60-1985, Safety IEC 601-1-1988).
  • CE Mark Approval: The device was also approved for Medical CE-marking, indicating compliance with European safety and performance requirements.

The document does not detail any clinical performance studies that might involve patient data, expert interpretations, or statistical measurements of accuracy, sensitivity, or specificity.

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K983832

Page 1 of 2

JAN 25 1999

510(k) SUMMARY

PREPARED BY:INTERNATIONAL DISTRIBUTORS OFELECTRONICS FOR MEDICINE, INC.(IDEM)4814 East Second StreetBenicia, CA 94510
CONTACT PERSON:Donna Ward, President
TELEPHONE:707-746-6334
DATE ON WHICH THE SUMMARYWAS PREPARED:October 1, 1998
NAME IF DEVICE:Interacoustics Model MT10 HandheldImpedance Audiometer
COMMON NAME:Impedance Audiometer
PREDICATE DEVICE:Grason Stadler GSI- 37 Auto Tymp

DESCRIPTION OF DEVICE: Our device, the Model MT10 Handheld Impedance Audiometer is an easy to use handheld diagnostic middle ear analyzer that is well suited for providing quick and reliable results in both diagnostic and screening settings. The tympanometry test features a user selectable extended pressure range that is capable of -600daPa. Four ipsilateral reflexes at different frequencies may be tested at each ear. Reflex testing operates either at a user defined fixed level or uses an automatic intensity search function. It assists in the diagnosis of possible otologic disorders.

Comparison of the Interacoustics Model MT10 Handheld Impedance Audiometer and the Grason Stadler GSI-37 Auto Tymp.

Indication for use - Identical for both units.

Similarities and differences:

Model MT10 Handheld ImpedanceAudiometerEquivalent - Grason Stadler GSI-37Auto Tymp
Display Description: DigitalDigital
Lightweight, handheldLightweight, handheld

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Hardcopy printout provides objectivedocumentation of otitis media andother middle ear disorders.Hardcopy printout provides objectivedocumentation of otitis media andother middle ear disorders.
Intensity: 10dBHL to 50dBHLNot applicable
Pressure range: +300 -600daPa/sec.+200 -400 daPa/sec.
Compliance range: .0 to 2.5 ccdisplayed; .0 to 5.0 cc numeric.0 to 1.5cm³ displayed
Tests: tympanometry, acoustic reflexand screening audiometryTympanometry
Compatible Windows Software:laBase 95 database program;Printview for on-line PC monitoring andprinting; NOAH hearing aid fittingsoftwareNone
Standards: meets or exceedsstandards specified in IEC 1027-1995,ANSI 3.60 -1989, ANSI 3.60-1985,Safety IEC 601-1-1988Meets ANSI S3.39 - 1987 for Type 4Instrument and IEC 601-1-1988
Available frequencies: .5kHz, 1kHz,2kHz, 3kHz & 4kHzNot applicable
Probe tone: frequency: 226 Hz, +/-3%226 Hz, +/-3%
Amplitude: 85dB SPL +/-3dB85.5 dB SPL, +/-2.0 dB
Power: NiMH batteries or Standard AANiCa batteriesNiCad batteries
Direction of Pressure Sweep: positiveto negativePositive to negative
Size and Weight: Probe: 4" x 10" x 5";1 lb.; printer/charger: 12" x 9" x 4"; 4lbs. 11.6 oz.Probe: 2.4" x 8.3" x 4.3"; 10.5 oz;printer/charger 9" x 7.6" x 4"; 3 lbs.
External Power Supply: (optional) 1.8Ibs (recharger power supply EPS11power transformer-11 volts)External Power Supply: (optional) 1.5Ibs. (recharger power supply -9 volts)

SAFETY AND EFFECTIVENESS:

The Interacoustics Model MT10 Handheld Impedance Audiometer is in compliance with the following performance and safety standards:

Standards in IEC 1027-1995, ANSI 3.60-1989, ANSI 3.60-1985, Safety IEC 601-1-1988. Approved for Medical CE-marking by Danish Notified Body D.G.M. Identification No. 0543, Quality System Certificate DGM 016 (CE 0543)

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Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 25 1999

Donna Ward President International Distributors of Electronics for Medicine, Inc. 4814 East Second Street Benicia, CA 94510

Re: K983832

Interacoustics Model MT10 Handheld Impedance Audiometer Dated: October 28, 1998 Received: October 30, 1998 Regulatory class: II: 21 CFR 874.1090/Procode: 77 ETY

Dear Ms. Ward:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we 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). 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 (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4613. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597, or at its internet address "http://www.fda.gov/cdrh/dsma/dsmamain.html".

Sincerely yours,

Capt. Daniel G. Schultz, M.D. Acting Director, Division of Reproductive, Abdominal, Ear, Nose and Throat, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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510(k) Number (if known): 49838383

Device Name: _________________________________________________________________________________________________________________________________________________________________

Indications For Usc:

The Interacoustics MT10 Handheld Impedance Audiometer is an easy to use handheld diagnostic middle ear analyzer that is well suited for providing quick and reliable results in both diagnostic and screening settings. The tympanometry test features a user selectable extended pressure range that is capable of -600daPa. Four ipsilateral reflexes at different frequencies may be tested at each ear. Reflex testing operates either at a user defined fixed level or uses an automatic intensity search function. It assists in the diagnosis of now sible otologic disorders.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)
(Division Sign-Off)
Division of Reproductive, Abdominal, ENT,and Radiological Devices
510(k) NumberK983832
Prescription UseOROver-The-Counter Use
(Per 21 CFR 801.109)(Optional Format)

(Optional Formal 1-2-96)

§ 874.1090 Auditory impedance tester.

(a)
Identification. An auditory impedance tester is a device that is intended to change the air pressure in the external auditory canal and measure and graph the mobility characteristics of the tympanic membrane to evaluate the functional condition of the middle ear. The device is used to determine abnormalities in the mobility of the tympanic membrane due to stiffness, flaccidity, or the presence of fluid in the middle ear cavity. The device is also used to measure the acoustic reflex threshold from contractions of the stapedial muscle, to monitor healing of tympanic membrane grafts or stapedectomies, or to monitor followup treatment for inflammation of the middle ear.(b)
Classification. Class II (special controls). The device, when it is a tympanometer or auditory impedance tester that complies with FDA-recognized consensus standard ANSI S3.39, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 874.9.