K Number
K012058
Device Name
STAT PROFILE PHOX PLUS L ANALYZER
Date Cleared
2001-08-20

(49 days)

Regulation Number
862.1120
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Stat Profile pHOx Plus L Analyzer is intended for in vitro diagnostic use by health care professionals and for Point-of-Care usage for the quantitative determination of pH, pCO2, pO2, SO2%, Hct, Hb, Na+, K+, Cl-(or Ca++), Glu and Lac in heparinized whole blood.
Device Description
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More Information

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Not Found

No
The provided 510(k) summary does not contain any mention of AI, ML, deep learning, or related concepts in the device description, intended use, or performance study sections. The device appears to be a standard blood gas analyzer.

No
The device is an in vitro diagnostic device used for quantitative determination of various analytes in blood, not for treating a disease or condition.

Yes
The "Intended Use / Indications for Use" section explicitly states that the device is "intended for in vitro diagnostic use".

No

The device is described as an "Analyzer" which is a hardware device used for in vitro diagnostic testing of blood samples. The description of the intended use clearly indicates the measurement of various analytes in whole blood, which requires physical interaction with a sample, not just software processing.

Yes, based on the provided information, the Stat Profile pHOx Plus L Analyzer is an IVD (In Vitro Diagnostic) device.

The "Intended Use / Indications for Use" section explicitly states:

"The Stat Profile pHOx Plus L Analyzer is intended for in vitro diagnostic use by health care professionals and for Point-of-Care usage for the quantitative determination of pH, pCO2, pO2, SO2%, Hct, Hb, Na+, K+, Cl-(or Ca++), Glu and Lac in heparinized whole blood."

This statement directly identifies the device's purpose as being for in vitro diagnostic use.

N/A

Intended Use / Indications for Use

The Stat Profile pHOx Plus L Analyzer is intended for in vitro diagnostic use by health care professionals and for Point-of-Care usage for the quantitative determination of pH, pCO2, pO2, SO2%, Hct, Hb, Na+, K+, Cl-(or Ca++), Glu and Lac in heparinized whole blood.

Product codes

KHP

Device Description

Stat Profile pHOx Plus L Analyzer

Mentions image processing

Not Found

Mentions AI, DNN, or ML

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Input Imaging Modality

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Anatomical Site

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Indicated Patient Age Range

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Intended User / Care Setting

health care professionals and for Point-of-Care usage

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Not Found

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

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Reference Device(s)

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Predetermined Change Control Plan (PCCP) - All Relevant Information

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§ 862.1120 Blood gases (P

CO2 , PO2 ) and blood pH test system.(a)
Identification. A blood gases (PCO2 , PO2 ) and blood pH test system is a device intended to measure certain gases in blood, serum, plasma or pH of blood, serum, and plasma. Measurements of blood gases (PCO2 , PO2 ) and blood pH are used in the diagnosis and treatment of life-threatening acid-base disturbances.(b)
Classification. Class II.

0

DEPARTMENT OF HEALTH & HUMAN SERVICES

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 stylized caduceus symbol, which is a staff with two snakes coiled around it, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged in a circular fashion around the symbol. The text is in all caps and is smaller than the caduceus symbol. The logo is black and white.

AUG 2 0 2001

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

Mr. Paul W. MacDonald Director of Quality Assurance/Regulatory Affairs Nova Biomedical Corp. 200 Prospect Street Waltham, MA 02254-9141

510(k) Number: K012058 Re: Trade/Device Name: Stat Profile pHOx Plus L Analyzer TraderDevice Namber: 862.1120, 862.1660, 862.1450, 862.6400, 862.6400, 862.1150, 862.1665, 862.1145, 862.1345, 862.3220, 862.5620 Regulatory Class: II Rogalatery Jorde: CHL, GKR, JIX, JGS, CEM, JFP, CGZ, CGA, JIP Regulatory Class: I Product Code: KHP Dated: June 29, 2001 Received: July 2, 2001

Dear Mr. MacDonald:

We have reviewed your Section 510(k) notification of intent to market the device referenced wo have lovice four bar buter is substantially equivalent to devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Ameridate of max 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 the general vegistration, 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 Good Manufacturing Prodoculations of Medical Devices: General (GMP) regulation (21 CFR Part 820) and that, through periodic GMP inspections, the Food and Drug Administration (FDA) will verify such penodio Shir million 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 region. Freasons on might have under sections 531 through 542 of the Act for devices under the any or agains of the Radiation Control provisions, or other Federal laws or regulations.

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Page 2 -

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 1 additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4588. 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" (21CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers International and Consumer 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,

Steven Sutman

Steven I. Gutman, M.D., M.B.A. Director Division of Clinical Laboratory Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number: Kolao58

Device Name: Stat Profile pHOx Plus L Analyzer

Indications for Use:

Intended Use

The Stat Profile pHOx Plus L Analyzer is intended for in vitro diagnostic use by health care by health care The Stat Profile pHOX Plus Lanayal is intenties not in vitro alegrovination of pH, pCO2, pO2,
professionals and for Point-of-Care usage for the quantitative determination of professionals and for Point-of-Oare usage for the quantinized whole blood.
SO2%, Hct, Hb, Na+, K+, Cl-(or Ca++), Glu and Lac in heparinized whole blood.

(Please do not WRITE BELOW THIS LINE- CONTINỤE ON ANOTHER PAGE IFNEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

(Optional Format 3-10-98)

Kezia Alexander Graham Cooper

Division of Clinical Labora 510(k) Number

Rx