K Number
K012677
Device Name
REPROCESSED PULSE OXIMETER SENSORS
Manufacturer
Date Cleared
2003-03-28

(591 days)

Product Code
Regulation Number
870.2700
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Reprocessed Pulse Oximeter Sensors are intended for use when continuous external monitoring of arterial oxygen saturation and pulse rate are required.
Device Description
The reprocessed pulse oximeter sensor is an electro-optical sensor that uses an optical means to determine the light absorption of functional arterial hemoglobin. The sensor contains three optical components: two light emitting diodes (LED's) that serve as light sources, and one photodiode, that acts as a light receiver. The oximeter sensor is positioned so that the LED's and photodiode oppose one another across the tissue. The sensor is connected via cable to a pulse oximeter, which provides continuous non-invasive, self-calibrated measurements of both oxygen saturation of functional hemoglobin and pulse rate. Please note that this submission only pertains to the sensor. It does not pertain to the pulse oximeter or connecting cable.
More Information

Not Found

No
The device description focuses on the electro-optical components and their function in measuring light absorption. There is no mention of AI, ML, or any algorithms that would suggest their use in data processing or interpretation. The performance studies described are standard bench and clinical testing for functional equivalence, not studies related to AI/ML model performance.

No.
The device is a sensor used for continuous monitoring of arterial oxygen saturation and pulse rate, which are diagnostic measurements, not therapeutic interventions.

Yes

Explanation: The "Intended Use / Indications for Use" section states that the device is "intended for use when continuous external monitoring of arterial oxygen saturation and pulse rate are required." This involves measuring physiological parameters to assess a patient's health status, which is a diagnostic purpose. The "Device Description" further clarifies that it determines "light absorption of functional arterial hemoglobin" and provides "measurements of both oxygen saturation of functional hemoglobin and pulse rate," which are diagnostic outputs.

No

The device description explicitly states it is an "electro-optical sensor" containing "two light emitting diodes (LED's)" and "one photodiode," which are physical hardware components.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is "continuous external monitoring of arterial oxygen saturation and pulse rate." This describes a physiological measurement taken directly from the body, not a test performed on a sample of biological material in vitro (outside the body).
  • Device Description: The description details an "electro-optical sensor" that uses light absorption across tissue. This is a non-invasive measurement technique applied to the patient's body.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (like blood, urine, etc.) or performing tests on these samples in a laboratory setting.

IVD devices are specifically designed to examine specimens derived from the human body to provide information for the diagnosis, prevention, monitoring, treatment, or alleviation of disease or injury. This pulse oximeter sensor does not fit that definition.

N/A

Intended Use / Indications for Use

Reprocessed Pulse Oximeter Sensors are intended for use when continuous external monitoring of arterial oxygen saturation and pulse rate are required.

Product codes

NLF, DQA

Device Description

The reprocessed pulse oximeter sensor is an electro-optical sensor that uses an optical means to determine the light absorption of functional arterial hemoglobin. The sensor contains three optical components: two light emitting diodes (LED's) that serve as light sources, and one photodiode, that acts as a light receiver. The oximeter sensor is positioned so that the LED's and photodiode oppose one another across the tissue. The sensor is connected via cable to a pulse oximeter, which provides continuous non-invasive, self-calibrated measurements of both oxygen saturation of functional hemoglobin and pulse rate. Please note that this submission only pertains to the sensor. It does not pertain to the pulse oximeter or connecting cable.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

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

Representative samples of reprocessed sensors underwent bench testing and a clinical study to verify functional characteristics which are substantially equivalent to the predicate devices'. Process validation testing was done to validate the cleaning and sterilization procedures as well as the device's packaging. In addition, the manufacturing process includes visual and functional testing of all products produced.

Key Metrics

Not Found

Predicate Device(s)

K863784

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.2700 Oximeter.

(a)
Identification. An oximeter is a device used to transmit radiation at a known wavelength(s) through blood and to measure the blood oxygen saturation based on the amount of reflected or scattered radiation. It may be used alone or in conjunction with a fiberoptic oximeter catheter.(b)
Classification. Class II (performance standards).

0

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 symbol resembling an eagle or bird in flight, composed of three curved lines.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

1 2004 NOV

Dr. Bruce Lester Vice President of Research and Development SterilMed, Incorporated 11400 73Rd. Avenue North Minneapolis, Minnesota 55369

Re: K012677 - Supplemental Validation Submission Trade/Device Name: See Enclosed List Regulation Number: 870.2700 Regulation Name: Oximeter Regulatory Class: II Product Code: NLF Dated: August 13, 2001 Received: August 14, 2001

Dear Dr. Lester:

The above-referenced premarket notification (510(k)) was cleared by the Office of Device Evaluation (ODE) on March 28, 2003. We have received your supplemental validation data as required for reprocessed single-use devices by the Medical Device User Fee and Modernization Act of 2002. After reviewing your supplemental validation data, we have determined the devices listed in the enclosure accompanying this letter are 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 these devices, 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 devices are classified (see above) into either class II (Special Controls) or class III (PMA) they 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 898. In addition, FDA may publish further announcements concerning your devices in the Federal Register.

1

Page 2 - Dr. Bruce Lester

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your devices comply 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 applicable requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); 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.

The FDA finding of substantial equivalence of your devices to legally marketed predicate devices results in classification for your devices and thus, permits you to legally market the devices. This letter will allow you to continue marketing the devices listed in the enclosure accompanying this letter.

If you desire specific advice for your devices on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at (240) 276-0120. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). 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) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.

Sincerely yours,

Chiu Lin, Ph.D.

Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Page 3 - Dr. Bruce Lester

Trade/Device Names

SterilMed Reprocessed Nellcor Pulse Oximeter Oxisensor II Sensor N-25 SterilMed Reprocessed Nellcor Pulse Oximeter Oxisensor II Sensor N-25LF

3

Indications for use Page

510(K) Number Kolze 77

Device Name: Reprocessed Pulse Oximeter Sensors

Indications for Use:

Reprocessed Pulse Oximeter Sensors are intended for use when continuous external monitoring of arterial oxygen saturation and pulse rate are required.

Concurrence of CDRH, Office of Device Evaluation (ODE)

$\underset{-}{\checkmark}$ PRESCRIPTION

SAWesterman

on of Anesthesiology, General Hospital Infection Control, Dental Devi

510(k) Number: K012677

SterilMed, Inc. Pulse Oximeter Probes Confidential

Premarket Notification

4

SECTION 2. SUMMARY AND CERTIFICATION

510(k) Summary A.

Submitter:SterilMed, Inc.
Contact Person:Patrick Fleischhacker
Submitted by SterilMed, Inc.
11400 73rd Avenue North
Minneapolis, MN 55369
Ph: 888-856-4870
Fax: 763-488-3350
Date Prepared:August 13, 2001
Trade Name:SterilMed Reprocessed Pulse Oximeter Sensors
Classification Name:
and Number:Class II, 21 CFR 870.2700
Product Code:DQA
Predicate Device(s):The reprocessed pulse oximeter sensors are substantially
equivalent to the Nellcor Oxisensors™, which are
compatible with the Nellcor N-200 pulse oximeter
(K863784).
Device Description:The reprocessed pulse oximeter sensor is an electro-optical
sensor that uses an optical means to determine the light
absorption of functional arterial hemoglobin. The sensor
contains three optical components: two light emitting
diodes (LED's) that serve as light sources, and one
photodiode, that acts as a light receiver. The oximeter
sensor is positioned so that the LED's and photodiode
oppose one another across the tissue. The sensor is
connected via cable to a pulse oximeter, which provides
continuous non-invasive, self-calibrated measurements of
both oxygen saturation of functional hemoglobin and pulse
rate. Please note that this submission only pertains to the
sensor. It does not pertain to the pulse oximeter or
connecting cable.
Intended Use:Reprocessed pulse oximeter sensors are used when
continuous external monitoring of arterial oxygen
saturation and pulse rate is required.
Functional and
Safety Testing:Representative samples of reprocessed sensors underwent
bench testing and a clinical study to verify functional
characteristics which are substantially equivalent to the
predicate devices'. Process validation testing was done to
validate the cleaning and sterilization procedures as well as
the device's packaging. In addition, the manufacturing
process includes visual and functional testing of all
products produced.
Conclusion:The pulse oximeter sensors reprocessed by SterilMed are
substantially equivalent the Nellcor Oxisensors™ which
are compatible with the Nellcor N-200 pulse oximeter.
This conclusion is based upon the fact that the reprocessed
sensors are substantially equivalent to their predicate
devices in terms of functional design, materials, indications
for use, and methods of construction.

5