K Number
K013427
Device Name
MODIFICATION TO:PHILIPS M3000A/M3046A COMPACT PORTABLE PATIENT MONITOR, MODELS PHILIPS M3000A/M3046A
Date Cleared
2001-11-29

(44 days)

Product Code
Regulation Number
870.1025
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Intended for monitoring, recording, and alarming of multiple physiological parameters of adults, pediatrics, and neonates in hospital and medical transport environments.
Device Description
Not Found
More Information

Not Found

No
The summary does not mention AI, ML, or related terms, nor does it describe features or studies typically associated with AI/ML in medical devices.

No
The text describes the device as intended for "monitoring, recording, and alarming of multiple physiological parameters". Monitoring devices are typically diagnostic or for information gathering, not therapeutic.

No.
The device is intended for monitoring, recording, and alarming of physiological parameters, not for diagnosing medical conditions.

Unknown

The provided 510(k) summary does not contain a "Device Description" section, which is crucial for determining if the device is software-only. The information about monitoring physiological parameters and correlating to an auscultatory reference standard suggests potential hardware components for data acquisition, but this cannot be confirmed without a device description.

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

Here's why:

  • Intended Use: The intended use is for "monitoring, recording, and alarming of multiple physiological parameters." This describes a device that measures physiological signals directly from the patient (e.g., heart rate, blood pressure, oxygen saturation).
  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections.
  • Lack of IVD Indicators: There is no mention of analyzing biological samples, performing tests on bodily fluids, or diagnosing conditions based on laboratory analysis.

The device described is a patient monitor, which is a type of medical device used for real-time physiological monitoring, not for in vitro diagnostic testing.

N/A

Intended Use / Indications for Use

monitoring, recording, and alarming of multiple physiological parameters of adults, pediatrics, and neonates in hospital and medical transport environments.

Product codes (comma separated list FDA assigned to the subject device)

74 MHX, 74 DSI, 74 MLD, 74 DRW, DSJ, DSK, DXN, 74 DRT, 74 FYW, 74 DXG, 74 DSA, 74 DRS, 73 CCK, 80 FLL

Device Description

The name of this device is Philips M2/M3/M4 Compact Portable Patient Monitor.

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

adults, pediatrics, and neonates

Intended User / Care Setting

hospital and medical transport environments

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)

The modification provides an auscultatory validation reference, according to subclause 4.4.2.1 of AAMI SP-10 for pediatric and adult patients. The results of the validation study indicate that the device performance correlates to auscultatory reference standard according to subclause 4.4.2.1 of AAMI SP-10 for pediatric and adult patients.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K971910, K981576

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 870.1025 Arrhythmia detector and alarm (including ST-segment measurement and alarm).

(a)
Identification. The arrhythmia detector and alarm device monitors an electrocardiogram and is designed to produce a visible or audible signal or alarm when atrial or ventricular arrhythmia, such as premature contraction or ventricular fibrillation, occurs.(b)
Classification. Class II (special controls). The guidance document entitled “Class II Special Controls Guidance Document: Arrhythmia Detector and Alarm” will serve as the special control. See § 870.1 for the availability of this guidance document.

0

K013427 p.1/2

NOV 2 9 2001

510 (k) Summary 8.0

This summary of 510(k) safety and effectiveness information is submitted in accordance with the requirements of the Safe Medical Devices Act of 1990 and 21 CFR §807.92.

  1. The submitter of this premarket notification is: Dave Osborn Quality Program Manager Philips Medical Systems 3000 Minuteman Road Andover, MA 01810-1085

978 659 3178 Tel: 978 685 5624 Fax: Email: dosborn@hsgmed.com

This summary was prepared on 15 October, 2001

    1. The name of this device is Philips M2/M3/M4 Compact Portable Patient Monitor. Classification names are as follows:
Device PanelClassificationProCodeDescription
Panel 74
CardiovascularNone74 MHXPhysiological
Monitor, Patient
Monitor
870.1025, III74 DSIArrhythmia Detector
and Alarm
870.1025, III74 MLDMonitor, ST Alarm
870.2350, II74 DRWElectrocardiograph
lead switching
adapter
870.1100, IIDSJAlarm, Blood-Pressure
870.1110, IIDSKComputer, Blood-
Pressure
870.1130, IIDXNSystem, Measurement,
Blood-Pressure, Non-
Invasive
870.2300, II74 DRTCardiac Monitor
870.2340, II74 FYWElectrocardiograph
870.1435, II74 DXGComputer, Diagnostic,
Pre-programmed,
Single Function
870.2900, II74 DSACable, Transducer and
Electrode, including
Patient Connector
870.2850, II74 DRSExtravascular Blood
Pressure Transducer
Panel 73
Anesthesiology868.1400, II73 CCKCarbon Dioxide Gas
Analyzer
Panel 80
General
Hospital880.2910, II80 FLLClinical Electronic
Thermometer
    1. The new device is substantially equivalent to the previously cleared M3 K971910 and K981576.
    1. The modification provides an auscultatory validation reference, according to subclause 4.4.2.1 of AAMI SP-10 for pediatric and adult patients.

3.5

1

    1. The new device has the same intended use as the legally marketed predicate devices. M3 is used for monitoring, recording, and alarming of multiple physiological parameters of adults, pediatrics, and neonates in hospital and medical transport environments.
    1. The new device has the same technological characteristics as the legally marketed predicate devices.
    1. The results of the validation study indicate that the device performance correlates to auscultatory reference standard according to subclause 4.4.2.1 of AAMI SP-10 for pediatric and adult patients.

K013427

2

Image /page/2/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo features a stylized eagle with three lines forming its body and head. The eagle is facing right. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV 2 9 2001

Mr. Dave Osborn Quality Program Manager Philips Medical Systems, Inc. Cardiac and Monitoring Systems 3000 Minuteman Road Andover, MA 01801

Re: K013427

Trade Name: Philips M3000A/M3046A, (M2/M3/M4) Compact Portable Monitor Regulation Number: 21 CFR 870.1025 Regulation Name: Patient Physiological Monitor Regulatory Class: Class III (three) Product Code: MHX Dated: November 12, 2001 Received: November 13, 2001

Dear Mr. Osborn:

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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), 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 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

3

Page 2 - Mr. Dave Osborn

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); 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.

This letter will allow you to begin marketing your device as described in your Section 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 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4646. 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 Part 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,

N. O'Keefe Tiller

James E. Dillard III Director Division of Cardiovascular and Respiratory Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

K013421

Page 1 of 1

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Device Name: Philips M3000A/M3046A, (M2/M3/M4) Compact Portable Patient Monitor .

Intended for monitoring, recording, and alarming of multiple physiological Indications for Use: moreations for Ose. " - Intented rowneonates in hospital and medical transport environments.

(Please do not write below this line-continue on another Page if needed) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use Usc Use V V CFR 801.109) (Optional Format 1-2-96) OR

Over-The-Counter

Division of Cardiovascular & Respiratory Devices
510(k) Number K013427