K Number
K013862
Device Name
BCI 1621 OXIMETRY DATA MANAGEMENT PROGRAM
Manufacturer
Date Cleared
2002-02-21

(92 days)

Product Code
Regulation Number
870.2700
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The BCI 1621 Oximetry Data Management Program analyzes data recorded using the BCI 3403 pulse oximeter and provides a printed oximetry data analysis report and graphical SpO2 trend. This information can aid in the analysis of pulse oximetry data from sleep screening, oxygen therapy validation, and/or related studies. Data from the BCI 3403 pulse oximeter are downloaded for analysis using a unique cable.
Device Description
The BCI® 1621 Oximetry Data Management Program is a software program used as a pulse oximetry accessory.
More Information

Not Found

No
The summary describes a software program for managing and analyzing pulse oximetry data, focusing on data download, reporting, and graphical trends. There is no mention of AI, ML, or related terms, and the analysis described appears to be based on standard algorithms for desaturation identification.

No
The device is a software program that analyzes data from a pulse oximeter and provides reports; it does not directly provide therapy or affect the body's function.

Yes

The "Intended Use / Indications for Use" states that the program "aids in the analysis of pulse oximetry data" which is used for "sleep screening, oxygen therapy validation, and/or related studies," indicating its use in diagnosing or monitoring health conditions.

Yes

The device is explicitly described as a "software program" and an "accessory" to a pulse oximeter, focusing solely on data management and analysis. While it interacts with a hardware device (the BCI 3403 pulse oximeter) for data input, the device itself is the software component that performs the analysis and reporting.

Based on the provided information, the BCI 1621 Oximetry Data Management Program is not an IVD (In Vitro Diagnostic).

Here's why:

  • 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.
  • Device Function: The BCI 1621 Oximetry Data Management Program analyzes data recorded by a pulse oximeter (BCI 3403). Pulse oximetry is a non-invasive method that measures oxygen saturation in the blood in vivo (within the living body) using light absorption. It does not involve analyzing samples taken from the body.
  • Intended Use: The intended use describes analyzing pulse oximetry data for sleep screening, oxygen therapy validation, and related studies. This is based on physiological measurements, not laboratory analysis of biological samples.
  • Device Description: It is described as a "software program used as a pulse oximetry accessory." This further reinforces its role in supporting a non-invasive physiological monitoring device.

Therefore, the BCI 1621 Oximetry Data Management Program is a medical device software that processes data from a non-invasive physiological monitoring device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The BCI® 1621 Oximetry Data Management Program provides a printed oximetry data analysis report and graphical SpO2 trend. It is designed for health care professionals in environments such as hospitals, skilled nursing facilities, physician offices, and home care. It can aid in the analysis of pulse oximetry data from sleep screening, oxygen therapy validation, and/or related studies. A unique cable is used to download data from the BCI 3403 pulse oximeter or compatible device.
The BCI 1621 Oximetry Data Management Program analyzes data recorded using the BCI 3403 pulse oximeter and provides a printed oximetry data analysis report and graphical SpO2 trend. This information can aid in the analysis of pulse oximetry data. Data from the BCI 3403 pulse oximeter are downloaded for analysis using a unique cable.

Product codes

74 DQA

Device Description

The BCI® 1621 Oximetry Data Management Program is a software program used as a pulse oximetry accessory.

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

health care professionals in environments such as hospitals, skilled nursing facilities, physician offices, and home care.

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

Testing of device performance included clinical testing of the desaturation identification algorithm and overall software validation using simulators. The results demonstrated that the BCI® 1621 Oximetry Data Management Program performed within its specifications.

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

Software development and testing was conducted in accordance with the Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices, FDA, May 29, 1998. Testing of device performance included clinical testing of the desaturation identification algorithm and overall software validation using simulators. The results demonstrated that the BCI® 1621 Oximetry Data Management Program performed within its specifications.

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

Not Found

Predicate Device(s)

K011156, K961450

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

K013862

Image /page/0/Picture/1 description: The image shows a logo with the letters 'BCI' in bold, sans-serif font. To the left of the letters, there is a circular graphic composed of vertical lines, resembling a stylized sun or a data visualization. A small circle is present to the upper right of the letters, possibly serving as a design element or a trademark symbol. The overall design is simple and modern, with a focus on clean lines and geometric shapes.

FFB 2 1 2002

BCI, Inc. N7 W22025 Johnson Road Waukesha, WI 53186-1856 USA Tel: 262-542-3100 Fax: 262-542-3325 www.smiths-bci.com

Summary of Safety and Effectiveness

Submitter:BCI, Inc.
Address:N7 W22025 Johnson Road
Waukesha, WI 53186
Telephone:(262) 542-3100
Contact:VP Regulatory Affairs
Prepared:November 15, 2001
Proprietary Name:BCI® 1621 Oximetry Data Management Program
Common/Classification Name:Pulse Oximeter Display Software
Predicate Devices:BCI® 3403 Sleep Screening Pulse Oximeter
(K011156)
Nellcor Score™ Software (K961450)

New Device Description:

The BCI® 1621 Oximetry Data Management Program is a software program used as a pulse oximetry accessory.

Intended Use:

The BCI® 1621 Oximetry Data Management Program provides a printed oximetry data analysis report and graphical SpO2 trend. It is designed for health care professionals in environments such as hospitals, skilled nursing facilities, physician offices, and home care. It can aid in the analysis of pulse oximetry data from sleep screening, oxygen therapy validation, and/or related studies. A unique cable is used to download data from the BCI 3403 pulse oximeter or compatible device.

1

Image /page/1/Picture/0 description: The image shows a logo with a circular design on the left and the letters 'BCI' on the right. The circular design is composed of vertical lines, creating a textured effect. The letters 'BCI' are in a bold, sans-serif font, with a small circle or dot above and to the right of the 'I'. The logo appears to be in black and white.

Performance Data:

The design of this device utilizes currently available technology found in legally marketed devices. The software performs the same analysis as the BCI 3403 pulse oximeter (K011156). In addition, it performs desaturation analysis, constructs histograms, and SpO2 graphs similar to the Nellcor Score™ software (K961450).

Software development and testing was conducted in accordance with the Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices, FDA, May 29, 1998. Testing of device performance included clinical testing of the desaturation identification algorithm and overall software validation using simulators. The results demonstrated that the BCI® 1621 Oximetry Data Management Program performed within its specifications.

Based on these results, it is our determination that the device is safe, effective, and performs as well as the legally marketed predicate device(s).

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

Respectfully,

Donald Alexander

Donald Alexander VP Regulatory Affairs

BCI is a trademark of BCI, Inc.. The symbol ® indicates it is registered in the U.S. Patent and Trademark Office and certain other countries. Score is a trademark of Mallinckrodt Inc.

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of an eagle or bird-like figure with flowing lines, suggesting movement or flight. Encircling the bird is the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" in a circular arrangement.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

FEB 2 1 2002

Mr. Donald J. Alexander BCI, Inc. N7 W22025 Johnson Road Waukesha, WI 53186-1856

Re: K013862

BCI 1621 Oximetry Data Management Program Regulation Number: 870.2700 Regulation Name: Oximeter Regulatory Class: II (two) Product Code: 74 DQA Dated: February 8, 2002 Received: February 11, 2002

Dear Mr. Alexander:

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. Donald J. Alexander

Please be advised that FDA's issuance of a substantial equivalence determination does not mean I loast of advised that I Dri brisualite over device complies with other requirements of the Act that I DA has made a acterimalistions administered by other Federal agencies. You must or any I cacal statutes and regarments, including, but not limited to: registration and listing (21 Comply with an the 11et 81equirements)01); good manufacturing practice requirements as set CI'N in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic form in the quality byticles (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) I mis letter will anow you to organization of substantial equivalence of your device to a legally premarket notification: "The Dr. I massification 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 If you desire specific ad rise for in vitro diagnostic devices), please contact the Office of additionally 21 OF N F art 6646. Additionally, for questions on the promotion and advertising of Compination at (301) 597-1 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 Other general informational 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,

Da V. Tellh

Bram D. Zuckerman, M.D. Acting Director Division of Cardiovascular and Respiratory Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

Indications For Use

510(k) Number (if Known):___

613862

Device Name: BCI 1621 Oximetry Data Management Program

Indications For Use:

Intended Use:

The BCI 1621 Oximetry Data Management Program analyzes data recorded using the BCI 3403 pulse The BCI 1621 Oximety Data Maliagently 110gran maryos and graphical Sportend. This information
oximeter and provides a printed oximery data and your and graphical Sport of en oximeter and provides a printed oximely data. Data from the BCI 3403 pulse oximeter are downloaded for analysis using a unique cable.

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

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUED ON NEXT PAGE)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Signature

Division of Cardiovascular & Respiratory Devices
510(k) NumberK013862
Prescription Use (Per 21 CFR 801.109)OROver-The-Counter Use
-------------------------------------------------------------------------------------------------------