K Number
K014078
Device Name
ON SITE GAS SYSTEMS PORTABLE OXYGEN GENERATOR SYSTEM
Date Cleared
2002-01-08

(28 days)

Product Code
Regulation Number
868.5440
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The POGS is intended to provide supplemental oxygen. Device is to be operated by trained medical personnel only for military use only.
Device Description
The On Site Gas Systems portable oxygen generator is a prescription device designed to provide an inexpensive supply of supplemental oxygen in a military environment without a continuous source of The feed air compressor creates a vacuum to draw air into a oxvaen. holding talk. The air is then flushed through two tanks in series to provide continuous oxygen. The molecular sieve material adsorbs nitrogen, which comprises approximately 78% of the makeup of air. The resulting gas is approximately 93% oxygen.
More Information

Not Found

No
The device description focuses on a physical process (molecular sieve) for oxygen generation and there is no mention of AI, ML, or related terms.

Yes
The device is intended to provide "supplemental oxygen," which is a form of medical treatment. It is compared to and meets standards for "Oxygen Concentrators," which are therapeutic devices.

No

The device is an oxygen generator, intended to provide supplemental oxygen, not to diagnose a particular condition or disease.

No

The device description clearly outlines hardware components like a feed air compressor, holding tank, and two tanks in series, indicating it is a physical device, not software-only.

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

Here's why:

  • Intended Use: The intended use is to "provide supplemental oxygen." This is a therapeutic purpose, delivering a substance to the body, not a diagnostic purpose, which involves examining samples from the body to diagnose or monitor a condition.
  • Device Description: The description details a process of generating oxygen from air using molecular sieves. This is a physical process for gas separation, not a method for analyzing biological samples.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring analytes (biomarkers, pathogens, etc.)
    • Providing information for diagnosis, monitoring, or prognosis of a disease or condition.

The device is clearly designed to provide a medical gas for respiratory support, which falls under the category of therapeutic medical devices, not in vitro diagnostics.

N/A

Intended Use / Indications for Use

The POGS is intended to provide supplemental oxygen. Device is to be operated by trained medical personnel only for military use only.

Product codes

CAW

Device Description

The On Site Gas Systems portable oxygen generator is a prescription device designed to provide an inexpensive supply of supplemental oxygen in a military environment without a continuous source of The feed air compressor creates a vacuum to draw air into a oxvaen. holding talk. The air is then flushed through two tanks in series to provide continuous oxygen. The molecular sieve material adsorbs nitrogen, which comprises approximately 78% of the makeup of air. The resulting gas is approximately 93% oxygen.

The variations of the device are to allow for greater total flow, to accommodate more cannulas per device. The variations are designed and tested for same indication of use, safety and effectiveness; variations are substantially equivalent to predicate devices.

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

trained medical personnel only for military use only.

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 device meets the requirements of the FDA recognized standard covering Oxygen Concentrators, ASTM F 1464-93, and is substantially equivalent to the predicate devices.

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

Not Found

Predicate Device(s)

K011844, K955549

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 868.5440 Portable oxygen generator.

(a)
Identification. A portable oxygen generator is a device that is intended to release oxygen for respiratory therapy by means of either a chemical reaction or physical means (e.g., a molecular sieve).(b)
Classification. Class II (performance standards).

0

K014078

10.0 510 (k) SUMMARY

10.1 Submitter's Name

Francis X. Hursey, President

10.2 Address

On Site Gas Systems. Inc. 100 Production Court New Britain, CT 06051

10.3 Phone

888-748-3429 (Toll-free) 860-229-2799 860-225-9405

10.4 Fax

860-225-9531

10.5 Contact Person

C. Barton ("Bart") Gullong, Vice President, Marketing and Technical Services

10.6 Date of Preparation

November 30, 2001

10.7 Device Name

Portable Oxygen Generator

10.8 Trade Name

On Site Gas Systems Portable Oxygen Generator System

10.9 Common Name

Oxygen Concentrator

  • 10.10 Proprietary Name P.O.G.S.

10.11 Classification Name Portable Oxygen Generator

10-1

1

Legally Marketed Device Claiming Substantial 10.12 Equivalency To:

Merits Health Products Oxygen Concentrators K 011844 K955549 Oxlife Oxygen Concentrators

10.13 Description of the Device

The On Site Gas Systems portable oxygen generator is a prescription device designed to provide an inexpensive supply of supplemental oxygen in a military environment without a continuous source of The feed air compressor creates a vacuum to draw air into a oxvaen. holding talk. The air is then flushed through two tanks in series to provide continuous oxygen. The molecular sieve material adsorbs nitrogen, which comprises approximately 78% of the makeup of air. The resulting gas is approximately 93% oxygen.

The variations of the device are to allow for greater total flow, to accommodate more cannulas per device. The variations are designed and tested for same indication of use, safety and effectiveness; variations are substantially equivalent to predicate devices.

10.14 Intended Use of Device

The Oxygen Concentrators are intended to provide supplemental oxygen. Device is to be operated by trained medical personnel.

Our portable oxygen generator provides supplemental oxygen, where oxygen is currently present. Specifically for military battlefields, primary oxygen may be unavailable or not feasible. In this application, POGS can actually fill cvlinders to provide primary oxygen besides.

10.15 Summary of Technological Characteristics of Device Compared to Predicates

The oxygen generator operates by using molecular sieve material to adsorb the nitrogen from filtered air. The resulting gas has an increased concentration of oxygen. This technology is well established. and has been used in the predicate device as well as other legally marketed products.

2

Discussion of Non-clinical Test to Support Determination 10.16 of Substantial Equivalency

10.17 Performance Data

The device meets the requirements of the FDA recognized standard covering Oxygen Concentrators, ASTM F 1464-93, and is substantially equivalent to the predicate devices.

Conclusions 10.18

Based on the design, performance specifications, and intended use, the Oxygen Concentrators are substantially equivalent to the currently marketed devices.

3

Image /page/3/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. 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 image of an eagle with its wings spread.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 8 2002

Mr. C. Barton Gullong On Site Gas Systems, Inc. 100 Production Court New Britain, CT 06051

Re: K014078

On Site Gas Systems Portable Oxygen Generator System Regulation Number: 868.5440 Regulation Name: Generator, Oxygen, Portable Regulatory Class: Class II (two) Product Code: CAW Dated: December 5, 2001 Received: December 11, 2001

Dear Mr. Gullong:

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. In addition, if you wish to change or expand the current indications for use to include non-military environments, you will need to submit a new 510(k) premarket notification, and receive FDA clearance prior to marketing the device.

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.

4

Page 2 - Mr. C. Barton Gullong

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,

Oaken Till

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

Enclosure

5

8.10 Statement of Indications for Use

510 (k) File Number 8.10.1

K014078

Device Name 8.10.2

On Site Gas Systems Portable Oxygen Generator System

Indications for Use 8.10.3

The POGS is intended to provide supplemental oxygen. Device is to be operated by trained medical personnel only for military use only.

Prescription use $\checkmark$

Division of Cardiovascular & Respiratory Devices
510(k) Number K04078

8-8 Revised 12/21/01