K Number
K031860
Device Name
SK MED ME202 MONITORING MIXER
Manufacturer
Date Cleared
2004-01-21

(219 days)

Product Code
Regulation Number
868.5330
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The M202 Monitoring Mixer is intended to mix air and oxygen gases and provide the mixed gas at the prescribed oxygen concentration level via flowmcter (1 to 12 I.PM). The device is a prescription device and is intended for use within the hospital or institutional environment.
Device Description
SK Med M202 Mixer
More Information

Not Found

Not Found

No
The document describes a gas mixing device and does not mention any AI or ML capabilities.

No
The device is described as a "Monitoring Mixer" and is intended to "mix air and oxygen gases and provide the mixed gas at the prescribed oxygen concentration level". While it provides a gas mixture that could be used for therapeutic purposes, the device itself is a mixer and monitor, not the therapeutic agent or device that directly treats a condition. It is an upstream component in a potential therapeutic chain.

No

The M202 Monitoring Mixer is described as a device that mixes air and oxygen gases and provides the mixed gas at a prescribed oxygen concentration. It is used to deliver gases, not to diagnose a medical condition.

No

The device description explicitly states it is a "Monitoring Mixer" intended to mix air and oxygen gases and provide the mixed gas via a flowmeter. This indicates a physical hardware component for gas mixing and delivery, not a software-only device.

Based on the provided information, the M202 Monitoring Mixer is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use is to mix air and oxygen gases for delivery to a patient via a flowmeter. This is a therapeutic or life-support function, not a diagnostic one.
  • Device Description: The description points to a gas mixing device.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.) or providing information for the diagnosis, monitoring, or treatment of a disease or condition based on such analysis.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information about a person's health. The M202 Monitoring Mixer's function is to prepare and deliver gases for respiration, which falls outside the scope of IVD.

N/A

Intended Use / Indications for Use

The M202 Monitoring Mixer is intended to mix air and oxygen gases and provide the mixed gas at the prescribed oxygen concentration level via flowmeter (1 to 12 LPM). The device is a prescription device and is intended for use within the hospital or institutional environment.

Product codes

BZR, CCL

Device Description

Not Found

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

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Intended User / Care Setting

hospital or institutional environment.

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.)

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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.

Not Found

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

§ 868.5330 Breathing gas mixer.

(a)
Identification. A breathing gas mixer is a device intended for use in conjunction with a respiratory support apparatus to control the mixing of gases that are to be breathed by a patient.(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" arranged around the perimeter. Inside the circle is a stylized symbol featuring a white eagle with its wings spread, overlaid with three horizontal bars that curve upwards. The eagle and bars are depicted in black, creating a contrast with the white background.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 2 1 2004

Mr. Dipak Ghosh President SK Med, Incorporated 16000 Sherman Way # 224 Van Nuys, California 91406-4057

Re: K031860

Trade/Devicc Name: SK Med M202 Mixer Regulation Number: 21 CFR 868.5330 Regulation Name: Breathing Gas Mixer Regulatory Class: II Product Code: BZR, CCL Dated: October 31, 2003 Received: November 4, 2003

Dear Mr. Ghosh:

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 received above and hat he enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device mendments, or to devices that have been reclassified in accordance with the provisions of Amendinens, or to ae rood Cosmetic Act (Act) that do not require approval of a premarket the rederal + 600; Drag, therefore, market the device, subject to the general approvisions of the Act. The general controls provisions of the Act include controls providents of a 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 If your devilos to such additional controls. Existing major regulations affecting (I NFA), it may to subject to Saccode of Federal Regulations, Title 21, Parts 800 to 898. In your device ear of 10 lower announcements concerning your device in the Eederal Register.

1

Page 2 - Mr. Ghosh

Please be advised that FDA's issuance of a substantial equivalence determination does not mcan that FDA has made a determination that your device complies with other requirements moun that + Dr mas may Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration r od linest compry with a 807); labeling (21 CFR Part 801); good manufacturing practice and ilouing (2) = 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) rms reter notification. The FDA finding of substantial equivalence of your device to a premits in the first and 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), n you deems the Office of Compliance at (301) 594-4646. 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 Into overn 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,

Clubs
Chin Lin, Ph.D.

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

Indications for Use

510(k) Number: K031860

Device Name: SK Med M202 Monitoring Mixer

Indications For Use:

The M202 Monitoring Mixer is intended to mix air and oxygen gases and provide the mixed gas at the prescribed oxygen concentration level via flowmcter (1 to 12 I.PM). The device is a prescription device and is intended for use within the hospital or institutional environment.

Prescription Use yes

AND/OR

Over-The-Counter Use _

(Part 21 CFR 801 Subpart D)

(21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

A. Wutrich
Division Sign-On

Page 1 of 1

ign-Off)
Division of Anesthesiology, General Hospital,
Infection Control, Dental Devices

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