K Number
K033897
Device Name
MEDICYL-E-LITE PORTABLE OXYGEN DELIVERY SYSTEM
Date Cleared
2004-07-19

(216 days)

Product Code
Regulation Number
868.2700
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The MEDICYL-E-Lite is an integrated portable oxygen delivery system intended to provide supplemental oxygen to adults. The device is MRI safe, MRIcompatible, and intended for use during MR imaging for MRI systems up to 3.0T. For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx only. Compressed gas cylinders in service or in storage shall be stabilized or otherwise secured to prevent falling and rolling.
Device Description
The MEDICYL-E-Lite is an integrated portable oxygen delivery system intended to provide supplemental oxygen to adults. The device is MRI safe, MRI-compatible, and intended for use during MR imaging for MRI systems up to 3.0T. For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx only. Compressed gas cylinders in service or in storage shall be stabilized or otherwise secured to prevent falling and rolling. The intearated system includes an aluminum cylinder, valve, requlator and flow meter. The device offers low flow settings that may be clinically appropriate for certain classes of patients.
More Information

Not Found

Not Found

No
The description focuses on the mechanical components and safety features related to MRI compatibility and oxygen delivery, with no mention of AI or ML.

Yes
The device is described as an oxygen delivery system used for oxygen deficiency and resuscitation, which are medical applications to treat a condition.

No

Explanation: The device is an integrated portable oxygen delivery system, which provides supplemental oxygen and is used for resuscitation. It does not perform any diagnostic functions.

No

The device description explicitly states that the integrated system includes hardware components such as an aluminum cylinder, valve, regulator, and flow meter.

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 to adults, particularly during MR imaging and for emergency situations involving oxygen deficiency and resuscitation. This is a therapeutic and life-support function, not a diagnostic one.
  • Device Description: The description details a system for delivering oxygen (cylinder, valve, regulator, flow meter). This aligns with a respiratory support device, not a device used to examine specimens from the human body.
  • Lack of IVD Characteristics: There is no mention of analyzing samples (blood, urine, tissue, etc.), detecting markers, or providing diagnostic information based on in vitro analysis.

IVD devices are used to examine specimens from the human body to provide information for the diagnosis, monitoring, or treatment of diseases or conditions. The MEDICYL-E-Lite does not perform this function.

N/A

Intended Use / Indications for Use

The MEDICYL-E-Lite is an integrated portable oxygen delivery system intended to provide supplemental oxygen to adults. The device is MRI safe, MRI-compatible, and intended for use during MR imaging for MRI systems up to 3.0T.

For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx only. Compressed gas cylinders in service or in storage shall be stabilized or otherwise secured to prevent falling and rolling.

Product codes

CAN, BXH, ECX, KGA

Device Description

The MEDICYL-E-Lite is an integrated portable oxygen delivery system intended to provide supplemental oxygen to adults. The device is MRI safe, MRI-compatible, and intended for use during MR imaging for MRI systems up to 3.0T. For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx only. Compressed gas cylinders in service or in storage shall be stabilized or otherwise secured to prevent falling and rolling.

The intearated system includes an aluminum cylinder, valve, requlator and flow meter. The device offers low flow settings that may be clinically appropriate for certain classes of patients.

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

Intended User / Care Setting

properly trained personnel

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

The aluminum cylinders conform to the requirements of 21 CFR49 § 178.46, Specification SAL seamless aluminum cylinders.

The MEDICYL-E-Lite portable oxygen delivery system has been evaluated in accordance with the draft CDRH Magnetic Resonance Working Group document, A Primer on Medical Device Interactions with Magnetic Resonance Imaging Systems, dated February 7, 1997.

Key Metrics

Not Found

Predicate Device(s)

MEDICYL-E-Lite Portable Oxygen System .
. Praxair Grab n' Go Portable Medical Oxygen System

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 868.2700 Pressure regulator.

(a)
Identification. A pressure regulator is a device, often called a pressure-reducing valve, that is intended for medical purposes and that is used to convert a medical gas pressure from a high variable pressure to a lower, more constant working pressure. This device includes mechanical oxygen regulators.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 868.9.

0

AGA Linde Healthcare

Image /page/0/Picture/2 description: The image shows the word "Linde" in a stylized, cursive font. The word is written in black ink on a white background. The "L" has a large, decorative swirl at the top, and the other letters are connected in a flowing script.

510(k) Summary MEDICYL-E-Lite Portable Oxygen System 510(k) Number: K033897

Submitted in accordance with the requirements of SMDA 1990 and 21CFR807.92.

1. APPLICANT'S INFORMATION:
Edward W. Siurek III
Dir., Operational Quality, IBD Global Operations
PH:(216) 328-9801
FX:(216) 328-9818
Internet:http://www.agalindehealthcare.com
Medical Establishment Registration No.:pending
2. SUBMITTER'S INFORMATION
James Jochen Rogers
General Manager
Coastal Consulting Group, Ltd.
P.O. Box 391117
Solon, OH 44139
PH/FX:440.546.4936
Mobile:724.713.2298
E-mail:coastalcg@earthlink.net
Internet:http://www.immersive-reality.biz
3. Date:December 15, 2003
4. DEVICE INFORMATION
Trade/Proprietary Name:MEDICYL-E-Lite Portable Oxygen delivery system
Common Name:MEDICYL-E-Lite Portable Oxygen delivery system
DEVICE NAME:Cylinder, Compressed Gas, and Valve
Classification Panel:Cardiovascular and Respiratory Devices
Classification Number:868.2700
Product Nomenclature:Regulator, Pressure, Gas Cylinder
Product Code(s):CAN
Classification Number:868.2610
Product Nomenclature:Gauge, Gas Pressure, Cylinder/Pipeline
Product Code(s):BXH
Classification Number:unclassified
Product Nomenclature:Cylinder, Compressed Gas, and Valve
Product Code(s):ECX
Classification Number:unclassified
Product Nomenclature:Cylinder, Gas (Empty)
Product Code(s):KGA

Helping You Care More Effectively
6055 Rockside Woods Blvd.
Corporate Office (216) 642-6600

1

AGA Linde Healthcare

Image /page/1/Picture/1 description: The image shows the word "Linde" in a stylized, cursive font. The letters are connected, and the "L" has a large, decorative swirl at the top. The word appears to be a logo or brand name.

5. DEVICE CLASSIFICATION:

Empty compressed gas cylinders and compressed gas cylinder with valve assemblies are unclassified devices, and reviewed by the Anesthesiology and Respiratory Devices Branch, Division of Anesthesiology, General Hospital, Infection Control, and Dental Devices.

Gas cylinder pressure regulators and gas pressure gauges are Class I devices and exempted from pre-market notification.

6. PREDICATE DEVICE(s):

  • MEDICYL-E-Lite Portable Oxygen System .
  • . Praxair Grab n' Go Portable Medical Oxygen System

7. DEVICE DESCRIPTION:

The MEDICYL-E-Lite is an integrated portable oxygen delivery system intended to provide supplemental oxygen to adults. The device is MRI safe, MRI-compatible, and intended for use during MR imaging for MRI systems up to 3.0T. For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx only. Compressed gas cylinders in service or in storage shall be stabilized or otherwise secured to prevent falling and rolling.

The intearated system includes an aluminum cylinder, valve, requlator and flow meter. The device offers low flow settings that may be clinically appropriate for certain classes of patients.

8. INDICATIONS FOR USE:

The MEDICYL-E-Lite is an integrated portable oxygen delivery system intended to provide supplemental oxygen to adults. The device is MRI safe, MRI-compatible, and intended for use during MR imaging for MRI systems up to 3.0T. For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx only. Compressed gas cylinders in service or in storage shall be stabilized or otherwise secured to prevent falling and rolling.

9. TECHNOLOGICAL CHARACTERISTICS:

A summary comparison of technological characteristics, including design and materials is provided in the table below:

| Parameter | MEDICYL-E-Lite
(MRI) | MEDICYL -E-Lite | Praxair Grab n'
Go |
|-----------------------|-------------------------|-----------------|-----------------------|
| Valve/Regulator | | | |
| Low Flow Settings | yes | yes | no |
| Flow Between Settings | no | no | no |
| Cylinder On/Off | yes | yes | no |
| Filling Port | active | active | active |
| Contents Gauge | non-active | non-active | active |
| Filters | 3 | 3 | 1 |
| Pressure Design | 4350psi | 4350psi | 3000psi |
| Excess Flow Device | yes | yes | no |

2

AGA Linde Healthcare

Image /page/2/Picture/1 description: The image shows the word "Linde" in a stylized, cursive font. The word is written in black ink and appears to be a logo or brand name. The letters are connected, and the "L" has a decorative swirl at the top.

| Parameter | MEDICYL-E-Lite
(MRI) | MEDICYL -E-Lite | Praxair Grab n'
Go |
|------------------------------------------|---------------------------|-----------------|-----------------------|
| Single stage piston
style | yes | yes | yes |
| Guard | | | |
| Hand grip | 2 grip | 2 grip | 1 grip |
| Access Ports | yes | yes | no |
| Flow selector/hose
barb/gauge aligned | yes | yes | no |
| Color | green | green | green |
| Height | 6.75" | 6.75" | 8" |
| Cylinder | | | |
| Sizes | D, E | D, E | E |
| Weight (E) | 900gr | 900gr | 1060gr |
| Materials/construction | Aluminum | Aluminum | Steel |
| MRI Compatibility | | | |
| MRI Safe | yes; tested up to
3.0T | no | no |
| MRI Compatible | yes; tested up to
3.0T | no | no |

The manufacturer believes that the technological characteristics of the MEDICYL-E-Lite portable oxygen system is substantially similar to those of the predicate devices.

    1. PERFORMANCE DATA:
      The aluminum cylinders conform to the requirements of 21 CFR49 § 178.46, Specification SAL seamless aluminum cylinders.

The MEDICYL-E-Lite portable oxygen delivery system has been evaluated in accordance with the draft CDRH Magnetic Resonance Working Group document, A Primer on Medical Device Interactions with Magnetic Resonance Imaging Systems, dated February 7, 1997.

11. STATEMENT OF SUBSTANTIAL EQUIVALENCE:

Based upon the safety and performance testing and compliance with voluntary standards, the manufacturer believes that the MEDICYL-E-Lite portable oxygen delivery system is substantially equivalent to the predicate devices, and does not raise any new questions of safety or effectiveness.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo is circular and contains the department's name around the perimeter. Inside the circle is an abstract symbol that resembles an eagle or bird in flight, composed of three curved lines.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUL 1 9 2004

AGA-Linde Healthcare, Incorporated C/O Mr. James Jochen Rogers General Manager Coastal Consulting Group, Limited P.O. Box 391117 Solon, Ohio 44139

Re: K033897

Trade/Device Name: Medicyl-E-Lite Portable Oxygen Delivery System Regulation Number: None Regulation Name: None Regulatory Class: Unclassified Product Code: ECX Dated: May 15, 2004 Received: May 19, 2004

Dear Mr. Rogers:

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.

4

Page 2 -Mr. Rogers

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), please contact 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 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,

Cluls

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

5

Indications for Use

510(k) Number (if known): K033897

Device Name: Medicyl-E-Lite Portable Oxygen Delivery System

Indications for Use:

The MEDICYL-E-Lite is an integrated portable oxygen delivery system intended to provide supplemental oxygen to adults. The device is MRI safe, MRIcompatible, and intended for use during MR imaging for MRI systems up to 3.0T.

For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx only. Compressed gas cylinders in service or in storage shall be stabilized or otherwise secured to prevent falling and rolling.

Sta y/t
7/16/2001

Division of Anesthesiology. General Hospital. Infection Control. Dental Devices

510(k) Number:

X Prescription Use (Part 21 CFR 801 Subpart D)

AND

X Over-the-Counter Use _ (21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

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