K Number
K040304
Device Name
PHILIPS INTELLIVUE PATIENT MONITOR, MODELS MP40 & MP50
Date Cleared
2004-03-01

(21 days)

Product Code
Regulation Number
870.1025
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients. Intended for monitoring, recording and alarming of multiple physiological parameters of adults, pediatrics and neonates in hospital environments and during transport within hospital environments. EASI 12-lead ECG is only for use on adult and pediatric patients. ST Segment monitoring is restricted to adult patients only. The transcutaneous gas measurement (tcp02 / tcpCO2) is restricted to neonatal patients only.
Device Description
The Philips MP40 and MP50 patient monitors. The modification is the merging of existing battery operation functionality for the IntelliVue patient monitor models MP40 and MP50.
More Information

Not Found

No
The summary explicitly states "Mentions AI, DNN, or ML: Not Found" and the device description focuses on merging existing battery functionality.

No.
The device is used for monitoring, recording, and alarming of physiological parameters, which is diagnostic, not therapeutic.

Yes
The device monitors, records, and alarms multiple physiological parameters, which are functions necessary for diagnosing patient conditions.

No

The device description explicitly states it is a modification to "Philips MP40 and MP50 patient monitors," which are hardware devices. The modification is related to battery operation functionality, further indicating a hardware-based change.

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 physiological parameters of patients (ECG, ST Segment, transcutaneous gas measurement). This involves measuring signals directly from the patient's body, not analyzing samples taken from the body (like blood, urine, or tissue).
  • Device Description: The device is a patient monitor, which is a type of medical device used for direct patient monitoring.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, reagents, or any of the typical components or processes associated with in vitro diagnostics.

IVDs are devices used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device falls under the category of patient monitoring devices, which are distinct from IVDs.

N/A

Intended Use / Indications for Use

Indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients. Intended for monitoring, recording and alarming of multiple physiological parameters of adults, pediatrics and neonates in hospital environments and during transport within hospital environments.

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

DSI, MLD, MHX, DSJ, DSK, DXN, DXG, KRB, DRQ, DRT, DPS, MLC, DRW, KRC, DXJ, DRJ, DQA, DSB, DSH, DSF, DRS, DSA, MSX, CCK, CBQ, NHO, NHP, NHQ, CBS, CBR, CCL, BZQ, LKD, KLK, FLL, GWR, GWS

Device Description

The modification is the merging of existing battery operation functionality for the IntelliVue patient monitor models MP40 and MP50.

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

health care professionals / hospital environments and during transport within hospital 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

Verification, validation, and testing activities establish the performance, functionality, and reliability characteristics of the new device with respect to the predicate. Testing involved system level tests, performance tests, and safety testing from hazard analysis. Pass/Fail criteria were based on the specifications cleared for the predicate device and test results showed substantial equivalence.

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

Not Found

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.

K001664, K021778, K030038, K031481, K032858, K971910, K922974, K981376

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

MAR - 1 2004

510 (k) Summary

This summary of 510(k) safety and effectiveness information is is Submitted in Gossiano - C.F.R. $807.92.

  1. The submitter of this premarket notification is: Hauke Schik naaks s Medizin Systeme Boeblingen GmbH Hewlett-Packard-Str. 2 D-71034 Boeblingen, Germany ++49 7031 463-2442 Tel: ++49 7031 463-2031 Fax: e-mail: hauke.schik@philips.com

This summary was prepared on February 05, 2004.

    1. The names of the devices are the Philips MP40 and MP50, The names of the devices a. Classification names are as follows:
Device PanelClassificationProCodeDescription
Circulatory
System Devices
(12625)$870.1025, IIDSIDetector and alarm, arrhythmia
$870.1025, IIMLDMonitor, ST Segment with Alarm
$870.1025, IIMHXMonitor, Physiological, Patient
(with arrhythmia detection or
alarms)
$870.1100, IIDSJAlarm, Blood Pressure
$870.1110, IIDSKComputer, Blood Pressure
$870.1130, IIDXNSystem, Measurement, Blood-
Pressure, Non-Invasive
$870.1435, IIDXGComputer, Diagnostic, Pre-
Programmed, Single-Function
$870.1915, IIKRBProbe, Thermodilution
$870.2060, IIDRQAmplifier and Signal
Conditioner, Transducer Signal
$870.2300, IIDRTMonitor, Cardiac (incl.
Cardiotachometer & Rate Alarm)
$870.2340, IIDPSElectrocardiograph
$870.2340, IIMLCMonitor, ST Segment
$870.2350, IIDRWElectrocardiograph, Lead
Switching Adapter
$870.2370, IIKRCTester, Electrode, Surface,
Electrocardiograph
$870.2450, IIDXJDisplay, Cathode-Ray Tube,
Medical
$870.2600, IDRJSystem, Signal Isolation
$870.2700, IIDQAOximeter
$870.2770, IIDSBPlethysmograph, Impedance
$870.2800, IIDSHRecorder, Magnetic tape,
Medical
$870.2810, IDSFRecorder, Paper Chart
$870.2850, IIDRSExtravascular Blood Pressure
Transducer
$870.2900, IDSACable, Transducer and
Electrode, incl. Patient
Connector

1

| | | MSX | System, Network and
Communication, Physiological
Monitors |
|------------------------------------------------------|----------------|-----|------------------------------------------------------------------------------|
| Anesthesiology
and Respiratory
Therapy (12624) | $868.1400, II | CCK | Analyzer, Gas, Carbon Dioxide,
Gaseous-Phase |
| | $868.1500, II | CBQ | Analyzer, Gas, Enflurane,
Gaseous-Phase (Anesthetic
Concentration) |
| | $868.1500, II | NHO | Analyzer, Gas, Desflurane,
Gaseous-Phase (Anesthetic
Concentration) |
| | $868.1500, II | NHP | Analyzer, Gas, Sevoflurane,
Gaseous-Phase (Anesthetic
Concentration) |
| | $868.1500, II | NHQ | Analyzer, Gas, Isoflurane,
Gaseous-Phase (Anesthetic
Concentration) |
| | $868.1620, II | CBS | Analyzer, Gas, Halothane,
Gaseous-Phase (Anesthetic
Concentration) |
| | $868.1700, II | CBR | Analyzer, Gas, Nitrous Oxide,
Gaseous-Phase (Anesthetic
Concentration) |
| | $868.1720, II | CCL | Analyzer, Gas, Oxygen, Gaseous-
Phase |
| | $868.2375, II | BZQ | Monitor, Breathing Frequency |
| | $868.2480, II | LKD | Monitor, Carbon Dioxide,
Cutaneous |
| | $868.2500, II | KLK | Monitor, Oxygen, Cutaneous, for
Infant not under Gas Anesthesia |
| General Hospital
and Personal Use
(12520) | $880.2910, II | FLL | Thermometer, Electronic,
Clinical |
| Neurological
(12513) | $882.1400, II | GWR | Electroencephalograph |
| | $882.1420, I | GWS | Analyzer, Spectrum,
Electroencephalogram Signal |

    1. The new devices are substantially equivalent to previously cleared Philips devices marketed pursuant to K001664, K021778, K030038, K031481, K032858, K971910, K922974 and K981376.
    1. The modification is the merging of existing battery operation functionality for the IntelliVue patient monitor models MP40 and MP50.
    1. The new devices have the same intended use as the legally marketed predicate devices. They are intended for the monitoring, recording, and alarming of multiple physiological parameters of adults, pediatrics, and neonates when used in the hospital environment or during transport within the hospital setting.
    1. The new devices have the same technological characteristics as the legally marketed predicate devices.

2

K040304
page 3 of 3

    1. Verification, validation, and testing activities establish the performance, functionality, and reliability characteristics of the new device with respect to the predicate. Testing involved system level tests, performance tests, and safety testing from hazard analysis. Pass/Fail criteria were based on the specifications cleared for the predicate device and test results showed substantial equivalence. The results demonstrate that the Philips IntelliVue Patient Monitor meets all reliability requirements and performance claims.

3

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract symbol resembling an eagle or a stylized human figure with outstretched arms. The symbol is composed of three curved lines that create a sense of movement and dynamism.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR - 1 2004

Phillips Medizin Systeme Boeblingen GmbH c/o Mr. Hauke Schik Sr. Regulatory Affairs Engineer Cardiac and Monitoring Systems Hewlett-Packard-Str. 2 D-71034 Boeblingen GERMANY

Re: K040304

Trade Name: Phillips Intellivue MP40 and MP50 Patient Monitors, Release B.0., Battery Release Regulation Number: 21 CFR 870.1025 Regulation Name: Arrhythmia Detector and Alarm Regulatory Class: II (two) Product Code: 74 MHX Dated: February 05, 2004 Received: February 09, 2004

Dear Mr. Schik:

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, labcling, 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

4

Page 2 - Mr. Hauke Schik

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.

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) 594-4648. 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

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

Enclosure

5

Indications for Use

510(k) Number (if known): K040304

The Philips IntelliVue MP40 and MP50 Patient Device Name: Monitors, Release B.O., Battery Release

Indications for Use: Indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients. Intended for monitoring, recording and alarming of multiple physiological parameters of adults, pediatrics and neonates in hospital environments and during transport within hospital environments.

EASI 12-lead ECG is only for use on adult and pediatric patients.

ST Segment monitoring is restricted to adult patients only.

The transcutaneous gas measurement (tcp02 / tcpCO2) is restricted to neonatal patients only.

Over-The-Counter Use No Prescription Use yes AND/OR (21 CFR 807 Subpart C) (Part 21 CFR 801 Subpart D) (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

(Division Sign Off)
Division of Cardiology
510(k) Number K040302

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