K Number
K040637
Date Cleared
2004-08-06

(149 days)

Product Code
Regulation Number
870.5310
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Powerheart® AED G3 Pro, model 9300P, is intended to be used by personnel who have been trained in its operation. The user should be qualified by training in basic life support or other physician-authorized emergency medical response.

The device is indicated for emergency treatment of victims exhibiting symptoms of sudden cardiac arrest who are unresponsive and not breathing. Post-resuscitation, if the victim is breathing, the AED should be left attached to allow for acquisition and detection of the ECG rhythm. If a shockable ventricular tachyarrhythmia recurs, the device will charge automatically and advise the operator to deliver therapy.

When a patient is a child or infant up to 8 years of age, or up to 55 Ibs (25kg), the Powerheart AED G3 Pro should be used with the Model 9730 Pediatric Attenuated Defibrillation Electrodes. The therapy should not be delayed to determine the patient's exact age or weight.

At the discretion of emergency care personnel, the G3Pro with ECG display enabled can also be used with the Model 5111 ECG Patient Cable to display the rhythm of a responsive or breathing patient, regardless of age. The G3Pro and ECG Patient Cable system provides a non-diagnostic display for attended patient monitoring. While connected the G3Pro ECG Patient Cable, the G3Pro evaluates the patient's ECG and disables its shock capability.

Device Description

The Powerheart® AED G3Pro is a portable, battery-operated, semi-automatic, low power DC defibrillator. The device is designed to diagnose and monitor the patient's cardiac rhythm and deliver the shock energy as required. The Powerheart@ AED G3Pro also has an ECG display and manual override for advanced users. The device in this submission is equivalent to the current Powerheart® ABD and accessories in commercial distribution that was cleared under premarket 510(k) notifications K022929, K011901, K982710 and K031987. The reason for this premarket notification is to introduce the semi-sutomatic

AI/ML Overview

The provided text is a 510(k) summary for the Cardiac Science Powerheart® AED G3 Pro. This document establishes substantial equivalence to predicate devices rather than providing a detailed study proving the device meets specific acceptance criteria in the way a new, de novo device might. Therefore, many of the requested elements about acceptance criteria, detailed study design, and performance metrics are not explicitly available or are presented indirectly through the claim of substantial equivalence.

Based on the provided text, here's what can be extracted and inferred:

1. A table of acceptance criteria and the reported device performance

The document does not specify quantitative "acceptance criteria" for performance metrics like sensitivity, specificity, or positive predictive value. Instead, it asserts that the device modifications (ECG display and manual override) had "no affect on the safety or effectiveness of the device" and that the "device was found to perform as intended." This is based on comparative testing against predicate devices.

Acceptance Criteria (Implied)Reported Device Performance
Safety and Effectiveness"No affect on the safety or effectiveness of the device" due to modifications. "Found to perform as intended."
Equivalence to Predicates"Equivalent to the current Powerheart® AED and the Philips Medical Systems Heartstream FR2 AED" regarding "indications for use, technological characteristics, and software algorithm."

2. Sample size used for the test set and the data provenance (e.g., country of origin of the data, retrospective or prospective)

The document mentions "performance software and hardware evaluations" and "testing" but does not specify:

  • The sample size for any test set (e.g., number of patients, number of ECG events).
  • The data provenance (country of origin, retrospective or prospective nature of data collection).

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g., radiologist with 10 years of experience)

The document does not provide details about how ground truth was established for any performance testing, nor does it mention the number or qualifications of experts involved in such a process.

4. Adjudication method (e.g., 2+1, 3+1, none) for the test set

The document does not describe any adjudication method used for a test set.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

The document does not describe an MRMC comparative effectiveness study involving human readers or AI assistance. The device is an AED, and the modifications discussed relate to an ECG display and manual override, not an AI-assisted diagnostic tool for interpretation by human readers.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

The document states that the Powerheart® AED G3Pro is a "semi-automatic" device, meaning it diagnoses and may advise shock delivery but requires operator action (human-in-the-loop) for therapy. While it performs internal diagnostic algorithms ("software algorithm"), the summary does not detail a standalone algorithm performance study independent of the complete device operation. The focus is on the device as a whole and its equivalence to predicates.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

The document does not specify the type of ground truth used for any testing. For an AED, ground truth would typically relate to the presence or absence of a shockable rhythm verified by expert cardiologists or electrophysiologists based on ECG analysis or patient outcomes.

8. The sample size for the training set

The document does not refer to a "training set" or provide any sample size for training data. As this is a 510(k) for a device claiming substantial equivalence, the focus is on comparative testing rather than a de novo algorithm development and training process.

9. How the ground truth for the training set was established

Since no training set is mentioned, there is no information on how its ground truth might have been established.


Summary of the Study:

The "study" described in this 510(k) notification is primarily a comparative equivalency assessment against previously cleared predicate devices. The modifications introduced in the Powerheart® AED G3 Pro (ECG display and manual override) were evaluated through "performance software and hardware evaluations" and "testing." The reported conclusion is that these modifications did not affect the safety or effectiveness of the device, and it performs as intended, being substantially equivalent to the Powerheart® AED G3 (K031987) and the Philips Medical Systems Heartstream FR2 (K014157, K013425). Specific quantitative performance metrics, detailed study designs, sample sizes, and ground truth methodologies are not provided in this summary, as is typical for 510(k) submissions focusing on substantial equivalence.

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Cardiaς Science Powerheart® AED G3 Pro Original Premarket 510(k) Notification

KD40637

AUG = 6 2004

SUMMARY OF SAFETY AND EFFECTIVENESS SECTION 17:

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

17.1: ADMINSTRATIVE INFORMATION

Name and AddressCardiac Science Incorporated5474 Feltl RoadMinnetonka, MN 55343
Submitted by:
Contact Person:Kenneth F. Olson
Telephone No.:952-939-4181
Facsimile No.:952-939-4191
Email:kolson@cardiacscience.com
Date Prepared:March 5, 2004

17.2: DEVICE INFORMATION

Common or Usual Name:Automatic External Defibrillator
Trade Name:Powerheart® Automatic External DefibrillatorG3Pro

17.3: DEVICE CLASSETCATION

Classification Name:Automated External Defibrillator
21 CFR 870.5310MKJ
Device Class:III

17.4: DEVICE DESCRIPTION

The Powerheart® AED G3Pro is a portable, battery-operated, semi-automatic, low power DC defibrillator. The device is designed to diagnose and monitor the patient's cardiac rhythm and deliver the shock energy as required. The Powerheart@ AED G3Pro also has an ECG display and manual override for advanced users. The device in this submission is equivalent to the current Powerheart® ABD and accessories in commercial distribution that was cleared under premarket 510(k) notifications K022929, K011901, K982710 and K031987. The reason for this premarket notification is to introduce the semi-sutomatic

252

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Cardiac Science Powerheart® AED G3 Pro Original Premarket 510(k) Notification

17.6: IDENTIFICATION OF PREDICATE DEVICE

CompanyDevice510(k) No.Date Cleared
Cardiac SciencePowerheart AEDK03198707/30/2003
Philips Medical SystemsHeartstream FR2K01415701/17/2002
K01342501/14/2002

17.7: SUBSTANTIAL EQUIVALENCE

The Powerheart® AED G3Pro covered by this submission is substantially equivalent to other legally marketed automatic external defibrillators. Specifically, the Powerheart® AED G3Pro that is the subject of this premarket notification is equivalent to the current Powerheart® AED G3 in commercial distribution with the exception of having the ECG display and manual override options. The Powerheart AED G3Pro is substantially equivalent to the ECG display and manual override features of the Philips Medical Systems Heartstream FR2 AED.

17.8 PERFORMANCE TESTING

The Powerheart® AED G3Pro is subjected to performance software and hardware evaluations in accordance with FDA guidelines and industry standards. The results of the testing showed that the device modifications had no affect on the safety or effectiveness of the device. The Powerheart® AED G3Pro was found to perform as intended.

17.9 CONCLUSIONS

Cardiac Science has demonstrated through its evaluation and testing of the Powerheart® AED G3Pro that the device is equivalent to the current Powerheart® AED and the Philips Medical Systems Heartstream FR2 AED. The proposed Powerheart® AED G3Pro is equivalent with respect to indications for use, technological characteristics, and software algorithm as the current commercially distributed Powerheart® AED and the Heartstream AED. This notification contains all information required by 21 CFR 807.87. A completed copy of the Premarket Notification 510(k) Reviewer's Checklist is provided in this submission.

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Image /page/2/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle-like symbol with three curved lines forming its body and wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the symbol.

MAR 2 4 2009

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Cardiac Science, Inc. c/o Mr. Kenneth F. Olson Chief Technology Officer 5474 Feltl Road Minnetonka, MN 55343

Re: K040637

Trade/Device Name: Powerheart Automatic External Defibrillator G3Pro Regulation Number: 21 CFR 870.5310 Regulation Name: Automated External Defibrillator Regulatory Class: Class III (Three) Product Code: MKJ Dated: June 22, 2004 Received: June 23, 2004

Dear Mr. Olson:

This letter corrects our substantially equivalent letter of August 6, 2004. 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 (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 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.

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Page 2 - Mr. Kenneth F. Olson

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 continue 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 (240) 276-0120. 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 (240) 276-3150 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

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Indications for Use

K040637 510(k) Number:

Powerheart® Automatic External Defibrillator G3 Pro Device Name:

Indications For Use:

The Powerheart® AED G3 Pro, model 9300P, is intended to be used by personnel who have been trained in its operation. The user should be qualified by training in basic life support or other physician-authorized emergency medical response.

The device is indicated for emergency treatment of victims exhibiting symptoms of sudden cardiac arrest who are unresponsive and not breathing. Post-resuscitation, if the victim is breathing, the AED should be left attached to allow for acquisition and detection of the ECG rhythm. If a shockable ventricular tachyarrhythmia recurs, the device will charge automatically and advise the operator to deliver therapy.

When a patient is a child or infant up to 8 years of age, or up to 55 Ibs (25kg), the Powerheart AED G3 Pro should be used with the Model 9730 Pediatric Attenuated Defibrillation Electrodes. The therapy should not be delayed to determine the patient's exact age or weight.

At the discretion of emergency care personnel, the G3Pro with ECG display enabled can also be used with the Model 5111 ECG Patient Cable to display the rhythm of a responsive or breathing patient, regardless of age. The G3Pro and ECG Patient Cable system provides a non-diagnostic display for attended patient monitoring. While connected the G3Pro ECG Patient Cable, the G3Pro evaluates the patient's ECG and disables its shock capability.

Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR

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)

Nilm N. Dahan
(Division Sign-Off) JV BDZ

Division of Cardiovascular De

510(k) Number K040637

Page 1 of 1

§ 870.5310 Automated external defibrillator system.

(a)
Identification. An automated external defibrillator (AED) system consists of an AED and those accessories necessary for the AED to detect and interpret an electrocardiogram and deliver an electrical shock (e.g., battery, pad electrode, adapter, and hardware key for pediatric use). An AED system analyzes the patient's electrocardiogram, interprets the cardiac rhythm, and automatically delivers an electrical shock (fully automated AED), or advises the user to deliver the shock (semi-automated or shock advisory AED) to treat ventricular fibrillation or pulseless ventricular tachycardia.(b)
Classification. Class III (premarket approval)(c)
Date PMA or notice of completion of PDP is required. A PMA will be required to be submitted to the Food and Drug Administration by April 29, 2015, for any AED that was in commercial distribution before May 28, 1976, or that has, by April 29, 2015, been found to be substantially equivalent to any AED that was in commercial distribution before May 28, 1976. A PMA will be required to be submitted to the Food and Drug Administration by April 29, 2015, for any AED accessory described in paragraph (a) that was in commercial distribution before May 28, 1976, or that has, by April 29, 2015, been found to be substantially equivalent to any AED accessory described in paragraph (a) that was in commercial distribution before May 28, 1976. Any other AED and AED accessory described in paragraph (a), shall have an approved PMA or declared completed PDP in effect before being placed in commercial distribution.