K Number
K041122
Date Cleared
2004-10-04

(158 days)

Product Code
Regulation Number
868.5655
Reference & Predicate Devices
N/A
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Precision Medical, Inc. Liquid Oxygen System is intended to provide supplemental oxygen to oxygen patients who may have difficulty extracting oxygen from the air that they breathe. The patients would normally receive the oxygen via a nasal cannula. The system delivers 100% oxygen at 4 different flow settings. It is intended to be used as ambulatory source of oxygen both inside and out side of the patient's home. It is not intended as a life supporting device. The device has no contraindications.

Device Description

The Precision Medical, Inc. Liquid Oxygen system consists of a vacuum insulated cryogenic container that includes a pressure relief valve and a pneumatic conserver. The vacuum insulated container allows oxygen to be stored in a liquid state under pressure. When the control valve is positioned to deliver, liquid oxygen inside the container is warmed and changes to gaseous state. The gas is than allowed to be released to the patient at the set rate. The device is intended to be used with a larger stationary liquid oxygen reservoir,where it is filled by a connection that allows the portable device to be filled by the larger reservoir. The Precision Medical Inc System is a mechanical device containing no electrical components.

AI/ML Overview

The provided document is a 510(k) summary for a medical device (Precision Liquid Oxygen System) and does not contain information about a study with acceptance criteria and reported device performance metrics in the format requested.

It's a regulatory submission demonstrating substantial equivalence to a predicate device, not a performance study report with detailed statistical analysis as might be found for AI/ML devices.

Here's why the requested information cannot be fully provided based on the input:

  • Type of Device: The Precision Medical, Inc. Liquid Oxygen System is a mechanical device with no electrical components. The questions in your prompt (e.g., sample size for test/training set, number of experts, adjudication methods, MRMC studies, standalone algorithm performance, ground truth types) are highly relevant to AI/ML device evaluations, not mechanical medical devices like this one.
  • Nature of "Performance Testing" described: The document states, "The Precision Medical, Inc. Liquid Oxygen System successfully passed tests in the following areas: Mechanical / Climatic Device Performance." This indicates physical and environmental testing typical for mechanical devices, not diagnostic or clinical performance metrics measured against ground truth with statistical analysis.
  • Absence of Specific Data: There is no table of acceptance criteria with corresponding reported device performance values, no sample sizes for test sets, no details on ground truth establishment, no mention of experts, or any of the other AI-related study parameters.

Therefore, I cannot directly populate the requested table and detailed study information based on this document. The document confirms that performance testing was done but only provides a very high-level summary that it "successfully passed" mechanical and climatic performance tests, without specifying the criteria or the quantitative results.

If this were an AI/ML device, the detailed study information would typically be present in a much more extensive clinical or performance study report.

{0}------------------------------------------------

510kliquidsystem42204

Ko41122 OCT 4 - 2004 510(k) Summary

Precision Medical, Inc. Portable Liquid Oxygen System

Submitter Information

SubmitterPrecision Medical, Inc.300 Held DriveNorthampton, Pa.18067
FDA registration number:2523148
ContactJames ParkerQuality Assurance Manager
Tel:Fax:(610)-262-6090 Extensions 228(610)-262-6080
Preparation Date:April 22, 2004
Proprietary Name:Common Name:Classification Name:Precision Liquid Oxygen SystemPortable Liquid Oxygen UnitPortable Liquid Oxygen Unit (73 BYJ) as per CFR868.5655

Predicate Device Equivalence

Precision Medical, Inc. is claiming substantial equivalence to the Puritan-Bennett Helios Liquid Oxygen System K 993220.

{1}------------------------------------------------

Device Description

The Precision Medical, Inc. Liquid Oxygen system consists of a vacuum insulated cryogenic container that includes a pressure relief valve

and a pneumatic conserver.

The vacuum insulated container allows oxygen to be stored in a liquid state under pressure. When the control valve is positioned to deliver, liquid oxygen inside the container is warmed and changes to gaseous state.

The gas is than allowed to be released to the patient at the set rate.

The device is intended to be used with a larger stationary liquid

oxygen reservoir,where it is filled by a connection that allows the portable device to be filled by the larger reservoir.

The Precision Medical Inc System is a mechanical device containing no electrical components.

Intended Use

The Precision Medical, Inc. Liquid Oxygen System is intended to provide supplemental oxygen to patients who may have difficulty extracting oxygen from the air that they breathe. The patients would normally receive the oxygen via a nasal cannula. The system delivers 100% oxygen at 4 different flow settings. It is intended to be used as ambulatory source of oxygen both inside and out side of the patient's home. It is not intended as a life-supporting device. The device has no contraindications.

Comparison of Technological Characteristics

The Helios and the Precision Medical, Inc. Liquid Oxygen System include a vacuum insulated cryogenic container, heat exchange system, and a pneumatic conserver. Both devices are intended only as sources of supplemental oxygen and are not intended to be life-supporting devices.

Summary of Performance Testing

The Precision Medical, Inc. Liquid Oxygen System successfully passed tests in the following areas: Mechanical / Climatic Device Performance

Conclusions

In Summary, Precision Medical, Inc. has demonstrated that the Precision Medical, Inc. portable liquid oxygen system is safe and effective. The combined testing and analysis of results provides assurance that the device meets it's specifications and is safe and effective for it's intended use.

{2}------------------------------------------------

Risk Analysis:

Precision Medical Inc. is using International Standard ISO 14971 Medical Devices Application of risk management to medical devices. Risk analysis has been completed for this device. This document will be updated and released as part of design control.

Design Control:

Precision Medical, Inc. is in compliance with 21 CFR 820.30 for design control. The Design inputs/outputs matrix has been developed using form PMF 202. These documents will be completed before the release of the product.

James Parker Quality Assurance Manager April 22, 2004

April 22, 2004

James Parker

{3}------------------------------------------------

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract image of an eagle.

OCT 4 - 2004

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. James Parker Quality Assurance Manager Precision Medical, Incorporated 300 Held Drive Northampton, Pennsylvania 18067

Re: K041122

Trade/Device Name: Precision Medical, Inc. Liquid Oxygen System Regulation Number: 868.5655 Regulation Name: Portable Liquid Oxygen Unit Regulatory Class: II Product Code: BYJ Dated: September 9, 2004 Received: September 10, 2004

Dear Mr. Parker:

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. Parker

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 (OS) 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 (240) 276-0115. 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,

Chiu 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

{5}------------------------------------------------

Indications for Use

510(k) Number (if known):

Device Name: Precision Medical, Inc. Liquid Oxygen System

Indications For Use:

本など

The Precision Medical, Inc. Liquid Oxygen System is intended to provide supplemental oxygen to oxygen patients who may have difficulty extracting oxygen from the air that they breathe. The patients would normally receive the oxygen via a nasal cannula. The system delivers 100% oxygen at 4 different flow settings. It is intended to be used as ambulatory source of oxygen both inside and out side of the patient's home. It is not intended as a life supporting device. The device has no contraindications.

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

Over-The-Counter Use __ (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Auu Sulious

(Division Sign-Off
Division of Anesthesiology, General Hospital,
Infection Control, Dental Devices

510(k) Number: K041122

Page 1 of

Once 29

§ 868.5655 Portable liquid oxygen unit.

(a)
Identification. A portable liquid oxygen unit is a portable, thermally insulated container of liquid oxygen that is intended to supplement gases to be inhaled by a patient, is sometimes accompanied by tubing and an oxygen mask. An empty portable liquid oxygen unit is a device, while the oxygen contained therein is a drug.(b)
Classification. Class II (performance standards).