K Number
K041524
Device Name
GE DATEX-OHMEDA HELIOX DELIVERY SYSTEM
Manufacturer
Date Cleared
2004-09-20

(104 days)

Product Code
Regulation Number
868.5895
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The GE Datex-Ohmeda Aptaér Heliox delivery system is designed to deliver heliox from a source gas cylinder to spontaneously breathing patients via a facemask using pressure support. A built-in nebulizer, the Aerogen Aeroneb Pro (K021175) is provided for adding nebulized medication to the delivered heliox. The system is designed for facility use and should only be used under the orders of a clinician. The Aptaér Heliox Delivery System is not intended as a life support device and is not intended for intubated patients.
Device Description
The GE Datex-Ohmeda Aptaér Heliox delivery system is designed to deliver heliox from a source gas cylinder to spontaneously breathing patients via a facemask using pressure support. A built-in nebulizer, the Aerogen Aeroneb Pro (K021175) is provided for adding nebulized medication to the delivered heliox. The system is designed for facility use and should only be used under the orders of a clinician. The Aptaér Heliox Delivery System is not intended as a life support device and is not intended for intubated patients.
More Information

No
The document describes a heliox delivery system with a nebulizer and pressure support, but there is no mention of AI or ML technology in the intended use, device description, or performance studies.

Yes
The device delivers heliox and nebulized medication to spontaneously breathing patients, which is a therapeutic intervention.

No

Explanation: The device is described as a "Heliox delivery system" that delivers heliox and nebulized medication to spontaneously breathing patients. Its function is therapeutic (delivery of gas and medication), not diagnostic (identifying or measuring a disease or condition).

No

The device description explicitly states it is a "Heliox delivery system" that delivers gas from a "source gas cylinder" via a "facemask" and includes a "built-in nebulizer." These are all hardware components, indicating it is not a software-only device.

Based on the provided information, the GE Datex-Ohmeda Aptaér Heliox delivery system is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use clearly states that the device is designed to "deliver heliox from a source gas cylinder to spontaneously breathing patients via a facemask using pressure support." This describes a therapeutic intervention, not a diagnostic test performed on samples taken from the body.
  • Device Description: The description reinforces the delivery of gas and medication to a patient, which is a treatment function.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting markers, or providing diagnostic information about a patient's condition.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. The Aptaér Heliox delivery system's function is to deliver a therapeutic gas mixture and medication directly to the patient.

N/A

Intended Use / Indications for Use

The GE Datex-Ohmeda Aptaér Heliox delivery system is designed to deliver heliox from a source gas cylinder to spontaneously breathing patients via a facemask using pressure support. A built-in nebulizer, the Aerogen Aeroneb Pro (K021175) is provided for adding nebulized medication to the delivered heliox. The system is designed for facility use and should only be used under the orders of a clinician.
The Aptaér Heliox Delivery System is not intended as a life support device and is not intended for intubated patients.

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

CBK

Device Description

The GE Datex-Ohmeda Aptaér Heliox delivery system is designed to deliver heliox from a source gas cylinder to spontaneously breathing patients via a facemask using pressure support. A built-in nebulizer, the Aerogen Aeroneb Pro (K021175) is provided for adding nebulized medication to the delivered heliox. The system is designed for facility use and should only be used under the orders of a clinician.

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

Not Found

Intended User / Care Setting

clinician / facility use

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)

The GE Datex-Ohmeda Aptaér Heliox Delivery System has been validated through rigorous testing that, in part, supports the compliance of GE Datex-Ohmeda Aptaér Heliox Delivery System to the standards listed above.

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.

K022674, K922705

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.

K021175

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

§ 868.5895 Continuous ventilator.

(a)
Identification. A continuous ventilator (respirator) is a device intended to mechanically control or assist patient breathing by delivering a predetermined percentage of oxygen in the breathing gas. Adult, pediatric, and neonatal ventilators are included in this generic type of device.(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 is circular and features the department's name around the perimeter. In the center is a stylized image of an eagle or bird-like figure with three curved lines representing its wings or body. The logo is black and white.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

OCT 1 8 2004

Mr. Dan Kosednar Manager, Regulatory Planning & Submissions Datex-Ohmeda, Incorporated CARE Business Area P.O. Box 7550 Madison, Wisconsin 53707

Re: K041524

Trade/Device Name: GE Datex-Ohmeda Aptaér Heliox Delivery System Regulation Number: 21 CFR 868.5895 Regulation Name: Continuous Ventilator Regulatory Class: II Product Code: CBK Dated: August 27, 2004 Received: August 30, 2004

Dear Mr. Kosednar:

This letter corrects our substantially equivalent letter of June 17, 2004 regarding the trade name.

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.

1

Page 2 - Mr. Kosednar

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 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 (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Que Saliem ba
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

K041524

Date:June 4, 2004SEP 20 2004
Subject:510(k) Summary of Safety and Effectiveness Information
for the GE Datex-Ohmeda Aptaér Heliox Delivery System
Proprietary:GE Datex-Ohmeda Aptaér Heliox Delivery System
Common:Ventilator, Continuous
Classification:Anesthesiology, 73 CBK , 21 CFR 868.5895

The 510(k) summary of safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 1992.

The GE Datex-Ohmeda Aptaér Heliox Delivery System is substantially equivalent to the following currently marketed device:

Viasys Avea Ventilator - Class II - 21CFR868.5895, which has been the subject of a cleared 510(k) with FDA log number K022674.

Puritan Bennett 7200 Series Ventilator -Class II - 21CFR868.5895, which has been the subject of several cleared 510(k)s, most recently with FDA log number K922705

The GE Datex-Ohmeda Aptaér Heliox delivery system is designed to deliver heliox from a source gas cylinder to spontaneously breathing patients via a facemask using pressure support. A built-in nebulizer, the Aerogen Aeroneb Pro (K021175) is provided for adding nebulized medication to the delivered heliox. The system is designed for facility use and should only be used under the orders of a clinician.

The Aptaér Heliox Delivery System is not intended as a life support device and is not intended for intubated patients.

The GE Datex- Aptaér Heliox Delivery System was designed to comply with the applicable portions of the following voluntary standards;

  • I . UL 2601 General requirements for Medical Electrical Equipment
    1. ASTM F100 Particular Requirements for Critical Care Ventilators
    1. EN/IEC 60601-1: General requirements for Medical Electrical Equipment
    1. EN/IEC 60601-1-2: 1998 Medical Electrical Equipment Electromagnetic Compatibility
    1. EN 475 Electrically Generated Alarm Signals
    1. CGA V-1 ad ISO 5145 Medical Gas Cylinders Threaded Cylinders
    1. EN 980 Graphical Symbols

3

The GE Datex-Ohmeda Aptaér Heliox Delivery System and the currently marketed device are substantially equivalent in design concepts, technologies and materials. The GE Datex-Ohmeda Aptaer Heliox Delivery System has been validated through rigorous testing that, in part, supports the compliance of GE Datex-Ohmeda Aptaér Heliox Delivery System to the standards listed above.

Dan Kosednar, RAC Contact: Manager, Regulatory Planning and Submissions

4

Indications for Use

510(k) Number (if known): K041524

Device Name: GE Datex-Ohmeda Aptaér Heliox Delivery System

Indications For Use:

The GE Datex-Ohmeda Aptaér Heliox delivery system is designed to deliver The GE Datex-Onmeda Aptacl Ticlion delivery Systems
heliox from a source gas cylinder to spontaneously breathing patients on Anragen nellox from a source gas bylinder to open . A built-in nebulizer, the Aerogen seated facemask using procedro on possible nebulized medication to the Aeroneb Pro (KUZTT7J) is provided for adaing naturing we and should only be used under the orders of a clinician.

The Aptaér Heliox Delivery System is not intended as a life support device and is not intended for intubated patients.

Prescription Use XXX (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)

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

510(k) Number