K Number
K042039
Device Name
FAMILY OF CRYSTAL 20 MONITORS MODEL #CS20-600,900,1300,1400,2400 & 120
Date Cleared
2004-11-17

(111 days)

Product Code
Regulation Number
882.1400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Family of Crystal 20 Monitors are intended for monitoring and recording of physiological signals to aid in research and/or diagnostic purposes. The device is not intended for use as life support equipment such as vital signs monitoring in intensive care units.
Device Description
The Family of Crystal 20 Monitors® are designed to monitor physiological signals such as cardiovascular, neurological, and muscular for the purpose of research and diagnostic purposes. The Crystal 20 Monitor is a device that is programmable to the type of physiological signals being monitored such as EEG, EOG, EMG, ENG, ECG, PSG, airflow, pulse oximetry, respiratory effort, temperature, blood pressure, etc. The signals are communicated between the patient module and the computer unit using wireless technology based on frequencies such as but not limited to 902-928 MHz, 2.4 - 2.484 GHZ, Wireless Medical Telemetry Bands (WMTS), 608-614 MHz, 1395-1400 MHz, or 1429-1432 MHz. The communication between the patient module and computer unit can also be wired (instead of wireless). The Family of Crystal 20 Monitors® will consist of three major components: 1. Patient Module; 2. Computer Unit; and 3. Interface Software 1. The Patient Module can have up to 32 channels and the ability to either transmit only (one-way) or transmit and receive (two-way). The basic functional feature of the component is to acquire signals from commercially available electrodes / sensors that are attached to the subject, perform analog-to-digital conversion (when appropriate), encode, format, and transmit the signals to the Computer Unit. The Patient Unit will also have on-board memory capability that will permit the physiological data to be stored inside the patient unit. The Patient Module will contain no-touch connectors to enable connections to commercially available electrodes / sensors. 2. The Computer Unit will have the ability to only receive (one-way) or receive and transmit (two-way). The basic functional feature of this component is to receive data packets, performs error detection and correction, and then sends the data to the PC Operator interface where the data can be monitored in real time or stored and analyzed at a later time.
More Information

Not Found

No
The description focuses on signal acquisition, transmission, and basic data processing/storage. There is no mention of AI/ML algorithms for analysis or interpretation.

No
Explanation: The device is described as "intended for monitoring and recording of physiological signals to aid in research and/or diagnostic purposes," and explicitly states it is "not intended for use as life support equipment." This indicates it is a diagnostic/research tool, not a therapeutic device.

Yes
Explanation: The "Intended Use / Indications for Use" section explicitly states that the device is "intended for monitoring and recording of physiological signals to aid in research and/or diagnostic purposes." The "Device Description" also reiterates that the monitors are "designed to monitor physiological signals such as cardiovascular, neurological, and muscular for the purpose of research and diagnostic purposes."

No

The device description explicitly lists three major hardware components: a Patient Module, a Computer Unit, and Interface Software. The Patient Module and Computer Unit are described as physical components that acquire, transmit, and receive physiological signals.

Based on the provided text, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used to examine specimens outside of the body.
  • Device Description: The description clearly states that the device monitors and records physiological signals from the subject using electrodes and sensors attached to the subject. This involves measuring electrical activity, airflow, temperature, etc., directly from the body.
  • Intended Use: The intended use is for monitoring and recording physiological signals for research and/or diagnostic purposes. This aligns with devices that measure bodily functions directly, not analyze samples taken from the body.

The device is designed to interact with the patient's body to acquire signals, which is the opposite of how an IVD operates.

N/A

Intended Use / Indications for Use

The Family of Crystal 20 Monitors are intended for monitoring and recording of physiological signals to aid in research and/or diagnostic purposes.

The device is not intended for use as life support equipment such as vital signs monitoring in intensive care units.

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

OLV, GWO

Device Description

The Family of Crystal 20 Monitors® are designed to monitor physiological signals such as cardiovascular, neurological, and muscular for the purpose of research and diagnostic purposes. The Crystal 20 Monitor is a device that is programmable to the type of physiological signals being monitored such as EEG, EOG, EMG, ENG, ECG, PSG, airflow, pulse oximetry, respiratory effort, temperature, blood pressure, etc. The signals are communicated between the patient module and the computer unit using wireless technology based on frequencies such as but not limited to 902-928 MHz, 2.4 - 2.484 GHZ, Wireless Medical Telemetry Bands (WMTS), 608-614 MHz, 1395-1400 MHz, or 1429-1432 MHz. The communication between the patient module and computer unit can also be wired (instead of wireless). The Family of Crystal 20 Monitors® will consist of three major components:

  1. Patient Module;

  2. Computer Unit; and

  3. Interface Software

  4. The Patient Module can have up to 32 channels and the ability to either transmit only (one-way) or transmit and receive (two-way). The basic functional feature of the component is to acquire signals from commercially available electrodes / sensors that are attached to the subject, perform analog-to-digital conversion (when appropriate), encode, format, and transmit the signals to the Computer Unit. The Patient Unit will also have on-board memory capability that will permit the physiological data to be stored inside the patient unit. The Patient Module will contain no-touch connectors to enable connections to commercially available electrodes / sensors.

  5. The Computer Unit will have the ability to only receive (one-way) or receive and transmit (two-way). The basic functional feature of this component is to receive data packets, performs error detection and correction, and then sends the data to the PC Operator interface where the data can be monitored in real time or stored and analyzed at a later time.

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

Not Found

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)

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.

K013863, K003175

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

§ 882.1400 Electroencephalograph.

(a)
Identification. An electroencephalograph is a device used to measure and record the electrical activity of the patient's brain obtained by placing two or more electrodes on the head.(b)
Classification. Class II (performance standards).

0

510(k) SUMMARY

K042039

The Summary of Safety and Effectiveness information on the Family of Crystal 20 Monitors® is being submitted in accordance with the requirements of 21 C.F.R. §807.92 and reflects data available and represented at the time the submission was prepared, but caution should be exercised in interpreting the data. The results of future studies and or tests may require alterations of the conclusions or recommendations set forth.

ApplicantCleveland Medical Devices Inc.
4415 Euclid Avenue
Cleveland, Ohio 44103
Telephone(216) 791-6720
Facsimile(216) 791-6739
DateJuly 26, 2004
NameRobert N. Schmidt, President
Classification882.1400
Predicate:Crystal Monitor Model 16, K013863 and Siesta System, K003175
Description:The Family of Crystal 20 Monitors® are designed to monitor physiological
signals such as cardiovascular, neurological, and muscular for the purpose
of research and diagnostic purposes. The Crystal 20 Monitor is a device
that is programmable to the type of physiological signals being monitored
such as EEG, EOG, EMG, ENG, ECG, PSG, airflow, pulse oximetry,
respiratory effort, temperature, blood pressure, etc. The signals are
communicated between the patient module and the computer unit using
wireless technology based on frequencies such as but not limited to 902-
928 MHz, 2.4 - 2.484 GHZ, Wireless Medical Telemetry Bands (WMTS),
608-614 MHz, 1395-1400 MHz, or 1429-1432 MHz. The
communication between the patient module and computer unit can also be
wired (instead of wireless). The Family of Crystal 20 Monitors® will
consist of three major components:
1. Patient Module;
  1. Computer Unit; and
  2. Interface Software | |
    | | 1. The Patient Module can have up to 32 channels and the ability to
    either transmit only (one-way) or transmit and receive (two-way). The
    basic functional feature of the component is to acquire signals from
    commercially available electrodes / sensors that are attached to the
    subject, perform analog-to-digital conversion (when appropriate),
    encode, format, and transmit the signals to the Computer Unit. The
    Patient Unit will also have on-board memory capability that will
    permit the physiological data to be stored inside the patient unit. The
    Patient Module will contain no-touch connectors to enable connections
    to commercially available electrodes / sensors.
  3. The Computer Unit will have the ability to only receive (one-way) or
    receive and transmit (two-way). The basic functional feature of this
    component is to receive data packets, performs error detection and
    correction, and then sends the data to the PC Operator interface where
    the data can be monitored in real time or stored and analyzed at a later
    time. | |

1

Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" arranged around the perimeter. Inside the circle is a stylized design featuring three abstract human profiles facing to the right, with flowing lines suggesting movement or progress.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

Cleveland Medical Devices, Inc. c/o Mr. Robert N. Schmidt President 4415 Euclid Avenue Cleveland, Ohio 44103

Re: K042039

Trade/Device Name: Family of Crystal 20 Monitors Regulation Number: 21 CFR 882.1400 Regulation Name: Electroencephalograph Regulatory Class: II Product Code: OLV, GWO Dated (Date on orig SE ltr): November 5, 2004 Received (Date on orig SE ltr): November 8, 2004

APR - 9 2012

Dear Mr. Schmidt:

This letter corrects our substantially equivalent letter of November 17, 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 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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

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.

2

Page 2 - Mr. Robert N. Schmidt

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled. "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely vours. Malvina B. Eydelman, M.D. Director Division of Ophthalmic, Neurological,

and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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510(k) Number (if known):K042039
Device Name:Family of Crystal 20 Monitors

The various types of model versions within the Family of Crystal 20 Monitors would be as follows:

#Wireless Model OptionTransmission FrequenciesBands
1CS20 - 600608 - 614 MHzWMTS
2CS20 - 900902 - 928 MHzISM
3CS20 - 13001395 - 1400 MHzWMTS
4CS20 - 14001429 - 1432 MHzWMTS
5CS20 - 24002400 - 2484 MHzISM
Hard-Wired Model OptionOperating Voltage
6CS20 - 120120 VAC

Indications For Use:

The Family of Crystal 20 Monitors are intended for monitoring and recording of physiological signals to aid in research and/or diagnostic purposes.

The device is not intended for use as life support equipment such as vital signs monitoring in intensive care units.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Miriam C. Provost

(Division Sign-Off) Division of General, Restorative, and Neurological Devices

510(k) Number KU42039

Prescription Use (Per 21 CFR 801.109) OR

Over-The-Counter-Use __

(Optional Format 1-2-96)

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