K Number
K043003
Device Name
TCM40 MONITORING SYSTEM
Date Cleared
2005-03-01

(120 days)

Product Code
Regulation Number
868.2480
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The TCM4 Monitoring System is intended for continuous transcutaneous monitoring of oxygen and carbon dioxide partial pressures. It is indicated for use on neonates, pediatrics, and adults not under gas anesthesia. The TCM40 Monitoring System is intended for continuous transcutaneous monitoring of oxygen and carbon dioxide partial pressures as well as of oxygen saturation of arterial hemoglobin and pulse rate. It is indicated for use on neonates, pediatrics, and adults not under gas anesthesia.
Device Description
The TCM4/40 Monitoring Systems essentially consist in a monitor unit, a combined oxygen/carbon dioxide interface module along with the combined electrodes assembly and (for the TCM40 only) an oxygen saturation/pulse module with a selection of three sensors.
More Information

Not Found

Not Found

No
The document describes a monitoring system for physiological parameters and does not mention any AI or ML components in its description or performance studies.

No
The device is a monitoring system that measures physiological parameters (oxygen and carbon dioxide partial pressures, oxygen saturation, and pulse rate); it does not provide any therapy or treatment.

Yes
The device monitors oxygen and carbon dioxide partial pressures, and oxygen saturation, which are physiological parameters used to assess a patient's health status and aid in diagnosis.

No

The device description explicitly states that the system consists of a monitor unit, interface modules, electrode assemblies, and sensors, which are all hardware components.

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

Here's why:

  • Intended Use: The intended use describes monitoring physiological parameters (oxygen and carbon dioxide partial pressures, oxygen saturation, pulse rate) on the patient's skin (transcutaneous). IVDs are designed to perform tests on samples taken from the human body (e.g., blood, urine, tissue).
  • Device Description: The description mentions a monitor unit, interface modules, electrodes, and sensors that are applied to the patient. This aligns with a device used for direct patient monitoring, not for analyzing samples in a lab setting.
  • No mention of sample analysis: There is no mention of collecting or analyzing biological samples.

Therefore, the TCM4/40 Monitoring System is a patient monitoring device, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The TCM4 Monitoring System is intended for continuous transcutaneous monitoring of oxygen and carbon dioxide partial pressures. It is indicated for use on neonates, pediatrics, and adults not under gas anesthesia.

The TCM40 Monitoring System is intended for continuous transcutaneous monitoring of oxygen and carbon dioxide partial pressures as well as of oxygen saturation of arterial hemoglobin and pulse rate. It is indicated for use on neonates, pediatrics, and adults not under gas anesthesia.

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

LKD, LPP, KLK, DQA

Device Description

The TCM4/40 Monitoring Systems essentially consist in a monitor unit, a combined oxygen/carbon dioxide interface module along with the combined electrodes assembly and (for the TCM40 only) an oxygen saturation/pulse module with a selection of three sensors.

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

neonates, pediatrics, and adults

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)

In order to ensure TCM4/40 Monitoring Systems is safe and effective for its intended use, it has been designed and tested to the requirements of the following standards:

  • . IEC-60601-1:1988 Medical electrical equipment - Part 1: General requirements for safety
  • IEC-60601-1-2:2001 . Medical Electrical Equipment - Part 1-2: General Requirements for Safety Collateral Standard: Electromagnetic Compatibility - Requirements and Tests
  • IEC-60601-2-23:1999 . Medical electrical equipment - Part 2-23: Particular reguirements for the safety, including essential performance, of transcutaneous partial pressure monitoring equipment
  • IEC-60601-3-1:1996 . Medical Electrical Equipment Part 3-1: Essential performance requirements for transcutaneous oxygen and carbon dioxide partial pressure monitoring equipment
  • EN-865:1997 . Pulse oximeters - Particular requirements
  • IEC-60601-1-8:2003 Medical electrical equipment - Part 1-8: General requirements for safety Collateral standard: General requirements, tests and quidance for alarm systems in medical electrical equipment and medical electrical systems

Based upon the extensive use of consensus standards covering all aspects of safety and performance, no clinical evaluation was deemed necessary to assess the product performance levels.

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.

TCM400 Monitoring System, TCM3 Monitoring System, OxiMAX N-550 Pulse Oximetry System, TOSCA PCO2, SpO2 and Pulse Rate Monitoring System, Perimed Transcutaneous PO2 and PCO2 Monitor (PF5040), MicroGas 7650 Transcutaneous Monitor, Siemens Transcutaneous TpO2/CO2 Gas Module

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

§ 868.2480 Cutaneous carbon dioxide (PcCO2) monitor.

(a)
Identification. A cutaneous carbon dioxide (PcCO2) monitor is a noninvasive heated sensor and a pH-sensitive glass electrode placed on a patient's skin, which is intended to monitor relative changes in a hemodynamically stable patient's cutaneous carbon dioxide tension as an adjunct to arterial carbon dioxide tension measurement.(b)
Classification. Class II (special controls). The special control for this device is FDA's “Class II Special Controls Guidance Document: Cutaneous Carbon Dioxide (PcCO2) and Oxygen (PcO2) Monitors; Guidance for Industry and FDA.” See § 868.1(e) for the availability of this guidance document.

0

510(k) Premarket Notification; TCM4/40; K043003

RADIOMETER COPENHAGEN

February 16, 2005

MAR ] - 2005

510(k) Summary - TCM4/40 Monitoring Systems

Submitter:Radiometer Medical ApS
Address:Åkandevej 21, DK-2700 Brønshøj, Denmark
Phone:+45 3827.3827
Fax:+45 3827.2736
Contact Person:Pierre Pelletier
Trade Name:TCM4/40 Monitoring Systems
Common name:Transcutaneous pO2/pCO2/SpO2/pulse monitoring system
Classification Names:21CFR§868.2500: Monitor, Oxygen, Cutaneous
21CFR§868.2480: Monitor, Carbon Dioxide, Cutaneous
21CFR§870.2700: Oximeter
Predicate Devices:TCM400 Monitoring System
TCM3 Monitoring System
OxiMAX N-550 Pulse Oximetry System
TOSCA PCO2, SpO2 and Pulse Rate Monitoring System
Perimed Transcutaneous PO2 and PCO2 Monitor (PF5040)
MicroGas 7650 Transcutaneous Monitor
Siemens Transcutaneous TpO2/CO2 Gas Module

Device Description

The TCM4/40 Monitoring Systems essentially consist in a monitor unit, a combined oxygen/carbon dioxide interface module along with the combined electrodes assembly and (for the TCM40 only) an oxygen saturation/pulse module with a selection of three sensors.

Intended use

The TCM4 Monitoring System is intended for continuous transcutaneous monitoring of oxygen and carbon dioxide partial pressures. It is indicated for use on neonates, pediatrics, and adults not under gas anesthesia.

The TCM40 Monitoring System is intended for continuous transcutaneous monitoring of oxygen and carbon dioxide partial pressures as well as of oxygen saturation of arterial hemoglobin and pulse rate. It is indicated for use on neonates, pediatrics, and adults not under gas anesthesia.

1

RADIOMETER COPENHAGEN

February 16, 2005

Technological characteristics

The monitoring unit (including software, cabinet, touch screen, electronic controls, power supply and battery) is an adaptation of Radiometer's TCM400 Monitoring System, with only one combined tcp02/tcpCO2 electrode and (for the TCM40 only) one pulse/SoO2 sensor (the TCM400 has up to 6 separate tcg0> electrodes). The combined tcp02/tcpCO2 electrode is identical to the electrode used in Radiometer's previous generation TCM3 Monitoring System. The pulse/SpO2 sensors are identical to the sensors used with Puritan Nellcor Bennett's OxiMAX N-550 Pulse Oximetry System.

Safety and performance evaluation studies

In order to ensure TCM4/40 Monitoring Systems is safe and effective for its intended use, it has been designed and tested to the requirements of the following standards:

  • . IEC-60601-1:1988 Medical electrical equipment - Part 1: General requirements for safety
  • IEC-60601-1-2:2001 . Medical Electrical Equipment - Part 1-2: General Requirements for Safety Collateral Standard: Electromagnetic Compatibility - Requirements and Tests
  • IEC-60601-2-23:1999 . Medical electrical equipment - Part 2-23: Particular reguirements for the safety, including essential performance, of transcutaneous partial pressure monitoring equipment
  • IEC-60601-3-1:1996 . Medical Electrical Equipment Part 3-1: Essential performance requirements for transcutaneous oxygen and carbon dioxide partial pressure monitoring equipment
  • EN-865:1997 . Pulse oximeters - Particular requirements

. IEC-60601-1-8:2003

Medical electrical equipment - Part 1-8: General requirements for safety Collateral standard: General requirements, tests and quidance for alarm systems in medical electrical equipment and medical electrical systems

Based upon the extensive use of consensus standards covering all aspects of safety and performance, no clinical evaluation was deemed necessary to assess the product performance levels.

Conclusions from safety and performance evaluation studies

Compliance with the requirements in the above-named safety and performance standards demonstrates that the TCM4/40 Monitoring Systems are state-of-the-art transcutaneous oxygen/carbon dioxide monitors and pulse oximeters that have the necessary safety mechanisms and performs up to the requirements of the relevant international consensus standards.

2

Image /page/2/Picture/1 description: The image shows the seal of the U.S. Department of Health & Human Services. The seal features an abstract design of an eagle's head and neck, rendered in black lines. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" are arranged in a circular pattern around the eagle design. The text is in a sans-serif font and is also black.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR 1 - 2005

Mr. Pierre Pelletier Regulatory Affairs Manager Radiometer Medical ApS Åkandevej 21, Brønshøj Denmark DK-2700

Re: K043003

Trade/Device Name: TCM4/40 Monitoring Systems Regulation Number: 21 CFR 868.2480 Regulation Name: Cutaneous Carbon Dioxide (PcCO2) Monitor Regulatory Class: II Product Code: LKD, LPP, KLK, DQA Dated: January 20, 2005 Received: January 24, 20045

Dear Mr. Pelletier:

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 Ecderal Register.

3

Page 2 - Mr. Pelletier

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 vour 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-frec number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Susan Runne
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

4

INDICATIONS FOR USE STATEMENT

510(k) Number (if known): K043003

TCM4/40 Monitoring Systems Device Name:

Indications for Use:

The TCM4 Monitoring System is intended for continuous transcutaneous monitoring of oxygen and The TCM4 Monitoring System is mended for continued for use on neonates, pediatrics, and adults not under gas anesthesia.

The TCM40 Monitoring System is intended for continuous transcutaneous monitoring of oxygen and carbon dioxide partial pressures as well as of oxygen saturation of arterial hemoglobin and pulse Carbon uloxide partial pressures as well as of thyger of the mot under gas anesthesia.

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)

and the comments of the comments of the comments of the comments of the comments of the comments of

Cicia Fowler

sion Sign-O
son of Anesthesiology, General Hospital.
action Control. Dental Devices

in Number

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