K Number
K043354
Device Name
MODULAR TELEMETRY SYSTEM FOR THE VISION TELEPAK, MODEL 20701
Date Cleared
2005-01-10

(35 days)

Product Code
Regulation Number
870.2300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Vision Telepak™ Telemetry Transmitter is portable monitor intended to be used for monitoring vital signs on critically ill adult and pediatric patients in the hospital environment.
Device Description
The Vision Telepak Telemetry Transmitter unit is a portable, wireless, patient monitor intended to be used for monitoring the ECG and SpO2 vital signs of critically ill and pediatric patients. The Telepak unit is used in all areas of the hospital which utilize telemetry transmitters for ECG and/or SpO2 monitoring. The Telepak transmits vital sign information to an ESCORT Vision Central Station or an ESCORT Series bedside monitor. Both the central station and beside monitors were cleared under K970763.
More Information

Not Found

No
The summary does not mention AI, ML, or any related terms, and the device description focuses on standard vital sign monitoring and transmission.

No.
The device is a monitor used for monitoring vital signs, not for treating a disease or condition.

No

The device is a monitor for vital signs, not a diagnostic device. Its purpose is to transmit vital sign information, not to diagnose a condition.

No

The device description explicitly states it is a "portable, wireless, patient monitor" and a "Telepak unit," indicating it is a physical hardware device that transmits vital sign information.

No, 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 diagnose, monitor, or screen for various health issues.
  • Device Function: The Vision Telepak Telemetry Transmitter is a patient monitor. It directly measures vital signs (ECG and SpO2) from the patient's body using sensors attached to the skin. It does not analyze samples taken from the body.
  • Intended Use: The intended use is for "monitoring vital signs on critically ill adult and pediatric patients in the hospital environment." This is a monitoring function, not a diagnostic test performed on a sample.

Therefore, based on the provided information, the Vision Telepak Telemetry Transmitter falls under the category of a patient monitoring device, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Vision Telepak Telemetry Transmitter is a portable monitor intended to be used for monitoring vital signs on critically ill adult and pediatric patients in the hospital environment.

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

74DRT, 74DQA

Device Description

The Vision Telepak Telemetry Transmitter unit is a portable, wireless, patient monitor intended to be used for monitoring the ECG and SpO2 vital signs of critically ill and pediatric patients. The Telepak unit is used in all areas of the hospital which utilize telemetry transmitters for ECG and/or SpO2 monitoring. The Telepak transmits vital sign information to an ESCORT Vision Central Station or an ESCORT Series bedside monitor. Both the central station and beside monitors were cleared under K970763.

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

Adult and pediatric patients

Intended User / Care Setting

Hospital environment

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 study conducted to compare equivalency of the MTS Option for the Escort II Monitor 510(k) cleared device to the modified Vision Telepak Telemetry Transmitter met the performance requirements for accuracy and precision relative to the reference laboratory system. Equivalent performance in meeting user requirements was determined.

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.

MTS Option for the Escort II Monitor, K970763

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

§ 870.2300 Cardiac monitor (including cardiotachometer and rate alarm).

(a)
Identification. A cardiac monitor (including cardiotachometer and rate alarm) is a device used to measure the heart rate from an analog signal produced by an electrocardiograph, vectorcardiograph, or blood pressure monitor. This device may sound an alarm when the heart rate falls outside preset upper and lower limits.(b)
Classification. Class II (performance standards).

0

K043354

JAN 1 0 2005

510(k) Summary

Submitted By:Medical Data Electronics, Inc.
12601 Research Parkway
Orlando, FL 32826
(800) 331-3220
(407) 249-2022 (fax)
Contact:Neil Battiste
Director of Regulatory Affairs
Date of Preparation:December 3, 2004
Establishment Registration
No:1051786
Device Name:Vision Telepak™ Telemetry Transmitter
Common/Classification
Name:Monitor, Cardiac
Device Classification:Class II
Regulation Number:CFR 870.2300 and 870.2700
Classification Panel:Division of Cardiovascular
Product Code:74DRT and 74DQA
Predicate Device:MTS Option for the Escort II Monitor, K970763

Device Description:

The Vision Telepak Telemetry Transmitter unit is a portable, wireless, patient monitor intended to be used for monitoring the ECG and SpO2 vital signs of critically ill and pediatric patients. The Telepak unit is used in all areas of the hospital which utilize telemetry transmitters for ECG and/or SpO2 monitoring. The Telepak transmits vital sign information to an ESCORT Vision Central Station or an ESCORT Series bedside monitor. Both the central station and beside monitors were cleared under K970763.

Intended Use:

The Vision Telepak Telemetry Transmitter is a portable monitor intended to be used for monitoring vital signs on critically ill adult and pediatric patients in the hospital environment.

1

KD43354

Comparison to the Predicate Device:

The Vision Telepak Telemetry Transmitter and the MTS Option for the Escort II Monitor are both portable monitors which are used to monitor ECG and Sp02. Both systems transmit vital sign information to either an ESCORT Vision Central Station or an ESCORT Series bedside monitor.

The systems differ in that the Telepak unit has been enhanced by reducing the size which makes the product easier to handle. In addition, the Telepak unit now requires 2 AA batteries instead of a 9v battery.

Environmental and Non-Clinical Testing:

Applicable environmental and non-clinical testing was performed per UL-2601-1 and EN 60601-1-2 as well as other applicable standards and procedures. The Vision Telepak Telemetry Transmitter passed all tests.

Performance Testing:

The study conducted to compare equivalency of the MTS Option for the Escort II Monitor 510(k) cleared device to the modified Vision Telepak Telemetry Transmitter met the performance requirements for accuracy and precision relative to the reference laboratory system. Equivalent performance in meeting user requirements was determined.

Conclusion:

The test results demonstrate the Vision Telepak Telemetry Transmitter is substantially equivalent to the MTS Option for the Escort II Monitor.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/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" around the perimeter. Inside the circle is a stylized graphic of three human profiles facing to the right, stacked on top of each other.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 1 0 2005

Invivo Research, Inc. c/o Mr. Neil Battiste Director of Regulatory Affairs Medical Data Electronics 12601 Research Parkway Orlando, FL 32826

Re: K043354

K04555+
Trade Name: Vision Telepak™ Telemetry Transmitter Trade Name: Vision Telepan
Regulation Number: 21 CFR 870.2300 and 21 CFR 870.2700 Regulation Number - 21 CFR 676.2500 and 25 - CFC - CF - Cardiotachometer and rate alarm) and Oximeter Regulatory Class: II (two) Product Code: DRT and DQA Dated: December 03, 2004 Received: December 06, 2004

Dear Mr. Battiste:

We have reviewed your Section 510(k) premarket notification of intent to market the device We have reviewed your Security (10(x) prematic is substantially equivalent (for the indications
referenced above and have determined the device is substantially equivale referenced above and have decimined the actrised predicate devices marketed in interstate for use stated in the encrosule) to regally manced promotion interestions of the Foderal Food. Drug commerce prior to May 28, 1970, the charger and the provisions of the Federal Food, Drug, devices that have been recassified in accordance who was areas approval applications (PMA).
and Cosmetic Act (Act) that do not require approval approval applicions of the Act and Cosmetic Act (Act) that do not require approval controls provisions of the Act. The
You may, therefore, market the device, subject to the general controls provisions of You may, therefore, market the device, seeject to the gentrator for annual registration, listing of
general controls provisions of the Act include requirements for any are an general controls provisions of the net net netalie sequilibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it ( If your device is classified (sec above) mio chairs and regulations affecting your device can
may be subject to such additional controls. Tim may be subject to such additional controlist. Existing major of 998. In addition, FDA may
be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addit be found in the Code of Pouch Ingerning your device in the Federal Register.

3

Page 2 – Mr. Neil Battiste

Please be advised that FDA's issuance of a substantial equivalence determination does not mean Prease be advised that FDA s issuates of a vadevice complies with other requirements of the Act that TDA has made a determination an administered by other Federal agencies. You must of any Federal statutes and regulations daminders, but not limited to: registration and listing (21 Comply with an the Act 3 requirements, morealing, and manufacturing practice requirements as set CFK Part 807), labeling (21 CFR Part 820); and if applicable, the electronic forth in the quality systems (Sections 531-542 of the Act); 21 CFR 1000-1050. product fadiation control provisions (Decleons over device as described in your Section 510(k) I his letter will anow you to ocgin manketing your antial equivalence of your device to a legally premarket notheadon. The PDA midning of backers 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 If you desire specific arvice for your ac now of the regulation of the regulation entitled, contact the Office of Compilance wa (== t notification" (21CFR Part 807.97) you may obtain. IMISURANGING by Telefone to promasibilities under the Act may be obtained from the Other general information on your responsible 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,

B. Zimmerman for
R.D. Zuckerman, M.D.

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

Indications for Use

K043354 510(k) Number (if known): Device Name: Vision Telepak™ Telemetry Transmitter

Indications for Use:

The Vision Telepak™ Telemetry Transmitter is portable monitor intended to be used for monitoring vital signs on critically ill adult and pediatric patients in the hospital environment.

× Prescription Use (21 CFR 801 Subpart D)

AND/OR

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

B.Brimmer

(Division Sign-Off) Division of Cardiovase 510(k) Number