K Number
K053609
Date Cleared
2006-02-28

(63 days)

Product Code
Regulation Number
870.1230
Reference & Predicate Devices
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The PreSep Oximetry and PediaSat Oximetry Catheters are indicated for hemodynamic monitoring in adults and pediatrics through blood sampling, hemodynamic monitoring and oxygen saturation measurement.

The dilator, included with each catheter, is indicated for enlarging the opening in a vessel for preparation of percutaneous entry of the catheter.

The Vigileo Arterial Pressure Cardiac Output /Oximetry Monitor is indicated for continuously measuring arterial pressure cardiac output and oximetry to assess oxygen delivery and consumption. When connected to an Edwards oximetry catheter, the monitor measures oximetry in adults and pediatrics.

Device Description

The PreSep Oximetry and PediaSat Oximetry Catheters are used with Edwards oximetry monitors to continuously measure oxygen saturation in adults and pediatrics. These catheters also provide the means for infusion of solutions, measuring pressure and taking blood samples. The dilator included with either the PreSep Oximetry or PediaSat Oximetry Catheter is used to enlarge the opening in a vessel for preparation of percutaneous entry of the catheter.

The Vigileo APCO/Oximetry monitor is a microprocessor-based instrument which, when connected to a dual disposable pressure transducer (DDPT), continuously measures arterial pressure cardiac output (APCO). When connected to an Edwards oximetry catheter, the monitor measures oxygen saturation (oximetry) in adults or pediatrics. The monitor also calculates other derived parameters including cardiac index, stroke volume, stroke volume index, stroke volume variation, system vascular resistance, and systemic vascular resistance index.

AI/ML Overview

The provided text describes a 510(k) summary for the Edwards Lifesciences PreSep Oximetry and PediaSat Oximetry Catheters, and the Vigileo Arterial Pressure Cardiac Output/Oximetry Monitor.

Based on the provided text, the submission does NOT include specific acceptance criteria or a study proving the device meets quantitative acceptance criteria in the typical sense for an AI/ML device.

The submission is for a medical device cleared through the 510(k) pathway, which focuses on demonstrating substantial equivalence to a legally marketed predicate device, rather than proving performance against specific acceptance criteria with detailed statistical studies as would be expected for a novel AI/ML algorithm.

Therefore, the following information cannot be extracted directly from the provided document:

  1. A table of acceptance criteria and the reported device performance: Not present. The submission focuses on substantial equivalence rather than numerical performance against pre-defined criteria.
  2. Sample size used for the test set and the data provenance: Not present. There is no mention of a "test set" in the context of an AI/ML performance study. The functional testing mentioned is likely for engineering verification and validation of the device hardware and software, not an AI/ML performance evaluation.
  3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not present. Ground truth for an AI/ML system is not applicable here as it is not an AI/ML device.
  4. Adjudication method for the test set: Not present.
  5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance: This is not an AI/ML device, so an MRMC study is not relevant and not mentioned.
  6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: This is not an AI/ML device, so "standalone algorithm performance" is not relevant and not mentioned.
  7. The type of ground truth used: Not applicable as this is not an AI/ML device.
  8. The sample size for the training set: Not applicable as this is not an AI/ML device.
  9. How the ground truth for the training set was established: Not applicable as this is not an AI/ML device.

What is present in the document is a claim of substantial equivalence and successful functional testing:

  • Acceptance Criteria (Implicit for 510(k) clearance): Substantial equivalence to predicate devices regarding safety and effectiveness for their intended use.
  • Study Proving Acceptance Criteria:
    • "The PreSep Oximetry and PediaSat Oximetry Catheters, dilator and the Vigileo Arterial Pressure Cardiac Output/Oximetry Monitor have been demonstrated to be as safe and effective as the predicate devices for their intended use."
    • "The PreSep Oximetry and PediaSat Oximetry Catheters, dilator and the Vigileo Arterial Pressure Cardiac Output/Oximetry Monitor have successfully undergone functional testing. These products have been shown to be equivalent to the predicate devices."

In summary, the provided text describes a traditional medical device submission (catheters and a monitor) and not an AI/ML device. Therefore, the specific criteria requested for an AI/ML performance study are not found in this document. The "study" mentioned is the functional testing and comparative analysis to predicate devices to establish substantial equivalence for 510(k) clearance.

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

Image /page/0/Picture/0 description: The image shows a logo with the word "Edwards" printed below it. The logo is a large, stylized letter "E" with a grid pattern in the background. Above the logo, the date "FEB 28 2006" is printed in a stamp-like font. The image appears to be a scan or photocopy, as the text and logo are slightly pixelated.

K053609
page 1 of 3

510(k) Summary 5

Submitter:Edwards Lifesciences LLCOne Edwards WayIrvine, CA 92614-5686
Contact Person:Diane Peterson
Project Manager, Regulatory Affairs
Date Prepared:December 21, 2005
Trade name:PreSep Oximetry and PediaSat Oximetry Catheters
Vigileo Arterial Pressure Cardiac Output/OximetryMonitor
ClassificationCatheter, Oximeter, Fiberoptic (21 CFR 870.1230)
Name:Single-Function, Preprogrammed Diagnostic Computer(21 CFR 870.1435)
Dilator, Vessel, For Percutaneous Catheterization (21CFR 870.1310)
PredicateCentral Venous Oximetry Probe Catheter and Probe
Devices:Multi-Med Multi-Lumen Central Venous Catheter
Edslab Dual Lumen Regional Saturation OximetryCatheter
Vigileo Arterial Pressure Cardiac Output/OximetryMonitor
SDM Percuglide
DeviceDescription:The PreSep Oximetry and PediaSat Oximetry Cathetersare used with Edwards oximetry monitors tocontinuously measure oxygen saturation in adults andpediatrics. These catheters also provide the means forinfusion of solutions, measuring pressure and takingblood samples.The dilator included with either the PreSep Oximetry orPediaSat Oximetry Catheter is used to enlarge the

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

053609
page 2 of 3

Image /page/1/Picture/1 description: The image shows a close-up of a letter 'E' superimposed on a grid pattern. The letter 'E' is partially obscured by circular shapes, creating a layered effect. The grid pattern provides a structured background, while the letter and circles add visual complexity to the composition.

Edwards

opening in a vessel for preparation of percutaneous entry of the catheter.

The Vigileo APCO/Oximetry monitor is a microprocessor-based instrument which, when connected to a dual disposable pressure transducer (DDPT), continuously measures arterial pressure cardiac output (APCO). When connected to an Edwards oximetry catheter, the monitor measures oxygen saturation (oximetry) in adults or pediatrics. The monitor also calculates other derived parameters including cardiac index, stroke volume, stroke volume index, stroke volume variation, system vascular resistance, and systemic vascular resistance index.

The PreSep Oximetry and PediaSat Oximetry Catheters i Intended Use: are intended to provide in adults and pediatrics the means for infusion of solutions, measuring pressure and taking blood samples through the distal, proximal and medial lumens. The PreSep Oximetry and PediaSat Oximetry Catheters also provide the means for continuously monitoring oxygen saturation using an Edwards Lifesciences oximetry monitor.

The dilator included with either the PreSep Oximetry or i PediaSat Oximetry Catheter is intended to be used in adults and pediatric patients for enlarging the opening in a vessel for preparation of percutaneous entry of the catheter.

The Vigileo Arterial Pressure Cardiac Output/Oximetry Monitor is intended to measure arterial pressure cardiac output and oximetry. The monitor also calculates hemodynamic and oxygenation parameters. When i connected to an Edwards oximetry catheter, the monitor measures oximetry in adults and pediatrics.

The PreSep Oximetry and PediaSat Oximetry Comparative Catheters, dilator and the Vigileo Arterial Pressure Analysis: Cardiac Output/Oximetry Monitor have been demonstrated to be as safe and effective as the predicate devices for their intended use i

Page 14

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

059609
3 of 3

Image /page/2/Picture/1 description: The image shows a logo with the word "Edwards" written below it. The logo consists of a large letter "E" with a design inside of it. The design appears to be a combination of circles and lines, creating a complex and abstract pattern within the letter. The logo and the word "Edwards" are both in black and white.

The PreSep Oximetry and PediaSat Oximetry Functional/Safety Catheters, dilator and the Vigileo Arterial Pressure Testing: Cardiac Output/Oximetry Monitor have successfully undergone functional testing. These products have been shown to be equivalent to the predicate devices. The PreSep Oximetry and PediaSat Oximetry Conclusion: Catheters, dilator and the Vigileo Arterial Pressure Cardiac Output/Oximetry Monitor are substantially

equivalent to the predicate devices.

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

Public Health Service

Image /page/3/Picture/2 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH AND HUMAN SERVICES, USA" around the perimeter. Inside the circle is a stylized symbol of three abstract human figures.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

FEB 2 8 2006

Edwards Lifesciences LLC c/o Ms. Diane Peterson Project Manager, Regulatory Affairs One Edwards Way Irvine, CA 92614

Re: K053609

Trade Name: Vigileo APCO/Oximetry Monitor (MIHM1 & MIHM1P), PediaSat Oximetry Catheter Kit, and PreSep - Central Venous Oximetry Catheter Kit Regulation Number: 21 CFR § 870.1230, 21 CFR § 870.1310, and 21 CFR §870.1435 Regulation Name: Fiberoptic Oximeter Catheter, Vessel Dilator for Percutaneous Vessel Dilation, and Single-Function, Preprogrammed Diagnostic Computer Regulatory Class: II (two) Product Code: DQE, DRE, and DXG Dated: December 21, 2005 Received: December 27, 2005

Dear Ms. Peterson:

We have reviewed your Section 510(k) premarket notification of intent to market the device w & nove 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, do nots that hat t (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 - Ms. Diane Peterson

Please be advised that FDA's issuance of a substantial equivalence determination does not mean Please be advised that I Dri- 3 issuation of a build with other requirements of the Act that IDA has made a decermination administered by other Federal agencies. You must of any it catal statutes and regalations and limited to: registration and listing (21 Comply with an the Her e requirements)01); good manufacturing practice requirements as set CFN in the quality systems (DS) regulation (21 CFR Part 820); and if applicable, the electronic forth in the quality bystems (Sections 531-542 of the Act); 21 CFR 1000-1050. product radiation control provisions (beting your device as described in your Section 510(k) This letter will anow you to begin manical equivalence of your device of your device to a legally prematicated 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 If you desire specific acrise at (240) 276-0120. Also, please note the regulation entitled, eonading by reference to premarket notification" (21CFR Part 807.97). You may obtain Whisoranding of reference to premassionsibilities under the Act from the Division of Small other general informational 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/industry/support/index.html.

Sincerely yours,

B/Zimmerman for

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

Enclosure

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

Image /page/5/Picture/0 description: The image shows the logo for Edwards Lifesciences. The logo consists of a square graphic on the left and the company name "Edwards Lifesciences" on the right. The text is in a simple, sans-serif font and is horizontally aligned.

Indications for Use Statement 4

510(k) Number (if known): KOS3609

Device Name: PreSep Oximetry Catheters PediaSat Oximetry Catheters PediaSal Oximetry Gatheloro
Vigileo Arterial Pressure Cardiac Output/Oximetry Monitor

Indications for Use:

The PreSep Oximetry and PediaSat Oximetry Catheters are indicated for The PreSep Oximelly and I Calabat Oximony of Ediatrics through blood sampling.
hemodynamic monitoring in adults and pediatrics through blood sampling. nemodynamio monitoring and oxygen saturation measurement.

The dilator, included with each catheter, is indicated for enlarging the opening in The difator, included wn of percutaneous entry of the catheter.

The Vigileo Arterial Pressure Cardiac Output /Oximetry Monitor is indicated for i he Vigiled Altenal Fressure Oardiae Output Foximal output and continuously measuring nemouynamic parsumption. When connected to an
oximetry to assess oxygen delivery and consumption. When end oximelly to assess oxygen doll. By and or monitor measures oximetry in adults and pediatrics.

Over-The-Counter Use AND/OR Prescription Use _____________________________________________________________________________________________________________________________________________________________ (21 CFR 807 Subpart C) (Part 21 CFR 801 Subpart D)

(Please do not WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Bhummana

Witness Sign Off

Page 1 of

§ 870.1230 Fiberoptic oximeter catheter.

(a)
Identification. A fiberoptic oximeter catheter is a device used to estimate the oxygen saturation of the blood. It consists of two fiberoptic bundles that conduct light at a desired wavelength through blood and detect the reflected and scattered light at the distal end of the catheter.(b)
Classification. Class II (performance standards).