K Number
K062392
Device Name
PHILIPS MP5 INTELLIVUE PATIENT MONITOR
Date Cleared
2006-09-06

(21 days)

Product Code
Regulation Number
870.1025
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients. Intended for monitoring and recording of and to generate alarms for multiple physiological parameters of adults, pediatrics and neonates in hospital environments. The MP5 is also intended for use in transport situations within hospital environments.
Device Description
The names of the device is the Philips MP5 IntelliVue Patient Monitor
More Information

No
The summary does not mention AI, ML, or any related concepts, and the device description and performance studies focus on standard physiological monitoring and testing against predicate devices.

No
The device is described as a "Patient Monitor" and its intended use is to "monitor and record" physiological parameters and "generate alarms." It does not mention delivering any form of treatment or therapy.

No

The device is intended for monitoring physiological parameters and generating alarms, not for diagnosing diseases or conditions.

No

The device description explicitly names the device as the "Philips MP5 IntelliVue Patient Monitor," which is a hardware device. The summary also mentions "system level tests, performance tests, and safety testing from hazard analysis" and "reliability requirements and performance claims," all of which are typical for a hardware medical device.

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

Here's why:

  • Intended Use: The intended use is for monitoring physiological parameters of patients (adults, pediatrics, and neonates) in a hospital setting and during transport. This involves measuring things like heart rate, blood pressure, oxygen saturation, etc., directly from the patient.
  • 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.

The Philips MP5 IntelliVue Patient Monitor is a device that monitors the patient directly, not through the analysis of samples taken from the patient. Therefore, it falls under the category of a patient monitoring device, not an IVD.

N/A

Intended Use / Indications for Use

Indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients. Intended for monitoring and recording of and to generate alarms for multiple physiological parameters of adults, pediatrics and neonates in hospital environments. The MP5 is also intended for use in transport situations within hospital environments.

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

DSI, MLD, MHX, DSJ, DSK, DXN, DXG, KRB, DRQ, DRT, DPS, MLC, DRW, KRC, DRJ, DQA, DSB, DSH, DSF, DRS, DSA, MSX, DRG, CCK, CBQ, NHO, NHP, NHQ, CBR, CCL, BZC, BZQ, LKD, KLK, FLL, GWR, GWS

Device Description

The modified device is the introduction of the model MP5 IntelliVue Patient Monitor.

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

adults, pediatrics, and neonates

Intended User / Care Setting

health care professionals in hospital environment and during transport within hospital environments.

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)

Verification, validation, and testing activities establish the performance, functionality, and reliability characteristics of the modified device with respect to the predicate. Testing involved system level tests, performance tests, and safety testing from hazard analysis. Pass/Fail criteria were based on the specifications cleared for the predicate device and test results showed substantial equivalence. The results demonstrate that the Philips MP5 IntelliVue Patient Monitor meets all reliability requirements and performance claims.

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.

K041235, K042845, K050141, K051106, K052801, K052961, K052801, K053522, K060221, K060541, K061052

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.

K020531, K030973, K033715, K050762, K060221

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

§ 870.1025 Arrhythmia detector and alarm (including ST-segment measurement and alarm).

(a)
Identification. The arrhythmia detector and alarm device monitors an electrocardiogram and is designed to produce a visible or audible signal or alarm when atrial or ventricular arrhythmia, such as premature contraction or ventricular fibrillation, occurs.(b)
Classification. Class II (special controls). The guidance document entitled “Class II Special Controls Guidance Document: Arrhythmia Detector and Alarm” will serve as the special control. See § 870.1 for the availability of this guidance document.

0

510 (k) Summary

This summary of 510(k) safety and effectiveness information is submitted in accordance with the requirements of the Safe Medical Devices Act of 1990 and 21 C.F.R. §807.92.

SEP - 1 2006

  1. The submitter of this premarket notification is: Markus Stacha Philips Medizin Systeme Boeblingen GmbH Hewlett-Packard-Str. 2 D-71034 Boeblingen, Germany Tel: ++49 7031 463-2840 Fax: ++49 7031 463-2442 e-mail: markus.stacha@philips.com

This summary was prepared on August 14, 2006.

  1. The names of the device is the Philips MP5 IntelliVue Patient Monitor

Classification names are as follows:

Device PanelClassificationProCodeDescription
Cardiovascular
Devices$870.1025, IIDSIDetector and alarm, arrhythmia
$870.1025, IIMLDMonitor, ST Segment with Alarm
$870.1025, IIMHXMonitor, Physiological, Patient
(with arrhythmia detection or
alarms)
$870.1100, IIDSJAlarm, Blood Pressure
$870.1110, IIDSKComputer, Blood Pressure
$870.1130, IIDXNSystem, Measurement, Blood-
Pressure, Non-Invasive
$870.1435, IIDXGComputer, Diagnostic, Pre-
Programmed, Single-Function
$870.1915, IIKRBProbe, Thermodilution
$870.2060, IIDRQAmplifier and Signal
Conditioner, Transducer Signal
$870.2300, IIDRTMonitor, Cardiac (incl.
Cardiotachometer & Rate Alarm)
$870.2340, IIDPSElectrocardiograph
$870.2340, IIMLCMonitor, ST Segment
$870.2350, IIDRWElectrocardiograph, Lead
Switching Adapter
$870.2370, IIKRCTester, Electrode, Surface,
Electrocardiograph
$870.2600, IDRJSystem, Signal Isolation
$870.2700, IIDQAOximeter
$870.2770, IIDSBPlethysmograph, Impedance
$870.2800, IIDSHRecorder, Magnetic tape,
Medical
$870.2810, IDSFRecorder, Paper Chart
$870.2850, IIDRSExtravascular Blood Pressure
Transducer
$870.2900, IDSACable, Transducer and
Electrode, incl. Patient
Connector
MSXSystem, Network and
Communication, Physiological
Monitors

1

Device PanelClassificationProCodeDescription
Anesthesiology
Devices$870.2910, IIDRGTransmitters and Receivers,
Physiological Signal,
Radiofrequency
$868.1400, IICCKAnalyzer, Gas, Carbon Dioxide,
Gaseous-Phase
$868.1500, IICBQAnalyzer, Gas, Enflurane,
Gaseous-Phase (Anesthetic
Concentration)
$868.1500, IINHOAnalyzer, Gas, Desflurane,
Gaseous-Phase (Anesthetic
Concentration)
$868.1500, IINHPAnalyzer, Gas, Sevoflurane,
Gaseous-Phase (Anesthetic
Concentration)
$868.1500, IINHQAnalyzer, Gas, Isoflurane,
Gaseous-Phase (Anesthetic
Concentration)
$868.1620, IICBSAnalyzer, Gas, Halothane,
Gaseous-Phase (Anesthetic
Concentration)
$868.1700, IICBRAnalyzer, Gas, Nitrous Oxide,
Gaseous-Phase (Anesthetic
Concentration)
$868.1720, IICCLAnalyzer, Gas, Oxygen, Gaseous-
Phase
$868.1880, IIBZCData calculator Pulmonary-
function
$868.2375, IIBZQMonitor, Breathing Frequency
$868.2480, IILKDMonitor, Carbon Dioxide,
Cutaneous
$868.2500, IIKLKMonitor, Oxygen, Cutaneous, for
Infant not under Gas Anesthesia
General Hospital
and Personal Use
Devices$880.2910, IIFLLThermometer, Electronic,
Clinical
Neurological
Devices$882.1400, IIGWRElectroencephalograph
$882.1420, IGWSAnalyzer, Spectrum,
Electroencephalogram Signal
    1. The modified device Philips MP5 IntelliVue Patient Monitor is substantially equivalent to previously cleared Philips MP30 IntelliVue Patient Monitor marketed pursuant to K041235, K042845, K050141, K051106, K052801, K052961, K052801, K053522, K060221, K060541, K061052, with Philips Multi-Parameter Module M3001A marketed pursuant to K020531, K030973, K033715 and its Philips M3014A Capnography Measurement Server Extension marketed pursuant to K050762 and K060221.
    1. The modification is the introduction of the model MP5 IntelliVue Patient Monitor.
    1. The modified device has the same intended use as the legally marketed predicate device. It is intended for the monitoring, recording, and alarming of multiple physiological parameters of adults, pediatrics, and neonates in hospital environment and during transport within hospital environments.

2

  • The modified device has the same technological characteristics 6. as the legally marketed predicate device.
    1. Verification, validation, and testing activities establish the performance, functionality, and reliability characteristics of the modified device with respect to the predicate. Testing involved system level tests, performance tests, and safety testing from hazard analysis. Pass/Fail criteria were based on the specifications cleared for the predicate device and test results showed substantial equivalence. The results demonstrate that the Philips MP5 IntelliVue Patient Monitor meets all reliability requirements and performance claims.

062392 > 3/3

3

Image /page/3/Picture/0 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with three tail feathers. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

SEP - 1 2006

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Philips Medizin Systeme Boblingen GmbH c/o Ms. Linda Stone Philips Medical Systems 3000 Minuteman Road Andover, MA 01810

Re: K062392

Trade Name: MP5 Intellivue Patient Monitor Regulation Number: 21 CFR 870.1025 Regulation Name: Arrhythmia Detector and Alarm (including ST-segment measurement and alarm Regulatory Class: Class II (two) Product Code: MHX Dated: August 14, 2006 Received: August 16, 2006

Dear Ms. Stone:

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 Federal Register.

4

Page 2 - Ms. Linda Stone

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 s set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the ed tonic 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 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 (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Blymmerman for

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

Enclosure

5

Indications for Use

510(k) Number (if known):_____________________________________________________________________________________________________________________________________________________

Device Name: Philips MP5 IntelliVue Patient Monitor.

Indications for Use: Indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients. Intended for monitoring and recording of and to generate alarms for multiple physiological parameters of adults, pediatrics and neonates in hospital environments. The MP5 is also intended for use in transport situations within hospital environments.

Prescription Use yes______ AND/OR Over-The-Counter Use No (Part 21 CFR 801 Subpart D) (21 CFR 807 Subpart C) (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Bremmer

Division Sian-C Division of Cardiovascular Devices 510/k) Nur