K Number
K071165
Device Name
ISCALERT SENSOR SYSTEM
Manufacturer
Date Cleared
2007-11-07

(195 days)

Product Code
Regulation Number
868.1150
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The IscAlert™ sensor system measures the partial pressure of carbon dioxide in peripheral tissue, such as forearm muscle tissue, where the sensor is inserted. The system is intended for monitoring trends in this parameter as an adjunct in the evaluation of the perfusion status of tissue in patients at risk of developing ischemia. IscAlert values are relative within an individual and should not be used as the sole basis for decisions as to diagnosis or therapy. The IscAlert™ sensor system should not be used in peripheral brain tissue, intra cranial tissue, all organ tissues including cardiac and kidney, and other peripheral muscle tissues other than forearm muscle.
Device Description
The IscAlert sensor system measures partial pressure of CO2 (pCO2) in peripheral tissue, such as forearm muscle tissue, where the sensor is inserted. The system is intended to monitor pCO2 trends as an adjunct in the evaluation of perfusion status of tissue in patients at risk of developing ischemia. Ischemia is a medical term for a shortage of blood supply to tissue. If severe, it can lead to death of the affected tissue (infarction). The tissue pCO2 increases significantly during the early and reversible stages of ischemia. This methodology provides the ability to identify the onset of ischemia events through real-time data. The IscAlert sensor system consists of three parts: - 1. The sterile disposable Sensors - 2. The Connection Unit (CU) - 3. Software to be installed in an off-the-shelf PC unit The sterile, disposable, catheter tip sensors are placed 2-5 cm into organ tissue with a split-off needle that is removed after insertion. The sensor is connected via a cable to the Connection Unit (CU). The CU processes the signals from the sensor unit. It is connected via a cable to a PC with the IscAlert software application installed. The software enables visualisation of the monitoring results.
More Information

No
The summary describes a sensor system that measures pCO2 and displays trends. There is no mention of AI or ML in the device description, intended use, or performance studies. The software is described as enabling visualization of monitoring results, not complex analysis or prediction using AI/ML.

No.
The device is strictly for monitoring and evaluation purposes to identify the onset of ischemia, and explicitly states it "should not be used as the sole basis for decisions as to diagnosis or therapy."

No

The document explicitly states that "IscAlert values are relative within an individual and should not be used as the sole basis for decisions as to diagnosis or therapy." This indicates it's an adjunct monitoring device rather than a primary diagnostic tool.

No

The device description explicitly states that the system consists of three parts: sterile disposable sensors, a Connection Unit (CU), and software. The sensors and CU are hardware components, making it a system with both hardware and software, not a software-only medical device.

Based on the provided information, the IscAlert™ sensor system is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens (like blood, urine, or tissue samples) taken from the human body to provide information about a person's health. This testing is done outside of the body (in vitro).
  • IscAlert's Function: The IscAlert system measures the partial pressure of carbon dioxide directly within the peripheral tissue (forearm muscle tissue) where the sensor is inserted. This is an in vivo measurement, meaning it's done inside the living body.

Therefore, because the IscAlert system performs measurements directly within the body rather than on a specimen taken from the body, it does not fit the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The IscAlert™ sensor system measures the partial pressure of carbon dioxide in peripheral tissue, such as forearm muscle tissue, where the sensor is inserted. The system is intended for monitoring trends in this parameter as an adjunct in the evaluation of the perfusion status of tissue in patients at risk of developing ischemia. IscAlert values are relative within an individual and should not be used as the sole basis for decisions as to diagnosis or therapy. The IscAlert™ sensor system should not be used in peripheral brain tissue, intra cranial tissue, all organ tissues including cardiac and kidney, and other peripheral muscle tissues other than forearm muscle.

Product codes

GWM, CCC

Device Description

The IscAlert sensor system measures partial pressure of CO2 (pCO2) in peripheral tissue, such as forearm muscle tissue, where the sensor is inserted. The system is intended to monitor pCO2 trends as an adjunct in the evaluation of perfusion status of tissue in patients at risk of developing ischemia.

Ischemia is a medical term for a shortage of blood supply to tissue. If severe, it can lead to death of the affected tissue (infarction). The tissue pCO2 increases significantly during the early and reversible stages of ischemia. This methodology provides the ability to identify the onset of ischemia events through real-time data.

The IscAlert sensor system consists of three parts:

    1. The sterile disposable Sensors
    1. The Connection Unit (CU)
    1. Software to be installed in an off-the-shelf PC unit

The sterile, disposable, catheter tip sensors are placed 2-5 cm into organ tissue with a split-off needle that is removed after insertion.

The sensor is connected via a cable to the Connection Unit (CU). The CU processes the signals from the sensor unit. It is connected via a cable to a PC with the IscAlert software application installed. The software enables visualisation of the monitoring results.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

peripheral tissue, such as forearm muscle tissue

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

The IscAlert Sensor System has been tested for function according to the product requirements. The System has also been tested for EMC and safety requirements. The results of these tests and a proof-of-concept clinical study using Neurotrend as comparative device show the IscAlert Sensor System to be safe and effective for its intended use.

Key Metrics

Not Found

Predicate Device(s)

K980308, K953893

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 868.1150 Indwelling blood carbon dioxide partial pressure (P

2CO2 ) analyzer.(a)
Identification. An indwelling blood carbon dioxide partial pressure PCO2 analyzer is a device that consists of a catheter-tip PCO2 transducer (e.g., PCO2 electrode) and that is used to measure, in vivo, the partial pressure of carbon dioxide in blood to aid in determining the patient's circulatory, ventilatory, and metabolic status.(b)
Classification. Class II (special controls). The special control for this device is FDA's “Class II Special Controls Guidance Document: Indwelling Blood Gas Analyzers; Final Guidance for Industry and FDA.”

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IscAlert Sensor System (K071165)

Attachment 3

Ko 71165

Page 1 of 2

510(k) Summary

Submitter: Alertis Medical ASA Oslo, Norway

Contact Information: Constance G. Bundy C. G. Bundy Associates, Inc. 6470 Riverview Terrace Fridley, MN 55432

NOV 0 7 2007

Submission Date: April 24, 2007

Device Name: IscAlert™ Sensor System

Classification: Class II, 21 CFR 882.1620, Code: GWM

Equivalent Device Identification: The IscAlert Sensor System is substantially equivalent in function to the Neurotrend™ Cerebral Tissue Monitoring System (K980308). The IscAlert sensing technology is substantially equivalent to the Paratrend 7 ™ Intravascular Blood Gas Monitoring System (K953893). The company provided performance data demonstrating the safety and efficacy of the Sensor System for the intended use of measurement of the partial pressure of carbon dioxide in peripheral tissue, such as the forearm muscle tissue.

Device Description: The IscAlert sensor system measures partial pressure of CO2 (pCO2) in peripheral tissue, such as forearm muscle tissue, where the sensor is inserted. The system is intended to monitor pCO2 trends as an adjunct in the evaluation of perfusion status of tissue in patients at risk of developing ischemia.

Ischemia is a medical term for a shortage of blood supply to tissue. If severe, it can lead to death of the affected tissue (infarction). The tissue pCO2 increases significantly during the early and reversible stages of ischemia. This methodology provides the ability to identify the onset of ischemia events through real-time data.

The IscAlert sensor system consists of three parts:

    1. The sterile disposable Sensors
    1. The Connection Unit (CU)
    1. Software to be installed in an off-the-shelf PC unit

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Ko 7/1/65

IscAlert Sensor System (K071165)

  1. Page 2 of 2

The sterile, disposable, catheter tip sensors are placed 2-5 cm into organ tissue with a split-off needle that is removed after insertion.

The sensor is connected via a cable to the Connection Unit (CU). The CU processes the signals from the sensor unit. It is connected via a cable to a PC with the IscAlert software application installed. The software enables visualisation of the monitoring results.

Intended Use: The IscAlert™ sensor system measures partial pressure of carbon dioxide in peripheral tissue, such as forearm muscle tissue, where the sensor is inserted. The system is intended for monitoring trends in this parameter as an adjunct in the evaluation of the perfusion status of tissue in patients at risk of developing ischemia. IscAlert values are relative within an individual and should not be used as the sole basis for decisions as to diagnosis or therapy. The IscAlert™ sensor system should not be used in peripheral brain tissue, intra cranial tissue, all organ tissues including cardiac and kidney, and other peripheral muscle tissues other than forearm muscle.

Substantial Equivalence: The IscAlert Sensor System is similar in function to the Neurotrend Cerebral Tissue Monitoring System (K980380). The IscAlert and Neurotrend devices measure pCO₂ in peripheral tissue and monitor trends in this parameter as an adjunct for managing patients at risk for ischemia. The IscAlert sensing technology is equivalent to the sensing technology of the Paratrend device. Both devices utilize electrochemical sensors to measure partial gas pressure. Alertis Medical believes the IscAlert to be substantially equivalent to device technology currently available and the device raises no new issues of safety when compared to the predicate devices. The company provided performance data to demonstrate the safety and efficacy of the Sensor System for the intended use.

Summary of Testing: The IscAlert Sensor System has been tested for function according to the product requirements. The System has also been tested for EMC and safety requirements. The results of these tests and a proof-of-concept clinical study using Neurotrend as comparative device show the IscAlert Sensor System to be safe and effective for its intended use.

2

Image /page/2/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features a stylized eagle with three stripes representing the three levels of government: federal, state, and local. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" are arranged in a circular pattern around the eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV 0 7 2007

Alertis Medical AS % C.G. Bundy Associates, Inc. Ms. Constance G. Bundy 6470 Riverview Terrace Fridley, Minnesota 55432

Re: K071165

Trade/Device Name: IscAlert™ Sensor System Regulation Number: 21 CFR 868.1150 Regulation Name: Indwelling blood carbon dioxide partial pressure (Poo2) analyzer Regulatory Class: II Product Code: CCC Dated: October 13, 2007 Received: October 17, 2007

Dear Ms. Bundy:

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.

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.

3

Page 2 - Ms. Constance G. Bundy

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) 276-0115. 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 Mark N. Melkerson Director Division of General, Restorative and Neurological Devices Office of Device Evaluation

Center for Devices and Radiological Health

Enclosure

4

IscAlert Sensor System (K071165)

Attachment 4

071165

Indications for Use

510(k) Number (if known): K071165

Device Name: IscAlert™ Sensor System

Indications For Use:

The IscAlert™ sensor system measures the partial pressure of carbon dioxide in peripheral tissue, such as forearm muscle tissue, where the sensor is inserted. The system is intended for monitoring trends in this parameter as an adjunct in the evaluation of the perfusion status of tissue in patients at risk of developing ischemia. IscAlert values are relative within an individual and should not be used as the sole basis for decisions as to diagnosis or therapy. The IscAlert™ sensor system should not be used in peripheral brain tissue, intra cranial tissue, all organ tissues including cardiac and kidney, and other peripheral muscle tissues other than forearm muscle.

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)

(Division Sign-Off)
Division of General, Restorative,
and Neurological Devicesfage 1 of
510(k) Number
28 September 2007
2017
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