K Number
K071168
Device Name
THE PORTABLE ANSISCOPE
Manufacturer
Date Cleared
2007-08-31

(126 days)

Product Code
Regulation Number
870.2340
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Dy Ansys, Inc. ANSiscope™ ECG Monitoring System and accessories, is intended to acquire, analyze, display and record electrocardiographic information and to measure-heart rate variability. These and other measurements are not intended for any specific clinical diagnosis. The clinical significance of HRV and other parameters must be determined by the physician.
Device Description
The Portable ANSiscope™ is a device used for measuring heart rate variability (HRV). The device is designed to process raw ECG signals acquired from the patient in order to produce Heart Rate and other ancillary indices. The Portable ANSiscope™ includes an ECG Acquisition System that can digitize raw ECG signals, perform proprietary calculations from the HRV and then display the results utilizing a display unit.
More Information

Not Found

No
The description mentions "proprietary calculations" for HRV, but there is no mention of AI, ML, or related terms. The focus is on standard ECG signal processing and HRV analysis.

No
The device is described as an ECG monitoring system intended to acquire, analyze, display, and record electrocardiographic information and measure heart rate variability. The intended use states that "These and other measurements are not intended for any specific clinical diagnosis." and "The clinical significance of HRV and other parameters must be determined by the physician." This indicates it's an informational and analytical tool, not one that directly treats or prevents a disease or condition.

No
The document explicitly states, "These and other measurements are not intended for any specific clinical diagnosis." This indicates it is not a diagnostic device.

No

The device description explicitly states it includes an "ECG Acquisition System that can digitize raw ECG signals," indicating a hardware component beyond just software.

Based on the provided information, the Dy Ansys, Inc. ANSiscope™ ECG Monitoring System is not an In Vitro Diagnostic (IVD).

Here's why:

  • IVDs are used to examine specimens derived from the human body. The ANSiscope™ directly acquires ECG signals from the patient's body. It does not analyze blood, urine, tissue, or other bodily fluids or substances.
  • The intended use is to acquire, analyze, display, and record electrocardiographic information and measure heart rate variability. This is a direct measurement of physiological activity within the body, not an analysis of a sample taken from the body.
  • The device description confirms it processes raw ECG signals acquired from the patient. This reinforces that it's working with signals from the living body, not a specimen.

Therefore, the ANSiscope™ falls under the category of a medical device that performs physiological measurements, but it is not an IVD.

N/A

Intended Use / Indications for Use

The Dy Ansys, Inc. ANSiscope™ ECG Monitoring System and accessories, is intended to acquire, analyze, display and record electrocardiographic information and to measure-heart rate variability. These and other measurements are not intended for any specific clinical diagnosis. The clinical significance of HRV and other parameters must be determined by the physician.

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

DPS

Device Description

The Portable ANSiscope™ is a device used for measuring heart rate variability (HRV). The device is designed to process raw ECG signals acquired from the patient in order to produce Heart Rate and other ancillary indices. The Portable ANSiscope™ includes an ECG Acquisition System that can digitize raw ECG signals, perform proprietary calculations from the HRV and then display the results utilizing a display unit.

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

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

The Portable ANSiscope™ was subjected to safety and performance tests against applicable recognized standards. Final testing for the product included various performance tests to confirm compliance with functional requirements and performance specifications.

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.

K972991, K973426, K991831, K991735

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

§ 870.2340 Electrocardiograph.

(a)
Identification. An electrocardiograph is a device used to process the electrical signal transmitted through two or more electrocardiograph electrodes and to produce a visual display of the electrical signal produced by the heart.(b)
Classification. Class II (performance standards).

0

3 510(k) SUMMARY

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

510(k) Number: _ K071168

Applicant Information:

Date Prepared:August 8, 2007
Name:DyAnsys, Inc.,
Address:c/o Emery & Howard,
577, Airport Boulevard, Suite 610,
Burlingame, CA 95032
Phone: 650.579.7100
Fax: 650.579.7313
Contact Person:Michael A. Daniel
Phone Number:Office: 925-254-5228 / Cell 415-407-0223
Facsimile Number:(925) 254-5187

madaniel@clinregconsult.com

Device Information:

Classification:DPS/class II/870.2340
Trade Name:The Portable ANSiscope™
Common Name:ECG Monitor
Classification Name:Electrocardiograph

Predicate Devices:

The Qmed monitor one nDxK972991
The D.E.Hokanson, Inc. ANS2000K973426
The Anscore SystemK991831
The MAC 500 ECG Analysis SystemK991735

Device Description:

The Portable ANSiscope™ is a device used for measuring heart rate variability (HRV). The device is designed to process raw ECG signals acquired from the patient in order to produce Heart Rate and other ancillary indices. The Portable ANSiscope™ includes an ECG Acquisition System that can digitize raw ECG signals, perform proprietary calculations from the HRV and then display the results utilizing a display unit.

1

Intended Use:

The Dy Ansys, Inc. ANSiscope™ ECG Monitoring System and accessories, is intended to acquire, analyze, display and record electrocardiographic information and to measure-heart rate variability. These and other measurements are not intended for any specific clinical diagnosis. The clinical significance of HRV and other parameters must be determined by the physician.

Comparison to Predicate Device(s):

The Portable ANSiscope™ is substantially equivalent to the following predicate devices:

The Qmed monitor one nDxK972991
The D.E.Hokanson, Inc. ANS2000K973426
The Anscore SystemK991831
The MAC 500 ECG Analysis SystemK991735
    1. The Portable ANSiscope™ is a portable system with a computer-based user interface and data acquisition system for testing, data collection and analysis. The device features a 5 lead ECG.
    1. The Portable ANSiscope™ has the same intended use as the legally marketed predicate devices. The Portable ANSiscope™ is intended for use in Heart Rate Variability (HRV) measurements. . Though the measurement technology and the technological characteristics are not the same as those of the legally marketed devices, the new characteristics do not affect the safety and effectiveness.
    1. The Portable ANSiscope™ was subjected to safety and performance tests against applicable recognized standards. Final testing for the product included various performance tests to confirm compliance with functional requirements and performance specifications.
    1. The Portable ANSiscope utilizes proprietary software within the device based on scale covariance physics to calculate the interactivity of certain "tool parameters" from the supine recordings. The ANSiscope extracts beat-by-beat information from the RR time-intervals of the ECG. Indices are calculated giving activity-degrees of subsystems locally. The ANSiscope considers the interactivity as the lack of coupling of these indices and then defines its measurement as a percentage of interactivity over the time period considered (512 indices are required). The lack of coupling is measured by a metric between indices in the optimal phase. The obtained interactivity measurements form aggregates of values whose boundaries define groups that can aid diagnosis.

Confidential

2

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG 3 1 2007

DyAnsys, Inc. c/o Mr. Michael A. Daniel Emery & Howard 577 Airport Boulevard, Suite 610 Burlingame, CA 95032

Re: K071168

Trade/Device Name: Portable ANSiscope ECG Monitoring System Regulation Number: 21 CFR 870.2340 Regulation Name: Electrocardiograph Regulatory Class: Class II Product Code: DPS Dated: August 29, 2007 Received: August 30, 2007

Dear Mr. Daniel:

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

3

Page 2 - Mr. Michael A. Daniel

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 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 Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0120. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. 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,

Blomimo for

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

Enclosure

4

NDS

5 INDICATIONS FOR USE FORM

KOJIII68 510(k) Number (if known): _ TBD

The Portable ANSiscope™ Device Name:

Indications for Use:

The Dy Ansys, Inc. ANSiscope™ ECG Monitoring System and accessories, is intended to acquire, analyze, display and record electrocardiographic information and to measure-heart rate variability. These and other measurements are not intended for any specific clinical diagnosis. The clinical significance of HRV and other parameters must be determined by the physician.

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription UseXOROver-The-Counter Use
(Per 21 CFR 801.109)
(Optional Format 1-2-96)

Signature

(Division Sign-Off)

Division of Cardiovascular Devices

510(k) NumberK071168
------------------------

DyAnsys, Inc

Confidential

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