K Number
K073656
Device Name
OXYVU -1 HYPERSPECTRAL TISSUE OXYGENATION (HTO) MEASUREMENT SYSTEM
Manufacturer
Date Cleared
2008-01-25

(30 days)

Product Code
Regulation Number
870.2700
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The OxyVu™-1 Hyperspectral Tissue Oxygenation (HTO) Measurement System is intended for use by healthcare professionals as a non-invasive tissue oxygenation measurement system that reports an approximate value of: - . oxygen saturation (HT-Sat), - oxyhemoglobin level (HT-Oxy), and . - deoxyhemoglobin (HT-Deoxy) level . in superficial tissue. The Oxy Vu™-1 system displays two-dimensional colorcoded images of tissue oxygenation of the scanned surface and reports hyperspectral tissue oxygenation measurements for selected tissue regions. The OxyVu™-1 system is indicated for use to determine oxygenation levels in superficial tissues for patients with potential circulatory compromise.
Device Description
The OxyVu™-1 system is based on hyperspectral imaging technology. The technology performs spectral analysis at each point in a two-dimensional scanned area producing an image displaying information derived from the analysis. For the Oxy Vu™-1 system, the spectral analysis determines in superficial tissues approximate values of oxygen saturation (HT-Sat), oxyhemoglobin levels (HToxy), and deoxyhemoglobin levels (HT-deoxy). The OxyVu™-1 system displays the tissue oxygenation in a two-dimensional, color-coded image. The system consists of: - System console: cart, system electronics, CPU, monitor, keyboard, pointing . device and printer. - Hyperspectral imaging instrument head with support arm: broadband . illuminator, camera and spectral filter for collecting hyperspectral imaging cube. - Single use Oxy VuTM Check Pads and Targets: The Oxy VuTM Check Pad is . used to perform an instrument check prior to patient measurements. The OxyVu™ Target is placed within the intended field of view and is used as a fiduciary mark for image registration and for focusing.
More Information

Not Found

No
The description focuses on hyperspectral imaging and spectral analysis to derive measurements and display images, with no mention of AI or ML algorithms for analysis, interpretation, or decision support.

No
The device is a diagnostic tool designed to measure and display oxygenation levels in superficial tissues, not to provide treatment.

Yes
The device is described as a "non-invasive tissue oxygenation measurement system" that reports approximate values and displays images of tissue oxygenation. Its intended use is to "determine oxygenation levels in superficial tissues for patients with potential circulatory compromise," which aligns with the purpose of a diagnostic device.

No

The device description explicitly lists hardware components such as a system console (cart, electronics, CPU, monitor, keyboard, pointing device, printer), a hyperspectral imaging instrument head (illuminator, camera, spectral filter), and single-use check pads and targets. This indicates it is a hardware-based system with associated software, not a software-only medical device.

Based on the provided text, the OxyVu™-1 Hyperspectral Tissue Oxygenation (HTO) Measurement System is not an In Vitro Diagnostic (IVD).

Here's why:

  • IVDs analyze samples taken from the human body. This typically includes blood, urine, tissue biopsies, etc.
  • The OxyVu™-1 system is described as a non-invasive tissue oxygenation measurement system. It uses hyperspectral imaging to analyze superficial tissue directly on the patient's body.

The device's function is to measure physiological parameters in vivo (within the living body), not to analyze samples in vitro (in a lab setting).

N/A

Intended Use / Indications for Use

The Oxy Vu-1™ Hyperspectral Tissue Oxygenation (HTO) Measurement System is intended for use by healthcare professionals as a non-invasive tissue oxygenation measurement system that reports an approximate value of:

  • oxygen saturation (HT-Sat), .
  • oxyhemoglobin level (HT-Oxy), and .
  • deoxyhemoglobin (HT-Deoxy) level .

in superficial tissue. The Oxy Vu™-1 system displays two-dimensional colorcoded images of tissue oxygenation of the scanned surface and reports hyperspectral tissue oxygenation measurements for selected tissue regions.

The OxyVu™-1 system is indicated for use to determine oxygenation levels in superficial tissues for patients with potential circulatory compromise.

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

MUD

Device Description

The OxyVu™-1 system is based on hyperspectral imaging technology. The technology performs spectral analysis at each point in a two-dimensional scanned area producing an image displaying information derived from the analysis. For the Oxy Vu™-1 system, the spectral analysis determines in superficial tissues approximate values of oxygen saturation (HT-Sat), oxyhemoglobin levels (HToxy), and deoxyhemoglobin levels (HT-deoxy). The OxyVu™-1 system displays the tissue oxygenation in a two-dimensional, color-coded image.

The system consists of:

  • System console: cart, system electronics, CPU, monitor, keyboard, pointing . device and printer.
  • Hyperspectral imaging instrument head with support arm: broadband . illuminator, camera and spectral filter for collecting hyperspectral imaging cube.
  • Single use Oxy VuTM Check Pads and Targets: The Oxy VuTM Check Pad is . used to perform an instrument check prior to patient measurements. The OxyVu™ Target is placed within the intended field of view and is used as a fiduciary mark for image registration and for focusing.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Hyperspectral imaging

Anatomical Site

superficial tissue

Indicated Patient Age Range

Not Found

Intended User / Care Setting

healthcare professionals

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)

Not Found

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.

K061848

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

§ 870.2700 Oximeter.

(a)
Identification. An oximeter is a device used to transmit radiation at a known wavelength(s) through blood and to measure the blood oxygen saturation based on the amount of reflected or scattered radiation. It may be used alone or in conjunction with a fiberoptic oximeter catheter.(b)
Classification. Class II (performance standards).

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Image /page/0/Picture/1 description: The image shows the logo for HyperMed. The logo consists of a diamond shape with four arrows pointing to the right, followed by the text "HyperMed" in a sans-serif font. The letters are black, and the arrows are gray. There is a trademark symbol in the upper right corner of the logo.

JAN 25 . Da

510(k) Summary

OxyVu™-1 Hyperspectral Tissue Oxygenation Measurement System (December 20, 2007)

Submittal information:

Kevin Schomacker, VP of Research and Regulatory Affairs, HyperMed, Inc. HyperMed, Inc. 41 Second Avenue Burlington, MA 01803

Phone: 781-229-5900

Device name and classification

| Proprietary Name: | OxyVu™-1 Hyperspectral Tissue Oxygenation
Measurement System |
|-----------------------|-----------------------------------------------------------------|
| Common Name: | Hyperspectral Tissue Oxygenation Measurement System |
| Classification Name: | Tissue Saturation Oximeter |
| Classification Panel: | Cardiovascular |
| CFR Section: | 21 CFR 870.2700 |
| Class: | II |
| Product Code: | MUD |

Substantial Equivalence

The OxyVu™-1 system is substantially equivalent to the OxyVu™-1 system cleared in 510(k) K061848.

Device Description

The OxyVu™-1 system is based on hyperspectral imaging technology. The technology performs spectral analysis at each point in a two-dimensional scanned area producing an image displaying information derived from the analysis. For the Oxy Vu™-1 system, the spectral analysis determines in superficial tissues approximate values of oxygen saturation (HT-Sat), oxyhemoglobin levels (HToxy), and deoxyhemoglobin levels (HT-deoxy). The OxyVu™-1 system displays

1

the tissue oxygenation in a two-dimensional, color-coded image.

The system consists of:

  • System console: cart, system electronics, CPU, monitor, keyboard, pointing . device and printer.
  • Hyperspectral imaging instrument head with support arm: broadband . illuminator, camera and spectral filter for collecting hyperspectral imaging cube.
  • Single use Oxy VuTM Check Pads and Targets: The Oxy VuTM Check Pad is . used to perform an instrument check prior to patient measurements. The OxyVu™ Target is placed within the intended field of view and is used as a fiduciary mark for image registration and for focusing.

Intended Use

The Oxy Vu-1™ Hyperspectral Tissue Oxygenation (HTO) Measurement System is intended for use by healthcare professionals as a non-invasive tissue oxygenation measurement system that reports an approximate value of:

  • oxygen saturation (HT-Sat), .
  • oxyhemoglobin level (HT-Oxy), and .
  • deoxyhemoglobin (HT-Deoxy) level .

in superficial tissue. The Oxy Vu™-1 system displays two-dimensional colorcoded images of tissue oxygenation of the scanned surface and reports hyperspectral tissue oxygenation measurements for selected tissue regions.

The OxyVu™-1 system is indicated for use to determine oxygenation levels in superficial tissues for patients with potential circulatory compromise.

OxyVu™-1Predicate OxyVu™-1
MeasuresOxygen saturation
Oxyhemoglobin level
Deoxyhemoglobin levelOxygen saturation
Oxyhemoglobin level
Deoxyhemoglobin level
Method of
MeasurementSpectral analysis at specific wavelengths of light returned from target tissue.Spectral analysis at specific wavelengths of light returned from target tissue.
Output DisplayNumeric
Two-dimensional color map of approximate tissue oxygenationNumeric
Two-dimensional color map of approximate tissue oxygenation

Comparison with the Predicate Device

Similarities and Differences

External, user-observable features are essentially the same. The changes described in the Special 510(k) involve changes in the sensor illumination and in the measurement

2

407656

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algorithm. Changes increase robustness of operation, but not fundamental accuracy of results.

The intended uses and indications of the modified device, as described in its labeling are the same as the intended uses and indications for the unmodified predicate device.

Basis of Substantial Equivalence

The intended use and the fundamental operating specifications are unchanged. Based on virtually the same methods of validation, the Oxy Vu™-1 Hyperspectral Tissue Oxygenation Measurement System as modified is substantially equivalent to the OxyVu™-1 cleared in 510(k) K061848.

3

Standards

Product conformity to IEC 60601-1, IEC 60601-1-1, and IEC 60601-1-2 was documented in the original 510(k), K061848. There is no new or modified statement of conformity in this Special 510(k).

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Image /page/4/Picture/2 description: The image shows the logo for the Department of Health & Human Services (HHS). The logo consists of a stylized eagle or bird symbol, composed of three curved lines, representing the department's mission of protecting the health of all Americans and providing essential human services. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the bird symbol.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 25 2008

Hypermed, Inc. c/o Mr. Chas Burr Chas Burr Q/R Services, Inc. 11 Mystic Avenue Winchester, MA 01890-2920

Re: K073656

Oxy Vu™-1 Hyperspectral Tissue Oxygenation (HTO) Measurement System Regulation Number: 21 CFR 870.2700 Regulation Name: Tissue Saturation Oximeter Regulatory Class: Class II (two) Product Code: MUD Dated: December 20, 2007 Received: December 26, 2007

Dear Mr. Burr:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave roviewed your betermined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for use stated in the encreativent date of the Medical Device Amendments, or to commerce prox to Frid 2011-03-19) in accordance with the provisions of the Federal Food, Drug, de flees that have been require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The r ou may, more rever mains 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 your device to such additional controls. Existing major regulations affecting your device it may be subject to bash af Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

5

Page 2 - Mr. Chas Burr

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. 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,

Bymima for

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

Enclosure

6

Indications for Use

510(k) Number (if known): Ko 73656

Device Name: Oxy Vu™-1 Hyperspectral Tissue Oxygenation Measurement System

Indications for Use:

The OxyVu™-1 Hyperspectral Tissue Oxygenation (HTO) Measurement System is intended for use by healthcare professionals as a non-invasive tissue oxygenation measurement system that reports an approximate value of:

  • . oxygen saturation (HT-Sat),
  • oxyhemoglobin level (HT-Oxy), and .
  • deoxyhemoglobin (HT-Deoxy) level .

in superficial tissue. The Oxy Vu™-1 system displays two-dimensional colorcoded images of tissue oxygenation of the scanned surface and reports hyperspectral tissue oxygenation measurements for selected tissue regions.

The OxyVu™-1 system is indicated for use to determine oxygenation levels in superficial tissues for patients with potential circulatory compromise.

Prescription Use _____________________________________________________________________________________________________________________________________________________________

AND/OR

Over-The-Counter Use (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)

Bhumima

n Slan-C lvision of Cardiova 510/k) Number