K Number
K080621
Device Name
FASTLOCK, MODEL PC175M01, PC175MCE, PC005R01
Date Cleared
2008-04-29

(55 days)

Product Code
Regulation Number
870.2900
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Fastlock pacing wire extension cable with connectors is indicated for use as an electrical extension cable used to transmit signal from, or power or excitation signal to patient-connected electrodes.
Device Description
The Fastlock pacing wire extension cable device provides simple connection between an external pacemaker and pacing wires that are attached to a patient body, in order to transmit low voltage electrical signals between the devices and sensors. The Fastlock product is limited by the Indications for Use of the connected external pacemaker.
More Information

Not Found

No
The summary describes a simple electrical extension cable and makes no mention of AI or ML.

No
The device is described as an "electrical extension cable" for transmitting signals, not as a device that directly provides therapy or diagnostic functions itself. It connects a pacemaker (which is a therapeutic device) to the patient.

No

The device is an extension cable for pacemakers, transmitting signals and power. It does not analyze or interpret physiological data to determine the presence or nature of a disease or condition, which is the function of a diagnostic device.

No

The device description explicitly states it is a "cable" and provides a physical connection between devices, indicating it is a hardware component.

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

Here's why:

  • IVDs are used to examine specimens derived from the human body. The intended use and device description clearly state that this cable is used to transmit electrical signals to or from patient-connected electrodes, connecting an external pacemaker to pacing wires attached to the patient's body. It does not involve the analysis of biological samples like blood, urine, or tissue.
  • The function is electrical signal transmission, not diagnostic testing of biological samples. The device's purpose is to facilitate the electrical connection for pacing, which is a therapeutic or monitoring function, not a diagnostic test performed on a biological specimen.

Therefore, the Fastlock pacing wire extension cable is a medical device, but it falls outside the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Fastlock pacing wire extension cable device is intended to be used as an interface between an external pacemaker and pacing wires, which are attached to a patient body.

Fastlock pacing wire extension cable with connectors is indicated for use as an electrical extension cable used to transmit signal from, or power or excitation signal to patient-connected electrodes.

Product codes

DSA

Device Description

The Fastlock pacing wire extension cable device provides simple connection between an external pacemaker and pacing wires that are attached to a patient body, in order to transmit low voltage electrical signals between the devices and sensors. The Fastlock product is limited by the Indications for Use of the connected external pacemaker.
The Fastlock pacing wire extension cable consists of an electrical cable with a safety connector at one end that allows electrical connection to the external pacemaker and connectors at the other end that will be attached to the patient's leads.

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)

Not Found

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

CP Medical Disposable Temporary Pacing Cable K022075

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.2900 Patient transducer and electrode cable (including connector).

(a)
Identification. A patient transducer and electrode cable (including connector) is an electrical conductor used to transmit signals from, or power or excitation signals to, patient-connected electrodes or transducers.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image shows the text "K080 621" in a handwritten style. The text appears to be a code or identifier. The characters are bold and clearly visible against the background.

FastLock Premarket Notification: Traditional 510(k)

510(k) Summary

APR 2 9 2008

| Submitter Name:
Submitter Address: | European Custom Manufacturing B.V.
PO Box 53, NL 5420 AB Gemert, The Netherlands |
|--------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Phone Number: | 31-492-371234 |
| Fax Number: | 31-492-371237 |
| Contact Person: | Rogier Eijck |
| Date Prepared: | 29 November 2007 |
| Device Trade Name: | Fastlock Pacing Wire Extension Cable |
| Common Name | ECG Cables |
| Classification Name,
Number &
Product Code: | Cable, transducer and electrode, patient (including connector)
870.2900
DSA |
| Predicate Devices: | CP Medical Disposable Temporary Pacing Cable |
| Device Description
and Statement of
Intended Use | The Fastlock pacing wire extension cable device provides simple
connection between an external pacemaker and pacing wires that are
attached to a patient body, in order to transmit low voltage electrical
signals between the devices and sensors. The Fastlock product is
limited by the Indications for Use of the connected external pacemaker.
Intended Use: The Fastlock pacing wire extension cable device is
intended to be used as an interface between an external pacemaker and
pacing wires, which are attached to a patient body. |
| Summary of
Technological
Characteristics | The Fastlock pacing wire extension cable consists of an electrical cable
with a safety connector at one end that allows electrical connection to
the external pacemaker and connectors at the other end that will be
attached to the patient's leads. |
| Conclusion | The information discussed above demonstrates that Fastlock product, as
effective, and performs as well as or better than the predicate devices. |
| Declarations | This summary includes only information that is also covered in the body
of the 510(k).
This summary does not contain any puffery or unsubstantiated labeling
claims. |

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1

This summary does not contain any raw data, i.e., contains only summary data.

This summary does not contain any trade secret or confidential commercial information.

This summary does not contain any patient identification information.

K080421 Page 2 of 3

Section 5.0: 510(k) Summary

2

| Feature | FastLock Extension
Cable | Disposable Temporary
Pacing Cable |
|------------------------------------|----------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 510(k) Number | | K022075 |
| Manufacturer | European Custom
Manufacturing BV | CP Medical, Inc. |
| Classification # &
Product Code | 870.2900
DSA | 870.2900
DSA |
| Intended Use | interface between
external pacemaker and
pacing wires, which are
attached to a patient
body. | Interface between various
diagnostic and
physiological monitoring
devices (not manufactured
by CP Medical) and
disposable sensor
devices(not manufactured
by CP Medical) which are
attached to a patient body. |
| Mode of Action | Connects to pacemaker | Connects to pacemaker |
| Reusable | No | No |
| Method of Clamp
Introduction | Male to female connector | Alligator clips |

Summary of Technical Characteristics

K080621 page 3 of 3

Section 5.0: 510(k) Summary

.

:

3

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with its wings spread, and the words "DEPARTMENT OF HEALTH & HUMAN SERVICES · USA" arranged in a circular pattern around the eagle. The eagle is black, and the text is also black. The logo is simple and recognizable.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

APR 2 9 2008

European Custom Manufacturing BV c/o Mr. William Greenrose President Oserve America, Inc. 220 River Road Claremont, NH 03743

Re: K080621

Trade/Device Name: Fastlock Regulation Number: 21 CFR 870.2900 Regulation Name: Patient transducer and electrode cable Regulatory Class: Class II (two) Product Code: DSA Dated: December 13, 2007 Received: March 5, 2008

Dear Mr. Greenrose:

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 - Mr. William Greenrose

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 (OS) 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 vours.

Blymmmofa

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): K080621

Device Name: Fastlock

Indications For Use:

Fastlock pacing wire extension cable with connectors is indicated for use as an electrical extension cable used to transmit signal from, or power or excitation signal to patient-connected electrodes.

Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Blummenauer