K Number
K091057
Device Name
MASIMO RAINBOW SET PRONTO PULSE CO-OXIMETER AND ACCESSORIES
Manufacturer
Date Cleared
2009-07-09

(87 days)

Product Code
Regulation Number
870.2700
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories are indicated for noninvasive spot checking of functional saturation of arterial oxygen hemoglobin (SpO2), pulse rate, and total hemoglobin concentration (SpHb). The Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories are indicated for use, by trained personnel, with adult and pediatric individuals during both no motion and motion conditions and for individuals who are well or poorly perfused and in clinical and non-clinical settings (e.g., hospital-type facilities, home, clinics, physician offices, blood donation facilities, and ambulatory surgery centers).
Device Description
The Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories in this filing are the same as the Rainbow SET® RadCheck Pulse CO-Oximeter and Accessories in K082052. The reason for this filing is to clarify the intended use and the labeling of the device.
More Information

No
The document explicitly states "Mentions AI, DNN, or ML: Not Found" and the description focuses on clarifying intended use and labeling, not new technological capabilities.

No.
The device is indicated for noninvasive spot checking of physiological parameters (SpO2, pulse rate, and SpHb), which are diagnostic measurements, not therapeutic interventions.

Yes

The device provides measurements of functional saturation of arterial oxygen hemoglobin (SpO2), pulse rate, and total hemoglobin concentration (SpHb), which are physiological parameters used to assess a patient's condition. While not explicitly stating "diagnosis," measuring these parameters for "spot checking" helps clinicians detect abnormalities and determine if further diagnostic investigation or intervention is needed.

No

The device description explicitly states "The Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories". The performance studies describe validation of "Masimo sensors", indicating the device includes hardware components (sensors and the oximeter itself) in addition to any potential software.

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

Here's why:

  • Intended Use: The intended use describes the device as a "noninvasive spot checking of functional saturation of arterial oxygen hemoglobin (SpO2), pulse rate, and total hemoglobin concentration (SpHb)". This involves measuring physiological parameters directly from the patient's body using a sensor applied externally.
  • 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. This device does not analyze samples taken from the body.
  • Device Description: The description confirms it's a "Pulse CO-Oximeter," which is a non-invasive monitoring device.
  • Performance Studies: The performance studies describe testing on human volunteers and benchtop simulators, measuring parameters directly from the body or simulated physiological signals, not analyzing biological samples.

Therefore, the Masimo Rainbow SET Pronto Pulse CO-Oximeter is a non-invasive physiological monitoring device, not an IVD.

N/A

Intended Use / Indications for Use

The Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories are indicated for noninvasive spot checking of functional saturation of arterial oxygen hemoglobin (SpO2), pulse rate, and total hemoglobin concentration (SpHb). The Masimo Rainbow SET® Pronto Pulse CO-Oximeter and Accessories are indicated for use, by trained personnel, with adult and pediatic individuals during both no motion and motion conditions, and for individuals who are well or poorly perfused in clinical and nonclinical settings (e.g., hospitals, hospital-type facilities, mobile environments, homes, clinics, physician offices, blood donation facilities, and ambulatory surgery centers).

Product codes

74DQA, 74DSA

Device Description

The Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories in this filing are the same as the Rainbow SET® RadCheck Pulse CO-Oximeter and Accessories in K082052. The reason for this filing is to clarify the intended use and the labeling of the device.

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

adult and pediatic individuals

Intended User / Care Setting

trained personnel, with ... in clinical and nonclinical settings (e.g., hospitals, hospital-type facilities, mobile environments, homes, clinics, physician offices, blood donation facilities, and ambulatory surgery centers).

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

  • SpO2 accuracy was determined by testing on healthy adult volunteers in the range of 1 60-100% SpO2 against a laboratory CO-Oximeter.
  • The Masimo sensors have been validated for no motion accuracy in human blood studies on healthy adult male and female volunteers with light to dark skin piomentation in induced hypoxia studies in the range of 70-100% SpO2 against a laboratory CO-Oximeter and ECG monitor.
  • The Masimo sensors have been validated for motion accuracy in human blood studies on healthy adult male and female volunteers with light to dark skin pigmentation in induced hypoxia studies while performing rubbing and tapping motions, at 2 to 4 Hz at an amplitude of 1 to 2 cm and a non-repetitive motion between 1 to 5 Hz at an amplitude of 2 to 3 cm in induced hypoxia studies in the range of 70-100% SpO2 against a laboratory CO-oximeter and ECG monitor.
  • The Masimo SET Technology has been validated for low perfusion accuracy in bench top testing against a Biotek Index 2 simulator and Masimo's simulator with signal strengths of greater than 0.02% and transmission of greater than 5% for saturations ranging from 70 to 100%.
  • The Masimo sensors have been validated for pulse rate accuracy for the range of 25-240 bpm in bench top testing against a Biotek Index 2 simulator.
  • SpHb accuracy has been validated with (arterial/venous) blood from healthy adult male and female volunteers and on surgical patients with light to dark skin pigmentation in the range of 8 - 17 g/dl SpHb against a laboratory CO-oximeter.

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

The Pronto complies with the voluntary standards as detailed in this submission. The following quality assurance measures were applied to the development of the Pronto:

  • Risk Analysis
  • Design Reviews
  • Biocompatibility Testing
  • Performance Testing
  • Safety Testing
  • Environmental Testing
  • Clinical Testing

Key results include:

  • SpO2, No Motion Conditions: Adults, Pediatrics: 60-80% ± 3%; 70-100% +2%
  • SpO2, Motion Conditions: Adults, Pediatrics: 70-100% ± 3%
  • SpO2, Low Perfusion: Adults, Pediatrics: 70-100% ± 2%
  • Pulse Rate, No Motion Conditions: Adults, Pediatrics: 25-240 ± 3 bpm
  • Pulse Rate, Motion Conditions: Adults, Pediatrics: 25-240 ± 5 bpm
  • Pulse Rate, Low Perfusion: Adults, Pediatrics: 25-240 ± 3 bpm
  • SpHb, No Motion Conditions: Adults, Pediatrics: 8-17 g/dl +1 g/dl (Arterial or Venous)

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

Not Found

Predicate Device(s)

Masimo Rainbow SET RadCheck Pulse CO-Oximeters and Accessories, 510(k) Number K082052

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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).

0

09105

Submitted by:

Masimo Corporation 40 Parker Irvine, CA 92618 949-297-7000 FAX 949-297-7001

JUL - 9 2009

Company Contact:

Date Summary Prepared:

April 10, 2009

Trade Name

Common Name

Oximeter

Classification Name and Product Code:

Oximeter (74DQA) (870.2700) Cable, Transducer and Electrode (74DSA) (870.2900)

Marguerite Thomlinson; Manager of Regulatory Affairs

Substantially Equivalent Devices:

Masimo Rainbow SET RadCheck Pulse CO-Oximeters and Accessories, 510(k) Number K082052

Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories

Device Description

The Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories in this filing are the same as the Rainbow SET® RadCheck Pulse CO-Oximeter and Accessories in K082052. The reason for this filing is to clarify the intended use and the labeling of the device.

Predicate Device

The predicate device used in this filing is the Masimo Rainbow SET® RadCheck Pulse CO-Oximeter and Accessories, 510(k) Number K082052.

Intended Use

The Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories are indicated for noninvasive spot checking of functional saturation of arterial oxygen hemoglobin (SpO2), pulse rate, and total hemoglobin concentration (SpHb). The Masimo Rainbow SET® Pronto Pulse CO-Oximeter and Accessories are indicated for use, by trained personnel, with adult and pediatic individuals during both no motion and motion conditions, and for individuals who are well or poorly perfused in clinical and nonclinical settings (e.g., hospitals, hospital-type facilities, mobile environments, homes, clinics, physician offices, blood donation facilities, and ambulatory surgery centers).

Technology Comparison

The Masimo Rainbow SET® Pronto Pulse CO-Oximeter is the same in design, principles of operation, materials, and performance to the predicate device (the RadCheck).

Page 1 of 4

1

.

The Pronto has the following specifications:

.

:

:

    1. 1
FEATURESSPECIFICATIONS
Display RangesSaturation (SpO2): 0-100%
Pulse Rate (bpm): 25-240 bpm
Total Hemoglobin (SpHb): 0-25 g/dl
Total Oxygen Concentration (SpOC): 0-35 ml/dl
Perfusion Index: 0.02-20%
AccuracySee Footnotes 1, 2, 3, 4, 5, 6, and 7
SpO2, No Motion ConditionsAdults, Pediatrics: 60-80% ± 3%; 70-100% +2%
SpO2, Motion ConditionsAdults, Pediatrics: 70-100% ± 3%
SpO2, Low PerfusionAdults, Pediatrics: 70-100% ± 2%
Pulse Rate, No Motion ConditionsAdults, Pediatrics: 25-240 ± 3 bpm
Pulse Rate, Motion ConditionsAdults, Pediatrics: 25-240 ± 5 bpm
Pulse Rate, Low PerfusionAdults, Pediatrics: 25-240 ± 3 bpm
SpHb, No Motion ConditionsAdults, Pediatrics: 8-17 g/dl +1 g/dl (Arterial or Venous)
General
ResolutionSpO2: 1%
Pulse Rate: 1 bpm.
SpHb: 0.1 g/dl
MeasurementsLow Signal IQ
Perfusion Index (PI)
Total Oxygen Concentration (SpOC)
ElectricalSee Footnote 8
BatteriesNon-rechargeable alkaline batteries
CircuitryMicroprocessor controlled
FirmwareRainbow SET technology, MX Board/Circuitry
Mechanical
MaterialPolycarbonate/ABS Blend
Environmental
Operating Temperature41°F to + 104°F (5°C to +40°C)
Storage Temperature-40°F to + 158°F (-40°C to +70°C)
Relative Humidity5% to 95% noncondensing
Operating AltitudeOperating Altitude: 500 mbar to 1,060 mbar pressure; -
1,000 ft to 18,000 ft (-304 m to 5,486m)
Mode & Sensitivity
Averaging Mode - SpO2Maximum sensitivity mode fixes perfusion limit to 0.02%
Alarms
SystemSystem failure
Battery AlarmLow battery

:

11.0

:

2

FEATURESSPECIFICATIONS
Display and IndicatorsSpO2 (%)
Pulse rate (bpm)
SpHb (g/dl)
SpHbv (g/dl)
Perfusion index (%)
SpOC (ml/dl)
Signal IQ
Pulse indicator
Spot Check Progress
Sensor Use indicator
Sensor status
Status messages
Battery status
Compliance
EMC ComplianceEN 60601-1-2, Class B
Electrical SafetyIEC 60601-1, UL 60601-1
Type of Protection (battery power)Internally Powered
Degree of Protection-Patient CableType BF-Applied Part
Enclosure Degree of ProtectionIPX1
Mode of OperationSpot check

Footnotes

  • SpO2 accuracy was determined by testing on healthy adult volunteers in the range of 1 60-100% SpO2 against a laboratory CO-Oximeter.
  • 2 The Masimo sensors have been validated for no motion accuracy in human blood studies on healthy adult male and female volunteers with light to dark skin piomentation in induced hypoxia studies in the range of 70-100% SpO2 against a laboratory CO-Oximeter and ECG monitor. This variation equals plus or minus one standard deviation. Plus or minus one standard deviation encompasses 68% of the population weight.
  • 3 The Masimo sensors have been validated for motion accuracy in human blood studies on healthy adult male and female volunteers with light to dark skin pigmentation in induced hypoxia studies while performing rubbing and tapping motions, at 2 to 4 Hz at an amplitude of 1 to 2 cm and a non-repetitive motion between 1 to 5 Hz at an amplitude of 2 to 3 cm in induced hypoxia studies in the range of 70-100% SpO2 against a laboratory CO-oximeter and ECG monitor. This variation equals plus or minus one standard deviation which encompasses 68% of the population.
  • The Masimo SET Technology has been validated for low perfusion accuracy in র্ণ bench top testing against a Biotek Index 2 simulator and Masimo's simulator with signal strengths of greater than 0.02% and transmission of greater than 5% for saturations ranging from 70 to 100%. This variation equals plus or minus one standard deviation which encompasses 68% of the population.
  • The Masimo sensors have been validated for pulse rate accuracy for the range of 25-240 bpm in bench top testing against a Biotek Index 2 simulator. This variation

3

equals plus or minus one standard deviation which encompasses 68% of the population.

  • િ SpHb accuracy has been validated with (arterial/venous) blood from healthy adult male and female volunteers and on surgical patients with light to dark skin pigmentation in the range of 8 - 17 g/dl SpHb against a laboratory CO-oximeter. This variation equals plus or minus one standard deviation which encompasses 68% of the population. The SpHb accuracy has not been validated with motion or low perfusion
  • 7 The following substances may interfere with pulse CO-oximetry measurements:
    • · Elevated levels of Methemoglobin (MetHb) may lead to inaccurate SpO2 measurements
    • · Elevated levels of Carboxyhemoglobin (COHb) may lead to inaccurate SpO2 measurements.
    • · Severe anemia may cause erroneous SpO2 readings.
    • · Dyes, or any substance containing dyes, that change usual blood pigmentation may cause erroneous readings.
    • · Elevated levels of total bilirubin may lead to inaccurate SpO2 and SpHb readings
  • 8 If the batteries are to be stored for extended periods of time, it is recommended that they be stored between -20 to +30°C, and at a relative humidity less than 85%. If stored for a prolonged period at environmental conditions beyond these limits, overall battery capacity may be diminished, and lifetime of the batteries may be shortened.

Test Summarv

The Pronto complies with the voluntary standards as detailed in this submission. The following quality assurance measures were applied to the development of the Pronto:

  • Risk Analysis
  • Design Reviews
  • Biocompatibility Testing
  • Performance Testing
  • Safety Testing
  • Environmental Testing
  • Clinical Testing

Conclusions

The information in this 510(k) submission demonstrates that the Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories are substantially equivalent to the predicate device, with respect to safety, effectiveness, and performance.

4

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/4/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 its wings spread, symbolizing protection and service. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" are arranged in a circular pattern around the eagle, indicating the department's name and national affiliation.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUL - 9 2009

Ms. Marguerite Thomlinson Manager of Regulatory Affairs Masimo Corporation 40 Parker Irvine, California 92618

Re: K091057

Trade/Device Name: Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories Regulation Number: 21 CFR 870.2700 Regulation Name: Oximeter Regulatory Class: II Product Code: DQA Dated: June 5, 2009 Received: June 16, 2009

Dear Ms. Thomlinson:

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 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.

5

Page 2- Ms. Thomlinson

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to

http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/cdrh/mdr/ for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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.

Susan Runnes

Susan Runner, D.D.S., M.A. Acting Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

6

Indications for Use

K091057

510(k) Number (if known):

Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories Device Name:

Indications For Use:

The Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories are indicated for noninvasive spot checking of functional saturation of arterial oxygen hemoglobin (SpO2), pulse rate, and total hemoglobin concentration (SpHb). The Masimo Rainbow SET Pronto Pulse CO-Oximeter and Accessories are indicated for use, by trained personnel, with adult and pediatric individuals during both no motion and motion conditions and for individuals who are well or poorly perfused and in clinical and non-clinical settings (e.g., hospital-type facilities, home, clinics, physician offices, blood donation facilities, and ambulatory surgery centers).

Prescription UseXAND/OROver-The-Counter Use
(Per 21 CFR 801.109 Subpart D)(Per 21 CFR 801.109 Subpart C)

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

Goncurrence of CDRH, Office of Device Evaluation (ODE) (Division Sign-Off) Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number:

Masimo Pronto, Special 510(k), 4/10/09 Page 12 of 88