K Number
K092947
Device Name
TELESENTRY, MODEL TS01
Date Cleared
2010-02-26

(155 days)

Product Code
Regulation Number
870.1025
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The TeleSentry device is intended for diagnostic evaluation of patients who experience transient symptoms or asymptomatic events that may suggest non-lethal cardiac arrhythmia. The device continuously monitors and records the data, automatically records alarm events triggered by an arrhythmia detection algorithm or manually by the patient, and automatically transmits the recorded event activity associated with these symptoms for review by a licensed physician.
Device Description
TeleSentry is a battery powered ambulatory ECG monitor which analyzes an electrocardiographic signal. The TeleSentry device classifies all detected heart beats and recognizes specific rhythm abnormalities. All detected results, including annotations for every detected heart beat and the ECG signals are securely transmitted via a cellular telephony network to a remote server. The server is accessible by a monitoring center for review and evaluation by trained qualified medical staff. The data transmission is automatically triggered when abnormalities are detected. The triggering criteria are based on physician's recommended predetermined settings and adjustable thresholds programmed for brady, tachy, pause and afib events. The data will also be transmitted when manually triggered by the patient; or periodically if programmed for regular transmission. The TeleSentry device is equipped with sufficient memory and processing capacity to record the signal received from the sensor, even while in parallel, allowing interrogation of the device data or adjustment of triggering thresholds. The TeleSentry device records and stores the entire ECG full disclosure for up to 30 days on its internal storage card. When cellular service is not available, the monitoring center is immediately notified and data can be transmitted via land-line telephone using a USB connection or a Bluetooth connection, or via broadband internet connection.
More Information

Not Found

No
The description mentions an "arrhythmia detection algorithm" and "adjustable thresholds programmed for brady, tachy, pause and afib events," which suggests rule-based or traditional algorithmic approaches rather than AI/ML. There is no mention of AI, ML, or related terms, nor is there information about training or test sets typically associated with ML development.

No.
The device is intended for diagnostic evaluation of cardiac arrhythmias and continuous monitoring and recording of data associated with non-lethal cardiac arrhythmias, not for treatment.

Yes
The "Intended Use / Indications for Use" section explicitly states that the device is "intended for diagnostic evaluation of patients who experience transient symptoms or asymptomatic events that may suggest non-lethal cardiac arrhythmia."

No

The device description explicitly states "TeleSentry is a battery powered ambulatory ECG monitor" and mentions internal storage, USB, and Bluetooth connections, indicating it includes hardware components beyond just software.

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

Here's why:

  • 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. They are used to examine these samples outside of the body.
  • TeleSentry's Function: The TeleSentry device monitors and records electrocardiographic (ECG) signals directly from the patient's body. It analyzes these electrical signals to detect cardiac arrhythmias. This is a form of in vivo (within the living body) monitoring, not in vitro testing of a sample.
  • Lack of Sample Analysis: The description does not mention the collection or analysis of any biological samples.

Therefore, while the TeleSentry is a diagnostic device, it falls under the category of in vivo diagnostic devices rather than in vitro diagnostics.

N/A

Intended Use / Indications for Use

The TeleSentry device is intended for diagnostic evaluation of patients who experience transient symptoms or asymptomatic events that may suggest non-lethal cardiac arrhythmia. The device continuously monitors and records the data, automatically records alarm events triggered by an arrhythmia detection algorithm or manually by the patient, and automatically transmits the recorded event activity associated with these symptoms for review by a licensed physician.

Product codes

DSI, DRG

Device Description

TeleSentry is a battery powered ambulatory ECG monitor which analyzes an electrocardiographic signal. The TeleSentry device classifies all detected heart beats and recognizes specific rhythm abnormalities. All detected results, including annotations for every detected heart beat and the ECG signals are securely transmitted via a cellular telephony network to a remote server. The server is accessible by a monitoring center for review and evaluation by trained qualified medical staff. The data transmission is automatically triggered when abnormalities are detected. The triggering criteria are based on physician's recommended predetermined settings and adjustable thresholds programmed for brady, tachy, pause and afib events. The data will also be transmitted when manually triggered by the patient; or periodically if programmed for regular transmission. The TeleSentry device is equipped with sufficient memory and processing capacity to record the signal received from the sensor, even while in parallel, allowing interrogation of the device data or adjustment of triggering thresholds. The TeleSentry device records and stores the entire ECG full disclosure for up to 30 days on its internal storage card. When cellular service is not available, the monitoring center is immediately notified and data can be transmitted via land-line telephone using a USB connection or a Bluetooth connection, or via broadband internet connection.

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

Monitoring center for review and evaluation by trained qualified medical staff.

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 TeleSentry device was tested and meets the requirements of following performance standards in accordance with FDA Class II Special Controls Guidance Document: Arrhythmia Detector and Alarm.

  • IEC 60601-1:1999 "Medical Electrical Equipment Part 1: General . Requirements for Safety, 1988; Amendment 1, 1991-11, Amendment 2, 1995"
  • . IEC 60601-1-2:2001/AI:2004 "Medical Electrical Equipment - Part 1-2: General Requirements for Safety; Electromagnetic Compatibility -- Requirements and Tests" Class B
  • . AAM1/ANSI EC38:2007 Medical electrical equipment - Part 2-47: Particular requirements for the safety, including essential performance, of ambulatory electrocardiographic systems
  • . AAMI / ANSI EC57:1998/(R)2003 Testing and Reporting Performance Results of Cardiac Rhythm and ST Segment Measurement Algorithms

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

Not Found

Predicate Device(s)

K081444

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.1025 Arrhythmia detector and alarm (including ST-segment measurement and alarm).

(a)
Identification. The arrhythmia detector and alarm device monitors an electrocardiogram and is designed to produce a visible or audible signal or alarm when atrial or ventricular arrhythmia, such as premature contraction or ventricular fibrillation, occurs.(b)
Classification. Class II (special controls). The guidance document entitled “Class II Special Controls Guidance Document: Arrhythmia Detector and Alarm” will serve as the special control. See § 870.1 for the availability of this guidance document.

0

Image /page/0/Picture/0 description: The image shows the logo for ScottCare. The logo consists of a stylized letter "S" to the left of the word "ScottCare". The letter "S" is enclosed in a square and has a decorative, swirling design. The word "ScottCare" is written in a simple, sans-serif font.

ScottCare Corporation 4791 West 150th Street Cleveland, Ohio 44135

P 800.243.9412 F 216.267 6129 www.scottcare.com

113

510(K) SUMMARY

This summary of 510(k) safety and effectiveness information is being supplied in accordance with the requirements of the SMDA of 1990 and 21 CFR 807.92

FEB 2 6 2010

The assigned 510(k) number is K092947.

Date: January 25, 2010

Submitted by: ScottCare Corporation Registration No: 1527715 4791 West 150th Street Cleveland, OH 44135

Contact Person: Mr. Timothy J. Leyva 216-362-0550 # 113 216-264-6129 Fax tleyva@scottcare.com

ScottCare Corporation Manufacturing Site: Registration No: 1527715 4791 West 150th Street Cleveland, OH 44135

TeleSentry Wireless Ambulatory ECG Arrhythmia Monitor Trade Name:

Common Name: Cardiac Event Monitor Mobile Cardiac Telemetry

Classification: Arrhythmia Detector and Alarm (including ST-segment measurement and alarm) (21 CFR 870.1025)

Class: Class II. Special Controls

Product Code: DSI

Subsequent Product Code: DRG

Legally Marketed

Predicate Device(s):

Braemar Fusion Wireless - Ambulatory ECG Arrhythmia Monitoring System (K081444), July 31, 2008

A Scott Fetzer, Berkshire Hathaway Company

1

Image /page/1/Picture/0 description: The image shows the logo for ScottCare. The logo consists of a stylized letter "S" on the left, followed by the text "ScottCare" in a bold, sans-serif font. The letter "S" is designed to resemble a medical symbol, possibly a caduceus or a similar emblem associated with healthcare.

ScottCare Corporatio 4791 West 150th Street Cleveland, Ohio 44135

P 800 243.9412 F 216.267 6129 www.scolicare.com

1. Device Description:

TeleSentry is a battery powered ambulatory ECG monitor which analyzes an electrocardiographic signal. The TeleSentry device classifies all detected heart beats and recognizes specific rhythm abnormalities. All detected results, including annotations for every detected heart beat and the ECG signals are securely transmitted via a cellular telephony network to a remote server. The server is accessible by a monitoring center for review and evaluation by trained qualified medical staff. The data transmission is automatically triggered when abnormalities are detected. The triggering criteria are based on physician's recommended predetermined settings and adjustable thresholds programmed for brady, tachy, pause and afib events. The data will also be transmitted when manually triggered by the patient; or periodically if programmed for regular transmission. The TeleSentry device is equipped with sufficient memory and processing capacity to record the signal received from the sensor, even while in parallel, allowing interrogation of the device data or adjustment of triggering thresholds. The TeleSentry device records and stores the entire ECG full disclosure for up to 30 days on its internal storage card. When cellular service is not available, the monitoring center is immediately notified and data can be transmitted via land-line telephone using a USB connection or a Bluetooth connection, or via broadband internet connection.

2. Indications for Use:

The TeleSentry device is intended for diagnostic evaluation of patients who experience transient symptoms or asymptomatic events that may suggest non-lethal cardiac arrhythmia. The device continuously monitors and records the data, automatically records alarm events triggered by an arrhythmia detection algorithm or manually by the patient, and automatically transmits the recorded event activity associated with these symptoms for review by a licensed physician.

Contraindications:

  • Patients with potentially life-threatening arrhythmias who require inpatient monitoring. a.
  • Patients who the attending physician thinks should be hospitalized. b.

3. Substantial Equivalence:

The TeleSentry device is technologically equivalent and identical to the predicate device except as specifically highlighted below:

| | Predicate Device
Braemar Fusion | ScottCare TeleSentry |
|----------------------------|------------------------------------|-----------------------|
| RF transmission range | 10 meters open space | 100 meters open space |
| Acoustic Transmission | Yes | No |
| Bandwidth | 0.5hz to 40Hz | 0.5Hz - 100 Hz |
| Display | LCD | LED |
| Input Impedance | 20 Mohm | >20 Mohm |
| 12 Lead | No | Yes |
| Differential Input@ AC15HZ | is + 5mV p-p | +/- 1mV p-p |

2

Image /page/2/Picture/0 description: The image shows the logo for ScottCare. The logo consists of a stylized letter "S" on the left, followed by the word "ScottCare" in a serif font. The letter "S" is designed with a heart shape incorporated into its form. The text is in all caps.

K092947

4791 West 150th Street Cleveland, Ohio 44135

F 216.267.6129

Differential Input RangeDC ± 165mVDC ± 100mV
Common Mode Ratio (CMR)60dB92 dB
Battery Type3.6V AA Disposable3.7V lithium polymer rechargeable
Battery Life7 days then disposed24-36 hours before re-charge
Relative Humidity30% to 85%25% to 95% RH, nc
SPS256100,200,1000
Alarm-no connectionNoYes

In each of these instances, the technology of the TeleSentry device meets or exceeds the operating specifications of the predicate device and they do not have any adverse impact on the safety and efficacy of the device as validated through our performance testing.

Referenced Standards and Performance Testing 4

The TeleSentry device was tested and meets the requirements of following performance standards in accordance with FDA Class II Special Controls Guidance Document: Arrhythmia Detector and Alarm.

  • IEC 60601-1:1999 "Medical Electrical Equipment Part 1: General . Requirements for Safety, 1988; Amendment 1, 1991-11, Amendment 2, 1995"
  • . IEC 60601-1-2:2001/AI:2004 "Medical Electrical Equipment - Part 1-2: General Requirements for Safety; Electromagnetic Compatibility -- Requirements and Tests" Class B
  • . AAM1/ANSI EC38:2007 Medical electrical equipment - Part 2-47: Particular requirements for the safety, including essential performance, of ambulatory electrocardiographic systems
  • . AAMI / ANSI EC57:1998/(R)2003 Testing and Reporting Performance Results of Cardiac Rhythm and ST Segment Measurement Algorithms

5. Conclusion:

ScottCare's TeleSentry ECG device (K092947) is safe, effective and substantially equivalent to the predicate Braemar Fusion device (K081444) as supported by the descriptive information and the performance testing.

3

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Food and Drug Administration 10903 New Hampshire Avenue Document Control Room W-O66-0609 Silver Spring, MD 20993-0002

FEB 2 6 2010

Scottcare Corporation c/o Mr. Timothy Leyva Director, Operations & Regulatory Affairs 4791 West 1500 St. Cleveland, OH 44135

Re: K092947

Trade/Device Name: TeleSentry Regulation Number: 21 CFR 870.1025 Regulation Name: Arrhythmia detector and alarm (including ST-segment measurement and alarm) Regulatory Class: Class II (Special Controls) Product Code: DSI, DRG Dated: January 25, 2010 Received: January 26, 2010

Dear Mr. Leyva:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you however, that device labeling must be truthful and not misleading.

4

Page 2 – Mr. Timothy Leyva

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.

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/MedicalDevices/Safety/ReportaProblem/default.htm 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 (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours.

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): K092947

Device Name: TeleSentry

Indications for Use:

The TeleSentry device is intended for diagnostic evaluation of patients who experience transient symptoms or asymptomatic events that may suggest non-lethal cardiac arrhythmia. The device continuously monitors and records the data, automatically records alarm events triggered by an arrhythmia detection algorithm or manually by the patient, and automatically transmits the recorded event activity associated with these symptoms for review by a licensed physician.

Contraindications:

  • Patients with potentially life-threatening arrhythmias who require inpatient monitoring. a.
  • Patients who the attending physician thinks should be hospitalized. b.

_ V Prescription Use (Part 21 CFR 801 Subpart D)

. "" เ

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)

W.M. West

(Division Sian-Off) Division of Cardiovascular Devices

510(k) Number

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