K Number
K093306
Device Name
SINGLE-PATIENT USE DISPOSABLE SENSOR
Date Cleared
2010-03-04

(133 days)

Product Code
Regulation Number
870.2700
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Nonin's Models 6500MA and 6500SA Single-Patient Use Disposable Pulse Oximeter Sensors are indicated for non-invasive spot-checking and/or continuous monitoring of adult and pediatric patients who are well or poorly perfused, weighing greater than 60 pounds (30 kilograms). It is intended for use in environments including operating room, surgical recovery, critical care, emergency room, long-term care, home use and mobile environments.
Device Description
The 6500MA (wrap-around model) and 6500SA (interlocking model) are fingertip single-patient use disposable, transmittance sensors. They are comprised of a lamination of two foams (patient contact side and external side) with the optical components and a malleable wire within the lamination. The optical components are identical to the currently marketed Model 7000 single-patient use disposable sensor. The sensors are compatible with all Nonin-branded pulse oximeters.
More Information

No
The summary describes a disposable pulse oximeter sensor and its physical components. There is no mention of AI, ML, or any computational processing beyond standard signal processing for pulse oximetry. The performance studies focus on accuracy metrics typical for pulse oximetry, not AI/ML model performance.

No.
The device is a pulse oximeter sensor, which is used for monitoring physiological parameters (SpO2 and pulse rate) and does not directly provide therapy.

Yes
The device is a pulse oximeter sensor, which measures blood oxygen saturation and pulse rate. These measurements provide information that can be used to assess a patient's physiological status, indicating its role in diagnosis or monitoring for diagnostic purposes.

No

The device description clearly states it is comprised of physical components like foam, optical components, and a malleable wire, indicating it is a hardware device.

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

Here's why:

  • Intended Use: The intended use is for non-invasive spot-checking and/or continuous monitoring of physiological parameters (SpO2 and pulse rate) in patients. This is a direct measurement of a physiological state, not an analysis of a sample taken from the body (like blood, urine, or tissue).
  • Device Description: The device is a sensor that attaches to the fingertip to measure light absorption. This is a physical measurement technique, not a chemical, immunological, or molecular test performed on a sample.
  • Lack of IVD Characteristics: The description does not mention any reagents, assays, or analysis of biological samples, which are hallmarks of IVD devices.

IVD devices are specifically designed to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device directly measures a physiological signal from the patient's body.

N/A

Intended Use / Indications for Use

Nonin's Models 6500MA and 6500SA Single-Patient Use Disposable Pulse Oximeter Sensors are indicated for non-invasive spot-checking and/or continuous monitoring of adult and pediatric patients who are well or poorly perfused, weighing greater than 60 pounds (30 kilograms). It is intended for use in environments including operating room, surgical recovery, critical care, emergency room, long-term care, home use and mobile environments.

Product codes

74 DQA

Device Description

The 6500MA (wrap-around model) and 6500SA (interlocking model) are fingertip single-patient use disposable, transmittance sensors. They are comprised of a lamination of two foams (patient contact side and external side) with the optical components and a malleable wire within the lamination. The optical components are identical to the currently marketed Model 7000 single-patient use disposable sensor. The sensors are compatible with all Nonin-branded pulse oximeters.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Fingers

Indicated Patient Age Range

adult and pediatric patients who are well or poorly perfused, weighing greater than 60 pounds (30 kilograms).

Intended User / Care Setting

operating room, surgical recovery, critical care, emergency room, long-term care, home use and mobile environments.

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

Nonin's Model 6500 sensor series have successfully undergone both bench and clinical testing in order to demonstrate that it meets the requirements of ISO 9919:2005 Clause 50 Accuracy of Operating Data, Clause 102 section 102.2 Labeling, and IEC 60601-1:1998 (ISO 10993-1:2003) Clause 48 Biocompatibility.

Key Metrics

SpO2 Accuracy (Arms) (70-100%): ± 2 digits
SpO2 Low Perfusion Accuracy (Arms) (70-100%): ± 2 digits
Pulse Rate Accuracy (Arms) (18-300 BPM): ± 3 digits
Low Perfusion Pulse Rate Accuracy (Arms) (40-240 BPM): ± 3 digits

Predicate Device(s)

Model 7500 (K07128), Model LS1-9R LifeSense (K063752), Model 9600 (K023044), Model 2500A (K050056), and Model 2500 (K002690)

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

K093306


510(k) Summary

Submitter:Nonin Medical, Inc.MAR - 4 2010
Contact Person:Lori M. Roth
Clinical/Regulatory Specialist
Nonin Medical, Inc.
13700 1st Ave. North
Plymouth, MN 55441-5443
Date Prepared:October 22, 2009
Trade Name:Oximeter Sensor
Classification Name:
and Number:Class II, 21 CFR 870.2700
Product Code:74 DQA
Predicate Device(s):Nonin's 7000 sensor as cleared in the following 510(K)
submissions: Model 7500 (K07128 cleared on July 12, 2007),
Model LS1-9R LifeSense (K063752 cleared on May 4, 2007), Model
9600 (K023044 cleared on July 23, 2003), Model 2500A (K050056
cleared on June 21, 2005), and Model 2500 (K002690 cleared on
October 11, 2000).
Device Description:The 6500MA (wrap-around model) and 6500SA (interlocking
model) are fingertip single-patient use disposable, transmittance
sensors. They are comprised of a lamination of two foams
(patient contact side and external side) with the optical
components and a malleable wire within the lamination. The
optical components are identical to the currently marketed Model
7000 single-patient use disposable sensor. The sensors are
compatible with all Nonin-branded pulse oximeters.
Intended Use:Nonin's Models 6500MA and 6500SA Single-Patient Use
Disposable Pulse Oximeter Sensors are indicated for non-invasive
spot-checking and/or continuous monitoring of adult and
pediatric patients who are well or poorly perfused, weighing
greater than 60 pounds (30 kilograms). It is intended for use in
environments including operating room, surgical recovery, critical
care, emergency room, long-term care, home use and mobile
environments.

1

Functional and Safety Testing:

Nonin's Model 6500 sensor series have successfully undergone both bench and clinical testing in order to demonstrate that it meets the requirements of ISO 9919:2005 Clause 50 Accuracy of Operating Data, Clause 102 section 102.2 Labeling, and IEC 60601-1:1998 (ISO 10993-1:2003) Clause 48 Biocompatibility.

Substantial Equivalence:

| | Predicate Device
Model 7000 Sensor Series | Subject Device
Model 6500 Sensor Series |
|--------------------------------------------------------------|--------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------|
| Patient Population: | Adult/Pediatric (weighing > 30
kilograms) | Same |
| Sensor Application Site: | Fingers | Same |
| Patient Use/Reuse: | Disposable | Same |
| Sterility: | Non-sterile | Same |
| Measurement Technique: | Fingertip transmittance sensor | Same |
| SpO2 Accuracy (Arms) (70-
100%): | $\pm$ 3 digits | $\pm$ 2 digits |
| SpO2 Low Perfusion Accuracy
(Arms) (70-100%): | $\pm$ 3 digits | $\pm$ 2 digits |
| Pulse Rate Accuracy (Arms)
(18-300 BPM): | $\pm$ 3 digits | Same |
| Low Perfusion Pulse Rate
Accuracy (Arms) (40-240
BPM): | $\pm$ 3 digits | Same |
| Red:
Infrared: | 660 nm @ 0.8 mW maximum
average power
910 nm @ 1.2 mW maximum
average power | Same |
| Operating: | 0 o to +40o C (32o F to 104o F) | Same |
| Storage/Transportation: | -30o to +50o C (-22o F to 122o F) | -30o to +70o C (-22o F to 158o F) |
| Operating:
Storage/Transportation: | 10 to 90% non-condensing
10 to 95% non-condensing | Same |
| Sensor Housing: | Microfoam | Polyurethane, cross-linked
polyester foam,
polyethylene/polyurethane,
polyester with adhesive |

Conclusion:

Nonin's Model 6500 sensor series is substantially equivalent to Nonin's Model 7000 sensors when used with Nonin-branded Pulse Oximeters monitors.

2

Image /page/2/Picture/0 description: The image shows the text "DEPARTMENT OF HEALTH & HUMAN SERVICES" in all caps. The text is in a bold, sans-serif font. The words are arranged on a single line and are centered horizontally.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

Ms. Lori Roth Clinical/Regulatory Specialist Nonin Medical, Incorporated 13700 15t Avenue North Plymouth, Minnesota 55441

MAR - 4 2010

Re: K093306

Trade/Device Name: Model 6500 Sensor Series Regulation Number: 21 CFR 870.2700 Regulation Name: Oximeter Regulatory Class: II Product Code: DQA Dated: February 1, 2010 Received: February 4, 2010

Dear Ms. Roth:

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.

3

Page 2 – Ms. Roth

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,

far

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

Enclosure

4

Indications for Use Statement

510(k) Number (if known)K093306
Device NameNonin Medical, Inc. Model 6500 Sensor Series
Indications for UseNonin's Models 6500MA and 6500SA Single-Patient Use Disposable Pulse Oximeter Sensors are indicated for non-invasive spot-checking and/or continuous monitoring of adult and pediatric patients who are well or poorly perfused, weighing greater than 60 pounds (30 kilograms). It is intended for use in environments including operating room, surgical recovery, critical care, emergency room, long-term care, home use and mobile environments.

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

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)

L. Schultetus

(Division Sign-Off) Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number: