K Number
K093802
Device Name
ULTRAVIEW DM3 MONITOR
Manufacturer
Date Cleared
2010-04-09

(119 days)

Product Code
Regulation Number
870.1130
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Ultraview DM3 Monitor is indicated for use by health care professionals for monitoring patient vital signs. The Ultraview DM3 Monitor is intended for monitoring, recording, and alarming basic vital signs on adult and pediatric patients. Monitored parameters include SpO2, pulse rate, NIBP, and temperature.
Device Description
The Ultraview DM3 Monitor is a portable patient monitor intended to be used by clinicians and medical qualified personnel for spot check and continuous monitoring of non-invasive blood pressure (NIBP), pulse oximetry (SpO2), and temperature.
More Information

Not Found

No
The document describes a standard vital signs monitor and does not mention any AI or ML capabilities.

No
The device is described as a monitor intended for "monitoring patient vital signs" and "monitoring, recording, and alarming basic vital signs." It does not actively treat or prevent disease, but rather provides information about the patient's condition.

No
The device monitors vital signs and indicates their values but does not diagnose a condition or disease.

No

The device description explicitly states it is a "portable patient monitor" and lists hardware parameters like SpO2, NIBP, and temperature, implying the inclusion of physical sensors and hardware components for measurement.

Based on the provided text, the Ultraview DM3 Monitor 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.
  • Device Function: The Ultraview DM3 Monitor is described as a device for monitoring vital signs (SpO2, pulse rate, NIBP, and temperature) directly from the patient's body. It does not involve analyzing samples taken from the body.
  • Intended Use: The intended use clearly states "monitoring patient vital signs" and "monitoring, recording, and alarming basic vital signs on adult and pediatric patients." This aligns with a patient monitoring device, not an IVD.

Therefore, the Ultraview DM3 Monitor falls under the category of a patient monitoring device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Ultraview DM3 Monitor is indicated for use by health care professionals for monitoring patient vital signs.

The Ultraview DM3 Monitor is intended for monitoring, recording, and alarming basic vital signs on adult and pediatric patients. Monitored parameters include SpO2, pulse rate, NIBP, and temperature.

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

DXN, DQA

Device Description

The Ultraview DM3 Monitor is a portable patient monitor intended to be used by clinicians and medical qualified personnel for spot check and continuous monitoring of non-invasive blood pressure (NIBP), pulse oximetry (SpO2), and temperature.

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 pediatric patients

Intended User / Care Setting

health care 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)

Software for the Ultraview DM3 Monitor was designed and developed according to Zoe Medical's software development process, and was verified and validated. Test results indicated that the Ultraview DM3 Monitor complies with its predetermined specification.
The Ultraview DM3 Monitor was tested for patient safety in accordance with applicable standards. Test results indicated that the Ultraview DM3 Monitor complies with its predetermined specification.
The Ultraview DM3 Monitor was tested for EMC in accordance with applicable standards. Test results indicated that the Ultraview DM3 Monitor complies with its predetermined specification.
The Ultraview DM3 Monitor was tested in accordance with internal requirements and procedures, and test results indicated that the device complies with the predetermined requirements. This testing includes performance and functional, environmental, and shipping and transportation testing.
Clinical performance testing was performed according to ISO 9919:2005 to demonstrate safety and effectiveness of the oximetry feature of the Ultraview DM3 Monitor.

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.

K090556, K955846

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

§ 870.1130 Noninvasive blood pressure measurement system.

(a)
Identification. A noninvasive blood pressure measurement system is a device that provides a signal from which systolic, diastolic, mean, or any combination of the three pressures can be derived through the use of tranducers placed on the surface of the body.(b)
Classification. Class II (performance standards).

0

Submitter

Zoe Medical Incorporated 460 Boston Street Topsfield, MA 01983-1223

Contact Name: James Chickering Contact Title: Regulatory Affairs Manager Phone: (978) 887-1410 X37 Fax: (978) 887-1406

Date Prepared: December 4, 2009

Trade Name

Ultraview DM3 Monitor

Common Name

Patient Physiological Monitor (with alarms)

Classification Name

Non-invasive Blood Pressure Measurement System

Classification Regulation

21 CFR 870.1130

Product Code

DXN

Substantially Equivalent Devices

| Ultraview DM3 Monitor | Predicate 510(k)
Number | Predicate Manufacturer / Model |
|---------------------------------------|----------------------------|-----------------------------------------------------------------|
| Non-invasive Blood Pressure component | K090556 | Spacelabs Healthcare /
élance Vital Signs Monitoring System |
| Pulse Oximetry component | K090556 | Spacelabs Healthcare /
élance. Vital Signs Monitoring System |
| Temperature component | K955846 | Cardinal Health /
Model 2082 Temp Plus III Thermometer |

Device Description

The Ultraview DM3 Monitor is a portable patient monitor intended to be used by clinicians and medical qualified personnel for spot check and continuous monitoring of non-invasive blood pressure (NIBP), pulse oximetry (SpO2), and temperature.

APR - 9 2010

1

Technology Comparison

The Ultraview DM3 Monitor utilizes the same or similar technology for each parameter as utilized by the predicate devices.

Intended Use

The Ultraview DM3 Monitor is indicated for use by health care professionals for monitoring patient vital signs.

The Ultraview DM3 Monitor is intended for monitoring, and alarming basic vital signs on adult and pediatric patients. Monitored parameters include SpO2, pulse rate, NIBP, and temperature.

Performance Testing

CategoryTesting Summary
Sterilization ValidationThe Ultraview DM3 Monitor is not sterilized or sterilizable, and
therefore this section does not apply to the monitor itself.
Shelf Life TestingThe Ultraview DM3 Monitor is not sterilized or sterilizable, and
therefore this section does not apply to the monitor itself.
Biocompatibility TestingThe Ultraview DM3 Monitor has no patient contact materials, and
therefore this section does not apply to the monitor itself.
Software TestingSoftware for the Ultraview DM3 Monitor was designed and
developed according to Zoe Medical's software development
process, and was verified and validated. Test results indicated that
the Ultraview DM3 Monitor complies with its predetermined
specification.
Electrical SafetyThe Ultraview DM3 Monitor was tested for patient safety in
accordance with applicable standards. Test results indicated that the
Ultraview DM3 Monitor complies with its predetermined specification.
Electromagnetic Compatibility
TestingThe Ultraview DM3 Monitor was tested for EMC in accordance with
applicable standards. Test results indicated that the Ultraview DM3
Monitor complies with its predetermined specification.
Performance Testing - BenchThe Ultraview DM3 Monitor was tested in accordance with internal
requirements and procedures, and test results indicated that the
device complies with the predetermined requirements. This testing
includes performance and functional, environmental, and shipping
and transportation testing.
Performance Testing - AnimalAnimal performance testing was not performed and is not necessary
to demonstrate safety and effectiveness of the Ultraview DM3
Monitor.
Performance Testing - ClinicalClinical performance testing was performed according to ISO
9919:2005 to demonstrate safety and effectiveness of the oximetry
feature of the Ultraview DM3 Monitor.

Conclusion

Based upon a comparison of devices and performance testing results, the Ultraview DM3 Monitor is substantially equivalent to the predicate devices.

2

Image /page/2/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" arranged around the top half of the circle. Inside the circle is an abstract symbol resembling a stylized caduceus or a family of three figures, with flowing lines suggesting movement or connection.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room W-066-0609 Silver Spring, MD 20993-0002

APR - 9 2010

Zoe Medical c/o Mr. James Chickering Regulatory Affairs Manager 460 Boston St. Topsfield, MA 01983

Re: K093802

Trade/Devicc Name: Ultraview DM3 Monitor Regulation Number: 21 CFR 870.1130 Regulation Name: Noninvasive Blood Pressure Measurement System Regulatory Class: Class II (two) Product Code: DXN, DQA Dated: March 29, 2010 Received: April 06, 2010

Dear Mr. Chickering:

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.

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 - Mr. James Chickering

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.html 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/ResourcesforYou/Industry/default.htm.

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely vours.

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

Enclosure

4

Indications for Use

510(k) Number: K093802

Device Name:

Ultraview DM3 Monitor

Indications for Use:

The Ultraview DM3 Monitor is indicated for use by health care professionals for monitoring patient vital signs.

The Ultraview DM3 Monitor is intended for monitoring, recording, and alarming basic vital signs on adult and pediatric patients. Monitored parameters include SpO2, pulse rate, NIBP, and temperature.

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

Over-The-Counter Use (Part 21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

(Division Sign-Off)
---------------------

Division of Cardiovascular Devices

510(k) NumberK093802
------------------------

Zoe Medical, Incorporated