K Number
K100617
Device Name
MASIMO RESPONSABLE OXIMETRY SENSORS MODEL S2-25/25D; S2-20/20D
Manufacturer
Date Cleared
2010-05-28

(85 days)

Product Code
Regulation Number
870.2700
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Masimo Resposable Oximetry Sensors are indicated for the continuous noninvasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate (measured by an SpO2 sensor) for use with adult and pediatric patients during both no motion conditions, and for patients who are well or poorly perfused in hospital-type facilities, mobile, and home environments.
Device Description
The Masimo Resposable Oximetry Sensors (S2 Sensors) are fully compatible for use with instruments which include or compatible with the following technologies: - · Masimo SET technology - · Masimo Rainbow SET technology - · Nellcor technology - · Philips FAST-SpO2 technology The S2 Sensors and the predicates (K051212), the LNCS Oximetry Sensors (LNCS Sensors), have the same indications for use/ intended use. The S2 Sensors also have the same sensor design as the predicates (K090165), the Masimo Rainbow Resposable Sensor (R2 Sensors). The reason for this filing is to modify the LNCS Sensor design.
More Information

Not Found

No
The document explicitly states "Mentions AI, DNN, or ML: Not Found" and the description focuses on sensor technology and compatibility with existing oximetry technologies.

No
The device is indicated for monitoring physiological parameters (SpO2 and pulse rate), not for treating or diagnosing any condition.

Yes

The device is indicated for "continuous noninvasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate," which are parameters measured to assess a patient's physiological state, thus serving a diagnostic purpose.

No

The device description explicitly states it is a "Resposable Oximetry Sensor" and details its compatibility with various hardware technologies (Masimo SET, Nellcor, Philips FAST-SpO2). This indicates it is a physical sensor, not a software-only device.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body (like blood, urine, or tissue) to provide information for diagnosis, monitoring, or screening.
  • Device Function: The Masimo Resposable Oximetry Sensors are described as being used for the "continuous noninvasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate". This is done by placing the sensor on the patient's body (likely a finger or earlobe), not by analyzing a sample taken from the body.
  • Lack of Specimen Analysis: The description does not mention any analysis of biological specimens.

Therefore, the device falls under the category of a non-invasive monitoring device, not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The Masimo Resposable Oximetry Sensors are indicated for the continuous noninvasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate (measured by an SpO2 sensor) for use with adult and pediatric patients, during both no motion conditions, and for patients who are well or poorly perfused in hospital-type facilities, mobile, and home environments.

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

DQA, DSA

Device Description

The Masimo Resposable Oximetry Sensors (S2 Sensors) are fully compatible for use with instruments which include or compatible with the following technologies:

  • Masimo SET technology
  • Masimo Rainbow SET technology
  • Nellcor technology
  • Philips FAST-SpO2 technology

The S2 Sensors and the predicates (K051212), the LNCS Oximetry Sensors (LNCS Sensors), have the same indications for use/ intended use. The S2 Sensors also have the same sensor design as the predicates (K090165), the Masimo Rainbow Resposable Sensor (R2 Sensors). The reason for this filing is to modify the LNCS Sensor design.

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

hospital-type facilities, mobile, and home 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 (study type, sample size, AUC, MRMC, standalone performance, key results)

The S2 Sensors comply with the voluntary standards as detailed in this submission. The following quality assurance measures were applied to the development of the S2 Sensors:

  • Risk Analysis.
  • Design Reviews.
  • Biocompatibility Testing.
  • Performance Testing
  • Safety Testing.

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

Arterial Oxygen Saturation (SpO2), No Motion: 70-100%, + 2%
Arterial Oxygen Saturation (SpO2), Motion: 70-100%, + 3%
Arterial Oxygen Saturation (SpO2), Low Perfusion: 70-100%, + 2%
Pulse Rate, No Motion: 25-240 bpm, + 3 bpm
Pulse Rate, Motion: 25-240 bpm, + 5 bpm
Pulse Rate, Low Perfusion: 25-240 bpm, + 3 bpm
(For Nellcor Technology and Philips FAST SpO2 Technology, No Motion:)
Arterial Oxygen Saturation (SpO2), No Motion: 70-100%, + 2%
Pulse Rate, No Motion: 25-240 bpm, + 3 bpm

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.

K051212, K090165

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

§ 870.2700 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

510(k) SUMMARY

K100617

Submitted by:Masimo CorporationMAY 2 8 2010
40 Parker
Irvine, CA 92618
949-297-7000
FAX 949-297-7592
Company Contact:Marguerite Thomlinson, Manager of Regulatory Affairs
Date Summary Prepared:March 2, 2010
Trade Name:Masimo Resposable Oximetry Sensors
Common Name:Oximeter Sensor
Regulation Number:21 CFR 870.2700
Regulation Name:Oximeter
Regulation Class:Class II
Product Code:DQA, DSA
Substantially Equivalent Devices:LNCS Oximetry Sensors, 510k) No. K051212
Masimo Rainbow Resposable Sensors, 510(k) No. K090165

Device Description

The Masimo Resposable Oximetry Sensors (S2 Sensors) are fully compatible for use with instruments which include or compatible with the following technologies:

  • · Masimo SET technology
  • · Masimo Rainbow SET technology
  • · Nellcor technology
  • · Philips FAST-SpO2 technology

The S2 Sensors and the predicates (K051212), the LNCS Oximetry Sensors (LNCS Sensors), have the same indications for use/ intended use. The S2 Sensors also have the same sensor design as the predicates (K090165), the Masimo Rainbow Resposable Sensor (R2 Sensors). The reason for this filing is to modify the LNCS Sensor design.

Predicate Device

The predicate devices used in this filing are:

  • · The LNCS Oximetry Sensors (LNCS Sensors), 510(k) No. K051212
  • · The Masimo Rainbow Resposable Sensors (R2 Sensors), 510(k) No. K090165.

1

510(k) SUMMARY

Intended Use/ Indications for Use

The Masimo Resposable Oximetry Sensors are indicated for the continuous nonitoring of functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate (measured by an SpO2 sensor) for use with adult and pediatric patients, during both no motion conditions, and for patients who are well or poorly perfused in hospital-type facilities, mobile, and home environments.

Technology Comparison

The S2 Sensors are substantially equivalent to the predicate sensors in the design, principles of operation, and performance. The S2 Sensors and the predicates operate on identical principles of noninvasive optical assessment of tissue oxygenation using emitters and detectors.

Specifications

The specifications for the S2 Sensors are as following:

| Masimo SEI Technology and Masimo Rainbow SEI Technology/

(Adults > 30kg, Pediatrics 10-50kg)
MeasurementAccuracy RangeAccuracy
Arterial Oxygen Saturation (SpO2), No Motion70-100%+ 2%
Arterial Oxygen Saturation (SpO2), Motion70-100%+ 3%
Arterial Oxygen Saturation (SpO2), Low Perfusion70-100%+ 2%
Pulse Rate, No Motion25-240 bpm+ 3 bpm
Pulse Rate, Motion25-240 bpm+ 5 bpm
Pulse Rate, Low Perfusion25-240 bpm+ 3 bpm
Nellcor Technology and Philips FAST SpO2 Technology/
(Adults > 30kg, Pediatrics 10-50kg)
MeasurementAccuracy RangeAccuracy
Arterial Oxygen Saturation (SpO2), No Motion70-100%+ 2%
Pulse Rate, No Motion25-240 bpm+ 3 bpm

Test Summary

The S2 Sensors comply with the voluntary standards as detailed in this submission. The following quality assurance measures were applied to the development of the S2 Sensors:

  • Risk Analysis .
  • Design Reviews .
  • Biocompatibility Testing .
  • Performance Testing �
  • Safety Testing .

. .

Conclusions

The information in this 510(k) submission demonstrates that the S2 Sensors are substantially equivalent to the predicate devices, with respect to safety, effectiveness, and performance.

2

Image /page/2/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which consists of a staff with a snake entwined around it. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" are arranged in a circular pattern around the symbol.

DEPARTMENT OF HEALTH & HUMAN SERVICES

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

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

MAY 2 8 2010

Re: K100617

Trade/Device Name: Masimo Resposable Oximetry Sensors Regulation Number: 21 CFR 870.2700 Regulation Name: Oximeter Regulatory Class: II Product Code: DQA Dated: April 26, 2010 Received: April 29, 2010

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. 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- Ms. Marguerite 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/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 vours.

for

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

510(k) Number (if known):

Masimo Resposable Oximetry Sensors Device Name:

Indications For Use:

The Masimo Resposable Oximetry Sensors are indicated for the continuous noninvasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate (measured by an SpO2 sensor) for use with adult and pediatric patients during both no motion conditions, and for patients who are well or poorly perfused in hospital-type facilities, mobile, and home environments.

Prescription Use × (Per 21 CFR 801.109 Subpart D) AND/OR

Over-The-Counter Use (Per 21 CFR 801.109 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluations (ODE)

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

510(k) Special, 3/2/2010 Resposable SpO2 Sensors Page 14 of 152

510(k) Number: