AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Indicated for use by health care professionals whenever there is a need for monitoring the physiological paramenters of patients.

Device Description

The Philips MP2, X2, MP5, MP5T, MP20, MP30, MP40, MP50, MP60, MP70, MP75, MP80, and MP90 IntelliVue patient monitors are intended for monitoring and recording of and to generate alarms for, multiple physiological parameters of adults, pediatrics and neonates in hospital environments. The MP2, X2, MP5, MP5T, MP20, MP30, MP40, and MP50 are additionally intended for use in transport situations within hospital environments. The MP2, X2 and MP5 are also intended for use during patient transport outside of a hospital environment. The monitors are not intended for home use. They are intended for use by health care professionals.

AI/ML Overview

This 510(k) summary describes a software revision (H.00) for Philips IntelliVue patient monitors, introducing a new model (MP75) and maintaining substantial equivalence to previously cleared devices. The submission focuses on verification and validation testing to ensure the modified devices meet performance and reliability requirements.

Here's an analysis based on your requested information:

1. Table of Acceptance Criteria and Reported Device Performance

The provided text does not include a specific table of acceptance criteria or detailed reported device performance metrics. Instead, it states broadly:

Acceptance CriteriaReported Device Performance
Specifications cleared for predicate devices and hazard analysis."Test results showed substantial equivalence." "The results demonstrate that the Philips IntelliVue patient monitors meet all reliability requirements and performance claims."

2. Sample Size Used for the Test Set and Data Provenance

The document states: "Testing involved system level and regression tests as well as testing from the hazard analysis."

  • Sample Size: Not explicitly stated. The testing appears to be based on the general system and regression tests covering the IntelliVue patient monitor family and the new MP75 model.
  • Data Provenance: Not specified. It's likely internal testing data generated by Philips. The document does not indicate whether it was retrospective or prospective, or the country of origin of the data.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and their Qualifications

Not applicable. The submission is for a software update to patient monitoring devices and does not involve AI/ML or expert adjudication for ground truth related to medical image interpretation or diagnosis. The "ground truth" here would be the expected functional performance and safety parameters of the monitoring system.

4. Adjudication Method for the Test Set

Not applicable. As noted above, this is not an AI/ML diagnostic device requiring expert adjudication. The "pass/fail criteria" were based on the specifications of predicate devices.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No. An MRMC study is not relevant for this type of device (patient physiological monitors with a software update). The submission is about maintaining performance equivalence, not evaluating human reader improvement with AI assistance.

6. Standalone (i.e. algorithm only without human-in-the-loop performance) Study

The assessment is inherently standalone in the sense that the device (monitor with software) is evaluated for its performance. The "algorithm" here is the monitoring software, and its performance is assessed against established specifications. There isn't a separate "algorithm-only" vs. "human-in-the-loop" concept described, as the device's function is to monitor and present physiological parameters to human users.

7. Type of Ground Truth Used

The ground truth used for testing appears to be the established performance specifications and safety requirements for patient physiological monitors, as defined by prior device clearances and hazard analyses. This would include parameters like accuracy of physiological measurements (e.g., heart rate, blood pressure, ECG), alarm functionality, and system reliability, rather than a diagnostic 'truth' from pathology or outcomes.

8. Sample Size for the Training Set

Not applicable. This is not an AI/ML device that requires a training set in the conventional sense of machine learning. The software development and testing follow traditional software engineering and medical device validation processes.

9. How the Ground Truth for the Training Set Was Established

Not applicable, as there is no mention of a training set for an AI/ML algorithm.

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510 (k) Summary

This summary of 510(k) safety and effectiveness information is submitted in accordance with the requirements of the Safe Medical Devices Act of 1990 and 21 C.F.R. §807.92.

  1. The submitter of this premarket notification is:

APR 80 2010

100939 1/3

Andreas Suchi Philips Medizin Systeme Boeblingen GmbH Hewlett-Packard-Str. 2 D-71034 Boeblingen, Germany Tel: ++49 7031 463-1291 Fax: ++49 7031 463-2442 e-mail: andreas.suchi@philips.com

This summary was prepared on April 1, 2010.

    1. The names of the devices are the Philips MP2, X2, MP5, MP5T, MP20, MP30, MP40, MP50, MP60, MP70, MP75, MP80, and MP90 IntelliVue patient monitors Classification names are as follows:
Device PanelClassificationProCodeDescription
CardiovascularDevices$870.1025, IIDSIDetector and alarm, arrhythmia
$870.1025, IIMLDMonitor, ST Segment with Alarm
$870.1025, IIMHXMonitor, Physiological, Patient(with arrhythmia detection oralarms)
$870.1100, IIDSJAlarm, Blood Pressure
$870.1110, IIDSKComputer, Blood Pressure
$870.1130, IIDXNSystem, Measurement, Blood-Pressure, Non-Invasive
$870.1435, IIDXGComputer, Diagnostic, Pre-Programmed, Single-Function
$870.1915, IIKRBProbe, Thermodilution
$870.2060, IIDRQAmplifier and SignalConditioner, Transducer Signal
$870.2300, IIDRTMonitor, Cardiac (incl.Cardiotachometer & Rate Alarm)
$870.2340, IIDPSElectrocardiograph
$870.2340, IIMLCMonitor, ST Segment
$870.2350, IIDRWElectrocardiograph, LeadSwitching Adapter
$870.2370, IIKRCTester, Electrode, Surface,Electrocardiograph
$870.2600, IDRJSystem, Signal Isolation
$870.2700, IIDQAOximeter
$870.2770, IIDSBPlethysmograph, Impedance
$870.2800, IIDSHRecorder, Magnetic tape,Medical
$870.2810, IDSFRecorder, Paper Chart
$870.2850, IIDRSExtravascular Blood PressureTransducer
$870.2900, IDSACable, Transducer andElectrode, incl. PatientConnector
Device PanelClassificationProCodeDescription
-MSXSystem, Network and Communication, PhysiologicalMonitors
AnesthesiologyDevices$870.2910, IIDRGTransmitters and Receivers,Physiological Signal,Radiofrequency
$868.1400, IICCKAnalyzer, Gas, Carbon Dioxide,Gaseous-Phase
$868.1500, IICBQAnalyzer, Gas, Enflurane,Gaseous-Phase (AnestheticConcentration)
$868.1500, IINHOAnalyzer, Gas, Desflurane,Gaseous-Phase (AnestheticConcentration)
$868.1500, IINHPAnalyzer, Gas, Sevoflurane,Gaseous-Phase (AnestheticConcentration)
$868.1500, IINHQAnalyzer, Gas, Isoflurane,Gaseous-Phase (AnestheticConcentration)
$868.1620, IICBSAnalyzer, Gas, Halothane,Gaseous-Phase (AnestheticConcentration)
$868.1700, IICBRAnalyzer, Gas, Nitrous Oxide,Gaseous-Phase (AnestheticConcentration)
$868.1720, IICCLAnalyzer, Gas, Oxygen, Gaseous-Phase
$868.1880, IIBZCData calculator Pulmonary-function
$868.2375, IIBZQMonitor, Breathing Frequency
$868.2480, IILKDMonitor, Carbon Dioxide,Cutaneous
$868.2500, IIKLKMonitor, Oxygen, Cutaneous, forInfant not under Gas Anesthesia
General Hospitaland Personal UseDevices$880.2910, IIFLLThermometer, Electronic,Clinical
NeurologicalDevices$882.1400, IIGWRElectroencephalograph
$882.1420, IGWSAnalyzer, Spectrum,

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K100939
R2/3

    1. The modified devices are substantially equivalent to previously cleared Philips IntelliVue patient monitors marketed pursuant to K013199, K031481, K032858, K040304, K050762, K053522, K062392, K71426, K081793, K082633, K083517, and K091927 .
    1. The modification is the introduction of software revision H.00 for the entire IntelliVue patient monitors family, models MP2, X2, MP5, MP5T, MP20, MP30, MP40, MP50, MP60, MP70, MP80, and MP90 .

Additionally a new model IntelliVue MP75 is introduced.

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    1. The modified devices have the same intended use as the legally marketed predicate devices. The Philips MP2, X2, MP5, MP5T, MP20, MP30, MP40, MP50, MP60, MP70, MP75, MP80, and MP90 IntelliVue patient monitors are intended for monitoring and recording of and to generate alarms for, multiple physiological parameters of adults, pediatrics and neonates in hospital environments. The MP2, X2, MP5, MP5T, MP20, MP30, MP40, and MP50 are additionally intended for use in transport situations within hospital environments. The MP2, X2 and MP5 are also intended for use during patient transport outside of a hospital environment. The monitors are not intended for home use. They are intended for use by health care professionals.
    1. The modified devices have the same technological characteristics as the legally marketed predicate device.
    1. Verification, validation, and testing activities establish the performance, functionality, and reliability characteristics of the modified devices with respect to the predicate. Testing involved system level and regression tests as well as testing from the hazard analysis. Pass/Fail criteria were based on the specifications cleared for the predicate devices and test results showed substantial equivalence. The results demonstrate that the Philips IntelliVue patient monitors meet all reliability requirements and performance claims.

(10093

$3/3

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three curved lines representing its body and wings. The eagle is positioned to the right of a circular arrangement of text that reads "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA".

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

APR 3 0 2010

Philips Medizin Systeme Boeblingen GmbH c/o Mr. Andreas Suchi Senior Regulatory Affairs Engineer Hewlett-Packard Str. 2 Boeblingen GERMANY 71034

Re: K100939

Trade/Device Name: Philips MP2, X2, MP5, MP5T, MP20, MP30, MP40, MP50, MP60, MP70, MP75, MP80, and MP90 IntelliVue patient monitors, Release H.00 Regulatory Number: 21 CFR 870.1025 Regulation Name: Patient Physiological Monitor (with arrhythmia detection or alarms) Regulatory Class: II (two) Product Code: 74 MHX Dated: April 1, 2010 Received: April 5, 2010

Dear Mr. Suchi:

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.

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Page 2 - Mr. Andreas Suchi

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/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Prem D. Zuckerman, M.D.

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

Enclosure

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Indications for Use

510(k) Number (if known):

Device Name: Philips MP2, X2, MP5, MP5T, MP20, MP30, MP40, MP50, MP60, MP70, MP75, MP80, and MP90 IntelliVue patient monitors, Release H.00.

Indications for Use: Indicated for use by health care professionals whenever there is a need for monitoring the physiological paramenters of patients.

Prescription Use (Part 21 CFR 801 Subpart D)

Yes AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

No

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OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

W. Wood

(Division Sign-Off)
Division of Cardiovascular Devices
510(k) Number K100939

§ 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.