K Number
K101280
Device Name
MIDWESTERN REPROCESSING CENTER REPROCESSED PULSE OXIMETER PROBE
Date Cleared
2010-10-07

(154 days)

Product Code
Regulation Number
870.2700
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The MRC Reprocessed Pulse Oximeter sensors are used as a noninvasive method to provide continuous SpO2 monitoring and pulse rate monitoring. These devices are intended for prescription use.
Device Description
The Midwestern Reprocessing Center reprocessed pulse oximeter sensors are non-invasive sensors used to provide continuous SpO2 monitoring and pulse rate. The sensors contain a dual wavelength light emitting diode (LED), and an optical photodiode sensor which are housed in a pad which attaches to the patient using adhesive material. The LED emits red and infrared light in alternate pulses, governed by the Oximeter instrument. The photodiode sensor responds to the light and generates a current that is interpreted by the Oximeter instrument. The Oximeter instrument interprets the different amounts of each light type (red and infrared) from the output of the photodiode and interprets the information and displays a reading. The sensor operates without any type of tissue penetration, electrical contact, or heat transfer to the patient. The sensors use optical means to determine the light absorption of functional arterial hemoglobin. The sensor is indicated for use as a non-invasive method to provide continuous SpO2 monitoring and pulse rate.
More Information

Not Found

No
The description focuses on the optical and electronic principles of pulse oximetry and reprocessing, with no mention of AI or ML algorithms for data interpretation or processing.

No
The device is a monitoring device, used to measure physiological parameters (SpO2 and pulse rate), not to treat a condition.

Yes
The device provides continuous SpO2 and pulse rate monitoring, which are physiological parameters used in diagnosing a patient's condition.

No

The device description explicitly details hardware components (LED, photodiode sensor, adhesive pad) and their physical interaction with the patient and an Oximeter instrument. It is not solely software.

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

Here's why:

  • IVDs analyze samples taken from the human body. This device is a pulse oximeter sensor, which is a non-invasive device that measures physiological parameters (SpO2 and pulse rate) on the body, not from a sample taken from the body.
  • The description focuses on optical measurement of light absorption in the body. This is a physical measurement technique, not a chemical or biological analysis of a sample.
  • The intended use is continuous monitoring of physiological signs. This is a typical function of a medical device used for patient monitoring, not an IVD used for diagnostic testing of samples.

Therefore, the MRC Reprocessed Pulse Oximeter sensor falls under the category of a medical device used for patient monitoring, not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The MRC Reprocessed Pulse Oximeter sensors are used as a noninvasive method to provide continuous SpO2 monitoring and pulse rate monitoring.

These devices are intended for prescription use.

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

NLF

Device Description

The Midwestern Reprocessing Center reprocessed pulse oximeter sensors are non-invasive sensors used to provide continuous SpO2 monitoring and pulse rate. The sensors contain a dual wavelength light emitting diode (LED), and an optical photodiode sensor which are housed in a pad which attaches to the patient using adhesive material. The LED emits red and infrared light in alternate pulses, governed by the Oximeter instrument. The photodiode sensor responds to the light and generates a current that is interpreted by the Oximeter instrument. The Oximeter instrument interprets the different amounts of each light type (red and infrared) from the output of the photodiode and interprets the information and displays a reading. The sensor operates without any type of tissue penetration, electrical contact, or heat transfer to the patient. The sensors use optical means to determine the light absorption of functional arterial hemoglobin.

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

Not Found

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)

Functional testing, cleaning validation, and biocompatibility testing demonstrates that the reprocessed devices perform as intended and are safe and effective. Clinical Testing demonstrated that the reprocessed devices used with its compatible pulse oximeter perform as intended and are safe and effective.

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.

K041815, K051212, K080424, K041867, K012891, K863784, K012715

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).

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OCT - 7 2010

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510K SummaryK101280
-------------------------

| Submitter: | Midwestern Reprocessing Center, LLC
3995 Fashion Square Blvd. Suite 11
Saginaw, MI 48603
Phone: (989) 583-4623
Fax: (989) 583-4633 |
|-------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact: | Jerome James
Consultant
Phone: (205) 314-3920
Fax: (205) 314-3959
Email: jerry.james@hygia.net |
| Date: | May 3, 2010 |
| Trade or
Proprietary Name: | Midwestern Reprocessing Center Reprocessed Sensors |
| Common Name: | Oximeter, Reprocessed |
| Classification: | 21 CFR 870-2700-Oximeter
NLF |
| Equivalent Device: | Corresponding Masimo LNCS, Nellcor OxiMax, and Nellcor
Oxisensor II Pulse Oximeter Sensors and Hygia Health Services
Reprocessed Pulse Oximeter Sensors legally marketed under various
510(k) premarket notifications. |
| | Masimo 510(k) K041815
Masimo 510(k) K051212
Hygia Health Services 510(k) K080424
Hygia Health Services 510(k) K041867
Nellcor Puritan Bennett, Inc. 510(k) K012891
Nellcor Puritan Bennett, Inc. 510(k) K863784
Hygia Health Services 510(k) K012715 |
| Device Description: | The Midwestern Reprocessing Center reprocessed pulse oximeter
sensors are non-invasive sensors used to provide continuous SpO2
monitoring and pulse rate. The sensors contain a dual wavelength
light emitting diode (LED), and an optical photodiode sensor which
are housed in a pad which attaches to the patient using adhesive
material. The LED emits red and infrared light in alternate pulses, |

1

510K Summary of Safety & Effectiveness (Con't)

governed by the Oximeter instrument. The photodiode sensor responds to the light and generates a current that is interpreted by the Oximeter instrument. The Oximeter instrument interprets the different amounts of each light type (red and infrared) from the output of the photodiode and interprets the information and displays a reading. The sensor operates without any type of tissue penetration, electrical contact, or heat transfer to the patient. The sensors use optical means to determine the light absorption of functional arterial hemoglobin. The sensor is indicated for use as a non-invasive method to provide Indications for Use: continuous SpO2 monitoring and pulse rate. Technological The predicate devices and the MRC reprocessed device contain dual Characteristics: wavelength LED and a photodiode. The LED and photodiode are encased in a pad which attaches to the patient using adhesive material. The sensors are connected to a cable and they terminate in a pin connector. Biocompatibility and performance/functional testing demonstrate that the devices are equivalent to their predicate devices Functional testing, cleaning validation, and biocompatibility testing Testing: demonstrates that the reprocessed devices perform as intended and are safe and effective. Clinical Testing demonstrated that the reprocessed devices used with its compatible pulse oximeter perform as intended and are safe and effective. Based on the assessment of clinical testing, non-clinical functional Conclusion: testing, cleaning validation, and biocompatibility testing performed, Midwestern Reprocessing Center concludes that the Midwestern Reprocessing Center reprocessed pulse Oximeter sensors are substantially equivalent to their predicate devices ..

3-3

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

Midwest Reprocessing Center LLC C/O Mr. Jerome James Hygia Health Services, Incorporated 434 Industrial Lane Birmingham, Alabama 35211

Re: K101280

Trade/Device Name: MRC Reprocessed Sensors Regulation Number: 21 CFR 870.2700 Regulation Name: Reprocessed Oximeter Regulatory Class: II Product Code: NLF Dated: September 29, 2010 Received: October 1, 2010

Dear Mr. James:

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.

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QCT - 7 2010

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Page 2- Mr. James

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,

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

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Indications For Use

111280 OCT - 7 2010

Applicant:Midwestern Reprocessing Center, LLC (MRC)
510 (k):K
Device Name:MRC Reprocessed Sensors

Indications for Use:

The MRC Reprocessed Pulse Oximeter sensors are used as a noninvasive method to provide continuous SpO2 monitoring and pulse rate monitoring.

These devices are intended for prescription use.

L. Schattner

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

510(k) Number: K101280