K Number
K102710
Device Name
NEO-SERVO I
Date Cleared
2010-12-22

(93 days)

Product Code
Regulation Number
880.5400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Neo-Servo i Atom Infant Incubator Model 102 is a closed-type incubator for newborns and premature neonates. It is mainly intended for temperature control in neonatal hypothermia, observation and examination in newborn nurseries, prevention of body temperature drop shortly after delivery, and pre-operative and post-operative intensive care in neonatal surgery. The incubator is provided with a function to control the infant's skin temperature.
Device Description
The Neo-Servo i Atom Infant incubator Model 102 consists of a hood, a main body, a control panel and is offered with or without a stand with casters. The Model 102 incorporates two (2) modes of control: air (manual control) and baby (servo control). The Model 102 incorporates the sensors (humidity and temperature) inside the hood monitor the air conditions inside the hood. These are connected to the Sensor module. It is equipped with an incubator air temperature control function to circulate air containing the heat generated b the heater attached to the conditioning chamber inside the hood by means of a fan in order to maintain the incubator air temperature at a fixed level. It is equipped with a skim temperature control function o maintain the infant's skin temperature at a fixed level in response to the patient's temperature as measured by the skin probe. There are optional humidity chamber and x-ray cassette tray. There are 2 functional modes: - Skin temperature control mode referred to as "Servo Control Mode" 1. - Air temperature control mode referred to as "Manual Control Mode" 2.
More Information

Not Found

No
The description details standard sensor-based feedback loops for temperature control (air and skin temperature servo control) and does not mention any AI/ML algorithms for prediction, analysis, or decision-making beyond basic setpoint maintenance. The "Servo Control Mode" refers to a standard control system, not necessarily AI/ML.

Yes
The device is intended for temperature control in neonatal hypothermia, prevention of body temperature drop, and pre-operative and post-operative intensive care, all of which are direct therapeutic interventions to maintain the health and well-being of newborns and premature neonates.

No
The device is an infant incubator designed for temperature control and observation of newborns and premature neonates. Its functions described are therapeutic and monitoring (temperature, humidity), not diagnostic.

No

The device description clearly outlines physical components such as a hood, main body, control panel, sensors, heater, and fan, indicating it is a hardware device with integrated software for control.

Based on the provided information, this device 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 (like blood, urine, or tissue) to detect diseases, conditions, or infections.
  • Device Function: The Neo-Servo i Atom Infant Incubator Model 102 is a medical device designed to provide a controlled environment (temperature and potentially humidity) for newborns and premature neonates. It directly interacts with the patient's external environment and monitors their skin temperature.
  • Lack of Sample Analysis: The description does not mention any analysis of biological samples taken from the infant. The sensors mentioned (humidity and temperature) are monitoring the environment within the incubator and the infant's external skin temperature.

Therefore, the device's function and intended use clearly fall outside the scope of In Vitro Diagnostics. It is a therapeutic and monitoring device used in a clinical setting.

N/A

Intended Use / Indications for Use

The Neo-Servo i Atom Infant Incubator Model 102 is a closed-type incubator for newborns and premature neonates. It is mainly intended for temperature control in neonatal hypothermia, observation and examination in newborn nurseries, prevention of body temperature drop shortly after delivery, and pre-operative and post-operative intensive care in neonatal surgery. The incubator is provided with a function to control the infant's skin temperature.

Environment of Use: Hospitals, delivery suites, NICU

Product codes

FMZ

Device Description

The Neo-Servo i Atom Infant Incubator Model 102 consists of a hood, a main body, a control panel and is offered with or without a stand with casters. The Model 102 incorporates two (2) modes of control: air (manual control) and baby (servo control).

The Model 102 incorporates the sensors (humidity and temperature) inside the hood monitor the air conditions inside the hood. These are connected to the Sensor module. It is equipped with an incubator air temperature control function to circulate air containing the heat generated by the heater attached to the conditioning chamber inside the hood by means of a fan in order to maintain the incubator air temperature at a fixed level. It is equipped with a skim temperature control function to maintain the infant's skin temperature at a fixed level in response to the patient's temperature as measured by the skin probe. There are optional humidity chamber and x-ray cassette tray.

There are 2 functional modes:

  • Skin temperature control mode referred to as "Servo Control Mode" 1.
  • Air temperature control mode referred to as "Manual Control Mode" 2.

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

newborns and premature neonates, Infant and neonates ≤ 10 kg

Intended User / Care Setting

Hospitals, delivery suites, NICU

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)

Performance testing has been performed according to recognized standards and the proposed device met and passed all testing criteria.

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

Not Found

Predicate Device(s)

Atom Model V-2200 – K061856

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 880.5400 Neonatal incubator.

(a)
Identification. A neonatal incubator is a device consisting of a rigid boxlike enclosure in which an infant may be kept in a controlled environment for medical care. The device may include an AC-powered heater, a fan to circulate the warmed air, a container for water to add humidity, a control valve through which oxygen may be added, and access ports for nursing care.(b)
Classification. Class II (performance standards).

0

Premarket Notification 510(k) Section 5 - 510(k) Summary

Neo-Servo i

DEC 2 2 2010

510(k) Summary Page 1 of 4 17-Sept-10

Atom Medical Corporation 3-18-15, Hongo, Bunkyo-ku Tel - 011-81-3-3815-3632

Tokyo, Japan 113-0033

Tokyo, Japan 113-0033Fax – 011-81-3-3812-3199
Official Contact:Tsuyoshi Sugino – Regulatory Affairs Manager
Proprietary or Trade Name:Neo-Servo i Atom Infant Incubator Model 102
Common/Usual Name:Neonatal Incubator
Classification Name/Code:FMZ – neonatal incubator
CFR 880.5400
Device:Neo-Servo i Atom Infant Incubator Model 102
Predicate Devices:Atom Model V-2200 – K061856

Device Description:

The Neo-Servo i Atom Infant incubator Model 102 consists of a hood, a main body, a control panel and is offered with or without a stand with casters. The Model 102 incorporates two (2) modes of control: air (manual control) and baby (servo control).

The Model 102 incorporates the sensors (humidity and temperature) inside the hood monitor the air conditions inside the hood. These are connected to the Sensor module. It is equipped with an incubator air temperature control function to circulate air containing the heat generated b the heater attached to the conditioning chamber inside the hood by means of a fan in order to maintain the incubator air temperature at a fixed level. It is equipped with a skim temperature control function o maintain the infant's skin temperature at a fixed level in response to the patient's temperature as measured by the skin probe. There are optional humidity chamber and x-ray cassette tray.

There are 2 functional modes:

  • Skin temperature control mode referred to as "Servo Control Mode" 1.
  • Air temperature control mode referred to as "Manual Control Mode" 2.

Indications for Use:

The Neo-Servo i Atom Infant Incubator Model 102 is a closed-type incubator for newborns and premature neonates. It is mainly intended for temperature control in neonatal hypothermia, observation and examination in newborn nurseries, prevention of body temperature drop shortly after delivery, and pre-operative and post-operative intensive care in neonatal surgery. The incubator is provided with a function to control the infant's skin temperature.

Environment of Use: Hospitals, delivery suites, NICU

1

510(k) Summary Page 2 of 4

17-Sept-10

·

Summary of substantial equivalence

ProposedPredicate
Neo-Servo iK061856
Atom Infant Incubator Model 102Atom V-2200 Infant Incubator
Indications for UseThe Neo-Servo i Incubator Model 102
is a closed-type incubator for newborns
and premature neonates. It is mainly
intended for temperature control in
neonatal hypothermia, observation and
examination in newborn nurseries,
prevention of body temperature drop
shortly after delivery, and pre-operative
and post-operative intensive care in
neonatal surgery. The incubator is
provided with a function to control the
infant's skin temperature.The V-2200 infant incubator is intended
to keep premature neonates or infants in
a warm environment which is covered
by a hood and isolated from ambient air
and of which internal air temperature
and humidity, are controlled.
Environment of useHospital, delivery suites, NICU
Not for transportHospital, delivery suites, NICU
Not for transport
Patient PopulationInfant and neonates ≤ 10 kgInfant and neonates ≤ 10 kg
Features and Performance Characteristics
Overall dimensionsWith HL stand
100(D) x 60(W) x 138-158(H) cm
Mattress - 65(W) x 36.5(D) x 2(T) cm
Adjustable height of 86 - 106 cm from
the floor to the mattress topWith HL stand
109 (D) x 61(W) x 133-153(H) cm
Mattress - 74(W) x 36(D) x 2(T) cm
Weight90 kg107.5 kg
Major componentsHood
Main body
Control unitHood
Main body
Control unit
PowerAC 120VAC 120 V
Operating conditionsAmbient - 20-30 °C
RH - 30-75%Ambient - 20-30 °C
RH - 30-75%
Storing conditionsAmbient - 0-50 °C
RH - 30-75%Ambient - 0-50 °C
RH - 30-75%
Maximum load capacityIV Pole ~ 10 kg
Drawer ~ 3kgIV Pole ~ 5kg
Drawer ~ 5kg
MF Rail ~ 10kg
ProposedPredicate
Neo-Servo iK061856
Atom Infant Incubator Model 102Atom V-2200 Infant Incubator
Features and Performance Characteristics (continued)
Accessories / optional
componentsSkin Temperature Probe
Electrostatic Air filter
Access port covers
X-ray cassette tray (optional)
Humidifier chamber (optional)Skin Temperature Probe
Electrostatic Air filter
Access port covers
X-ray cassette tray (optional)
Humidifier chamber (optional)
Optional only on V-2200
Pulse oximeter
Oxygen sensor
Control modesManual and ServoManual and Servo
Skin Temperature Setting
RangeServo
34 - 37.5 °C
(override mode 37.6 - 38.0 °C)Servo
34 - 37.5 °C
(override mode 37.6 - 38.0 °C)
Incubator air temperature23 - 39 °C (including override)23 - 39 °C (including override)
Display rangeSkin - 30.0 - 42 °C
Accuracy - ± 0.3 °C
Air - 20.0 - 42.0°C
Accuracy - ± 0.3 °CSkin - 30.0 - 42 °C
Accuracy - ± 0.3 °C
Air - 20.0 - 42.0°C
Accuracy - ± 0.3 °C
Heater output0 - 100% in 10 increments0 - 100% in 10 increments
Warm-up time≤ 60 min @ 25°C≤ 60 min @ 25°C
AlarmsHigh temperature
Set temperature
Skin temperatureHigh temperature
Set temperature
Skin temperature
HumidityIn Servo modeIn Servo mode
Humidity setting range40 - 95% RH40 - 95% RH
Humidity display15 - 99% RH15 - 99% RH
Continuous humidity~ 8 hours~ 8 hrs
AlarmsHumidity sensor
Low water level
No water
Humidity chamber off
Set humidityHumidity sensor
No water
Humidity chamber off
Set humidity
Oxygen supplyMaximum concentration ≥ 65% @ 10
LpmMaximum concentration ≥ 65% @ 10
Lpm
Environment CO2
concentration in the hood