K Number
K102824
Manufacturer
Date Cleared
2011-01-28

(121 days)

Product Code
Regulation Number
868.5915
Panel
AN
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Ambu® Oval Silicone resuscitator is intended for manual pulmonary resuscitation and emergency respiratory support.For use by CPR-trained personnel only, in hospital and pre-hospital settings.

The Ambu Oval Silicone resuscitator is reusable. The range of application for the sizes are:

Adult: Adults and children with a body weight of more than approx. 30 kg (66 lbs.). Paediatric: Infants and children with a body weight between approx. 10-30 kg (22~66 lbs.)

Device Description

Ambu Oval Resuscitators is for manual pulmonary resuscitation and emergency respiratory support. Ambu Oval Resuscitators are in two sizes; Adult & Pediatric. It is a reusable product.

The product consists of a resuscitator bag, inlet valve and outlet valve. Oxygen reservoirs can be mounted to the inlet valve.

Facemask, Endotracheal Tube or similar device is connected to the resuscitator patient valve to ensure contact to the patient's airway.

The inlet valve allows ambient air with or without supplementary oxygen to flow into the bag and prevents air flowing backwards from the bag through the inlet valve during ventilation.

When the resuscitator bag is compressed air is delivered via the patient valve to the patient. The bag is made of a self-expanding material, which ensures the bag to have sufficient compression and recoiling properties.

Pressure limiting valve (40 cmH2O) with an override mechanism is placed in patient valve housing. On Pediatric resuscitators there are always a Pressure limiting valve and on Adult resuscitators there are product types available with and without Pressure limiting valve.

Ambu Ova! Resuscitator complies with ISO 10651-4: Particular requirements for operator powered resuscitators.

Ambu Oval Resuscitators have the following physical and performance characteristics:

  • Provided in two sizes: Adult & Pediatric .
  • -Reusable
  • 22 mm (outside) / 15 mm (inside) Patient Connector -
  • 30 mm Expiratory Connector -
  • Resuscitator Volume: Pediatric: 635 ml Adult: 1475 ml .
  • Stoke Volume one hand: Pediatric: 450 ml Adult: 700 ml ・
  • Stroke Volume two hands: Pediatric: NA Adult: 1475 ml -
  • Can be used with ambient air and/or supplementary oxygen.
  • : Pressure Limiting Valve: 40 cmH2O / 4.0 kPa, and port for attachment of manometer
AI/ML Overview

The Ambu® Oval Silicone Resuscitator's acceptance criteria and the study proving its compliance are described below. The device is a manual resuscitator for pulmonary resuscitation and emergency respiratory support, available in adult and pediatric sizes.

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria for the Ambu® Oval Silicone Resuscitator are primarily based on conformance to recognized consensus standards and performance characteristics comparable to legally marketed predicate devices.

Acceptance Criteria CategorySpecific Criteria/StandardReported Device Performance
Regulatory ComplianceDeclaration of conformity to ISO 10651-4Complies
Declaration of conformity to ISO 5356-1Complies
BiocompatibilityConformance to ISO 10993-1 (cytotoxicity, sensitization, intracutaneous reactivity)Complies with requirements of ISO 10993-1 (Cytotoxicity, Sensitization, Intracutaneous reactivity tests performed)
Cleaning/SterilizationAutomated Cleaning Validation (per AAMI TIR 12 and TIR 30)Data submitted demonstrated compliance
Steam Sterilization Validation (per AAMI TIR 12 and TIR 30)Data submitted demonstrated compliance
Physical CharacteristicsProvided in two sizesAdult & Pediatric sizes provided
Patient Connector (22mm outside/15mm inside)22 mm (outside) / 15 mm (inside) Patient Connector
Expiratory Connector (30mm)30 mm Expiratory Connector
Performance CharacteristicsResuscitator VolumePediatric: 635 ml; Adult: 1475 ml
Stroke Volume (one hand)Pediatric: 450 ml; Adult: 700 ml
Stroke Volume (two hands)Pediatric: NA; Adult: 1475 ml
Usability with ambient air and/or supplementary oxygenCan be used with ambient air and/or supplementary oxygen
Pressure Limiting Valve40 cmH2O / 4.0 kPa, and port for attachment of manometer
Substantial EquivalenceEquivalence to listed predicate devices for intended use, operation, and technological characteristicsConcluded to be substantially equivalent to K910040, K053140 (Adult) and K914187, K053142 (Pediatric)

2. Sample size used for the test set and the data provenance

The provided 510(k) summary does not specify the exact sample sizes used for each individual test (e.g., biocompatibility testing involved multiple tests as listed but the number of samples tested for each is not detailed). The testing falls under bench testing, meaning the data provenance is from laboratory tests of the device itself rather than patient data. Therefore, there is no information on country of origin for patient data or whether it was retrospective or prospective, as no clinical data was used.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

This information is not applicable as the device's acceptance criteria and performance data are based on bench testing against recognized standards and comparative characteristics of predicate devices, not on expert-established ground truth from clinical cases. There were no experts involved in establishing ground truth for a "test set" in the context of clinical or diagnostic performance. Expertise would have been involved in the design and execution of the bench tests and the interpretation of results against engineering and biological safety standards, but these individuals are not described as "experts" used to establish a ground truth for a test set in the way one would for an AI diagnostic device.

4. Adjudication method for the test set

This information is not applicable as the determination of whether the device meets acceptance criteria is based on objective measurements and compliance with established standards during bench testing, not on adjudicated clinical outcomes or interpretations.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

No MRMC comparative effectiveness study was done. The 510(k) summary explicitly states: "No clinical tests are performed." This device is a manual resuscitator, not an AI-assisted diagnostic tool, so the concept of human readers improving with or without AI assistance is irrelevant here.

6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done

Not applicable. This device is a manual resuscitator, a physical medical device operated by CPR-trained personnel, not an algorithm. Therefore, "standalone algorithm performance" is not a relevant concept for this product.

7. The type of ground truth used

The "ground truth" for this device's performance is established through conformance to recognized consensus standards (ISO 10651-4, ISO 5356-1, ISO 10993-1, AAMI TIR 12, AAMI TIR 30) and the measured physical and performance characteristics of the device, which are then compared to those of legally marketed predicate devices. This is a form of benchmarking and standard compliance.

8. The sample size for the training set

Not applicable. A "training set" typically refers to data used to train machine learning models. As this is a physical medical device without AI components, there is no training set in this context.

9. How the ground truth for the training set was established

Not applicable for the reasons stated in point 8.

§ 868.5915 Manual emergency ventilator.

(a)
Identification. A manual emergency ventilator is a device, usually incorporating a bag and valve, intended to provide emergency respiratory support by means of a face mask or a tube inserted into a patient's airway.(b)
Classification. Class II (performance standards).