K Number
K103345
Device Name
BREATHE TECHNOLOGIES VENTILATOR AND ACCESSORIES (BT-V2S)
Date Cleared
2011-02-11

(88 days)

Product Code
Regulation Number
868.5895
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Breathe Technologies™ Ventilator, with accessories, is a volume assist ventilator intended to aid adult patients with respiratory insufficiency. It is designed for patients who are capable of spontaneously breathing a minimum tidal volume of 3.5cc/kg of predicted body weight. The device is designed for continuous applications such as patient ambulation, physical therapy, occupational therapy, respiratory therapy, and other rehabilitation efforts in an institutional or home care environment. The device is intended for operation by trained personnel, patients, or caregivers under the direction of a physician.
Device Description
The Breathe Technologies Ventilator with Accessories (BT-V2S) is a small, wearable, ventilator that interfaces with proprietary nasal and tracheostomy breathing circuits.
More Information

Not Found

No
The summary does not mention AI, ML, or any related concepts like neural networks, deep learning, or algorithms that adapt over time. The performance studies focus on compliance with existing standards and human factors, not on the performance of an AI/ML model.

Yes
The device is a ventilator intended to aid patients with respiratory insufficiency, which directly treats a medical condition.

No

The device is described as a ventilator intended to aid patients with respiratory insufficiency, which is a therapeutic function, not a diagnostic one. Its purpose is to deliver air to patients, not to diagnose a condition.

No

The device description explicitly states it is a "small, wearable, ventilator that interfaces with proprietary nasal and tracheostomy breathing circuits," indicating it is a physical hardware device with accessories, not solely software.

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

Here's why:

  • Intended Use: The intended use clearly states that the device is a ventilator intended to aid adult patients with respiratory insufficiency. This is a life-support device that directly interacts with the patient's respiratory system.
  • Device Description: The description confirms it's a "small, wearable, ventilator."
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens derived from the human body (like blood, urine, tissue, etc.) to provide information for diagnosis, monitoring, or screening. IVDs are used in vitro (outside the body). This device is used in vivo (on the patient).

Therefore, the Breathe Technologies Ventilator is a medical device, but it falls under the category of a ventilator, not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The Breathe Technologies™ Ventilator, with accessories, is a volume assist ventilator intended to aid adult patients with respiratory insufficiency. It is designed for patients who are capable of spontaneously breathing a minimum tidal volume of 3.5cc/kg of predicted body weight. The device is designed for continuous applications such as patient ambulation, physical therapy, occupational therapy, respiratory therapy, and other rehabilitation efforts in an institutional or home care environment. The device is intended for operation by trained personnel, patients, or caregivers under the direction of a physician.

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

ONZ

Device Description

The Breathe Technologies Ventilator with Accessories (BT-V2S) is a small, wearable, ventilator that interfaces with proprietary nasal and tracheostomy breathing circuits.

This application is being filed to clear the use of the BT-V2S in the Home Care Environment. The device is unchanged from the previous cited submissions, except for the layout and workflow of its User Interface, along with the various Instructions for Use necessary to ensure proper use by the patient or lay caregiver.

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 patients

Intended User / Care Setting

trained personnel, patients, or caregivers under the direction of a physician
institutional or home care environment

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 Software Design and Validation process (Section 16) along with the bench testing of the device (Section 18) demonstrated that the BT-V2S operates as intended.

In particular, testing demonstrated that the BT-V2S continues to be compliant with the following Guidelines and Standards:

  • FDA Draft Reviewer Guide for Ventilators (July 1995) .
  • ASTM F1100 90 (1997), Standard Specification for Ventilators Intended for . Use in Critical Care
  • IEC 60601 1 (1988), Amendment 1 (1991-11), Amendment 2 (1995); Medical . electrical equipment - General Requirements for Safety
  • IEC 60601 2- 12 (2001-10): Medical electrical equipment Particular ● requirements for the safety of lung ventilators - Critical care ventilators
  • ASTM F1246-91 (1991, Reapproved 2005); Standard Specification for . Electrically Powered Home Care Ventilators, Part 1 - Positive Pressure Ventilators and Ventilator Circuits

Additionally, three Human Factors Studies (Section 20) demonstrated that the intended users of the Ventilator (trained personnel, patients, or caregivers under the direction of a physician) can properly operate the device. The first study was with clinicians, and the second was with respiratory therapy patients. The third study demonstrated that the changes required in the training, Instructions for Use and User Interface were adequate to address the issues observed in the second study.

The Human Factors testing documented conformance with these external Guidelines/Standards:

FDA Guideline: Medical Device Use-Safety: Incorporating Human Factors Engineering into Risk Management. July 18, 2000

IEC 62366: 2007: Medical devices - Application of usability engineering to medical devices. FDA Recognition Number 5-50.

ANSI/AMEE HE75:2009: Human Factors Engineering-Design of Medical Devices.

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.

K102525

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

§ 868.5895 Continuous ventilator.

(a)
Identification. A continuous ventilator (respirator) is a device intended to mechanically control or assist patient breathing by delivering a predetermined percentage of oxygen in the breathing gas. Adult, pediatric, and neonatal ventilators are included in this generic type of device.(b)
Classification. Class II (performance standards).

0

K103345

Image /page/0/Picture/1 description: The image shows the logo for Breathe Technologies. The word "Breathe" is in large, bold letters on the top line. Below that, in smaller letters, is the word "TECHNOLOGIES". There is a curved line below the word "TECHNOLOGIES".

BT-V2S and Accessories Traditional 510(k): Expanded Indication

Section 5: 510(k) Summary

FEB 1 1 201

Device Information:
CategoryComments
Sponsor:Breathe Technologies
4000 Executive Parkway, Ste. 190
San Ramon, CA 94583
Tel: 925-359-1500
Correspondent Contact
Information:Craig Coombs
President
Coombs Medical Device Consulting, Inc
1193 Sherman St.
Alameda, CA 94501
Office: 510.337.0140
Fax: 510.337.0416
Device Common Name:Mechanical Ventilator
Device Classification & Name:21 CFR 868.5895 Continuous Ventilator
Device Classification &
Product Code:Class II
ONZ
Device Proprietary Name:Ventilator (BT-V2S)

Predicate Device Information:

Predicate Device:Ventilator, BT-V2S
Predicate Device Manufacturer:Breathe Technologies
Predicate Device Premarket Notification #K102525
Predicate Device Common Name:Mechanical Ventilator
Predicate Device Classification & Name:21 CFR 868.5895
Predicate Device Classification &Class II
Product Code:ONZ

b. Date Summary Prepared

11 February 2011

c. Description of Device

The Breathe Technologies Ventilator with Accessories (BT-V2S) is a small, wearable, ventilator that interfaces with proprietary nasal and tracheostomy breathing circuits.

This application is being filed to clear the use of the BT-V2S in the Home Care Environment. The device is unchanged from the previous cited submissions, except for the layout and workflow of its User Interface, along with the various Instructions for Use necessary to ensure proper use by the patient or lay caregiver.

d. Intended Use

The Breathe Technologies™ Ventilator, with accessories, is a volume assist ventilator intended to aid adult patients with respiratory insufficiency. It is designed for patients who are capable of spontaneously

1

Image /page/1/Picture/0 description: The image contains the words "Breathe" and "Technologies" stacked on top of each other. The word "Breathe" is in a larger font than the word "Technologies". There is a curved line underneath the word "Technologies".

breathing a minimum tidal volume of 3.5cc/kg of predicted body weight. The device is designed for continuous applications such as patient ambulation, physical therapy, occupational therapy, respiratory therapy, and other rehabilitation efforts in an institutional or home care environment. The device is intended for operation by trained personnel, patients, or caregivers under the direction of a physician.

e. Comparison to Predicate Device

The Breathe Technologies Ventilator (BT-V2S) is substantially equivalent in Intended Use, Indications for Use, technology, design, and performance to the BT-V2S that was cleared in a previous 510(k) (K102525). The predicate and application ventilators and patient circuits are mechanically identical.

The application BT-V2S's Indication for Home Use is supported by multiple Human Factors studies. These studies demonstrate that the application device works as described in its labeling, and is therefore substantially equivalent to its predicate.

f. Summary of Supporting Data

The Software Design and Validation process (Section 16) along with the bench testing of the device (Section 18) demonstrated that the BT-V2S operates as intended.

In particular, testing demonstrated that the BT-V2S continues to be compliant with the following Guidelines and Standards:

  • FDA Draft Reviewer Guide for Ventilators (July 1995) .
  • ASTM F1100 90 (1997), Standard Specification for Ventilators Intended for . Use in Critical Care
  • IEC 60601 1 (1988), Amendment 1 (1991-11), Amendment 2 (1995); Medical . electrical equipment - General Requirements for Safety
  • IEC 60601 2- 12 (2001-10): Medical electrical equipment Particular ● requirements for the safety of lung ventilators - Critical care ventilators
  • ASTM F1246-91 (1991, Reapproved 2005); Standard Specification for . Electrically Powered Home Care Ventilators, Part 1 - Positive Pressure Ventilators and Ventilator Circuits

Additionally, three Human Factors Studies (Section 20) demonstrated that the intended users of the Ventilator (trained personnel, patients, or caregivers under the direction of a physician) can properly operate the device. The first study was with clinicians, and the second was with respiratory therapy patients. The third study demonstrated that the changes required in the training, Instructions for Use and User Interface were adequate to address the issues observed in the second study.

2

Image /page/2/Picture/1 description: The image shows the word "Breathe" in a bold, sans-serif font. Below "Breathe" is the word "TECHNOLOGIES" in a smaller, sans-serif font. Underneath the words is a curved line that resembles a wave or a stylized breath.

The Human Factors testing documented conformance with these external Guidelines/Standards:

FDA Guideline: Medical Device Use-Safety: Incorporating Human Factors Engineering into Risk Management. July 18, 2000

IEC 62366: 2007: Medical devices - Application of usability engineering to medical devices. FDA Recognition Number 5-50.

ANSI/AMEE HE75:2009: Human Factors Engineering-Design of Medical Devices.

END

3

Image /page/3/Picture/0 description: The image shows the text "DEPARTMENT OF HEALTH & HUMAN SERVICES". The text is in all caps and is black. The background is white. The text is centered in the image.

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

Mr. Joseph Cipillone Vice President Breathe Technologies, Incorporated 4000 Executive Parkway, Suite 190 San Ramon, California 94583

FFB 1 1 201

Re: K103345

Trade/Device Name: Breathe Technologies Ventilator (BT-V2S) with Accessories Regulation Number: 21 CFR 868.5895 Regulation Name: Continuous Ventilator Regulatory Class: II Product Code: ONZ Dated: November 11, 2010 Received: November 15, 2010

Dear Mr. Capillone:

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.

4

Page 2- Mr. Capillone

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.

hh 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

5

Section 4: Indications for Use Statement

510(k) Number (if known):

Breathe Technologies Ventilator (BT-V2S) with Accessories Device Name:

Indications for Use:

The Breathe Technologies™ Ventilator, with accessories, is a volume assist ventilator intended to aid adult patients with respiratory insufficiency. It is designed for patients who are capable of spontaneously breathing a minimum tidal volume of 3.5cc/kg of predicted body weight. The device is designed for continuous applications such as patient ambulation, physical therapy, occupational therapy, respiratory therapy, and other rehabilitation efforts in an institutional or home care environment. The device is intended for operation by trained personnel, patients, or caregivers under the direction of a physician.

Prescription Use × (Part 21 CFR 801 Subpart D) Over-The-Counter Use (21 CFR 807 Subpart C)

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

AND/OR

Concurrence of CDRH, Office of Device Evaluation (ODE)

Page 1 of

L. Achutha

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

510(k) Number: _