K Number
K111542
Date Cleared
2011-10-20

(140 days)

Product Code
Regulation Number
870.2100
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The CardioQ-EDM cardiac function and fluid status monitoring system is designed to provide clinicians with real-time information about a patient's left ventricular blood flow and key hemodynamic parameters. The CardioQ-EDM's beat-to-beat data on cardiovascular status can be used by the managing clinician to evaluate and optimize hemodynamic performance in anesthetized, sedated or conscious sedated patients in the operating room, intensive care unit, emergency room or ward.

Device Description

The CardioQ-EDM system employs esophageal Doppler techniques using 4 MHz continuous thoracic aorta, displaying this data as a maximum velocity curve, a descriting there is derived measurements. Thus, real-time information about verouty opesant in particular left ventricular flow, is displayed continuously. This is the same as for the predicate CardioQ K031706. CardioQ-EDM is an enhancement of the CardioQ K031706; obsolete The components have been replaced and an improved/modernized user interface created, by utilizing the full capabilities of the new components.

AI/ML Overview

The provided text describes a 510(k) premarket notification for the Deltex Medical CardioQ-EDM Esophageal Doppler Monitor, aiming to demonstrate substantial equivalence to a predicate device (Deltex Medical CardioQ - K031706). Since it's a 510(k) submission, the "acceptance criteria" are implied by comparing the new device's performance to the legally marketed predicate device, rather than explicit numerical thresholds typically seen in AI/ML performance studies. The study described is a comparative bench study.

Here's the breakdown of the information requested based on the provided text, recognizing that it's a medical device submission focused on substantial equivalence rather than AI/ML performance:


1. Table of Acceptance Criteria and Reported Device Performance

For a 510(k) submission, acceptance criteria are generally to demonstrate that the new device (CardioQ-EDM) performs as safely and effectively as the predicate device (CardioQ K031706). The "reported device performance" is the conclusion of the bench testing that substantial equivalence was achieved. Specific numerical acceptance criteria are not explicitly stated for individual device parameters, but rather the overall conclusion of comparable performance across all listed characteristics.

Feature/ParameterAcceptance Criteria (Implied - substantial equivalence to predicate)Reported Device Performance (CardioQ-EDM)
Indications for UseSame as predicate (with minor textural updates)Same as predicate
Patient PopulationSame as predicateSame as predicate
Patient StatusSame as predicateSame as predicate
Insertion RouteOral or NasalOral or Nasal (predicate was Oral, Nasal added later)
ContraindicationsSame as predicateSame as predicate
System DesignSame as predicateSame as predicate
System ComponentsFunctionally equivalent/improved as predicateUpdated components, modernized user interface
Mode of OperationSame as predicateSame as predicate
Ultrasonic Clutter RejectionSame as predicateSame as predicate
Spectral DisplaySame as predicateSame as predicate
Velocity Spectrum Display Time Range (x-axis)Performance comparable to predicateFull screen: 4.3 seconds (Predicate: 3.6 sec) Split screen: 1.4 seconds (Predicate: 1.4 sec)
Velocity Display Scales (y-axis)Performance comparable to predicate50, 100, 200 cm/s, 250 cm/s (Predicate: 50, 100, 200 cm/s)
Doppler Audio ConfirmationSame as predicateSame as predicate
DisplayPerformance comparable to predicateColor 10.4" TFT LCD screen (800 x 600 pixels) (Predicate: 640 x 480 pixels)
Ranges of Directly Measured ParametersComparable to or improved from predicatePeak Velocity (PV) 10 - 250 cm/s (Predicate: 10 - 220 cm/s) Other parameters same range
Ranges of Calculated ParametersSame as predicateSame as predicate
Operating ModesSame as predicateSame as predicate
Controls & User InterfacePerformance and functionality comparable to predicateSimilar controls with updated implementation
Parameters DisplayedPerformance comparable to predicate, with potential for improvement/increase of displayed parametersEight of listed parameters displayed (Predicate: Six)
Parameters Update RateSame as predicateSame as predicate
Trend HistoryPerformance comparable to or improved from predicateUp to 240 hours/Unlimited (Predicate: Up to 48 hours)
Trend Temporal ResolutionSame as predicateSame as predicate
Acoustic OutputCompliance with NEMA UD 2Compliant with NEMA UD 2
Electrical Safety & EMCCompliance with IEC 60601 seriesCompliant with IEC 60601 series
Overall PerformanceSubstantially equivalent to predicateSubstantially equivalent performance achieved

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

  • Sample Size for Test Set: This was a bench testing study, therefore there is no "patient test set" in the traditional sense. The comparison was between the physical device (CardioQ-EDM) and the predicate device (CardioQ K031706) within a laboratory/bench environment. The text does not specify a "sample size" of individual tests or measurements, but rather refers to "Comparative bench testing of the CardioQ-EDM... using a CardioQ..."
  • Data Provenance: The study was conducted by Deltex Medical Limited, based in the United Kingdom. The data is from bench testing, implicitly a prospective assessment of the new device's engineering and performance characteristics against the predicate's known specifications and performance.

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

  • Not applicable. For this type of device (a diagnostic/monitoring tool) and study (bench testing for substantial equivalence), "expert ground truth" as understood in clinical evaluation or AI/ML performance is not relevant. The "ground truth" for the bench testing would be the engineering specifications and validated performance characteristics of the predicate device, against which the new device's measurements and functionalities were compared. This would be established by experts in device design, testing, and regulatory compliance, but not in the sense of clinical annotation.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

  • None. This concept is not applicable to bench testing where objective measurements and engineering specifications are compared. Discrepancies would be resolved through engineering re-evaluation or re-testing, not through a consensus-based adjudication of clinical observations.

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, an MRMC study was NOT done. This submission is for a medical device (Esophageal Doppler Monitor), not an AI/ML diagnostic tool. Therefore, the concept of "human readers improve with AI vs without AI assistance" is not relevant. The device measures physiological parameters, and its performance is assessed against directly measured physical quantities or established specifications.

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

  • Not applicable in the context of AI/ML algorithms. The CardioQ-EDM is a standalone medical device that provides direct measurements and calculated parameters. Its "standalone performance" refers to its ability to accurately measure and compute these physiological metrics as designed, compared to the predicate device. It's not an AI algorithm that processes data to generate a finding that a human then interprets or acts upon.

7. The type of ground truth used (expert concensus, pathology, outcomes data, etc)

  • The "ground truth" for the bench testing was primarily the engineering specifications and established performance characteristics of the predicate device (CardioQ K031706), along with compliance with recognized consensus standards (IEC 60601 series for electrical safety/EMC, NEMA UD 2 for acoustic output). The goal was to show that the new device met or exceeded these, demonstrating substantial equivalence.

8. The sample size for the training set

  • Not applicable. This submission is for a medical device that does not use machine learning algorithms, thus there is no "training set."

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

  • Not applicable. As there is no training set, there is no ground truth established for it.

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OCT 2 0 2011

$\frac{1}{7}$

Deltex Medical Limited: Premarket Notification for CardioQ-EDM Esophageal Doppler Monitor

510(k) Summary 1.1.6

Deltex Medical Limited Terminus Road Chichester West Sussex, PO19 8TX, United Kingdom Telephone: +44 1243 774837 Fax: +44 1243 532534

Image /page/0/Picture/5 description: The image shows the words "DELTEX MEDICAL" stacked on top of each other. To the left of the words is a black and white graphic that looks like a wave. The words are in all caps and are a simple font.

510(k) Summary

(as required by 21 CFR 807.92 (c))

Owner's Name:

Deltex Medical Terminus Road Chichester West Sussex PO19 8TX United Kingdom 011 44 1243 523174 Tel: 011 44 1243 532534 Fax:

Date Summary Prepared:

May 18, 2011

Classification:

The FDA has classified: Cardiovascular Blood Flowmeter (21 CFR 870.2100 Product ProCode DPW),

Extravascular Blood Flow Probe (21 CFR 870.2120, ProCode DPT),

Patient transducer and electrode cable (including connector) (21 CFR 870.2900, ProCode DSA) as a Class II Medical Device.

Common/Usual Name:

Esophaqeal Doppler Monitor

Proprietary Name:

Deltex Medical CardioQ-EDM

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11 15 4/2 .2/7

Predicate Devices used to Demonstrate Substantial Equivalence:

Deltex Medical CardioQ - K031706

Description, including Intended Use:

The CardioQ-EDM system employs esophageal Doppler techniques using 4 MHz .ne caraloQ 2D. 0)-----------------------------------------------------------------------------------------------------------------------------------------------------------continuous thoracic aorta, displaying this data as a maximum velocity curve, a descriting there is derived measurements. Thus, real-time information about verouty opesant in particular left ventricular flow, is displayed continuously. This is the same as for the predicate CardioQ K031706.

CardioQ-EDM is an enhancement of the CardioQ K031706; obsolete The components have been replaced and an improved/modernized user interface created, by utilizing the full capabilities of the new components.

PREDICATE DEVICE COMPARISON-GENERAL SYSTEM DESCRIPTION
Deltex CardioQ-EDMDeltex CardioQ, K031706
Indications for useThe CardioQ-EDM cardiacfunction and fluid statusmonitoring system isdesigned to provideclinicians with real-timeinformation about apatient's left ventricularblood flow and keyhemodynamic parameters.The CardioQ-EDM's beat-to-beat data on cardiovascularstatus can be used by themanaging clinician toevaluate and optimizehemodynamic performancein anesthetized, sedated orconscious patients in theoperating room, intensivecare unit, emergency roomor wardsame,but with minor texturalupdates, see section 1.3
Patient populationFor use in patients59″ (149 cm) or tallersame
Patient statusAnesthetized/sedatedpatients/awakesame
Insertion routeOral or NasalOral in K031706Nasal use probes addedlater in K052989
PREDICATE DEVICE COMPARISON-GENERAL SYSTEM DESCRIPTION
Deltex CardioQ-EDMDeltex CardioQ, K031706
ContraindicationsIntra-aortic balloonpumpingsame
Severe coarctation of theaortasame
Pharyngo-esophago-gastricpathologysame
Severe bleeding diathesessame
System designEsophageal probe transmitsand receives 4 MHzContinuous Wave Doppler(CWD) ultrasound tomeasure blood flowvelocities in the descendingthoracic aortasame
Signals are returned via thePatient Interface Cable(PIC) to CardioQ-EDMMonitorsame
CardioQ-EDM Monitorprocesses the signal anddisplays it as real-timespectrum, to show thedistribution of red blood cellvelocities over the entirecardiac cyclesame
Maximum velocity envelopeis continuously delineatedand used to calculatevelocity-integral of thewaveform during systolesame
Patient age, weight & heightused with velocity-integralto provide volumetric flowdata, including cardiacoutput, from 'nomogram'calculationsame
System ComponentsCardioQ-EDM MonitorComponents updated
Power cordsame
PREDICATE DEVICE COMPARISON-GENERAL SYSTEM DESCRIPTION
Deltex CardioQ-EDMDeltex CardioQ, K031706
Patient Interface Cableno probe includedsameprobe included
Mode of operationContinuoussame
Ultrasonic clutter rejection450 Hz & 900 Hz high-pass filterssame
Spectral Display512 point. Fast Fourier TransformTemporal resolution 6 mssame
Velocity spectrum display time range (x-axis)Full screen: 4.3 secondsSplit screen: 1.4 secondsFull screen: 3.6 secondsSplit screen: 1.4 seconds
Velocity display scales (y-axis)50, 100, 200 cm/s250 cm/ssamenot available
Doppler audio confirmationYessame
DisplayColor 10.4" TFT LCD screen(800 x 600 pixels) SVGAsame,but (640 x 480 pixels)
Ranges of directly measured parametersPeak Velocity (PV) 10 - 250 cm/sHeart Rate (HR) 20 - 360 bpmFlow time (systolic) (FT)* 42 - 1500 msFlow time to peak (FTp) 6 - 750 msStroke Distance (SD) 0.2 - 165 cmMean Acceleration (MA) 0.1 - 366 m/s2*not displayed (see FTc below)Peak Velocity (PV) 10 - 220 cm/ssamesamesamesamesame
Ranges of calculated parametersStroke Volume (SV) 0 - 999 mlCardiac Output (CO) 0 - 99.9 L/minsamesame
PREDICATE DEVICE COMPARISON-GENERAL SYSTEM DESCRIPTION
Deltex CardioQ-EDMDeltex CardioQ, K031706
Corrected Flow Time (FTc)24 - 999 mssame
Minute Distance (MD)4 - 59400 cmsame
Cardiac Index (CI)0 - 99.9 L/min/m²same
Stroke Volume Index (SVI)0 - 99.9 L/m²same
Systemic VascularResistance (SVR)0 - 9999 dyne.sec/cm-5same
Systemic VascularResistance Index (SVRI)0 - 999 dyne.sec/cm-5same
Operating modesPatient Data entrysame
Probe Focussame
Run Modesame
Controls & user interfaceControl knob (functiondependent on screen)same
Audio volume knob6 'soft' buttons (functiondependent on screen)same
Parameters displayedEight of the following canbe displayed above thespectral display (access toall with split screen):Six of the following can bedisplayed above thespectral display (access toall with split screen):
Peak Velocity (PV)same
Heart Rate (HR)same
Stroke Distance (SD)Mean Acceleration (MA)Stroke Volume (SV)Cardiac Output (CO)Minute Distance (MD)Corrected Flow Time (FTc)Flow Time to peak (FTp)Cardiac Index (CI)Stroke Volume Index (SVI)samesamesamesamesamesamesamesamesame
PREDICATE DEVICE COMPARISON-GENERAL SYSTEM DESCRIPTION
Deltex CardioQ-EDMDeltex CardioQ, K031706
Systemic VascularResistance (SVR)same
Systemic VascularResistance Index (SVRI)same
Parameters update rateEvery 1 to 20 heart beatssame
Trend historyUp to 240 hours/UnlimitedUp to 48 hours
Trend temporalresolution30 secondssame
AccessoriesRoll StandCardioQ Pole ClampCardioQ Probe Holder
Roll Stand Interface KitScreenshot Utility Package
Probes and Probeaccessories:
Deltex Medical 240 HourEsophageal Doppler Probe(DP240)Deltex Medical 6 hourEsophageal Doppler Probe(I₂S)Deltex Medical 24 hourEsophageal Doppler Probe(I₂P)Deltex Medical 72 hourEsophageal Doppler Probe(I₂C)

Technology Characteristics Compared to Predicate Devices:

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K111542 3/7

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111542 4/7

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111542 6/7

Summary of Clinical and Non-Clinical Data:

Electrical safety and Electromagnetic Compatibility:

Testing has been conducted following IEC 60601 series of standards, which are FDA recognized voluntary consensus standards.

Acoustic Output Testing:

.

Testing has been conducted following NEMA UD 2, which is a recognized voluntary consensus standard.

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KH1542 7/7

Bench Testing:

Comparative bench testing of the CardioQ-EDM Cardiac Function and Fluid Status Monitoring System, using a CardioQ Cardiac Output and Fluid Status Monitoring System K031706, is included. This concludes that the two systems have substantially equivalent performance.

Animal Testing:

No animal testing is included.

Clinical Testing:

No clinical testing is included

Conclusion:

From a review of the non-clinical and clinical data, Deltex Medical Limited concludes that the CardioQ EDM is substantially equivalent in terms of safety, effectiveness and performance to the predicate device.

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Image /page/7/Picture/0 description: The image shows the logo for the Department of Health & Human Services USA. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" written around the perimeter. Inside the circle is an abstract image of an eagle or bird-like figure. The image is black and white.

DEPARTMENT OF HEALTH & HUMAN SERVICES

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

OCT 2 0 2011

Deltex Medical Ltd c/o Lawrence Brookfield Regulatory Affairs Manager Terminus Road Chichester West Sussex, PO19 8TX, United Kingdom

Re: K111542 Trade/Device Name: CardioQ-EDM Esophageal Doppler Monitor Regulation Number: 21 CFR 870.2100 Regulation Name: Cardiovascular Blood Flowmeter Regulatory Class: Class II (two) Product Code: DPW, DPT, DSA Dated: September 19, 2011 Received: September 20, 2011

Dear Mr. Brookfield:

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. Brookfield

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,

(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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1.1.5 Indications for Use Statement

Indications for Use

K 111542 510(k) Number (if known):

Device Name:

CardioQ-EDM

Indications For Use:

The CardioQ-EDM cardiac function and fluid status monitoring system is designed to provide clinicians with real-time information about a patient's left ventricular blood flow and key hemodynamic parameters. The CardioQ-EDM's beat-to-beat data on cardiovascular status can be used by the managing clinician to evaluate and optimize hemodynamic performance in anesthetized, sedated or conscious sedated patients in the operating room, intensive care unit, emergency room or ward.

Prescription Use _ X__________________________________________________________________________________________________________________________________________________________

(Part 21 CFR 801 Subpart D)

(21 CFR 801 Subpart C)

Over-The-Counter Use

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

AND/OR

Concurrence of CDRH, Office of Device Evaluation (ODE)

(Division Sign-Off)
Division of Cardiovascular Devices

Page 1 of 1 510(k) Number K111542

Page 25 of 160

§ 870.2100 Cardiovascular blood flowmeter.

(a)
Identification. A cardiovascular blood flowmeter is a device that is connected to a flow transducer that energizes the transducer and processes and displays the blood flow signal.(b)
Classification. Class II (performance standards).