K Number
K113657
Device Name
INTELLIVUE PATIENT MONITOR
Date Cleared
2012-03-22

(101 days)

Product Code
Regulation Number
870.1025
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The monitor is indicated for use by healthcare professionals whenever there is a need for monitoring the physiological parameters of patients. The monitor is intended to be used for monitoring and recording of, and to generate alarms, for, multiple physiological parameters of adults, pediatrics, and neonates. The monitor is intended for use by trained healthcare professionals in a hospital environment. The monitor is also intended for use during patient transport inside and outside of the hospital environment. The monitor is only for use on one patient at a time. It is not intended for home use. Not a therapeutic device. The monitor is for prescription use only. The ECG measurement is intended to be used for diagnostic recording of rhythm and detailed morphology of complex cardiac complexes (according to AAMI EC 11). ST segment monitoring is intended for use with adult patients only and is not clinically validated for use with neonatal and pediatric patients. The Predictive Temperature unit is intended for use with adult and pediatric patients in a hospital environment. The SSC Sepsis Protocol, in the ProtocolWatch clinical decision support tool, is intended for use with adult patients only. The derived measurement Pulse Pressure Variation (PPV) is intended for use with sedated patients receiving controlled mechanical ventilation and mainly free from cardiac arrhythmia. The PPV measurement has been validated only for adult patients. The transcutaneous gas measurement (tcGas) is restricted to neonatal patients only. BIS is intended for use under the direct supervision of a licensed health care practitioner or by personnel trained in its proper use. It is intended for use on adult and pediatric patients within a hospital or medical facility providing patient care to monitor the state of the brain by data acquisition of EEG signals. The BIS may be used as an aid in monitoring the effects of certain anesthetic agents. Use of BIS monitoring to help guide anesthetic administration may be associated with the reduction of the incidence of awareness with recall in adults during general anesthesia and sedation.
Device Description
The Philips IntelliVue Patient Monitor family comprises the multi-parameter patient monitor models: MP2, X2, MP5, MP5T, MP5SC, MP20, MP30, MP40, MP50, MP60, MP70, MP80, MX600, MX700 and MX800 IntelliVue Patient Monitors that consist of display units including built-in or separate flat panel displays and central processing units (CPU) and physiological measurement modules. All monitors share the same system architecture and exactly the same software is executed on each monitor. The IntelliVue Patient Monitors measure multiple physiological parameters such as surface ECG, invasive and non-invasive pressure, etc., generate alarms, record physiological signals, store derived data, and communicate derived data and alarms to central stations via the IntelliVue Clinical Network. The subject modification is enhancement of ProtocolWatch SCC Sepsis protocol by an introduction of configurable thresholds, modification of sepsis criteria and free text fields within the Sepsis Resuscitation Bundle and Sepsis Management Bundle phase of SSC Sepsis protocol. Additionally the software revision J.03 is made available for the entire IntelliVue Patient Monitors family.
More Information

Not Found

No
The document explicitly states "Mentions AI, DNN, or ML: Not Found". The description focuses on standard physiological parameter monitoring and a clinical decision support tool (ProtocolWatch) with configurable thresholds, which does not inherently indicate AI/ML.

No
The "Intended Use / Indications for Use" section explicitly states "Not a therapeutic device."

Yes

Explanation: The device is described as aiding in diagnostic recording and monitoring of various physiological parameters and conditions, such as ECG rhythm and morphology, ST segments, and the state of the brain via EEG signals, which are all used to help diagnose or monitor medical conditions.

No

The device description explicitly states that the Philips IntelliVue Patient Monitor family comprises multi-parameter patient monitor models that consist of display units, central processing units (CPU), and physiological measurement modules, indicating it is a hardware device with integrated software.

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

Here's why:

  • Intended Use: The intended use clearly states that the monitor is for "monitoring the physiological parameters of patients." It measures parameters like ECG, pressure, temperature, etc. These are measurements taken directly from the patient's body, not from a sample of bodily fluid or tissue in vitro (outside the body).
  • Device Description: The description reinforces that the device measures "multiple physiological parameters such as surface ECG, invasive and non-invasive pressure, etc."
  • Lack of IVD Characteristics: There is no mention of analyzing samples of blood, urine, tissue, or other bodily substances. The device's function is focused on real-time physiological monitoring of the patient.

IVD devices are specifically designed to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This patient monitor does not fit that description.

N/A

Intended Use / Indications for Use

The monitor is indicated for use by healthcare professionals whenever there is a need for monitoring the physiological parameters of patients.

The monitor is intended to be used for monitoring and recording of, and to generate alarms, for, multiple physiological parameters of adults, pediatrics, and neonates. The monitor is intended for use by trained healthcare professionals in a hospital environment.

The monitor is also intended for use during patient transport inside and outside of the hospital environment.

The monitor is only for use on one patient at a time. It is not intended for home use. Not a therapeutic device. The monitor is for prescription use only.

The ECG measurement is intended to be used for diagnostic recording of rhythm and detailed morphology of complex cardiac complexes (according to AAMI EC 11).

ST segment monitoring is intended for use with adult patients only and is not clinically validated for use with neonatal and pediatric patients.

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

DSI, MLD, MHX, DSJ, DSK, DXN, DXG, KRB, DRQ, DRT, DPS, MLC, DRW, KRC, DRJ, DQA, DSB, DSH, DSF, DRS, DSA, MSX, DRG, CCK, CBQ, NHO, NHP, NHQ, CBS, CBR, CCL, BZC, BZQ, LKD, KLK, FLL, GWR, GWS

Device Description

The Philips IntelliVue Patient Monitor family comprises the multi-parameter patient monitor models: MP2, X2, MP5, MP5T, MP5SC, MP20, MP30, MP40, MP50, MP60, MP70, MP80, MX600, MX700 and MX800 IntelliVue Patient Monitors that consist of display units including built-in or separate flat panel displays and central processing units (CPU) and physiological measurement modules. All monitors share the same system architecture and exactly the same software is executed on each monitor.
The IntelliVue Patient Monitors measure multiple physiological parameters such as surface ECG, invasive and non-invasive pressure, etc., generate alarms, record physiological signals, store derived data, and communicate derived data and alarms to central stations via the IntelliVue Clinical Network.

The subject modification is enhancement of ProtocolWatch SCC Sepsis protocol by an introduction of configurable thresholds, modification of sepsis criteria and free text fields within the Sepsis Resuscitation Bundle and Sepsis Management Bundle phase of SSC Sepsis protocol.

Additionally the software revision J.03 is made available for the entire IntelliVue Patient Monitors family.

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

adults, pediatrics, and neonates.
ST segment monitoring is intended for use with adult patients only.
The Predictive Temperature unit is intended for use with adult and pediatric patients.
The SSC Sepsis Protocol, in the ProtocolWatch clinical decision support tool, is intended for use with adult patients only.
The derived measurement Pulse Pressure Variation (PPV) ... has been validated only for adult patients.
The transcutaneous gas measurement (tcGas) is restricted to neonatal patients only.
BIS is intended for use on adult and pediatric patients.

Intended User / Care Setting

trained healthcare professionals in a hospital environment.
The monitor is also intended for use during patient transport inside and outside of the hospital environment.
It is not intended for home use. Not a therapeutic device. The monitor is for prescription use only.
BIS is intended for use under the direct supervision of a licensed health care practitioner or by personnel trained in its proper use.

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)

Verification, validation, and testing activities establish the performance, functionality, and reliability characteristics of the modified devices with respect to the predicate. Testing involved system level and as well as testing from the hazard analysis. Pass/Fail criteria were based on the specifications cleared for the predicate devices and test results showed substantial equivalence. The results demonstrate that the Philips IntelliVue patient monitors meet all reliability requirements and performance claims.

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.

K110622, K102562, K101449, K100939, K093268, K091927, K083517, K082633, K081793, K072070, K071426, K063725, K063315, K062283, K062392, K061610, K061052, K060541, K060221, K053522, K052801, K051106, K050762, K050141, K042845, K041235, K040304, K033513, K033444, K032858, K031481, K030038, K023871, K021778

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

§ 870.1025 Arrhythmia detector and alarm (including ST-segment measurement and alarm).

(a)
Identification. The arrhythmia detector and alarm device monitors an electrocardiogram and is designed to produce a visible or audible signal or alarm when atrial or ventricular arrhythmia, such as premature contraction or ventricular fibrillation, occurs.(b)
Classification. Class II (special controls). The guidance document entitled “Class II Special Controls Guidance Document: Arrhythmia Detector and Alarm” will serve as the special control. See § 870.1 for the availability of this guidance document.

0

MAR 2 2 2012

510(k) Summary - K113657

This summary of 510(k) safety and effectiveness information is submitted in accordance with the requirements of the Safe Medical · Devices Act of 1990 and 21 C.F.R. $807.92.

  1. The submitter of this premarket notification is:

Manfred Stever Philips Medizin Systeme Boeblingen GmbH Hewlett-Packard-Str. 2 D-71034 Boeblingen, Germany Tel: ++49 7031 463-2186 Fax: ++49 7031 463-2442 e-mail: manfred.stever@philips.com

This summary was prepared on March 14, 2012.

    1. The names of the devices are the Philips MP2, X2, MP5, MP5T, MP5SC, MP20, MP30, MP40, MP50, MP60, MP70, MP80, MP90, MX600, MX700 and MX800 IntelliVue patient monitors Classification names are as follows:
Device PanelClassificationProCodeDescription
Cardiovascular
Devices$870.1025, IIDSIDetector and alarm, arrhythmia
$870.1025, IIMLDMonitor, ST Segment with Alarm
$870.1025, IIMHXArrhythmia detector and alarm
(including ST-segment
measurement and alarm)
$870.1100, IIDSJAlarm, Blood Pressure
$870.1110, IIDSKComputer, Blood Pressure
$870.1130, IIDXNSystem, Measurement, Blood-
Pressure, Non-Invasive
$870.1435, IIDXGComputer, Diagnostic, Pre-
Programmed, Single-Function
$870.1915, IIKRBProbe, Thermodilution
$870.2060, IIDRQAmplifier and Signal
Conditioner, Transducer Signal
$870.2300, IIDRTMonitor, Cardiac (incl.
Cardiotachometer & Rate Alarm)
$870.2340, IIDPSElectrocardiograph
$870.2340, IIMLCMonitor, ST Segment
$870.2350, IIDRWElectrocardiograph, Lead
Switching Adapter
$870.2370, IIKRCTester, Electrode, Surface,
Electrocardiograph
$870.2600, IDRJSystem, Signal Isolation
$870.2700, IIDQAOximeter
$870.2770, IIDSBPlethysmograph, Impedance
$870.2800, IIDSHRecorder, Magnetic tape,
Medical
$870.2810, IDSFRecorder, Paper Chart
$870.2850, IIDRSExtravascular Blood Pressure
Transducer
Device PanelClassificationProCodeDescription
$870.2900, IDSACable, Transducer and
Electrode, incl. Patient
Connector
-MSXSystem, Network and
Communication, Physiological
Monitors
$870.2910, IIDRGTransmitters and Receivers,
Physiological Signal,
Radiofrequency
Anesthesiology
Devices$868.1400, IICCKAnalyzer, Gas, Carbon Dioxide,
Gaseous-Phase
$868.1500, IICBQAnalyzer, Gas, Enflurane,
Gaseous-Phase (Anesthetic
Concentration)
$868.1500, IINHOAnalyzer, Gas, Desflurane,
Gaseous-Phase (Anesthetic
Concentration)
$868.1500, IINHPAnalyzer, Gas, Sevoflurane,
Gaseous-Phase (Anesthetic
Concentration)
$868.1500, IINHQAnalyzer, Gas, Isoflurane,
Gaseous-Phase (Anesthetic
Concentration)
$868.1620, IICBSAnalyzer, Gas, Halothane,
Gaseous-Phase (Anesthetic
Concentration)
$868.1700, IICBRAnalyzer, Gas, Nitrous Oxide,
Gaseous-Phase (Anesthetic
Concentration)
$868.1720, IICCLAnalyzer, Gas, Oxygen, Gaseous-
Phase
$868.1880, IIBZCData calculator Pulmonary-
function
$868.2375, IIBZQMonitor, Breathing Frequency
$868.2480, IILKDMonitor, Carbon Dioxide,
Cutaneous
$868.2500, IIKLKMonitor, Oxygen, Cutaneous, for
Infant not under Gas Anesthesia
General Hospital
and Personal Use
Devices$880.2910, IIFLLThermometer, Electronic,
Clinical
Neurological
Devices$882.1400, IIGWRElectroencephalograph
$882.1420, IGWSAnalyzer, Spectrum,
Electroencephalogram Signal

1

2

    1. The Philips IntelliVue Patient Monitor family comprises the multi-parameter patient monitor models: MP2, X2, MP5, MP5T, MP5SC, MP20, MP30, MP40, MP50, MP60, MP70, MP80, MX600, MX700 and MX800 IntelliVue Patient Monitors that consist of display units including built-in or separate flat panel displays and central processing units (CPU) and physiological measurement modules. All monitors share the same system architecture and exactly the same software is executed on each monitor.
      The IntelliVue Patient Monitors measure multiple physiological parameters such as surface ECG, invasive and non-invasive pressure, etc., generate alarms, record physiological signals, store derived data, and communicate derived data and alarms to central stations via the IntelliVue Clinical Network.

The subject modification is enhancement of ProtocolWatch SCC Sepsis protocol by an introduction of configurable thresholds, modification of sepsis criteria and free text fields within the Sepsis Resuscitation Bundle and Sepsis Management Bundle phase of SSC Sepsis protocol.

Additionally the software revision J.03 is made available for the entire IntelliVue Patient Monitors family.

    1. The modified devices have the same intended use as the legally marketed predicate devices.

MP2 IntelliVue Patient monitor:

The monitor is indicated for use by healthcare professionals whenever there is a need for monitoring the physiological parameters of patients.

The monitor is intended to be used for monitoring and recording generate alarms, for, multiple oi, and to physiological parameters of adults, pediatrics, and neonates. The monitor is intended for use by trained healthcare professionals in a hospital environment.

The monitor is also intended for use during patient transport inside and outside of the hospital environment.

The monitor is only for use on one patient at a time. It is not intended for home use. Not a therapeutic device. The monitor is for prescription use only.

The ECG measurement is intended to be used for diagnostic recording of rhythm and detailed morphology of complex cardiac complexes (according to AAMI EC 11).

ST segment monitoring is intended for use with adult patients only and is not clinically validated for use with neonatal and pediatric patients.

3

4/6

MP5, MP5T and MP5SC IntelliVue Patient Monitor:

The monitors are indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients.

monitors are intended to be used for monitoring The and generate recording of, and to alarms for, multiple physiological parameters of adults, pediatrics, and neonates. The monitors are intended for use by trained healthcare professionals in a hospital environment.

The MP5, MP5SC and MP5T monitors are also intended for use during patient transport inside the hospital environment; only the MP5 monitor is for use during patient transport outside of the hospital environment. The MP5, MP5SC and MP5T when used with the TRx4841A/TRx4851A IntelliVue

Telemetry System Transceiver or with the IntelliVue Cableless Measurement Devices, are intended for use in a hospital environment and during patient transport inside the hospital environment.

The monitors are only for use on one patient at a time. They are not intended for home use. Not therapeutic devices. The monitors are for prescription use only.

ECG measurement is intended to be used for diagnostic The recording of rhythm and detailed morphology of complex cardiac complexes (according to AAMI EC 11) .

ST segment monitoring is intended for use with adult patients only and is not clinically validated for use with neonatal and pediatric patients.

The Predictive Temperature unit is intended for use with adult and pediatric patients in a hospital environment.

The SSC Sepsis Protocol, in the ProtocolWatch clinical decision support tool, is intended for use with adult patients only.

The derived measurement Pulse Pressure Variation (PPV) i s intended for use with sedated patients receiving controlled mechanical ventilation and mainly free from cardiac arrhythmia. The PPV measurement has been validated only for adult patients.

MP20 - MP90 IntelliVue Patient Monitor:

The monitors are indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients.

The monitors are intended to be used for monitoring and to generate recording of, and alarms for, multiple physiological parameters of adults, pediatrics, and neonates. The monitors are intended for use by trained healthcare professionals in a hospital environment.

The MP20/MP30/MP40/MP50 monitors are additionally intended for use in transport situations within hospital environments.

The monitors are only for use on one patient at a time. They are not intended for home use. Not therapeutic devices. The monitors are for prescription use only.

4

The ECG measurement is intended to be used for diagnostic recording of rhythm and detailed morphology of complex cardiac complexes (according to AAMI EC 11) .

ST segment monitoring is intended for use with adult patients only and is not clinically validated for use with neonatal and pediatric patients.

derived measurement Pulse Pressure Variation (PPV) The is intended for use with sedated patients receiving controlled mechanical ventilation and mainly free from cardiac arrhythmia. The PPV measurement has been validated only for adult patients. The transcutaneous gas measurement (tcGas) is restricted to neonatal patients only.

BIS is intended for use under the direct supervision of a licensed health care practitioner or by personnel trained in its proper use. It is intended for use on adult and pediatric patients within a hospital or medical facility providing patient care to monitor the state of the brain by data acquisition of EEG signals. The BIS may be used as an aid in monitoring the effects of certain anesthetic agents.

Use of BIS monitoring to help guide anesthetic administration may be associated with the reduction of the incidence of awareness with recall in adults during general anesthesia and sedation.

The SSC Sepsis Protocol, in the ProtocolWatch clinical decision support tool, is intended for use with adult patients only.

MX600, MX700 and MX800 IntelliVue Patient Monitor:

The monitors are indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients.

The monitors are intended to be used for monitoring and recording of, and to generate alarms for, multiple physiological parameters of adults, pediatrics, and neonates. The monitors are intended for use by trained healthcare professionals in a hospital environment.

The monitors are only for use on one patient at a time. They are not intended for home use. Not therapeutic devices. The monitors are for prescription use only.

The ECG measurement is intended to be used for diagnostic recording of rhythm and detailed morphology of complex cardiac complexes (according to AAMI EC 11).

ST segment monitoring is intended for use with adult patients only and is not clinically validated for use with neonatal and pediatric patients.

The transcutaneous gas measurement (tcGas) is restricted to neonatal patients only.

BIS is intended for use under the direct supervision of a licensed health care practitioner or by personnel trained in its proper use. It is intended for use on adult and pediatric patients within a hospital or medical facility providing patient care to monitor the state of the brain by data acquisition of EEG signals. The BIS may be used as an aid in monitoring the effects of certain anesthetic agents.

5

6/b

Use of BIS monitoring to help guide anesthetic administration may be associated with the reduction of the incidence of awareness with recall in adults during general anesthesia and sedation.

The SSC Sepsis Protocol, in the ProtocolWatch clinical decision support tool, is intended for use with adult patients only.

The derived measurement Pulse Pressure Variation (PPV) ાં ક intended for use with sedated patients receiving controlled mechanical ventilation and mainly free from cardiac arrhythmia. The PPV measurement has been validated only for adult patients.

X2 Multi-Measurement Module:

The monitor is indicated for use by healthcare professionals whenever there is a need for monitoring the physiological parameters of patients.

The monitor is intended to be used for monitoring and recording of, and to generate alarms, for, multiple physiological parameters of adults, pediatrics, and neonates. The monitor is intended for use by trained healthcare professionals in a hospital environment.

The monitor is also intended for use during patient transport inside and outside of the hospital environment.

The monitor is only for use on one patient at a time. It is not intended for home use. Not a therapeutic device. The monitor is for prescription use only.

The ECG measurement is intended to be used for diagnostic recording of rhythm and detailed morphology of complex cardiac complexes (according to AAMI EC 11).

ST segment monitoring is intended for use with adult patients only and is not clinically validated for use with neonatal and pediatric patients.

    1. The modified devices have the same technological characteristics as the legally marketed predicate device.
    1. Verification, validation, and testing activities establish the performance, functionality, and reliability characteristics of the modified devices with respect to the predicate. Testing involved system level and as well as testing from the hazard analysis. Pass/Fail criteria were based on the specifications cleared for the predicate devices and test results showed substantial equivalence. The results demonstrate that the Philips IntelliVue patient monitors meet all reliability requirements and performance claims.

6

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/6/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of the department's name encircling a symbol. The symbol is a stylized representation of a human figure, with three abstract shapes resembling a person's head, body, and legs. The text reads "DEPARTMENT OF HEALTH & HUMAN SERVICES · USA".

Public Health Service

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

MAR 2 2 2012

Philips Medizin Systeme Böblingen GmbH c/o Mr. Manfred Stever Sr. Regulatory Affairs Engineer Hewlett-Packard-Str. 2 Boeblingen Germany D-71034

Re: K113657

Trade/Device Name: IntelliVue Patient Monitors Model MP2, X2, MP5, MP5, MP5T, MP5SC, MP20, MP30, MP40, MP50, MP60, MP70, MP80, MP90, MX600, MX700 and MX800 Regulation Number: 21 CFR 870.1025

Regulation Name: Arrhythmia detector and alarm (including ST-segment measurement and alarm)

Regulatory Class: Class II (two)

Product Code: MHX. DSI. MLD. DSJ. DSK. DXN. DXG. KRB. DRO. DRT. DPS. MLC. DRW, KRC, DRJ, DQA, DSB, DSH, DSF, DRS, DSA, MSX, DRG, CCK, CBQ, NHO, NHP, NHQ, CBS, CBR, CCL, BZC, BZQ, LDK, KLK, FLL, GWR, GWS. Dated: February 21, 2012

Received: February 23, 2012

Dear Mr. Stever:

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.

7

Page 2 – Mr. Manfred Stever

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 (OS) 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

8

3.1 Indications Statement

Indications for Use MP2

510(k) Number (if known) : (c) | 365 7

Philips MP2 IntelliVue patient monitor, software Device Name: revision J.03.

MP2 IntelliVue Patient monitor:

by The monitor i s indicated for use healthcare professionals whenever there is a need for monitoring the physiological parameters of patients.

The monitor is intended to be used for monitoring and recording of, and to generate alarms, for, multiple physiological parameters of adults, pediatrics, and neonates. The monitor is intended for use by trained healthcare professionals in a hospital environment.

The monitor is also intended for use during patient transport inside and outside of the hospital environment.

The monitor is only for use on one patient at a time. It is not intended for home use. Not a therapeutic device. The monitor is for prescription use only.

The ECG measurement is intended to be used for diagnostic recording rhythm and detailed morphology of complex cardiac of complexes (according to AAMI EC 11) .

ST segment monitoring is intended for use with adult patients only and is not clinically validated for use with neonatal and pediatric patients.

Prescription Use (Part 21 CFR 801 Subpart D)Yes
AND/OR
Over-The-Counter Use (21 CFR 807 Subpart C)No

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

(Division Sign-Off)
Division of Cardiovascular Devices

510(k) Number K113657

9

Indications for Use MP5, MP5T and MP5SC

510 (k) Number (if known) :

Device Name: Philips MP5, MP5T and MP5SC IntelliVue patient monitors, software revision J.03.

MP5, MP5T and MP5SC IntelliVue Patient Monitor:

The monitors are indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients.

monitors are intended to be used for monitoring and recording of, and to The generate alarms for, multiple physiological parameters of adults, pediatrics, and neonates. The monitors are intended for use by trained healthcare professionals in a hospital environment.

The MP5, M25SC and MP5T monitors are also intended for use during patient transport inside the hospital environment; only the MP5 monitor is for use during patient transport outside of the hospital environment. The MP5, MP5SC and MP5T when used with the Trx4841A/TRx4851A IntelliVue Telemetry System Transceiver or with the IntelliVue Cableless Measurement Devices, are intended for use in a hospital environment and during patient transport inside the hospital environment.

The monitors are only for use on one patient at a time. They are not intended for home use. Not therapeutic devices. The monitors are for prescription use only.

The ECG measurement is intended to be used for diagnostic recording of rhythm and detailed morphology of complex cardiac complexes (according to AAMI EC 11)

ST segment monitoring is intended for use with adult patients only and is not clinically validated for use with neonatal and pediatric patients.

The Predictive Temperature unit is intended for use with adult and pediatric patients in a hospital environment.

The SSC Sepsis Protocol, in the ProtocolWatch clinical decision support tool, is intended for use with adult patients only.

The derived measurement Pulse Pressure Variation (PPV) is intended for use with sedated patients receiving controlled mechanical ventilation and mainly free from cardiac arrhythmia. The PPV measurement has been validated only for adult patients.

Prescription Use Over-The-Counter Use Y es No AND/OR (Part 21 CFR 801 Subpart D) (21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

ion of Cardiovascular Devices

510(k) Number K113652

10

..

Indications for Use MP20-90

510(k) Number (if known):

Philips MP20, MP30, MP40, MP50, MP60, MP70, MP80 Device Name: and MP90 IntelliVue patient monitors, software revision J.03.

MP20 - MP90 IntelliVue Patient Monitor:

The monitors are indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients.

The monitors are intended to be used for monitoring and recording of, and to generate alarms for, multiple physiological parameters of adults, pediatrics, and neonates. The monitors are intended for use by trained healthcare professionals in a hospital environment.

The MP20/MP30/MP50 monitors are additionally intended for use in transport situations within hospital environments.

The monitors are only for use on one patient at a time. They are not intended for home use. Not therapeutic devices. The monitors are for prescription use only.

The ECG measurement is intended to be used for diagnostic recording of rhythm and detailed morphology of complex cardiac complexes (according to AAMI EC 11).

ST segment monitoring is intended for use with adult patients only and is not clinically validated for use with neonatal and pediatric patients.

The derived measurement Pulse Pressure Variation (PPV) is intended for use with sedated patients receiving controlled mechanical ventilation and mainly free from cardiac arrhythmia. The PPV measurement has been validated only for adult patients. The transcutaneous gas measurement (tcGas) is restricted to neonatal patients only.

BIS is intended for use under the direct supervision of a licensed health care practitioner or by personnel trained in its proper use. It is intended for use on adult and pediatric patients within a hospital facility providing patient care to monitor the state of the brain by data acquisition of EBG signals. The BIS may be used as an aid in monitoring the effects of certain anesthetic agents .

Use of BIS monitoring to help guide anesthetic administration may be associated with the reduction of the incidence of awareness with recall in adults during general anesthesia and sedation.

The SSC Sepsis Protocol, in the ProtocolWatch clinical decision support tool, is intended for use with adult patients only.

| Prescription Use

(Part 21 CFR 801 Subpart D)Yes
AND/OR
Over-The-Counter Use
(21 CFR 807 Subpart C)No

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Concurrence of CDRH, Office of Device Evaluation (ODE)
(Division Sign-Off)
Division of Cardiovascular Devices

510(k) Number_ /