K Number
K120173
Device Name
PATIENT MONITOR
Date Cleared
2012-05-16

(117 days)

Regulation Number
870.1025
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

This monitor is intended to be used for monitoring, storing, reviewing, recording, and generating alarms for multiple physiological parameters including ECG, respiration (RESP), temperature (TEMP), functional arterial oxygen saturation (SpO2), pulse rate (PR), non-invasive blood pressure (NIBP), invasive blood pressure (IBP), expired CO2, cardiac output (C.O.) and anesthetic gas (AG)of adults, pediatrics and neonates in hospital environments.
This monitor is suitable for use in hospital environments including but not limited to OR, PACU, ICU and neonate intensive care room.

Device Description

The elite V8 Patient Monitor can perform long-time continuous monitoring of multiple physiological parameters. Also, it is capable of storing, displaying, analyzing and controlling measurements, and it will indicate alarms in case of abnormities happen.
The elite V8 realizes the monitoring of physiological parameters by configuration with different parameter modules which include SpO2 (pulse oxygen saturation, pulse rate and SpO2 plethysmogram) with EDAN SpO2 module or Nellcor SPO2 module, NIBP (systolic pressure, diastolic pressure, mean pressure and pulse rate), TEMP, ECG, RESP, CO2, IBP, C.O. and AG.
The above is the maximum configuration for elite V8, the user may select different monitoring parameters in according with the requirement.
Elite V8 configures with 17-inch touch screen and build-in Lithium-ion battery. Besides, elite V8 supports software upgrade online and networking.

AI/ML Overview

The provided document is a 510(k) Summary for a patient monitor and outlines the device's intended use and comparison to predicate devices. However, it does not contain specific acceptance criteria, study details, or performance data for the device. The document mostly focuses on regulatory classification, comparison to predicate devices, and a general statement of quality assurance measures.

Therefore, I cannot fulfill your request for:

  • A table of acceptance criteria and the reported device performance
  • Sample sizes used for the test set and data provenance
  • Number of experts used and their qualifications for ground truth
  • Adjudication method
  • MRMC comparative effectiveness study details or effect size
  • Standalone algorithm performance
  • Type of ground truth used
  • Sample size for the training set
  • How ground truth for the training set was established

The document states:

"The elite V8 Patient Monitors have the following similarities to that which previously received 510(k) concurrence: have the same indications for use, use the similar operating principle, have the same or similar performance specifications."

And:

"Verification and validation testing was done on the Patient Monitor. This premarket notification submission demonstrates that Patient Monitor is substantially equivalent to the predicate device."

These statements indicate that specific performance data and detailed study information are not included in this particular 510(k) summary, but rather the device's equivalence to existing cleared devices is asserted based on similar design and presumed performance. To find the specific study details and acceptance criteria, one would typically need to refer to the full 510(k) submission or the referenced predicate device documentation, which are not part of the provided text.

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Section 1

510(k) Summary of Safety and Effectiveness

This summary of 510k safety and effectiveness is being submitted in according with 21CFR part 807.92

Submitter:Edan Instruments, Inc
3/F - B, Nanshan Medical
Equipments Park, Nanhai Rd 1019#,
shekou, Nanshan Shenzhen,
518067 P.R. China
Tel: 86-755-26882220
Fax:86-755-26882223
Contact person: Randy Jiang

Date of Preparation: 2011-12-02

Proprietary Name: Patient Monitor Model elite V8

Classification:

DescriptionClassificationProductcode
21 CFR 870.1025 monitor, physiological, patient(with arrhythmia detectionor alarms)IIMHX
21 CFR 870.2300 Cardiac monitor (including cardiotachoment and ratealarm)IIDRT
21 CFR 870.1130 Non-Invasive blood pressure measurement SystemIIDXN
21 CFR 870.1110 Blood pressure computerIIDSK
21 CFR 880.2910 Clinical Electronic Thermometers-Temperature Monitorwith ProbeIIFLL
21 CFR 870.2700 Oximeter, PulseIIDQA
21 CFR 870.1400 Carbon Dioxide Gas AnalyzerIICCK
21 CFR 868.1500 Enflurane gas analyzerIICBQ
21 CFR 868.1620 Halothane gas analyzerIICBS
21 CFR 868.1700 Nitrous Oxide gas analyzerIICBR
21 CFR 868.1720 Oxygen gas analyzerIICCL
21 CFR 868.2900 cable, transducer and electrode, patient, (includingconnector)IIDSA
21 CFR 870.2300 monitor, cardiac (incl. cardiotachometer & rate alarm)IIDRT
21 CFR 870.1025 Detector and Alarm, ArrhythmiaIIDSI
21 CFR 870.1025 Monitor, ST Segment with AlarmIIMLD

Regulatory Class:_ Class II

Page 5 of 45

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ManufacturerPredicate Device510(k) #Cleared date
Edan Instruments, IncM3 and M3AK102825Dec.27.2010
Philips Medical SystemMP70K100939April.1.2010
Edan Instruments, IncM3BK083821May. 14,2009
ZOLL MedicalCorporationZOLL M series NIBPoptionK032363July 30, 2003
PHASEIN ABCarbon-dioxide gasanalyzerK103604March.28,2011

Legally Marketed Predicate Devices::

Device Description:

The elite V8 Patient Monitor can perform long-time continuous monitoring of multiple physiological parameters. Also, it is capable of storing, displaying, analyzing and controlling measurements, and it will indicate alarms in case of abnormities happen.

The elite V8 realizes the monitoring of physiological parameters by configuration with different parameter modules which include SpO2 (pulse oxygen saturation, pulse rate and SpO2 plethysmogram) with EDAN SpO2 module or Nellcor SPO2 module, NIBP (systolic pressure, diastolic pressure, mean pressure and pulse rate), TEMP, ECG, RESP, CO2, IBP, C.O. and AG.

The above is the maximum configuration for elite V8, the user may select different monitoring parameters in according with the requirement.

Elite V8 configures with 17-inch touch screen and build-in Lithium-ion battery. Besides, elite V8 supports software upgrade online and networking.

Comparison with predicate device

The elite V8 Patient Monitors have the following similarities to that which previously received 510(k) concurrence:

  • have the same indications for use, .
  • use the similar operating principle, .
  • have the same or similar performance specifications .

In summary, the elite V8 Patient Monitor described in this submission is, in our opinion, substantially equivalent to the

Page 6 of 45

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device.

predicate device
Intended Use:This monitor is intended to be used for monitoring, storing, reviewing, recording, and generating alarms for multiple physiological parameters including ECG, respiration (RESP), temperature (TEMP), functional arterial oxygen saturation (SpO2), pulse rate (PR), non-invasive blood pressure (NIBP), invasive blood pressure (IBP), expired CO2, cardiac output (C.O.) and anesthetic gas (AG)of adults, pediatrics and neonates in hospital environments.This monitor is suitable for use in hospital environments including but not limited to OR, PACU, ICU and neonate intensive care room.
Contraindications:It is not intended for use in patient's home or residence, or when it has not been ordered by a physician.
Test Summary:The following quality assurance measures were applied to the development of the Patient Monitor Software testingHardware testingSafety testingEnvironment testRisk analysisFinal validation
Conclusion:Verification and validation testing was done on the Patient Monitor. This premarket notification submission demonstrates

that Patient Monitor is substantially equivalent to the predicate

Page 7 of 45

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized caduceus, which is a symbol of medicine, with three wavy lines representing the branches of government. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the caduceus.

Public Health Service

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

MAY 1 6 2012

Edan Instruments, Inc. c/o Mr. Randy Jiang Regulation Affairs Engineer 3/F - B. Nanshan Medical Equipments Park Nanhai Rd 1019#, shekou, Nanshan Shenzhen 518067 P.R. China

Re: K120173

Trade/Device Name: Patient Monitor Elite V8

Regulation Number: 21 CFR 870.1025

Regulation Name: Patient Physiological Monitor (with arrhythmia detection or alarms) Regulatory Class: Class II (two)

Product Code: MHX. DRT, DXN, DSK, FLL, DQA, CCK, CBQ, CBS, CBR, CCL, DSA, DRT, DSI, MLD

Dated: April 24, 2012

Received: April 25, 2012 .

Dear Mr. Jiang:

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.

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Page 2 - Mr. Randy Jiang

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.

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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Indication for Use

510(k) Number (if known): .

Device Name: Elite V8 Patient Monitor

This monitor is intended to be used for monitoring, storing, recording, and generating alarms for multiple physiological parameters including ECG, respiration (RESP), temperature (TEMP), functional arterial oxygen saturation (SpO2), pulse rate (PR), non-invasive blood pressure (NIBP), invasive blood pressure (IBP), expired CO2, cardiac output (C.O.) and anesthetic gas (AG)of adults, pediatrics and neonates in hospital environments. The monitor is equipped with alarms that indicate system faults (such as loose or defective electrodes), physiologic parameters that have exceeded the limits set by the operator, or both.

This monitor is suitable for use in hospital environments including but not limited to OR, PACU, ICU and neonate intensive care room.

Prescription Use x (21 CFR Part 801 Subpart D) And/Or Over the Counter Use (21 CFR Part 801 Subpart C)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Division Sign-Off) Division of Cardiovascular Devices

20175 510(k) Numb

Page 8 of 45

§ 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.