K Number
K121379
Device Name
PNEUTON MINI VENTILATOR PNEUTON MINI NON-INVASIVE VENTILATION (NIV) KIT ACCESSORY
Manufacturer
Date Cleared
2012-10-11

(156 days)

Product Code
Regulation Number
868.5895
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The pNeuton mini is intended to provide ventilatory support for critically ill patients who require the following general types of ventilatory support: - Positive pressure ventilation delivered invasively (via an ET Tube) or non-invasively (via a mask or nasal prongs) - CMV and IMV mode of ventilation with or without PEEP / CPAP - Provide oxygen or a mixture of medical air and oxygen
Device Description
The pNeuton mini ventilator is a small, lightweight transport ventilator designed for use on patients from neonate to pediatric in size (400 gram to 25 kg). It is a time cycled, flow limited ventilator providing Continuous Mechanical Ventilation (CMV) or Intermittent Mandatory Ventilation (IMV). In these modes of ventilation, an adjustable inspiratory time, expiratory time and pressure is delivered to the patient. The patient is allowed to breath spontaneously between the mandatory breaths with little added work of breathing. A built-in PEEP / CPAP system can be set to provide expiratory positive pressure. The delivered oxygen is adjustable from 21 to 100 percent. The pNeuton mini ventilator is a pure pneumatic ventilator. Electrical power is not used. The ventilator operates from oxygen and medical grade air input pressures from 40 to 70 psi. The various control systems that manage the time controls, PEEP / CPAP, and safety systems / pneumatic alarms is powered with pure oxygen to maintain stability and accuracy. There are no electronic controls or software in this device. The device provides ventilation and CPAP support for the care of individuals who require respiratory assistance. The device is a restricted medical device for use by qualified medical personnel under the direction of a physician. The device may be used in prehospital environments, inter and intra-hospital patient transport, air and ground transport, and all areas of the hospital including the MRI (NOT for use in the presence of flammable anesthetics). The mini ventilator has been specifically designed for ruggedness and ease of use. The pNeuton mini ventilator uses accessories during normal operation. The primary accessory is a patient tubing circuit to attach the device to the patient. The patient circuit is a single-use disposable device. The patient circuit uses the same major component (expiratory valve) included with the predicate pNeuton Ventilator K043085 with smaller diameter hoses.
More Information

No
The device description explicitly states, "There are no electronic controls or software in this device. The ventilator operates from oxygen and medical grade air input pressures... The various control systems... is powered with pure oxygen... There are no electronic controls or software in this device." This indicates a purely pneumatic system without the necessary components for AI/ML.

Yes
The device is a ventilator, which provides ventilatory support for critically ill patients, directly addressing a medical condition to restore or improve health.

No
The device is described as a "transport ventilator" intended to provide "ventilatory support," which is a therapeutic function, not a diagnostic one. It delivers air and oxygen and aids breathing, rather than detecting or identifying a medical condition.

No

The device description explicitly states, "There are no electronic controls or software in this device." It is described as a "pure pneumatic ventilator."

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

Here's why:

  • Intended Use: The intended use is to provide ventilatory support to critically ill patients by delivering positive pressure ventilation. This is a direct intervention on the patient's respiratory system.
  • Device Description: The device is a ventilator that physically assists breathing. It operates on pneumatic power and controls the delivery of air and oxygen to the patient.
  • Lack of IVD Characteristics: IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. The pNeuton mini does not interact with or analyze such specimens.

The pNeuton mini is a medical device used for life support and respiratory assistance, not for in vitro diagnostic testing.

N/A

Intended Use / Indications for Use

The pNeuton mini is intended to provide ventilatory support for critically ill patients who require the following general types of ventilatory support:

  • Positive pressure ventilation delivered invasively (via an ET Tube) or non-invasively (via a mask or nasal prongs)
  • CMV and IMV mode of ventilation with or without PEEP / CPAP .
  • Provide oxygen or a mixture of medical air and oxygen .

Patient population:

Neonates, infants, and children, from 400 g to 25 kg in weight

Environments of Use

  • Inter and intra-hospital patient transport .
  • Air & ground transport Pressurized and non-pressurized aircraft (to 15,000 ft) .
  • Intensive care units (short term use only associated with patient transport)
  • Emergency Departments
  • Radiology suites including MRI (MR Conditional 3T)
  • Operating rooms (short term use only associated with patient transport)

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

CBK

Device Description

The pNeuton mini ventilator is a small, lightweight transport ventilator designed for use on patients from neonate to pediatric in size (400 gram to 25 kg). It is a time cycled, flow limited ventilator providing Continuous Mechanical Ventilation (CMV) or Intermittent Mandatory Ventilation (IMV). In these modes of ventilation, an adjustable inspiratory time, expiratory time and pressure is delivered to the patient. The patient is allowed to breath spontaneously between the mandatory breaths with little added work of breathing. A built-in PEEP / CPAP system can be set to provide expiratory positive pressure. The delivered oxygen is adjustable from 21 to 100 percent.

The pNeuton mini ventilator is a pure pneumatic ventilator. Electrical power is not used. The ventilator operates from oxygen and medical grade air input pressures from 40 to 70 psi. The various control systems that manage the time controls, PEEP / CPAP, and safety systems / pneumatic alarms is powered with pure oxygen to maintain stability and accuracy. There are no electronic controls or software in this device.

The device provides ventilation and CPAP support for the care of individuals who require respiratory assistance. The device is a restricted medical device for use by qualified medical personnel under the direction of a physician. The device may be used in prehospital environments, inter and intra-hospital patient transport, air and ground transport, and all areas of the hospital including the MRI (NOT for use in the presence of flammable anesthetics). The mini ventilator has been specifically designed for ruggedness and ease of use.

The pNeuton mini ventilator uses accessories during normal operation. The primary accessory is a patient tubing circuit to attach the device to the patient. The patient circuit is a single-use disposable device. The patient circuit uses the same major component (expiratory valve) included with the predicate pNeuton Ventilator K043085 with smaller diameter hoses.

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

Neonates, infants, and children, from 400 g to 25 kg in weight

Intended User / Care Setting

Qualified medical personnel under the direction of a physician.
Prehospital environments, inter and intra-hospital patient transport, air and ground transport, and all areas of the hospital including the MRI (NOT for use in the presence of flammable anesthetics).
Intensive care units (short term use only associated with patient transport), Emergency Departments, Radiology suites including MRI (MR Conditional 3T), Operating rooms (short term use only associated with patient transport).

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 performance of the pNeuton mini ventilator has been comprehensively tested. All functions as listed in the specifications have been validated. The device meets all test requirements as identified in the FDA Draft Reviewer Guidance for Ventilators (April, 1995).

Specific non-clinical tests included:

  • Specification verification and waveform tests. Following the requirements of ASTM F1100 90, all operational functions were tested to meet required specifications. This included operation at the extremes of input gas pressures as specified. Waveform tests using Pressure / Time, Flow / Time and Volume / Time graphics showed that the accuracy and precision of breath delivery meets or exceeds specifications during four different clinical simulated conditions.
  • Reliability and endurance tests. Tests were performed to demonstrate reliability of performance during the entire device lifetime, under conditions comparable to the clinical environment as specified. Following the requirements of ASTM F1100 90. the device operated continuously for 2,200 hours at two different clinical simulated conditions. In addition, reliability tests were performed for an additional 240 hours at the extremes of environmental conditions which may be encountered during clinical use of this transport ventilator. Following these tests operation was verified using specification verification and waveform tests as described above.
  • Environmental and mechanical safety. The device was tested and passed the environmental / mechanical safety tests identified in the following standards: RTCA DO-160G, section 4, Altitude and Overpressure tests using Category A2; RTCA DO-160G, section 4 & 5, Temperature Variation tests of Procedure 5.3.1 using Category A4; RTCA DO-160G, section 6, Humidity tests using Category A; RTCA DO-160G, section 8, Robust Vibrations Tests for Category R; RTCA DO-160G, section 10, Spray Proof Test using Procedure 10.3.3; ISO 10651-3: 1997, section 21.6c}, Bump test in accordance with IEC 68-2-29, test Eb; MIL-STD-810F, section 500.4, Procedure III, Rapid decompression; MIL-STD-810F, section 514.5, Procedure I, Jet Aircraft Random Vibration Test.
  • Testing for MRI environments. All tests were performed according to ASTM F2052 - 06e1 and ASTM F2119 - 07 using a 3 Tesla scanner. There was no induced displacement force, performance variance or artifact generated in the scans. The pNeuton mini ventilator is not intended for implant so the assessment of magnetic field interactions for this product specifically involved evaluations of translational attraction and function in relation to exposure to a 3 Tesla MR system only.

Clinical testing was not performed on this device. Safety and efficacy were established through non-clinical testing and risk analysis. The pNeuton mini ventilator performs as intended according to its performance specification and is substantially equivalent to the predicate 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.

K043085, K043495, K993167

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.

K110471

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

Image /page/0/Picture/0 description: The image shows the logo for Airon. The logo consists of a stylized graphic to the left of the word "Airon". The graphic appears to be a circle with an abstract design inside, possibly representing a bird or an airplane. The word "Airon" is written in a simple, sans-serif font.

OCT 11 2012

pNeuton mini Ventilator

510(k) Summary - K121379 14 September 2012 Page 1 of 8

Contact Information

G. Eric Gjerde President Airon Corporation 751 North Drive, Unit 6 Melbourne, FL 32934 Tel: 321-821-9433 Fax: 321-821-9443 email: egjerde@AironUSA.com

Device Trade Name

pNeuton mini Ventilator

Device Classification

Continuous Ventilator (21 CFR 868.5895, Product Code CBK)

Device Class

Class II

Predicate Devices

pNeuton Transport Ventilator model A

  • manufactured by Airon Corporation .
  • 510(k) number K043085 .

BabyPAC 100 Ventilator

  • manufactured by Smiths Medical International Ltd. .
  • 510(k) number K043495 .

Millennium Infant Ventilator

  • manufactured by Sechrist Industries Inc. .
  • 510(k) number K993167 .

Babi Plus Nasal Cannula System

  • manufactured by A Plus Medical .
  • 510(k) number K110471 .

Airon Corporation 751 North Drive, Unit 6 Melbourne, FL 32934 USA tel (321) 821-9433 fax (321) 821-9443

1

510(k) Summary - K121379 14 September 2012 Page 2 of 8

Device Description

The pNeuton mini ventilator is a small, lightweight transport ventilator designed for use on patients from neonate to pediatric in size (400 gram to 25 kg). It is a time cycled, flow limited ventilator providing Continuous Mechanical Ventilation (CMV) or Intermittent Mandatory Ventilation (IMV). In these modes of ventilation, an adjustable inspiratory time, expiratory time and pressure is delivered to the patient. The patient is allowed to breath spontaneously between the mandatory breaths with little added work of breathing. A built-in PEEP / CPAP system can be set to provide expiratory positive pressure. The delivered oxygen is adjustable from 21 to 100 percent.

The pNeuton mini ventilator is a pure pneumatic ventilator. Electrical power is not used. The ventilator operates from oxygen and medical grade air input pressures from 40 to 70 psi. The various control systems that manage the time controls, PEEP / CPAP, and safety systems / pneumatic alarms is powered with pure oxygen to maintain stability and accuracy. There are no electronic controls or software in this device.

The device provides ventilation and CPAP support for the care of individuals who require respiratory assistance. The device is a restricted medical device for use by qualified medical personnel under the direction of a physician. The device may be used in prehospital environments, inter and intra-hospital patient transport, air and ground transport, and all areas of the hospital including the MRI (NOT for use in the presence of flammable anesthetics). The mini ventilator has been specifically designed for ruggedness and ease of use.

The pNeuton mini ventilator uses accessories during normal operation. The primary accessory is a patient tubing circuit to attach the device to the patient. The patient circuit is a single-use disposable device. The patient circuit uses the same major component (expiratory valve) included with the predicate pNeuton Ventilator K043085 with smaller diameter hoses.

Intended Use

The pNeuton mini is intended to provide ventilatory support for critically ill patients who require the following general types of ventilatory support:

  • Positive pressure ventilation delivered invasively (via an ET Tube) or non-. invasively (via a mask or nasal prongs)
  • CMV and IMV mode of ventilation with or without PEEP / CPAP .
  • Provide oxygen or a mixture of medical air and oxygen .

Patient population:

Neonates, infants, and children, from 400 g to 25 kg in weight

Environments of Use

  • · Inter and intra-hospital patient transport
    Airon Corporation 751 North Drive, Unit 6 Melbourne, FL 32934 USA tel (321) 821-9433 fax (321) 821-9443

2

510(k) Summary - K121379 14 September 2012 Page 3 of 7

  • Air & ground transport Pressurized and non-pressurized aircraft (to . 15.000 ft)
  • Intensive care units (short term use only associated with patient . transport)
  • Emergency Departments .
  • Radiology suites including MRI (MR Conditional 3T) .
  • Operating rooms (short term use only associated with patient transport) ●

Substantial Equivalence

The pNeuton mini ventilator shares substantial equivalency with the pNeuton model A Ventilator, the BabyPAC 100 Ventilator and the Millennium Infant Ventilator across the spectrum of patient population for which each was designed.

The pNeuton mini ventilator utilizes many similar components as found in the pNeuton model A Ventilator including an identical timing and pressure control system with patient / gas supply alarms. Due to the requirements of neonatal ventilation a precision air / oxygen blender is used instead of the air entrainment based oxygen mixing of the model A ventilator.

The pNeuton mini ventilator shares common modalities with the BabyPAC 100 Ventilator and the Millennium Infant Ventilator with significant overlap in the clinical range of function for their target population. The essential clinical function of each device is significantly similar and mimics each other in the typical frame of use by the health care providers. All are pneumatic based and applicable for the same areas of use.

| Characteristic | pNeuton mini
Ventilator | pNeuton A
Ventilator | BabyPAC
Ventilator | Millennium
Ventilator |
|------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------|
| 510(k) number
Intended Use –
application | Provide continuous or
intermittent
mechanical
ventilation and / or
CPAP for neonate to
child patients (400 g
to 25 kg) via mask,
nasal prongs or
endo-tracheal tube | K043085
Provide continuous or
intermittent mechanical
ventilation and / or
CPAP for pediatric to
adult patients via mask
or endo-tracheal tube | K043495
Provide continuous
or intermittent
mechanical
ventilation and / or
CPAP for neonate
to child patients up
to 20 kg | K993167
Provide continuous
or intermittent
mechanical
ventilation and / or
CPAP for neonate to
pediatric patients up
to 50 kg |
| Environments of use | Hospital, pre-hospital
and transport
environments | Hospital, pre-hospital,
transport and sub-
acute/alternate site
facility environments | Ambulance,
hospital,
emergency and
transport
environments | Hospital environment |
| Operation
environmental
requirements | -15 to 49 °C (5 to 120
°F), 15 to 95 percent
humidity | -5 to 40 °C (23 to 104
°F), 15 to 95 percent
humidity | -10 to 40°C (14 to
104 °F) | -10 to 40°C (14 to
104 °F), 15 to 95 percent
humidity |

Airon Corporation 751 North Drive, Unit 6 Melbourne, FL 32934 USA tel (321) 821-9433 fax (321) 821-9443

3

510(k) Summary – K121379 14 September 2012 Page 4 of 8

| Personnel
Requirements | Training as physician,
nurse, respiratory
therapist | Training as physician,
nurse, respiratory
therapist, EMT | Training as
qualified medical
caregiver,
paramedics and
other trained
personnel | Training as
physician, nurse,
respiratory therapist |
|----------------------------------------|-----------------------------------------------------------------------------|--------------------------------------------------------------------------|------------------------------------------------------------------------------------------------|-----------------------------------------------------------|
| Operating principle | Pneumatic driven and
controlled with
pneumatic alarms | Pneumatic driven and
controlled with
pneumatic alarms | Pneumatic driven
and controlled with
electronic alarms | Pneumatic driven
and electronically
controlled |
| Gas Input(s) | 40 to 70 psi | 40 to 70 psi | 40 to 87 psi | 40 to 60 psi |
| Patient circuit | Tubing with external
expiratory valve and
proximal pressure
line | Tubing with external
expiratory valve | Tubing with
external attached
expiratory valve | Tubing with external
attached expiratory
valve |
| Enclosure | Rugged, lightweight | Rugged, lightweight | Rugged, lightweight | Single enclosure on
stand for hospital use |
| Displays | Manometer | Manometer | Manometer | Electronic screen |
| Safety features | Internal high pressure
release, spontaneous
breathing safety
valve | Internal high pressure
release, spontaneous
breathing safety valve | None | Internal high
pressure release |
| MRI compatibility | MRI Conditional 3T | MRI Conditional 3T | MRI Conditional 3T | None |
| Patient support
modes | CMV, IMV, CPAP | CMV, IMV, CPAP | CMV, IMV, CPAP | Assist / Control,
SIMV / IMV, CPAP |
| Maximum working
pressure limitation | 80 cm H2O | 80 cm H2O | 80 cm H2O | 70 cm H2O |
| Maximum inspiratory | 20 L/min | Mandatory - 36 L/min | 10 L/min | 40 L/min |

| Maximum working

pressure limitation80 cm H2O80 cm H2O80 cm H2O70 cm H2O
Maximum inspiratory
flow20 L/minMandatory - 36 L/min
Spontaneous - 140 L/min10 L/min40 L/min
Inspiratory time
Control setting:
Accuracy:0.25 to 2.0 sec
± 10%label as tidal volume
0.6 to 2.0 sec
± 10%0.25 to 2.0 sec
± 0.8 sec0.1 to 3.0 sec
Expiratory time
Control setting:
Accuracy:0.25 to 20.0 sec
± 10%label as resp rate
0.6 to 20.0 sec
± 10%0.25 to 40 sec
± 0.8 sec0.3 to 30.0 sec
Peak patient
pressure
Control setting:
Accuracy:15 – 60 cm H2O
± 2 cm H2O15 – 75 cm H2O
± 10%10 – 70 cm H2O
± 15%5 – 70 cm H2O

4

510(k) Summary – K121379 14 September 2012 Page 5 of 8

Flow Rate
Control setting:6, 8, 10, 15, 20 L/min
± 10%Non adjustable @ 36Non adjustable @ 102 to 32 L/min
CPAP
Control setting:0 - 20 cm H2O
± 2 cm H2O0 - 20 cm H2O
± 5%0 - 20 cm H2O
± 15%0 - 20 cm H2O
Oxygen
Control setting:21 to 100%
± 3%2 choices, 65 or 100
± 10%21 to 100%
± 8%21 to 100%
Measurements
Pressure sensor
type:Mechanical gauge
Use proximal airway signalMechanical gauge
Use internal signalMechanical gauge
Use internal signalTransducer
Proximal airway
Volume sensor type:NoneNoneNoneNone
Monitored
parameters
Parameter / range:Pressure -10 to 80
± 2 cm H2OPressure -10 to 80
± 2 cm H2OPressure -10 to 100
± 2 cm H2OPressure -10 to 70
I:E ratio 4:1 to 1:10
Resp rate 0 to 150
Alarms
Parameter / range:High pressure
10 - 70 cm H2ONo adjustable alarmsHigh pressure
12 - 80 cm H2OHigh pressure
5 - 70 cm H2O

High rate
2 to 150 |
| Default setting: | 30 cm H2O | N/A | | |
| Non-adjustable: | Patient disconnect,
low gas supply | Patient disconnect, low
gas supply | Patient disconnect,
low gas supply, low
battery | Patient disconnect,
low PEEP, apnea,
low gas supply, low
electrical power, vent
inop |
| Battery | | | | |
| Type: | None | None | 3/3.6 volt lithium | None |
| Operating time: | N/A | N/A | 1 year | N/A |
| Materials in gas
pathway | Identical to Pneuton
ventilator | Cleared in K043085 | | |

The pNeuton mini Ventilator can provide non-invasive and invasive ventilation to the intended patient population. To provide invasive ventilation the Airon patient breathing circuit includes a wye piece with a standard 15 mm ID fitting for connection to an endotracheal tube. To provide non-invasive ventilation (NIV), accessory kits are used to

Airon Corporation 751 North Drive, Unit 6 Melbourne, FL 32934 USA tel (321) 821-9433 fax (321) 821-9443

5

510(k) Summary - K121379 14 September 2012 Page 6 of 8

replace the wye piece with appropriate tubing and patient interfaces (nasal prongs or mask).

Two NIV kits are available for use with the Airon patient breathing circuit. One NIV kit is called the NIC CK CPAP Kit. This is the same device as the Babi Plus Infant Nasal Cannula System cleared under K110471 by A Plus Medical.

The other NIV kit is called the NIC FM CPAP Kit. The NIC FM CPAP Kit is substantially equivalent in the indications for use, environment of use, patient population, material and function to the A Plus Medical Nasal Cannula Kit (K110471). The NIC FM CPAP Kit includes both nasal pronos and nasal masks while the A Plus Medical Nasal Cannula Kit only has nasal prongs. The addition of the nasal mask, which is Class 1 exempt under 21 CFR 868.5580 and Product Classification BYG – Oxygen mask, allows for the patient interface pressure points to be switched from inside of the nares (prongs) to outside (mask). . The essential clinical function of each device is significantly similar and mimics each other in the typical frame of use by the health care providers

| Characteristic | NIC FM CPAP Kit | Babi Plus Nasal
Cannula System |
|----------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 510(k) number | | K110471 |
| Intended Use -
application | Single patient use device
intended for use with neonates,
infants and children under 10 Kg
requiring a non-invasive nasal
interface during intermittent or
continuous gas flow therapy | Single patient use device
intended for use with neonates,
infants and children under 10 Kg
requiring a nasal prong interface
during intermittent or continuous
gas flow therapy |
| Environments of use | Hospital critical care unit | Hospital critical care unit |
| Connection to Airon
patient circuit | 10 mm male connectors in kit fit
10 mm female connectors in
patient circuit. Length of tubing
to patient interface is 10 mm. | 10 mm male connectors in kit fit
10 mm female connectors in
patient circuit. Length of tubing
to patient interface is 10 mm. |
| Patient interfaces | 6 sizes of nasal prongs and 4
sizes of nasal mask | 8 sizes of nasal prongs |
| Inspiratory flow
resistance | 1.0 to 1.7 cm H2O | 1.1 to 1.3 cm H2O |
| Expiratory flow
resistance | 1.2 to 1.4 cm H2O | 1.2 to 1.4 cm H2O |
| Materials in gas
pathway | Silicone, K-resin, Polypropylene | Silicone, K-resin, Ethyl Vinyl
Acetate (EVA) tubing, Polyvinyl
chloride (DEHP, DAP free) |

Airon Corporation 751 North Drive, Unit 6 Melbourne, FL 32934 USA tel (321) 821-9433 fax (321) 821-9443

6

510(k) Summary - K121379 14 September 2012 Page 7 of 8

Summary of Non-Clinical Testing and Validation

The performance of the pNeuton mini ventilator has been comprehensively tested. All functions as listed in the specifications have been validated. The device meets all test requirements as identified in the FDA Draft Reviewer Guidance for Ventilators (April, 1995).

The pNeuton mini ventilator complies with the following voluntary standards:

  • ASTM: F1100 90 Ventilators Intended for Use in Critical Care .
  • ISO: 10651-3: 1997 Lung Ventilators for Medical Use- Particular requirements . for emergency and transport ventilators
  • RTCA DO-160G Environmental Conditions and Test Procedures for Airborne . Equipment, as applicable
  • MIL-STD-810F Environmental Engineering Considerations and Laboratory . · Tests, as applicable
  • CGA V-5:2008 Diameter-Index Safety System (Noninterchangeable Low ● Pressure Connections for Medical Gas Applications)
  • ASTM F2052 06e1 Standard Test Method for Measurement of Magnetically . Induced Displacement Force on Medical Devices in the Magnetic Resonance Environment
  • ASTM F2119 07 Standard Test Method for Evaluation of MR Image Artifacts . from Passive Implants

Specific non-clinical tests included:

  • Specification verification and waveform tests. Following the requirements of . ASTM F1100 90, all operational functions were tested to meet required specifications. This included operation at the extremes of input gas pressures as specified. Waveform tests using Pressure / Time, Flow / Time and Volume / Time graphics showed that the accuracy and precision of breath delivery meets or exceeds specifications during four different clinical simulated conditions.
  • Reliability and endurance tests. Tests were performed to demonstrate reliability . of performance during the entire device lifetime, under conditions comparable to the clinical environment as specified. Following the requirements of ASTM F1100 90. the device operated continuously for 2,200 hours at two different clinical simulated conditions. In addition, reliability tests were performed for an additional 240 hours at the extremes of environmental conditions which may be encountered during clinical use of this transport ventilator. Following these tests operation was verified using specification verification and waveform tests as described above.
    • Environmental and mechanical safety. The device was tested and passed the . environmental / mechanical safety tests identified in the following standards:
      • RTCA DO-160G, section 4, Altitude and Overpressure tests using Category o A2

Airon Corporation 751 North Drive, Unit 6 Melbourne, FL 32934 USA tel (321) 821-9433 fax (321) 821-9443

7

510(k) Summary - K121379 14 September 2012 Page 8 of 8

  • RTCA DO-160G, section 4 & 5, Temperature Variation tests of Procedure o 5.3.1 using Category A4
  • RTCA DO-160G, section 6, Humidity tests using Category A o
  • RTCA DO-160G, section 8, Robust Vibrations Tests for Category R o
  • RTCA DO-160G, section 10, Spray Proof Test using Procedure 10.3.3 O
  • ISO 10651-3: 1997, section 21.6c}, Bump test in accordance with IEC 68-2-O 29, test Eb
  • MIL-STD-810F, section 500.4, Procedure III, Rapid decompression o
  • MIL-STD-810F, section 514.5, Procedure I, Jet Aircraft Random Vibration O Test
  • Testing for MRI environments. All tests were performed according to ASTM . F2052 - 06e1 and ASTM F2119 - 07 using a 3 Tesla scanner. There was no induced displacement force, performance variance or artifact generated in the scans. The pNeuton mini ventilator is not intended for implant so the assessment of magnetic field interactions for this product specifically involved evaluations of translational attraction and function in relation to exposure to a 3 Tesla MR system only.

Clinical testing was not performed on this device. Safety and efficacy were established through non-clinical testing and risk analysis. The pNeuton mini ventilator performs as intended according to its performance specification and is substantially equivalent to the predicate devices.

Airon Corporation 751 North Drive, Unit 6 Melbourne, FL 32934 USA tel (321) 821-9433 fax (321) 821-9443

8

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/8/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of an eagle or bird-like figure with three curved lines representing its wings or body. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged in a circular fashion around the emblem.

Public Health Service

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

OCT 1 1 2012

Airon Corporation
G. Eric Gjerde
President & CEO
751 North Drive, Unit 6
Melborne, Fl 32934

Re: K121379

Trade/Device Name: pNeuton mini Ventilator Regulation Number: 21 CFR 868.5895 Regulation Name: Continuous Ventilator Regulatory Class: II Product Code: CBK Dated: September 17, 2012 Received: September 18, 2012

Dear Mr. Gjerde :

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.

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

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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/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Nh 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

Enclosure

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Indications For Use

510(k) Number: K121379

Device Name: pNeuton mini Ventilator

Indications For Use: The pNeuton mini is intended to provide ventilatory support for critically ill patients who require the following general types of ventilatory support:

  • Positive pressure ventilation delivered invasively (via an ET Tube) or non-. invasively (via a mask or nasal prongs)
  • CMV and IMV mode of ventilation with or without PEEP / CPAP .
  • Provide oxygen or a mixture of medical air and oxygen .

Patient population:

Neonates, infants, and children, from 400 g to.25 kg in weight

Environments of Use

  • Inter and intra-hospital patient transport .
  • Air & ground transport Pressurized and non-pressurized aircraft (to 15,000 ft) .
  • Intensive care units (short term use only associated with patient transport)
  • Emergency Departments
  • Radiology suites including MRI (MR Conditional 3T)
  • Operating rooms (short term use only associated with patient transport)

Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (Part 21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Z. Schullk

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

510(k) Number: icl 21379