K Number
K122214
Device Name
TG-970P SENSOR KIT W/ NEW AIRWAY ADAPTER (YG-213T)
Manufacturer
Date Cleared
2013-05-21

(300 days)

Product Code
Regulation Number
868.1400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Nihon Kohden TG-970P and is intended for medical purposes to measure the concentration of carbon dioxide in a gas mixture to aid in determining the patient's ventilatory status. Along with other methods indicated by the physician for medical diagnosis, this device is intended as an indicator of patient carbon dioxide concentration during expiration. The device is intended for use by qualified medical personnel within a hospital or clinical environment and is available for use on any patient weighing 2kg or more.
Device Description
The TG-970P Series CO2 Sensor Kit is comprised of three main components, a CO2 Sensor (photo detector and light emitter) with cable and connector, a CO2 Adapter and an airway adapter. The CO2 Sensor incorporates an infrared light source, of specified wavelength, and an infrared detector. The photo detector and light emitter end of the CO2 sensor is connected to an airway adapter. The airway adapter is connected between the patient airway and the respirator. As the patient completes an expiratory breath the sensor measures the CO2 levels in the expiratory breath and sends that data to the CO2 adapter. The adapter then reads the data and converts the data so it can be displayed on the patient monitor.
More Information

Not Found

No
The device description and performance studies focus on standard infrared sensing technology and data conversion, with no mention of AI or ML algorithms for data analysis or interpretation.

No
The device measures carbon dioxide concentration to aid in determining ventilatory status and as an indicator of patient carbon dioxide concentration during expiration. It does not actively treat or restore a patient's health.

Yes
The "Intended Use / Indications for Use" section states that the device is "intended for medical purposes to measure the concentration of carbon dioxide in a gas mixture to aid in determining the patient's ventilatory status. Along with other methods indicated by the physician for medical diagnosis, this device is intended as an indicator of patient carbon dioxide concentration during expiration." This clearly indicates its role in providing information for medical diagnosis.

No

The device description explicitly states it is comprised of hardware components: a CO2 Sensor (photo detector and light emitter), a CO2 Adapter, and an airway adapter.

Based on the provided information, the Nihon Kohden TG-970P is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • IVD devices are intended for use in vitro (outside the body) to examine specimens derived from the human body. The TG-970P measures carbon dioxide concentration in vivo (within the body), specifically in the patient's expired breath.
  • The device description clearly states it is connected between the patient airway and the respirator. This is a direct connection to the patient's respiratory system, not the analysis of a sample taken from the patient.
  • The intended use is to measure CO2 concentration in a gas mixture (expired breath) to aid in determining ventilatory status. This is a physiological measurement taken directly from the patient.

Therefore, the Nihon Kohden TG-970P is a physiological monitoring device, not an IVD.

N/A

Intended Use / Indications for Use

The Nihon Kohden TG-970P and is intended for medical purposes to measure the concentration of carbon dioxide in a gas mixture to aid in determining the patient's ventilatory status. Along with other methods indicated by the physician for medical diagnosis, this device is intended as an indicator of patient carbon dioxide concentration during expiration.

The device is intended for use by qualified medical personnel within a hospital or clinical environment and is available for use on any patient weighing 2kg or more.

Product codes

CCK

Device Description

The TG-970P Series CO2 Sensor Kit is comprised of three main components, a CO2 Sensor (photo detector and light emitter) with cable and connector, a CO2 Adapter and an airway adapter. The CO2 Sensor incorporates an infrared light source, of specified wavelength, and an infrared detector. The photo detector and light emitter end of the CO2 sensor is connected to an airway adapter. The airway adapter is connected between the patient airway and the respirator. As the patient completes an expiratory breath the sensor measures the CO2 levels in the expiratory breath and sends that data to the CO2 adapter. The adapter then reads the data and converts the data so it can be displayed on the patient monitor.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Patient airway

Indicated Patient Age Range

The device is intended for use on any patient weighing 2kg or more.

Intended User / Care Setting

Qualified medical personnel within a hospital or clinical environment.
Facilities: Hospitals, Clinics, Physician office

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)

Testing of the Nihon Kohden TG-970P with new YG-213T Neonatal/Infant Airway Adapter was performed in compliance with Nihon Kohden Corporation design control process.
Key Results:

  • Validation/verification testing confirms that the accuracy of the measured gas is substantially equivalent to the predicate device.
  • Validation/verification testing confirms that the smaller dead space does not affect the accuracy of the measured gas and is substantially equivalent to the predicate device.
  • Validation/verification testing confirms that the accuracy of the measured gas is not changed with longer continuous use time.
  • The intended use, technology and materials of the YG-213T Airway Adapter was shown to be equivalent in safety and effectiveness to the predicate devices YG-211T and YG-211TW which are accessories of the TG-970P CO2 Sensor Kit K083456 (TG-970P). No new questions of safety or effectiveness are raised.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K083456

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 868.1400 Carbon dioxide gas analyzer.

(a)
Identification. A carbon dioxide gas analyzer is a device intended to measure the concentration of carbon dioxide in a gas mixture to aid in determining the patient's ventilatory, circulatory, and metabolic status. The device may use techniques such as chemical titration, absorption of infrared radiation, gas chromatography, or mass spectrometry.(b)
Classification. Class II (performance standards).

0

KIZZZIY

Nihon Kohden America, Inc. Revised May 3, 2013

510(k) Notification TG-970P Sensor Kit w/new Airway Adaptor

510(k) Summary

MAY 2 1 2013

Company Name:Nihon Kohden Corporation 90 Icon Street Foothill Ranch, CA 92610
Device Name:Nihon Kohden TG-970P CO2 Sensor Kit w/new Airway Adaptor
510(k) Sponsor, Contact:Nihon Kohden America, Inc. 90 Icon Street Foothill Ranch, CA 92610 Steve Geerdes Director Quality Assurance and Regulatory Affairs Phone: (949) 580-1555 Ext. 3325 Fax: (949) 580-1550
Summary Date:Revised 05/03/2013
Common Name:Carbon Dioxide (CO2) Analyzer
Classification Names:Anesthesiology Device868.1400CCKAnesthesiology Device868.1400CCK
Anesthesiology Device868.1400CCK
Predicate Device(s):

Predicate Device(s):

TG-970P CO2 Sensor Kit

1.0 Description of Device

The TG-970P Series CO2 Sensor Kit is comprised of three main components, a CO2 Sensor (photo detector and light emitter) with cable and connector, a CO2 Adapter and an airway adapter. The CO2 Sensor incorporates an infrared light source, of specified wavelength, and an infrared detector. The photo detector and light emitter end of the CO2 sensor is connected to an airway adapter. The airway adapter is connected between the patient airway and the respirator. As the patient completes an expiratory breath the sensor measures the CO2 levels in the expiratory breath and sends that data to the CO2 adapter. The adapter then reads the data and converts the data so it can be displayed on the patient monitor.

K083456

Depending on which airway adapter is used, the TG-970 can be used with patients weighing 2kg or more. The device is not recommended for patients weighing less than 2kg or patients with a respiration rate greater than 150 breaths per minute.

1

Nihon Kohden America, Inc. Revised May 3, 2013

510(k) Notification TG-970P Sensor Kit w/new Airway Adaptor

Image /page/1/Figure/2 description: This image shows the parts of a CO2 adapter. The parts include a photo detector and light emitter, a CO2 adapter connector, a JG-970P CO2 adapter, and a TG-221T CO2 sensor. The image also shows an airway adapter, a transparent film, and the connection points to the mask or tracheal tube and to the resuscitation bag or respirator.

2.0 -Intended Use of Device

The Nihon Kohden TG-970P and is intended for medical purposes to measure the concentration of carbon dioxide in a gas mixture to aid in determining the patient's ventilatory status. Along with other methods indicated by the physician for medical diagnosis, this device is intended as an indicator of patient carbon dioxide concentration during expiration.

The device is intended for use by qualified medical personnel within a hospital or clinical environment and is available for use on any patient weighing 2kg or more.

3.0 Technical Characteristics

The Nihon Kohden CO2 Sensor Kit, model number TG-970P Series, is intended for medical purposes to measure the concentration of carbon dioxide in a gas mixture to aid in determining the patient's ventilatory (end tidal CO2) status. The device measuring technique is through absorption of infrared radiation.

Modified DevicePredicate DeviceComments
ProductTG-970P with YG-213T
airway adapterTG-970P with YG-211T
airway adapter (K#083456)
Intended UseTo measure theSame
Modified DevicePredicate DeviceComments
ProductTG-970P with YG-213T
airway adapterTG-970P with YG-211T
airway adapter (K#083456)
concentration of carbon
dioxide in a gas mixture to
aid in determining the
patient's ventilatory status
Use frequencySingle Patient UseSame
Shelf life36 monthsSame
PopulationYG-213T: For patients 2kg to
7kg.For patients more than
approx. 7kg.Technology & materials
are substantially equivalent
to the predicate device.
Validation/verification
testing confirms that the
accuracy of the measured
gas is substantially
equivalent to the predicate
device. No new questions
of safety or effectiveness
were raised
Dead space1mL4mLThe change in dead space
is due to smaller airway
adapter.
Validation/verification
testing confirms that the
smaller dead space does
not affect the accuracy of
the measured gas and is
substantially equivalent to
the predicate device. No
new questions of safety or
effectiveness were raised
FunctionAirway adapter with windows
which infrared light of the CO2
sensor kit can pass through is
connected to respiratory
circuit.Same
Specifications
TransmissivityMore than approx 45%
(at 4.27um±0.02um)Same
Modified DevicePredicate DeviceComments
ProductTG-970P with YG-213T
airway adapterTG-970P with YG-211T
airway adapter (K#083456)
Optical length6mm±0.2mmSame
Ratio of
antifogging
performance :
fogRatio of fog: less than 5%(at
15°Cto35°C 20% to 80RH 10
minutes later)Same
Ratio of
antifogging
performance
: WetRatio of Wet: less than ±8%
(at 15°C to 35°C, 20% to 80RH
10 minutes later)Same

Technical Comparison

Page 2 of 2

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Nihon Kohden America, Inc. Revised May 3, 2013

510(k) Notification

TG-970P Sensor Kit w/new Airway Adaptor

Page 3 of 3

·

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Nihon Kohden America, Inc. Revised May 3, 2013

510(k) Notification

TG-970P Sensor Kit w/new Airway Adaptor

Environment
FacilityHospitals, Clinics, Physician officeSame
Same
Same
Operating environment10 to 40 degree C
30 to 85%RH, non condensingSame
Storage environment-20 to 65 degree C
10 to 95%RHSame
Chemical resistanceThis product cannot be
cleaned or disinfected.Same
SterilizationNoNo
Continuation use time72 hours24 hoursValidation/verification testing confirms that the accuracy of the measured gas is not changed with longer continuous use time.
No new questions of safety or effectiveness were raised

4.0 Data Summary

·

.

4

Testing of the Nihon Kohden TG-970P with new YG-213T Neonatal/Infant Airway Adapter was performed in compliance with Nihon Kohden Corporation design control process. Testing included:

The device is in compliance with the following voluntary industrial standards:

Medical Electrical Equipment

IEC 60601-1Part 1: General requirements for safety 1998-12
IEC 60601-1, Amendment 1Part 1: General Requirements for safety, Amendment 1 1991-11
IEC 60601-1, Amendment 2Part 1: General Requirements for safety, Amendment 2 1995-03
ISO 10993-1Biological Evaluation of Medical Devices - Part 1: Evaluation and Testing, 2003-08

Medical Devices - Application of Risk Management to Medical Devices, 2007

5.0 Conclusions

ISO 14971

TG-970P CO2 Sensor Kit was previously cleared in K083456 and the airway adaptor cleared with the TG-970P (YG-211T) is capable of accurately measuring CO2 in the patient's airway during expiration on patients 7kg or larger. A new airway adapter (YG-213T) is being added to the TG-970P. This will allow the TG-970P to accurately measure CO2 in the patient's airway during expiration on patients 2kg or larger.

The technology of the photo detector and light emitter of the TG-970P has not changed. The only change is the new YG-213T airway adapter which has under gone verification and validation testing.

Based on the comparison in the technical comparison chart above and confirmed by verification/validation testing in compliance with the Design Control requirements. The intended use, technology and materials of the YG-213T Airway Adapter was shown to be equivalent in safety and effectiveness to the predicate devices YG-211T and YG-211TW which are accessories of the TG-970P CO2 Sensor Kit K083456 (TG-970P). No new questions of safety or effectiveness are raised.

5

Image /page/5/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" around the perimeter. Inside the circle is a stylized symbol that resembles a human figure embracing a bird, representing the department's mission to protect and promote the health and well-being of Americans.

DEPARTMENT OF HEALTH & HUMAN SERVICES

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

May 21, 2013

Mr. Steve Geerdes Director of Regulatory Affairs and Quality Assurance Nihon Kohden Corporation 90 Icon Street FOOTHILL RANCH CA 92610

Re: K122214

Trade/Device Name: Nihon Kohden TG-970P Regulation Number: 21 CFR 868.1400 Regulation Name: Carbon Dioxide Gas Analyzer Regulatory Class: II Product Code: CCK Dated: May 8, 2013 Received: May 9, 2013

Dear Mr. Geerdes:

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.

6

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 devicerelated 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 contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. 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,

Kwame O. Ulmer -S for

Anthony D. Watson, B.S., M.S., M.B.A. Director Division of Anesthesiology, General Hospital,

Respiratory, Infection Control and Dental Devices

Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

7

Indications for Use Form

510(k) Number (if known): K122214

Nihon Kohden TG-970P Device Name:

Indications for Use:

The Nihon Kohden TG-970P and is intended for medical purposes to measure the concentration of carbon dioxide in a gas mixture to aid in determining the patient's ventilatory status. Along with other methods indicated by the physician for medical diagnosis, this device is intended as an indicator of patient carbon dioxide concentration during expiration.

The device is intended for use by qualified medical personnel within a hospital or clinical environment and is available for use on any patient weighing 2kg or more.

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

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Division Sign-Off Office of In Device Evaluation 510(k)

Lester W. Schultheis Jr
2013.05.21[13:40:16-04'00']

510(k) Number:

Page 1 of

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