(129 days)
The noninvasive FORE-SIGHT Elite Absolute Tissue Oximeter is intended for use as an adjunct monitor of absolute regional hemoglobin oxygen saturation of blood under the sensors in individuals at risk for reduced flow or no-flow ischemic states and is indicated for use as follows:
When used with large sensors, the FORE-SIGHT Oximeter is indicated for use on the brain of adults and transitional adolescents ≥ 40 kg.
The FORE-SIGHT Elite Absolute Tissue Oximeter measures hemoglobin under the Sensor, allowing the clinician to continuously and accurately determine absolute levels of blood oxygenation saturation in the tissue (StO2).
The Oximeter consists of a monitor unit, preamplifier assembly, and sensor uses multiple wavelengths of light in the range of 660 to 900 nm to precisely measure light absorption in tissue. Sensors are sized to provide targeted penetration depths appropriate for the tissue and patient populations of interest. The monitor unit controls the measurement sequence, regulating sensor light output and processing the detected light signals after amplification by the dual-channel preamplifier assembly. The FORE-SIGHT algorithm determines the StO2 values for the tissue under the sensor from the light absorption values and measured patient characteristics. The monitor unit provides simultaneous measurements on up to four sensors with both numeric and real-time graphical display formats.
The monitor unit is a mains-powered device with a field-replaceable battery backup module. A touchscreen user interface allows configuration of the Oximeter including audible, on-screen, and dedicated visual alarm indicators. The monitor display can be replicated for simultaneous remote viewing through an auxiliary VGA video output. Measurement data can be exported through various interfaces such as USB and RS-232.
The provided text describes the CASMED FORE-SIGHT ELITE ABSOLUTE TISSUE OXIMETER (K123700) and its substantial equivalence to predicate devices, but it does not include detailed acceptance criteria tables or specific reported device performance metrics against those criteria. It also does not provide information about a study proving the device meets specific acceptance criteria in the format requested, particularly regarding sample sizes for test sets, data provenance, expert qualifications, or details about comparative effectiveness studies.
The document primarily focuses on establishing substantial equivalence to previously cleared devices through non-clinical and clinical testing, stating that it "successfully underwent extensive performance, safety, electromagnetic, clinical, software and environmental testing" and "extensive clinical validation for the indicated use." However, it does not provide the specifics of these tests as requested in the prompt.
Therefore, for aspects relating to specific performance criteria, reported device performance against those criteria, sample sizes, expert details, and adjudication methods, the provided document does not contain the necessary information.
Here's an attempt to answer based on the information provided and to explicitly state when information is not available:
1. Table of Acceptance Criteria and Reported Device Performance
The provided document does not contain a table of acceptance criteria or specific reported device performance metrics (e.g., accuracy, precision, sensitivity, specificity) against defined criteria. It generally states that the device "successfully underwent extensive performance... testing" to ensure substantial equivalence.
2. Sample Size Used for the Test Set and Data Provenance
The document mentions "extensive clinical validation for the indicated use" and "a validation report for Cerebral Tissue Oxygen Saturation (StO2%) in Adult and Transitional Adolescent Subjects." However, it does not specify the sample size used for any test set or the data provenance (e.g., country of origin, retrospective/prospective).
3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts
This information is not provided in the document.
4. Adjudication Method (e.g., 2+1, 3+1, none) for the Test Set
This information is not provided in the document.
5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, If so, What Was the Effect Size of How Much Human Readers Improve with AI vs without AI Assistance
This document describes an oximeter, which is a measurement device for physiological parameters (blood oxygen saturation). It is not an AI-assisted diagnostic imaging device for which MRMC comparative effectiveness studies involving human readers and AI assistance would typically be conducted. Therefore, this question is not applicable in the context of the provided device.
6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done
The device is an oximeter with an algorithm to determine StO2 values. The "accuracy" or "performance" of such a device is inherently its standalone measurement capability. The document states: "The FORE-SIGHT algorithm determines the StO2 values for the tissue under the sensor from the light absorption values and measured patient characteristics." It also mentions "extensive performance... testing" and "clinical validation." This implies standalone performance was evaluated, but specific metrics are not provided.
7. The Type of Ground Truth Used (expert consensus, pathology, outcomes data, etc.)
For an oximeter, the ground truth would typically be established against a reference standard method for blood oxygen saturation measurement (e.g., arterial blood gas analysis, co-oximetry). The document does not explicitly state the "type of ground truth" used for its clinical validation studies, but for physiological measurements, it is usually a recognized clinical gold standard.
8. The Sample Size for the Training Set
The document does not mention a "training set" or its sample size. This type of information is typically relevant for machine learning or AI models that require distinct training and testing phases. While the device uses an "algorithm," the document doesn't explicitly refer to its development structure in terms of training sets.
9. How the Ground Truth for the Training Set Was Established
Since a "training set" and its ground truth establishment are not discussed, this information is not provided.
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CASMED Nov. 28, 2012
FORE-SIGHT ELITE ABSOLUTE TISSUE OXIMETER
Page 18 of 240
APR 1 1 2013
2 (2)
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510(k) SUMMARY OF SAFETY AND EFFECTIVENESS
and the same of the same
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| Submitter: | CAS Medical Systems, Inc. |
|---|---|
| Address: | 44 East Industrial Rd. Branford CT. 06405 USA |
| Contact: | Ron Jeffrey – Director, Regulatory AffairsPhone – (203) 488-6056Fax – (203) 488-9438Email – rjeffrey@casmed.com |
| Prepared: | November 28, 2012 |
| Trade Name: | FORE-SIGHT Elite™ Absolute Tissue Oximeter |
| Common Name: | FORE-SIGHT Oximeter |
| Classification Name: | Oximeter, Tissue Saturation (870.2700) (MUD) |
Page 1 of 3
.
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EQUIVALENCE (Predicate Device)
The FORE-SIGHT Elite™ Absolute Tissue Oximeter is equivalent to the following devices:
-
- FORE-SIGHT Absolute Tissue Oximeter Monitor (K112820)
-
- Nonin Model 7600 Regional Oximeter Equanox (K102715)
DESCRIPTION
The FORE-SIGHT Elite Absolute Tissue Oximeter measures hemoglobin under the Sensor, allowing the clinician to continuously and accurately determine absolute levels of blood oxygenation saturation in the tissue (StO2).
The Oximeter consists of a monitor unit, preamplifier assembly, and sensor uses multiple wavelengths of light in the range of 660 to 900 nm to precisely measure light absorption in tissue. Sensors are sized to provide targeted penetration depths appropriate for the tissue and patient populations of interest. The monitor unit controls the measurement sequence, regulating sensor light output and processing the detected light signals after amplification by the dual-channel preamplifier assembly. The FORE-SIGHT algorithm determines the StO2 values for the tissue under the sensor from the light absorption values and measured patient characteristics. The monitor unit provides simultaneous measurements on up to four sensors with both numeric and real-time graphical display formats.
The monitor unit is a mains-powered device with a field-replaceable battery backup module. A touchscreen user interface allows configuration of the Oximeter including audible, on-screen, and dedicated visual alarm indicators. The monitor display can be replicated for simultaneous remote viewing through an auxiliary VGA video output. Measurement data can be exported through various interfaces such as USB and RS-232.
FORE-SIGHT Oximeter Monitor Intended Use
The noninvasive FORE-SIGHT Elite Absolute Tissue Oximeter is intended for use as an adjunct monitor of absolute regional hemoglobin oxygen saturation of blood under the sensors in individuals at risk for reduced flow or no-flow ischemic states and is indicated as follows:
When used with Large sensors, the FORE-SIGHT Oximeter is indicated for use on the brain of adults and transitional adolescents ≥ 40 Kg.
FORE-SIGHT Monitor Technology Compared to Predicate Devices
The FORE-SIGHT Elite Absolute Tissue Oximeter compares substantially to the cited predicate devices in that they use fundamentally the same optical operating principle, called multi-distance diffuse reflectance spectroscopy. All cited monitors use light to examine a cross-section tissue microvasculature (a mixed bed of arterioles, capillaries and venules). The FORE-SIGHT Elite Monitor and predicate devices analyze the light that is returned after having passed through tissues. The spectroscopic analysis determines concentrations of hemoglobin in its oxygenated and deoxygenated states. All cited monitors calculate oxygen saturation which reflects the percentage of oxygenated hemoglobin in the sampled tissue.
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The FORE-SIGHT Elite Absolute Tissue Oximeter compares substantially to the FORE-SIGHT predicate device. Differences between the FORE-SIGHT predicate and the Elite include a 4-channel capability, enhanced user interface features and the benefits of portability.
Non-Clinical Performance Testing to Demonstrate Substantial Equivalence
The FORE-SIGHT Elite Absolute tissue Oximeter has successfully undergone extensive performance, safety, electromagnetic, clinical, software and environmental testing to ensure it has been found to be substantially equivalent to the FORE-SIGHT predicate device. In addition to the above laboratory tests, CAS has conducted a full program of individual hardware, systems verification and validation studies of the FORE-SIGHT monitor and sensors.
Clinical Testing to Show Substantial Equivalence
The FORE-SIGHT Elite Absolute Tissue Oximeter has successfully undergone extensive clinical validation for the indicated use. The premarket notification cites a validation report for Cerebral Tissue Oxygen Saturation (StO2%) in Adult and Transitional Adolescent Subjects.
Conclusions Drawn from Clinical and Non-Clinical Testing
Clinical evaluation, safety testing and software validation demonstrate the FORE-SIGHT Elite Absolute Tissue Oximeter is substantially equivalent to the predicate devices.
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DEPARTMENT OF HEALTH & HUMAN SERVICES
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Public Health Service
Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
April 11, 2013
CAS Medical Systems c/o Mr. Ron Jeffrey 44 East Industrial Rd Brandford, CT 06405
Re: K123700
Trade/Device Name: FORE-SIGHT Elite Absolute Tissue Oximeter Regulation Number: 21 CFR 870.2700 Regulation Name: Oximeter, Tissue Saturation Regulatory Class: Class II Product Code: MUD Dated: February 19, 2013 Received: March 7, 2013
Dear Mr. Jeffrey:
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 of the Act or any Federal statutes and regulations administered by other Federal agencies. You must
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Page 2 - Mr. Ron Jeffrey
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 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.goy/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.
for
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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Indications for Use
| 510(k) Number: | K123700 |
|---|---|
| Device Name: | FORE-SIGHT Elite™ Absolute Tissue Oximeter. |
| Indications for Use: | The noninvasive FORE-SIGHT Elite Absolute Tissue Oximeter is intended for use as an adjunct monitor of absolute regional hemoglobin oxygen saturation of blood under the sensors in individuals at risk for reduced flow or no-flow ischemic states and is indicated for use as follows:When used with large sensors, the FORE-SIGHT Oximeter is indicated for use on the brain of adults and transitional adolescents≥ 40 kg. |
Prescription Use
✓
AND/OR
Over-the-Counter Use
Prescription Use J (Part 21 CFR 801 Subpart D)
ANDIOK
Over-the-Counter Use (21 CFR 807 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED)
Con
ﺎﻧ
Concurrence of CDRH, Office of Device Evaluation (ODE)
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§ 870.2700 Oximeter.
(a)
Identification. An oximeter is a device used to transmit radiation at a known wavelength(s) through blood and to measure the blood oxygen saturation based on the amount of reflected or scattered radiation. It may be used alone or in conjunction with a fiberoptic oximeter catheter.(b)
Classification. Class II (performance standards).