K Number
K123882
Device Name
AGE AUTOMATIC UPPER ARM BLOOD PRESSURE MONITOR
Date Cleared
2013-08-14

(240 days)

Product Code
Regulation Number
870.1130
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
AGE Automatic Upper Arm Blood Pressure Monitor is for use by medical professionals or at home and is a non-invasive blood pressure measurement system intended to measure the diastolic and systolic blood pressures and pulse rate of an adult individual by using a non-invasive technique in which an inflatable cuff is wrapped around the upper arm. The cuff circumference is limited to 24~34 cm.
Device Description
AGE Automatic Upper Arm Blood Pressure Monitor is a battery driven automatic non-invasive blood pressure meter. It can automatically conduct the inflation and measurement, which can measure systolic and diastolic blood pressure as well as the pulse rate of adult at arm within its claimed range and accuracy via the oscillometric technique. The device also has low voltage indication, which will be triggered when the battery is low.
More Information

Not Found

No
The summary describes a standard oscillometric blood pressure monitor and does not mention any AI or ML components or capabilities.

No
This device is for measurement and monitoring of blood pressure, not for therapy or treatment.

Yes

Explanation: The device measures diastolic and systolic blood pressures and pulse rate, which are physiological parameters used to assess a patient's health status and aid in diagnosing conditions like hypertension.

No

The device description explicitly states it is a "battery driven automatic non-invasive blood pressure meter" and mentions components like an "inflatable cuff" and "low voltage indication," indicating it is a hardware device with integrated software, not a software-only device.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD devices are used to examine specimens derived from the human body. This typically involves things like blood, urine, tissue, etc., and the tests are performed outside of the body (in vitro).
  • This device measures blood pressure and pulse rate directly from the patient's arm. This is a non-invasive measurement taken on the body, not a test performed on a sample taken from the body.

The description clearly states it's a "non-invasive blood pressure measurement system" that uses an "inflatable cuff is wrapped around the upper arm." This is the definition of a device used for physiological measurement on a living person, not an in vitro diagnostic test.

N/A

Intended Use / Indications for Use

AGE Automatic Upper Arm Blood Pressure Monitor is intended for use by medical professionals or at home to monitor and display diastolic, systolic blood pressure and pulse rate on adult each time, with the cuff around the left arm according to the instruction in the user's guide manual.

AGE Automatic Upper Arm Blood Pressure Monitor is for use by medical professionals or at home and is a non-invasive blood pressure measurement system intended to measure the diastolic and systolic blood pressures and pulse rate of an adult individual by using a non-invasive technique in which an inflatable cuff is wrapped around the upper arm. The cuff circumference is limited to 24~34 cm.

Product codes

DXN

Device Description

AGE Automatic Upper Arm Blood Pressure Monitor is a battery driven automatic non-invasive blood pressure meter. It can automatically conduct the inflation and measurement, which can measure systolic and diastolic blood pressure as well as the pulse rate of adult at arm within its claimed range and accuracy via the oscillometric technique. The device also has low voltage indication, which will be triggered when the battery is low.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Arm / upper arm

Indicated Patient Age Range

Adult

Intended User / Care Setting

medical professionals or at home

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)

AGE Automatic Upper Arm Blood Pressure Monitor has been evaluated the safety and performance by lab bench testing according to the following standards:

  • IEC 60601-1, Medical Electrical Equipment - Part 1: General Requirements for Safety, 1988+A1:1991+A2:1995
  • IEC 60601-1-2, Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic compatibility -Requirements and tests, 2007
  • ISO 10993-5, Biological evaluation of medical devices -- Part 5: Tests for In Vitro cytotoxicity, 2009
  • ISO 10993-10, Biological evaluation of medical devices - Part 10: Tests for irritation and skin sensitization, 2010
  • ANSI/AAMI SP10, Manual, electronic or automated sphygmomanometers, 2002+A1:2003+A2:2006+(R)2008

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

Not Found

Predicate Device(s)

K110281

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.1130 Noninvasive blood pressure measurement system.

(a)
Identification. A noninvasive blood pressure measurement system is a device that provides a signal from which systolic, diastolic, mean, or any combination of the three pressures can be derived through the use of tranducers placed on the surface of the body.(b)
Classification. Class II (performance standards).

0

K123882 Page 1 of 5

Sponsor: Ageless Health Industrial Ltd. AGE Automatic Upper Arm Blood Pressure Monitor, Model: BA-801, BA-803, Subject Device: BA-805, BA-806, BA-811, BA-812, BA-813 File No.: 510(k) submission report (V1.0), Chapter 6

Chapter 6. 510(k) Summary

510(k) Summary

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA and 21 CFR 870.1130.

1. Submitter Information

Sponsor Name: Ageless Health Industrial Ltd.

Address: 3/F, A1 Bldg, Dongshen Sima Industrial Area, No.33 Shenbei Road, Sima Village, Changping Town, Dongguan City, Guangdong Province, China

Contact Person: Victor Wan (Vice-president)

Phone: 0769-81158038

Fax: 0769-82289331 E-mail: victor@agelh.com / c.ceng@foxmail.com Web: www.agelh.com

2. Subject Device Information

Type of 510(k) submission:Traditional
Common Name:Noninvasive blood pressure measurement systems
Trade Name:AGE Automatic Upper Arm Blood Pressure Monitor
Classification Name:Noninvasive blood pressure measurement system
Review Panel:Cardiovascular
Product Code:DXN
Regulation Number:21 CFR 870.1130
Regulation Class:2

3. Predicate Device Information

Sponsor:Fudakang Industrial Co., Ltd.
Common Name:Noninvasive blood pressure measurement systems
Trade Name:Arm Automatic Blood Pressure Meter

Report by Ageless Health Industrial Ltd.

1

K123882 Page 2 of 5

Sponsor:Ageless Health Industrial Ltd.
Subject Device:AGE Automatic Upper Arm Blood Pressure Monitor, Model: BA-801, BA-802, BA-803, BA-805, BA-806, BA-811, BA-812, BA-813
File No.:510(k) submission report (V1.0), Chapter 6
510(k) number:K110281
Review Panel:Cardiovascular
Product Code:DXN
Regulation Number:21 CFR 870.1130
Regulation Class:2

4. Device Description

AGE Automatic Upper Arm Blood Pressure Monitor is a battery driven automatic non-invasive blood pressure meter. It can automatically conduct the inflation and measurement, which can measure systolic and diastolic blood pressure as well as the pulse rate of adult at arm within its claimed range and accuracy via the oscillometric technique. The device also has low voltage indication, which will be triggered when the battery is low.

5. Intended Use

AGE Automatic Upper Arm Blood Pressure Monitor is intended for use by medical professionals or at home to monitor and display diastolic, systolic blood pressure and pulse rate on adult each time, with the cuff around the left arm according to the instruction in the user's guide manual.

6. Test Summary

AGE Automatic Upper Arm Blood Pressure Monitor has been evaluated the safety and performance by lab bench testing according to the following standards:

  • � IEC 60601-1, Medical Electrical Equipment - Part 1: General Requirements for Safety, 1988+A1:1991+A2:1995
  • � IEC 60601-1-2, Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic compatibility -Requirements and tests, 2007
  • � ISO 10993-5, Biological evaluation of medical devices -- Part 5: Tests for In Vitro cytotoxicity, 2009
  • � ISO 10993-10, Biological evaluation of medical devices - Part 10: Tests for irritation and skin sensitization, 2010
  • . ANSI/AAMI SP10, Manual, electronic or automated sphygmomanometers, 2002+A1:2003+A2:2006+(R)2008

2

K123882

Page 3 of 5

Sponsor:Ageless Health Industrial Ltd.
Subject Device:AGE Automatic Upper Arm Blood Pressure Monitor, Model: BA-801, BA-802, BA-803
BA-805, BA-806, BA-811, BA-812, BA-813
File No.:510(k) submission report (V1.0), Chapter 6

7. Comparison to Predicate Device

Compare with predicate device, the subject device is very similar in design principle, intended use, indications for use, functions, material and the applicable standards. The differences between subject device and predicate device do not raise and new questions of safety or effectiveness.

| Elements of

ComparisonSubject DevicePredicate DeviceVerdict
ManufacturerAgeless Health Industrial Ltd.Fudakang Industrial Co., Ltd.--
Product NameAGE Automatic Upper Arm Blood
Pressure MonitorArm Automatic Blood Pressure
Meter--
Intended Use and Indications for Use
Intended UseAGE Automatic Upper Arm Blood
Pressure Monitor is intended for
use by medical professionals or at
home to monitor and display
diastolic, systolic blood pressure
and pulse rate on adult each time,
with the cuff around the left arm
according to the instruction in the
user's guide manual.Fudakang Arm Automatic Blood
Pressure Meter is intended for use
by medical professionals or at
home to monitor and display
diastolic, systolic blood pressure
and pulse rate on adult each time.
with the cuff around the left upper
arm according to the instruction in
the user's guide manual.SE
Indications for
UseAGE Automatic Upper Arm Blood
Pressure Monitor is for use by
medical professionals or at home
and is a non-invasive blood
pressure measurement system
intended to measure the diastolic
and systolic blood pressures and
pulse rate of an adult individual by
using a non-invasive technique in
which an inflatable cuff is wrapped
around the upper arm. The cuff
circumference is limited to 24~34
cm.Fudakang Arm Automatic Blood
Pressure Meter is for use by
medical professionals or at home
and is a non-invasive blood
pressure measurement system
intended to measure the diastolic
and systolic blood pressures and
pulse rate of an adult individual by
using a non-invasive technique in
which an inflatable cuff is wrapped
around the upper arm. The cuff
circumference is limited to 22cm-
30cm.SE
Note 1
ELECTRICAL REQUIREMENT
Power Supply6Vdc (4 "AA" batteries)6Vdc (4 "AA" batteries)SE
PERFORMANCE SPECIFICATION
Measuring
MethodOscillometryOscillometrySE
Measuring
RangePressure: 0~280 mmHg
Pulse: 40~199 beats/minutePressure: 0~300 mmHg
Pulse: 30~180 beats/minuteNote 2
AccuracyPressure: ±3 mmHg
Pulse: ±5%Pressure: ±3mmHg
Pulse: ±5%SE
Patient
PopulationAdultAdultSE

Report by Ageless Health Industrial Ltd.

3

K123882 Page 4 of 5

Sponsor:Ageless Health Industrial Ltd.
Subject Device:AGE Automatic Upper Arm Blood Pressure Monitor, Model: BA-801, BA-802, BA-803, BA-805, BA-806, BA-811, BA-812, BA-813
File No.:510(k) submission report (V1.0), Chapter 6

| Elements of

ComparisonSubject DevicePredicate DeviceVerdict
Measurement
Site of BodyArmArmSE
Cuff
Circumference24-34 cm22~30 cmSE
Note 1
Inflation and
DeflationAutomaticAutomaticSE
Memory Size2 x 90 sets record60 or 90 sets recordSE
Note 3
OPERATING & STORAGE CONDITIONS
Storage
EnvironmentTemperature: -20℃ ~ +65℃
Humidity: 10~95%RHTemperature: -20℃ ~ +60 ℃
Humidity: