K Number
K130068
Device Name
DISMOUNTED MEDICAL & SUPPLEMENTAL OXYGEN SYSTEM (DMOS)
Date Cleared
2013-07-19

(189 days)

Product Code
Regulation Number
868.5655
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The DMOS is intended to convert liquid oxygen to gaseous oxygen for delivery to a patient and/or for delivery to rescue personnel to supplement environmental oxygen at high altitudes while being carried by a rescue personnel at one-half (0.5) to fifteen (15) liters per minute (LPM) and fifty (50) pounds per square inch gauge (psig).
Device Description
The DMOS, when filled with liquid oxygen, will be used to provide medical oxygen treatment to injured personnel or provide supplemental oxygen to operator during dismounted operations above 10,000 feet MSL. The DMOS provides for storing of 1.4 liters of liquid oxygen and converting this liquid into its gaseous state. The gaseous oxygen is capable of being delivered in controlled amounts to provide medical treatment to injured patients and uncontrolled amounts to drive respiratory medical devices or supplemental oxygen in high altitude. The DMOS is capable of being filled with liquid oxygen from the Oxygen Generator System (OGS) and with current liquid oxygen storage/ filling stations. The DMOS contains a thermally insulated container of liquid oxygen (LOX) that is intended to supplement gases to be inhaled by a patient. The DMOS supports medical devices provided by the user including masks, cannulas, and Bag Valve Mask (BVM) being attached to the flow control patient outlets. The DMOS is portable and can be carried onboard, tied down, transported and operationally perform on various aircraft and ground vehicles. The DMOS converts liquid oxygen from its insulated container through its heat exchanger into gaseous oxygen and finally the gaseous oxygen is available for distribution from an outlet port on the user interface.
More Information

Not Found

No
The device description and intended use focus on the physical conversion of liquid oxygen to gas and its delivery, with no mention of AI or ML technologies for control, analysis, or prediction. The performance studies rely on bench testing and comparison to a predicate device, not on data-driven model performance.

Yes.
The device provides medical oxygen treatment and supplements gases to be inhaled by a patient, directly contributing to therapy.

No
The device is described as converting liquid oxygen to gaseous oxygen for delivery to a patient, functioning as a medical oxygen treatment device. It does not mention any diagnostic capabilities such as detecting, monitoring, or analyzing physiological parameters or conditions.

No

The device description clearly outlines a physical device that stores and converts liquid oxygen to gaseous oxygen, involving hardware components like an insulated container, heat exchanger, and outlet ports. There is no mention of software being the primary or sole component.

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

Here's why:

  • Intended Use: The intended use is to convert liquid oxygen to gaseous oxygen for delivery to a patient or rescue personnel to supplement environmental oxygen. This is a therapeutic and life-support function, not a diagnostic one.
  • Device Description: The description details how the device stores and converts liquid oxygen for inhalation. It mentions supporting medical devices like masks and cannulas, which are used for delivering oxygen, not for performing in vitro diagnostic tests.
  • Lack of Diagnostic Elements: There is no mention of the device analyzing biological samples (blood, urine, tissue, etc.) or providing information about a patient's health status based on such analysis.
  • Anatomical Site: The concept of an "Anatomical Site" in the context of this device refers to where the oxygen is delivered (respiratory system), not where a diagnostic test is performed.
  • Performance Studies: The performance studies focus on the device's ability to convert and deliver oxygen, not on its accuracy in diagnosing a condition.

In vitro diagnostics are devices used to examine specimens taken from the human body to provide information for diagnosis, monitoring, or screening. The DMOS does not perform any of these functions. It is a medical device used for oxygen delivery.

N/A

Intended Use / Indications for Use

The DMOS is intended to convert liquid oxygen to gaseous oxygen for delivery to a patient and/or for delivery to rescue personnel to supplement environmental oxygen at high altitudes while being carried by a rescue personnel at one-half (0.5) to fifteen (15) liters per minute (LPM) and fifty (50) pounds per square inch gauge (psig).

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

BYJ

Device Description

The DMOS provides for storing of 1.4 liters of liquid oxygen and converting this liquid into its gaseous state. The gaseous oxygen is capable of being delivered in controlled amounts to provide medical treatment to injured patients and uncontrolled amounts to drive respiratory medical devices or supplemental oxygen in high altitude. The DMOS is capable of being filled with liquid oxygen from the Oxygen Generator System (OGS) and with current liquid oxygen storage/ filling stations.

DMOS contains liquid oxygen (LOX). The DMOS contains a thermally insulated container of liquid oxygen (LOX) that is intended to supplement gases to be inhaled by a patient. The DMOS supports medical devices provided by the user including masks, cannulas, and Bag Valve Mask (BVM) being attached to the flow control patient outlets. An empty portable liquid oxygen unit is a device, while the oxygen contained therein is a drug.

The DMOS is portable. The handle on the front control make the DMOS portable. The DMOS can be carried onboard, tied down, transported and operationally perform on various aircraft and ground vehicles.

The DMOS converts liquid oxygen from its insulated container through its heat exchanger into gaseous oxygen and finally the gaseous oxygen is available for distribution from an outlet port on the user interface. After connecting a tube assembly connector of a mask, cannula, and Bag Valve Mask (BVM) to an outlet port, masks, cannulas, and BVMs or other similar medical device (none of these devices is included in the DMOS) the patient can inhale the gaseous oxygen.

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

Adult

Intended User / Care Setting

Military & commercial emergency response /rescue

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)

Essex Industries, Inc. Engineering personnel completed extensive DMOS capability, performance, and environmental testing with similar acceptable results as that of BMOS and so have determined that DMOS is substantially equivalent to BMOS. The combined testing and analysis of results provides assurance that the device meets it specifications and meets its intended use.

Bench tests performed: Insulation Resistance, Visual & Dimensional Examination, Leakage, Quantity Indicator Performance, Weight & Capacity, Fill Time, Buildup Time, Parachutist Mask Delivery Rate, Patient Delivery Rate, Patient Delivery Temperature, Delivery Duration, Normal Evaporative Rate, High Temperature Operation, Low Temperature Operation, Altitude, Helicopter Vibration, Aircraft Vibration, Ground Vehicle Vibration, Functional Shock, Crash Hazard Shock, Safety Drop.

Analysis performed: Ballistic Test, Salt Fog, Humidity, Rain, Freezing Rain, Blowing Snow.

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.

K071581

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.

Not Found

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

§ 868.5655 Portable liquid oxygen unit.

(a)
Identification. A portable liquid oxygen unit is a portable, thermally insulated container of liquid oxygen that is intended to supplement gases to be inhaled by a patient, is sometimes accompanied by tubing and an oxygen mask. An empty portable liquid oxygen unit is a device, while the oxygen contained therein is a drug.(b)
Classification. Class II (performance standards).

0

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K130068

JUL 1 9 2013

510(k) Summary

  1. Owner Information
Owner's Name:Essex Industries, Inc. d/b/a Essex Cryogenics of Missouri
Address:8007 Chivvis Drive
St. Louis, Missouri 63123-2395
Phone Number:314-338-8533
Fax Number:314-832-8208
Contact Person:Kenneth L. Seise
Date:January 5, 2013 (Revised July 19, 2013)
  1. Medical Device Information

Dismounted Medical & Supplemental Oxygen System (DMOS) Trade Name: Common Name: Portable Liquid Oxygen System Classification Name: Portable Liquid-Oxygen Unit Classification Code: II Product Code: BYJ CFR Section: 21CFR 868.5655

510(k): K130068

  1. Substantial Equivalence to Predicate Medical Device

The DMOS is substantially equivalent to the Backpack Medical Oxygen System (BMOS) (K071581).

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4. Medical Device Description

Physical and performance characteristics

The DMOS, when filled with liquid oxygen, will be used to provide medical oxygen treatment to injured personnel or provide supplemental oxygen to operator during dismounted operations above 10,000 feet MSL. The following general requirements apply.

  • The DMOS shall supply 93% oxygen concentration when filled from Oxygen a) Generator System (OGS).
  • The DMOS shall be capable of delivering gaseous oxygen to one patient at a b) maximum flow rate of 15 ambient Liters Per Minute (LPM).
  • The DMOS shall be capable of connecting to medical mask or cannula to supply c) oxygen during operations above 10,000 feet MSL.
  • d) The DMOS shall be capable of delivering oxygen to one patient at a flow rate of 5 LPM for a minimum duration of 4 hours.
  • The DMOS operating pressure shall be 50 ± 5 pounds per square inch gauge e) (psig).
  • f) The liquid oxygen (LOX) capacity shall be 1.4 liters.
  • The DMOS shall operate up to 35,000 feet MSL. g)
  • The overall weight of the DMOS, including LOX, shall be less than 16 lbs. h)
  • The oxygen delivery pressure shall be monitored and displayed. i)
  • The liquid oxygen quantity shall be monitored and displayed. j)
  • Any power required by the DMOS shall be self-contained. k)
    1. The DMOS shall have the capability to be filled with LOX by standard Department of Defense (DoD) and North Atlantic Treaty Organization (NATO) servicing connectors.

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  • The DMOS shall be refilled in 10 minutes or less from the Oxygen Generator m) System (OGS).

How the device functions

The DMOS provides for storing of 1.4 liters of liquid oxygen and converting this liquid into its gaseous state. The gaseous oxygen is capable of being delivered in controlled amounts to provide medical treatment to injured patients and uncontrolled amounts to drive respiratory medical devices or supplemental oxygen in high altitude. The DMOS is capable of being filled with liquid oxygen from the Oxygen Generator System (OGS) and with current liquid oxygen storage/ filling stations.

DMOS contains liquid oxygen (LOX). The DMOS contains a thermally insulated container of liquid oxygen (LOX) that is intended to supplement gases to be inhaled by a patient. The DMOS supports medical devices provided by the user including masks, cannulas, and Bag Valve Mask (BVM) being attached to the flow control patient outlets. An empty portable liquid oxygen unit is a device, while the oxygen contained therein is a drug.

The DMOS is portable. The handle on the front control make the DMOS portable. The DMOS can be carried onboard, tied down, transported and operationally perform on various aircraft and ground vehicles.

The DMOS converts liquid oxygen from its insulated container through its heat exchanger into gaseous oxygen and finally the gaseous oxygen is available for distribution from an outlet port on the user interface. After connecting a tube assembly connector of a mask, cannula, and Bag Valve Mask (BVM) to an outlet port, masks, cannulas, and BVMs or other similar medical device (none of these devices is included in the DMOS) the patient can inhale the gaseous oxygen.

    1. Indications for Use of Medical Device
      The DMOS is intended to convert liquid oxygen to gaseous oxygen for delivery to a patient and/or for delivery to rescue personnel to supplement environmental oxygen at high altitudes while being carried by a rescue personnel at one-half (0.5) to fifteen (15) liters per minute (LPM) and fifty (50) pounds per square inch gauge (psig).

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6. Comparison to Predicate Medical Device

The BMOS (K071581) is the predicate medical device to which DMOS (K130068) is compared. Indications for Use for BMOS is that the BMOS is intended to be used by emergency response personnel in military and commercial fields to provide an emergency source of supplemental oxygen for a patient while being transported from a crisis situation to a health care facility. The BMOS is not intended to be a life sustaining or life-supporting device.

  • Both the submission device and predicate device convert liquid oxygen to gaseous . oxygen
  • Both devices can be used in military and commercial applications .
  • Both devices supply supplemental oxygen to a patient .
  • Both flow at one-half (0.5) to fifteen (15) liters per minute (LPM) and fifty (50) . pounds per square inch gauge (psig)
  • The only difference between the two devices is that DMOS is capable of . supplying oxygen to rescue personnel in situations where they themselves need additional oxygen when they are in high altitude, mountainous region

BMOS & DMOS are both portable. Personnel can move a BMOS device by picking up the unit by the handle on the front face and walking with it while personnel can move a DMOS device by in the same manner. Both the BMOS and DMOS devices are similar in that they include a thermally insulated container. Both containers are designed built, and tested per 49 CFR §178.57, Specification 4L welded insulated cylinders, and are housed in aluminum sheet metal enclosures that contain heat exchangers that convert the liquid oxygen to gaseous oxygen. Both devices have ports that can be connected to tubing intended for connection to an oxygen mask or other similar medical device to ultimately supplement gases to be inhaled by a patient.

Both devices can be monitored for pressure and liquid oxygen quantity. The differences in the BMOS and DMOS are in the container size and LOX capacity. The BMOS container is a cylinder that is approximately 13.1 inches long and 5.0 inches in diameter with a LOX capacity of 2 liters while the DMOS container is a cylinder that is approximately 12.3 inches long and 4.4 inches in diameter with a LOX capacity of 1.4 liters.

The DMOS has an additional parachute port, which the BMOS does not have, that allows the military rescue personnel to plug in his/her parachutist mask for additional oxygen when they are in high altitude, mountainous region.

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DMOS is a slightly smaller version of the BMOS, where both systems function exactly the same, with the exception that DMOS has the capability to provide oxygen at high altitude for rescue personnel.

PerformanceDMOS (K130068)BMOS (K071581)
Characteristics(PREDICATE DEVICE)
Indications for UseThe DMOS is intended to convert liquidThe BMOS is intended to be used by
oxygen to gaseous oxygen for delivery to aemergency response personnel in military
patient and/or for delivery to rescue personneland commercial fields to provide an
to supplement environmentalemergency source of supplemental oxygen
oxygen at high altitudes while being carriedfor a patient while being transported from a
by a rescue personnel at one-half (0.5) tocrisis situation to a health care facility. The
fifteen (15) liters per minute (LPM) and fiftyBMOS is intended to be a life sustaining or
(50) pounds per square inch gaugelife-supporting device.
(psig).
Target PopulationAdultAdult
Where UsedMilitary & commercial emergency responseMilitary & commercial emergency response
/rescue/rescue
Dimensional EnvelopeHeight = 5.5"Height = 6.5"
Width = 7.25"Width = 7.5"
Depth = 17.0"Depth = 17.5"
System Weight15.3 lbs when filled with LOX18.5 lbs max when filled with LOX
Delivery Rate (outlet15 LPM @ 50 PSIG15 LPM @ 50 PSIG
flow)
Delivery TemperatureWithin +10/-20 °F of low ambient (-40 °F)Within +10/-20 °F of ambient at outlet ports.
and within +10/-65 °F of high ambient (130
°F) at the outlet ports.
Delivery TemperatureNo alarmNo alarm
Alarm
# Person Carry1-Person-unit has one handle.1-Person-unit has one handle.
Energy UsedBattery operatedBattery operated
LOX Quantity IndicatorBattery powered indicator (One 9V)Battery powered indicator (Six AA)
Low Quantity AlarmNo alarmNo alarm
Outlet Pressure50 PSIG outlet pressure50 PSIG outlet pressure
Outlet Pressure AlarmNo alarmNo alarm
Outlet Ports2 Outlet Ports (DISS 1240 & Female Dixon1 Outlet Port (DISS 1240)
Quick-Disconnect)
Flow Control Outlet1 Flow Control Valve (0.5-15 LPM, with 121 Flow Control Valve (0.5-15 LPM, with 12
Portssettings)settings)
Human FactorsSingle-person carrySingle-person carry
Standards MetDOT-4L (Production Units)DOT-4L
Sterility / Shelf LifeN/AN/A
Electrical SafetyTested IAW MIL-STD-810GTested IAW MIL-STD-810F

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| Performance/
Characteristics | DMOS (K130068) | BMOS (K071581)
(PREDICATE DEVICE) |
|----------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------|
| Medical Devices
Compatibility | Commercial Mask
Commercial Cannula
Flow Control Valve (0.5-15 LPM, with 12 settings) | Commercial Mask
Commercial Cannula
Flow Control Valve (0.5-15 LPM, with 12 settings) |
| Fill Connection | Standard Military CRU-50/A connection
which connects with the military standard
CRU-59/E connector on all the LOX filling
equipment | Standard Military CRU-50/A connection
which connects with the military standard
CRU-59/E connector on all the LOX filling
equipment |
| Storage Capacity | 1.4 Liters of LOX | 2 Liters of LOX |
| Operating Temperature | -40°F to 130°F | 32°F to 120°F |
| Storage Temperature | -40°F to 130°F | -40°F to 160°F |

7. Medical Device Tests

Essex Industries, Inc. Engineering personnel completed extensive DMOS capability, performance, and environmental testing with similar acceptable results as that of BMOS and so have determined that DMOS is substantially equivalent to BMOS. The combined testing and analysis of results provides assurance that the device meets it specifications and meets its intended use. See the following table for bench tests and standards.

Bench TestTest or AnalysisTest Standard
Insulation ResistanceTest
Visual & Dimensional
ExaminationTest
LeakageTest
Quantity Indicator PerformanceTest
Weight & CapacityTest
Fill TimeTest
Buildup TimeTest
Parachutist Mask Delivery RateTest
Patient Delivery RateTest
Patient Delivery TemperatureTest
Delivery DurationTest
Normal Evaporative RateTest
High Temperature Operationl estMIL STD 810 Rev. G
Low Temperature OperationTestMIL STD 810 Rev. G
AltitudeTestMIL STD 810 Rev. G

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Bench TestTest or AnalysisTest Standard
Helicopter VibrationTestMIL STD 810 Rev. G
Aircraft VibrationTestMIL STD 810 Rev. G
Ground Vehicle VibrationTestMIL STD 810 Rev. G
Functional ShockTestMIL STD 810 Rev. G
Crash Hazard ShockTestMIL STD 810 Rev. G
Safety DropTestMIL STD 810 Rev. G
Ballistic TestAnalysis
Salt FogAnalysis
HumidityAnalysis
RainAnalysis
Freezing RainAnalysis
Blowing SnowAnalysis

8. Conclusions

Based on review of the design and test results, Essex Industries, Inc. believes that no significant differences exist between this medical device, DMOS, and the predicate medical device, BMOS, and therefore DMOS is substantially equivalent to BMOS.

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

July 19, 2013

Essex Industries, Inc. d/b/a Essex Cryogenics of Missouri C/O Mr. Kenneth Seise Quality Assurance/Regulatory Compliance Manager 8007 Chivvis Drive St. Louis, MO 63123-2395

Re: K130068

Trade/Device Name: Dismounted Medical & Supplemental Oxygen System Regulation Number: 21 CFR 868.5655 Regulation Name: Portable Liquid-Oxygen Unit Regulatory Class: II Product Code: BYJ Dated: June 17, 2013 Received: June 19, 2013

Dear Mr. Seise:

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.

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Page 2 - Mr. Seise

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/Resourcesfor You/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.

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Kwame Ulmer, M.S. Acting Division Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use Statement

510(k) Number (if known):

Device Name: Dismounted Medical & Supplemental Oxygen System

Indications for Use: The DMOS is intended to convert liquid oxygen to gaseous oxygen for delivery to a patient and/or for delivery to rescue personnel to supplement environmental oxygen at high altitudes while being carried by a rescue personnel at one-half (0.5) to fifteen (15) liters per minute (LPM) and fifty (50) pounds per square inch gauge (psig).

Anya C. Harry Digitally signed by Anya C. Harry
DN: c=US, o=U.S. Government, ou=HHS,
ou=FDA, ou=People, cn=Anya C. Harry,
0.9.2342.19200300.100.1.1=0011315590

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

510(k) Number: K130068

Prescription Use. X (CFR Title 21, Part 801, Subpart D)

AND/OR

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

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assexindustries.com

Even Industries, Inc. | 9007 Chivats Drive | St. Lovic, MC143123 | 314.832.8077 | 314.832.8208 Fax