K Number
K131968
Device Name
LONGFIAN OXYGEN CONCENTRATOR
Date Cleared
2014-09-05

(434 days)

Product Code
Regulation Number
868.5440
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Longfian Oxygen Concentrator, Model Jay-5 is intended to be used by patients with respiratory disorders who require supplemental oxygen. A high concentration of supplemental oxygen is supplied and a nasal cannula is used to channel oxygen from the concentrator to the patient. The Longfian Oxygen Concentrator, Model Jay-5 can be used in a home, institution, vehicle, and various mobile environments. The Longfian Oxygen Concentrator, Model Jay-5 does not nor is it intended to sustain or support life.
Device Description
JAY-5 medical oxygen concentrator adopts pressure swing adsorption principle, which can separate oxygen, nitrogen and other gas from the air, at constant temperature. As soon as power is connected, the air is taken in and compressed by oilless air compressor through filtering, then the compressed air goes through the cooler and it is cooled. After that, the air is taken into absorption tower by control valve and the oxygen can be separated in the absorption tower. At the same time, the high purity oxygen is collected into the oxygen tank, and it goes through the flow meter and humidifier, finally the oxygen that meets medical standards can be supplied. Oxygen is generated by pure physical method. The concentrator can supply 1-2 patients simultaneously, with steady oxygen flowing out and reliable, adjustable flow. The device is capable of providing oxygen flow up to 5 LPM. The concentration of supplied oxygen is from 90%-96%. The key parts of the generator adopt anti-tiring and anti-aging design, and the planned life of the whole generator reaches up to 20,000 hours. The weight of Jay-5 is around 25kg (~55lbs). There is no influence on indoor oxygen percent during the generator operating. JAY-5 medical oxygen concentrator contains the following items: - · One (1) Jay-5 Oxygen Concentrator Unit - · One (1) AC Power Supply - · One (1) Nasal Oxygen Tube - One (1) Humidifier - One (1) Operation Manual
More Information

No
The device description focuses on the physical process of oxygen concentration using pressure swing adsorption and does not mention any computational or algorithmic components that would suggest AI/ML.

Yes
The device is described as a "medical oxygen concentrator" and is intended to be used by patients with respiratory disorders who require supplemental oxygen, which directly addresses a medical condition.

No

Explanation: The device is an oxygen concentrator intended to supply supplemental oxygen to patients with respiratory disorders. It is a therapeutic device that provides a treatment (oxygen), not a diagnostic device that identifies or characterizes a disease or condition.

No

The device description clearly outlines a physical hardware device (oxygen concentrator unit, power supply, tubes, humidifier) that uses a physical process (pressure swing adsorption) to generate oxygen. There is no mention of software being the primary or sole component.

Based on the provided text, the Longfian Oxygen Concentrator, Model Jay-5 is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use clearly states that the device is used by patients with respiratory disorders to provide supplemental oxygen. This is a therapeutic use, not a diagnostic one.
  • Device Description: The description details how the device physically separates oxygen from air and delivers it to the patient. This process does not involve testing samples from the human body (in vitro).
  • Lack of IVD Characteristics: The text does not mention any of the typical characteristics of an IVD device, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in those samples
    • Providing information for diagnosis, monitoring, or screening

The device is a medical device used for respiratory support, which falls under a different regulatory category than IVD devices.

N/A

Intended Use / Indications for Use

The Longfian Oxygen Concentrator, Model Jay-5 is intended to be used by patients with respiratory disorders who require supplemental oxygen. A high concentration of supplemental oxygen is supplied and a nasal cannula is used to channel oxygen from the concentrator to the patient. The Longfian Oxygen Concentrator, Model Jay-5 can be used in a home, institution, vehicle, and various mobile environments. The Longfian Oxygen Concentrator, Model Jay-5 does not nor is it intended to sustain or support life.

Product codes

CAW

Device Description

JAY-5 medical oxygen concentrator adopts pressure swing adsorption principle, which can separate oxygen, nitrogen and other gas from the air, at constant temperature. As soon as power is connected, the air is taken in and compressed by oilless air compressor through filtering, then the compressed air goes through the cooler and it is cooled. After that, the air is taken into absorption tower by control valve and the oxygen can be separated in the absorption tower. At the same time, the high purity oxygen is collected into the oxygen tank, and it goes through the flow meter and humidifier, finally the oxygen that meets medical standards can be supplied. Oxygen is generated by pure physical method.

The concentrator can supply 1-2 patients simultaneously, with steady oxygen flowing out and reliable, adjustable flow. The device is capable of providing oxygen flow up to 5 LPM. The concentration of supplied oxygen is from 90%-96%. The key parts of the generator adopt anti-tiring and anti-aging design, and the planned life of the whole generator reaches up to 20,000 hours. The weight of Jay-5 is around 25kg (~55lbs). There is no influence on indoor oxygen percent during the generator operating.

JAY-5 medical oxygen concentrator contains the following items:

  • One (1) Jay-5 Oxygen Concentrator Unit
  • One (1) AC Power Supply
  • One (1) Nasal Oxygen Tube
  • One (1) Humidifier
  • One (1) Operation Manual

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

Not Found

Intended User / Care Setting

patients with respiratory disorders who require supplemental oxygen. The Longfian Oxygen Concentrator, Model Jay-5 can be used in a home, institution, vehicle, and various mobile environments.

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

Non-clinical testing of the Longfian Oxygen Concentrator, Models Jay-5 has been performed against requirements for performance, physical attributes, environmental conditions, materials and to provide objective evidence that the device's intended use is met.

Key Metrics

Not Found

Predicate Device(s)

K083559

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 868.5440 Portable oxygen generator.

(a)
Identification. A portable oxygen generator is a device that is intended to release oxygen for respiratory therapy by means of either a chemical reaction or physical means (e.g., a molecular sieve).(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of three human profiles facing to the right, stacked on top of each other.

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

September 5, 2014

Longfian Scitech Co., Ltd. c/o Mr. Jun Peng P&L Scientific, Inc. 6840 SW 45th LN Unit 5 Miami, FL 33155

Re: K131968

Trade/Device Name: OXY.LIFE Oxygen Concentrator, Models Jay-5 Regulation Number: 21 CFR 868.5440 Regulation Name: Oxygen concentrator, portable Regulatory Class: Class II Product Code: CAW Dated: August 1, 2014 Received: August 7, 2014

Dear Mr. Peng:

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.

1

Page 2 Mr. Peng

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 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 contact the Division of Industry and Consumer Education 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. 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 Industry and Consumer Education 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,

Image /page/1/Picture/8 description: The image shows the name Tejashri Purohit-Sheth, M.D. twice. Below the second instance of the name, the text "Clinical Deputy Director" is present. The text "DAGRID/ODE/CDRH FOR" is located below the title.

Erin I. Keith, M.S. 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

K131968 510(k) Number (if known):

Device Name: The Longfian Oxygen Concentrator, Model Jay-5

Indications for Use:

The Longfian Oxygen Concentrator, Model Jay-5 is intended to be used by patients with respiratory disorders who require supplemental oxygen. A high concentration of supplemental oxygen is supplied and a nasal cannula is used to channel oxygen from the concentrator to the patient. The Longfian Oxygen Concentrator, Model Jay-5 can be used in a home, institution, vehicle, and various mobile environments. The Longfian Oxygen Concentrator, Model Jay-5 does not nor is it intended to sustain or support life.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use: ✓ (Per 21 CFR 801.109) OR

Over-the Counter Use:

Image /page/2/Picture/10 description: The image shows the FDA logo. The logo is in a light gray color. The letters "FDA" are stacked on top of each other.

Anya C. Harry -S 2014.09.04 15:55:34 -04'00'

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510(k) Summary

510(k) summary as required in 21 CFR 807.92 upon which Substantial Equivalence is based:

The Assigned 510(k) Number is: K131968

    1. Submitter Information:
    • Sponsor/510(K) Owner: . LONGFIAN SCITECH CO., LTD. Longxing Building A(413) No.77 Longxing Road Baoding 071051, China Phone: +86 10 312-3169262

Date: November 12, 2013

Contact Name: ●

Mr. Jun Peng P&L SCIENTIFIC, INC. 6840 SW 45TH LN UNIT 5, MIAMI, FL 33155 Phone: (305) 609 4701 Fax: (305) 397 0289 Email: jpeng@plscientificinc.com

2. Device Name

Trade Name: OXY.LIFE Oxygen Concentrator, Models Jay-5 Common Name: Oxygen concentrator; Classification Name: Oxygen concentrator, portable;

3. Classification:

Classification:21 CFR 868.5440; Class II
Product Code:CAW;

4. Predicate Devices:

| Yuyue OxygenMaxTM 7F-5
Oxygen Concentrator | K083559,
September 4, 2009 | Cleared | JIANGSU
MEDICAL EQUIPMENT
& SUPPLY CO., LTD. | YUYUE |

--------------------------------------------------------------------------------------------------------------------------------------------------

5. Description of Device

JAY-5 medical oxygen concentrator adopts pressure swing adsorption principle, which can separate oxygen, nitrogen and other gas from the air, at constant temperature. As soon as power is connected, the air is taken in and compressed by oilless air compressor through filtering, then the compressed air goes through the cooler and it is cooled. After that, the air is taken into absorption tower by control valve and the oxygen can be separated in the absorption tower. At the same time, the high purity oxygen is collected into the oxygen tank, and it goes through the flow meter and humidifier, finally the

4

oxygen that meets medical standards can be supplied. Oxygen is generated by pure physical method.

The concentrator can supply 1-2 patients simultaneously, with steady oxygen flowing out and reliable, adjustable flow. The device is capable of providing oxygen flow up to 5 LPM. The concentration of supplied oxygen is from 90%-96%. The key parts of the generator adopt anti-tiring and anti-aging design, and the planned life of the whole generator reaches up to 20,000 hours. The weight of Jay-5 is around 25kg (~55lbs). There is no influence on indoor oxygen percent during the generator operating.

JAY-5 medical oxygen concentrator contains the following items:

  • · One (1) Jay-5 Oxygen Concentrator Unit
  • · One (1) AC Power Supply
  • · One (1) Nasal Oxygen Tube
  • One (1) Humidifier
  • One (1) Operation Manual

6. Intended Use

The Longfian Oxygen Concentrator, Model Jay-5 is intended to be used by patients with respiratory disorders who require supplemental oxygen. A high concentration of supplemental oxygen is supplied and a nasal cannula is used to channel oxygen from the concentrator to the patient. The Longfian Oxygen Concentrator, Model Jay-5 can be used in a home, institution, vehicle, and various mobile environments. The Longfian Oxygen Concentrator, Model Jay-5 does not nor is it intended to sustain or support life.

NamePredicate deviceSubject device
K numberK083559K131968
Device Trade NameYuyue OxygenMax™ 7F-5
Oxygen ConcentratorJAY-5 Medical Molecular Sieve
Oxygen Concentrator
Common NameOxygen concentratorOxygen concentrator
Classification NameOxygen concentrator, PortableOxygen concentrator, Portable
Indications for useThe YuYue OxygenMax™ 7F-5 Oxygen
Concentrator is intended solely for
medical use in oxygen therapy programs
under the supervision of a physician. It is
intended to provide supplemental oxygen
to patients with respiratory disorders for
use in the home or health care facility.
This device is available by prescription
only and is not intended to support or
sustain lifeThe Longfian Oxygen Concentrator,
Model Jay-5 is intended to be used by
patients with respiratory disorders who
require supplemental oxygen. A high
concentration of supplemental oxygen is
supplied and a nasal cannula is used to
channel oxygen from the concentrator to
the patient. The Longfian Oxygen
Concentrator, Model Jay-5 can be used in
a home, institution, vehicle, and various
mobile environments. The Longfian
Oxygen Concentrator, Model Jay-5 does
not nor is it intended to sustain or support
life.
Classification21 CFR 868.544021 CFR 868.5440

Summary of Comparison in to Technological Characteristics Predicate Device 7.

5

Feature
Power supplyAC 220±22V, 50±1HzAC 230±23V, 50±1Hz
Input power500W500W
Oxygen concentration90%-94%93%±3%
Oxygen flow0.5~5L/min0~5L/min
Outlet pressure40~70kPa40~70kPa
Noise≤53dB(A)≤53dB(A)
Fuse/T6.3AL/250V
Operating systemPressure Swing AdsorptionPressure Swing Adsorption
Electrical classificationClass II Type BClass II Type B
Dimensions445×372×680mm365×375×600mm
(14.37"×14.76"×23.62")
Net weight25.8Kg26Kg
AlarmLow & high pressureLow & high pressure;
Power failure
LCD displayAccumulating timingAccumulating timing;
present timing;
timing
AccessoriesNasal oxygen cannula
HumidifierNasal oxygen tube
Humidifier
Materials
Sieve BedSynthetic ZeoliteSynthetic Zeolite
Nasal Oxygen TubePVCPVC
Principles of operation
Operating systemTime cycle/ Pressure Swing AdsorptionTime cycle/ Pressure Swing Adsorption
Electronic safetyElectrical Safety per IEC-60601Electrical Safety per IEC-60601
Software/HardwareAnalog and digital electronics with microprocessorAnalog and digital electronics with microprocessor
Operating , transportation and storage environment
Operating conditions/Ambient temperature : 10~40℃
Relative humidity:30%~85%
Atmospheric pressure:700 1060hPa
Transportation and storage Conditions/Ambient temperature :-20~45℃
Relative humidity:≤95%
Atmospheric pressure:500-1060hPa

The Longfian Oxygen Concentrator, Model Jay-5 is similar to the predicate devices:

  • . Has the same intended use and indications for use
  • . Utilizes the same operating principle
  • Incorporates the same basic design .
  • Incorporates the same technological characteristics

6

  • Tested to the same electrical and electromagnetic safety standards for medical electrical equipment
  • Manufactured under a quality system

Differences between the subject device and predicate do not affect the safety and effectiveness of the device.

8. Assessment of Non-Clinical Testing:

Non-clinical testing of the Longfian Oxygen Concentrator, Models Jay-5 has been performed against requirements for performance, physical attributes, environmental conditions, materials and to provide objective evidence that the device's intended use is met.

9. Summary Performance Data

  • . IEC 60601-1 Medical Electrical Equipment - Part 1: General Requirements for Safety and essential performance, 1988; Amendment 1, 1991-11, Amendment 2, 1995. (General)
  • IEC 60601-1-2, (Second Edition, 2001), Medical Electrical Equipment Part 1-2: ● General Requirements for Safety - Collateral Standard: Electromagnetic
  • ISO 8359:1996 Oxygen concentrators for medical use -- Safety requirements ●
  • ISO 10993-1:2009 Biological Evaluation of Medical Devices Part 1: Evaluation and Testing
  • ASTM F 1464-93:2005 Oxygen Concentrators for medical use-Safety Requirements
  • Volatile organic compounds (VOC) test per EPA TO-15 ●
  • PM 2.5 test per US EPA requirement ●
  • Ozone test per 21 CFR 801.415 ●
  • . Software validation

10. Conclusion

After analyzing both bench and external laboratory testing data, the intended use and supporting data can conclude that the device in the submission is substantially equivalent to the predicate device.