K Number
K132696
Device Name
TRUSIGNAL SPO2 ADULT AND PEDIATRIC ADHESIVE WRAP DISPOSABLE SENSOR
Date Cleared
2013-09-27

(29 days)

Product Code
Regulation Number
870.2700
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
TS-AAW-10 and TS-AAW-25 The Disposable Sensor is a single-patient use sensor intended for continuous non-invasive arterial oxygen saturation (SpO2) and pulse rate monitoring. Patient weight range: > 20 kg (>44 pounds) TS-PAW-10 and TS-PAW-25 The Disposable Sensor is a single-patient use sensor intended for continuous non-invasive arterial oxygen saturation (SpO2) and pulse rate monitoring. Patient weight ronge: 3-20 kg (6.6-44 pounds)
Device Description
The TruSignal SpO2 Adult and Pediatric Disposable Sensors are used together with standalone oximeters or modular patient monitors to measure continuous non-invasive arterial oxygen saturation (SpO2) and pulse rate monitoring. The sensors are to be connected to a device using an interconnect cable TS-G3, TS-M3, TS-H3 or TS-N3 (cleared in K093881). The interconnect cable type depends on the monitor end connector of the device. The sensors contain light emitting diodes (LEDs) that emit light of different wavelengths. The sensors also contain a photodetector for detecting the emitted light after it has been attenuated by tissue. The sensors further contain a resistor, which is used to encode the wavelength of the LEDs used in the sensor. The resistor value is read by the monitor to determine the calibration curve used for that specific sensor.
More Information

Not Found

No
The device description focuses on hardware components (LEDs, photodetector, resistor) and traditional signal processing for SpO2 and pulse rate measurement. There is no mention of AI, ML, or related concepts in the document.

No
The device is described as a sensor intended for continuous non-invasive arterial oxygen saturation (SpO2) and pulse rate monitoring, which are diagnostic/monitoring functions, not therapeutic.

Yes

Explanation: The device is intended for continuous non-invasive arterial oxygen saturation (SpO2) and pulse rate monitoring, which are diagnostic measurements used to assess a patient's physiological state.

No

The device description explicitly states that the device is a "Disposable Sensor" containing physical components like LEDs, a photodetector, and a resistor. It also requires connection to other hardware (standalone oximeters or modular patient monitors) via interconnect cables. This indicates it is a hardware device, not software-only.

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

Here's why:

  • Intended Use: The intended use is for "continuous non-invasive arterial oxygen saturation (SpO2) and pulse rate monitoring." This involves measuring physiological parameters directly from the patient's body.
  • Device Description: The description details how the sensor uses light and a photodetector to measure these parameters through tissue. This is a non-invasive method.
  • Lack of In Vitro Activities: There is no mention of the device being used to examine specimens (like blood, urine, or tissue) outside of the body. IVDs are specifically designed for testing such specimens.

Therefore, the device described is a non-invasive physiological monitoring device, not an IVD.

N/A

Intended Use / Indications for Use

TS-AAW-10 and TS-AAW-25

The Disposable Sensor is a single-patient use sensor intended for continuous non-invasive arterial oxygen saturation (SpO2) and pulse rate monitoring. Patient weight range: > 20 kg (>44 pounds)

TS-PAW-10 and TS-PAW-25

The Disposable Sensor is a single-patient use sensor intended for continuous non-invasive arterial oxygen saturation (SpO2) and pulse rate monitoring. Patient weight range: 3-20 kg (6.6-44 pounds)

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

DOA

Device Description

The TruSignal SpO2 Adult and Pediatric Disposable Sensors are used together with standalone oximeters or modular patient monitors to measure continuous non-invasive arterial oxygen saturation (SpO2) and pulse rate monitoring.
The sensors are to be connected to a device using an interconnect cable TS-G3, TS-M3, TS-H3 or TS-N3 (cleared in K093881). The interconnect cable type depends on the monitor end connector of the device.
The sensors contain light emitting diodes (LEDs) that emit light of different wavelengths. The sensors also contain a photodetector for detecting the emitted light after it has been attenuated by tissue. The sensors further contain a resistor, which is used to encode the wavelength of the LEDs used in the sensor. The resistor value is read by the monitor to determine the calibration curve used for that specific sensor.

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: > 20 kg (>44 pounds)
Pediatric: 3-20 kg (6.6-44 pounds)

Intended User / Care Setting

Not Found

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

Summary of Clinical Tests:
Clinical verification tests were performed on the proposed devices on an extensive selection of GE patient monitors.
TruSignal SpO2 Adult Disposable Sensor: The test consisted of induced hypoxia studies on healthy adult volunteers (ages 19-31 yr.) conducted in an independent research laboratory. The measured arterial hemoglobin saturation values of the proposed devices were compared to CO-oximeter based arterial hemoglobin saturation values.
TruSignal SpO2 Pediatric Disposable Sensor did not require clinical studies to support substantial equivalence.
TruSignal SpO2 Pediatric Disposable Sensor has identical materials and electro-optical components and equivalent sensor characteristics to TruSignal SpO2 Adult Disposable Sensor, thus the clinical data from Adult Disposable Sensor applies to this sensor as well.

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Study Type: Clinical verification tests, induced hypoxia studies.
Sample Size: Healthy adult volunteers (ages 19-31 yr.)
Key Results: The proposed sensor was shown to have an A_RMS of less than 2 during steady state conditions over the range of 70-100%. The S5 Compact Monitors with an E-PRESTN module meets an A_RMS of less than 2.5% for the same range. The results of the study provide supporting evidence that the SpO2 accuracy performance of the new design of the GE Healthcare disposable sensors does not adversely affect the SpO2 accuracy performance and the proposed sensors pass the respective A_RMS specifications under steady state / non-motion conditions for the range 70-100% as stated in the Instructions for use.

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

Accuracy (A_RMS)

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.

TruSignal SpO2 Allfit Sensor cleared in K093881 TruSignal® Sensors and Interconnect Cables

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

§ 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).

0

K132 bab

Image /page/0/Picture/1 description: The image shows the General Electric (GE) logo. The logo consists of the letters "g" and "e" intertwined within a circular border. The logo is in black and white.

GE Healthcare Finland Oy
Kuortaneenkatu 2, P.O. Box 900 ビ
Finland
T: +358 10 39411
T: +358 10 39411
F: +358 10 39411
F: +358 9 1463310

510(k) Summary

In accordonce with 21 CFR 807.92 the following summary of information is provided:

Date:September 27, 2013
Owner/Submitter:GE Healthcare Finland Oy
Kuortaneenkatu 2
FIN-00510 Helsinki, Finland
Primary Contact Person:Joel Kent
Manager, Quality and Regulatory Affairs
GE Healthcare
Phone: 781-449-8685
Fax: 781-433-1344
E-mail: joel.kent@ge.com
Secondary Contact Person:Rauno Ruoho
Regulatory Affairs Manager
GE Healthcare Finland Oy
Kuortaneenkatu 2
00510 Helsinki
Finland
Phone: + 358 10 394 3624
Fax: +358-92726532
E-mail: Rauno.ruoho@ge.com
Device names (807.92(a)(2)):Device Trade Name:
TruSignal® SpO2 Adult and Pediatric Adhesive Wrap Disposable
Sensors
Common/Usual Name:
Pulse Oximeter Sensors
Classification Names:
21 CFR 870.2700 Oximeter
Product Code:DOA
Predicate Device(s)
(807.92(a)(3)):TruSignal SpO2 Allfit Sensor cleared in K093881 TruSignal® Sensors
and Interconnect Cables
Device Description
(807.92(a)(4)):The TruSignal SpO2 Adult and Pediatric Disposable Sensors are used
together with standalone oximeters or modular patient monitors to
measure continuous non-invasive arterial oxygen saturation (SpO2)
and pulse rate monitoring.
The sensors are to be connected to a device using an interconnect
cable TS-G3, TS-M3, TS-H3 or TS-N3 (cleared in K093881). The
interconnect cable type depends on the monitor end connector of
the device.
The sensors contain light emitting diodes (LEDs) that emit light of
different wavelengths. The sensors also contain a photodetector for
detecting the emitted light after it has been attenuated by tissue. The
sensors further contain a resistor, which is used to encode the
wavelength of the LEDs used in the sensor. The resistor value is read
by the monitor to determine the calibration curve used for that
specific sensor.
Intended Use (807.92(a)(5):TS-AAW-10 and TS-AAW-25
The Disposable Sensor is a single-patient use sensor intended for
continuous non-invasive arterial oxygen saturation (SpO2) and pulse
rate monitoring. Patient weight range: > 20 kg (>44 pounds)
TS-PAW-10 and TS-PAW-25
The Disposable Sensor is a single-patient use sensor intended for
continuous non-invasive arterial oxygen saturation (SpO2) and pulse
rate monitoring. Patient weight range: 3-20 kg (6.6-44 pounds)
Technology
(807.92(a)(6)):The TruSignal SpO2 Adult and Pediatric Disposable Sensors employ
the same fundamental scientific technology as their predicate device
TruSignal SpO2 Allfit Sensor K093881.
The following is an overview of the differences between the proposed
TruSignal SpO2 Adult and Pediatric Disposable Sensors and the
predicate device:
Patient Population Equivalent to the predicate device: Patient weight range has been changed from all patients of the predicate device to 3-20 kg (6.6-44 pounds) of the TS-PAW proposed device and > 20 kg (>44 pounds) of the TS-AAW proposed device. Applicable Electromagnetic Compatibility, Electrical safety, Usability, biocompatibility, engineering verification tests (such as cleaning, and material durability) and clinical performance testing test report show that the proposed device is as safe and effective as the predicate K093881.
Anatomical Sites
Equivalent to the predicate device:
Palm of the hand and side of the foot excluded from
0
the application sites.
Applicable Electromagnetic Compatibility, Electrical
0
safety, Usability, biocompatibility, engineering
verification tests (such as cleaning, and material
durability) and clinical performance testing test report
show that the proposed device is as safe and
effective as the predicate K093881
Environment of Use
Step down units added to the list of environments of
o
use of the proposed device. ESU removed from the list
of environments of use of the proposed device.
Applicable Electromagnetic Compatibility, Electrical
O
safety, Usability, biocompatibility, engineering
verification tests (such as cleaning, and material
durability) and clinical performance testing test report
show that the proposed device is as safe and
effective as the predicate K093881.
Sensor head
Geometry and dimensions
0
TS-AAW-10 and TS-AAW-25: Identical to the predicate
0
device.
TS-PAW-10, TS-PAW-25: Equivalent to the predicate
O
device: Geometry is identical to the predicate device.
The distance of the optical components have been
changed to be slightly less compared to the predicate
device to better fit the finger of the smaller pediatric
patients.
Applicable Electromagnetic Compatibility, Electrical
O
safety, Usability, biocompatibility, engineering
verification tests (such as cleaning, and material
durability) and clinical performance testing test report
show that the proposed device is as safe and
effective as the predicate K093881.
Equivalent to the predicate device in terms of
Materials
intended use.
Applicable Electromagnetic Compatibility, Electrical
o
safety, Usability, biocompatibility, engineering
verification tests (such as cleaning, and material
durability) and clinical performance testing test report
show that the proposed device is as safe and
effective as the predicate K093881.
Electro-optical components Equivalent to the predicate
device:
• Identical LEDs, detector and leadframes. The color of
the sensor head have been changed from light pink
of the predicate device to white of the proposed
device.
• Applicable Electromagnetic Compatibility, Electrical
safety, Usability, biocompatibility, engineering
verification tests (such as cleaning, and material
durability) and clinical performance testing test report
show that the proposed device is as safe and
effective as the predicate K093881.
Performance Equivalent to the predicate device:
• Accuracy of the TruTrak®, TruTrak+® technologies
changed to A_rms ± 2.5 digits in the range of 70% to
100% SpO2 compared to ± 2 digits in the range of
70% to 100% SpO2 of the predicate device.
• Accuracy of the Datex Ohmeda technology changed
to A_rms ± 2.5 digits in the range of 70% to 100%
SpO2 compared to ± 3 digits in the range of 70% to
100% SpO2 of the predicate device.
• Applicable Electromagnetic Compatibility, Electrical
safety, Usability, biocompatibility, engineering
verification tests (such as cleaning, and material
durability) and clinical performance testing test report
show that the proposed device is as safe and
effective as the predicate K093881
Biocompatibility: Identical to the predicate device.
• No change in the Body Contact materials
Connector Geometry and dimensions Equivalent to the
predicate device:
• The mating part of the connector is identical to the
predicate device. The size of the connector body of
the proposed devices is made smaller to reduce the
amount of material needed.
• Applicable Electromagnetic Compatibility, Electrical
safety, Usability, biocompatibility, engineering
verification tests (such as cleaning, and material
durability) and clinical performance testing test report
show that the proposed device is as safe and
effective as the predicate K093881.
Materials (non body contact) Equivalent to the predicate
device:
Connector body materials have been changed
O
compared to the predicate device. Conductor
insulation and outer jacket materials have been
changed compared to the predicate device. Raw
cable tissue paper was removed from the raw cable
of the proposed device.
Applicable Electromagnetic Compatibility, Electrical
o
safety, Usability, biocompatibility, engineering
verification tests (such as cleaning, and material
durability) and clinical performance testing test report
show that the proposed device is as safe and
effective as the predicate K093881.
Cable lengths Equivalent to the predicate device:
Applicable Electromagnetic Compatibility, Electrical
o
safety, Usability, biocompatibility, engineering
verification tests (such as cleaning, and material
durability) and clinical performance testing test report
show that the proposed device is as safe and
effective as the predicate K093881.
Compatibility with other devices Equivalent to the predicate
device:
Removed discontinued platforms from the
0
compatibility list of the proposed devices and added
platforms released after the clearance of the
predicate device.
Applicable Electromoqnetic Compatibility, Electrical
0
safety, Usability, biocompatibility, engineering
verification tests (such as cleaning, and material -
durability) and clinical performance testing test report
show that the proposed device is as safe and
effective as the predicate K093881.
Electrical Safety Identical to the predicate device K093881.
Thermal Safety Identical to the predicate device K093881.
This comparison of the specifications demonstrates the functional
equivalence of the products. The differences discussed do not raise
new issues of safety and effectiveness. Verification and Validation
testing demonstrated that no adverse effects have been introduced
by these differences.
GE Healthcare believes that the TruSignal SpO2 Adult and Pediatric
Disposable Sensors are as safe and effective, and perform in a
substantially equivalent manner to the predicate TruSignal® SpO2
Allfit sensor (K093881).
Determination of Substantial
Equivalence (807.92(b)(1)):Summary of Non-Clinical Tests:
The TruSignal SpO2 Adult and Pediatric Disposable Sensors and its
applications comply with voluntary standards. The following quality
assurance measures were applied to the development of the system
Risk Analysis
Requirements Reviews
Design Reviews
Testing on unit level (Module verification)
Integration testing (System verification)
Performance testing (Verification)
Safety testing (Verification)
Simulated use testing (Validation)
The TruSignal SpO2 Adult and Pediatric Disposable was designed and
tested for compliance to the following standards:
1. IEC 60601-1 2005; Medical Electrical Equipment - Part 1: General
Requirements for Safety
2. IEC 60601-1-2; Ed3. 2007; Medical electrical equipment - Part 1-2:
General requirements for basic safety and essential performance -
Collateral standard: Electromagnetic compatibility - Requirements
and tests
3. ISO 9919 2009; Medical electrical equipment - Particular
requirements for the basic safety and essential performance of pulse
oximeter equipment for medical use
4. ISO 10993-1:2009; Biological evaluation of medical devices
5. IEC 60601-1-6:2010 Medical electrical equipment - Part 1-6:
General requirements for basic safety and essential performance -
Collateral standard: Usability - Edition 3.0
6. IEC 62366:2007 Medical devices - Application of usability
engineering to medical devices – Edition 1.0
Clinical
(807.92(b)(2)):Summary of Clinical Tests:
Clinical verification tests were performed on the proposed devices on
an extensive selection of GE patient monitors.
TruSignal SpO2 Adult Disposable Sensor: The test consisted of
induced hypoxia studies on healthy adult volunteers (ages 19-31 yr.)
conducted in an independent research laboratory. The measured
arterial hemoglobin saturation values of the proposed devices were
compared to CO-oximeter based arterial hemoglobin saturation
values.

The proposed sensor was shown to have an A_RMS of less than 2
during steady state conditions over the range of 70-100%. The S5
Compact Monitors with an E-PRESTN module meets an A_RMS of less
than 2.5% for the same range. The results of the study provide
supporting evidence that the SpO2 accuracy performance of the new
design of the GE Healthcare disposable sensors does not adversely
affect the SpO2 accuracy performance and the proposed sensors
pass the respective A_RMS specifications under steady state / non-
motion conditions for the range 70-100% as stated in the
Instructions for use.

TruSignal SpO2 Pediatric Disposable Sensor did not require clinical
studies to support substantial equivalence.

TruSignal SpO2 Pediatric Disposable Sensor has identical materials |
| | | and electro-optical components and equivalent sensor
characteristics to TruSignal SpO2 Adult Disposable Sensor, thus the
clinical data from Adult Disposable Sensor applies to this sensor as
well. |
| Conclusion | (807.92(b)(3)): | GE Healthcare considers the TruSignal SpO2 Adult and Pediatric
Disposable Sensors to be as safe, as effective, and performance is
substantially equivalent to the predicate device TruSignal SpO2 Allfit
Sensor (K093881). |

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Public Health Service

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

September 27, 2013

GE Healthcare Mr. Joel Kent Manager, Quality and Regulatory Affairs Kuortaneenkatu 2 FIN-00510 Helsinki, Finland

Re: K132696

Trade/Device Name: TruSignal SpO2 Adult and Pediatric Disposable Sensors Regulation Number: 21 CFR 870.2700 Regulation Name: Oximeter Regulatory Class: II Product Code: DQA Dated: August 28, 2013 Received: August 29, 2013

Dear Mr. Kent:

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.

8

Page 2 - Mr. Kent

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 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" (2)CFR 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/Resourcesfor You/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

9

Ki32696

Device Nome: TruSignal® SpO2 Adult and Pediatric Disposable Sensors

Indications for Use:

TS-AAW-10 and TS-AAW-25

510fk) Number (if known):

The Disposable Sensor is a single-patient use sensor intended for continuous non-invasive arterial oxygen saturation (SpO2) and pulse rate monitoring. Patient weight range: > 20 kg (>44 pounds)

TS-PAW-10 and TS-PAW-25

The Disposable Sensor is a single-patient use sensor intended for continuous non-invasive arterial oxygen saturation (SpO2) and pulse rate monitoring. Patient weight ronge: 3-20 kg (6.6-44 pounds)

AND/OR Prescription Use_X lPart 21 CFR 801 Sub part DI

Over-The-Counter Use lPort 21 CFR 801 Subport Cl

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Nayan J. Patel - S
2013.09.26 17:47:51 -04'00'

Division Sign-Off) ·vision of Anesthesiology, General Hospital ifection Control, Dental Devices

510(k) Number K132696

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