K Number
K133886
Device Name
PERSEUS A500
Date Cleared
2014-06-20

(182 days)

Product Code
Regulation Number
868.5160
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The anesthesia workstation Perseus is intended for use in anesthetizing adults, children, and neonates and can be used for automatic and manual ventilation, pressure-supported spontaneous breathing, and spontaneous breathing.

Perseus is equipped with airway monitoring, gas measurement and device monitoring, O2 insufflation, and an anesthetic gas receiving system.

Anesthesia is achieved through a mixture of pure oxygen and Air (medical compressed air) or pure oxygen and nitrous oxide, with the addition of volatile anesthetic agents.

Ventilation is accomplished on the patient through a laryngeal mask, a mask, or an endotracheal tube.

The integrated breathing system can be used with partial rebreathing (low-flow or minimumflow).

A non-rebreathing system such as the Kuhn or Medec Water System may be used at the external fresh-gas outlet (optional).

Perseus A500 is specified for inhalational anesthesia and/or patient ventilation in accordance with the intended use during surgical or diagnostic interventions.

Device Description

The Perseus A500 is a continuous flow gas anesthesia system that delivers anesthetic vapour, provides for automatic and manual modes of ventilation, and is equipped with a monitoring system for ventilation, inspired and expired gas, and agent identification.

The main functionality of the anesthesia system comprises

  • gas delivery for mixing oxygen and carrier gases, -
  • anesthetic agent delivery (via vaporizers such as Dräger Vapor 3000),
  • anesthesia ventilator (blower based), -
  • anesthesia breathing system ABS, -
  • airway monitoring (flow, pressure, gas concentrations) .

The Perseus A500 consists of the following main components:

  • M3 Blower based Anesthesia Ventilator, electrical driven, supporting the Ventilation . modes
    • o Man/Spont
    • o Volume Controlled
    • Pressure Controlled o
  • Embedded control display with touch screen technology and rotary/confirm knob for selecting and confirming parameters.
  • . Gas Mixer
  • . Heated integrated Anaesthesia Breathing System ABS
  • Patient Gas Monitoring with agent mixture detection and Oxygen monitoring .
  • Integrated Anesthesia Gas Scavenging System -
  • Auxiliary Oxygen Therapy w/ flow indicator -
  • Oxygen cylinder support (reserve gas inlet) -
AI/ML Overview

The provided document is a 510(k) premarket notification for the Dräger Perseus A500 anesthesia machine. This type of submission focuses on demonstrating substantial equivalence to a legally marketed predicate device, rather than providing detailed clinical study results often found for novel devices or AI/ML-driven diagnostics.

Therefore, the document does not contain the detailed information requested regarding specific acceptance criteria for performance metrics (like sensitivity, specificity, accuracy), nor does it describe a study explicitly designed to "prove the device meets the acceptance criteria" in the way one would for a diagnostic or AI algorithm.

Instead, the submission demonstrates compliance with recognized safety, performance, and electromagnetic compatibility standards, and states that the device's functionality and performance are substantially equivalent to its predicate devices.

Here's an attempt to answer the questions based on the available information, noting where information is not present:


Acceptance Criteria and Study for Dräger Perseus A500 Anesthesia Machine

The Dräger Perseus A500 anesthesia machine is a Class II medical device, and its 510(k) submission (K133886) focuses on demonstrating substantial equivalence to predicate devices and compliance with relevant industry standards for safety and performance. This is a different regulatory pathway than for novel diagnostic devices, especially those utilizing AI, which would typically involve detailed performance metrics like sensitivity, specificity, and ROC curves.

1. Table of Acceptance Criteria and Reported Device Performance

As this is an anesthesia machine and not a diagnostic device, the acceptance criteria are based on compliance with harmonized standards, functional equivalence to predicate devices, and safety. Quantitative performance metrics (e.g., sensitivity, specificity, accuracy) are not presented in this 510(k) summary in the way they would be for an AI model.

Acceptance Criteria CategoryDescription (Based on Standards and Substantial Equivalence)Reported Device Performance / Compliance
Safety and Essential PerformanceCompliance with IEC 60601-1 (General requirements for basic safety and essential performance) and its collateral standards (e.g., alarms, programmable electrical medical systems).The Perseus A500 has been tested and found to be in compliance with these recognized safety and performance standards.
Anesthetic Systems Specific RequirementsCompliance with IEC 60601-2-13 (Particular requirements for the safety and essential performance of anaesthetic systems).The Perseus A500 has been tested and found to be in compliance with this standard.
Gas Scavenging SystemsCompliance with ISO 8835-3 (Inhalational anaesthesia systems - Part 3: Transfer and receiving systems of active anaesthetic gas scavenging systems).The Perseus A500 has been tested and found to be in compliance with this standard.
Anaesthesia VentilatorsCompliance with ISO 8835-5 (Inhalational anaesthesia systems - Part 5: Anaesthesia ventilators).The Perseus A500 has been tested and found to be in compliance with this standard.
Respiratory Gas MonitorsCompliance with ISO 21647 (Particular requirements for the basic safety and essential performance of respiratory gas monitors).The Perseus A500 has been tested and found to be in compliance with this standard.
BiocompatibilityVerification according to Memorandum - #G95-1 and ISO 10993 standards.Biocompatibility was verified.
Hygienic EvaluationCompliance with ISO 17664.Compliance was demonstrated.
Oxygen CompatibilityCompliance with ISO 15001.Compliance was demonstrated.
Functional Equivalence (Operating Concept)Uniform use concept, user interface, integrated display equivalent to predicate devices (Primus US, JULIAN ANESTHESIA WORKSTATION, Infinity Acute Care System Workstation Critical Care).Stated as "equivalent to the predicate devices."
Functional Equivalence (Gas Mixing)Gas mixing concept equivalent to Primus US (mechanically controlled) or Julian (electronically controlled).Stated as "equivalent to the predicate devices."
Functional Equivalence (Ventilation Parameters & Monitoring)Ventilation parameters (Pressure Support, Pressure Control, Press. Ctrl. APRV, Volume Control, Vol. Ctrl. AutoFlow) and monitoring (Pressure waveform, Volume, Anesthetic gas, CO2, O2 measurement) equivalent to predicate devices.Stated as "equivalent to the predicate devices."
Indications / Intended UseLabelling and indications are substantially equivalent to predicate devices.Stated as "substantially equivalent."
Software Verification & ValidationSoftware verified and validated according to specifications and test requirements as per FDA Guidance for Content of Premarket Submissions for Software.Passed all verification activities.
Risk ManagementPotential hazards identified, risk analysis conducted, and mitigation documented.Risk management file in place.
UsabilityEvaluated by end-users.Found safe and effective for intended users, use, and environment.

2. Sample Size Used for the Test Set and Data Provenance

Not applicable in this context. The "test set" here refers to the device itself being tested against standards and its predicate, not a dataset for an algorithm. The evidence presented focuses on engineering verification and validation, and demonstrating equivalence. No specific "data provenance" related to a test set for an algorithm is mentioned.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications

Not applicable. This is not a study requiring expert-established ground truth for an AI algorithm. The "ground truth" for this device's performance is compliance with established engineering and medical device standards, and functional equivalence to legally marketed predicate devices.

4. Adjudication Method for the Test Set

Not applicable. There is no mention of an adjudication process for a test set in the context of this device.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done, nor would it be expected for this type of device (anesthesia machine). This type of study is relevant for diagnostic devices where human readers interpret medical images or data, and the effect of AI assistance on their performance is being evaluated.

6. Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study

Not applicable. The Perseus A500 is an anesthesia machine, not a standalone algorithm. Its performance is inherent to its mechanical and electronic functions.

7. Type of Ground Truth Used

The "ground truth" for this submission is multifaceted:

  • Compliance with harmonized standards: The device's performance is measured against the requirements of international and national standards (e.g., IEC 60601 series, ISO 8835 series, ISO 21647, ISO 10993, ISO 15001, ISO 17664).
  • Engineering specifications: The device is verified and validated against its own design specifications.
  • Functional equivalence to predicate devices: The functionality, indications for use, and general performance are compared directly to previously cleared anesthesia machines.
  • Risk analysis: Hazard identification and mitigation are based on established risk management processes.
  • Usability evaluation: User feedback validates the intuitiveness and safety of operation.

8. Sample Size for the Training Set

Not applicable. The Perseus A500 is an anesthesia machine, not an AI/ML algorithm that requires a training set.

9. How the Ground Truth for the Training Set Was Established

Not applicable, for the same reasons as #8.

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K13896

JUN 2 0 2014

Traditional 510(k) Perseus A500

Date: 16. December 2013

Dräger

Premarket Notification 510(k) summary As required per 807.92

General Company Information

Submitters Name and Address:Dräger Medical GmbH
Moislinger Allee 53-55,
D-23542 Luebeck, Germany

Contact Person:

Mr. Ulrich Schroeder Moislinger Allee 53-55, D-23542 Luebeck, Germany Phone : 49 (451) 882-3648 Fax :49 (451) 882-3018 Email: Ulich.Schroeder@draeger.com

Alternate:

Mrs. Beth Zis Draeger Medical Systems, Inc., 6 Tech Dr, Andover, MA 01810 Phone +1 (978) 3798255 Fax: +1 (978) 3798335 Email: beth.zis@draeger.com

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:

Image /page/1/Picture/1 description: The image shows the word "Dräger" in a bold, sans-serif font. The "a" has an umlaut, which is two dots above the letter. The word is black and the background is white.

Device Name

Common Name:Gas-machine, anesthesia
Legally Marketed DeviceIdentification:Perseus A500
Regulation Number868.5160
Regulation DescriptionGas machine for anesthesia
Regulation Medical SpecialtyAnesthesiology
Product CodeBSZ
Class2

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Image /page/2/Picture/1 description: The image shows the word "Dräger" in a bold, sans-serif font. The "a" in Dräger has an umlaut, which is a diacritical mark consisting of two dots placed over the letter. The word is in black and is set against a white background. A horizontal line is present at the bottom of the image.

Device description:

The Perseus A500 is a continuous flow gas anesthesia system that delivers anesthetic vapour, provides for automatic and manual modes of ventilation, and is equipped with a monitoring system for ventilation, inspired and expired gas, and agent identification.

Image /page/2/Picture/4 description: The image shows a Dräger Perseus A500 anesthesia machine. The machine has a monitor at the top, a work surface in the middle, and a base with wheels. The monitor displays various waveforms and numerical data. The work surface has several knobs and dials. The base has a footrest and a storage compartment.

The main functionality of the anesthesia system comprises

  • gas delivery for mixing oxygen and carrier gases, -
  • anesthetic agent delivery (via vaporizers such as Dräger Vapor 3000),
  • anesthesia ventilator (blower based), -
  • anesthesia breathing system ABS, -
  • airway monitoring (flow, pressure, gas concentrations) .

{3}------------------------------------------------

The Perseus A500 consists of the following main components:

  • M3 Blower based Anesthesia Ventilator, electrical driven, supporting the Ventilation . modes
    • o Man/Spont
    • o Volume Controlled
    • Pressure Controlled o
  • Embedded control display with touch screen technology and rotary/confirm knob for selecting and confirming parameters.
  • . Gas Mixer
  • . Heated integrated Anaesthesia Breathing System ABS
  • Patient Gas Monitoring with agent mixture detection and Oxygen monitoring .
  • Integrated Anesthesia Gas Scavenging System -
  • Auxiliary Oxygen Therapy w/ flow indicator -
  • Oxygen cylinder support (reserve gas inlet) -

Image /page/3/Figure/14 description: This image shows a labeled diagram of an anesthesia machine. The diagram labels the control display, APL vent, vapor bar, table with electronics, blower and patient gas monitoring, auxiliary mains outlets, mixer status display, on/off switch, optional gas cylinders, optional drawer element, and batteries with optional separation. The diagram provides a comprehensive overview of the machine's components and their functions.

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Image /page/4/Picture/1 description: The image shows the word "Dräger" in a bold, sans-serif font. The word is in black and is set against a white background. The two dots above the "a" are also black. A black line is present below the word.

Indications / Intended Use:

The anesthesia workstation Perseus is intended for use in anesthetizing adults, children, and neonates and can be used for automatic and manual ventilation, pressure-supported spontaneous breathing, and spontaneous breathing.

Perseus is equipped with airway monitoring, gas measurement and device monitoring, O2 insufflation, and an anesthetic gas receiving system.

Anesthesia is achieved through a mixture of pure oxygen and Air (medical compressed air) or pure oxygen and nitrous oxide, with the addition of volatile anesthetic agents.

Ventilation is accomplished on the patient through a laryngeal mask, a mask, or an endotracheal tube.

The integrated breathing system can be used with partial rebreathing (low-flow or minimumflow).

A non-rebreathing system such as the Kuhn or Medec Water System may be used at the external fresh-gas outlet (optional).

Perseus A500 is specified for inhalational anesthesia and/or patient ventilation in accordance with the intended use during surgical or diagnostic interventions.

Substantial Equivalence:

The Perseus A500 is substantial equivalent to the following predicate devices:

510(k) NumberTrade or Proprietary or Model NameManufacturer
K042607Primus USDraeger Medical GmbH
K983635JULIAN ANESTHESIAWORKSTATION, MODEL # JULIANDraeger Medical GmbH
K093633Infinity Acute Care System WorkstationCritical CareDraeger Medical GmbH

The devices are substantial equivalent the following characteristics:

General performance including operation concept

The Perseus is equivalent to the predicate devices by a uniform use concept, user interface and integrated display. The general performance is equivalent to the predicate devices and typical for anesthesia devices available on the market. The gas mixing concept is equivalent to the Primus US (K042607) for the product variant with the mechanically controlled mixer and equivalent to the Julian (K983635) for the product variant with the electronically controlled mixer.

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Image /page/5/Picture/1 description: The image shows the word "Dräger" in a bold, sans-serif font. The word is black and the background is white. The two dots above the "a" are also black and bold. The word is slightly distorted, as if it were printed on a slightly uneven surface.

Ventilation parameters, gas delivery, ventilation monitoring

The ventilation parameters Pressure Support, Pressure Control, Press. Ctrl. APRV (Airway Pressure Release Ventilation), Volume Control and Vol. Ctrl. AutoFlow are equivalent to the predicate devices Primus US (K042607) and the Infinity Acute Care System Workstation Critical Care (K093633) for Airway Pressure Release Ventilation.

The monitoring principals and parameters like Pressure waveform display, Volume measurement, Anesthetic gas measurement CO2 and O2 measurement are equivalent to the predicate devices.

Indications:

The side by side comparison of the indications between the Perseus A500 and the predicate devices showed that labelling and indications are substantial equivalent.

{6}------------------------------------------------

Dräger

Performance and testing:

Dräger installed and maintains an internal Quality Management (QM) System. The QM System describes the procedures for development related to medical devices and requires a particular development process with all related activities including risk management, verification, validation and documentation. This procedure is in accordance with the design controls as defined in the current "Good Manufacturing Practice" published by FDA.

Design controls procedures are implemented and maintained at Dräger. All product developments and changes to Dräger products follow this internal procedure laid down in internal standard operating procedures DMS IN4000 "Develop Product" and DMTN LM2310 "Execute Product Design Changes" respectively. The software has been verified and validated according to the specification and test requirements, and documented as described in the FDA Guidance for the Content of Premarket Submissions for Software.

The development of Perseus A500 was in accordance with these procedures and passed all verification activities. The risk management file identifies potential hazards and documents the result of the risk analysis including mitigation of hazards. Usability features have been evaluated by end-users and found that the Perseus A500 is safe and effective for use by the intended users, intended use, and use environment.

Utilized Standards:

The Perseus A500 has been tested and found to be in compliance with recognized safety, performance and electromagnetic compatibility standards:

IEC 60601-1 Medical electrical equipment - Part 1: General requirements for basic safety and essential performance Including: National Deviations as per UL 60601.1

IEC 60601-1-4 Medical electrical equipment - Part 1-4: General requirements for safety: Collateral standard: Programmable electrical medical systems

IEC 60601-1-8 Medical electrical equipment - Part 1-8: General requirements for basic safety and essential performance - Collateral Standard: General requirements, tests and guidance for alarm systems in medical electrical equipment and medical electrical systems

IEC 60601-2-13 Medical electrical equipment - Part 2-13: Particular requirements for the safety and essential performance of anaesthetic systems (Recognition Number 1-61)

IEC 60601-1-2 Medical electrical equipment - Part 1-2: General requirements for safety - Collateral standard: Electromagnetic compatibility - Requirements and tests

ISO 8835-2 Inhalational anaesthesia systems - Part 2: Anaesthetic breathing systems

ISO 8835-3 Inhalational anaesthesia systems - Part 3: Transfer and receiving systems

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Image /page/7/Picture/1 description: The image shows the word "Dräger" in a bold, sans-serif font. The "a" in Dräger has an umlaut, which is a diacritical mark consisting of two dots placed over the letter. The text is black and the background is white. The image appears to be a logo or brand name.

of active anaesthetic gas scavenging systems

ISO 8835-5 Inhalational anaesthesia systems - Part 5: Anaesthesia ventilators

ISO 21647 Medical electrical equipment - Particular requirements for the basic safety and essential performance of respiratory gas monitors (Recognition Number 1-65)

Biocompatibility was verified according to the requirements Memorandum - #G95-1 (and tested based on the requirements of IEC 60601-1 (Clause 48) and the applicable ISO 10993 standards)

Hygienic evaluation as defined in ISO 17664.

ISO 15001 Oxygen Compatibility

Conclusion:

Based on similarities in the indications and technological characteristics the Perseus A500 is considered substantially equivalent to the predicate devices. The results of performance and validation/verification testing show, that the use of the device is safe and effective.

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Image /page/8/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized depiction of an eagle or bird-like figure with three curved lines representing its wings or body. The logo is encircled by the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement.

Public Health Service

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

June 20, 2014

Dräger Medical GmbH Mr. Ulrich Schroeder Moislinger Allee 53-55 D-23542 Luebeck, Germany

Re: K133886

Trade/Device Name: Gas-machine, anesthesia Regulation Number: 21 CFR 868.5160 Regulation Name: Gas-machine for anesthesia Regulatory Class: II Product Code: BSZ Dated: May 12, 2014 Received: May 12, 2014

Dear Mr. Schroeder:

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. Schroeder

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/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.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.

Sincerely yours,

Mary S. Runner -S

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 Statement

K133886

The anesthesia workstation Perseus A500 is intended for use in anesthetizing adults, children, and neonates and can be used for automatic and manual ventilation, pressuresupported spontaneous breathing, and spontaneous breathing.

Perseus A500 is equipped with airway monitoring, gas measurement and device monitoring. O2 insufflation, and an anesthetic gas receiving system.

Anesthesia is achieved through a mixture of pure oxygen and Air (medical compressed air) or pure oxygen and nitrous oxide, with the addition of volatile anesthetic agents.

Ventilation is accomplished on the patient through a laryngeal mask, a mask, or an endotracheal tube.

The integrated breathing system can be used with partial rebreathing (low-flow or minimum-flow).

A non-rebreathing system such as the Kuhn or Medec Water System may be used at the external fresh-gas outlet (optional).

Perseus A500 is specified for inhalational anesthesia and/or patient ventilation in accordance with the intended use during surgical or diagnostic interventions.

Prescription Use X
(Part 21 CFR 801 Subpart D)

AND/OR

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Neha Gu
2014.06.2011

510(k) Perseus A500

§ 868.5160 Gas machine for anesthesia or analgesia.

(a)
Gas machine for anesthesia —(1)Identification. A gas machine for anesthesia is a device used to administer to a patient, continuously or intermittently, a general inhalation anesthetic and to maintain a patient's ventilation. The device may include a gas flowmeter, vaporizer, ventilator, breathing circuit with bag, and emergency air supply.(2)
Classification. Class II (performance standards).(b)
Gas machine for analgesia —(1)Identification. A gas machine for analgesia is a device used to administer to a patient an analgesic agent, such as a nitrous oxide-oxygen mixture (maximum concentration of 70 percent nitrous oxide).(2)
Classification. Class II (performance standards).