K Number
K140682
Date Cleared
2014-07-17

(121 days)

Product Code
Regulation Number
870.2700
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Fingertip Pulse Oximeter MD300C29-H is a portable, non-invasive device intended for spot checking of oxygen saturation of arterial hemoglobin (SpO2) and pulse rate of adult, adolescent and child patient in hospital.

Device Description

The proposed device Fingertip Pulse Oximeter MD300C29-H is a battery powered device, which can detect and display the measured %SpO2 and pulse rate value, pulse bar graph and SpO2 waveform. The device is normally applied to adult, child and adolescent patient in the hospital.

The proposed device consists of power supply module, detector and emitter LED, signal collection and process module, display module, user interface and button control circuit.

The pulse oximeter works by applying a sensor to a pulsating arteriolar vascular bed. The sensor contains a dual light source and photo detector. The one wavelength of light source is 660nm, which is red light; the other is 905nm, which is infrared-red light. Skin, bone, tissue, and venous vessels normally absorb a constant amount of light over time. The photo detector in finger sensor collects and converts the light into electronic signal which is proportional to the light intensity. The arteriolar bed normally pulsates and absorbs variable amounts of light during systole and diastole, as blood volume increases and decreases. The ratio of light absorbed at systole and diastole is translated into an oxygen saturation measurement. This measurement is referred to as SpO2.

The proposed device is not for life-supporting or life-sustaining, not for implant.

The device is not sterile and the transducers are reusable and do not need sterilization or re-sterilization.

The device is for prescription.

The device does not contain drug or biological products.

The device is software -driven and the software validation is provided in Software

AI/ML Overview

Here's an analysis of the acceptance criteria and study information provided in the document:

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria for the SpO2 accuracy are explicitly stated. The device performance (result of the clinical test) is stated to conform to these specifications.

ParameterAcceptance Criteria (Predicate)Reported Device Performance (Applicant)
SpO2 Accuracy (70-100%)±3%±2%
SpO2 Accuracy (0-69%)No definitionNo definition
PR Accuracy (30-99bpm)±2bpm±2bpm
PR Accuracy (100-235bpm)±2%±2% (100-250bpm)

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

The document does not explicitly state the sample size used for the clinical test set (number of patients or measurements).

The data provenance is not specified (e.g., country of origin, retrospective or prospective).

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

The document does not provide information on the number of experts used or their qualifications for establishing ground truth in the clinical test.

4. Adjudication Method for the Test Set

The document does not describe the adjudication method used for the clinical test set.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

No, an MRMC comparative effectiveness study was not done. This study is a standalone clinical test to verify the device's accuracy against a reference.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

Yes, a standalone clinical test was performed to assess the accuracy of the device. The "Clinical Test" section states: "The results of the study provide supporting evidence that the Fingertip Pulse Oximeter MD300C29-H is compliance to the accuracy specification claimed by the manufacturer."

7. The Type of Ground Truth Used

The ground truth for the clinical test for SpO2 accuracy is based on the reference standard outlined in ISO 80601-2-61:2011, which dictates the methodology for testing pulse oximeter equipment accuracy (clause 201.12.1). This typically involves comparing the device's readings to measurements from a co-oximeter or other reference method during controlled hypoxemia studies in healthy volunteers.

8. The Sample Size for the Training Set

The document does not mention a training set for an algorithm, as this device appears to be a direct measurement device rather than one employing machine learning that requires a distinct training phase. If there were internal algorithm or calibration factors, the training data for those are not described.

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

Not applicable, as no training set for a machine learning algorithm is mentioned. For the device's internal calibration/development, the ground truth would have been established through a controlled process similar to the clinical test, or using validated calibration artifacts, but this information is not detailed in the provided summary.

{0}------------------------------------------------

JUL 1 7 2014

Section III 510(k) Summary

This 510(k) summary is being submitted in accordance with the requirements of 21 CFR 807.92.

The assigned 510(K) number is _ K140682

3.1 Date of Submission: June 11, 2014

3.2 Sponsor Information

Establishment Registration Number: 3005569927 Beijing Choice Electronic Technology Co., Ltd. Room 320, West Building 4, No.83 Fuxing Road, Beijing 100039, P.R.China

Contact Person:

Mr. Lei Chen Beijing Choice Electronic Technology Co., Ltd. North Building 3F, No.9 Shuangyuan Road, Badachu Hi -tech Zone, Shijingshan District, Beijing, P.R. China, 100041 Phone: +86-10-88798300 Ext 6020 Fax: 215-4052545

3.3 Proposed Device Information

Device Common or Usual Name: Pulse Oximeter Device Trade or Proprietary Name: Fingertip Pulse Oximeter Model: MD300C29-H Classification Name: Oximeter Product Code: DQA Regulation Number: 870.2700 Panel: Anesthesiology Class: II

3.4 Predicate Device

510(k) Number: K070371 Common Name: Oximeter Device Trade or Proprietary Name: Fingertip Pulse Oximeter Model: MD300C Classification Name: Oximeter

{1}------------------------------------------------

Device Class: II Product Code: DQA Regulation Number: 870.2700 Review Panel: Anesthesiology

Manufacturer: Beijing Choice Electronic Technology Co., Ltd.

Intended Use : Fingertip Pulse Oximeter MD300C is a portable non-invasive, spot-check, oxygen saturation of arterial hemoglobin (SpO2) and pulse rate of adult and pediatric patient at home, and hospital (including clinical use in internist/surgery, Anesthesia, intensive care and etc). Not for continuously monitoring.

3.5 Device Description

The proposed device Fingertip Pulse Oximeter MD300C29-H is a battery powered device, which can detect and display the measured %SpO2 and pulse rate value, pulse bar graph and SpO2 waveform. The device is normally applied to adult, child and adolescent patient in the hospital.

The proposed device consists of power supply module, detector and emitter LED, signal collection and process module, display module, user interface and button control circuit.

The pulse oximeter works by applying a sensor to a pulsating arteriolar vascular bed. The sensor contains a dual light source and photo detector. The one wavelength of light source is 660nm, which is red light; the other is 905nm, which is infrared-red light. Skin, bone, tissue, and venous vessels normally absorb a constant amount of light over time. The photo detector in finger sensor collects and converts the light into electronic signal which is proportional to the light intensity. The arteriolar bed normally pulsates and absorbs variable amounts of light during systole and diastole, as blood volume increases and decreases. The ratio of light absorbed at systole and diastole is translated into an oxygen saturation measurement. This measurement is referred to as SpO2.

The proposed device is not for life-supporting or life-sustaining, not for implant.

The device is not sterile and the transducers are reusable and do not need sterilization or re-sterilization.

The device is for prescription.

The device does not contain drug or biological products.

The device is software -driven and the software validation is provided in Software

3.6 Intended Use

The Fingertip Pulse Oximeter MD300C29-H is a portable, non-invasive device intended for spot checking of oxygen saturation of arterial hemoglobin (SpO2) and pulse rate of adult, adolescent and child patient in hospital.

{2}------------------------------------------------

1
82
90
T
V
>

Page 3 of 7

Premarket Notification 510(k) Submission - Section III 510(k) Summary

Fingertip Pulse Oximeter MD300C29-H

3.7 Comparison with the Predicate Device

Comparison with the Predicate Device
Comparison ElementsApplicant DevicePredicate Device
Device NameFingertip Pulse Oximeter MD300C29-HMD300C Fingertip Pulse Oximeter (K070371)
ModelMD300C29-HMD300C
Regulation No.21 CFR 870.270021 CFR 870.2700
ClassificationIIII
Classification NameOximeterOximeter
Product CodeDQADQA
Indented UseThe Fingertip Pulse Oximeter MD300C29-H is a portable, non-invasive device intended for spot checking of oxygen saturation of arterial hemoglobin (SpO2) and pulse rate of adult, child and adolescent patient in hospital.Fingertip Pulse Oximeter MD300C is a portable non-invasive, spot-check, oxygen saturation of arterial hemoglobin (SpO2) and pulse rate of adult and pediatric patient at home, and hospital (including clinical use in internist/surgery, Anesthesia, intensive care and etc). Not for continuously monitoring.
Comparison StatementThe proposed devices have the similar intended use and classification.
ComponentsThe applicant device consists of detector and emitter LED, signal amplify unit, CPU, data display unit and power unitdetector and emitter LED, signal amplify unit, CPU, data display unit and power unit
Design PrincipleSkin, bone, tissue, and venous vessels normally absorb a constant amount of light over time. The photo detector in finger sensor collects and converts the light into electronic signal which is proportional to the light intensity. The arteriolar bed normally pulsates and absorbs variable amounts of light during systole and diastole, as blood volume increases and decreases. The ratio of light absorbed at systole and diastole is translated into an oxygen saturation measurement. This measurement is referred to as SpO2.Skin, bone, tissue, and venous vessels normally absorb a constant amount of light over time. The photo detector in finger sensor collects and converts the light into electronic signal which is proportional to the light intensity. The arteriolar bed normally pulsates and absorbs variable amounts of light during systole and diastole, as blood volume increases and decreases. The ratio of light absorbed at systole and diastole is translated into an oxygen saturation measurement. This measurement is referred to as SpO2.
MeasurementwavelengthRed$660\pm3nm$$660\pm2nm$
Infrared$905\pm8nm$$940\pm10nm$
Comparison StatementThe proposed device has the same design principle and similar components. The only difference is thewavelength of the infrared LED emitter, and we can verify that which will not effect the basic safetyand the essential performance of the proposed device.
Display TypeOLEDOLED
Working timeApproximately 25 hours of continuous operationApproximately 30 hours of continuous operation
Brightness of backlightAdjustableAdjustable
User Interface6 directions for display6 directions for display
Power supply2*AAA alkaline battery2*AAA alkaline battery
Display DataSpO2; PRSpO2, PR
SpO2 display range35%~100%0~100%
SpO2 measurement range70~100%70~100%
Device SpecificationSpO2 Accuracy70%~100%; $\pm$ 2%0%~69% no definition70%~100%; $\pm$ 3%0%~69% no definition
SpO2 resolution1%1%
PR Display Range30-250bpm0-254bpm
PR Measurement Range30~250bpm30~235bpm
PR Accuracy$\pm$ 2bpm (30-99bpm) and $\pm$ 2%(100-250bpm)$\pm$ 2bpm (30-99bpm) and $\pm$ 2% (100-235bpm)
PR resolution1bpm1bpm
Operating temperature5℃~40℃5°C~40°C
Relative humidity≤80% , no condensation (operating)≤93% no condensation (storage)≤80% , no condensation (operating)≤93% no condensation (storage)
Atmosphere pressure86kPa~106kPa86kPa~106kPa
Comparison StatementThe proposed device has similar device specifications as the predicate device.

III-3

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

.

.

'

Page 4 of 7

IJI-4

{4}------------------------------------------------

82
406
1
X

Page 5 of 7 .

Premarket Notification 510(k) Submission - Section III 510(k) Summar

Fingertip Pulse Oximeter MD300C29-H

ABSLaser Etching Medical Silicon gelInksThe contacting materials of Proposed device are same to those of the predicate device except Fingertip Cushion andPower Button.The bench tests include SpO2 and PR accuracy Test, WeakPerfusion Test, High and Low Temperature and HumidityTest, Performance Test After Disinfection and ISO80601-2-61.Meet the requirements of FDA GuidanceConformed to ISO 9919Conformed to ISO 9919 & ISO80601-2-61Conformed to IEC60601-1Conformed to IEC60601-1Conformed to IEC60601-1-2.Conformed to IEC60601-1-2.Moderate Level of ConcernModerate Level of ConcernCompliance with FDA Guidance for the Content ofPremarket Submissions for Software Contained in MedicalDevices.
Battery coverEnclosureFingertipCushionPower buttonCoatingComparison StatementBench TestClinical TestElectrical SafetyElectromagneticCompatibilitySoftware
ContactingMaterialPerformance TestingClinical TestEMC andElectrical Safe

ાત-ર

{5}------------------------------------------------

K140682

Page 6 of 7

Premarket Notification 510(k) Submission - Section III 510(k) Summan

Fingertip Pulse Oximeter MD300C29-H

Risk Management in Compliance with ISO14971:2007Risk Management in Compliance with ISO14971:2007
In Vitro CytotoxicityNo cytotoxic potentialIn Vitro CytotoxicityNo cytotoxic potential
BiocompatibilitySkin Irritation TestNo evidence of causing sensitizationSkin Irritation TestNo evidence of causing sensitization
Animal skin irritation testNo evidence of significant irritation from the test extract to rabbitsAnimal skin irritation testNo evidence of significant irritation from the test extract to rabbits
Medical silicone gel
Comparison StatementCompliance with the ISO 10993
Label and LabelingCompliance with the Guidance of pulse oximeter-premarket notification submission issued on March 4, 2013Compliance with FDA guidance

:

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

3.8 Test Conclusion

Non-clinical Test

The Fingertip Pulse Oximeter MD300C29-H is designed and tested and will be manufactured in accordance with the following standards, including:

  • . IEC 60601-1:2005 Medical Electrical Equipment - Partl: General requirements for safety.
  • . IEC 60601-1-2:2007 Medical Electrical Equipment - Part 1: General requirements for safety-2, Collateral Standard: Electromagnetic compatibility - Requirements and tests.
  • � 80601-2-61:2011 Medical electrical equipment - part2-61:Particular ISO requirements for the basic safety and essential performance of pulse oximeter equipment.

The Software Validation is in compliance with FDA Guidance for the Content of PreMarket Submissions for Software Contained in Medical Devices.

The compatibility of the skin-contact component material in the finished product meets the requirement of Biocompatibility. The Biological Evaluation Tests are in compliance with the standards of ISO 10993, "Biological Evaluation of Medical Devices".

Clinical Test

The Clinical Test were conducted following the testing described in clause 201.12.1 of ISO 80601-2-61:2011, Medical electrical equipment- Part 2-61 Particular reguirements for basic safety and essential performance of pulse oximeter equipment.

The results of the study provide supporting evidence that the Fingertip Pulse Oximeter MD300C29-H is compliance to the accuracy specification claimed by the manufacturer. The Fingertip Pulse Oximeter can be used under steady state / non-motion conditions for the range 70-100%.

3.9 Determination of substantial equivalence

The proposed device has the same classification information, similar intended use, same design principle, similar product design and specifications, same performance effectiveness. performance safety as the predicate device. The main difference is the wavelength of the infrared LED emitter, and we can verify that which will not effect the basic safety and the essential performance of the proposed device. So the proposed devices are Substantially Equivalent (SE) to the predicate device which is US legally market device.

{7}------------------------------------------------

Image /page/7/Picture/0 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized eagle or bird-like symbol with three curved lines representing its wings or body. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the symbol. The text is in all capital letters and is smaller than the central symbol.

Public Flealth Service

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

July 17, 2014

Beijing Choice Electronic Technology Co., Ltd. Mr. Lei Chen Quality Director North Building 3F, No.9 Shuangyuan Road Badachu Hi -tech Zone, Shijingshan District. Beijing, P.R. China, 100041

Re: K140682

Trade/Device Name: Fingertip Pulse Oximeter MD300C29-H Regulation Number: 21 CFR 870.2700 Regulation Name: Oximeter Regulatory Class: II Product Code: DOA Dated: June 11, 2014 Received: June 16, 2014

Dear Mr. Chen:

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 cither 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. Lei Chen

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 (OS) 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/ResourcesforYou/Industry/default.htm.

Sincerely yours.

在线视频 | Tejasbri Purobit-Sheth, M.D. Tejashri Purofiit-Sheth, M.D. Clialcal Deputy Director A CORPORATION DAGRID/ODE/CDRH FOR

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

{9}------------------------------------------------

Section II Indication for Use Statement

Indication for Use

510(k) Number (if known):

Device Name: Fingertip Pulse Oximeter MD300C29-H

Indications for Use:

The Fingertip Pulse Oximeter MD300C29-H is a portable, non-invasive device intended for spot checking of oxygen saturation of arterial hemoglobin (SpO2) and pulse rate of adult, adolescent and child patient in hospital.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ (Part 21 CFR 801 Subpart D)

Over-The-Counter Use AND/OR (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)

Todd D. Courtney -S 2014.07.16 14:01:12 -04'00'

§ 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).