K Number
K141140
Device Name
COMP A-I-R
Date Cleared
2014-09-30

(151 days)

Product Code
Regulation Number
868.5630
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The NE-C802 Compressor Nebulizer System is intended to provide air to the pneumatic nebulizer in order to aerosolize medications for inhalation by the patient for respiratory disorders. The system is designed for use with pediatric (3 year old and greater) and adult patients in the home, hospital, and sub-acute settings.
Device Description
The Omron Model NE-C802 is a standard nebulizer compressor system with an integral compressor and handheld, pneumatic nebulizer intended for general purpose use. It is powered by standard AC. This is a modification of the NE-C801 cleared under K110860.
More Information

Not Found

No
The device description and performance studies focus on standard nebulizer compressor technology and aerosol performance, with no mention of AI or ML.

Yes
The device is intended to aerosolize medications for inhalation by patients with respiratory disorders, which is a therapeutic purpose.

No

Explanation: The NE-C802 Compressor Nebulizer System is described as providing air to a nebulizer to aerosolize medications for inhalation, making it a therapeutic device for drug delivery, not a device used to diagnose a condition.

No

The device description clearly states it is a "standard nebulizer compressor system with an integral compressor and handheld, pneumatic nebulizer," indicating it is a hardware device. The performance studies also focus on hardware characteristics like aerosol performance and mechanical testing.

Based on the provided information, the NE-C802 Compressor Nebulizer System is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is to "provide air to the pneumatic nebulizer in order to aerosolize medications for inhalation by the patient for respiratory disorders." This describes a device used to deliver medication to the patient, not a device used to test samples from the patient to diagnose or monitor a condition.
  • Device Description: The description focuses on the mechanical function of the compressor and nebulizer in creating an aerosol for inhalation.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting analytes, or providing diagnostic information based on testing samples.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information for diagnosis, monitoring, or screening. The NE-C802's function is purely therapeutic (drug delivery).

N/A

Intended Use / Indications for Use

The NE-C802 Compressor Nebulizer System is intended to provide air to the pneumatic nebulizer in order to aerosolize medications for inhalation by the patient for respiratory disorders. The system is designed for use with pediatric (3 year old and greater) and adult patients in the home, hospital, and sub-acute settings.

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

CAF

Device Description

The Omron Model NE-C802 is a standard nebulizer compressor system with an integral compressor and handheld, pneumatic nebulizer intended for general purpose use. It is powered by standard AC. This is a modification of the NE-C801 cleared under K110860.

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

pediatric (3 year old and greater) and adult

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

Not Found

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

Performance Testing: Verification activities, as required by the risk analysis, for the modification were performed by the designated individual(s) and the results demonstrated that the predetermined acceptance criteria were met. Table 5.1 summarizes the difference, Table 5.2 equivalence comparison, and Table 5.3 the testing.

A series of aerosol performance tests were performed using an 8 stage cascade impactor at a sampling flow rate of 15 l/min equipped with a USP induction port throat. Aerosol was sampled directly from the outlet. A summary of results is listed below with intervals given for a 99% confidence level.

Non-clinical Testing:

  • IEC 60601-1
  • IEC 60601-1-2
  • Cascade Impactor particle characterization testing with 3 devices for 3 runs with 3 drugs
  • Compressor testing
    • VOC testing per EPA TO-15
    • CO, CO2 testing EPA Part 60
    • Ozone testing per OSHA method ID 214
    • PM25 testing per NIOSH NMAM 0600
  • Cleaning
  • Simulated life and age testing
  • Mechanical testing

The non-clinical testing demonstrated that the performance of the proposed device was equivalent to the predicate Omron NE-C801 (K110860).

Clinical Testing:
There was no clinical testing performed.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K110860

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 868.5630 Nebulizer.

(a)
Identification. A nebulizer is a device intended to spray liquids in aerosol form into gases that are delivered directly to the patient for breathing. Heated, ultrasonic, gas, venturi, and refillable nebulizers are included in this generic type of device.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/1 description: The image shows the logo for the United States Department of Health and Human Services. The logo features a stylized image of a human face in profile, with three overlapping profiles suggesting a sense of community and support. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the image.

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

September 30, 2014

Omron Healthcare, Incorporated C/O Mr. Paul Dryden ProMedic. Incorporated 24301 Woodsage Drive Bonita Springs, FL 34134-2958

Re: K141140

Trade/Device Name: Omron Compressor Nebulizer Systems -NE-C802 Regulation Number: 21 CFR 868.5630 Regulation Name: Nebulizer Regulatory Class: Class II Product Code: CAF Dated: August 28, 2014 Received: August 29, 2014

Dear Mr. Dryden:

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. Dryden

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,

Tejashri Purohit-Sheth, M.D.

Tejashri Purohit-Sheth, M.D. Clinical Deputy Director 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

2

Indications for Use

510(k) Number (if known) K141140

Device Name NE-C802

Indications for Use (Describe)

The NE-C802 Compressor Nebulizer System is intended to provide ar to the pneumatic nebulizer in order to aerosolize medications for inhalation by the patient for respiratory disorders. The system is designed for use with pediatric (3 year old and greater) and adult patients in the home, hospital, and sub-acute settings.

Type of Use (Select one or both, as applicable)

X Prescription Use (Part 21 CFR 801 Subpart D)

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

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

3

510(k) Summary
Page 1 of 6
30-Apr-14
Omron Healthcare, Inc.
1200 Lakeside DriveTel – 847-247-5626
Bannockburn, IL 60015 USAFax – 847-680-6269
Official Contact:Renee Thornborough – Director, Quality & Regulatory
Proprietary or Trade Name:NE-C802
Common/Usual Name:Nebulizer (direct patient interface)
Classification Name/Code:CAF, Class 2, Nebulizer (direct patient interface)
CFR 870.1130
Device:NE-C802
Modified Device:Omron – NE-C801 – K110860

Device Description:

The Omron Model NE-C802 is a standard nebulizer compressor system with an integral compressor and handheld, pneumatic nebulizer intended for general purpose use. It is powered by standard AC. This is a modification of the NE-C801 cleared under K110860.

The modifications to the device do not change the intended use of the predicate device. The modifications to the device do not alter the fundamental scientific technology. As there are no changes in hardware that will impact performance, there is no need to validate the changes through a clinical investigation.

Indications for Use:

The NE-C802 Compressor Nebulizer System is intended to provide air to the pneumatic nebulizer in order to aerosolize medications for inhalation by the patient for respiratory disorders. The system is designed for use with pediatric (3 year old and greater) and adult patients in the home, hospital, and sub-acute settings.

Contraindications:

None

Summary of Modifications:

The modifications to the device do not change the intended use of the predicate device. The modifications to the device do not alter the fundamental scientific technology. As there are no changes in hardware that will impact performance, there is no need to validate the changes through a clinical investigation.

Modifications:

  • Minor changes to nebulizer design
  • Changes to physical dimensions ●
  • Change to compressor design to make it smaller and lighter weight ●

4

510(k) Summary Page 2 of 6 30-Apr-14

There is no change in intended use, including patient population and environment of use. There is no change in contraindications.

Performance Testing:

Verification activities, as required by the risk analysis, for the modification were performed by the designated individual(s) and the results demonstrated that the predetermined acceptance criteria were met. Table 5.1 summarizes the difference, Table 5.2 equivalence comparison, and Table 5.3 the testing.

Table 5.1 - Description of the modifications of the New Model NE-C802 vs. the Predicate

| Features | New model
NE-C802 | Predicate (K110860)
NE-C801 |
|---------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------|
| Compressor | Roller – 3 valves | Roller - 4 valves |
| Power | DC 6V | DC 12V |
| Operating pressure and flow from compressor | 1.2 lpm | 2.54 lpm |
| Nebulizer design | Design change to some nebulizer
components to improve air flow
but still pneumatic and principle of
operation is the same | |
| Delivery rate | 0.25 ml / min | 0.3 ml / min |
| Particle size (MMAD) in um | @ 15L/min
Pulmicort - 4.43 $\mu$ m
Intal – 3.78 $\mu$ m
Salbutamol - 3.25 $\mu$ m | @ 15L/min
Pulmicort - 4.89 $\mu$ m
Intal – 3.33 $\mu$ m
Salbutamol - 3.38 $\mu$ m |
| | @ 32L/min
Pulmicort – 4.08 $\mu$ m
Intal - 3.37 $\mu$ m
Salbutamol – 2.94 $\mu$ m | @ 32L/min
Pulmicort - 4.37 $\mu$ m
Intal - 2.79 $\mu$ m
Salbutamol - 2.72 $\mu$ m |
| | Non-significance of Variance and mean difference (p value) | |
| Dimensions (mm) | 85mm (W) x 43mm (H) x 115mm (D) | 142 mm (W) x 98 mm (H) x 72 mm (D) |
| Weight (kg) without battery | 190 gm | 270 gm |
| Reservoir size | 10 ml | 7 ml |

5

510(k) Summary Page 3 of 6 30-Apr-14

FeaturesNewPredicate (K110860)
NE-C802NE-C801
Indications for useThe NE-C802 Compressor Nebulizer
System is intended to provide air to the
pneumatic nebulizer in order to aerosolize
medications for inhalation by the patient
for respiratory disorders.The NE-C801 Compressor Nebulizer
System is intended to provide air to the
pneumatic nebulizer in order to aerosolize
medications for inhalation by the patient
for respiratory disorders.
Environment of UseHome, Hospital, Sub-acute InstitutionsSame
Patient PopulationPediatric (3 years and older) to adultPediatric and adult
ContraindicationsNoneNone
Pneumatic compressorYesYes
Pneumatic nebulizerYesYes
Software drivenNoNo
Materials in patient
contactPolypropylene and PVCABS, Polypropylene and PVC
Patient InterfaceMouthpiece or maskMouthpiece or mask
Standards metIEC 60601-1:2005IEC60601-1:1988 +A1:1991+A2:1995
IEC 60601-1-2:2007IEC60601-1-2:2007
IEC 60601-1-11:2007
IEC 62366:2007ISO10993-1:2009
ISO10993-1:2009ISO10993-5:2009
ISO10993-5:2009ISO10993-10:2009
ISO10993-10:2010
Nebulizer components
cleanableYesYes
Operating conditions10°C to 40°C 30% to 85% RHSame
Storage conditions-20°C to 60°C 10% to 95% RHSame
Power SourceACAC

Table 5.2 - Comparison and Equivalence of New Model NE-C802 and the Predicate

The differences between the proposed device and the predicates are:

  • Physical size
  • A modification to nebulizer

It is our view that these are not significant differences that affect the safety or effectiveness of the intended device as compared to the predicate device.

Table 5.3 - Particle Characterization results

A series of aerosol performance tests were performed using an 8 stage cascade impactor at a sampling flow rate of 15 1/min equipped with a USP induction port throat. Aerosol was sampled directly from the outlet. A summary of results is listed below with intervals given for a 99% confidence level.

6

Premarket Notification 510()

Section 5

| 310(k) Summary
Page 4 of 6

30-Apr-14
CharacteristicDevice NE-C802 (NEW)Predicate Device - NE-C801 K110860
Pulmicort
250 ug.mlIntal
10 mg/mlSalbutamol
5 mg/mlPulmicort
250 ug.mlIntal
10 mg/mlSalbutamol
5 mg/ml
MMAD (um)
5 lpm4.893.333.384.433.783.25
2 lpm4.373.792.724.083.372.94
GSD
5 lpm2.42.82.92.22.42.7
2 lpm2.553.23.42.322.72.89
Total Delivered Dose (ug)
5 lpm385129937483395135677650
2 lpm392129927494378125337716
Total Delivered Dose Fraction (%)
5 lpm76%65%74%80%69%78%
2 lpm78%65%75%81%64%79%
Respirable Fraction (0.5-5 um) (%)
5 lpm50%60%56%55%59%59%
2 lpm54%64%57%58%62%60%
Total Respirable Dose (0.5-5 um) (ug)
5 lpm1.9378.2741.632.1780.1344.9
2 lpm2.1282.443.032.3977.8646.24

510(k) Summar

ummary of result

NF-C802 was found to be substantially equivalent on all performance areas except as noted below. These differences are in GSD and Ultr
particle fraction. Neither of which

statistical analysis was done with a 99% confidence inter

7

510(k) Summary Page 5 of 6 30-Apr-14

The Model NE-C802 is viewed as substantially equivalent to the predicate device because:

Indications -

The Indications for Use are as a general purpose nebulizer and compressor system which is identical to predicate - Omron NE-C801 (K110860).

Discussion - We have not changed the indications for use statement, only defined the pediatric population to 3 years and older, which has been a recent FDA request.

Technology -

The technology of the compressor is identical compressor technology to predicate - Omron NE-C801 (K110860). The technology of the pneumatic nebulization is identical nebulizer technology to predicate – Omron NE-C801 (K110860).

Discussion - The modifications to compressor, smaller and lighter weight has not changed the technology. As to the nebulizer changes, this is still a pneumatic nebulizer to aerosolize medications. The changes have been for simplification and efficiency of performance. The particle characterization performance demonstrates that the 2 devices perform substantially equivalent.

Materials -

The materials in the gas and fluid pathway are identical to predicate device, Omron NE-C801 (K110860).

Discussion - The materials are identical to our own predicate device are have the identical patient contact, exposure, and duration of use. The use of these materials has been determined to be safe by FDA under previous submission reviews.

Environment of Use -

The environment of use is - home, hospital and sub-acute care settings which are identical to predicate - Omron NE-C801 (K110860).

Discussion - There have been no changes in the environment of use and thus the proposed device can be found substantially equivalent to the predicate.

Patient Population -

The patient population is pediatric and adult which is identical to predicate - NE-C801 (K110860).

Discussion - We have not changed the patient population, but as requested by FDA, there are subsets of "pediatric" populations and we have added clarification of this in our indications for use. It is common practice that nebulizers may be used with patients that are 3 years and old, or can follow verbal instructions. Our added language does not alter the indications for use, but only to supports FDA's request for clarification of "pediatrics" population.

Non-clinical Testing -

We have performed a number of performance tests which are identical to those done with the predicate, Omron NE-C801 (K110860). These included:

  • IEC 60601-1 ●
  • IEC 60601-1-2

8

510(k) Summary Page 6 of 6 30-Apr-14

  • Cascade Impactor particle characterization testing with 3 devices for 3 runs with 3 drugs o
  • Compressor testing
    • VOC testing per EPA TO-15 o
    • CO, CO2 testing EPA Part 60 o
    • o Ozone testing per OSHA method ID 214
    • PM25 testing per NIOSH NMAM 0600 O
  • Cleaning
  • Simulated life and age testing
  • Mechanical testing ●

Discussion – The non-clinical testing demonstrated that the performance of the proposed device was equivalent to the predicate Omron NE-C801 (K110860).

Clinical Testing -

There was no clinical testing performed.

Substantial Equivalence Conclusion -

The proposed device has been found to be substantially equivalent to the predicate. Differences between the proposed device and the predicate do not raise new questions of safety or efficacy.