K Number
K141634
Device Name
NAUTILUS DELTA
Date Cleared
2015-01-27

(223 days)

Product Code
Regulation Number
880.5970
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Nautilus Delta is indicated for navigation and positioning of central venous access devices (CVADs) of at least 3 Fr in size. Nautilus Delta provides real-time catheter tip location by using the patient's cardiac electrical activity and is indicated for use as an alternative method to chest X-ray and fluoroscopy for CVAD tip placement confirmation. In adult patients and in adolescents (greater than 12 through 21 years of age), Nautilus Delta can be used with CVADs such as peripherally inserted central catheters (PICCs), central venous catheters (CVCs), implantable ports, and hemodialysis catheters; in children (greater than 2 to 12 years of age), Nautilus Delta can be used with PICCs and with centrally inserted central catheters (CICCs); in infants (greater than 1 month to 2 years of age) and in neonates (from birth to 1 month of age), Nautilus Delta can be used with CICCs. In each specific age group, the CVAD type and size must be chosen and the CVAD must be used according to the CVAD's indications and instructions for use. Limiting but not contraindicated situations for this method are in patients where alterations of cardiac rhythm change the presentation of the P wave as in atrial fibrillation, atrial flutter, severe tachycardia, and pacemaker driven rhythm. In such patients, who are easily identifiable prior to central venous catheter insertion, the use of an additional method is required to confirm catheter tip location.
Device Description
The Nautilus Delta™ system consists of the following elements: single use sterile ECG extension cable (also known as Nautilus Electrical Adaptor also known as NautilusE), non-sterile ECG cable, patient module (ECG data acquisition and processing and integrated remote control), and mobile medical application running on any mobile platform which complies with the minimum requirements. Nautilus Delta™ provides real-time catheter tip location information by using the patient's cardiac electrical activity (ECG). This information can be used to position any central venous access devices (CVADs) at or around the cavo-atrial junction (CAJ). Nautilus Delta supports navigation of central venous catheters from the vascular access point towards the CAJ by computing and displaying a navigation signal. Nautilus Delta also displays on its graphical user interface the surface (skin) ECG signal, a marker identifying the R-peak, and the patient's heart rate. In order to obtain intravascular ECG information at the tip (distal end) of a catheter, a stylet or a guidewire inserted in the catheter can be connected to Nautilus Delta patient module via the sterile Nautilus Delta ECG extension cable. Nautilus Delta and NautilusE do not have any direct or indirect contact with the patient.
More Information

Not Found

No
The summary describes the device as using the patient's cardiac electrical activity (ECG) to determine catheter tip location and compute a navigation signal. There is no mention of AI, ML, or any complex learning algorithms being used for this processing. The description focuses on standard ECG data acquisition and processing.

No.
This device is designed for navigation and positioning of central venous access devices (CVADs), providing real-time catheter tip location. It functions as a diagnostic and positioning aid, not a therapeutic intervention itself.

Yes

This device is used to confirm the tip placement of central venous access devices, and this confirmation is a form of diagnosis, as it determines the location of the catheter.

No

The device description explicitly states that the system consists of hardware components including a single-use sterile ECG extension cable, a non-sterile ECG cable, and a patient module, in addition to the mobile medical application.

Based on the provided information, the Nautilus Delta device is not an In Vitro Diagnostic (IVD).

Here's why:

  • IVDs analyze samples taken from the body (like blood, urine, tissue) to provide information about a patient's health. The Nautilus Delta system works by using the patient's cardiac electrical activity (ECG) to guide the placement of a catheter within the body.
  • The device description explicitly states: "Nautilus Delta and NautilusE do not have any direct or indirect contact with the patient." While the ECG extension cable connects to a stylet or guidewire inserted in the catheter, the device itself is not analyzing a biological sample.
  • The intended use is for navigation and positioning of medical devices within the body. This is a procedural guidance tool, not a diagnostic test performed on a sample.

Therefore, the Nautilus Delta is a medical device used for guiding a procedure, not an IVD.

N/A

Intended Use / Indications for Use

The intended use of Nautilus DeltaTM is to support navigation and tip positioning of central venous access devices. Nautilus DeltaTM can be used as an alternative method to fluoroscopy and chest X-ray for central venous catheter tip placement confirmation.
Nautilus Delta is indicated for navigation and positioning of central venous access devices (CVADs) of at least 3 Fr in size. Nautilus Delta provides real-time catheter tip location information by using the patient's cardiac electrical activity and is indicated for use as an alternative method to chest X-ray and fluoroscopy for CVAD tip placement confirmation.
In adult patients and in adolescents (greater than 12 through 21 years of age), Nautilus Delta can be used with CVADs such as peripherally inserted central catheters (PICCs), central venous catheters (CVCs), implantable ports, and hemodialysis catheters; in children (greater than 2 to 12 years of age), Nautilus Delta can be used with PICCs and with centrally inserted central catheters (CICCs); in infants (greater than 1 month to 2 years of age) and in neonates (from birth to 1 month of age), Nautilus Delta can be used with CICCs. In each specific age group, the CVAD type and size must be chosen and the CVAD must be used according to the CVAD's indications and instructions for use.
Limiting but not contraindicated situations for this method are in patients where alterations of cardiac rhythm change the presentation of the P wave as in atrial fibrillation, atrial flutter, severe tachycardia, and pacemaker driven rhythm. In such patients, who are easily identifiable prior to central venous catheter insertion, the use of an additional method is required to confirm catheter tip location.

Product codes

LJS

Device Description

The Nautilus Delta™ system consists of the following elements: single use sterile ECG extension cable (also known as Nautilus Electrical Adaptor also known as NautilusE), non-sterile ECG cable, patient module (ECG data acquisition and processing and integrated remote control), and mobile medical application running on any mobile platform which complies with the minimum requirements. Nautilus Delta™ provides real-time catheter tip location information by using the patient's cardiac electrical activity (ECG). This information can be used to position any central venous access devices (CVADs) at or around the cavo-atrial junction (CAJ). Nautilus Delta supports navigation of central venous catheters from the vascular access point towards the CAJ by computing and displaying a navigation signal. Nautilus Delta also displays on its graphical user interface the surface (skin) ECG signal, a marker identifying the R-peak, and the patient's heart rate. In order to obtain intravascular ECG information at the tip (distal end) of a catheter, a stylet or a guidewire inserted in the catheter can be connected to Nautilus Delta patient module via the sterile Nautilus Delta ECG extension cable. Nautilus Delta and NautilusE do not have any direct or indirect contact with the patient.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

cavo-atrial junction (CAJ)

Indicated Patient Age Range

Adult patients, adolescents (greater than 12 through 21 years of age), children (greater than 2 to 12 years of age), infants (greater than 1 month to 2 years of age), and neonates (from birth to 1 month of age).

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)

Romedex has performed extensive testing in order to demonstrate that the new characteristics do not affect safety and effectiveness when compared to the predicate devices and to demonstrate compliance with the following standards: ES60601-1, IEC 60601-1-2, IEC 60601-2-27, IEC 62304, IEC 62366, ISO 11737-1, ISO 11135-1, ISO 11135-2, EN 55022, and EN 300328.

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.

K973371, K113808

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

§ 880.5970 Percutaneous, implanted, long-term intravascular catheter.

(a)
Identification. A percutaneous, implanted, long-term intravascular catheter is a device that consists of a slender tube and any necessary connecting fittings, such as luer hubs, and accessories that facilitate the placement of the device. The device allows for repeated access to the vascular system for long-term use of 30 days or more, and it is intended for administration of fluids, medications, and nutrients; the sampling of blood; and monitoring blood pressure and temperature. The device may be constructed of metal, rubber, plastic, composite materials, or any combination of these materials and may be of single or multiple lumen design.(b)
Classification. Class II (special controls) Guidance Document: “Guidance on Premarket Notification [510(k)] Submission for Short-Term and Long-Term Intravascular Catheters.”

0

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

January 27, 2015

Romedex International SRL Sorin Grunwald, PhD. Managing Director 625 Clayton Street San Francisco, CA 94117

Re: K141634

Trade/Device Name: Nautilus Delta™ Regulation Number: 21 CFR 880.5970 Regulation Name: Percutaneous, implanted, long- term intravascular catheter Regulatory Class: II Product Code: LJS Dated: December 15, 2015 Received: December 17, 2015

Dear Dr. Grunwald:

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 - Sorin Grunwald, Ph.D.

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,

Tina
Kiang -S

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

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Indications for Use

510(k) Number (if known) K141634

Device Name Nautilus Delta

Indications for Use (Describe)

Nautilus Delta is indicated for navigation and positioning of central venous access devices (CVADs) of at least 3 Fr in size. Nautilus Delta provides real-time catheter tip location by using the patient's cardiac electrical activity and is indicated for use as an alternative method to chest X-ray and fluoroscopy for CVAD tip placement confirmation. In adult patients and in adolescents (greater than 12 through 21 years of age), Nautilus Delta can be used with CVADs such as peripherally inserted central catheters (PICCs), central venous catheters (CVCs), implantable ports, and hemodialysis catheters; in children (greater than 2 to 12 years of age), Nautilus Delta can be used with centrally inserted central catheters (CICCs); in infants (greater than 1 month to 2 years of age) and in neonates (from birth to 1 month of age), Nautilus Delta can be used with CICCs. In each specific age group, the CVAD type and size must be chosen and the CVAD must be used according to the CVAD's indications for use. Limiting but not contraindicated situations for this method are in patients where alterations of cardiac rhythm change the presentation of the P wave as in atrial fibrillation, atrial flutter, severe tachycardia, and pacemaker driven rhythm. In such patients, who are easily identifiable prior to central venous catheter insertion, the use of an additional method is required to confirm catheter tip location.

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

2 Prescription Use (Part 21 CFR 801 Subpart D)

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

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FOR FDA USE ONLY

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510(k) Summary

Proprietary Name:Nautilus Delta™ also known as Handy Nautilus™
Device Trade Name:Nautilus Delta™
Applicant Name:Romedex International SRL
Applicant Address:74 Fundeni Str., 022325, Bucharest, Romania
+40.21.255.0385, info@romedex.com, www.romedex.com
Contact person:Sorin Grunwald PhD, 625 Clayton Str., San Francisco, CA 94117
sorin@romedex.com, Tel: +1.650.209.4838, Fax: +1.650.636.9666
Date of Preparation:June 16, 2014
Product Classification:Class II, 21 CFR §880.5970
LJS - Accessory to Percutaneous, Implanted, Long-Term
Intravascular Catheters
Classification Panel:General Hospital
Predicate devices:Epidural Catheter Connector (K973371)
Sherlock 3CG Tip Confirmation System (K113808)
Device Description:The Nautilus Delta™ system consists of the following elements:
single use sterile ECG extension cable (also known as Nautilus
Electrical Adaptor also known as NautilusE), non-sterile ECG
cable, patient module (ECG data acquisition and processing and
integrated remote control), and mobile medical application
running on any mobile platform which complies with the minimum
requirements. Nautilus Delta™ provides real-time catheter tip
location information by using the patient's cardiac electrical
activity (ECG). This information can be used to position any
central venous access devices (CVADs) at or around the cavo-
atrial junction (CAJ). Nautilus Delta supports navigation of central
venous catheters from the vascular access point towards the CAJ
by computing and displaying a navigation signal. Nautilus Delta
also displays on its graphical user interface the surface (skin) ECG
signal, a marker identifying the R-peak, and the patient's heart
rate. In order to obtain intravascular ECG information at the tip
(distal end) of a catheter, a stylet or a guidewire inserted in the
catheter can be connected to Nautilus Delta patient module via the
sterile Nautilus Delta ECG extension cable. Nautilus Delta and
NautilusE do not have any direct or indirect contact with the
patient.
Intended Use:The intended use of Nautilus DeltaTM is to support navigation and
tip positioning of central venous access devices. Nautilus DeltaTM
can be used as an alternative method to fluoroscopy and chest X-
ray for central venous catheter tip placement confirmation.
Indications for Use:Nautilus Delta is indicated for navigation and positioning of central
venous access devices (CVADs) of at least 3 Fr in size. Nautilus
Delta provides real-time catheter tip location information by using
the patient's cardiac electrical activity and is indicated for use as an
alternative method to chest X-ray and fluoroscopy for CVAD tip
placement confirmation.
In adult patients and in adolescents (greater than 12 through 21
years of age), Nautilus Delta can be used with CVADs such as
peripherally inserted central catheters (PICCs), central venous
catheters (CVCs), implantable ports, and hemodialysis catheters;
in children (greater than 2 to 12 years of age), Nautilus Delta can
be used with PICCs and with centrally inserted central catheters
(CICCs); in infants (greater than 1 month to 2 years of age) and
in neonates (from birth to 1 month of age), Nautilus Delta can be
used with CICCs. In each specific age group, the CVAD type and
size must be chosen and the CVAD must be used according to the
CVAD's indications and instructions for use.
Limiting but not contraindicated situations for this method are in
patients where alterations of cardiac rhythm change the
presentation of the P wave as in atrial fibrillation, atrial flutter,
severe tachycardia, and pacemaker driven rhythm. In such patients,
who are easily identifiable prior to central venous catheter
insertion, the use of an additional method is required to confirm
catheter tip location.
Summary of Technological
Characteristics compared
to Predicate Devices:Nautilus Delta has features, materials and technological
characteristics which are similar to the ones of the predicate
devices. The most notable differences are:
a) Nautilus Delta uses wireless technology (Bluetooth) instead of
an USB cable for the ECG data transmission between the
Patient and the Operator modules.
b) Nautilus Delta uses a mobile platform instead of a netbook PC.
c) Nautilus Delta provides a Bluetooth remote control integrated
in the Patient Module instead of a standalone Bluetooth remote
control.
d) Nautilus Delta provides an additional optional navigation
signal to support catheter tip navigation from the vascular
access point towards the cavo-atrial junction.
e) Nautilus Delta displays the patient's heart rate and markers to
identify the R-peak of the QRS complex of the ECG
waveform.

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Summary of Romedex has performed extensive testing in order to demonstrate Performance Testing: that the new characteristics do not affect safety and effectiveness when compared to the predicate devices and to demonstrate compliance with the following standards: ES60601-1, IEC 60601-1-2, IEC 60601-2-27, IEC 62304, IEC 62366, ISO 11737-1, ISO 11135-1, ISO 11135-2, EN 55022, and EN 300328. Summary of Since obtaining the CE mark, Nautilus Delta also known as Handy Nautilus was successfully used in Europe in hundreds of patients in Clinical Data: several hospitals in several countries by many different users of different backgrounds and experience levels. No adverse events were reported. Side-by-side comparisons with legally marketed similar devices, including the predicate devices, were performed in clinical settings to demonstrated substantial equivalence of Nautilus Delta with the predicate devices. Summary of Based on the analysis of the indications for use, intended use, Substantial Equivalence: technological characteristics, performance tests, and post-market clinical experience, Romedex International has concluded that the new characteristics of the subject device do not affect the safety or effectiveness of the subject device as compared to the predicate devices. Romedex International considers that the new device Nautilus Delta is substantially equivalent to the predicate devices K973371 and K113808.