K Number
K141963
Device Name
12SL ECG ANALYSIS PROGRAM
Date Cleared
2015-02-05

(202 days)

Product Code
Regulation Number
870.1025
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The 12SL ECG Analysis Program assists the physician in measuring and interpreting resting 12lead ECGs for rhythm and contour information by providing an initial automated interpretation. The interpretation by the analysis program may then be confirmed, edited, or deleted by the physician. The analysis program is intended for use in the general population ranging from healthy subjects to patients with cardiac and/or non-cardiac abnormalities. The analysis program is intended for use in hospitals, outpatient clinics, emergency departments, and out-of hospital sites such as ambulances and patients' homes. The ACS Tool option is intended for adult patient populations who are suspected clinically to have acute coronary syndrome.
Device Description
The 12SL ECG Analysis Program is a software only algorithm
More Information

K#092369

Not Found

No
The document explicitly states "Mentions AI, DNN, or ML: Not Found" and describes the device as a "software only algorithm" without mentioning any characteristics typically associated with AI/ML, such as training data or complex model architectures.

No.
The device assists in measuring and interpreting ECGs, providing diagnostic information, but it does not directly treat or provide therapy to patients.

Yes
The device assists physicians in measuring and interpreting resting 12-lead ECGs and provides an automated interpretation, which directly supports the diagnosis of cardiac conditions.

Yes

The device description explicitly states "The 12SL ECG Analysis Program is a software only algorithm".

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

Here's why:

  • IVD definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections.
  • Device function: The 12SL ECG Analysis Program analyzes electrocardiogram (ECG) data, which is a recording of the electrical activity of the heart. This data is obtained through electrodes placed on the body, not from a sample taken from the body.
  • Intended Use: The intended use clearly states it assists in measuring and interpreting resting 12-lead ECGs. This is a non-invasive procedure that does not involve analyzing biological samples.

Therefore, the 12SL ECG Analysis Program falls under the category of a medical device that analyzes physiological signals, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The 12SL ECG Analysis Program assists the physician in measuring and interpreting resting 12-lead ECGs for rhythm and contour information by providing an initial automated interpretation. The interpretation by the analysis program may then be confirmed, edited, or deleted by the physician. The analysis program is intended for use in the general population ranging from healthy subjects to patients with cardiac and/or non-cardiac abnormalities. The analysis program is intended for use in hospitals, outpatient clinics, emergency departments, and out-of-hospital sites such as ambulances and patients' homes.
The ACS Tool option is intended for adult patient populations who are suspected clinically to have acute coronary syndrome.

Product codes

MHX

Device Description

The 12SL ECG Analysis Program is a software only algorithm

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

general population ranging from healthy subjects to patients with cardiac and/or non-cardiac abnormalities. The ACS Tool option is intended for adult patient populations.

Intended User / Care Setting

The physician. Intended for use in hospitals, outpatient clinics, emergency departments, and out-of-hospital sites such as ambulances and patients' homes.

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

The subject of this premarket submission, 12SL ECG Analysis Program, did not require clinical studies to support substantial equivalence.

Key Metrics

Not Found

Predicate Device(s)

12SL ECG Analysis Program K#092369

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.1025 Arrhythmia detector and alarm (including ST-segment measurement and alarm).

(a)
Identification. The arrhythmia detector and alarm device monitors an electrocardiogram and is designed to produce a visible or audible signal or alarm when atrial or ventricular arrhythmia, such as premature contraction or ventricular fibrillation, occurs.(b)
Classification. Class II (special controls). The guidance document entitled “Class II Special Controls Guidance Document: Arrhythmia Detector and Alarm” will serve as the special control. See § 870.1 for the availability of this guidance document.

0

Public Health Service

Image /page/0/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract symbol that resembles three human profiles facing to the right, stacked on top of each other.

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

February 5, 2015

GE Medical Systems Information Technologies, Inc. Kristin Pabst Regulatory Affairs Manager 9900 West Innovation Drive Wauwatosa, Wisconsin 53226

Re: K141963

Trade/Device Name: 12SL ECG Analysis Program Regulation Number: 21 CFR 870.1025 Regulation Name: Arrhythmia Detector And Alarm (Including ST-Segment Measurement And Alarm) Regulatory Class: Class II Product Code: MHX

Dated: January 29, 2015 Received: February 2, 2015

Dear Kristin Pabst,

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.

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

1

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 of medical devicerelated 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/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of 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,

Melissa A. Torres -S

For Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Image /page/2/Picture/2 description: The image shows the General Electric (GE) logo. The logo consists of the letters 'GE' in a stylized, cursive font, enclosed within a circular border. The color of the logo is a light blue. The logo is simple and recognizable.

GE Healthcare

510(k) Premarket Notification Submission

510(k) Number:

Device Name: 12SL ECG Analysis Program

Indications for Use:

The 12SL ECG Analysis Program assists the physician in measuring and interpreting resting 12lead ECGs for rhythm and contour information by providing an initial automated interpretation. The interpretation by the analysis program may then be confirmed, edited, or deleted by the physician. The analysis program is intended for use in the general population ranging from healthy subjects to patients with cardiac and/or non-cardiac abnormalities. The analysis program is intended for use in hospitals, outpatient clinics, emergency departments, and out-of hospital sites such as ambulances and patients' homes.

The ACS Tool option is intended for adult patient populations who are suspected clinically to have acute coronary syndrome.

Prescription Use_ X AND/OR (Part 21 CFR 801 Subpart D)

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

3

Image /page/3/Picture/1 description: The image shows the General Electric (GE) logo. The logo consists of the letters 'g' and 'e' intertwined in a stylized script, enclosed within a blue circle. The letters are white, creating a contrast against the blue background. The logo is simple, recognizable, and represents the multinational conglomerate corporation.

GE Healthcare

510(k) Premarket Notification Submission

510(k) Summary

In accordance with 21 CFR 807.92 the following summary of information is provided:
Date:July 17, 2014
Submitter:GE Medical Systems Information Technologies
9900 Innovation Drive
Wauwatosa, WI 53226
Primary Contact Person:Kristin Pabst
Regulatory Affairs Manager
GE Medical Systems Information Technologies
Phone: (414) 721-3104
Fax: (414) 721-3863
Secondary Contact Person:Doug Kentz
Regulatory Affairs
GE Medical Systems Information Technologies
Phone (414) 362-2038
FAX: (414) 362-2585
Device: Trade Name:12SL ECG Analysis Program
Common/Usual Name:ECG Analysis Program
Classification Names:Monitor, Physiological, Patient (With Arrhythmia Detection Or Alarms)
Product Code:MHX 21CFR 870.1025
Predicate Device(s):12SL ECG Analysis Program K#092369
Device Description:The 12SL ECG Analysis Program is a software only algorithm
Intended Use:The 12SL ECG Analysis Program assists the physician in measuring
and interpreting resting 12-lead ECGs for rhythm and contour
information by providing an initial automated interpretation. The
interpretation by the analysis program may then be confirmed, edited,
or deleted by the physician. The analysis program is intended for use
in the general population ranging from healthy subjects to patients with
cardiac and/or non-cardiac abnormalities. The analysis program is
intended for use in hospitals, outpatient clinics, emergency
departments, and out-of hospital sites such as ambulances and
patients' homes.
The ACS Tool option is intended for adult patient populations who are
suspected clinically to have acute coronary syndrome.
Technology:The 12SL ECG Analysis Program employs the same functional
scientific technology as its predicate device. 12SL ECG Analysis
Program (K092369).
Determination of Substantial
Equivalence:Summary of Non-Clinical Tests:
The 12SL ECG Analysis program was designed and tested for
compliance with applicable clauses of the following voluntary standard:

4

Image /page/4/Picture/0 description: The image shows the logo for General Electric (GE). The logo is a blue circle with the letters "GE" in white inside. The letters are stylized and connected, and the circle is surrounded by a decorative border. The logo is simple and recognizable, and it is often used to represent the company.

GE Healthcare

510(k) Premarket Notification Submission

  • . IEC 60601-2-25:2011Medical electrical equipment – Part 2-25: Particular requirements for the basic safety and essential performance of electrocardiographs - Edition 2.0
    The 12SL ECG Analysis Program and its applications comply with the Guidances and/or Special Controls as detailed in Section 9 of this premarket submission. The following quality assurance measures were applied to the development of the system:

  • Requirements Reviews

  • o Risk Analysis

  • Software Verification and Validation .

  • . Performance testing

Summary of Clinical Tests:

The subject of this premarket submission, 12SL ECG Analysis Program, did not require clinical studies to support substantial equivalence.

  • GE Healthcare considers the 12SL ECG Analysis Program to be as Conclusion: safe, as effective, and performance is substantially equivalent to the predicate device.