K Number
K142332
Device Name
BT-400
Manufacturer
Date Cleared
2015-03-20

(212 days)

Product Code
Regulation Number
880.5700
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
BT-400 is the Phototherapy unit intended for the treatment of Neonatal Hyperbilirubinemia caused by Indirect Hyperbilirubinemia.
Device Description
BT-400 Neonatal phototherapy is designed to emit the blue light wave length range 450-470nm spectrum to treat Neonatal Jaundice to use in Bassinets, Incubators, Open beds or Radiant warmer and consists of Head ( Light Source ) Control box with LCD window Roll Stand ( optional)
More Information

Not Found

No
The document describes a standard phototherapy unit for treating neonatal jaundice and does not mention any AI or ML components or functionalities.

Yes.
The device is intended for the treatment of Neonatal Hyperbilirubinemia, indicating a therapeutic purpose.

No

The device is a phototherapy unit intended for treatment, not for diagnosing a condition.

No

The device description explicitly states it is a "Phototherapy unit" and consists of hardware components like a "Head (Light Source)", "Control box with LCD window", and "Roll Stand (optional)". This indicates it is a physical medical device, not software-only.

Based on the provided information, the BT-400 is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use is for the treatment of Neonatal Hyperbilirubinemia by emitting blue light. IVD devices are used for the diagnosis or monitoring of conditions by examining samples from the body (like blood, urine, etc.).
  • Device Description: The description details a phototherapy unit that emits light. There is no mention of analyzing biological samples.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples.
    • Measuring analytes in samples.
    • Providing diagnostic information based on sample analysis.

The BT-400 is a therapeutic device, not a diagnostic one.

N/A

Intended Use / Indications for Use

BT-400 is the Phototherapy unit intended for the treatment of Neonatal Hyperbilirubinemia caused by Indirect Hyperbilirubinemia.

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

LBI

Device Description

BT-400 Neonatal phototherapy is designed to emit the blue light wave length range 450-470nm spectrum to treat Neonatal Jaundice to use in Bassinets, Incubators, Open beds or Radiant warmer and consists of
Head ( Light Source ) Control box with LCD window Roll Stand ( optional)

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

Neonatal

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)

Performed below listed Bench Tests, and all data met cited standard required criteria.
IEC60601-1 Medical Electrical Equipment :2006 part 1 : General requirements for basic safety and essential performance.
IEC 60601-1-2:2007 Electromagnetic compatibility test
IEC60601-2-50 Medical Electrical Equipment part 2-50: Particular requirements for the basic safety and essential performance of Infant Phototherapy Equipment
The Device is non contacted mode.
Note performance is similar since subject device intensity is few microwatts higher and effective area is slightly large compared to the predicate device.

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

Light Source: Blue LEDs
Wavelength: Peak 450-475nm
Intensity: 30-45uW/cm2 at 30cm distance
Variation in intensity in 6 hrs: +- 10% in Illumination area
Effective Surface: 40x20cm
Head output over 6 hrs:

§ 880.5700 Neonatal phototherapy unit.

(a)
Identification. A neonatal phototherapy unit is a device used to treat or prevent hyperbilirubinemia (elevated serum bilirubin level). The device consists of one or more lamps that emit a specific spectral band of light, under which an infant is placed for therapy. This generic type of device may include supports for the patient and equipment and component parts.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which is a staff with two snakes entwined around it. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the caduceus symbol. The logo is simple and clean, and it is easily recognizable.

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

March 20, 2015

Bio-Med USA Inc. Mr. Young Chi President 27 New England Drive Ramsey, NJ 07446

Re: K142332

Trade/Device Name: BT-400 Neonatal Phototherapy Regulation Number: 21 CFR 880.5700 Regulation Name: Neonatal Phototherapy Unit Regulatory Class: II Product Code: LBI Dated: February 9, 2015 Received: February 18, 2015

Dear Mr. Chi:

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. Young Chi

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/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 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,

Tina
Kiang -S

for Erin I. Keith, M.S. Division Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indication for use statement

510 (K) Number: K142332
Device Name: BT-400 Neonatal Phototherapy
Indication for use: BT-400 is the Phototherapy unit intended for the treatment of Neonatal Hyperbilirubinemia caused by Indirect Hyperbilirubinemia.
Prescription useXX or/and Over the Counter use
(Part CFR 801 sub part D) (Part 21CFR 801 Sub part C)

Please do not write below line- continued an another pages if needed


Concurrence of CDRH office of ODE

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510 (K) Summary

As required by CFR 807.92(c)

1. Manufacturer

Revised Mar 18,2015

Bistos Co Ltd. Reg Nr: 3005179052 7th fl, A bldg WooLim Lions Valley, 302 Galmachi ro, JungWon gu, Seoung Nam, GeongGi, Rep of Korea t: 82 31 750 0340 f: 82 31 750 0344

2. Applicant and Contact person

Bio-Med USA Inc. Young Chi, President. 27 New England Drive, Ramsey, NJ 07446. U.S.A. t: 1-973 278 5222 f: 1 201 934 6030 e mail: biomedusa@msn.com

3. Name of Device

Trade name:BT-400 Neonatal Phototherapy
Classification name:Unit, Neonatal Phototherapy
Common name:Neonatal Phototherapy
Regulation:880.5700 Class II
Classification Panel:General Hospital.
Product Code:LBI

4. Legally marketed Predicate Device

K103828 Atom Medical Corp, Japan BILI-THERAPY Spot type.

5. Device Description

BT-400 Neonatal phototherapy is designed to emit the blue light wave length range 450-470nm spectrum to treat Neonatal Jaundice to use in Bassinets, Incubators, Open beds or Radiant warmer and consists of

Head ( Light Source ) Control box with LCD window Roll Stand ( optional)

4

6. Intended use

BT-400 Phototherapy unit is intended for the treatment of Neonatal Hyperbilinemia caused by indirect Hyperbilinemia.

7. Performance Data

Performed below listed Bench Tests, and all data met cited standard required criteria.

IEC60601-1 Medical Electrical Equipment :2006 part 1 : General requirements for basic safety and essential performance.

IEC 60601-1-2:2007 Electromagnetic compatibility test

IEC60601-2-50 Medical Electrical Equipment part 2-50: Particular requirements for the basic safety and essential performance of Infant Phototherapy Equipment

The Device is non contacted mode.

8.Technological Characteristics .

BT-400 Phototherapy is light emitting Blue LED ( Light Emitting Diode) to treat Neonatal Hyperbilirubinemia in the range of 450-475 nm wave length, which are considering most effective for the degradation of Bilirubin.

The The BT-400 Phototherapy and the predicate device are phototherapy units intended to treat neonatal hyperbilirubinemia. The wavelength and intensity of blue light utilized is comparable between the two devices. Operational and functional parameters between the two devices are also highly similar. Both devices are in compliance with the applicable IEC 60601 standards.

Note performance is similar since subject device intensity is few microwatts higher and effective area is slightly large compared to the predicate device.

Comparison to Predicate Device

FeatherProposed DevicePredicate Device
Bistos Co., Ltd BT-400Atom Medical Corp
Model BT-400Model : BILI-THERAPY spot type
K103828
Light SourceBlue LEDsBlue LEDs
WavelengthPeak 450-475nmPeak 450-475nm
Intensity30-45uW/cm2 at 30cm distance30-40uW cm2 at 30cm distance
Variation in intensity in 6 hrs$$\pm$$ 10% in Illumination areaIdentical
Effective Surface40x20cm30x20cm
Head output over 6 hrs