K Number
K142832
Date Cleared
2015-02-06

(129 days)

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

Unimed Disposable and Reusable SPO2 Sensors are indicated for continuous non-invasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate (PR) for adult patients weighing greater than 40kg, pediatric patients weighing 10 -50 kg, and neonatal patients weighing no less than 3 Kg.

Device Description

The Unimed Disposable and Reusable SpO2 Sensors are a family of oximeter sensors designed to function the same as the compatible Original Equipment Manufacturer (OEM) Pulse Oximeter Sensor.

The sensors contain two specific wavelength LEDs and a photo detector assembled into the sensor housing. The sensor cable terminates into an OEM compatible connector. The sensors use optical means to determine the light absorption of functional arterial hemoglobin by being connected between the patient and the oximeter.

Four types of sensor housings are described in this submission:

  • Reusable soft tip sensor comprised of an integrated silicone rubber tip.
  • Reusable finger clip sensor with rigid halves and silicone pads
  • Disposable non- adhesive sensor with sponge and velcro backing.
  • Disposable adhesive sensors constructed of a medical tape laminate.

Each sensor has unique labeling and specifications designed for compatibility with the specific monitor (Nellcor, Nonin, BCI, Ohmeda).

AI/ML Overview

The Unimed Disposable and Reusable SpO2 Sensors were evaluated through clinical testing, specifically a clinical hypoxia study, to establish their accuracy.

1. Table of Acceptance Criteria and Reported Device Performance:

The document summarizes the clinical test results but does not provide a table with specific numerical acceptance criteria or detailed performance metrics like accuracy range (e.g., A_rms value) against arterial oxygen saturation (SaO2). It broadly states that "Clinical test results support device accuracy claims for the specified saturation range."

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

The document states that "Clinical hypoxia test results were obtained in human adult volunteers."

  • Sample Size: Not explicitly stated, though it refers to "human adult volunteers" (plural), indicating more than one.
  • Data Provenance: The study was "prospective" as it involved "clinical hypoxia test results obtained in human adult volunteers" under an "approved protocol with subject informed consent." The country of origin of the data is not specified.

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

This information is not provided in the document. The ground truth (SaO2) was determined by co-oximetry, which is a laboratory measurement. While experts would be involved in performing and interpreting co-oximetry, the document doesn't detail their number or qualifications as it pertains to establishing the ground truth for the test set.

4. Adjudication Method for the Test Set:

This is not applicable as the ground truth was established by co-oximetry, which is a quantitative measurement, not a subjective interpretation requiring adjudication among experts.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done:

No, an MRMC comparative effectiveness study was not done. This study focuses on the accuracy of the device itself against a clinical standard (co-oximetry), not on how human readers improve with or without AI assistance.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) was done:

Yes, the clinical hypoxia test evaluated the standalone performance of the Unimed Disposable and Reusable SpO2 Sensors. The study assessed the device's accuracy in continuously monitoring SpO2 and pulse rate against arterial oxygen saturation (SaO2) determined by co-oximetry. There is no mention of a human-in-the-loop component in this specific clinical test.

7. The Type of Ground Truth Used:

The ground truth used was arterial oxygen saturation (SaO2) as determined by co-oximetry. This is an objective laboratory measurement from arterial blood samples.

8. The Sample Size for the Training Set:

This information is not provided. The document describes a clinical "validation" study (test set), not a study focused on training a model.

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

This information is not provided. As mentioned above, the document describes a validation study for the device, not a training study for an algorithm.

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the circle is an abstract symbol that resembles a stylized human figure in profile, with three overlapping heads.

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

February 6, 2015

Unimed Medical Supplies, Inc. Xinmei Tan QA and RA Manager No. 37, Yanshan Road, Shekou Shenzhen, 518067 CHINA

Re: K142832

Trade/Device Name: Unimed Disposable and Reusable SpO2 Sensors Models: U103-01, U103S-01, U403-01, U403-06, U403-07, U403-08, U403-125, U403S-01, U410-03, U503-01, U543-01, N543-01 Regulation Number: 21 CFR 870.2700 Regulation Name: Oximeter Regulatory Class: Class II Product Code: DQA Dated: December 29, 2014 Received: January 6, 2015

Dear Ms. Tan,

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 - Ms. Xinmei Tan

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 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,

Tejashri Purohit-Sheth, M.D.

Tejashri Purohit-Sheth, M.D. Clinical Deputy Director DAGRID/ODE/CDRH FOR

Erin Keith 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) K142832

Device Name

Unimed Disposable And Reusable Spo2 Sensors

Indications for Use (Describe)

Unimed Disposable and Reusable SPO2 Sensors are indicated for continuous non-invasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate (PR) for adult patients weighing greater than 40kg, pediatric patients weighing 10 -50 kg, and neonatal patients weighing no less than 3 Kg.

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

☑ Prescription Use (Part 21 CFR 801 Subpart D)
☐ Over-The-Counter Use (21 CFR 801 Subpart C)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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Image /page/3/Picture/1 description: The image shows the logo for Unimed Medical Supplies. The word "unimed" is written in gray, sans-serif font, with the words "medical supplies" written in a smaller font below. To the right of the word "unimed" is a red oval with a white design inside.

Section 5 510(K) Summary

1. Prepared Date: 2014-12-25

2. Submitter Information

NameUnimed Medical Supplies Inc
AddressNo. 37, Yanshan Road, Shekou, Shenzhen, China 518067
Tel+86-755 26695165
Fax+86-755 26697984
EstablishmentRegistration No.3007307487

3. Contact Person

Contact personTan xinmei
TitleQA&RA manager
AddressNo. 37, Yanshan Road, Shekou, Shenzhen, China 518067
Tel+86-755 26695165
Fax+86-755 26697984
E-mailtanxinmei@unimed.cn

4. Manufacturer Information

NameUnimed Medical Supplies Inc
AddressNo. 37, Yanshan Road, Shekou, Shenzhen, China 518067
Establishment3007307487
Registration No.3007307487

5. Proposed Device Information

Trade NameUnimed Disposable and Reusable SPO2 Sensors
Common nameOximeter
Regulatory classII
Production regulation21 CFR §870.2700
Product codeDQA
PanelCardiovascular

6. Predicate Device Information

510(K)No.Trade Name/modelSubmitter
K100077Solaris Medical Technology, Inc.Reusable & Disposable SPO2 SensorsSolaris Medical Technology, Inc.
K111888Masimo LNOP/M-LNCS/LNCSMasimo Corporation

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Unimed Medical Supplies Inc

No. 37, Yanshan Road, Shekou, Shenzhen, China 518067 Tel: 86 755 26695165 Fax: 86 755 26697984 Website: www.unimed.cn Email: info@unimed.cn

Image /page/4/Picture/2 description: The image shows the logo for Unimed Medical Supplies. The word "unimed" is written in gray, with the words "medical supplies" written in a smaller font below it. To the right of the word "unimed" is a red circle with a white design inside.

Multisite-L Oximetry Sensors
K082546Unimed compatible oximeter sensorsUnimed Medical supplies Inc

7. Device description

The Unimed Disposable and Reusable SpO2 Sensors are a family of oximeter sensors designed to function the same as the compatible Original Equipment Manufacturer (OEM) Pulse Oximeter Sensor.

The sensors contain two specific wavelength LEDs and a photo detector assembled into the sensor housing. The sensor cable terminates into an OEM compatible connector. The sensors use optical means to determine the light absorption of functional arterial hemoglobin by being connected between the patient and the oximeter.

Four types of sensor housings are described in this submission:

  • Reusable soft tip sensor comprised of an integrated silicone rubber tip.
  • Reusable finger clip sensor with rigid halves and silicone pads
  • Disposable non- adhesive sensor with sponge and velcro backing.
  • Disposable adhesive sensors constructed of a medical tape laminate.

Each sensor has unique labeling and specifications designed for compatibility with the specific monitor (Nellcor, Nonin, BCI, Ohmeda),please refer to the following table:

Compatiblemonitor modelSPO2 sensor modelCompatiblemonitor modelSPO2 sensormodel
NellcorNBP-40U403S-01, U403-01 ,U103-01, U103S-01,U543-01, U503-01N543-01Masimo RadicalRDS-1U403-125
Ohmeda 3800U410-03BCI 3301U403-06
Nonin 8500U403-08Ohmeda 3800U403-07

8. Intended use

Unimed Disposable and Reusable SPO2 Sensors are indicated for continuous non-invasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate(PR) for adult patients weighing greater than40kg, pediatric patients weighing 10 -50 kg, and neonatal patients weighing no less than 3 Kg.

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Image /page/5/Picture/1 description: The image shows the logo for Unimed Medical Supplies. The word "Unimed" is written in gray, block letters. Below it, the words "medical supplies" are written in a smaller font. To the right of the words is a red oval with a white, stylized "UM" inside.

9. Comparison to predicate device

The Unimed Disposable and Reusable SpO2 Sensors utilize the same measurement principles as the listed predicate devices: two wavelengths of light (red, infrared) from light emitting diodes (LED's) illuminate the patients arterial tissue; and the light transmission through the tissue is measured using a photodiode light detector. The transmission properties vary with the patient's arterial blood saturation and pulse rate.

This method is fundamental to all pulse oximeter sensors and monitors for the non-invasive measurement of functional oxygen saturation (SpO2).

10. Non-clinical test data

The subject device meets the following the recognized standards:

  • IEC 60601-1 Medical Electrical Equipment-Part 1: General Requirements for ● Safety, 2005
  • IEC 60601-1-2 Medical Electrical Equipment-Part 1-2: General Requirements for Safety -Collateral Standard: Electromagnetic Compatibility-Requirements and Tests, 2007
  • ISO 80601-2-61 Medical electrical equipment - Part 2-61: Particular requirements for basic safety and essential performance of pulse oximeter equipment
  • ISO 10993-5, Biological evaluation of medical devices-Part 5: Tests for In Vitro ● cytotoxicity, 2009
  • ISO 10993-10, Biological evaluation of medical devices-Part 10: Tests for irritation and delayed-type hypersensitivity, 2010

11. Clinical test data

Clinical testing has been performed under an approved protocol with subject informed consent. Clinical hypoxia test results were obtained in human adult volunteers to validate the accuracy of Unimed Disposable and Reusable SPO2 Sensors versus arterial oxygen saturation (SaO2) as determined by co-oximetry. Clinical test results support device accuracy claims for the specified saturation range.

12. Substantial Equivalence Statement

Based on the comparison ,analysis, and the submitted performance data, Unimed believes that the Unimed Disposable and Reusable SPO2 Sensors are as safe and effective and are substantially equivalent to the predicate devices.

§ 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).