K Number
K143060
Device Name
Intelli-Ox
Date Cleared
2015-05-21

(209 days)

Product Code
Regulation Number
868.2700
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Intelli-Ox is an integrated portable oxygen delivery system intended to provide supplemental oxygen to adults. When administered by properly trained personnel for oxygen deficiency and resuscitation, the Intelli-Ox is for emergency use only. For all other medical applications, the device is Rx only.

Device Description

The Intelli-Ox portable oxygen system is a solution for supplying Oxygen USP using a device comprised of an integrated valve-regulator, flow meter and medical Oxygen aluminum cylinder with handle and shroud all integrated into a single unit. A range of user-selectable flow setting is available with the user being able to control the flow rate, including low flows that may be clinically appropriate for certain classes of patients. An additional DISS-1240 connection provides high flow oxygen delivery. When administered by properly trained personnel for oxygen deficiency and resuscitation, the Intelli-Ox is for emergency use only. For all other medical applications, the device is Rx only.

Key specifications include hose barb connection, protective shroud, carrying handle, easy to read digital content gauge, indexed flow meter, integrated valve-regulator and user instructions. This design allows medical personnel the ability to provide patient care and treatment sooner without delays caused by the need to mount a conventional regulator.

AI/ML Overview

This document describes the regulatory submission for the Intelli-Ox portable oxygen delivery system, not a study evaluating its performance against acceptance criteria in the context of an AI/human-in-the-loop system. The document focuses on demonstrating substantial equivalence to a predicate device (EZ-OX Plus) for FDA clearance. Therefore, many of the requested categories related to AI/human performance studies and ground truth establishment are not applicable.

Here's an analysis based on the provided text, addressing the applicable points:

1. Table of Acceptance Criteria and Reported Device Performance

The submission does not present specific acceptance criteria in the form of performance metrics (e.g., sensitivity, specificity, accuracy) that the device must meet, nor does it provide reported device performance in that sense. Instead, it relies on demonstrating substantial equivalence to a predicate device through technological characteristics and compliance with recognized industry standards. The key "performance" reported is compliance with these standards.

ParameterAcceptance Criteria (Implied by Predicate & Standards)Reported Device Performance (Compliance)
Valve/Regulator Low FlowYes (≥ .5L)Yes (≥ .5L)
Flow Between SettingsNoNo
Cylinder on/offNoNo
Filling PortActiveActive
Contents GaugeActiveActive (Digital)
Filters33
Pressure Design (max)3,000 psi3,000 psi
Single stage piston styleYesYes
Guard Hand Grip1 grip1 grip
Access PortsYesYes
Flow selector/hose barb/gaugeAlignedAligned
ColorGreenGreen
Height (guard + valve-regulator)7"7"
Cylinder SizesEE
Weight (E) (product)950 gr950gr
Materials/constructionAluminumAluminum
ISO 14971 ComplianceYesYes
ISO 13485 ComplianceYesYes
IEC 60513 ComplianceYesYes
UN Manual of Tests & CriteriaYesYes
IP RatingIP55IP55
IEC 61326-2-6-2 ComplianceYesYes
ISO 21730 ComplianceYesYes
IEC 61000-6-4 ComplianceYesYes
IEC 60601-1-2 (various)YesYes
ISO 10651-3 ComplianceYesYes
21 CFR Parts 210/211 ComplianceYesYes

2. Sample size used for the test set and the data provenance

This is not applicable as the submission is for a medical device (oxygen delivery system) and not an AI algorithm evaluated on a typical "test set" of data. The "test" involved physical and engineering evaluations against standards and comparison to a predicate device. Data provenance (country of origin, retrospective/prospective) is not mentioned for such testing.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable. There is no concept of a "ground truth" established by experts in the context of an image or data interpretation for this device. The evaluation is based on engineering specifications and compliance with standards.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

Not applicable.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

Not applicable. This is not an AI-assisted device requiring a MRMC study.

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

Not applicable. This is a physical medical device, not an algorithm.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

Not applicable. The "ground truth" in this context is adherence to validated engineering specifications and recognized industry standards.

8. The sample size for the training set

Not applicable. No training set is involved for this type of device submission.

9. How the ground truth for the training set was established

Not applicable.

Summary of the Study and Device Clearance:

The provided document (K143060) is an FDA 510(k) premarket notification for the "Intelli-Ox" portable oxygen delivery system. The "study" described is a demonstration of substantial equivalence to a previously cleared predicate device, the "EZ-OX Plus" (K053117).

The basis for substantial equivalence is primarily through:

  • Comparison of technological characteristics: The Intelli-Ox is described as "very similar" to the EZ-OX Plus, with the main modification being the replacement of an analog gauge with a digital gauge. Both gauges serve informational purposes and do not control flow. The submission details a table (page 5) comparing various parameters (e.g., low flow settings, filters, pressure design, materials, dimensions) and states that the technological characteristics are the same.
  • Compliance with recognized voluntary standards: The Intelli-Ox system complies with a list of industry and international standards applicable to medical gas regulators (listed on page 6). These include standards for risk management (ISO 14971), quality management (ISO 13485), electrical safety (IEC 60513, 60601-1-2), electromagnetic compatibility (IEC 61326-2-6-2, ISO 21730, IEC 61000-6-4, ISO 10651-3), and others like the United Nations Manual of tests and Criteria, IP rating, and 21 CFR regulations.

The ultimate conclusion is that "Based upon the performance testing and compliance with voluntary standards, the manufacturer believes that the Intelli-OX portable oxygen delivery system is substantially equivalent to the predicate device, and does not raise any new questions of safety and effectiveness."

This document does not describe a clinical trial or performance study against specific, quantified acceptance criteria in the manner one might find for a novel diagnostic or therapeutic device requiring clinical validation or an AI algorithm. Instead, it leverages the regulatory pathway of substantial equivalence based on established predicates and adherence to existing safety and performance standards for a well-understood type of medical device.

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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 features a stylized image of an eagle or bird with three profiles of human faces incorporated into its design. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the bird symbol.

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

May 21, 2015

Air Liquide Healthcare Ms. Angie Beyer Compliance Specialist 2700 Post Oak Blvd., Suite 325 Houston, Texas 77056

Re: K143060

Trade/Device Name: Intelli-Ox Regulation Number: Unclassified Regulation Name: Unclassified Regulatory Class: Unclassified Product Code: ECX Dated: April 20, 2015 Received: April 21, 2015

Dear Ms. Beyer:

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. Beyer

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

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Indications for Use

510(k) Number (if known):

Device Name: Intelli-Ox

Indications For Use:

The Intelli-Ox is an integrated portable oxygen delivery system intended to provide supplemental oxygen to adults. When administered by properly trained personnel for oxygen deficiency and resuscitation, the Intelli-Ox is for emergency use only. For all other medical applications, the device is Rx only.

Prescription Use _X AND/OR Over-The-Counter Use ________________________________________________________________________________________________________________________ (Part 21 CFR 801 Subpart D) (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)

Page 1 of

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510 (k) Summary Intelli-Ox Portable Oxygen System 510(k) Number: _K143060

Traditional 510(K): Premarket Notification: Intelli-Ox Portable Oxygen System

APPLICANT'S/SUBMITTER'S INFORMATION 1.

Air Liquide Healthcare America Corporation 12800 West Little York Road Houston, TX 77041

Direct Phone:800-624-8000
Internet:www.us.airliquide.com
Establishment Registration No:3003764448
Contact:Angie Beyer
Contact's Phone:713-624-8268
Contact's Fax:713-803-1246

2. DATE

May 12, 2015

DEVICE INFORMATION 3.

Trade/Proprietary Name: Intelli-Ox

Common Name:Portable Oxygen Delivery System
Device Name:Cylinder, Compressed Gas, and Integrated Valve-Regulator
Classification Panel:Anesthesiology
Classification Number:Unclassified
Product Nomenclature:Cylinder, Compressed Gas, and Integrated Valve-Regulator
Product Code(s):ECX
Prior Submission :No prior submission for the subject device.

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DEVICE CLASSIFICATION 4.

Empty Compressed gas cylinders and compressed gas cylinder with valve assemblies are unclassified devices under product code ECX and reviewed by the Anesthesiology Branch, Division of Anesthesiology and Respiratory, General Hospital, Infection Control, and Dental Devices.

Individually, gas cylinder pressure regulators and gas pressure gauges are Class 1 devices and exempted from pre-market notification, but are part of the above mentioned assembly.

5. PREDICATE DEVICE(s)

The predicate device for the Intelli-Ox is the EZ-OX Plus, which was cleared under 510(k) K053117.

DEVICE DESCRIPTION 6.

The Intelli-Ox portable oxygen system is a solution for supplying Oxygen USP using a device comprised of an integrated valve-regulator, flow meter and medical Oxygen aluminum cylinder with handle and shroud all integrated into a single unit. A range of user-selectable flow setting is available with the user being able to control the flow rate, including low flows that may be clinically appropriate for certain classes of patients. An additional DISS-1240 connection provides high flow oxygen delivery. When administered by properly trained personnel for oxygen deficiency and resuscitation, the Intelli-Ox is for emergency use only. For all other medical applications, the device is Rx only.

Key specifications include hose barb connection, protective shroud, carrying handle, easy to read digital content gauge, indexed flow meter, integrated valveregulator and user instructions. This design allows medical personnel the ability to provide patient care and treatment sooner without delays caused by the need to mount a conventional regulator.

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7. INDICATIONS FOR USE

The intended use for the modified device, as described in its labeling, has not changed as a result of the modification.

The Intelli-OX is an integrated portable oxygen delivery system intended to provide supplemental oxygen to adults. When administered by properly trained personnel for oxygen deficiency and resuscitation, the Intelli-Ox is for emergency use only. For all other medical applications, the device is Rx only.

COMPARISON WITH PREDICATE DEVICE 8.

Very similar to the original EZ-OX Plus, the newly designed Intelli-Ox has been modified by replacing the analog gauge with a digital gauge. The gauge in both devices does not control the administration of flow, but rather is for information purposes. Both the Indications for Use and the Fundamental scientific technology of the proposed device are unchanged from the legally marketed device (predicate). A summary comparison of technological characteristics, including design and materials is provided in the table below:

ParameterEZ-OX PlusIntelli-Ox
Valve/Regulator
Low Flow SettingsYes (≥ .5L)Yes (≥ .5L)
Flow Between SettingsNoNo
Cylinder on/offNoNo
Filling PortActiveActive
Contents GaugeActiveActive
Filters33
Pressure Design3,000 psi (max)3,000 psi (max)
Single stage piston styleYesYes
Guard
Hand Grip1 grip1 grip
Access PortsYesYes
Flow selector/ hose barb/YesYes
gauge aligned
ColorGreenGreen
Height (guard and7"7"
integrated valve-regulator)
Cylinder
Cylinder SizesEE
Weight (E) (product)950 gr950gr
Materials/constructionAluminumAluminum

The technological characteristics of the EZ-OX Plus (predicate device) and the Intelli-Ox (modified device) are the same.

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SUMMARY OF NON-CLINICAL TESTING AS BASIS FOR 9. SUBSTANTIAL EQUIVALENCE

The Intelli-Ox system complies with the following industry and international standards that are applicable to medical gas regulators:

  • · ISO 14971: Medical Device Risk Management
  • · ISO 13485: Medical Device Quality Management System
  • · IEC 60513 ed. 2.0 (1994-01): Fundamental Aspects of Safety Standards for Medical Electrical Equipment
  • · United Nations Manual of tests and Criteria, 4th Edition revised with Amendment 2, Part III, Classification Procedures, Test Methods, and Criteria Relating to Class 3, Class 4 Division 5.1 and Class 9, Section 38.3, Lithium Batteries
  • · International Protection Rating (IP) of IP55
  • · IEC 61326-2-6-2 2nd Ed. 2012, EMC requirements, Medical Equipment
  • · ISO 21730 2nd Ed. 2007, Recommendations for Electromagnetic Compatiblity
  • · IEC 61000-6-4 2nd Ed. 2006-07, Electromagnetic Compatibility
  • · IEC 60601-1-2 Electrical Equipment Healthcare Application
  • · IEC 60601-1-2 Ed. 4.0. Medical Electrical Equipment
  • · ISO 10651-3 Electromagnetic Compatibility
  • · Title 21 of the U.S. Code of Federal Regulations (21 CFR) Parts 210 and 211

10. STATEMENT OF SUBSTANTIAL EQUIVALENCE

Based upon the performance testing and compliance with voluntary standards, the manufacturer believes that the Intelli-OX portable oxygen delivery system is substantially equivalent to the predicate device, and does not raise any new questions of safety and effectiveness.

§ 868.2700 Pressure regulator.

(a)
Identification. A pressure regulator is a device, often called a pressure-reducing valve, that is intended for medical purposes and that is used to convert a medical gas pressure from a high variable pressure to a lower, more constant working pressure. This device includes mechanical oxygen regulators.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 868.9.