K Number
K143148
Device Name
Disposable Pressure Manometer (DPM)
Manufacturer
Date Cleared
2015-08-11

(281 days)

Product Code
Regulation Number
868.2600
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
To provide visual indication of a patient's airway pressure during ventilation. It may be attached to the manometer port or proximal port on ventilation devices such as resuscitation bags, hyperinflation bags, CPAP mask, or CPAP circuits. For patients that the clinician desires to monitor or measure airway or circuit pressure. Home, Physician office, Hospital, Sub-acute Institutions, Emergency services or anywhere measurement of airway pressure is desired.
Device Description
The Westmed disposable pressure manometer is a means of providing visual indication of patient airway pressure during ventilation. The device consists of: - 1. Clear housing with a printed pressure scale - 2. A float with indicator and - 3. Spring It functions by reacting to the positive present in the ventilation device. When pressure is in the device the float moves up or down to indicate the pressure of the system. This manometer displays the pressure in the "circuit". The proposed design incorporates a calibrated spring, which has demonstrated reasonable accuracy over the expected clinical pressure range -0-60 cm H2O. The performance characteristics are that the measured pressures are accurate to: - + 3 cm H2O up to 60 cm H2O It is a single patient, disposable, packaged non-sterile device.
More Information

No
The device is a simple mechanical manometer that uses a float and spring to indicate pressure. There is no mention of any computational or learning components.

No.
This device is for monitoring and measuring airway pressure, not for providing therapy. It provides visual indication of airway pressure but does not actively treat or ameliorate a condition.

Yes

The device provides a "visual indication of a patient's airway pressure during ventilation" and is used to "monitor or measure airway or circuit pressure." This act of measuring a physiological parameter to gain information about a patient's condition falls under the definition of a diagnostic device.

No

The device description explicitly details physical components (clear housing, float, spring) and its function relies on mechanical reaction to pressure, not software processing.

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

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body, such as blood, urine, or tissue, to provide information about a person's health.
  • Device Function: This device measures airway pressure during ventilation. This is a direct measurement of a physiological parameter within the patient's respiratory system, not an analysis of a specimen taken from the patient.
  • Intended Use: The intended use is to provide a visual indication of airway pressure, which is a real-time measurement during a medical procedure (ventilation).
  • Device Description: The description details a mechanical device that reacts to pressure within a ventilation circuit. There is no mention of analyzing biological samples.

Therefore, this device falls under the category of a medical device used for monitoring a physiological parameter, but it does not meet the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

To provide visual indication of a patient's airway pressure during ventilation. It may be attached to the manometer port or proximal port on ventilation devices such as resuscitation bags, hyperinflation bags, CPAP mask, or CPAP circuits.

Patient Population: For patients that the clinician desires to monitor or measure airway or circuit pressure.

Environments for use: Home, Physician office. Hospital, Sub-acute Institutions, Emergency services or anywhere measurement of airway pressure is desired.

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

CAP

Device Description

The Westmed disposable pressure manometer is a means of providing visual indication of patient airway pressure during ventilation.

The device consists of:

  1. Clear housing with a printed pressure scale
  2. A float with indicator and
  3. Spring

It functions by reacting to the positive present in the ventilation device. When pressure is in the device the float moves up or down to indicate the pressure of the system. This manometer displays the pressure in the "circuit". The proposed design incorporates a calibrated spring, which has demonstrated reasonable accuracy over the expected clinical pressure range -0-60 cm H2O. The performance characteristics are that the measured pressures are accurate to:

  • 3 cm H2O up to 60 cm H2O
    It is a single patient, disposable, packaged non-sterile device.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

airway

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Home, Physician office, Hospital, Sub-acute Institutions, Emergency services or anywhere measurement of airway pressure is desired.

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)

Non-Clinical Testing Summary -
Testing included:

  • Accuracy and Repeatability across the full pressure range
  • Age testing real-time and simulated to 1 year
  • Mechanical testing Drop test
  • Environmental testing
  • Positional testing

Summary:

  • Accuracy and Repeatability
  • Samples were pressurized across the range and confirmed with the digital manometer
  • Aging, Mechanical, Environmental, Positional Orientation, and Accuracy
  • Samples were dropped
  • Samples which had real-time aging and samples in accelerated aging were pressurized to various pressures and confirmed via digital manometer
  • Each sample was tested multiple times

All samples met the pass/fail criteria

    • 3 cm H2O up to 60 cm H2O
      All testing demonstrated that the proposed device is substantially equivalent to the predicate and reference devices.

Biocompatibility
We performed the following ISO 10993-1 tests:

  • Cytotoxicity; Sensitization; Intracutaneous Reactivity / Irritation
    The test requirements were met for the materials to be considered as non-reactive.

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

Accuracy and Repeatability: +/- 3 cm H2O up to 60 cm H2O

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.

K003497 - Engineered Medical Systems - Pressure Monitor

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.

K954486 - Mercury Medical – Pressure Monitor, K040991 – Ambu DPM

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

§ 868.2600 Airway pressure monitor.

(a)
Identification. An airway pressure monitor is a device used to measure the pressure in a patient's upper airway. The device may include a pressure gauge and an alarm.(b)
Classification. Class II (performance standards).

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is an emblem featuring a stylized representation of three human profiles facing to the right, stacked one behind the other.

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

August 11, 2015

Westmed, Inc. C/O Paul E. Dryden Consultant Pro Medic Inc., 2430 Woodsage Dr. Bonita Springs, FL 34134-2958

Re: K143148

Trade/Device Name: Disposable Pressure Manometer Regulation Number: 21 CFR 868.2600 Regulation Name: Airway pressure manometer Regulatory Class: II Product Code: CAP Dated: July 9, 2015 Received: July 13, 2015

Dear Paul E. Dryden:

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

1

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.

Erin I. Keith -S

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 Statement 4

We have prepared the Indications for Use statement utilizing Form 3881.

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known)

Device Name

Disposable Pressure Manomter (DPM) Indications for Use (Describe)

To provide visual indication of a patient's airway pressure during ventilation. It may be attached to the manometer port or proximal port on ventilation devices such as resuscitation bags, hyperinflation bags, CPAP mask, or CPAP circuits.

Patient Population: For patients that the clinician desires to monitor or measure airway or circuit pressure.

Environments for use: Home, Physician office. Hospital, Sub-acute Institutions, Emergency services or anywhere measurement of airway pressure is desired.

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

XX Prescription Use (Part 21 CFR 801 Subpart D)

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

PLEASE DO NOT WRITE BELOW THIS LINE – CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

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Date Prepared:06-Aug-2015
CompanyWestmed, Inc.
5580 South Nogales Highway
Tucson, AZ 85706
Tel – 520-294-7987
Fax - 520-294-2780
Official Contact:Diana Upp, Vice President RA / QA
Proprietary or Trade Name:Disposable Pressure Manometer
Common/Usual Name:Airway Pressure Monitor
Classification Name:21CFR 868.2600
CAP – Airway Pressure Monitor
Class II
Predicate Device:K003497 - Engineered Medical Systems - Pressure Monitor
Reference Device:K954486 - Mercury Medical – Pressure Monitor
We cite this reference device, as it has the identical
indications for use with a pressure range of 0 to 80 cm H2O.
K040991 – Ambu DPM
We cite this reference device, as it has the identical
indications for use with a pressure range of 0 to 60 cm H2O
and the accuracy range consistent with the proposed device.

Device Description:

The Westmed disposable pressure manometer is a means of providing visual indication of patient airway pressure during ventilation.

The device consists of:

    1. Clear housing with a printed pressure scale
    1. A float with indicator and
    1. Spring

It functions by reacting to the positive present in the ventilation device. When pressure is in the device the float moves up or down to indicate the pressure of the system. This manometer displays the pressure in the "circuit". The proposed design incorporates a calibrated spring, which has demonstrated reasonable accuracy over the expected clinical pressure range -0-60 cm H2O. The performance characteristics are that the measured pressures are accurate to:

    • 3 cm H2O up to 60 cm H2O
      It is a single patient, disposable, packaged non-sterile device.

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510(k) Summary Page 2 of 4 06-Aug-2015

Indications for Use:

To provide visual indication of a patient's airway pressure during ventilation. It may be attached to the manometer port or proximal port on ventilation devices such as resuscitation bags, hyperinflation bags, CPAP mask, or CPAP circuits.

For patients that the clinician desires to monitor or measure airway or circuit pressure.

Home, Physician office, Hospital, Sub-acute Institutions, Emergency services or anywhere measurement of airway pressure is desired.

Substantial Equivalence Discussion:

Table 1 compares the key features of the proposed Westmed DPM with the identified predicate and demonstrates that the proposed device is substantially equivalent.

In summary, one can conclude that substantial equivalence is met based upon the following:

Indications for Use -

The indications for use are identical for the proposed device when compared to the predicate -K003497.

Discussion – Each device is indicated for use to measure pressure in a circuit or airway.

Technology and construction -

The design, components, shape, size, etc. are equivalent to the predicates - K003497. Discussion – The design is simple housing with a float that sits on a spring that goes up or down based upon the pressure in the device. There are markings to indicate the pressure observed as well as a fixed leak to avoid over pressurization. There are no differences in the technological characteristics of the proposed device, predicate and reference devices. The only differences related to the measured pressure ranges: 0-50 cm H2O for the predicate K003467; 0-80 cm H2O for the reference K954486; and the proposed which is 0-60 cm H2O; the accuracy range of the reference K040991. The differences in measured pressure range and accuracy across the pressure range do not raise any new safety or effectiveness concerns.

Environment of Use –

The environments of use are identical to predicate - K003497 - EMS pressure manometer. Discussion - The environments of use are identical to the predicates - K003497.

Patient Population -

The patient population is defined as patients where the clinician wants to measure or monitor circuit or airway pressure. Therefore there is no specific patient population. Discussion - The patient populations are equivalent to the predicates - K003497.

Non-Clinical Testing Summary -

We performed a number of tests including comparative pressure accuracy and the results demonstrated equivalent performance demonstrating the proposed device is equivalent to the -K003497 – EMS pressure manometer.

Testing included:

  • · Accuracy and Repeatability across the full pressure range

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510(k) Summary

Page 3 of 4

  • 06-Aug-2015
  • Age testing real-time and simulated to 1 year
  • Mechanical testing Drop test ●
  • Environmental testing .
  • Positional testing

Summary:

  • Accuracy and Repeatability
    • O Samples were pressurized across the range and confirmed with the digital manometer
  • . Aging, Mechanical, Environmental, Positional Orientation, and Accuracy
    • Samples were dropped o
    • Samples which had real-time aging and samples in accelerated aging were o pressurized to various pressures and confirmed via digital manometer
    • Each sample was tested multiple times o

All samples met the pass/fail criteria

  • · + 3 cm H2O up to 60 cm H2O
    All testing demonstrated that the proposed device is substantially equivalent to the predicate and reference devices.

Biocompatibility

Based upon G95-1 and ISO 10993-1:2009 the proposed device would be considered as having the following patient contact classification:

  • External Communication (Indirect contact) for all materials .
  • Tissue contact ●
  • Limited duration (