K Number
K143646
Device Name
MR810 System, 900MR810 Adult Single Limb Circuit, 900MR810E Adult Dual Limb Circuit
Date Cleared
2015-03-05

(73 days)

Product Code
Regulation Number
868.5450
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Fisher & Paykel MR810 System is intended to provide therapeutic levels of heat and humidity to a patient's inspired respiratory gases, when using a continuous or intermittent ventilator system or a continuous gas flow system. The MR810 System is intended for both non-invasive therapies. Addition of heat and humidity to the supply of cold and dry respiratory gases provided through non-invasive or invasive ventilation is beneficial to prevent drying of the patient airways. The MR810 System is for use for adult and pediatric patients requiring a flow range ≥5 L/min. The MR810 System is designed for use in hospitals, long term care facilities and homes under the prescription of a qualified medical professional.
Device Description
The Fisher & Paykel MR810 System is intended to heat and humidify breathing gases and therefore meets the definition of a respiratory gas humidifier in accordance with 21 CFR §868.5450 and the FDA guidance document Heated Humidifier Review Guide. The MR810 System consists of the following components: - . MR810 Respiratory Humidifier; - . Accessories: - Breathing circuit (e.g. 900MR810 Adult Single Limb Circuit, 900MR810E o Adult Dual Limb Circuit); and - Humidification chamber (e.g. MR370 reusable humidification chamber). O The MR810 respiratory humidifier is an electrically-powered heat controller which utilizes a microprocessor with embedded software to control the heating elements. Unconditioned (i.e. cold, dry) gases are delivered to the MR810 System from a gas source (e.g. ventilator) via the dryline component of the breathing circuit. The unconditioned gases are transported to the humidification chamber where they are heated and humidified. The heated and humidified gases then travel down the inspiratory limb of the breathing circuit. The inspiratory limb of the 900MR810/900MR810E breathing circuits is electrically heated by means of a heaterwire in order to maintain the temperature of the gases. The heater wire is powered by the MR810 respiratory humidifier via a built-in heaterwire adaptor. When a return flow of expired gases from the patient to the gas source is required, the expired gases are transported via the expiratory limb of the breathing circuit. In other cases, the expired gases from the patient are exhaled into the environment, as per normal, unassisted breathing.
More Information

K131957 MR810 System

Not Found

No
The document mentions a microprocessor with embedded software for control, but there is no mention of AI or ML algorithms, training data, or performance metrics typically associated with AI/ML devices.

Yes
The device is intended to provide "therapeutic levels of heat and humidity to a patient's inspired respiratory gases" and its purpose is "beneficial to prevent drying of the patient airways," which are therapeutic actions.

No.

The device is intended to provide therapeutic levels of heat and humidity to a patient's inspired respiratory gases, acting as a respiratory gas humidifier, rather than diagnosing a medical condition.

No

The device description explicitly lists hardware components such as the respiratory humidifier, breathing circuit, and humidification chamber. While the humidifier utilizes embedded software, the system is not solely software.

Based on the provided information, the Fisher & Paykel MR810 System is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use is to provide therapeutic levels of heat and humidity to a patient's inspired respiratory gases. This is a therapeutic intervention, not a diagnostic test performed on samples taken from the body.
  • Device Description: The device heats and humidifies breathing gases delivered to the patient. It does not analyze biological samples.
  • Regulatory Classification: The device is described as a "respiratory gas humidifier in accordance with 21 CFR §868.5450". This CFR section specifically covers respiratory humidifiers, which are considered medical devices, but not IVDs.
  • Lack of IVD Characteristics: The description does not mention any analysis of biological samples (blood, urine, tissue, etc.), diagnostic claims, or the use of reagents or assays typically associated with IVD devices.

Therefore, the Fisher & Paykel MR810 System is a therapeutic medical device, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Fisher & Paykel MR810 System is intended to provide therapeutic levels of heat and humidity to a patient's inspired respiratory gases, when using a continuous or intermittent ventilator system or a continuous gas flow system.

The MR810 System is intended for both non-invasive therapies. Addition of heat and humidity to the supply of cold and dry respiratory gases provided through non-invasive or invasive ventilation is beneficial to prevent drying of the patient airways.

The MR810 System is for use for adult and pediatric patients requiring a flow range ≥5 L/min.

The MR810 System is designed for use in hospitals, long term care facilities and homes under the prescription of a qualified medical professional.

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

BTT

Device Description

The Fisher & Paykel MR810 System is intended to heat and humidify breathing gases and therefore meets the definition of a respiratory gas humidifier in accordance with 21 CFR §868.5450 and the FDA guidance document Heated Humidifier Review Guide.

The MR810 System consists of the following components:

  • . MR810 Respiratory Humidifier;
  • . Accessories:
    • Breathing circuit (e.g. 900MR810 Adult Single Limb Circuit, 900MR810E o Adult Dual Limb Circuit); and
    • Humidification chamber (e.g. MR370 reusable humidification chamber). O

The MR810 respiratory humidifier is an electrically-powered heat controller which utilizes a microprocessor with embedded software to control the heating elements.

Unconditioned (i.e. cold, dry) gases are delivered to the MR810 System from a gas source (e.g. ventilator) via the dryline component of the breathing circuit. The unconditioned gases are transported to the humidification chamber where they are heated and humidified.

The heated and humidified gases then travel down the inspiratory limb of the breathing circuit. The inspiratory limb of the 900MR810/900MR810E breathing circuits is electrically heated by means of a heaterwire in order to maintain the temperature of the gases. The heater wire is powered by the MR810 respiratory humidifier via a built-in heaterwire adaptor.

When a return flow of expired gases from the patient to the gas source is required, the expired gases are transported via the expiratory limb of the breathing circuit. In other cases, the expired gases from the patient are exhaled into the environment, as per normal, unassisted breathing.

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

adult and pediatric patients

Intended User / Care Setting

hospitals, long term care facilities and homes under the prescription of a qualified medical professional.

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)

Bench testing has been carried out on the MR810 System to demonstrate that the differences in indications for use and assembly sub-components does not raise any new questions or safety of effectiveness when compared with the predicate device. MR810 System (K131957).

The following bench testing demonstrates subject and predicate devices are substantially equivalent:

  • System-level performance and safety testing in accordance with ISO 8185 Respiratory tract humidifiers for medical use - Particular requirements for respiratory humidification systems.
  • . Basic safety and essential performance testing in accordance with IEC 60601-1 Medical electrical equipment – Part 1: General requirements for basic safety and essential performance.
  • . Basic safety and essential performance in accordance with IEC 60601-1-2 Medical electrical equipment – Part 1-2: General requirements for basic safety and essential performance - Collateral Standard: Electromagnetic disturbances - Requirements and tests.

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

Not Found

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.

K131957 MR810 System

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.

Not Found

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

§ 868.5450 Respiratory gas humidifier.

(a)
Identification. A respiratory gas humidifier is a device that is intended to add moisture to, and sometimes to warm, the breathing gases for administration to a patient. Cascade, gas, heated, and prefilled humidifiers are included in this generic type of device.(b)
Classification. Class II (performance standards).

0

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 text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized symbol of three human profiles facing right, with flowing lines representing connection and support.

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

March 5, 2015

Fisher & Paykel Healthcare Ltd Elizabeth Goldstein Regulatory Affairs Specialist 15 Maurice Paykel Place, East Tamaki Auckland, 2013 New Zealand

Re: K143646 Trade/Device Name: MR810 System Regulation Number: 21 CFR 868.5450 Regulation Name: Respiratory Gas Humidifier Regulatory Class: II Product Code: BTT Dated: December 18, 2014 Received: January 7, 2015

Dear Ms. Goldstein,

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 (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) K143646

Device Name MR810 System

Indications for Use (Describe)

The Fisher & Paykel MR810 System is intended to provide therapeutic levels of heat and humidity to a patient's inspired respiratory gases, when using a continuous or intermittent ventilator system or a continuous gas flow system.

The MR810 System is intended for both non-invasive therapies. Addition of heat and humidity to the supply of cold and dry respiratory gases provided through non-invasive or invasive ventilation is beneficial to prevent drying of the patient airways.

The MR810 System is for use for adult and pediatric patients requiring a flow range ≥5 L/min.

The MR810 System is designed for use in hospitals, long term care facilities and homes under the prescription of a qualified medical professional.

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

X Prescription Use (Part 21 CFR 801 Subpart D)

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

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510(k) Summary 5

Image /page/3/Picture/4 description: The image shows the logo for Fisher & Paykel Healthcare. Below the logo is the address "15 Maurice Paykel Place, East Tamaki". The logo is in blue and the address is in black.

P O Box 14 348, Panmure Auckland, New Zealand Telephone: +64 9 574 0100 Facsimile: +64 9 574 0158 Website: www.fphcare.com

Establishment registration number: 9611451

Contact person/submitterElizabeth Goldstein
Date prepared5 March 2015
Contact detailsAddress: 15 Maurice Paykel Place
East Tamaki
Auckland 2013, New Zealand
Telephone: +64 9 574 0100
Fax: +64 9 574 0158
Trade nameMR810 System
Common nameRespiratory gas humidifier
Classification nameRespiratory gas humidifier
II (21 CFR §868.5450), product code BTT
Predicate deviceK131957 MR810 System
Reason for submissionExpanded indications

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Device Description 5.1

The Fisher & Paykel MR810 System is intended to heat and humidify breathing gases and therefore meets the definition of a respiratory gas humidifier in accordance with 21 CFR §868.5450 and the FDA guidance document Heated Humidifier Review Guide.

The MR810 System consists of the following components:

  • . MR810 Respiratory Humidifier;
  • . Accessories:
    • Breathing circuit (e.g. 900MR810 Adult Single Limb Circuit, 900MR810E o Adult Dual Limb Circuit); and
    • Humidification chamber (e.g. MR370 reusable humidification chamber). O

The MR810 respiratory humidifier is an electrically-powered heat controller which utilizes a microprocessor with embedded software to control the heating elements.

Unconditioned (i.e. cold, dry) gases are delivered to the MR810 System from a gas source (e.g. ventilator) via the dryline component of the breathing circuit. The unconditioned gases are transported to the humidification chamber where they are heated and humidified.

The heated and humidified gases then travel down the inspiratory limb of the breathing circuit. The inspiratory limb of the 900MR810/900MR810E breathing circuits is electrically heated by means of a heaterwire in order to maintain the temperature of the gases. The heater wire is powered by the MR810 respiratory humidifier via a built-in heaterwire adaptor.

When a return flow of expired gases from the patient to the gas source is required, the expired gases are transported via the expiratory limb of the breathing circuit. In other cases, the expired gases from the patient are exhaled into the environment, as per normal, unassisted breathing.

Intended Use and Indications for Use 5.2

Intended Use 5.2.1

The Fisher & Paykel Healthcare MR810 System is intended to provide therapeutic levels of heat and humidity to a patient's inspired respiratory gases to prevent drying of the patient's airways.

The intended use of the subject device is identical to the intended use of the predicate device.

5.2.2 Indications for Use

The Fisher & Paykel MR810 System is intended to provide therapeutic levels of heat

5

and humidity to a patient's inspired respiratory gases, when using a continuous or intermittent ventilator system or a continuous gas flow system.

The MR810 System is intended for both non-invasive therapies. Addition of heat and humidity to the supply of cold and dry respiratory gases provided through non- invasive or invasive ventilation is beneficial to prevent drying of the patient airways.

The MR810 System is for use for adult and pediatric patients requiring a flow range ≥ 5 L/min.

The MR810 System is designed for use in hospitals, long term care facilities and homes, under the prescription of a qualified medical professional.

The indications for use of the subject device and the predicate device are identical with the exception of the applications for use, where:

  • . The indications for use statement for the subject device. MR810 System, has been revised to specify the intended patient population and operating flow range.
  • . The predicate device, MR810 System (K131957), is intended for use for non- invasive applications only.
  • . The subject device, MR810 System, is intended for use for both non-invasive and invasive applications.

Performance bench testing has been carried out on the MR810 System which verifies that the system is suitable for use for invasive applications.

Technological Characteristics Comparison 5.3

The subject device, MR810 System, is a modification of the predicate device, MR810 System (K131957).

The subject device is identical to the predicate device with respect to:

  • Principle device design: The subject device, MR810 System, and the predicate . device, MR810 System (K131957), have identical principle device designs. Both the subject and predicate devices are heated passover humidifiers.
  • . Patient-contacting components (i.e. material biocompatibility): The subject device, MR810 System, and the predicate device, MR810 System (K131957), have identical patient-contacting components (i.e. breathing circuits, e.g. 900MR810 and 900MR810E, and humidification chambers, e.g. MR370).
  • . Energy source: The subject device, MR810 System, and the predicate device, MR810 System (K131957), use an identical energy source. Both the subject and predicate respiratory humidifier devices are powered via mains electricity and the heated breathing circuits are powered by the respiratory humidifier devices.
  • . Operation: The operation of the subject device, MR810 System, and the predicate device, MR810 System (K131957), is identical. Both the subject device and the predicate device have three temperature settings which can be selected by the operator, and two modes of operation which are specific to the type of breathing

6

circuit used (i.e. heater-wire mode, non heater-wire mode).

  • Safety features: The subject device, MR810 System, and the predicate device, . MR810 System (K131957), have identical safety features. Both the subject device and predicate device have a "see manual" fault indicator, heater wire indicator and shut down mechanisms which render the system inoperable during fault conditions.
  • Sterility: The subject device, MR810 System, and the predicate device, MR810 . System (K131957), are identical in terms of sterility. No components of the subject device or the predicate device are sold sterile, nor are they intended to be sterilized prior to use.
  • Reusable accessories: The subject device, MR810 System, and the predicate device, . MR810 System (K131957), can be used with identical reusable accessories. Both the subject device and predicate device can be used with cleared Fisher & Paykel Healthcare reusable breathing circuits (e.g. 900MR810, 900MR810E) and cleared Fisher & Paykel Healthcare reusable humidification chambers (e.g. MR370).

Minor revisions have been made to sub-components of the MR810 System assembly since submission of K131957. Performance bench testing has been carried out on the modified MR810 System which verifies that the revisions made to the assembly subcomponents does not raise any new questions of safety or effectiveness when compared with the predicate device.

Non-Clinical Performance Data 5.4

Bench testing has been carried out on the MR810 System to demonstrate that the differences in indications for use and assembly sub-components does not raise any new questions or safety of effectiveness when compared with the predicate device. MR810 System (K131957).

The following bench testing demonstrates subject and predicate devices are substantially equivalent:

  • System-level performance and safety testing in accordance with ISO 8185 Respiratory tract humidifiers for medical use - Particular requirements for respiratory humidification systems.
  • . Basic safety and essential performance testing in accordance with IEC 60601-1 Medical electrical equipment – Part 1: General requirements for basic safety and essential performance.
  • . Basic safety and essential performance in accordance with IEC 60601-1-2 Medical electrical equipment – Part 1-2: General requirements for basic safety and essential performance - Collateral Standard: Electromagnetic disturbances - Requirements and tests.

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5.5 Clinical Performance Data

The subject device, MR810 System, is a modification to the legally marketed predicate device, MR810 System (K131957).

Clinical performance data is not required as bench testing was sufficient to demonstrate substantial equivalence to the predicate device.

Conclusions 5.6

The subject device, MR810 System, is a modification to the legally marketed predicate device, MR810 System.

The subject device and the predicate device are identical in terms of the intended use, environment for use, principle device design, patient-contacting components and materials, biocompatibility, energy source, operation, safety features, sterility and reusable accessories.

Since submission of K131957, the indications for use of the MR810 System have been expanded to include invasive applications. In addition, minor revisions have been made to MR810 System assembly sub-components. The differences between the subject device and the predicate device do not constitute significant changes in the materials, design, energy source or other features, as demonstrated through bench testing, and therefore the MR810 System is substantially equivalent to the predicate device, MR810 System (K131957).