K Number
K150804
Device Name
QBioScan
Manufacturer
Date Cleared
2015-10-19

(207 days)

Product Code
Regulation Number
882.1540
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
QBioScan is indicated for the measurement of galvanic skin response to aid in the assessment of the sudomotor function. The device is intended for use on the general adult population in medical clinics, healthcare practices and out-patient departments of hospitals.
Device Description
QBioScan™ is a galvanic skin response measurement device intended for the collection and display of galvanic skin response recorded by the device consists of the following components: - . an off-the-shelf computer with proprietary device software pre-installed - . a custom electronics box that houses the QBioScan circuitry - a USB cable to connect the electronics box to the computer . - reusable electrode lead cables . - reusable hand and foot electrodes and optional disposable forehead electrodes . - . an off-the-shelf printer (optional) The device allows for a evaluation of sweat gland function based on a measuring method where patients are in contact with surface electrodes (reusable stainless-steel plates and optional disposable electrodes) and are exposed to an incremental low voltage (under the 60601-1 standard safety limits). The device tests the electrochemical reaction between electrodes and the chloride ion released by the stimulated sweat glands. This active test method provides information and evidence of a sweat gland dysfunction that might otherwise not be detectable in a physiological examination. The Bioelectrical Conductance (BEC, in micro-Siemens, uS) representing galvanic skin response for the hands and feet are expressed as quantitative results along with an asymmetry value expressed as the percent difference between the BEC values of the right / left hands and the right / left feet. The device does not provide any direct diagnosis rather the device provides information to the physician for inclusion in their decision making process.
More Information

Not Found

No
The summary describes a device that measures galvanic skin response and provides quantitative results and asymmetry values. There is no mention of AI, ML, or any algorithms that would suggest learning or complex pattern recognition beyond basic calculations and data display. The performance studies focus on electrical safety, EMC, and software verification/validation, not on the performance of an AI/ML model.

No

The device is indicated for measurement to aid in assessment and provides information to the physician for inclusion in their decision-making process, but it does not directly treat or alleviate a medical condition.

Yes
The device is indicated for the measurement of galvanic skin response to aid in the assessment of sudomotor function, and provides information for the physician's decision-making process regarding sweat gland dysfunction. While it does not provide a direct diagnosis, it gathers data used for diagnostic purposes.

No

The device description explicitly lists multiple hardware components including a custom electronics box, USB cable, electrode lead cables, and electrodes, in addition to the software.

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

Here's why:

  • IVDs analyze samples taken from the human body. The QBioScan measures galvanic skin response by applying electrodes to the surface of the skin (hands, feet, forehead). It's measuring a physiological response in vivo, not analyzing a sample like blood, urine, or tissue in vitro (outside the body).
  • The device description focuses on electrical measurements and electrochemical reactions on the skin surface. It describes the interaction between electrodes and chloride ions released by sweat glands, which is a measurement taken directly from the body.
  • The intended use is for measuring galvanic skin response to aid in the assessment of sudomotor function. This is a physiological measurement, not a diagnostic test performed on a biological sample.

Therefore, the QBioScan falls under the category of a medical device that performs a physiological measurement, but it does not meet the definition of an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

QBioScan is indicated for the measurement of galvanic skin response to aid in the assessment of the sudomotor function.

The device is intended for use on the general adult population in medical clinics, healthcare practices and out-patient departments of hospitals.

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

GZO

Device Description

QBioScan™ is a galvanic skin response measurement device intended for the collection and display of galvanic skin response recorded by the device consists of the following components:

  • . an off-the-shelf computer with proprietary device software pre-installed
  • . a custom electronics box that houses the QBioScan circuitry
  • a USB cable to connect the electronics box to the computer .
  • reusable electrode lead cables .
  • reusable hand and foot electrodes and optional disposable forehead electrodes .
  • . an off-the-shelf printer (optional)

The device allows for a evaluation of sweat gland function based on a measuring method where patients are in contact with surface electrodes (reusable stainless-steel plates and optional disposable electrodes) and are exposed to an incremental low voltage (under the 60601-1 standard safety limits). The device tests the electrochemical reaction between electrodes and the chloride ion released by the stimulated sweat glands. This active test method provides information and evidence of a sweat gland dysfunction that might otherwise not be detectable in a physiological examination. The Bioelectrical Conductance (BEC, in micro-Siemens, uS) representing galvanic skin response for the hands and feet are expressed as quantitative results along with an asymmetry value expressed as the percent difference between the BEC values of the right / left hands and the right / left feet.

The device does not provide any direct diagnosis rather the device provides information to the physician for inclusion in their decision making process.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Hands, Feet, Forehead

Indicated Patient Age Range

general adult population

Intended User / Care Setting

medical clinics, healthcare practices and out-patient departments of hospitals.

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)

The QBioScan™ device was subjected to the following non-clinical performance testing:

Electrical Safety and Electromagnetic Compatibility (EMC) Testing The device was submitted for testing and was found to be in compliance with the requirements of IEC 60601-1, 30 Edition and EN 60601-1-2, 30 Edition.

Software Verification and Validation Testing
Software verification and validation testing were conducted following the FDA guidance document for software contained in medical devices. The software was considered to be a "moderate" level of concern since a failure or latent flaw could indirectly result in a minor injury to the patient through incorrect or delayed information or through action of the operator.

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.

K100233, K141872

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

§ 882.1540 Galvanic skin response measurement device.

(a)
Identification. A galvanic skin response measurement device is a device used to determine autonomic responses as psychological indicators by measuring the electrical resistance of the skin and the tissue path between two electrodes applied to the skin.(b)
Classification. Class II (special controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 882.9.

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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 consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of three human profiles facing right, with flowing lines representing hair or clothing.

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

October 19, 2015

Medeia, Inc. % Daniel Lehtonen Regulatory Consultant Compliance and Regulatory Services LLC 3771 Southbrook Drive Dayton, Ohio 45430

Re: K150804

Trade/Device Name: QBioScan Regulation Number: 21 CFR 882.1540 Regulation Name: Galvanic skin response measurement device Regulatory Class: Class II Product Code: GZO Dated: September 14, 2015 Received: September 16, 2015

Dear Mr. Lehtonen:

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 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

1

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/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,

Michael J. Hoffmann -S

for Carlos L. Peña, PhD, MS Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K150804

Device Name

QBioScan

Indications for Use (Describe)

QBioScan is indicated for the measurement of galvanic skin response to aid in the assessment of the sudomotor function.

The device is intended for use on the general adult population in medical clinics, healthcare practices and out-patient departments of hospitals.

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

This summary of 510(k) safety and effectiveness information is submitted in accordance with the Requirements of Safe Medical Device systems Act 1990 and 21 CFR Sec. 807.92

510(k) Number:

a1 APPLICANT INFORMATION:

Date Prepared: March 16, 2015 Name: Medeia, Inc. Address: 80 S.W. 8th St. Suite 2000 Miami, FL 33130

Contact Person:Slav Danev
Phone Number:+1 800 433 4609
Fax Number:+1 800 433 4609
Email:danev@medeia-inc.com

NAME OF DEVICE: a2

Trade Name:QBioScanTM, model HW4
Common Name:Galvanic Skin Measurement Device
Classification Name:Galvanic Skin Measurement Device (21 CFR 882.1540 / GZC)

a3 PREDICATE DEVICE:

Device Name:Sudoscan
K Numbers:K100233 and K141872
Manufacturer:Impeto Medical
17, rue Campagne Première
75014 Paris - France

The FDA database for recalls was searched during the writing of this 510(k) submission and no recalls for the predicate device or manufacturer were found.

DESCRIPTION OF THE DEVICE: a4

QBioScan™ is a galvanic skin response measurement device intended for the collection and display of galvanic skin response recorded by the device consists of the following components:

  • . an off-the-shelf computer with proprietary device software pre-installed
  • . a custom electronics box that houses the QBioScan circuitry
  • a USB cable to connect the electronics box to the computer .
  • reusable electrode lead cables .
  • reusable hand and foot electrodes and optional disposable forehead electrodes .
  • . an off-the-shelf printer (optional)

The device allows for a evaluation of sweat gland function based on a measuring method where patients are in contact with surface electrodes (reusable stainless-steel plates and optional disposable electrodes) and are exposed to an incremental low voltage (under the 60601-1 standard safety limits). The device tests the electrochemical reaction between electrodes and the chloride ion released by the stimulated sweat glands. This active test method provides information and evidence of a sweat gland dysfunction that might otherwise not be detectable in a physiological examination. The Bioelectrical Conductance (BEC, in micro-Siemens, uS) representing galvanic skin response for the hands and feet are expressed as quantitative results

4

along with an asymmetry value expressed as the percent difference between the BEC values of the right / left hands and the right / left feet.

The device does not provide any direct diagnosis rather the device provides information to the physician for inclusion in their decision making process.

STATEMENT OF INTENDED USE: a5

QBioScan is indicated for the measurement of galvanic skin response to aid in the assessment of the sudomotor function.

The device is intended for use on the general adult population in medical clinics, healthcare practices and out-patient departments of hospitals.

TECHNOLOGICAL CHARACTERISTIC COMPARISON: a6

Determination of the bioelectrical conductance value of the hands and feet via application of a variable amplitude low voltage, low current excitation is the technological principle of both the subject and predicate devices. The following table shows the similarities and differences between the devices. The differences have no material impact on the equivalence between the devices.

Proposed DevicePredicate DevicePredicate Device
510(k) NumberN/AK100233K141872
Device NameQBioScan™SUDOSCANSUDOSCAN
ManufacturerMedeia, Inc.IMPETO MedicalIMPETO Medical
Classification Regulation882.1540, Class II882.1540, Class II882.1540, Class II
Product CodeGZOGZOGZO
IndicationQBioScan is indicated for
the measurement of
galvanic skin response to
aid in the assessment of
the sudomotor function.
The device is intended for
use on the general adult
population in medical
clinics, healthcare
practices and out-patient
departments of hospitals.The SUDOSCAN system
is a medical device for the
measurement of galvanic
skin responses.The SUDOSCAN system
is a medical device for the
measurement of galvanic
skin response to aid in the
assessment of sudomotor
function.
SUDOSCAN is indicated
for use in the general adult
population.
Operating Characteristics• Measures difference in
skin conductance.
• Used to provide
feedback to physicians,
not to diagnose.
• Skin Contact Pads
measure skin
conductance.• Measures difference in
skin conductance.
• Used to provide
feedback to physicians,
not to diagnose.
• Skin Contact Pads
measure skin
conductance.• Measures difference in
skin conductance.
• Used to provide
feedback to physicians,
not to diagnose.
• Skin Contact Pads
measure skin
conductance.
Electrode Surface AreaHand: 384 cm²
Foot: 384 cm²
Head: 7 cm²Hand: 212 cm²
Foot: 269 cm²
Head: 7 cm²Hand: 212 cm²
Foot: 269 cm²
Head: N/A
Electrode Placement
(Anatomic Sites)Hands, Feet, ForeheadHands, Feet, ForeheadHands, Feet
Electrode MaterialsHead Electrode:
• Stainless Steel with
Ag/AgCl layer (cleared
electrode)
Hand and Foot Electrode:
• AISI 304 Stainless SteelHead Electrode:
• Nickel Silver Alloy
Hand and Foot Electrode:
• AISI 304 Stainless SteelHand and Foot Electrode:
• AISI 304 Stainless Steel
Skin Conductance
Measurement Range10 - 100 µS/cm²10 - 100 µS/cm²10 - 100 µS/cm²
Proposed DevicePredicate DevicePredicate Device
510(k) NumberN/AK100233K141872
Skin Conductance Resolution1 nS/cm²1 nS/cm²1 nS/cm²
Acquisition Duration (total)120, 300 or 600 seconds120 seconds120 seconds
Electrical Output to the skin4 V max4 V max4 V max
Electrical Output FrequencyContinuousContinuousContinuous
Electrical Output Unit
Duration1 second1 second1 second
Power Density (at electrode)0.01 μΑ/mm²0.01 μΑ/mm²0.01 μΑ/mm²
User DisplayComputer DisplayVGA Color LCDVGA Color LCD
User ControlComputer provided with
systemTouch screenTouch screen
Audible IndicatorsInternal Computer Speaker
and Optional HeadphoneInternal Speaker and
Optional HeadphoneInternal Speaker and
Optional Headphone
Output Report• Subject details (patient
data)
• Indication for referral
[entered by examining
physician]
• Method
• Results
• Impressions [entered by
examining physician]
• Measured STC† values
of the test
• 4 average values of 12
STC measurements:
• Two STC for each
Hand:
Average value of a
minimum of 6 STC
measurements
• Two STC for each
Foot:
Average value of a
minimum of 6 STC
measurements
• Head:
Average value of a
minimum of 6 STC
measurements• Subject details (patient
data)
• Indication for referral
[entered by examining
physician]
• Method
• Results
• Impressions [entered by
examining physician]
• Measured STC† values
of the test
• Two average values of
12 STC measurements:
• Hand:
Average value of 6
STC measurements
• Foot:
Average value of 6
STC measurements• Subject details (patient
data)
• Indication for referral
[entered by examining
physician]
• Method
• Results
• Impressions [entered by
examining physician]
• Measured STC† values
of the test
• Two average values of
12 STC measurements:
• Hand:
Average value of 6
STC measurements
• Foot:
Average value of 6
STC measurements
• Head:
Average value of 6
STC measurements
InterfaceUSB from laptop(USB) Internal(USB) Internal
Power Source5 V provided by USB5 V provided by USB5 V provided by USB
Electrical Safety StandardsIEC 60601-1
EN 60601-1-2IEC 60601-1
EN 60601-1-2IEC 60601-1
EN 60601-1-2
ANSI/AAMI PC69
Electrical Safety ClassificationClass II
Type BF Applied PartClass I
Type BF Applied PartClass I
Type BF Applied Part

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Medeia, Inc.

「 STC- Standard Conductance; the terminology used to describe the ionic current measured by the predicate device electrodes

Based on comparisons of device technological characteristics, features, materials, intended use and performance the QBioScan™ has been shown to be substantially equivalent to the commercially available and legally marketed Sudoscan device.

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b1 NON-CLINICAL TESTING:

The QBioScan™ device was subjected to the following non-clinical performance testing:

Electrical Safety and Electromagnetic Compatibility (EMC) Testing The device was submitted for testing and was found to be in compliance with the requirements of IEC 60601-1, 30 Edition and EN 60601-1-2, 30 Edition.

Software Verification and Validation Testing

Software verification and validation testing were conducted following the FDA guidance document for software contained in medical devices. The software was considered to be a "moderate" level of concern since a failure or latent flaw could indirectly result in a minor injury to the patient through incorrect or delayed information or through action of the operator.

b2 CLINICAL TESTING:

No Clinical testing was necessary to determine substantial equivalence.

b3 CONCLUSIONS DRAWN FROM TESTING:

Based on information obtained on the predicate device with reference to the design specification, electrical safety / EMC testing and intended use, the QBioScan™ device was subjected to the same type of testing. The results support the conclusion that the QBioScan™ device is substantially equivalent to the Sudoscan device from Impeto Medical.