K Number
K151506
Device Name
Demand Nasal Oxygen Cannula, Modified Demand Nasal Oxygen Cannula
Manufacturer
Date Cleared
2016-03-11

(281 days)

Product Code
Regulation Number
868.5905
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The intended use is to deliver oxygen to the patient nasally, controlled by a demand system.
Device Description
The demand cannula is a special cannula designed to give adult and pediatric users of dual port oxygen conservation delivery system all the comfort and conveniences of a Salter-Style® cannula. Unique dual tubing delivers oxygen on demand through one tube while inspiratory / expiratory effort is also sensed through the other tube. Meets dual port device manufacturers' specifications.
More Information

Not Found

No
The description focuses on a mechanical demand system for oxygen delivery and sensing, with no mention of AI or ML terms or functionalities.

Yes
The device is intended to deliver oxygen to a patient nasally, which is a therapeutic intervention.

No

The device is described as an oxygen delivery system, and its function involves delivering oxygen and sensing inspiratory/expiratory effort, not diagnosing medical conditions or diseases.

No

The device description clearly describes a physical cannula with tubing, indicating it is a hardware device, not software-only.

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

Here's why:

  • Intended Use: The intended use is to "deliver oxygen to the patient nasally, controlled by a demand system." This describes a device that interacts directly with the patient's body to provide a therapeutic intervention (oxygen delivery).
  • Device Description: The description details a cannula designed for oxygen delivery and sensing inspiratory/expiratory effort. This is a physical device used for patient care.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens (like blood, urine, tissue) in vitro (outside the body) to provide information about a physiological state, health, or disease.

IVD devices are used to perform tests on samples taken from the body to diagnose, monitor, or screen for conditions. This device is a delivery system for a therapeutic gas.

N/A

Intended Use / Indications for Use

The intended use is to delivery oxygen to patient nasally, controlled by a demand system.

Product codes

NFB

Device Description

The demand cannula is a special cannula designed to give adult and pediatric users of dual port oxygen conservation delivery system all the comfort and conveniences of a Salter-Style® cannula. Unique dual tubing delivers oxygen on demand through one tube while inspiratory / expiratory effort is also sensed through the other tube. Meets dual port device manufacturers' specifications.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

nasally

Indicated Patient Age Range

adult and pediatric users

Intended User / Care Setting

Not Found

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 NOP Demand Nasal Oxygen Cannula and Modified NOP Demand Nasal Oxygen Cannula were tested to verify that the new material bond and performance characteristics of flow rate, back pressure, and tubing bond strength did not impact the strength or performance of the modified demand devices after the material change. Statistical methods were used to determine, the minimum required sample size was 29 to support a 95% confidence level at 91% reliability.
The test results demonstrate that the NOP Demand Nasal Oxygen Cannula and Modified NOP Demand Nasal Oxygen Cannula is substantially equivalent to the predicate devices.

The tests performed are summarized below:

  • Shall not have a back pressure that exceeds 3 psi at a maximum flow rate in ambient of 5°C, 20°C, and 40°C: The NOP Demand/Modified Demand Nasal Oxygen Cannula met the objective back pressure requirements. Maximum back pressure was found to be less than 2 psi.
  • The bonded components of the set will have a bond strength that is ≥ 2 lbs. when pulled at a rate of 5 inches per minute: The NOP Demand/Modified Demand Nasal Oxygen Cannula passed all bond strength requirements. All test samples measured above the bond interface tensile load limit. The worst case cannula sample was able to achieve over 2 times the minimum allowable value.
  • The cannula shall withstand storage and transport temperatures. A high temperature limit of 50°C and a low temperature limit of -29°C: The NOP Demand/Modified Demand Nasal Oxygen Cannula met the above performance criteria after storage and transport environmental conditioning.

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

Not Found

Predicate Device(s)

K890298, K892407

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 868.5905 Noncontinuous ventilator (IPPB).

(a)
Identification. A noncontinuous ventilator (intermittent positive pressure breathing-IPPB) is a device intended to deliver intermittently an aerosol to a patient's lungs or to assist a patient's breathing.(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 & 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 an abstract symbol that resembles three human profiles facing to the right, with a stylized design that suggests flowing hair or water beneath the profiles.

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

March 11, 2016

Salter Labs Margaret Caler Regulatory Associate 2365 Camino Vida Robles Carlsbad, California 92011

Re: K151506

Trade/Device Name: NOP Demand Nasal Oxygen Cannula, Models 4804, 4805, 4807, 4824. & 4827 and NOP Modified Demand Nasal Oxygen Cannula, Models 4904, 4905, & 4907 Regulation Number: 21 CFR 868.5905 Regulation Name: Noncontinuous Ventilator (IPPB) Regulatory Class: Class II Product Code: NFB Dated: February 5, 2016 Received: February 11, 2016

Dear Ms. Caler:

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,

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) K151506

Device Name

NOP Demand Nasal Oxygen Cannula, Models 4804, 4807, 4824, & 4827 and NOP Modified Demand Nasal Oxygen Cannula, Models 4904, 4905, & 4907.

Indications for Use (Describe)

The intended use is to deliver oxygen to the patient nasally, controlled by a demand system

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)

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Section 9.0: 510 (k) Summary

In accordance with the Safe Medical Devices Act (SMDA) of 1990 and Title 21 of the Code of Federal Regulations Part 807 (21 CFR §807), a the following summary information is provided:

510 (k) Summary

A. Submitter:

Salter Labs 2365 Camino Vida Robles Carlsbad, CA 92011 Telephone: 760-795-7100 Fax: 760-683-6797

Contact Person: Mara Caler Director, Regulatory Affairs

Date Prepared: 11 March 2016

B. Device Names:

Trade NameCommon Name
NOP Demand Nasal Oxygen Cannula
models: 4804, 4805, 4807, 4824, & 4827.NOP Demand Nasal Oxygen Cannula
NOP Modified Demand Nasal Oxygen
Cannula models: 4904, 4905, & 4907.NOP Modified Demand Nasal Oxygen Cannula
Classification Name:Conserver, Oxygen
Product Code:NFB
Regulation Number:868.5905
Classification:II
Classification Panel:Anaesthesiology

Predicate Devices: C.

This submission demonstrates substantial equivalence to the predicate devices:

K890298, Demand Nasal Oxygen Cannula

K892407, Modified Demand Nasal Oxygen Cannula

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D. Device Descriptions

The demand cannula is a special cannula designed to give adult and pediatric users of dual port oxygen conservation delivery system all the comfort and conveniences of a Salter-Style® cannula. Unique dual tubing delivers oxygen on demand through one tube while inspiratory / expiratory effort is also sensed through the other tube. Meets dual port device manufacturers' specifications.

Indications for Use E.

The intended use is to delivery oxygen to patient nasally, controlled by a demand system.

Comparison of Technological Characteristics with the Predicate Device F.

The proposed NOP Demand Nasal Oxygen Cannula and Modified NOP Demand Nasal Oxygen Cannula is substantially equivalent to the predicate device listed above in that the the indications for use, the intended use, and fundamental scientific technology remain unchanged.

The differences between the NOP Demand Nasal Oxygen Cannula and Modified NOP Demand Nasal Oxygen Cannula and the predicate device are:

| Features | Predicate Demand
Nasal Oxygen
Cannula | NOP Demand Oxygen
Cannula | Performance
Testing |
|-------------------------|---------------------------------------------|------------------------------|------------------------|
| Material
Formulation | PVC, DIDP | PVC, DINCH | Biocompatibility |
| | PVC, DEHP | PVC, DOTP | and Performance |

ﻦ Performance Data

The NOP Demand Nasal Oxygen Cannula and Modified NOP Demand Nasal Oxygen Cannula were tested to verify that the new material bond and performance characteristics of flow rate, back pressure, and tubing bond strength did not impact the strength or performa nce of the modified demand devices after the material change. Statistical methods were used to determine, the minimum required sample size was 29 to support a 95% confidence level at 91% reliability.

The test results demonstrate that the NOP Demand Nasal Oxygen Cannula and Modified NOP Demand Nasal Oxygen Cannula is substantially equivalent to the predicate devices.

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The tests performed are summarized below:

CriteriaResultsComments
Shall not have a back
pressure that exceeds 3 psi at
a maximum flow rate in
ambient of 5°C, 20°C, and
40°CThe NOP Demand/Modified
Demand Nasal Oxygen
Cannula met the objective back
pressure requirementsMaximum back
pressure was
found to be less
than 2 psi.
The bonded components of
the set will have a bond
strength that is $≥$ 2 lbs. when
pulled at a rate of 5 inches
per minute.The NOP Demand/Modified
Demand Nasal Oxygen
Cannula passed all bond strength
requirements. All test samples
measured above the bond interface
tensile load limit.The worst case
cannula sample
was able
to achieve over
2 times the
minimum
allowable
value.
The cannula shall withstand
storage and transport
temperatures. A high
temperature limit of 50°C
and a low temperature limit
of -29°C.The NOP Demand/Modified
Demand Nasal Oxygen
Cannula met the above
performance criteria after storage
and transport environmental
conditioning.N/A

The NOP Demand Nasal Oxygen Cannula and Modified NOP Demand Nasal Oxygen

Cannula meet established Salter Labs performance specifications.

Clinical / Non-Clinical H.

The following biocompatibility testing was performed. The materials passed all parameters:

  • Irritation
  • · Sensitization ·
  • · Cytotoxicity
  • Particulate
  • Volatile organic compounds

I. Conclusions

The NOP Modified Demand and NOP Demand Nasal Oxygen Cannula data and test results demonstrate that the devices are substantially equivalent to the predicate devices