K Number
K153160
Device Name
AVIVO Mobile Patient Management (MPM) System
Manufacturer
Date Cleared
2016-03-30

(149 days)

Product Code
Regulation Number
870.1025
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The AVIVO™ Mobile Patient Management (MPM) System is intended to continuously measure, record and periodically transmit physiological data. The AVIVOTM MPM System is indicated for patients: - · With fluid management problems - · Taking diuretic medication - · Living with heart failure - · Living with end-stage renal disease - Suffering from recurrent dehydration - Who require monitoring for the detection of non-lethal cardiac arrhythmias such as, but not limited to, supraventricular tachycardias (e.g. atrial florillation, atrial flutter, paroxysmal SVTs), ventricular ectopy, bradyarthythmias and conduction disorders. The AVIVO™ MPM System monitors, derives and displays: - · ECG - · Heart Rate (including HR variability) - · Activity - Posture - · Respiration Rate (including RR variability) - · Body Fluid Status The system has not been tested specifically for pediatric use.
Device Description
The AVIVO™ MPM System is a wearable, wireless physiological monitoring and arrhythmia detection system that is used by patients to aid clinicians in the identification, diagnosis and management of various clinical conditions, events and/or trends. It consists primarily of the Wearable Sensor (monitoring device) and the Transmitter (portable data transmission device). In combination with interpretation services provided by Medtronic Monitoring, Inc.'s Monitoring Center, as well as secure online review of data by healthcare providers, the AVIVO™ MPM System enables patient- and physician-friendly physiological monitoring and arrhythmia detection for extended periods of time. The AVIVO™ MPM System is comprised of the following non-sterile components: - The Wearable Sensor, which adheres to the patient's torso, contains electrodes and ● sensors for recording patient information. - . The Transmitter, which is the patient hand-held transceiver, receives information from the Wearable Sensor and transmits it to the Medtronic Server. - . The secure Server, which receives information from the Wearable Sensor via the Transmitter, and among other things, derives, calculates and displays the patient's physiological parameters using the data collected by the Wearable Sensor.
More Information

Not Found

No
The document describes the device as measuring, recording, transmitting, deriving, calculating, and displaying physiological parameters. There is no mention of AI, ML, or any related concepts like algorithms that learn or adapt. The focus is on data collection, transmission, and standard physiological parameter derivation.

No
The device is described as a monitoring and detection system that measures, records, and transmits physiological data to aid clinicians in identification, diagnosis, and management, but it does not directly treat or alleviate conditions.

Yes

The device description explicitly states that the system is used "to aid clinicians in the identification, diagnosis and management of various clinical conditions, events and/or trends." Furthermore, one of its indications for use is "monitoring for the detection of non-lethal cardiac arrhythmias." These phrases indicate a diagnostic function.

No

The device description explicitly states it consists of a "Wearable Sensor" and a "Transmitter," which are hardware components.

Based on the provided information, the AVIVO™ Mobile Patient Management (MPM) System is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • IVD Definition: In Vitro Diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections.
  • AVIVO™ MPM System Function: The AVIVO™ MPM System is a wearable device that continuously measures, records, and transmits physiological data directly from the patient's body. It uses electrodes and sensors to collect information like ECG, heart rate, activity, posture, respiration rate, and body fluid status. This is in vivo monitoring, not in vitro testing of samples.

The system's purpose is to aid clinicians in the identification, diagnosis, and management of various clinical conditions by monitoring the patient's physiological state directly. This aligns with the definition of a physiological monitoring device, not an IVD.

N/A

Intended Use / Indications for Use

The AVIVO™ Mobile Patient Management (MPM) System is intended to continuously measure, record and periodically transmit physiological data. The AVIVO™ MPM System is indicated for patients:

  • · With fluid management problems
  • · Taking diuretic medication
  • · Living with heart failure
  • · Living with end-stage renal disease
  • Suffering from recurrent dehydration

· Who require monitoring for the detection of non-lethal cardiac arrhythmias such as, but not limited to, supraventricular tachycardias (e.g. atrial florillation, atrial flutter, paroxysmal SVTs), ventricular ectopy, bradyarthythmias and conduction disorders.

The AVIVO™ MPM System monitors, derives and displays:

  • · ECG
  • · Heart Rate (including HR variability)
  • · Activity
  • Posture
  • · Respiration Rate (including RR variability)
  • · Body Fluid Status

The system has not been tested specifically for pediatric use.

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

MHX, DSB, DSI

Device Description

The AVIVO™ MPM System is a wearable, wireless physiological monitoring and arrhythmia detection system that is used by patients to aid clinicians in the identification, diagnosis and management of various clinical conditions, events and/or trends. It consists primarily of the Wearable Sensor (monitoring device) and the Transmitter (portable data transmission device). In combination with interpretation services provided by Medtronic Monitoring, Inc.'s Monitoring Center, as well as secure online review of data by healthcare providers, the AVIVO™ MPM System enables patient- and physician-friendly physiological monitoring and arrhythmia detection for extended periods of time.

The AVIVO™ MPM System is comprised of the following non-sterile components:

  • The Wearable Sensor, which adheres to the patient's torso, contains electrodes and ● sensors for recording patient information.
  • . The Transmitter, which is the patient hand-held transceiver, receives information from the Wearable Sensor and transmits it to the Medtronic Server.
  • . The secure Server, which receives information from the Wearable Sensor via the Transmitter, and among other things, derives, calculates and displays the patient's physiological parameters using the data collected by the Wearable Sensor.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

patient's torso

Indicated Patient Age Range

The system has not been tested specifically for pediatric use.

Intended User / Care Setting

clinicians, healthcare providers

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)

System validation testing was also successfully completed to demonstrate that the modified A VIVO™ MPM System functions as expected and that the system meets user needs and intended use.

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.

K113187, K113372, K133701

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

§ 870.1025 Arrhythmia detector and alarm (including ST-segment measurement and alarm).

(a)
Identification. The arrhythmia detector and alarm device monitors an electrocardiogram and is designed to produce a visible or audible signal or alarm when atrial or ventricular arrhythmia, such as premature contraction or ventricular fibrillation, occurs.(b)
Classification. Class II (special controls). The guidance document entitled “Class II Special Controls Guidance Document: Arrhythmia Detector and Alarm” will serve as the special control. See § 870.1 for the availability of this guidance document.

0

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

March 30, 2016

Medtronic, Inc. Cheryl Swanson Sr. Principal Regulatory Affairs Specialist 8200 Coral Sea Street NE Mounds View, Minnesota 55112

Re: K153160

Trade/Device Name: AVIVO™ Mobile Patient Management (MPM) System Regulation Number: 21 CFR 870.1025 Regulation Name: Arrhythmia Detector and Alarm (Including ST-Segment Measurement and Alarm) Regulatory Class: Class II Product Code: MHX, DSB, DSI Dated: February 29, 2016 Received: March 1, 2016

Dear Cheryl Swanson:

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,

Mitchell Stein

for Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement below.

510(k) Number (if known) K153160

Device Name

AVIVO™ ® Mobile Patient Management (MPM) System

Indications for Use (Describe)

The AVIVO™ Mobile Patient Management (MPM) System is intended to continuously measure, record and periodically transmit physiological data. The AVIVOTM MPM System is indicated for patients:

  • · With fluid management problems
  • · Taking diuretic medication
  • · Living with heart failure
  • · Living with end-stage renal disease
  • Suffering from recurrent dehydration

· Who require monitoring for the detection of non-lethal cardiac arrhythmias such as, but not limited to, supraventricular tachycardias (e.g. atrial florillation, atrial flutter, paroxysmal SVTs), ventricular ectopy, bradyarthythmias and conduction disorders.

The AVIVO™ MPM System monitors, derives and displays:

  • · ECG
  • · Heart Rate (including HR variability)
  • · Activity
  • Posture
  • · Respiration Rate (including RR variability)
  • · Body Fluid Status

The system has not been tested specifically for pediatric use.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

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510(k) SUMMARY

The following table provides background information regarding this Special 510(k) submission:

Date Prepared:October 30, 2015
510(k) Owner / Address:Medtronic, Inc.
Cardiac Rhythm and Heart Failure
8200 Coral Sea Street NE
Mounds View, MN 55112
Contact Person:Cheryl Swanson
Senior Principal Regulatory Affairs Specialist
cheryl.swanson@medtronic.com
Office: (763) 514-0088
Cell: (651) 242-3506

Secondary Contact:
Ryan Calabrese
Regulatory Affairs Director
ryan.s.calabrese@medtronic.com
Office: 763-526-3515 |
| Submission Type: | Special 510(k): Device Modification |
| Device Trade Name: | AVIVOTM Mobile Patient Management (MPM) System |
| Device Common Name: | Mobile Patient Management (MPM) System |
| Product Code and
Classification Regulation
Name: | DSB: Plethysmograph, Impedence
DSI: Detector and Alarm, Arrhythmia
MHX: Monitor, Physiological, Patient (With Arrhythmia
Detection or Alarms) |
| Predicate Devices: | Primary
K113187, cleared January 4, 2012 (AVIVO™ MPM)

Secondary
K113372, cleared March 7, 2012 (NUVANT™ MCT)
K133701, cleared February 6, 2014 (NUVANT™ MCT) -
rebranded as SEEQ™ MCT |

4

Device Description

The AVIVO™ MPM System is a wearable, wireless physiological monitoring and arrhythmia detection system that is used by patients to aid clinicians in the identification, diagnosis and management of various clinical conditions, events and/or trends. It consists primarily of the Wearable Sensor (monitoring device) and the Transmitter (portable data transmission device). In combination with interpretation services provided by Medtronic Monitoring, Inc.'s Monitoring Center, as well as secure online review of data by healthcare providers, the AVIVO™ MPM System enables patient- and physician-friendly physiological monitoring and arrhythmia detection for extended periods of time.

Significant Physical and Performance Characteristics of the Device

The AVIVO™ MPM System is comprised of the following non-sterile components:

  • The Wearable Sensor, which adheres to the patient's torso, contains electrodes and ● sensors for recording patient information.
  • . The Transmitter, which is the patient hand-held transceiver, receives information from the Wearable Sensor and transmits it to the Medtronic Server.
  • . The secure Server, which receives information from the Wearable Sensor via the Transmitter, and among other things, derives, calculates and displays the patient's physiological parameters using the data collected by the Wearable Sensor.

This remains unchanged from the predicate device.

Indications for Use Statement

The AVIVO™ Mobile Patient Management (MPM) System is intended to continuously measure, record and periodically transmit physiological data. The AVIVO™ MPM System is indicated for patients:

  • . With fluid management problems
  • . Taking diuretic medication
  • Living with heart failure
  • Living with end-stage renal disease
  • Suffering from recurrent dehydration
  • Who require monitoring for the detection of non-lethal cardiac arrhythmias such as, but not limited to, supraventricular tachycardias (e.g. atrial fibrillation, atrial flutter, paroxysmal SVTs), ventricular ectopy, bradyarrhythmias and conduction disorders.

The AVIVO™ MPM System monitors, derives and displays:

  • . ECG
  • Heart Rate (including HR variability) ●
  • Activity
  • Posture

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  • . Respiration Rate (including RR variability)
  • . Body Fluid Status

The system has not been tested specifically for pediatric use.

Intended Use of the Device

The AVIVO™ MPM System is intended for the ambulatory recording and monitoring of physiological parameter(s).

This remains unchanged from the predicate device.

Comparison of Fundamental Scientific Technology with the Predicate Devices

The subject AVIVO™ MPM System operates the same as the predicates, based on the following fundamental scientific technology:

  • . The collection of physiological parameters by a multi-sensor patient-worn device (Wearable Sensor);
  • . The transmission of these parameters to a remote Server through a transceiver (Transmitter); and
  • . The receipt of the parameters by the Server and subsequent derivation into appropriate useful values for display.

This remains unchanged from the predicate device.

Summary of Testing and Performance Data to Demonstrate Substantial Equivalence

The AVIVO™ MPM System is supported by the successful completion of the following tests to demonstrate substantial equivalence.

Section DescriptionModification 1Modification 2Modification 3
Sterilization and
Shelf LifeN/A – no changes to
sterilization or shelf
life related to this
modificationTesting for this
change already
provided in K133701N/A - no changes to
sterilization or shelf
life related to this
modification
BiocompatibilityN/A – no changes to
biocompatibility
related to this
modificationAlthough there were
no changes to the
patient-contacting
materials related to
this modification,
biocompatibility
testing was repeatedN/A - no changes to
biocompatibility
related to this
modification
Section DescriptionModification 1Modification 2Modification 3
SoftwareTesting for this
modification already
provided in K113372Testing for this
modification already
provided in K133701
and results provided
in K133701Discussed in the
Software Section
EMC TestingN/A – no EMC
changes associated
with this modificationTesting for this
modification already
provided in K133701N/A – no EMC
changes associated
with this modification
Performance Testing
– Bench
Mechanical
ElectricalN/A – no mechanical
or electrical changes
associated with this
modificationTesting for this
change already
provided in K133701N/A- no mechanical
or electrical changes
associated with this
modification
Performance Testing
– AnimalN/A – no animal
testing required for
this modificationN/A - no animal
testing required for
this modificationN/A - no animal
testing required for
this modification
Performance Testing
  • Clinical | N/A – no clinical
    testing required for
    this modification | N/A – no clinical
    testing required for
    this modification | N/A – no clinical
    testing required for
    this modification |
    | Cybersecurity | N/A - no
    cybersecurity changes
    associated with this
    modification | N/A – no
    cybersecurity changes
    associated with this
    modification | N/A - no
    cybersecurity changes
    associated with this
    modification.

Note: This section is
included due to the
release of the final
FDA guidance
document since the
last submission. See
the Cybersecurity
Section for details. |
| RF & Wireless
Technology | N/A – no RF &
Wireless changes
associated with this
modification. | N/A - no RF or
Wireless changes
associated with this
modification.

Note: following this
submission, the
Transmitter's cellular
technology was
updated. As such, RF | N/A – no RF &
Wireless changes
associated with this
modification. |
| Section Description | Modification 1 | Modification 2 | Modification 3 |
| | | Technology is
discussed in the RF
& Wireless
Technology Section | |

Table 4: Summary of Completed Testing to Support this Submission

6

7

System validation testing was also successfully completed to demonstrate that the modified A VIVO™ MPM System functions as expected and that the system meets user needs and intended use.

Guidance Used to Demonstrate Substantial Equivalence

Guidance documents used/considered for these device modifications include, but are not limited to, the following:

  • Draft Guidance Document titled Use of International Standard ISO 10993, Biological ● Evaluation of Medical Devices Part 1: Evaluation and Testing, issued on April 23, 2013
  • Design Considerations for Devices Intended for Home Use, issued on November 24, . 2014
  • Radio Frequency Wireless Technology in Medical Devices. issued on August 13, 2013 .
  • Content of Premarket Submissions for Management of Cybersecurity in Medical Devices, issued on October 2, 2014
  • Guidance for the Content of Premarket Submissions for Software Contained in Medical ● Devices, issued May 11, 2005
  • Class II Special Controls Guidance Document: Arrhythmia Detector and Alarm dated ● October 28, 2003

Standards Used to Demonstrate Substantial Equivalence

Table 5 identifies the standards that were also used, in whole or in part, to demonstrate substantial equivalence:

| Standards Organization /

NumberStandards TitleDate / Version
IEC 60601-1Medical electrical equipment – Part 1:
General requirements for basic safety
and essential performance2005 + CORR 1
(2006) + CORR 2
(2007) / 3rd Edition
Standards Organization /
NumberStandards TitleDate / Version
IEC 60601-1-2Medical electrical equipment - Part 1-2:
General requirements for basic safety
and essential performance - Collateral
standard: Electromagnetic
compatibility - Requirements and tests2007 / 3rd Edition
IEC 60601-1-6Medical electrical equipment - Part 1-
6: General Requirements for Basic
Safety and Essential Performance -
Collateral Standard: Usability2010-01 / 3rd Edition
IEC 60601-1-11Medical electrical equipment - Part 1-
11: General Requirements for Basic
Safety and Essential Performance -
Collateral Standard Requirements for
Medical Electrical Equipment and
Medical Electrical Systems Used in the
Home Healthcare Environment2010-04 / 1st Edition
ANSI/AAMI/IEC 60601-2-
47Medical electrical equipment - Part 2-
47: Particular requirements for the
safety and essential performance of
ambulatory electrocardiographic
systems2012 / 2nd Edition
ANSI/AAMI/IEC 62304Medical Device Software - Software
life cycle processes (Edition 1)2006-005
AAMI/ANSI EC 12Disposable ECG electrodes2000 (R) 2010
AAMI/ANSI EC 57Testing and reporting performance
results of cardiac rhythm and ST-
segment measurement algorithms2012
AAMI/ANSI/ISO 10993-1Biological evaluation of medical
devices - Part 1: Evaluation and testing
within a risk management process2009
Standards Organization /
NumberStandards TitleDate / Version
AAMI/ANSI/ISO 10993-5Biological evaluation of medical
devices – Part 5: Tests for in vitro
cytotoxicity2009
AAMI/ANSI/ISO 10993-10Biological evaluation of medical
devices – Part 10: Tests for irritation
and skin sensitization2010
ISO 14971Medical Devices – Application of Risk
Management to Medical Devices
(Edition 2)2007-03-01; 2012

Table 5: Standards to Demonstrate Substantial Equivalence

8

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Conclusion

Medtronic has demonstrated that the AVIVO™ MPM System, as described in this submission, results in a substantially equivalent device because the fundamental scientific technology, operating principles and intended use are unchanged from the predicate devices. Summary data has been provided to demonstrate reasonable assurance of safety and effectiveness of the A VIVO™ MPM System and to demonstrate substantial equivalence to its predicates. As supported by the descriptive information, verification, validation and standards testing, the modified AVIVO™ MPM System is substantially equivalent to the predicate devices.