K Number
K160127
Device Name
iCodeConnect
Manufacturer
Date Cleared
2016-11-10

(295 days)

Product Code
Regulation Number
868.5905
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
iCodeConnect, in conjunction with a Luna CPAP or Auto-CPAP device, is intended for use in treating obstructive sleep apnea (OSA) on adult patients (>30 kg). iCodeConnect is intended to augment the standard follow-up care of patients diagnosed with obstructive sleep apnea by displaying usage and therapeutic information that has been transmitted from the patient's Luna CPAP or Auto-CPAP therapy device located in the home to the clinician or healthcare professional. iCodeConnect also provides remote settings capabilities.
Device Description
iCodeConnect is a web based patient management system used to store and manage sleep compliance and efficacy data uploaded from a Luna CPAP or Auto-CPAP device. iCodeConnect allows device patient data to be uploaded using a variety of methods, including manual entry, SD Card, and wireless transmission. Use of wireless transmission (i.e. WiFi) can provide wireless compliance monitoring and remote settings update functions. For wireless transmission, iCodeConnect consists of the wireless data transmission module Wi-Fi kit and web based iCodeConnect patient management software. The Wi-Fi Kit is intended to be used in conjunction with the Luna CPAP System (E-20C-H-O), Auto-CPAP System (E-20A-H-O / E-20AJ-H-O), which were cleared in K141770. 1) iCodeConnect Software is an analysis and management platform for the patient's therapy data. This platform, adopting the form of a website, not only realizes the uniform management of the patient's data and the information of the provider, the doctor and the patient, but also allows for the Wi-Fi Kit or other wireless communication module to transmit data and remotely updating therapy device settings, which reduces the inconvenience brought by the traditional mailing of SD card and makes data collection more timely. Wi-Fi Kit is an accessory module that attaches via USB cable to the data output port of a Luna® CPAP or Auto-CPAP devices. The wireless module Wi-Fi Kit uploads the device's therapy data to the iCodeConnect software with the help of Wi-Fi off-the-shelf technology. After connecting to the internet. the wireless kit shall automatically collect the user information, statistical information and detailed information in the therapy device for uploading.
More Information

No
The description focuses on data storage, management, transmission, and remote settings updates, with no mention of analytical capabilities beyond displaying usage and therapeutic information. There is no indication of algorithms that learn or make predictions.

No

The device is a web-based patient management system used to store and manage sleep compliance and efficacy data from CPAP devices, and to provide remote settings capabilities. It does not directly treat or diagnose a medical condition. Its function is to augment follow-up care by providing data and remote adjustments for devices that are therapeutic (Luna CPAP/Auto-CPAP devices).

No

The device is a web-based patient management system used to store and manage sleep compliance and efficacy data uploaded from a CPAP or Auto-CPAP device, not to diagnose a condition. Its purpose is to augment follow-up care by displaying usage and therapeutic information.

No

The device description explicitly states that iCodeConnect consists of both the web-based software and a "wireless data transmission module Wi-Fi kit," which is a hardware component.

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

Here's why:

  • Intended Use: The intended use is to augment the standard follow-up care of patients with obstructive sleep apnea by displaying usage and therapeutic information from a CPAP device. It also provides remote settings capabilities. This is related to monitoring and managing a patient's therapy, not performing diagnostic tests on biological samples.
  • Device Description: The device is a web-based patient management system and a wireless data transmission module. It stores and manages sleep compliance and efficacy data. This aligns with a data management and communication system for a medical device, not an in vitro diagnostic test.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting specific analytes, or providing diagnostic information based on laboratory testing.

The device's function is to facilitate the communication and management of data generated by a therapeutic device (the CPAP machine) used for treating a diagnosed condition. This falls outside the scope of in vitro diagnostics.

N/A

Intended Use / Indications for Use

iCodeConnect, in conjunction with a Luna CPAP or Auto-CPAP device, is intended for use in treating obstructive sleep apnea (OSA) on adult patients (>30 kg). iCodeConnect is intended to augment the standard follow-up care of patients diagnosed with obstructive sleep apnea by displaying usage and therapeutic information that has been transmitted from the patient's Luna CPAP or Auto-CPAP therapy device located in the home to the clinician or healthcare professional. iCodeConnect also provides remote settings capabilities.

Product codes

BZD

Device Description

iCodeConnect is a web based patient management system used to store and manage sleep compliance and efficacy data uploaded from a Luna CPAP or Auto-CPAP device. iCodeConnect allows device patient data to be uploaded using a variety of methods, including manual entry, SD Card, and wireless transmission. Use of wireless transmission (i.e. WiFi) can provide wireless compliance monitoring and remote settings update functions. For wireless transmission, iCodeConnect consists of the wireless data transmission module Wi-Fi kit and web based iCodeConnect patient management software. The Wi-Fi Kit is intended to be used in conjunction with the Luna CPAP System (E-20C-H-O), Auto-CPAP System (E-20A-H-O / E-20AJ-H-O), which were cleared in K141770. 1) iCodeConnect Software is an analysis and management platform for the patient's therapy data. This platform, adopting the form of a website, not only realizes the uniform management of the patient's data and the information of the provider, the doctor and the patient, but also allows for the Wi-Fi Kit or other wireless communication module to transmit data and remotely updating therapy device settings, which reduces the inconvenience brought by the traditional mailing of SD card and makes data collection more timely. Wi-Fi Kit is an accessory module that attaches via USB cable to the data output port of a Luna® CPAP or Auto-CPAP devices. The wireless module Wi-Fi Kit uploads the device's therapy data to the iCodeConnect software with the help of Wi-Fi off-the-shelf technology. After connecting to the internet. the wireless kit shall automatically collect the user information, statistical information and detailed information in the therapy device for uploading.

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 patients (>30 kg)

Intended User / Care Setting

clinician or healthcare professional, home

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: Non-clinical testing of the iCodeConnect has been carried out to cover functional verification and device performance. The proposed iCodeConnect has been tested to appropriate standards and other applicable requirements. The device was designed and tested according to: - IEC 60601-1-2:2014, medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance -Collateral compatibility - Requirements and tests - IEC 60601-1 Medical Electrical Equipment-Part 1: General requirements for basic safety and essential performance. - IEC | 60601-1-1 | Medical | | 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 environment. - ISO14971:2007 | Medical | | devices Application of risk management to medical devices - FCC Regulation 47 CFR Part 15 Radio Frequency Devices Additional design considerations were applied based on published guidance and draft guidance documents from FDA: 1. FDA Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices (May 11, 2005) 2. FDA Guidance - Design Considerations for Devices Intended for Home Use (Nov24, 2014) 3. FDA Guidance -Content of Premarket Submissions for Management of Cybersecurity in Medical Devices (Oct 2, 2014) 4. FDA Guidance - Radio Frequency Wireless Technology in Medical Devices (Aug 14, 2013) All tests confirmed that iCodeConnect met the predetermined and demonstrated substantial equivalence to the predicate device. Clinical Testing: Clinical testing was not required to demonstrate the safety and effectiveness of the iCodeConnect. The product functionality has been adequately assessed.

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

Not Found

Predicate Device(s)

EasyCare Online (K093684)

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).

0

Image /page/0/Picture/1 description: The image is a logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which is a staff with two snakes coiled around it. The symbol is surrounded by the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement. The logo is simple and clean, and it is easily recognizable.

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

November 10, 2016

3B Medical, Inc. Alex Lucio Vice President 799 Overlook Drive Winter Haven, Florida 33884

Re: K160127

Trade/Device Name: iCodeConnect Regulation Number: 21 CFR 868.5905 Regulation Name: Noncontinuous Ventilator (IPPB) Regulatory Class: Class II Product Code: BZD Dated: October 10, 2016 Received: October 12, 2016

Dear Alex Lucio:

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 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.

1

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

Tina Kiang, Ph.D. Acting Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K160127

Device Name iCodeConnect

Indications for Use (Describe)

iCodeConnect, in conjunction with a Luna CPAP or Auto-CPAP device, is intended for use in treating obstructive sleep apnea (OSA) on adult patients (>30 kg).

iCodeConnect is intended to augment the standard follow-up care of patients diagnosed with obstructive sleep apnea by displaying usage and therapeutic information that has been transmitted from the patient's Luna CPAP or Auto-CPAP therapy device located in the home to the clinician or healthcare professional. iCodeConnect also provides remote settings capabilities.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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and review the collection of information. Send comments regarding this burden estimate or any other aspect
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"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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3

510(k) Summary

Device Trade NameiCodeConnect
Common/Usual NameNoncontinuous ventilator (IPPB)
Date PreparedNovember 10, 2016
Sponsor Identification3B Medical, Inc.
799 Overlook Drive
Winter Haven, FL 33884
Phone863-226-6285
Fax863-226-6284
Emailalucio@3bproducts.com
Submission CorrespondentAlex Lucio
3B Medical, Inc.
799 Overlook Drive
Winter Haven, FL 33884
Phone863-226-6285
Fax863-226-6284
Emailalucio@3bproducts.com

4

Establishment Registration# 3008566132
BMC Medical CO., LTD
5/F Main Building No.19Gucheng Street
West, Shijingshan,Beijing, CHINA 100043
ClassificationClass II Device
Classification NameNon-continuous ventilator
Classification PanelMedical Device
Classification Reference21 CFR 878.5905
Products CodeBZD
Medical SpecialtiesAnesthesiology
Predicate Device(s)EasyCare Online (K093684)
Reason for Submission:New Device
Intended UseiCodeConnect, in conjunction with a Luna CPAP
or Auto-CPAP device, is intended for use in
treating obstructive sleep apnea (OSA) on adult
patients (>30 kg).
iCodeConnect is intended to augment the standard
follow-up care of patients diagnosed with
obstructive sleep apnea by displaying usage and
therapeutic information that has been transmitted
from the patient's Luna CPAP or Auto-CPAP
therapy device located in the home to the clinician
or healthcare professional. iCodeConnect also
provides remote settings capabilities.
Device DescriptioniCodeConnect is a web based patient management
system used to store and manage sleep compliance
and efficacy data uploaded from a Luna CPAP or
Auto-CPAP device.
iCodeConnect allows device patient data to be

5

uploaded using a variety of methods, including manual entry, SD Card, and wireless transmission. Use of wireless transmission (i.e. WiFi) can provide wireless compliance monitoring and remote settings update functions.

For wireless transmission, iCodeConnect consists of the wireless data transmission module Wi-Fi kit and web based iCodeConnect patient management software. TheWi-Fi Kit is intended to be used in conjunction with the Luna CPAP System (E-20C-H-O), Auto-CPAP System (E-20A-H-O / E-20AJ-H-O), which were cleared in K141770.

  1. iCodeConnect Software is an analysis and management platform for the patient's therapy data. This platform, adopting the form of a website, not only realizes the uniform management of the patient's data and the information of the provider, the doctor and the patient, but also allows for the Wi-Fi Kit or other wireless communication module to transmit data and remotely updating therapy device settings, which reduces the inconvenience brought by the traditional mailing of SD card and makes data collection more timely.

Wi-Fi Kit is an accessory module that attaches via USB cable to the data output port of a Luna® CPAP or Auto-CPAP devices. The wireless module Wi-Fi Kit uploads the device's therapy data to the iCodeConnect software with the help of Wi-Fi off-the-shelf technology. After connecting to the internet. the wireless kit shall automatically collect the user information, statistical information and detailed information in the therapy device for uploading.

Non-Clinical Testing Non-clinical testing of the iCodeConnect has been

3

6

carried out to cover functional verification and device performance. The proposed iCodeConnect has been tested to appropriate standards and other applicable requirements. The device was designed and tested according to:

  • IEC 60601-1-2:2014, medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance -Collateral compatibility - Requirements and tests
  • IEC 60601-1 Medical Electrical Equipment-Part 1: General requirements for basic safety and essential performance.
  • IEC | 60601-1-1 | Medical | | 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 environment.
  • ISO14971:2007 | Medical | | devices Application of risk management to medical devices
  • FCC Regulation 47 CFR Part 15 Radio Frequency Devices

Additional design considerations were applied based on published guidance and draft guidance documents from FDA:

  1. FDA Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices (May 11, 2005)

  2. FDA Guidance - Design Considerations for Devices Intended for Home Use (Nov24, 2014)

FDA Guidance -Content of of Premarket 3. Submissions for Management of Cybersecurity in Medical Devices (Oct 2, 2014)

7

  1. FDA Guidance - Radio Frequency Wireless Technology in Medical Devices (Aug 14, 2013)

All tests confirmed that iCodeConnect met the predetermined and demonstrated substantial equivalence to the predicate device.

Clinical Testing Clinical testing was not required to demonstrate the safety and effectiveness of the iCodeConnect. The product functionality has been adequately assessed

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Substantial Equivalence

| Features/

FunctionProposed DevicePredicate DeviceComments
iCodeConnect
(510K Number: K160127)EasyCare Online
(510K Number: K093684)
Product CodeBZDBZDSame as predicate
Regulation
Number868.5905868.5905Same as predicate
Regulation
NameNoncontinuous
ventilator (IPPB)Noncontinuous
ventilator (IPPB)Same as predicate
Intended UseiCodeConnect, in conjunction with a Luna
CPAP or Auto-CPAP device, is intended for
use in treating obstructive sleep apnea (OSA)
on adult patients (>30 kg).

iCodeConnect is intended to augment the
standard follow-up care of patients diagnosed
with obstructive sleep apnea by displaying
usage and therapeutic information that has been
transmitted from the patient's Luna CPAP or
Auto-CPAP therapy device located in the home
to the clinician or healthcare professional.
iCodeConnect also provides remote settings
capabilities. | EasyCare Online is intended to
augment the standard follow-up care
of
patients diagnosed with
obstructive sleep apnea by
displaying usage and therapeutic
information that has been transmitted
from the patient's flow generator
located in the home to the care giver.
EasyCare Online also provides
remote settings capabilities.

It is intended to be used by
Clinicians in conjunction with
ResMed compatible flow generators. | |
| Features/
Function | Proposed Device | Predicate Device | |
| | iCodeConnect
(510K Number: K160127) | EasyCare Online
(510K Number: K093684) | Comments |
| Device
Composition | A web-based software and a wireless module | A web-based software and a wireless
module | Same as predicate |
| Software
Function | The iCodeConnect Software is designed to
display the data which was uploaded from the
CPAP / Auto-CPAP device, store the
information in a database and provide a secure
interface, allowing the user to query and view
patient and treatment information.
The iCodeConnect Software supports applying
new settings to the CPAP/Auto-CPAP device
remotely from the clinician's PC. | The Server System of Easycare
Online is designed to display the
data which was got from the flow
generator, store the information in a
database and provide a secure
interface, allowing the user to query
and view patient and treatment
information.
The Server System Software
supports to apply new settings to the
flow generator device remotely from
the clinician's PC. | Same as predicate |
| Remoter
Settings
Change
Function | Flow generator settings can be changed,
through wireless module can be made from the
clinicians' PC by iCodeConnect Software. | Flow generator settings can
be
changed, through wireless module
can be made from the clinicians' PC
by Server System. | Same as predicate |
| Data Transfer
Technology | Wireless | Wireless | Same as predicate |
| Connectivity | WiFi | GSM | Both
the
wireless
modules
are
pre-
approved. |
| Features/
Function | Proposed Device | Predicate Device | |
| | iCodeConnect
(510K Number: K160127) | EasyCare Online
(510K Number: K093684) | Comments |
| Therapy
Setting | Pressure
Mode
Comfort | Pressure
Mode
Comfort | Same as predicate |
| Power
Requirements | The wireless module is powered via electrical
connection form the flow generator. | The wireless module is powered via
electrical connection form the flow
generator. | Same as predicate |
| Environmental
Specifications | Operating temperature:
5°C to 35°C
Operating humidity :
15% ~ 93%, Non-condensing
Storage and transport temperature:
-25°C ~ 70°C
Storage and transport humidity:
≤ 93%, Non-condensing | Operating temperature:
5°C to 35°C
Operating humidity :
10 to 95% non-condensing
Storage and transport temperature:
-20°C to 60°C
Storage and transport humidity:
10 to 95% non-condensing | Both the devices meet
the requirement. |
| Degree of
Protection
Against
Electric Shock | Type BF Vertical Applied Part | Type BF Vertical Applied Part | Same as predicate |
| Degree of
Protection
Against Ingress
of Water | IP22 | IP21 | Both the devices meet
the requirement. |
| Sterilization/
Reuse | Not provided sterile
Reusable with cleaning instructions | Not provided sterile
Reusable with cleaning instructions | Same as predicate |

9

510K) Summary

10

510K) Summary

11

510K) Summary

iCodeConnect

Conclusions

Hardware testing carried out for iCodeConnect indicates it meets design and performance functional requirements. Software verification demonstrates that device features and the system configuration functions are substantially equivalent to the predicate device. This information indicates that the iCodeConnect is substantially equivalent to the predicate device.