K Number
K170497
Device Name
V10
Manufacturer
Date Cleared
2017-12-15

(301 days)

Product Code
Regulation Number
870.1130
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The V10 is intended to be used to monitor noninvasive blood pressure (NIBP) - systolic, diastolic and mean arterial pressures, functional arterial oxygen saturation (SpO2), pulse rate (PR), temperature (Temp) for adult, pediatric and neonatal patients in all areas of a hospital-type facilities. Monitor users should be skilled at the level of a technician, doctor, nurse or medical specialist. The V10 is suitable for continuous operation.

Device Description

The V10 vital signs monitor non-invasive blood pressure, pulse rate, non-invasive functional oxygen saturation of arterial hemoglobin for adult, pediatric and neonate patients and body temperature for adult and pediatric patients in general hospital and alternate care facilities by medically trained personnel. This monitor is available for sale only upon the order of a physician or licensed health care professional.

The Mediana V10 vital signs monitor is a lightweight and compact device (249 x 211 x 154 (mm) (WxHxD) and 3.0 kg) powered by AC mains (100-240VAC, 50Hz/60Hz) and also powered by internal battery. The monitor provides patient data and monitoring status on 7-segment LED displays.

AI/ML Overview

The provided text describes the Mediana V10 vital signs monitor, which measures non-invasive blood pressure (NIBP), pulse rate (PR), functional arterial oxygen saturation (SpO2), and temperature (Temp). The document is a 510(k) summary for FDA clearance.

Here's an analysis of the acceptance criteria and study proving the device meets them, based on the provided text:

Acceptance Criteria and Reported Device Performance

The acceptance criteria are implicitly tied to the device's ability to demonstrate substantial equivalence to its predicate device (Mediana V10, K152659) and compliance with relevant international standards. The performance is reported in terms of equivalence to the predicate and compliance with these standards.

1. Table of Acceptance Criteria and Reported Device Performance

ParameterAcceptance Criteria (Implied)Reported Device PerformanceStudy Type
Non-Invasive Blood Pressure (NIBP)Substantially equivalent to predicate device (Mediana V10, K152659). Compliance with ISO 81060-2 standard for NIBP accuracy.NIBP measurement specifications and performance are equivalent to the predicate device. Added display of Mean Arterial Pressure (MAP). Clinical evaluation performed on adult, pediatric, and neonate to verify accuracy. Complies with ISO 81060-2 standard.Clinical (NIBP)
Pulse Rate (PR)Substantially equivalent to predicate device (Mediana V10, K152659).Pulse rate specifications and performance derived from NIBP or SpO2 are equivalent to the predicate device.Not explicitly detailed as a separate clinical study, likely part of NIBP/SpO2 validation.
Pulse Oximetry (SpO2)Substantially equivalent to predicate device (Mediana V10, K152659).SpO2 specifications and performance are equivalent to the predicate device.Not explicitly detailed as a separate clinical study, but implied accuracy is equivalent.
Temperature (Temp)Substantially equivalent to predicate device (Mediana V10, K152659).Temperature specifications and performance are equivalent to the predicate device.Clinical (Temp)
Electrical SafetyCompliance with IEC 60601-1 and IEC 60601-2-49 standards.Tested in accordance with IEC 60601-1 and IEC 60601-2-49.Performance Testing (Electrical Safety)
Electromagnetic Compatibility (EMC)Compliance with IEC 60601-1-2 standard.Tested in accordance with IEC 60601-1-2.Performance Testing (EMC)
BiocompatibilityNo patient contact material (for the monitor itself). Patient contact accessories subject to biocompatibility testing.Monitor does not contain patient contact material. Reference to Section 16 for accessory biocompatibility.Performance Testing (Biocompatibility)
System Verification & Validation (V&V)Compliance with system V&V plan #MDR-EG161022-02.Tested in accordance with system V&V plan #MDR-EG161022-02.Verification and Validation Testing
Risk ManagementRisk analysis identifying potential hazards and documenting mitigation.Risk analysis developed and applied as part of Mediana design control procedure.Design Control/Quality System

2. Sample Sizes Used for the Test Set and Data Provenance

  • NIBP Clinical Evaluation: The text states, "To verify the accuracy of measuring, the clinical evaluation was performed on adult, pediatric and neonate." It does not specify the exact sample size (number of patients) within each age group.
  • Data Provenance: The document does not explicitly state the country of origin for the clinical data or whether the studies were retrospective or prospective. Given the submitter's location (Republic of Korea), it's plausible the studies were conducted there. The nature of clinical evaluations for device clearance typically implies prospective data collection, but this is not explicitly stated.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications

The document does not provide details on the number of experts or their qualifications for establishing ground truth in the clinical evaluations (NIBP and Temperature).

4. Adjudication Method for the Test Set

The document does not describe any specific adjudication method (e.g., 2+1, 3+1) for the clinical test sets.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

No, an MRMC comparative effectiveness study was not done. The device is a vital signs monitor, and the performance evaluation is based on the accuracy of its measurements against established standards and predicate device performance, not on a human-in-the-loop diagnostic task that would typically involve MRMC studies.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

Yes, the primary clinical evaluation for NIBP and Temperature accuracy is a standalone performance assessment of the device's measurement capabilities. The device directly measures these parameters; it is not an AI algorithm assisting human interpretation of images, for instance.

7. The Type of Ground Truth Used

The ground truth for NIBP and Temperature measurements would typically be established using a reference standard method for blood pressure (e.g., intra-arterial measurement or an established oscillometric reference device for NIBP accuracy, and a high-accuracy reference thermometer for temperature) in a clinical setting. While not explicitly stated, compliance with ISO 81060-2 for NIBP implies a rigorous clinical validation against an accepted reference.

8. The Sample Size for the Training Set

The document describes performance testing for a finished device, not a machine learning model that would require a separate "training set." Therefore, there is no mention of a training set or its size.

9. How the Ground Truth for the Training Set Was Established

As there is no mention of a machine learning model or a training set, this question is not applicable. The device's performance is based on its underlying hardware and signal processing, validated through the clinical and performance tests described.

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December 15, 2017

Mediana Co., Ltd. % Charlie Mack President International Regulatory Consultants 7808 Rush Creek Drive Pasco, Washington 99301

Re: K170497

Trade/Device Name: V10 Regulation Number: 21 CFR 870.1130 Regulation Name: Noninvasive Blood Pressure Measurement System Regulatory Class: Class II Product Code: DXN, DOA, FLL Dated: October 24, 2017 Received: November 17, 2017

Dear Charlie Mack:

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 of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820);

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and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR

1000-1050. 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.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

M.A. Hilleman

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

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K170497

Device Name V10

Indications for Use (Describe)

The V10 is intended to be used to monitor noninvasive blood pressure (NIBP) - systolic, diastolic and mean arterial pressures, functional arterial oxygen saturation (SpO2), pulse rate (PR), temperature (Temp) for adult, pediatric and neonatal patients in all areas of a hospital-type facilities. Monitor users should be skilled at the level of a technician, doctor, nurse or medical specialist. The V10 is suitable for continuous operation.

Note: Hospital use typically includes such as general care floors, operating rooms, special procedure areas, intensive and critical care area, within the hospital-type facilities include physician office-based facilities, sleep labs, skilled nursing facilities, surgical centers, and sub acute care centers.

Note: The medically skilled and trained user can be clinicians like doctors and nurses who know how to take and interpret a patient's vital signs. These clinicians must take direct responsibility for the patient's life. This can include care-givers or medically trained interpreters who are authorized under the appropriate clinical facility procedures to support patient care. Any inappropriate setting, especially the alarm notification settings, can lead to a hazardous situation that injures the patient, harms the patient, or threatent's life. This equipment should only be operated by trained users who can adjust the settings of the vital signs monitor.

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) ❌ Prescription Use (Part 21 CFR 801 Subpart D) ❍ Over-The-Counter Use (21 CFR 801 Subpart C)
❌ Prescription Use (Part 21 CFR 801 Subpart D) ❍ Over-The-Counter Use (21 CFR 801 Subpart C)

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510(k) Summary of Safety and Effectiveness

Submitter

Mediana Co., Ltd. 132, Donghwagongdan-ro, Munmak-eup, Wonju-si, Gangwon-do, Republic of Korea Tel) +82-33-742-5400 Fax) +82-33-742-5483

Company Contact: Ju-yeon, Song

Date Summary Prepared: October 20, 2017

Device Name

Trade Name:V10
Common Name:Vital Signs Monitor
Classification Name:NIBP measurement system (21CFR870.1130), also containsnon-invasive pulse oximetry, SpO2 (21CFR870.2700) andclinical electronic thermometer (21CFR880.2910)
Classification:Class II
Product Code:DXN, DQA, FLL

Predicate Devices (Legally Marketed Devices)

The predicate device for the V10 are:

  • Mediana Co., Ltd. Vital Signs Monitors, V10 i Cleared by FDA through 510(k) No. K152659

Device Description

The V10 vital signs monitor non-invasive blood pressure, pulse rate, non-invasive functional oxygen saturation of arterial hemoglobin for adult, pediatric and neonate patients and body temperature for adult and pediatric patients in general hospital and alternate care facilities by medically trained personnel. This monitor is available for sale only upon the order of a physician or licensed health care professional.

The Mediana V10 vital signs monitor is a lightweight and compact device (249 x 211 x 154 (mm) (WxHxD) and 3.0 kg) powered by AC mains (100-240VAC, 50Hz/60Hz) and also powered by internal battery. The monitor provides patient data and monitoring status on 7-segment LED displays.

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Intended Use

The V10 is intended to be used to monitor noninvasive blood pressure (NIBP) - systolic, diastolic and mean arterial pressures, functional arterial oxygen saturation (SpO2), pulse rate (PR), temperature (Temp) for adult, pediatric and neonatal patients in all areas of a hospital and hospital-type facilities. Monitor users should be skilled at the level of a technician, doctor, nurse or medical specialist. The V10 is suitable for continuous operation.

  • Note: Hospital use typically includes such as general care floors, operating rooms, special procedure areas, intensive and critical care area, within the hospital. Hospital-type facilities include physician office-based facilities, sleep labs, skilled nursing facilities, surqical centers, and sub acute care centers.
  • Note: The medically skilled and trained user can be clinicians like doctors and nurses who know how to take and interpret a patient's vital signs. These clinicians must take direct responsibility for the patient's life. This can include care-givers or medically trained interpreters who are authorized under the appropriate clinical facility procedures to support patient care. Any inappropriate setting, especially the alarm limit or alarm notification settings, can lead to a hazardous situation that injures the patient, harms the patient, or threatens the patient's life. This equipment should only be operated by trained users who can adjust the settings of the vital signs monitor.

Summary of Technical Characteristics of the Device Compared to the Predicate Devices (Legally Marketed Devices)

The subject device (Mediana vital signs monitor, Model V10) is substantially equivalent to the predicate device (current Mediana vital signs monitor, Model V10). They have the same technological characteristics and material, and they are comparable in key safety and effectiveness features and software design and have the same intended uses and basic operation modes as the predicate device.

  • The Non-Invasive Blood Pressure (NIBP) measurement specifications and performance are equivalent to the predicate device. The subject device is partially modified to display mean arterial pressure (MAP) value. The subject device uses the oscillometric technique to measure non-invasive blood pressure. This measurement technique of blood pressure is not changed and the mean arterial pressure is additionally displayed on LED displays. To verify the accuracy of measuring, the clinical evaluation was performed on adult, pediatric and neonate. The V10 vital signs monitor complies with the testing validations defined in ISO 81060-2 standard so that it is substantially equivalent to predicate devices as Mediana model V10 vital signs monitor.
  • . The Pulse rate specifications and performance derived from either Non-Invasive Blood Pressure (NIBP) or Pulse Oximetry (SpO2) are equivalent to the predicate device.
  • . The Pulse Oximetry (SpO2) specifications and performance are equivalent to the predicate device.
  • i The Temperature specifications and performance are equivalent to the predicate device.

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Summary of Performance Testing

. Biocompatibility Testing

The Mediana vital signs monitor, Model V10 does not contain any patient contact material. See Section 16 "Biocompatibility" of this submission for biocompatibility testing of patient contact accessories.

. Electrical Safety and Electromagnetic Compatibility Testing

The Mediana vital signs monitor, Model V10 substantially has been tested in accordance with the IEC 60601-1, IEC 60601-2-49 standards for safety and the IEC 60601-1-2 standard for EMC.

ı Verification and Validation Testing

The Mediana vital signs monitor, Model V10 substantially has been tested in accordance with the system V & V plan #MDR-EG161022-02 included with the submission.

י Clinical Testing

The Mediana vital signs monitor, Model V10 substantially has been tested in accordance with the NIBP and Temp clinical investigations. See Section 20 "Performance testing -Clinical" of this submission.

A risk analysis identifying potential hazards and documenting mitigation of the hazards has been developed and applied as part of Mediana design control procedure. Mediana's quality system confirms to 21CFR820, ISO13485 and CMDCAS ISO 13485 certified by DNV (Det Norske Veritas).

Conclusions

As stated above, the V10 is safe and effective, complies with the appropriate medical device guidance and standards and is substantially equivalent to the predicate device.

§ 870.1130 Noninvasive blood pressure measurement system.

(a)
Identification. A noninvasive blood pressure measurement system is a device that provides a signal from which systolic, diastolic, mean, or any combination of the three pressures can be derived through the use of tranducers placed on the surface of the body.(b)
Classification. Class II (performance standards).