(134 days)
The CARESCAPE Respiratory Modules (E-SCO, E-SCOV, E-SCOVX, E-sCAIO, ESCAIOV, E-SCAIOVX) are indicated for use with a host device for monitoring respiratory parameters (CO2, O2, N2O, anesthetic agents, anesthetic agent identification and respiratory rate) and ventilatory parameters (airway pressure, flow and volume) of adult, pediatric and neonatal patients and gas exchange parameters (VCO2, VO2) of adult and pediatric patients.
When monitoring neonatal or other patients that have high respiration rate or low tidal volume these modules shall be used within the limits of respiration rates and tidal volumes to ensure specified measurement accuracy.
These modules are intended for use by qualified medical personnel only.
The CARESCAPE Respiratory Modules E-sCO, E-sCOV, EsCOVX, E-sCAiO, E-sCAiOV, E-sCAiOVX and accessories measure respiratory parameters (concentrations of Carbon Dioxide. Oxygen, Nitrous Oxide and anesthetic agents in the patient's breath, as well as the patient's respiration rate), ventilatory parameters (airway pressure, flow and breathing volumes) and gas exchange parameters (oxygen consumption and carbon dioxide production) of hospital patients.
Parameters measured by the CARESCAPE Respiratory Modules are CO2. N2O. O2. Anesthetic agents, Agent ID, Spirometry, oxygen consumption (VO2) and carbon dioxide production (VCO2) depending on the model used. The CARESCAPE Respiratory Modules is a family of single-width plug-in parameter modules for modular monitoring systems. The CARESCAPE Respiratory Modules are of the diverting type, which means that a small continuous flow of gas is sampled from the patient's breath to the module for measuring the gas concentrations. The CARESCAPE Respiratory Modules acquire the detected signals from the sensors of the modules, calculate the parameter values and communicate them to the host device. The CARESCAPE Respiratory Modules measure the patient's respiration rate and activate a status signal if no breaths are detected in 20 second time and the modules activate relevant status signals upon detecting failures or anomalies in the operation of the module hardware, software or gas sampling system.
The CARESCAPE Respiratory Modules do not trigger or issue any physiological or technical alarms by themselves. All management of alarms is entirely performed by the host devices based on parameter and status data received from the modules, as well as on the alarm condition data stored in the host device.
The provided document is a 510(k) premarket notification for the GE Healthcare CARESCAPE Respiratory Modules. This document describes the device, its intended use, and its substantial equivalence to a predicate device (K150245). It does not contain information about acceptance criteria and study data for the device's performance that would typically be found in a clinical study report.
Here's a breakdown of why the requested information cannot be fully provided from this document:
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A table of acceptance criteria and the reported device performance: This document states that "The CARESCAPE Respiratory Modules and accessories is as safe and effective as the predicate device" and that "Performance testing (Verification)" was conducted. However, it does not explicitly list quantitative acceptance criteria or the specific performance results against those criteria (e.g., accuracy, precision, bias for gas measurements). It only indicates that "an evaluation was performed to account for gas return connection and gas return filter impact on the gas measurement accuracy, sample flow measurement accuracy as well as pump and filter lifetime."
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Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective): The document states that no clinical studies were required, and non-clinical tests were performed. It does not provide details on sample sizes for these tests or data provenance.
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Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience): This information is not present as the document focuses on device modifications and compliance with standards rather than clinical validation involving expert-established ground truth.
-
Adjudication method (e.g. 2+1, 3+1, none) for the test set: Not applicable, as expert adjudication for a test set is not described.
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If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance: This is not applicable. The device is a respiratory gas module, not an AI-assisted diagnostic tool for "human readers."
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If a standalone (i.e. algorithm only without human-in-the loop performance) was done: The document describes a medical device, not an AI algorithm in the context of standalone performance studies for AI. Its performance is inherent to its sensors and processing of physiological parameters.
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The type of ground truth used (expert consensus, pathology, outcomes data, etc): For non-clinical tests, ground truth would typically refer to established reference measurements or calibrated standards. The document doesn't explicitly detail the "ground truth" methods used for the non-clinical evaluations but implies standard metrological practices for testing medical devices.
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The sample size for the training set: Not applicable, as there's no mention of a machine learning or AI training set.
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How the ground truth for the training set was established: Not applicable for the same reason as above.
Summary based on the provided document:
The document focuses on demonstrating substantial equivalence to a predicate device (K150245) for premarket notification, particularly highlighting that recent modifications do not introduce new technology or software. The changes mainly involve the addition of a "sample gas return feature."
Here's what can be extracted regarding the study that proves the device meets the acceptance criteria (though specific criteria and results are generalized):
Study Type: Non-clinical testing and evaluation were performed. No clinical studies were required.
Purpose of the Study: To ensure that the addition of the sample gas return feature and ongoing product maintenance activities do not affect product safety and performance, and that the device remains substantially equivalent to its predicate.
Specific Evaluations Mentioned:
- Evaluation of gas return connection and gas return filter impact on:
- Gas measurement accuracy
- Sample flow measurement accuracy
- Pump and filter lifetime
- System level Volatile Organic Component (VOC) and particulate matter testing for new components and materials in the dry gas path.
Table of Acceptance Criteria and Reported Device Performance (Generalized based on the document):
| Parameter Evaluated | Acceptance Criteria (Implied by Substantial Equivalence and Safety/Performance Statements) | Reported Device Performance (Implied) |
|---|---|---|
| Safety and Effectiveness | As safe and effective as the predicate device (K150245). | The device is concluded to be as safe and effective as the predicate device. |
| Gas Measurement Accuracy | Measurement accuracy maintained within specified limits for respiratory parameters (CO2, O2, N2O, anesthetic agents). | Evaluation performed, no adverse impact from gas return connection/filter; performance is "as effective" as predicate. |
| Sample Flow Measurement Accuracy | Accuracy maintained within specified limits. | Evaluation performed, no adverse impact from gas return connection/filter; performance is "as effective" as predicate. |
| Pump and Filter Lifetime | Maintained within expected operational parameters. | Evaluation performed, no adverse impact from gas return connection/filter. |
| VOC and Particulate Matter (new components/materials) | Compliance with relevant safety and material standards. | System level testing performed and found acceptable. |
| Compliance with Voluntary Standards | Compliance with a list of IEC and ISO standards (e.g., IEC 60601-1, IEC 60601-1-2, IEC 62304, ISO 21647, ISO 14971, etc.). | The CARESCAPE Respiratory Modules were designed and tested for compliance to these standards. |
| Software, Hardware, Mechanics, Accessories (after modification) | No changes or additions beyond the gas return feature that would impact safety or performance from the predicate device. | "No changes or additions to module software, hardware, mechanics or accessories related to the addition of sample gas return feature." |
Data Provenance and Sample Size:
- Sample Size (Test Set): Not specified in the document. The testing was non-clinical (laboratory/bench testing).
- Data Provenance: Implied to be from GE Healthcare's internal testing facilities (Finland, given the company's address).
- Retrospective/Prospective: Non-clinical verification and validation testing would typically be prospective (designed to verify specific requirements).
Ground Truth: For non-clinical tests, ground truth would be established through calibrated reference instruments and known gas concentrations. Specific details are not provided.
Training Set: Not applicable as this is not an AI/ML device in the context of self-learning algorithms.
In essence, this document serves as a regulatory submission arguing for equivalence based on adherence to standards and internal non-clinical evaluations, rather than a detailed report of a clinical performance study with specific acceptance criteria and outcome data as one might expect for a novel device or AI algorithm.
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Image /page/0/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an image of three stylized human profiles facing to the right, with a triple-line design representing the bodies.
Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
August 17, 2017
GE Healthcare Finland Oy Anna Pehrsson Regulatory Affairs Leader Kuortaneenkatu 2, Helsinki FI-00510 FINLAND
Re: K171028
Trade/Device Name: CARESCAPE Respiratory Modules, E-sCO, E-sCOV, E-sCOVX, EsCAiO, E-sCAiOV, E-sCAiOVX and accessories Regulation Number: 21 CFR 868.1400 Regulation Name: Carbon Dioxide Gas Analyzer Regulatory Class: Class II Product Code: CCK, CCL, BZK, CAP, CBR, BZL, CBQ, CBS, NHO, NHQ, NHP Dated: July 5, 2017 Received: July 17, 2017
Dear Anna Pehrsson:
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
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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.
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 (DICE) 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 (DICE) 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.
Tara A. Ryan -S 2017.08.17 06:34:11 -04'00' for Lori Wiggins Acting 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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| Form Approved: OMB No. | 0910-0120 |
|---|---|
| Expiration Date: | 06/30/2020 |
| See | PRA Statement below. |
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
Indications for Use
| 510(k) Number (if known) | K171028 |
|---|---|
| Device Name | CARESCAPE Respiratory Modules, E-SCO, E-SCOV, E-SCOVX, ESCAIO, E-sCAIOV, E-SCAIOVX and accessories |
| Indications for Use (Describe) | The CARESCAPE Respiratory Modules (E-SCO, E-SCOV, E-SCOVX, E-sCAIO, ESCAIOV, E-SCAIOVX) are indicated for use with a host device for monitoring respiratory parameters (CO2, O2, N2O, anesthetic agents, anesthetic agent identification and respiratory rate) and ventilatory parameters (airway pressure, flow and volume) of adult, pediatric and neonatal patients and gas exchange parameters (VCO2, VO2) of adult and pediatric patients. |
| When monitoring neonatal or other patients that have high respiration rate or low tidal volume these modules shall be used within the limits of respiration rates and tidal volumes to ensure specified measurement accuracy. | |
| These modules are intended for use by qualified medical personnel only. |
| 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.
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
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information unless it displays a currently valid OMB number."
FORM FDA 3881 (7/17)
Page 1 of 1
PSC Publishing Services (301) 413-674) EF
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Image /page/3/Picture/0 description: The image shows the logo for General Electric (GE). The logo is a blue circle with the letters "GE" in a stylized font in the center. There are three white teardrop shapes around the outside of the circle. The logo is simple and recognizable, and it is associated with a well-known and respected company.
GE Healthcare Finland Oy
Kuortaneenkatu 2, P.O. Box 900 FI-00031 GE Finland T: +358 10 39411
F: +358 9 1463310
510(k) Summary
In accordance with 21 CFR 807.92 the following summary of information is provided:
| Date:Submitter: | July 5, 2017GE Healthcare Finland Oy,Kuortaneenkatu 2. Helsinki,FI-00510 FINLAND |
|---|---|
| Primary Contact Person: | Anna Pehrsson |
| Regulatory Affairs Leader | |
| GE Healthcare Finland Oy | |
| phone (+358) 40-569-5018 | |
| email anna.pehrsson@ge.com | |
| Secondary Contact Person: | Rauno Ruoho |
| Regulatory Affairs Director | |
| GE Healthcare Finland Oy | |
| phone (+358) 10-394-3624 | |
| email rauno.ruoho@ge.com | |
| Device names: |
| Trade Name: | CARESCAPE Respiratory Modules, E-sCO, E-sCOV, E-sCOVX, E-sCAiO, E-sCAiOV, E-sCAiOVX and accessories |
|---|---|
| Common/Usual Name: | Respiratory gas module and accessories |
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Image /page/4/Picture/0 description: The image shows the logo for General Electric (GE). The logo is a blue circle with the letters "GE" in a stylized font in the center. There are several water droplet shapes surrounding the circle. The logo is simple and recognizable.
Classification Name: 21 CFR 868.1400 Analyzer, Gas, Carbon-Dioxide, Gaseous Phase CCK Product code: Additional Classification 21 CFR 868.1720 Analyzer, Gas, Oxygen, Gaseous-phase Names: 21 CFR 868.1850 Spirometer, Monitoring (W/WO Alarm) 21 CFR 868.2600 Monitor, Airway Pressure (Includes gauge and/or alarm) 21 CFR 868.1700 Analyzer, Gas, Nitrous-Oxide, Gaseous-phase (Anesthetic conc) 21 CFR 868.1730 Computer, Oxygen-uptake 21 CFR 868.1500 Analyzer, Gas, Enflurane, Gaseous-phase (Anesthetic conc.) 21 CFR 868.1620 Analyzer, Gas, Halothane Gaseous-phase (Anesthetic conc.) 21 CFR 868.1500 Analyzer, Gas, Desflurane, Gaseous-phase (Anesthetic conc.) 21 CFR 868.1500 Analyzer, Gas, Isoflurane Gaseous-phase (Anesthetic conc.) 21 CFR 868.1500 Analyzer, Gas, Sevoflurane, Gaseous-phase (Anesthetic conc) Additional Product Codes: CCL, BZK, CAP, CBR, BZL, CBQ, CBS, NHO, NHQ, NHP Predicate Device(s): K150245: CARESCAPE Respiratory Modules, E-sCO, E-sCOV, E-sCOVX, E-sCAiO, E-sCAiOV, E-sCAiOVX Device Description: The CARESCAPE Respiratory Modules E-sCO, E-sCOV, EsCOVX, E-sCAiO, E-sCAiOV, E-sCAiOVX and accessories measure respiratory parameters (concentrations of Carbon Dioxide. Oxygen, Nitrous Oxide and anesthetic agents in the
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Image /page/5/Picture/0 description: The image shows the logo for General Electric (GE). The logo is a blue circle with the letters "GE" in white inside. There are three water droplet shapes around the circle. The logo is simple and recognizable.
patient's breath, as well as the patient's respiration rate), ventilatory parameters (airway pressure, flow and breathing volumes) and gas exchange parameters (oxygen consumption and carbon dioxide production) of hospital patients.
Parameters measured by the CARESCAPE Respiratory Modules are CO2. N2O. O2. Anesthetic agents, Agent ID, Spirometry, oxygen consumption (VO2) and carbon dioxide production (VCO2) depending on the model used. The CARESCAPE Respiratory Modules is a family of single-width plug-in parameter modules for modular monitoring systems. The CARESCAPE Respiratory Modules are of the diverting type, which means that a small continuous flow of gas is sampled from the patient's breath to the module for measuring the gas concentrations. The CARESCAPE Respiratory Modules acquire the detected signals from the sensors of the modules, calculate the parameter values and communicate them to the host device. The CARESCAPE Respiratory Modules measure the patient's respiration rate and activate a status signal if no breaths are detected in 20 second time and the modules activate relevant status signals upon detecting failures or anomalies in the operation of the module hardware, software or gas sampling system.
The CARESCAPE Respiratory Modules do not trigger or issue any physiological or technical alarms by themselves. All management of alarms is entirely performed by the host devices based on parameter and status data received from the modules, as well as on the alarm condition data stored in the host device.
- Intended Use: The CARESCAPE Respiratory Modules (E-sCO, E-sCOV, EsCOVX, E-sCAiO, E-sCAiOV, E-sCAiOVX) are indicated for use with a host device for monitoring respiratory parameters (CO2, O2, N2O, anesthetic agents, anesthetic agent identification and respiratory rate) and ventilatory parameters (airway pressure, flow and volume) of adult, pediatric and neonatal patients and gas exchange parameters (VCO2, VO2) of adult and pediatric patients.
When monitoring neonatal or other patients that have high respiration rate or low tidal volume these modules shall be used within the limits of respiration rates and tidal volumes to ensure specified measurement accuracy.
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Image /page/6/Picture/0 description: The image shows the logo for General Electric (GE). The logo consists of the letters 'GE' in a stylized, cursive font, enclosed within a blue circle. There are decorative, water-like flourishes around the perimeter of the circle, adding a touch of elegance to the design. The logo is simple, recognizable, and represents a well-established global brand.
These modules are intended for use by qualified medical personnel only.
The modified CARESCAPE Respiratory Modules E-sCO. E-Technology: sCOV, E-sCOVX, E-sCAiO, E-sCAiOV, E-sCAiOVX and accessories do not add any new technology or software to existing predicate device CARESCAPE Respiratory Modules.
The sample gas return feature is added to CARESCAPE Respiratory Modules. The feature may only be used with host device anesthesia machines which have 510(k) clearance for the gas return feature.
The technology of the CARESCAPE Respiratory Modules and accessories is the same as in the predicate device.
The CARESCAPE Respiratory Modules and accessories is as safe and effective as the predicate device.
Determination of Substantial Summary of Non-Clinical Tests Equivalence:
The CARESCAPE Respiratory Modules and its applications comply with voluntary standards as detailed below. The following quality assurance measures were applied to the development of the system:
- Risk Analysis
- Requirements Reviews
- Design Reviews ●
- . Testing on unit level (Module verification)
- Integration testing (System verification)
- Final acceptance testing (Validation) .
- Performance testing (Verification)
- Safety testing (Verification) ●
There are no changes or additions to module software, hardware, mechanics or accessories related to the addition of sample gas return feature. Based on this, testing of the modules is only done to cover any possible effects introduced by the gas return circuit in the host device. An evaluation was performed to account for gas return connection and gas return filter impact on the gas measurement accuracy, sample flow measurement accuracy as well as pump and filter lifetime. System level
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Image /page/7/Picture/0 description: The image shows the logo for General Electric (GE). The logo consists of the letters 'GE' in a stylized script, enclosed within a blue circle. The circle is surrounded by swirling, water-like shapes, also in blue. The overall design is clean and recognizable, representing the brand identity of GE.
Volatile Organic Component (VOC) and particulate matter testing was performed to evaluate new components and materials in the dry gas path.
Changes to the labeling, hardware and components of the CARESCAPE Respiratory Modules since the last clearance of the CARESCAPE Respiratory Modules (K150245) reflect ongoing product maintenance activities and do not affect product safety and performance. It is concluded that the CARESCAPE Respiratory Modules and accessories are substantially equivalent to the predicate device.
The CARESCAPE Respiratory Modules were designed and tested for compliance to the following standards:
-
- IEC 60601-1:1988, A1:1991, A2:1995, Corr1:1995, Medical electrical equipment Part 1: General Requirements for Safety - Second Edition
-
- IEC 60601-1-2:2001, A1:2004, Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic compatibility - Requirements and tests - Edition 2.0
-
- IEC 60601-1-2:2007, Medical electrical equipment --Part 1-2: General requirements for basic safety and essential standard: Electromagnetic compatibility - Requirements and tests
-
- IEC 60601-1-4:1996 + A1:1999, Medical Electrical Equipment - Part 1-4: General Requirements for Safety - Collateral Standard: Programmable Electrical Medical Systems
-
- IEC 62304:2006, Medical device software Software life-cycle processes
-
- IEC 60601-1-6:2006, Medical electrical equipment-Part 1-6: General requirements for basic safety and essential performance - Collateral Standard: Usability - Edition 2.0
-
- IEC 60601-1-6:2010. Medical electrical equipment -Part 1-6: General requirements for basic safety and essential performance - Collateral standard: Usability
- IEC 62366:2007. Medical Devices Application of 8. usability engineering to medical devices
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Image /page/8/Picture/0 description: The image shows the logo for General Electric (GE). The logo is a blue circle with the letters "GE" in a stylized font in the center. There are four water droplet shapes surrounding the circle. The logo is simple and recognizable.
-
- ISO 21647:2004 + C1:2005, Medical electrical equipment - Particular requirements for the basic safety and essential performance of respiratory gas monitors
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- EN 1041:2008, Information supplied by the manufacturer of medical devices
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- ISO 14971: 2007 Medical devices Application of risk management to medical devices
The subject of this premarket submission, CARESCAPE Summary of Clinical Tests: Respiratory Modules, E-sCO, E-sCOV, E-sCOVX, E-sCAiO, E-sCAiOV, E-sCAiOVX and accessories did not require clinical studies to support substantial equivalence.
GE Healthcare considers the CARESCAPE Respiratory Conclusion: Modules, E-sCO, E-sCOV, E-sCOVX, E-sCAiO, E-sCAiOV, E-sCAiOVX and accessories to be as safe, as effective, and performance is substantially equivalent to the predicate device.
§ 868.1400 Carbon dioxide gas analyzer.
(a)
Identification. A carbon dioxide gas analyzer is a device intended to measure the concentration of carbon dioxide in a gas mixture to aid in determining the patient's ventilatory, circulatory, and metabolic status. The device may use techniques such as chemical titration, absorption of infrared radiation, gas chromatography, or mass spectrometry.(b)
Classification. Class II (performance standards).