K Number
K172226
Device Name
MX40 Release B.07
Date Cleared
2017-11-09

(107 days)

Regulation Number
870.1025
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The intended use of the MX40 is to: The device is intended for monitoring and recording of and to generate alarms for, multiple physiological parameters of adults and pediatrics in a hospital environment and during patient transport inside hospitals. Not intended for home use. Intended for use by health care professionals. Indications for Use: Indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients. Intended for monitoring and recording of, and to generate alarms for, multiple physiological parameters of adults and pediatrics in hospital environments and during transport inside hospitals. Rx only.
Device Description
The MX40 is a multi-parameter, battery operated patient monitor that is small enough to be worn by the patient. Its multi-radio design enables device operation within existing Philips telemetry networks while providing compatibility to the IntelliVue Information Center solutions. Along with infrastructure radios, the MX40 integrates a short-range radio (SRR), enabling wireless connectivity to the IntelliVue family of monitors. Acquired physiological data, along with physiological alarms and technical alert information are provided to multiple monitoring systems (local, bedsides and /or information systems).
More Information

No
The summary does not mention AI, ML, or related terms, and the device description focuses on hardware and connectivity for physiological monitoring.

No.
The device is a patient monitor intended for monitoring and recording physiological parameters and generating alarms, not for treating or providing therapy.

No

The device is described as a "multi-parameter, battery operated patient monitor" intended for "monitoring and recording of... multiple physiological parameters." It does not mention interpretation or diagnosis based on these parameters.

No

The device description explicitly states it is a "multi-parameter, battery operated patient monitor" and mentions hardware components like "multi-radio design" and "short-range radio (SRR)".

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

Here's why:

  • Intended Use/Indications for Use: The intended use and indications clearly state that the device is for "monitoring and recording of and to generate alarms for, multiple physiological parameters of adults and pediatrics". This involves measuring physiological signals directly from the patient's body (e.g., heart rate, blood pressure, oxygen saturation).
  • Device Description: The description reinforces this by stating it's a "multi-parameter, battery operated patient monitor" that acquires "physiological data".
  • Lack of IVD Characteristics: An IVD device is used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. This device does not process or analyze such specimens.

The device is a patient monitor, which is a different category of medical device than an IVD.

N/A

Intended Use / Indications for Use

The intended use of the MX40 is to: The device is intended for monitoring and recording of and to generate alarms for, multiple physiological parameters of adults and pediatrics in a hospital environment and during patient transport inside hospitals. Not intended for home use. Intended for use by health care professionals.

Indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients. Intended for monitoring and recording of, and to generate alarms for, multiple physiological parameters of adults and pediatrics in hospital environments and during transport inside hospitals.

Product codes

MHX, DSI, DOA, DSA, DRW, DRG, MLD, MSX

Device Description

The MX40 is a multi-parameter, battery operated patient monitor that is small enough to be worn by the patient. Its multi-radio design enables device operation within existing Philips telemetry networks while providing compatibility to the IntelliVue Information Center solutions. Along with infrastructure radios, the MX40 integrates a short-range radio (SRR), enabling wireless connectivity to the IntelliVue family of monitors. Acquired physiological data, along with physiological alarms and technical alert information are provided to multiple monitoring systems (local, bedsides and /or information systems).

Previously cleared compatible Accessories are still in use, no new accessories in this filing. The MX40 is compatible with the legally marketed Philips CL SpO2 Pod and CL NBP Pod (K101600, K111905). The CL SpO2/NBP Pods are small battery powered devices that measure oxygen saturation, pulse rate and blood pressure, pulse rate, respectively. A list of all accessories is available in the Instructions for Use.

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

adults and pediatrics

Intended User / Care Setting

health care professionals in a hospital environment and during patient transport inside hospitals. Not intended for home use.

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)

No performance standards have been issued under the authority of Section 514. The MX40 Release B.07 was tested in accordance with Philips verification and validation processes. Quality Assurance measures were applied to the system design and development, including:

  • Risk Analysis
  • Product Specifications
  • Design Reviews
  • Verification & Validations

Clinical Performance testing for MX40 Release B.07 was not performed, as there were no new clinical applications that had hazards or risk mitigations that required a clinical performance testing to support equivalence.

Verification, validation, and testing activities, where required to establish the performance, functionality, and reliability characteristics of the new device with respect to the predicate are performed. Testing involved system level tests, performance tests, and safety testing from hazard analysis. Pass/Fail criteria were based on the specifications cleared for the predicate device and test results showed substantial equivalence. The MX40 Release B.07 meets all defined reliability requirements and performance claims.

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

Not Found

Predicate Device(s)

K103646

Reference Device(s)

K113125, K101600, K111905

Predetermined Change Control Plan (PCCP) - All Relevant Information

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

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the seal of the Department of Health & Human Services. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the FDA logo is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

November 9, 2017

Philips Medical Systems Theresa Poole Regulatory Specialist 3000 Minuteman Road Andover, Massachusetts 01810

Re: K172226

Trade/Device Name: MX40 Release B.07 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, DSI, DOA, DSA, DRW, DRG, MLD, MSX Dated: July 18, 2017 Received: July 25, 2017

Dear Theresa Poole:

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 (OS) regulation (21 CFR Part 820);

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Page 2 - Theresa Poole

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 mediation-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. Wilhelm

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

Enclosure

2

Indications for Use

510(k) Number (if known)

K172226

Device Name

MX40 Release B.07

Indications for Use (Describe)

The intended use of the MX40 is to:

The device is intended for monitoring and recording of and to generate alarms for, multiple physiological parameters of adults and pediatrics in a hospital environment and during patient transport inside hospitals. Not intended for home use. Intended for use by health care professionals.

Indications for Use

Indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients. Intended for monitoring and recording of, and to generate alarms for, multiple physiological parameters of adults and pediatrics in hospital environments and during transport inside hospitals.

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.

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Image /page/3/Picture/1 description: The image shows the word "PHILIPS" in large, bold, blue letters. Below the word "PHILIPS" is the text "MX40 Release B.07" in a smaller font size. Underneath that, the text "Special 510(k)" is displayed.

510(k) Summary MX40 Release B.07

This 510(k) summary of safety and effectiveness information is prepared in accordance with 21 CFR 807.92(c).

Date Prepared: 17 July 2017

I. Submitter's name and address

| Manufacturer: | Philips Medical Systems
3000 Minuteman Road
Andover, MA 01810 USA |

----------------------------------------------------------------------------------------

Theresa Poole Contact Person: Regulatory Affairs Specialist Philips Medical Systems 3000 Minuteman Road, MS0480 Andover, MA 01810-1099

Tel: 978 659 7621 Fax: 978 685 5624 Email: theresa.poole@philips.com

II. Device information

Device Name: MX40 Release B.07 Common Name: Physiological Monitor, Patient Monitor Classification panel: 74 - Cardiovascular

Classification names are as follows:

ClassificationProCodeDescription
§870.1025, IIDSIDetector and alarm, arrhythmia
§870.1025, IIMLDMonitor, ST Segment with Alarm
§870.1025, IIMHXMonitor, Physiological, Patient (with arrhythmia detection or alarms)
§870.2350, IIDRWElectrocardiograph, Lead Switching Adapter
§870.2700, IIDQAOximeter
§870.2900, IDSACable, Transducer and Electrode, incl. Patient Connector
§870.2300, IIMSXSystem, Network and Communication, Physiological Monitors
§870.2910, IIDRGTransmitters and Receivers, Physiological Signal, Radiofrequency
§870.2300, IIDRTMonitor, Cardiac (Incl. Cardiotachometer & Rate Alarm)

III. Predicate device information

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Image /page/4/Picture/0 description: The image shows the word "PHILIPS" in a large, bold, blue font. Below the brand name, the text "MX40 Release B.07" is displayed, followed by "Special 510(k)" on the next line. The text is in a smaller, black font, providing additional context or information related to the Philips brand.

INTELLIVUE MX40 PATIENT MONITOR Trade name: Manufacturer: Philips Medical Systems 510(k) clearance: K103646 Classification name: Monitor, Physiological, Patient (With Arrhythmia Detection Or Alarms) Device class: Class II Classification regulation: 21 CFR 870.1025 Classification panel: Cardiovascular Product code: MHX

IV.Device Description

The MX40 is a multi-parameter, battery operated patient monitor that is small enough to be worn by the patient. Its multi-radio design enables device operation within existing Philips telemetry networks while providing compatibility to the IntelliVue Information Center solutions. Along with infrastructure radios, the MX40 integrates a short-range radio (SRR), enabling wireless connectivity to the IntelliVue family of monitors. Acquired physiological data, along with physiological alarms and technical alert information are provided to multiple monitoring systems (local, bedsides and /or information systems).

Previously cleared compatible Accessories are still in use, no new accessories in this filing. The MX40 is compatible with the legally marketed Philips CL SpO2 Pod and CL NBP Pod (K101600, K111905). The CL SpO2/NBP Pods are small battery powered devices that measure oxygen saturation, pulse rate and blood pressure, pulse rate, respectively. A list of all accessories is available in the Instructions for Use.

V. Intended use/ Indications for Use

| MX40 Intended

Use/Indications for UseThe intended use of the MX40 is to:
The device is intended for monitoring and recording of and to generate
alarms for, multiple physiological parameters of adults and pediatrics in a
hospital environment and during patient transport inside hospitals. Not
intended for home use. Intended for use by health care professionals.
Indications for Use
Indicated for use by health care professionals whenever there is a need
for monitoring the physiological parameters of patients. Intended for
monitoring and recording of, and to generate alarms for, multiple
physiological parameters of adults and pediatrics in hospital
environments and during transport inside hospitals.
Rx only.

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Image /page/5/Picture/0 description: The image shows the word "PHILIPS" in a large, bold, blue font. Below the brand name, the text "MX40 Release B.07" is displayed in a smaller, black font. Underneath that, the phrase "Special 510(k)" is also written in black.

Comparison of Technological Characteristics with the Predicate Device

The device has the same technological characteristics as the legally marketed predicate devices. The change summary includes items listed in the table starting on page 4.

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Image /page/6/Picture/0 description: The image shows the word "PHILIPS" in large, blue, sans-serif font. Below the word "PHILIPS" is the text "MX40 Release B.07" and "Special 510(k)" in a smaller, black, sans-serif font. The text appears to be a label or identifier for a product or software release.

| Key Characteristic | Predicate MX40
K103646, K113125 | MX40 Release B.07 |
|---------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Indications for Use
Intended Use
Statement | Indicated for use by health care
professionals whenever there is a need
for monitoring the physiological
parameters of patients. Intended for
monitoring and recording of, and to
generate alarms for, multiple
physiological parameters of adults and
pediatrics in hospital environments and
during transport inside hospitals.
Intended for monitoring and recording of
and to generate alarms for, multiple
physiological parameters of adults and
pediatrics in a hospital environment and
during patient transport inside hospitals.
Not intended for home use. Intended for
use by health care professionals. | Same |
| Target Patient
Population | Adult and pediatric | Same |
| Users | Trained health care professionals | Same |
| System Interface | Connects to the Philips IntelliVue
Information Center for transmission of
patient parameters | Same |
| Care and Cleaning | Available instructions in IFU | Same |
| Communication | Smart Hopping 1.4GHz (CTS) Radio
802.11a/b/g/h Radio
Short Range Radio 2.4 GHz | Same |
| Multi-Parameter
patient monitoring | ECG, Resp, SpO2, and NIBP (data
acquisition for NIBP is not done by the
MX40) | Same |
| Device Software,
Device safety,
environmental
specifications, and all
specifications of
measurement
characteristics | Unchanged, as previously submitted | 1. Heart Rate Alarm
from Pulse,
requires PIC IX
version C.01 or
higher.
2. Auto report
battery inop
(Technical Alert)
when Standby is
in low battery
state
3. Support CI
(Connection
Indication)
message
transport using
Unicast protocol
for WLAN
4. Malfunc Inop for
software license
failure - Added
self-test to MX40
to allow for
confirmation of
Software License
version to assist
users to identify
compatibility to
other systems
5. Claim IEC60601-1
3rd edition
update IFU and
Product Labeling
appropriately
6. AAMI screen - A
new portrait
screen 1-wave
and 2 numerics to
support AAMI
EC13 display, local
control only &
cannot default to
this screen from
PIC-iX |
| Device Accessories | Unchanged, as previously submitted | MCS PigTail and Block
Adapter* Hardware to
support Respiration
measurements.
*Use of Block Adapter
requires MX40
software B.06 or
higher. |
| Device Hardware | Unchanged, as previously submitted | Same |
| Charging method | Unchanged, as previously submitted | Same |

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Image /page/7/Picture/1 description: The image shows the word "PHILIPS" in a large, blue, sans-serif font. Below the word "PHILIPS" are the words "MX40 Release B.07" in a smaller, black, sans-serif font. Below that is the text "Special 510(k)" in the same font.

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Image /page/8/Picture/0 description: The image shows the word "PHILIPS" in large, blue, bold letters. Below the brand name, the text "MX40 Release B.07 Special 510(k)" is displayed in a smaller, black font. The text appears to be related to a specific product or software version of Philips, possibly indicating a special release or compliance with regulatory standards.

Summary of Non-clinical testing

No performance standards have been issued under the authority of Section 514. The MX40 Release B.07 was tested in accordance with Philips verification and validation processes. Quality Assurance measures were applied to the system design and development, including:

  • Risk Analysis ●
  • Product Specifications ●
  • Design Reviews
  • Verification & Validations ●

Summary of Clinical Testing

Clinical Performance testing for MX40 Release B.07 was not performed, as there were no new clinical applications that had hazards or risk mitigations that required a clinical performance testing to support equivalence.

Conclusions drawn from the Non-clinical and Clinical testing

Verification, validation, and testing activities, where required to establish the performance, functionality, and reliability characteristics of the new device with respect to the predicate are performed. Testing involved system level tests, performance tests, and safety testing from hazard analysis. Pass/Fail criteria were based on the specifications cleared for the predicate device and test results showed substantial equivalence. The MX40 Release B.07 meets all defined reliability requirements and performance claims.

VI.Conclusion

In summary, there is no change in either intended use or in the fundamental scientific technology employed by the MX40 patient monitor in the modification for B.07. We consider these device modifications to be substantially equivalent to previously cleared devices. Additionally, substantial equivalence was demonstrated with non-clinical performance testing, which complied with the requirements specified in the international and FDA-recognized consensus standards. The non-clinical performance tests provided in this 510(k) premarket notification demonstrate that the subject device is as safe and effective as its predicate device without raising any new safety and/or effectiveness concerns.