K Number
K172890
Device Name
SedLine Sedation Monitor
Manufacturer
Date Cleared
2018-01-26

(126 days)

Product Code
Regulation Number
882.1400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The SedLine Sedation Monitor is intended to monitor the state of the data acquisition and processing of EEG signals. The system includes the Patient State Index (PSI), a proprietary computed EEG variable that is related to the effect of anesthetic agents. The agents include: Alfentanil, Desflurane, Nitrous Oxide, Propofol, Remifentanil, and Sevoflurane. The Sedation Monitor is intended for use with adult patients (18 years of age and older) in the operating room (OR), intensive care unit (ICU), and clinical research laboratory.
Device Description
SedLine® Sedation Monitor is a patient-connected, 4-channel processed Electroencephalograph (EEG) monitor designed specifically for intraoperative or intensive care use. It displays electrode status, EEG waveforms, Density Spectral Array (DSA), and Patient State Index (PSI), EMG Index, Suppression Ratio (SR) and Artifact (ARTF). The operator controls the unit using menus and dedicated buttons to select various display options. The system consists of 4 major components: Root, SedLine Module, SedLine Patient Cable, and SedLine Sensor.
More Information

Not Found

No
The document describes a device that processes EEG signals to derive a "Patient State Index (PSI)," which is a "proprietary computed EEG variable." While this involves signal processing and potentially complex algorithms, there is no mention of AI, ML, or related terms like DNN. The validation study focuses on comparing the new algorithm to a predicate algorithm, not on training or testing an AI/ML model.

No
The device monitors the state of EEG signals and provides information related to the effect of anesthetic agents but does not actively administer treatment or alter the patient's condition.

No

The device monitors the state of EEG signals and provides computed variables related to the effect of anesthetic agents. While it provides information, it does not explicitly state that it diagnoses a condition or disease, but rather monitors a physiological state influenced by medication.

No

The device description explicitly lists hardware components: Root, SedLine Module, SedLine Patient Cable, and SedLine Sensor.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are devices intended for use in the collection, preparation, and examination of specimens taken from the human body (such as blood, urine, or tissue) to provide information for the diagnosis, treatment, or prevention of disease.
  • SedLine's Function: The SedLine Sedation Monitor directly monitors physiological signals (EEG) from the patient's body. It processes these signals to provide information about the patient's state of sedation, which is related to the effect of anesthetic agents.
  • Lack of Specimen Analysis: The device does not involve the collection or analysis of any specimens taken from the body. It is a patient-connected device that measures electrical activity directly.

Therefore, the SedLine Sedation Monitor falls under the category of a patient-monitoring device, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The SedLine Sedation Monitor is intended to monitor the state of the data acquisition and processing of EEG signals. The system includes the Patient State Index (PSI), a proprietary computed EEG variable that is related to the effect of anesthetic agents. The agents include: Alfentanil, Desflurane, Nitrous Oxide, Propofol, Remifentanil, and Sevoflurane. The Sedation Monitor is intended for use with adult patients (18 years of age and older) in the operating room (OR), intensive care unit (ICU), and clinical research laboratory.

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

OLW, GXY, OLT, OMC, ORT

Device Description

SedLine® Sedation Monitor is a patient-connected, 4-channel processed Electroencephalograph (EEG) monitor designed specifically for intraoperative or intensive care use. It displays electrode status, EEG waveforms, Density Spectral Array (DSA), and Patient State Index (PSI), EMG Index, Suppression Ratio (SR) and Artifact (ARTF).

The operator controls the unit using menus and dedicated buttons to select various display options. The system consists of 4 major components: Root, SedLine Module, SedLine Patient Cable, and SedLine Sensor.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

The SedLine EEG Sensor is noninvasively applied to the patient on one end.

Indicated Patient Age Range

Adult patients (18 years of age and older)

Intended User / Care Setting

Operating room (OR), intensive care unit (ICU), and clinical research laboratory.

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

Validation of the subject algorithm was performed by retrospective analysis of the clinical data in 100 surgical patients (age: 18-77 years, male/female: 26/74). The clinical data was collected at the operating room from three different hospitals. Clinical data used for the analysis includes continuous EEG, anesthetic drug dose information, and other physiological vital signs such as mean arterial blood pressure and heart rate.

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Non-clinical Testing:

  • Electrical safety testing per IEC 60601-1
  • EMC testing per IEC 60601-1-2
  • Alarm testing per IEC60601-1-8
  • Usability testing per FDA Human Factors and Usability Draft Guidance
  • Software verification per FDA Software Guidance
  • Mechanical Testing per EN 60601-2-26
  • Environmental testing per EN 60601-2-26

The results demonstrate that all requirements and performance specifications were satisfied, and that the subject device is substantially equivalent to the predicate device.

The multi-taper DSA evaluation was conducted as part of the "Software verification per FDA Software Guidance." The tests validated DSA by comparing multi-taper DSA against the predicate's Hanning DSA, both computed for a known input signal. The following functionality were tested for multi-taper DSA:

  • Dynamic range of the power spectrum,
  • Frequency range,
  • Spectral Edge Frequency, and
  • High-contrast feature of the multi-taper DSA against the predicate's Hanning DSA.

Clinical Testing:
Validation of the subject algorithm was performed by retrospective analysis of the clinical data in 100 surgical patients (age: 18-77 years, male/female: 26/74). The subject PSi algorithm was compared to the predicate PSi algorithm. The clinical data was collected at the operating room from three different hospitals. Clinical data used for the analysis includes continuous EEG, anesthetic drug dose information, and other physiological vital signs such as mean arterial blood pressure and heart rate.

Conclusion:
The clinical and non-clinical testing provided in this 510(k) submission demonstrates that the subject device, SedLine® Sedation Monitor, is substantially equivalent to its predicate.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K140188

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 882.1400 Electroencephalograph.

(a)
Identification. An electroencephalograph is a device used to measure and record the electrical activity of the patient's brain obtained by placing two or more electrodes on the head.(b)
Classification. Class II (performance standards).

0

January 26, 2018

Masimo Corporation Matthew Tiacharoen Regulatory Affairs Specialist II, Regulatory Affairs 52 Discovery Irvine, California 92618

Re: K172890

Trade/Device Name: SedLine Sedation Monitor Regulation Number: 21 CFR 882.1400 Regulation Name: Electroencephalograph Regulatory Class: Class II Product Code: OLW, GXY, OLT, OMC, ORT Dated: December 22, 2017 Received: December 26, 2017

Dear Matthew Tiacharoen:

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

1

manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820); 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,

Tara A. Ryan -
S

for

Digitally signed by Tara A. Ryan -S
DN: c=US, o=U.S. Government, ou=HHS,
ou=FDA, ou=People, cn=Tara A. Ryan -S,
0.9.2342.19200300.100.1.1=1300030749
Date: 2018.01.26 14:48:19 -05'00'

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) K172890

Device Name SedLine Sedation Monitor

Indications for Use (Describe)

The SedLine Sedation Monitor is intended to monitor the state of the data acquisition and processing of EEG signals. The system includes the Patient State Index (PSI), a proprietary computed EEG variable that is related to the effect of anesthetic agents. The agents include: Alfentanil, Desflurane, Nitrous Oxide, Propofol, Remifentanil, and Sevoflurane. The Sedation Monitor is intended for use with adult patients (18 years of age and older) in the operating room (OR), intensive care unit (ICU), and clinical research laboratory.

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)

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Image /page/3/Picture/0 description: The image shows the logo for Masimo Corporation. The logo consists of a red circle with a white checkmark inside, followed by the word "Masimo" in black, bold letters. To the right of the word "Masimo" is the text "MASIMO CORPORATION" in gray, followed by the address "52 Discovery, Irvine, CA 92618" also in gray.

| Submitter and Address of
Manufacturing Facility: | Masimo Corporation
52 Discovery
Irvine, CA 92618
Phone: (949) 297-7982
FAX: (949) 297-7199 |
|-----------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Date: | January 26, 2018 |
| Contact: | Matthew Tiacharoen
Regulatory Specialist II, Regulatory Affairs |
| Trade Name: | SedLine Sedation Monitor |
| Common Name: | Brain Function Monitor |
| Classification Regulation/
Product Code: | 21 CFR 882.1400, Class II/OLW |
| Additional Product Codes: | GXY,OLT, OMC, ORT |
| Establishment
Registration Number: | 2031172 |
| Reason for Premarket
Notification: | Device modification |
| Predicate Device: | K140188 - Masimo Root Monitoring System |
| Performance Standards | No performance standards for the above device have been
promulgated pursuant to Section 514 of the Food and Drug
Administration Modernization Act of 1997 (FDAMA) |

5.1 Device Description

SedLine® Sedation Monitor is a patient-connected, 4-channel processed Electroencephalograph (EEG) monitor designed specifically for intraoperative or intensive care use. It displays electrode status, EEG waveforms, Density Spectral Array (DSA), and Patient State Index (PSI), EMG Index, Suppression Ratio (SR) and Artifact (ARTF).

The operator controls the unit using menus and dedicated buttons to select various display options. The system consists of 4 major components: Root, SedLine Module, SedLine Patient Cable, and SedLine Sensor.

4

Image /page/4/Picture/0 description: The image shows the logo for Masimo Corporation. The logo consists of a red circle with a white checkmark inside, followed by the word "Masimo" in bold, black letters. To the right of the logo is the text "MASIMO CORPORATION" in gray, followed by the address "52 Discovery, Irvine, CA 92618" also in gray.

Note: For clarification, the purpose of this submission is to demonstrate that the subject device, SedLine® Sedation Monitor, is the substantially equivalent to the predicate device's SedLine Module.

5.2 Significant Physical and Performance Characteristics of the Device

The device specifications are shown below for the general functions of the subject device.

TABLE 5.2 SedLine® Sedation Monitor Specifications
FEATURESPECIFICATION
Display
Display Range
PSI0 to 100
EMG0 to 100%
SR0 to 100%
ARTF0 to 100%
DSA Amplitude (Left
and Right-60 to 40 dB
SEFL/SEFR0-30Hz
DSA Asymmetry-100% to +100%
Electrode Impedance0 to 65 KOhms
Resolution
PSI1
EMG1%
SR2%
ARTF1%
DSA Amplitude (Left
and Right≤1db
SEFL/SEFR1 Hz
DSA Asymmetry1%
Electrode Impedance1 KOhm
General
Visual/audible alarmHost/Backboard Device (Masimo Root Monitoring System) is
IEC60601-1-8 compliant per
K140188
Storage/recordingMasimo Root Monitoring System has trend/data storage per
K140188
Electrical
AC PowerHost/Backboard Device (Masimo Root Monitoring System)
provides AC power per K140188
Rechargeable batteryHost/Backboard Device (Masimo Root Monitoring System)
provides internal battery power per K140188
Interface
SedLine Module
ConnectionMOC-9 interface with Host/Backboard device (Masimo Root
Monitoring System, per K140188)

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Image /page/5/Picture/0 description: The image shows the logo for Masimo Corporation. The logo consists of a red circle with a white checkmark inside, followed by the word "Masimo" in black, bold letters. To the right of the word "Masimo" is the text "MASIMO CORPORATION" in gray, followed by the address "52 Discovery, Irvine, CA 92618" also in gray.

TABLE 5.2 SedLine® Sedation Monitor Specifications
FEATURESPECIFICATION
Mechanical
Module: Dimensions1 3/10 in (3.3 cm) x 4 in (10.2 cm) x .8 in (2.0 cm)
Environmental
Operating Conditions
Temperature+41°F to +104°F (+5°C to +40°C)
Humidity15% to 95%, non-condensing
Storage Conditions
Temperature-40°F to +158°F (-40°C to +70°C)
Humidity15–95%, non-condensing
Pressure500 to 1060 mbar

5.3 Intended Use

The SedLine® Sedation Monitor is indicated for use in the operating room (OR), intensive care unit (ICU), and clinical research laboratory. It is intended to monitor the state of the brain by real-time data acquisition and processing of EEG signals. The system includes the Patient State Index (PSI), a proprietary computed EEG variable that is related to the effect of anesthetic agents. The computed values are displayed on a Host/Backboard monitor such as the Masimo Root Monitoring System (K140188).

5.4 Indications For Use

The SedLine Sedation Monitor is indicated for use in the operating room (OR), intensive care unit (ICU), and clinical research laboratory. It is intended to monitor the state of the brain by real-time data acquisition and processing of EEG signals for adult patients (18 years of age and older). The system includes the Patient State Index (PSI), a proprietary computed EEG variable that is related to the effect of anesthetic agents include: Alfentanil, Desflurane, Fentanyl, Isoflurane, Nitrous Oxide, Propofol, Remifentanil, and Sevoflurane.

Note: The Indication for Use is the same as the SedLine Sedation Monitor, cleared under K140188, with the exception of identification of anesthetic agents used for validation and the intended use population age.

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Image /page/6/Picture/0 description: The image shows the logo for Masimo Corporation. The logo consists of the word "Masimo" in a bold, sans-serif font, with a red checkmark symbol to the left of the word. To the right of the word "Masimo" is the text "MASIMO CORPORATION" in a smaller, sans-serif font, followed by the address "52 Discovery, Irvine, CA 92618".

5.5 Technological Characteristics

5.5.1 Principle of Operation

The Patient State Index (PSI) formula was constructed based upon multivariate combinations of quantitative electroencephalogram (OEEG) variables found to be sensitive to changes in the level of anesthesia but insensitive to the specific substances producing such changes. The PSI is the result of a complex computation that combines weighted quantitative values reflecting many dimensions of brain electrical activity, such as: (1) changes in power in various EEG frequency bands, (2) changes in symmetry and synchronization between critical brain regions, and (3) the inhibition of regions of the frontal cortex.

The PSI is computed from continuously monitored changes in the OEEG during surgery, using statistical analysis to estimate the likelihood that the patient is anesthetized. The SedLine performs these computations automatically on the continuously recorded EEG after automatic removal of data contaminated with artifact from physiological and environmental signals. The computed PSI is periodically updated, displayed in numeric form, and presented in a color-coded trend graphic for monitoring the effect of certain anesthetics on the state of the brain.

5.5.2 Mechanism of Action for Achieving the Intended Effect

The SedLine EEG Sensor is noninvasively applied to the patient on one end. The other end of the SedLine EEG Sensor connects to the SedLine Module. In turn, the SedLine Module connects to a Host/Backboard device. The SedLine EEG Sensor collects patient EEG signals which are processed by the SedLine Module and displayed on the Host/Backboard device.

5.5.3 Summary of Technological Characteristics of Subject Device Compared to Predicate Device

The subject device, SedLine® Sedation Monitor, and the predicate device. Masimo Root Monitoring System (K140188), have the following key similarities:

  • Both devices have the same parameters to measure patient sedation state;
  • Both devices display their calculated values on a Host/Backboard device . (Masimo Root Monitoring System);
  • Both devices have the same indications for use;
  • Both devices have the same intended use; ●
  • Both devices have the same measurement site; ●

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Image /page/7/Picture/0 description: The image shows the logo for Masimo Corporation. On the left is a red circle with a white line going through it. To the right of the logo is the word "Masimo" in black, and to the right of that is the text "MASIMO CORPORATION 52 Discovery Irvine, CA 92618" in gray.

  • Both devices include EEG sensors and patient cables.
    The subject device and the predicate device. Root Monitoring System (K140188). differ only in the SedLine software. The differences are:

  • . An optional additional DSA display is now available that uses a multi-taper window EEG to display the spectral waveform;

  • Modified Patient State Index (PSI) algorithm.

5.5.4 Non-clinical Testing

See below for the non-clinical testing that was completed.

  • Electrical safety testing per IEC 60601-1
  • EMC testing per IEC 60601-1-2 ●
  • Alarm testing per IEC60601-1-8 ●
  • Usability testing per FDA Human Factors and Usability Draft Guidance
  • Software verification per FDA Software Guidance ●
  • Mechanical Testing per EN 60601-2-26 ●
  • Environmental testing per EN 60601-2-26

The results demonstrate that all requirements and performance specifications were satisfied, and that the subject device is substantially equivalent to the predicate device.

The multi-taper DSA evaluation was conducted as part of the "Software verification per FDA Software Guidance." The tests validated DSA by comparing multi-taper DSA against the predicate's Hanning DSA, both computed for a known input signal. The following functionality were tested for multi-taper DSA:

  • Dynamic range of the power spectrum,
  • Frequency range,
  • Spectral Edge Frequency, and
  • High-contrast feature of the multi-taper DSA against the predicate's Hanning DSA.

5.5.5 Clinical Testing

Validation of the subject algorithm was performed by retrospective analysis of the clinical data in 100 surgical patients (age: 18-77 years, male/female: 26/74). The

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Image /page/8/Picture/0 description: The image shows the logo for Masimo Corporation. The logo consists of a red symbol on the left, followed by the word "Masimo" in black. To the right of the word "Masimo" is the text "MASIMO CORPORATION" in gray, followed by the address "52 Discovery, Irvine, CA 92618" also in gray. The logo is clean and modern, with a focus on the company name and location.

subject PSi algorithm was compared to the predicate PSi algorithm. The clinical data was collected at the operating room from three different hospitals. Clinical data used for the analysis includes continuous EEG, anesthetic drug dose information, and other physiological vital signs such as mean arterial blood pressure and heart rate.

5.5.6 Conclusion

The clinical and non-clinical testing provided in this 510(k) submission demonstrates that the subject device, SedLine® Sedation Monitor, is substantially equivalent to its predicate.