K Number
K172895
Device Name
AGE Automatic Upper Arm Blood Pressure Monitor with models BA-815, BA-816, BA-818 and BA-819
Date Cleared
2018-06-18

(269 days)

Product Code
Regulation Number
870.1130
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
AGE Automatic Upper Arm Blood Pressure Monitor is intended for use by medical professionals or at home to monitor and display diastolic, systolic blood pressure and pulse rate on adult each time, with the cuff around the left upper arm according to the instruction in the user's guide manual.
Device Description
AGE Automatic Upper Arm Blood Pressure Monitor is a battery driven automatic non-invasive blood pressure meter. It can automatically conduct the inflation and measurement, which can measure systolic and diastolic blood pressure as well as the pulse rate of adult at arm within its claimed range and accuracy via the Oscillometry technique. The device also has low voltage indication, which will be triggered when the battery is low.
More Information

Not Found

No
The summary describes a standard oscillometric blood pressure monitor and does not mention any AI/ML capabilities, image processing, or data training/testing sets.

No.
The device is intended for monitoring and displaying blood pressure and pulse rate, which are diagnostic and monitoring functions, not therapeutic.

Yes

Explanation: The device monitors and displays diastolic and systolic blood pressure and pulse rate, which are measurements used in the diagnosis and monitoring of medical conditions.

No

The device description explicitly states it is a "battery driven automatic non-invasive blood pressure meter" and mentions components like a cuff and the Oscillometry technique, indicating it is a hardware device with integrated software.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body, such as blood, urine, or tissue, to provide information for diagnosis, monitoring, or screening.
  • Device Function: The AGE Automatic Upper Arm Blood Pressure Monitor measures blood pressure and pulse rate directly from the patient's arm using a cuff and the oscillometry technique. It does not analyze any biological specimens taken from the body.
  • Intended Use: The intended use is to monitor and display blood pressure and pulse rate on an adult's arm. This is a direct measurement from the patient, not an analysis of a sample.

The information provided clearly describes a non-invasive device that measures physiological parameters directly from the body, which falls outside the scope of In Vitro Diagnostics.

N/A

Intended Use / Indications for Use

AGE Automatic Upper Arm Blood Pressure Monitor is intended for use by medical professionals or at home to monitor and display diastolic, systolic blood pressure and pulse rate on adult each time, with the cuff around the left upper arm according to the instruction in the user's guide manual.

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

DXN

Device Description

AGE Automatic Upper Arm Blood Pressure Monitor is a battery driven automatic non-invasive blood pressure meter. It can automatically conduct the inflation and measurement, which can measure systolic and diastolic blood pressure as well as the pulse rate of adult at arm within its claimed range and accuracy via the Oscillometry technique. The device also has low voltage indication, which will be triggered when the battery is low.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

left upper arm

Indicated Patient Age Range

adult

Intended User / Care Setting

medical professionals or at home

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

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

AGE Automatic Upper Arm Blood Pressure Monitor has been evaluated the safety and performance by lab bench testing according to the following standards:

  • IEC 60601-1, Medical Electrical Equipment - Part 1: General Requirements for Safety, 2005 + A1:2012
  • IEC 60601-1-2. Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic Disturbances - Requirements and tests, 2014
  • IEC 60601-1-11, Medical Electrical Equipment - Part 1-11: General Requirements For Basic Safety And Essential Performance - Collateral Standard: Requirements For Medical Electrical Equipment And Medical Electrical Systems Used In The Home Healthcare Environment [Including: Technical Corrigendum 1 (2011)]
  • IEC 80601-2-30, Medical Electrical Equipment - Part 2-30: Particular Requirements For The Basic Safety And Essential Performance Of Automated Noninvasive Sphygmomanometers
  • ISO 10993-5, Biological evaluation of medical devices -- Part 5: Tests for In Vitro cytotoxicity, 2009
  • ISO 10993-10, Biological evaluation of medical devices -- Part 10: Tests for irritation and skin sensitization, 2010
  • AAMI / ANSI / ISO 81060-2 Second Edition, Non-Invasive Sphygmomanometers - Part 2: Clinical Validation Of Automated Measurement Type. (Cardiovascular)

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

Pressure: ±3 mmHg
Pulse: ±5%

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.

K153552

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

§ 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).

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June 18, 2018

Ageless Health Industrial Co., Ltd. % Cassie Lee Manager Guangzhou Glomed Biological Technology Co., Ltd. Suite 306, Kecheng Mansion, No.121 Science Road Guangzhou Science Park Guangzhou, 510000 China

Re: K172895

Trade/Device Name: AGE Automatic Upper Arm Blood Pressure Monitor with Models BA-815, BA-816, BA-818 and BA-819 Regulation Number: 21 CFR 870.1130 Regulation Name: Noninvasive Blood Pressure Measurement System Regulatory Class: Class II Product Code: DXN Dated: May 8, 2018 Received: May 15, 2018

Dear Cassie Lee:

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 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) K172895

Device Name

AGE Automatic Upper Arm Blood Pressure Monitor with Models BA-815, BA-816, BA-819

Indications for Use (Describe)

AGE Automatic Upper Arm Blood Pressure Monitor is intended for use by medical professionals or at home to monitor and display diastolic, systolic blood pressure and pulse rate on adult each time, with the cuff around the left upper arm according to the instruction in the user's guide manual.

Type of Use (Select one or both, as applicable)

| | Prescription Use (Part 21 CFR 801 Subpart D)

|X | Over-The-Counter Use (21 CFR 801 Subpart C)

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3

Sponsor:Ageless Health Industrial Co., Ltd
Subject Device:AGE Automatic Upper Arm Blood Pressure Monitor Model: BA-815, BA-816, BA-818, BA-819
File No.:

File No.:

Chapter 5. 510(k) Summary

510(k) Summary

This summary of 510(K) safety and effectiveness information is being submitted in accordance with the requirement of 21 CFR 807.92.

1. Submitter's Information

510(k) Owner's Name: Ageless Health Industrial Ltd. Establishment Registration Number: Applying Address: 3/F, A1 Bldg, Dongshen Sima Industrial Area, No.33 Shenbei Road, Sima Village, Changping Town, Dongquan, Guangdong, China Contact Person: Victor Wan (Vice-president) Email: victor@agelh.com

Application Correspondent:

Contact Person: Ms. Cassie Lee Guangzhou GLOMED Biological Technology Co., Ltd. Address: Suite 306, Kecheng Mansion, No.121 Science Road, Guangzhou Science Park, Guangzhou 510663, China Tel: +86-20-61099984 Email: regulatory@glomed-info.com

2. Subject Device Information

Common Name: System, Measurement, Blood-Pressure, Non-Invasive Trade Name: AGE Automatic Upper Arm Blood Pressure Monitor Models: BA-815, BA-816, BA-818, BA-819 Review Panel: Cardiovascular Product Code: DXN Regulation Number: 21 CFR 870.1130 Regulation Class: 2

3. Predicate Device Information

SponsorAgeless Health Industrial Ltd.
Device NameAGE Automatic Upper Arm Blood Pressure Monitor
510(k) NumberK153552
Product CodeDXN
Regulation Number21 CFR 870.1130
Regulation ClassII

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4. Device Description

AGE Automatic Upper Arm Blood Pressure Monitor is a battery driven automatic non-invasive blood pressure meter. It can automatically conduct the inflation and measurement, which can measure systolic and diastolic blood pressure as well as the pulse rate of adult at arm within its claimed range and accuracy via the Oscillometry technique. The device also has low voltage indication, which will be triggered when the battery is low.

5. Intended Use / Indications for Use

AGE Automatic Upper Arm Blood Pressure Monitor is intended for use by medical professionals or at home to monitor and display diastolic, systolic blood pressure and pulse rate on adult each time, with the cuff around the left upper arm according to the instruction in the user's guide manual.

6. Test Summary

effectiveness.

AGE Automatic Upper Arm Blood Pressure Monitor has been evaluated the safety and performance by lab bench testing according to the following standards:

  • ◆ IEC 60601-1, Medical Electrical Equipment - Part 1: General Requirements for Safety, 2005 + A1:2012
  • ◆ IEC 60601-1-2. Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic Disturbances - Requirements and tests, 2014
  • ◆ IEC 60601-1-11, Medical Electrical Equipment - Part 1-11: General Requirements For Basic Safety And Essential Performance - Collateral Standard: Requirements For Medical Electrical Equipment And Medical Electrical Systems Used In The Home Healthcare Environment [Including: Technical Corrigendum 1 (2011)]
  • ◆ IEC 80601-2-30, Medical Electrical Equipment - Part 2-30: Particular Requirements For The Basic Safety And Essential Performance Of Automated Noninvasive Sphygmomanometers
  • � ISO 10993-5, Biological evaluation of medical devices -- Part 5: Tests for In Vitro cytotoxicity, 2009
  • ◆ ISO 10993-10, Biological evaluation of medical devices -- Part 10: Tests for irritation and skin sensitization, 2010
  • ◆ AAMI / ANSI / ISO 81060-2 Second Edition, Non-Invasive Sphygmomanometers - Part 2: Clinical Validation Of Automated Measurement Type. (Cardiovascular)

7. Comparison to predicate device and conclusion

The technological characteristics, features, specifications, materials, and intended use is substantially equivalent to the predicate devices quoted above. The differences between the subject devices do not raise new issues of safety or

5

Sponsor:Ageless Health Industrial Co., Ltd
Subject Device:AGE Automatic Upper Arm Blood Pressure Monitor Model: BA-815, BA-816, BA-818, BA-819
File No.:K172895

| Elements of

ComparisonSubject DevicePredicate DeviceVerdict
Product
Name
Model NameAGE Automatic Upper Arm Blood
Pressure Monitor
BA-815, BA-816, BA-818, BA-819AGE Automatic Upper Arm Blood
Pressure Monitor
BA-801X, BA-802X, BA-803X, BA-
805X, BA-806X, BA-811X, BA-
812X, BA-813X, BA-821X, BA-
822X, BA-823X, BA-826X--
Intended UseAGE Automatic Upper Arm Blood
Pressure Monitor is intended for use
by medical professionals or at home to
monitor and display diastolic, systolic
blood pressure and pulse rate on adult
each time, with the cuff around the left
upper arm according to the instruction
in the user's guide manual.AGE Automatic Upper Arm Blood
Pressure Monitor is intended for
use by medical professionals or at
home to monitor and display
diastolic, systolic blood pressure
and pulse rate on adult each time,
with the cuff around the left upper
arm according to the instruction in
the user's guide manual.SE
Power
SupplyDC 6V (4 X AA 1.5V alkline batteries)6Vdc (4 "AA" batteries)SE
Measuring
MethodOscillometryOscillometrySE
Measuring
RangePressure: 0~280 mmHg
Pulse: 40~199 beats/minute
SYS(systolic pressure ): 60-255mmHg
DIA (diastolic pressure): 40-200mmHgPressure: 0~280 mmHg
Pulse: 40~199 beats/minute
SYS(systolic pressure ): 60-
255mmHg
DIA (diastolic pressure): 40-
200mmHgSE
Pressure
resolution1mmHg or 0.1kPa1mmHg or 0.1kPaSE
AccuracyPressure: ±3 mmHg
Pulse: ±5%Pressure: ±3mmHg
Pulse: ±5%SE
Patient
PopulationAdultAdultSE
Measuremen
t Site of BodyUpper ArmUpper ArmSE
Inflation and
DeflationAutomaticAutomaticSE
Memory Size2 x 90 sets record2 x 90 sets recordSE
Software
VersionV01V01SE
IndicatorsBlood Pressure (Systolic and
Diastolic), Pulse, Date, Time, WHO BP
Classification Indicating Bar, Low
Battery Icon, Heart Icon, MemoryBlood Pressure (Systolic and
Diastolic), Pulse, Date, Time, WHO
BP Classification Indicating Bar,
Low Battery Icon, Heart Icon,
MemorySE

6

Sponsor:Ageless Health Industrial Co., Ltd
Subject Device:AGE Automatic Upper Arm Blood Pressure Monitor Model: BA-815, BA-816, BA-818, BA-819
File No.:K172895

| Elements of

ComparisonSubject DevicePredicate DeviceVerdict
Cuff
CircumferenceFor BA-815: 22-34 cm;
For BA-816: 28-42 cm;
For BA-818 and BA-819, there are 6
size:
size A: 17cm--22cm (SMALL ADULT CUFF)
size B: 22cm--30cm (ADULT CUFF-1)
size C: 24cm--34cm (ADULT CUFF-2)
size D: 22cm--42cm (L-LARGE ADULT CUFF)
size E: 30cm--42cm (LARGE ADULT CUFF)
size F: 42cm--50cm (EXTRA LARGE ADULT CUFF)Size A: 17cm--22cm (SMALL ADULT CUFF)
Size B: 22cm--30cm (ADULT CUFF-1)
Size C: 24cm--34cm (ADULT CUFF-2)
Size D: 22cm--42cm (L-LARGE ADULT CUFF)
Size E: 30cm--42cm (LARGE ADULT CUFF)
Size F: 42cm--50cm (EXTRA LARGE ADULT CUFF)SE
Note 1
OPERATING & STORAGE CONDITIONS
Storage
EnvironmentTemperature: -20°C ~ +65°C
Humidity: 10~95%RH
Atmospheric Pressure:86 kPa~106 kPaTemperature: -20°C ~ +65°C
Humidity: 10~95%RH
Atmospheric Pressure:86 kPa~106 kPaSE
Working
EnvironmentTemperature: 5°C ~ 40°C
Humidity: 15~90%RH
Atmospheric Pressure:86 kPa~106 kPaTemperature: 5°C ~ 40°C
Humidity: 15~90%RH
Atmospheric Pressure:86 kPa~106 kPaSE
COMPLIANCE STANDARDS
Electrical,
Mechanical
and Thermal
EvaluationIEC 60601-1
IEC 60601-1-2
IEC 60601-1-11
IEC 80601-2-30IEC 60601-1
IEC 60601-1-2
IEC 60601-1-11
IEC 80601-2-30SE
Biocompatibility EvaluationAll the patient contracting materials are
evaluated by the biocompatibility
standard ISO 10993 - 5, -10.All the patient contracting materials
are evaluated by the
biocompatibility standard ISO
10993 - 5, -10.SE
PerformanceISO 81060-2-30ISO 81060-2-30SE

Comparison in Detail(s):

Note 1:

Although there is difference for measurement cuff circumference of subject device and predicate device, both of them are complied with ISO 81060-2. This difference does not affect the safety and effectiveness.

Conclusion:

The subject device AGE Automatic Upper Arm Blood Pressure Monitor has all features of the predicate device. The differences between them do not affect the safety and effectiveness. Thus, the subject device is substantially equivalent to the predicate device.

7

Sponsor:Ageless Health Industrial Co., Ltd
Subject Device:AGE Automatic Upper Arm Blood Pressure Monitor Model: BA-815, BA-816, BA-818, BA-819
File No.:K172895

8. Date of the summary prepared: September 16, 2017