K Number
K173439
Device Name
Bloom2 Programmable Electrophysiology Stimulator
Manufacturer
Date Cleared
2018-03-29

(146 days)

Product Code
Regulation Number
870.1750
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Bloom2 is intended for use in the electrophysiology laboratory during electrophysiology testing, under the direction of qualified personnel trained to administer electrophysiology procedures. The Bloom2 Cardiac Stimulator System is a programmable, electrical, pulse generator intended to provide diagnostic, electrical, cardiac stimulation. It is not intended for use, nor should it be used, as an external pacemaker for long-term support of the pacemaker dependent patient.
Device Description
The Bloom2™ Cardiac Stimulator System (Bloom²) is a programmable pulse generator used for electrophysiological testing of the human heart. The Bloom² has three main components, the Bloom2 Console, the Bloom2 Stimulator Unit and the Bloom2 Increment / Decrement Floater. The Console and the Floater contain the main user controls of the system. The Console consists of a touch screen and will allow the operator to setup the functions and parameters of the system. The user interface of the Console is based on the proven and familiar interface of the Bloom DTU-215B. The Floater provides additional user controls and will provide the operator with tactile feedback on those functions that the user is expected to use while going through their protocols. The Stimulator is the heart and brains of the system. The Stimulator has four, independent output channels that have a direct connection to the patient through third party catheters.
More Information

Not Found

No
The description focuses on programmable pulse generation and user interface controls, with no mention of AI, ML, or related concepts. The "Stimulator is the heart and brains of the system" refers to its core functionality, not necessarily AI/ML processing.

Yes
The device is intended to provide diagnostic, electrical, cardiac stimulation to the human heart, indicating its use in treating or managing a condition.

Yes

The "Intended Use / Indications for Use" section explicitly states that the Bloom2 Cardiac Stimulator System "is intended to provide diagnostic, electrical, cardiac stimulation."

No

The device description clearly outlines three main hardware components: the Bloom2 Console (with a touch screen), the Bloom2 Stimulator Unit (the "heart and brains" with output channels), and the Bloom2 Increment / Decrement Floater (providing additional controls). This indicates it is a hardware device with integrated software, not a software-only medical device.

Based on the provided information, the Bloom2 Cardiac Stimulator System is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use clearly states that the Bloom2 is used for "diagnostic, electrical, cardiac stimulation" in the electrophysiology laboratory. This involves directly interacting with the patient's heart to gather diagnostic information through electrical signals.
  • Device Description: The description details a programmable pulse generator with output channels that connect directly to the patient through catheters. This is a device that acts on the patient, not on a sample taken from the patient.
  • Lack of IVD Characteristics: IVD devices are typically used to examine specimens (like blood, urine, tissue) taken from the human body to provide information about a physiological state, disease, or condition. The Bloom2 does not process or analyze such specimens.

The Bloom2 is a medical device used for in vivo (within the living body) diagnostic procedures, specifically electrophysiology testing.

N/A

Intended Use / Indications for Use

The Bloom2 is intended for use in the electrophysiology laboratory during electrophysiology testing, under the direction of qualified personnel trained to administer electrophysiology procedures. The Bloom2 Cardiac System is a programmable, electrical, pulse generator intended to provide diagnostic, electrical, cardiac stimulation. It is not intended for use, nor should it be used, as an external pacemaker for long-term support of the pacemaker dependent patient.

Product codes

JOQ

Device Description

The Bloom2™ Cardiac Stimulator System (Bloom²) is a programmable pulse generator used for electrophysiological testing of the human heart. The Bloom² has three main components, the Bloom2 Console, the Bloom2 Stimulator Unit and the Bloom2 Increment / Decrement Floater. The Console and the Floater contain the main user controls of the system. The Console consists of a touch screen and will allow the operator to setup the functions and parameters of the system. The user interface of the Console is based on the proven and familiar interface of the Bloom DTU-215B. The Floater provides additional user controls and will provide the operator with tactile feedback on those functions that the user is expected to use while going through their protocols. The Stimulator is the heart and brains of the system. The Stimulator has four, independent output channels that have a direct connection to the patient through third party catheters.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

human heart

Indicated Patient Age Range

Not Found

Intended User / Care Setting

qualified personnel trained to administer electrophysiology procedures. The electrophysiology 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

Not Found

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

Performance analysis has shown the Bloom2 device to perform as intended and as well as the predicate devices under the same and/or similar conditions. These devices have been tested with settings set equal to those seen in typical procedures where these devices would be indicated for use. No differences have been observed between the performance of the predicate devices and the device subject of this 510(k) Notification submission. Additionally, Certified Third Party testing conducted to 60601-1 & 60601-1-2 to verify electrical safety & electromagnetic compatibility. The following tests demonstrated that the Bloom2 device fulfils the referenced standards:
• IEC/EN 60601-1 3.1 Edition Safety Test Report
• IEC 60601-1-1-2 Forth Edition EMC Test Report
• Software Life Cycle Processes Test Report
• FCC CFR 47, Part 15, subpart EMC Test Report
• ICES-001 for Class A Digital EMC Test Report
• Canada Differences to IEC 60601-1 Test Report

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

Not Found

Predicate Device(s)

K072200, K991293

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.1750 External programmable pacemaker pulse generator.

(a)
Identification. An external programmable pacemaker pulse generators is a device that can be programmed to produce one or more pulses at preselected intervals; this device is used in electrophysiological studies.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image contains the logos of the Department of Health and Human Services and the Food and Drug Administration (FDA). The Department of Health and Human Services logo is on the left, and the FDA logo is on the right. The FDA logo includes the text "FDA U.S. FOOD & DRUG ADMINISTRATION" in blue.

March 29, 2018

Fischer Medical % Charles Hart Principal Consultant HART Consulting LLC 615 Reid Place Castle Rock, Colorado 80108

Re: K173439

Trade/Device Name: Bloom2 Cardiac Stimulator System Regulation Number: 21 CFR 870.1750 Regulation Name: External Programmable Pacemaker Pulse Generator Regulatory Class: Class II Product Code: JOQ Dated: March 6, 2018 Received: March 6, 2018

Dear Charles Hart:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820);

1

1000-1050.

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

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. Hillebrand

for 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) K173439

Device Name Bloom2 Cardiac Stimulator System

Indications for Use (Describe)

The Bloom2 is intended for use in the electrophysiology laboratory during electrophysiology testing, under the direction of qualified personnel trained to administer electrophysiology procedures. The Bloom2 Cardiac System is a programmable, electrical, pulse generator intended to provide diagnostic, electrical, cardiac stimulation. It is not intended for use, nor should it be used, as an external pacemaker for long-term support of the pacemaker dependent patient.

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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3

510(k) Summary

Date prepared:March 27, 2018
Applicant:Fischer Medical
Contact person:Wes Rogers
President & CEO
Fischer Medical
Wheat Ridge, Colorado 80233-3862 USA
Phone: 303.280.2311
Fax: 303.920.0836
Email: sdwrogers@gmail.com
Trade name:Bloom2
Common name:Electrophysiology StimulatorClass:2
Classification
name:Generator, Pulse, Pacemaker, External
ProgrammableProduct code:JOQ
Predicate
devices:K072200, StimLab™/EPS320™ Electrophysiology Stimulator System
& Accessories and K991293, EPStim Bloom DTU-215B™
Electrophysiology Stimulator System & Accessories

Device description:

The Bloom2™ Cardiac Stimulator System (Bloom²) is a programmable pulse generator used for electrophysiological testing of the human heart. The Bloom² has three main components, the Bloom2 Console, the Bloom2 Stimulator Unit and the Bloom2 Increment / Decrement Floater. The Console and the Floater contain the main user controls of the system. The Console consists of a touch screen and will allow the operator to setup the functions and parameters of the system. The user interface of the Console is based on the proven and familiar interface of the Bloom DTU-215B. The Floater provides additional user controls and will provide the operator with tactile feedback on those functions that the user is expected to use while going through their protocols. The Stimulator is the heart and brains of the system. The Stimulator has four, independent output channels that have a direct connection to the patient through third party catheters.

Indications for use:

The Bloom2 is intended for use in the electrophysiology laboratory during electrophysiology testing, under the direction of qualified personnel trained to administer electrophysiological procedures. The Bloom2 Cardiac Stimulator System is a programmable, electrical, pulse generator intended to provide diagnostic, electrical, cardiac stimulation. It is not intended for use, nor should it be used, as an external pacemaker for long-term support of the pacemaker dependent patient.

4

510(k) Summary

Shipping & Storage:

The packaged device will withstand normal shipping and storage environments and labeling shall meet 21CFR 801, EN 1041, and ISO 15223.

| Non-clinical tests
submitted or relied upon: | Performance analysis has shown the Bloom2 device to
perform as intended and as well as the predicate devices
under the same and/or similar conditions. These devices have
been tested with settings set equal to those seen in typical
procedures where these devices would be indicated for use.
No differences have been observed between the performance
of the predicate devices and the device subject of this 510(k)
Notification submission.
Additionally, Certified Third Party testing conducted to 60601-
1 & 60601-1-2 to verify electrical safety & electromagnetic
compatibility. The following tests demonstrated that the
Bloom2 device fulfils the referenced standards:
• IEC/EN 60601-1 3.1 Edition Safety Test Report
• IEC 60601-1-1-2 Forth Edition EMC Test Report
• Software Life Cycle Processes Test Report
• FCC CFR 47, Part 15, subpart EMC Test Report
• ICES-001 for Class A Digital EMC Test Report
• Canada Differences to IEC 60601-1 Test Report |
|-------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Clinical tests submitted or
relied upon: | None |
| Substantial equivalence
conclusion: | The Bloom2 device is substantially equivalent to the legally
marketed FDA cleared predicate devices, based on intended
use, materials, and design. |