K Number
K180001
Device Name
Disposable BreathSensor Adult, Disposable BreathSensor Small Adult / Child, Disposable BreathSensor Preemie, Disposable BreathSensor Infant
Manufacturer
Date Cleared
2019-09-27

(633 days)

Product Code
Regulation Number
868.2375
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Embla BreathSensor provides a qualitative air flow signal by oral and/or nasal temperature sensitive resistive components for recording onto a recording system in support of airflow analysis and sleep studies. The Embla BreathSensor does not provide any diagnostic conclusion about the patient's condition to the user. The Embla BreathSensor user is a qualified medical practitioner in a hospital environment only who will exercise their professional judgment in using this information.
Device Description
The Embla BreathSensors (Model 970 Series) are airflow thermistors used as an accessory to a polysomnogram (PSG) or sleep study recording system. The BreathSensor family is comprised of two different variations: Models 971 Adult and Model 974 Small Adult/Child. The BreathSensors are for use with any standard PSG amplifier or recorder. An interface cable connects the BreathSensor to the polysomnography equipment. Embla BreathSensors are designed to provide a qualitative measure of respirations (flow) from the mouth and/or nose. The user selects the appropriate size of BreathSensor based on their clinical judgment. The nasal and/or oral temperature sensor elements are carbon ink placed on a substrate. The carbon ink is the temperature sensitive material. Silver ink interfaces with the carbon ink temperature sensing elements to provide a connection to the interface cable. The Embla BreathSensors are non-sterile, single patient use, disposable devices.
More Information

Not Found

No
The device description and intended use focus on providing a qualitative airflow signal based on temperature sensing. There is no mention of AI or ML in the device description, performance studies, or key metrics. The device acts as a sensor, not an analytical tool using AI/ML.

No
Explanation: The device is used to provide a qualitative airflow signal for recording onto a system in support of airflow analysis and sleep studies. It does not provide any diagnostic conclusions or therapeutic benefit to the patient.

No

The "Intended Use / Indications for Use" section explicitly states, "The Embla BreathSensor does not provide any diagnostic conclusion about the patient's condition to the user." It provides a qualitative airflow signal for recording onto a system in support of airflow analysis and sleep studies, not a diagnostic conclusion itself.

No

The device description explicitly states that the Embla BreathSensors are physical components (airflow thermistors) with temperature-sensitive resistive elements and an interface cable, indicating it is a hardware device, not software-only.

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

Here's why:

  • IVD Definition: IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • Embla BreathSensor Function: The Embla BreathSensor measures airflow from the mouth and/or nose using temperature-sensitive components. It is applied externally to the patient and does not analyze any bodily fluids or tissues.
  • Intended Use: The intended use is to provide a qualitative airflow signal for recording onto a system in support of airflow analysis and sleep studies. It explicitly states that it "does not provide any diagnostic conclusion about the patient's condition to the user."

Therefore, the Embla BreathSensor is a medical device used for physiological monitoring during sleep studies, but it does not fit the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Embla BreathSensor provides a qualitative air flow signal by oral and/or nasal temperature sensitive resistive components for recording onto a recording system in support of airflow analysis and sleep studies.

The Embla BreathSensor does not provide any diagnostic conclusion about the patient's condition to the user.

The Embla BreathSensor user is a qualified medical practitioner in a hospital environment only who will exercise their professional judgment in using this information.

Product codes

MNR

Device Description

The Embla BreathSensors (Model 970 Series) are airflow thermistors used as an accessory to a polysomnogram (PSG) or sleep study recording system. The BreathSensor family is comprised of two different variations: Models 971 Adult and Model 974 Small Adult/Child.

The BreathSensors are for use with any standard PSG amplifier or recorder. An interface cable connects the BreathSensor to the polysomnography equipment.

Embla BreathSensors are designed to provide a qualitative measure of respirations (flow) from the mouth and/or nose. The user selects the appropriate size of BreathSensor based on their clinical judgment.

The nasal and/or oral temperature sensor elements are carbon ink placed on a substrate. The carbon ink is the temperature sensitive material. Silver ink interfaces with the carbon ink temperature sensing elements to provide a connection to the interface cable.

The Embla BreathSensors are non-sterile, single patient use, disposable devices.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

oral and/or nasal, Between upper lip and nostrils

Indicated Patient Age Range

Children and adult patients

Intended User / Care Setting

qualified medical practitioner in a hospital environment only

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 Tests to Demonstrate Substantial Equivalency:
To establish the technical equivalency of the BreathSensors, evaluations were conducted to confirm compliance with performance requirements.

Evaluations and Results:

  • Dimensions: Verification of dimensions. Result: Pass.
  • Labels and Labeling: Verification of label and labeling content for variations. Result: Pass.
  • Material: Verification of specified materials. Result: Pass.
  • Biocompatibility of patient contact materials: Supported with final finished form cytotoxicity, sensitization and irritation evaluations. Result: Pass.
  • Resistance: Verify BreathSensor base resistance. Result: Pass.
  • Temperature Sensitivity: Verify minimum temperature sensitivity of resistance change per ℃. Result: Pass.
  • Performance Testing: Comparison with predicate Disposable Flow Sensor, evaluation of qualitative airflow response with Interface Cable. Result: Pass.
  • Electromagnetic compatibility: BreathSensor and Interface Cable compliance with IEC 60601-1-2:2014, 4th edition. Result: Pass.

Conclusion: The Embla BreathSensors meet performance requirements. The intended use and technology of the Embla BreathSensors are similar to the predicate devices.

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

Not Found

Predicate Device(s)

K913749, K042253

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 868.2375 Breathing frequency monitor.

(a)
Identification. A breathing (ventilatory) frequency monitor is a device intended to measure or monitor a patient's respiratory rate. The device may provide an audible or visible alarm when the respiratory rate, averaged over time, is outside operator settable alarm limits. This device does not include the apnea monitor classified in § 868.2377.(b)
Classification. Class II (performance standards).

0

September 27, 2019

Image /page/0/Picture/1 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo features the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

Embla Systems (Embla) Sanjay Mehta Director, Quality Assurance & Regulatory Affairs 1 Hines Road, Suite 202 Kanata, ON, CA K2K 3C7

Re: K180001

Trade/Device Name: Embla BreathSensors Regulation Number: 21 CFR 868.2375 Regulation Name: Breathing frequency monitor Regulatory Class: Class II Product Code: MNR Dated: August 26, 2019 Received: August 29, 2019

Dear Sanjay Mehta:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

1

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) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

for

Michael Ryan Director DHT1C: Division of ENT, Sleep Disordered Breathing, Respiratory and Anesthesia Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health

Enclosure

2

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: 06/30/2020 See PRA Statement below.

510(k) Number (if known) K180001

Device Name Embla BreathSensors

Indications for Use (Describe)

The Embla BreathSensor provides a qualitative air flow signal by oral and/or nasal temperature sensitive resistive components for recording onto a recording system in support of airflow analysis and sleep studies.

The Embla BreathSensor does not provide any diagnostic conclusion about the patient's condition to the user.

The Embla BreathSensor user is a qualified medical practitioner in a hospital environment only who will exercise their professional judgment in using this information.

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)
-------------------------------------------------------------------------------------------------

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Image /page/3/Picture/0 description: The image contains the logo for Natus Neurology. The word "natus" is written in a teal sans-serif font, with a registered trademark symbol next to the "s". Below "natus" is the word "neurology" in a smaller, italicized, black sans-serif font. The logo is simple and clean, with a focus on the company name.

510(K): K180001, EMBLA BREATHSENSORS

K180001 510(k) Summary

510(k) Summary This summary is provided to support the 510(k) pre-market notification for the Embla BreathSensors.

| Company Name: | Embla Systems (Embla)
1 Hines Road, Suite 202
Kanata, ON, CA, K2K 3C7 |
|------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Company Contact: | Mr. Sanjay Mehta
Director, Quality Assurance & Regulatory Affairs
Phone: (905) 287-5055
Email: Sanjay.Mehta@natus.com |
| Date Summary Prepared: | September 27, 2019 |
| Trade Name: | Embla BreathSensors |
| Common Name: | Thermistor for Air Flow |
| Classification Name: | Breathing Frequency Monitor
21 CFR 868.2375
Product Code: MNR
Class II |
| Predicate Device: | K913749 EdenTrace Airflow 3171, Sleep Lab Airflow 3170
EdenTec Corporation (Primary predicate)
K042253 SleepSense Sleep Disorder Sensors
S.L.P. Ltd |

Product Description

The Embla BreathSensors (Model 970 Series) are airflow thermistors used as an accessory to a polysomnogram (PSG) or sleep study recording system. The BreathSensor family is comprised of two different variations: Models 971 Adult and Model 974 Small Adult/Child.

The BreathSensors are for use with any standard PSG amplifier or recorder. An interface cable connects the BreathSensor to the polysomnography equipment.

Embla BreathSensors are designed to provide a qualitative measure of respirations (flow) from the mouth and/or nose. The user selects the appropriate size of BreathSensor based on their clinical judgment.

The nasal and/or oral temperature sensor elements are carbon ink placed on a substrate. The carbon ink is the temperature sensitive material. Silver ink interfaces with the carbon ink temperature sensing elements to provide a connection to the interface cable.

The Embla BreathSensors are non-sterile, single patient use, disposable devices.

Intended Use of the Device

The Embla BreathSensor provides a qualitative air flow signal by oral and/or nasal temperature resistive resistive resistive components for recording onto a recording system in support of airflow analysis and sleep studies. The Embla BreathSensor does not provide any diagnostic conclusion about the patient's condition to the user. The Embla BreathSensor user is a qualified medical practitioner in a hospital environment who will exercise their professional judgment in using this information.

4

Image /page/4/Picture/0 description: The image shows the logo for Natus Neurology. The word "natus" is in a teal sans-serif font, and the word "neurology" is in a black italicized sans-serif font. The logo is simple and modern, and it is likely used to represent the company's brand.

Summary of Technological Characteristics

The BreathSensors are single patient use, disposable sensors applied to a patient below the nose, (above the mouth), to support a qualitative indication of airflow from the nostrils and/or mouth. The BreathSensors are a form of thermistor, indicating airflow by temperature change. The accessory interface cables connect between the BreathSensor and user equipment for display and recording by the user's equipment.

Table 1 provides a side-by-side comparison of the BreathSensors to the predicate device applied to support this premarket notification.

Table 1: Substantial Equivalence Technical Characteristics
FeatureBreathSensors
Under ReviewEdenTrace Airflow
3171, Sleep Lab
Airflow 3170
(Primary Predicate
K913749)S.L.P. Ltd
SleepSense Sleep
Disorder Sensors
(Predicate K042253)Equivalence
Comments
Intended UseDisposable temperature
sensitive sensor to
support recording
airflow.Disposable temperature
sensitive sensor to
support recording
airflow.Disposable temperature
sensitive sensor to
support recording
airflow.Same
Indications for
UseThe Embla
BreathSensor provides a
qualitative air flow
signal by oral and/or
nasal temperature
sensitive resistive
components for
recording onto a
recording system in
support of airflow
analysis and sleep
studies.
The Embla
BreathSensor does not
provide any diagnostic
conclusion about the
patient's condition to
the user.
The Embla
BreathSensor user is a
qualified medical
practitioner who will
exercise their
professional judgment
in using this
information.
Rx onlyThe airflow signal is
provided by oral and/ or
nasal temperature
sensitive components.
Accessory single use
airflow sensors are used
to provide resistance
changes as affected by
temperature changes in
airflow representing
inhaled and exhaled air.
Rx onlySleepSense sensors
provide a qualitative
measure of a patient's
physiological
parameters for
recording onto an FDA-
cleared data acquisition
system. Their target
population: Children
and adult patients who
are screened during
sleep disorder studies.
Their environment of
use is usually at a sleep
laboratory or sometimes
at the patient's home.
Rx OnlyBoth the Embla
BreathSensors under
review and primary
predicate Airflow Sensors
provide oral and/or nasal
temperature sensitive
components.
The population of use of
the Embla BreathSensors
under review and primary
predicate EdenTec Airflow
Sensors are similar.
The variations of the
primary predicate Airflow
Sensors and Embla
BreathSensors under
review are identified by a
Model variation name
(Adult, Small Adult /
Child).
All three devices apply
interface cables as
applicable to condition the
signal for medical
professional user's
recording equipment.
All Rx Only
The Embla BreathSensors
under review provide
additional detail with
regard to the indications.
ContraindicationContraindicated for use
on patients who exhibitNoneNoneThe allergic reaction to
tape adds clarification on
Table 1: Substantial Equivalence Technical Characteristics
FeatureBreathSensors
Under ReviewEdenTrace Airflow
3171, Sleep Lab
Airflow 3170
(Primary Predicate
K913749)S.L.P. Ltd
SleepSense Sleep
Disorder Sensors
(Predicate K042253)Equivalence
Comments
allergic reactions to
adhesive tape.use.
Environment of
UseHospitalsHospitals, clinics and
home.Hospitals, clinics (sleep
labs) and home.The Embla Breath Sensors
have a hospital
environment of use.
Sensor
variationsBreathSensor
Adult, Small Adult /
ChildAirflow Sensor
Adult, Small Adult,
Child, Infant, PreemieDisposable Thermal
Flow Sensor
Adult, Child, Extra
SmallSimilar
The medical professional
selects the size of
BreathSensor that best fits
their patient with regard to
placement of nasal and oral
BreathSensor elements.
Temperature
Sensing
ElementsBreath Sensor
Nasal and Oral: Adult,
Small Adult / Child,Airflow Sensor
Nasal and Oral: Adult,
Small Adult, Child,
Infant
Oral only: PreemieDisposable Flow Sensor
Nasal and Oral, Oral
only options: Adult,
Child, Extra SmallSimilar
The primary predicate
variation names of Small
Adult and Child are
renamed to one variation.
BreathSensor:
Single patient
use, disposableYesYesYesSame
Qualitative
temperature
outputYesYesYesSame
The signal output from the
BreathSensor is a
qualitative signal based
upon the difference in
ambient and exhaled air.
The medical professional
will adjust signal amplitude
on the recording
equipment.
Duration of useDuration of a sleep
study, anticipated to be
up to 12 hoursDuration of a sleep
studyDuration of a sleep
studySame
Patient applied
locationBetween upper lip and
nostrilsBetween upper lip and
nostrilsBetween upper lip and
nostrilsSame
Sensor materialsCarbon Ink
Silver Ink
Polyester
TapeCarbon Ink
Silver Ink
Polyester (Mylar)
TapeUnknownCarbon ink is the
temperature sensitive
material. The conductive
silver ink conducts the
signal to the interface cable
input connector. The
carbon and silver ink are
placed on a polyester
substrate. The polyester
substrate and ink are
Table 1: Substantial Equivalence Technical Characteristics
FeatureBreathSensors
Under ReviewEdenTrace Airflow
3171, Sleep Lab
Airflow 3170
(Primary Predicate
K913749)S.L.P. Ltd
SleepSense Sleep
Disorder Sensors
(Predicate K042253)Equivalence
Comments
covered by tape.
Patient contact
materialMicro-Pore,
Micro-Foam TapeMicro-Pore TapeUnknownEquivalent
Final finished form
BreathSensors have been
evaluated for cytotoxicity,
irritation and sensitization
with passing results.
SterilitySupplied non-sterileSupplied non-sterileSupplied non-sterileSame
Accessory
Interface cablesYes
ActiveYes
Passive and activeYes
Passive and activeSimilar
Active interface cable
variations are available.
The interface cables
connect to the medial
professional's amplifier,
recording equipment,
supporting transfer of the
BreathSensor thermistor
signal to their equipment.
Accessory
Interface cable:
Active CableYes
Battery powered,
filtering and conversion
of sensor thermistor to
thermocouple sensor
signal.Yes
Battery Powered,
filtering and conversion
of sensor thermistor to
thermocouple sensor
signal.Yes
Battery Powered,
filtering and conversion
of sensor thermistor to
thermocouple sensor
signal.Equivalent
The active interface cables
have sensor and user
recording equipment
compatible connectors and
are battery powered
(internal).
The active interface cables
are battery-powered by an
internal non-user
replaceable battery. The
active interface cables
provide filtering and
conversion of the
thermistor sensor signal to
thermocouple sensor signal
for presentation to the
user's recording equipment
Accessory
interface cable:
ReusableYesYesYesSame
Connection to
user's
equipmentYes
Accessory Interface
CableYes
Accessory Interface
CableYes
Accessory Interface
CableSame
Interface cable
variationsActiveActive and passiveActive and passiveSimilar
The active interface cables
interface the BreathSensor
Table 1: Substantial Equivalence Technical Characteristics
FeatureBreathSensors
Under ReviewEdenTrace Airflow
3171, Sleep Lab
Airflow 3170
(Primary Predicate
K913749)S.L.P. Ltd
SleepSense Sleep
Disorder Sensors
(Predicate K042253)Equivalence
Comments
to recording equipment.

5

Image /page/5/Picture/0 description: The image contains the logo for Natus Neurology. The word "natus" is in a teal color and in a larger font. Below that, the word "neurology" is in a smaller, black font. There is a registered trademark symbol to the right of the word "natus".

6

Image /page/6/Picture/0 description: The image contains the logo for Natus Neurology. The word "natus" is in a teal color and in a larger font. Below that, the word "neurology" is in a smaller, black font. There is a registered trademark symbol to the right of the word "natus".

7

Image /page/7/Picture/0 description: The image shows the logo for Natus Neurology. The word "natus" is written in a teal, sans-serif font. Below that, the word "neurology" is written in a black, sans-serif font. The logo is simple and modern.

As noted, the differences do not affect substantial equivalence of safety and effectiveness:

  • A contraindication is added for patients who may have allergic reactions to adhesive tape. .
  • . The BreathSensors are supported by available accessory interface cable(s).

Performance Tests to Demonstrate Substantial Equivalency

To establish the technical equivalency of the BreathSensors, evaluations were conducted to confirm compliance with performance requirements. Table 2 summarizes evaluations and results supporting substantial equivalence.

Table 2: Summary of Evaluations Supporting Substantial Equivalence
FeatureEvaluation SummaryResult
DimensionsVerification of dimensions.Pass
Labels and LabelingVerification of label and labeling content for variations.Pass
MaterialVerification of specified materials.Pass
Biocompatibility of patient
contact materialsSupported with final finished form cytotoxicity, sensitization and irritation
evaluations.Pass
ResistanceVerify BreathSensor base resistance.Pass
Temperature SensitivityVerify minimum temperature sensitivity of resistance change per ℃.Pass
Performance TestingComparison with predicate Disposable Flow Sensor, evaluation of qualitative airflow
response with Interface Cable.Pass
Electromagnetic
compatibilityBreathSensor and Interface Cable compliance with IEC 60601-1-2:2014,
4th editionPass

Conclusion

The Embla BreathSensors meet performance requirements. The intended use and technology of the Embla BreathSensors are similiar to the predicate devices.