K Number
K180298
Device Name
welloStationX
Manufacturer
Date Cleared
2018-11-30

(301 days)

Product Code
Regulation Number
880.2910
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The welloStationX is a non-contact infrared forehead thermometer intended for use to measure the body temperature of individuals over 5 years of age and older. The welloStationX can be used by medical professionals or laypersons in any public or private indoor facility with environmental conditions maintained within 15°C to 28°C (59°F to 82.4°F), 20 -70% RH non-condensing.
Device Description
The welloStationX uses an infrared sensor to measure human body temperature. It is offered as a desktop or kiosk model. The WSX consists of a display screen with an IR camera mounted to the top of the display screen. The display screen provides instructions to subjects being screened. Both the kiosk and desktop model operate in the same manner. The subject reads and follows the on-screen instructions to position themselves in the correct location approximately 10 inches from the WSX. In 3 seconds, the WSX provides output of the subject's core body temperature. Each temperature reading will be output with either a green background or a red background. Temperature displayed with a red background will also include a prompt to obtain a second temperature evaluation using an alternate method. The facility can select the action threshold or use the default threshold above which the reading will be displayed with a red background. Users can receive email alerts for any subject with a temperature reading displayed with a red background. For some features, an active internet connection is required.
More Information

Not Found

No
The description focuses on standard infrared temperature measurement and basic software functions like displaying instructions, providing color-coded output based on a threshold, and sending email alerts. There is no mention of AI, ML, image processing for complex analysis, or training/test data sets typically associated with AI/ML models.

No.

The device is a non-contact infrared forehead thermometer used to measure body temperature, which is a diagnostic function, not a therapeutic one. It does not treat or alleviate any medical condition.

Yes.
The device is intended to measure body temperature, which is a physiological parameter used in health assessment. While it's a screening tool, the output (red/green background, suggestion for alternate evaluation) indicates its role in identifying potential health issues, classifying it as a diagnostic device.

No

The device description explicitly states it uses an infrared sensor and is offered as a desktop or kiosk model with a display screen and IR camera, indicating it includes hardware components beyond just software.

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

Here's why:

  • Definition of IVD: In Vitro Diagnostic devices are used to examine specimens taken from the human body, such as blood, urine, or tissue, to provide information for diagnosis, monitoring, or screening.
  • WelloStationX Function: The WelloStationX measures body temperature directly from the forehead using infrared technology. It does not analyze any biological specimens taken from the individual.

Therefore, based on the provided information, the welloStationX is a medical device, specifically a non-contact infrared thermometer, but it does not fit the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The welloStationX is a non-contact infrared forehead thermometer intended for use to measure of individuals over 5 years of age and older. The welloStationX can be used by medical professionals or laypersons in any public or private indoor facility with environmental conditions maintained within 15°C to 28°C (59°F to 82.4°F), 20 -70% RH non-condensing.

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

FLL

Device Description

The welloStationX uses an infrared sensor to measure human body temperature. It is offered as a desktop or kiosk model.

The WSX consists of a display screen with an IR camera mounted to the top of the display screen. The display screen provides instructions to subjects being screened. Both the kiosk and desktop model operate in the same manner. The subject reads and follows the on-screen instructions to position themselves in the correct location approximately 10 inches from the WSX. In 3 seconds, the WSX provides output of the subject's core body temperature.

Each temperature reading will be output with either a green background or a red background. Temperature displayed with a red background will also include a prompt to obtain a second temperature evaluation using an alternate method. The facility can select the action threshold or use the default threshold above which the reading will be displayed with a red background. Users can receive email alerts for any subject with a temperature reading displayed with a red background. For some features, an active internet connection is required.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

forehead

Indicated Patient Age Range

over 5 years of age and older

Intended User / Care Setting

medical professionals or laypersons in any public or private indoor facility

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)

A Clinical accuracy validation of the welloStationX® based on ISO 80601-2-56 was conducted in 110 males and females aged 5 years of age and older. Temperature was measured using the WelloStationX and a Welch Allyn SureTemp oral thermometer. Each measurement was recorded by a trained technician following the instructions for use in the respective device labeling. The validation study demonstrated that the clinical accuracy of the welloStationX® was equivalent to the oral thermometer and reported values for the predicate device.

Additional tests included verification testing to internal functional specifications (including software) and side-by-side bench accuracy testing of the new device and the predicate device. Documentation was provided demonstrating compliance to FDA requirements stated in Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices, including results of verification/validation plus traceability of verification/validation tests to software requirements and software hazards. Testing was also conducted for compliance to:

  • IEC 60601-1. Medical electrical equipment Part 1: General requirements for basic safety and . essential performance
  • 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
  • IEC 60601-1-6. Medical electrical equipment Part 1-6: General requirements for basic safety and ● essential performance - Collateral standard: Usability
  • IEC 62366, Medical Devices Application of usability engineering to medical devices ●
  • IEC 62304, Medical device software -- Software life cycle processes
  • ASTM E1965 - 98, Standard Specification for Infrared Thermometers for Intermittent Determination of Patient Temperature
  • ISO 80601-2-56 Medical electrical equipment -- Part 2-56: Particular requirements for basic safety ● and essential performance of clinical thermometers for body temperature measurement.

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

±0.2°C (±0.4°F)

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.

K131771

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

§ 880.2910 Clinical electronic thermometer.

(a)
Identification. A clinical electronic thermometer is a device used to measure the body temperature of a patient by means of a transducer coupled with an electronic signal amplification, conditioning, and display unit. The transducer may be in a detachable probe with or without a disposable cover.(b)
Classification. Class II (performance standards). The device is exempt from the premarket notification procedures in part 807, subpart E of this chapter, subject to the limitations in § 880.9 and the following conditions for exemption:(1) Device is not a clinical thermometer with telethermographic functions;
(2) Device is not a clinical thermometer with continuous temperature measurement functions; and
(3) Appropriate analysis and testing (such as that outlined in the currently FDA-recognized editions, as appropriate, of ISO 80601-2-56, “Medical electrical equipment—Part 2-56: Particular requirements for basic safety and essential performance of clinical thermometers for body temperature measurement,” or ASTM E1965, “Standard Specification for Infrared Thermometers for Intermittent Determination of Patient Temperature,” or ASTM E1112, “Standard Specification for Electronic Thermometer for Intermittent Determination of Patient Temperature,” or ASTM E1104, “Standard Specification for Clinical Thermometer Probe Covers and Sheaths”) must validate specifications and performance of the device.

0

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November 30, 2018

Wello, Inc Alan C. Heller Chairman and CEO 800 East Campbell Road, Suite 202 Richardson, Texas 75081

Re: K180298

Trade/Device Name: welloStationX Regulation Number: 21 CFR 880.2910 Regulation Name: Clinical Electronic Thermometer Regulatory Class: Class II Product Code: FLL Dated: November 29, 2018 Received: November 29, 2018

Dear Alan C. Heller:

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 requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part

1

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/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.htm); good manufacturing practice requirements as set forth in the quality systems (QS) 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 http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm.

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.

Geeta K. Pamidimukkala -S

for 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

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Indications for Use

510(k) Number (if known) K180298

Device Name welloStationX

Indications for Use (Describe)

The welloStationX is a non-contact infrared forehead thermometer intended for use to measure of individuals over 5 years of age and older. The welloStationX can be used by medical professionals or laypersons in any public or private indoor facility with environmental conditions maintained within 15°C to 28°C (59°F to 82.4°F), 20 -70% RH non-condensing.

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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510(k) SUMMARY

510(k) Number:K180298
Submitter:Wello Inc.
3939 Belt Line Road, Suite 400
Addison, TX 75001
Contact Person:Mr. Alan Camerik (Rik) Heller
Chairman and CEO
TEL: 469-518-1228
FAX: 469-522-5200
rik.heller@welloinc.com
Date Prepared:November 30, 2018
Proposed DeviceManufacturer: Wello, Inc.
Trade Name: welloStationXTM
Common Name: IR Thermometer
Classification Name: Clinical Electronic Thermometer
Product Code FLL
Regulation: 21 CFR 880.2910, Thermometer, Electronic, Clinical
Classification: Class II
Predicate Device:Clearance: K131771 dated Oct 07, 2013
Manufacturer: Thermomedics, Inc.
Trade Name: Caregiver Professional Clinical Thermometer
Common Name: IR Thermometer
Classification Name: Clinical Electronic Thermometer
Product Code FLL
Regulation: 21 CFR 880.2910, Thermometer, Electronic, Clinical
Classification: Class II
Device
Description:The welloStationX uses an infrared sensor to measure human body temperature. It is offered as a desktop or kiosk model.

The WSX consists of a display screen with an IR camera mounted to the top of the display screen. The display screen provides instructions to subjects being screened. Both the kiosk and desktop model operate in the same manner. The subject reads and follows the on-screen instructions to position themselves in the correct location approximately 10 inches from the WSX. In 3 seconds, the WSX provides output of the subject's core body temperature.

Each temperature reading will be output with either a green background or a red background. Temperature displayed with a red background will also include a prompt to obtain a second temperature evaluation using an alternate method. The facility can select the action threshold or use the default threshold above which the reading will be displayed with a red background. Users can receive email alerts for any subject with a temperature reading displayed with a red background. For some features, an active internet connection is required. |

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Indications for The welloStationX is a non-contact infrared forehead thermometer intended for use to measure the body Use Statement: temperature of individuals over 5 years of age and older. The welloStationX can be used by medical professionals or laypersons in any public or private indoor facility with environmental conditions maintained within 15°C to 28°C (59°F to 82.4°F), 20 - 70% RH non-condensing.

Summary of Technological Characteristics:

| Device & Predicate

Device(s):K180298K131771Conclusion
General Device
Characteristics
Product Code(s)FLLFLLIdentical
Regulation(s)880.2910880.2910Identical
Rx/OTCOTCOTCIdentical
FeaturesTemperature & Photo Recall
Multiple Modes
°F/°C scale
Date and Time
Error Messages
Wi-Fi/Ethernet Connectivity
Online Storage/NotificationsTemperature Recall
Multiple Modes
°F/°C scale
Date and Time
Error Messages
Sleep/Auto Shutoff
Low Battery IndicatorDifferent
Operational Mode(s)Online Mode
Offline Mode
Standalone ModeBody Temperature Mode
Surface Temperature Mode
Room Temperature ModeDifferent
TechnologyNon-contacting IR sensor;
FreestandingNon-contacting IR senor;
HandheldDifferent
AccessoriesThermal Printer (optional)
Mounting Hardware
WelloCloud/welloinc.net
(optional)Protective Cap
Wall Mount (optional)
Security Tether (optional)Different
Displayed
Temperature Range(s)Body: 95°F to 107.6°F (35°C to
42°C)
"Invalid Measurement"
Displayed if
temperature appear outside of the
body
temperature range.Body: 94°F to 108.0°F (34.4°C
to 42.2°C)
"Lo" Temperatures 108°F
(42.2°C)
"LOW Temps" Displayed
temperatures
appear to be too low
Surface: 32°F to 140°F (0°C to
60°C)Different
Displayed Accuracy±0.2°C (±0.4°F)96.8/102.2°F ±0.4°F (36/39°C
±0.2°C)
71.6/96.7°F ±0.5°F (22/35.9°C
±0.3°C)
102.3/108.0°F ±0.5°F
(39.1/42.2°C ±0.3°C)
Not specified below 71.6°F
(22°C)Different
Power SourceMains 100-240 V / 50-60 Hz
NO BATTERIESTwo 1.5v "AA" Alkaline
BatteriesDifferent
DimensionsDesktop: 13.5 W x 13.25 H x 7
D (in)
Kiosk: 19.5 W x 57.5 H x 14.5 D
(in)150 L x 48.48 W x 55.16 H
(mm)Different
Field of View±5° cone angle±8° cone angleDifferent
Measuring Distance12 to 13 inches0.5 to 2.0 inchesDifferent
CalibrationFactory Calibration Only
Start-up auto calibrationUser Calibration ModeDifferent
Reading Time3 sec
10 sec between measurements1-2 sec
20 sec between measurementsSimilar
Start-up / Acclimation
TimeStart-up: 30 seconds
includes self-test and calibrationPatient Acclimation: 20 minutes
Thermometer Acclimation: 20
minutesDifferent
Cleaning SurfaceWipe with IPAWipe with IPA/DetergentIdentical
Operation Conditions15°C to 28°C (59°F to 82.4°F)
20% to 70% RH non-condensing50°F to 104°F (10°C to 40°C)
A Clinical accuracy validation of the welloStationX® based on ISO 80601-2-56 was conducted in 110 males and females aged 5 years of age and older. Temperature was measured using the WelloStationX and a Welch Allyn SureTemp oral thermometer. Each measurement was recorded by a trained technician following the instructions for use in the respective device labeling. The validation study

6

demonstrated that the clinical accuracy of the welloStationX® was equivalent to the oral thermometer and reported values for the predicate device.

Additional tests included verification testing to internal functional specifications (including software) and side-by-side bench accuracy testing of the new device and the predicate device. Documentation was provided demonstrating compliance to FDA requirements stated in Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices, including results of verification/validation plus traceability of verification/validation tests to software requirements and software hazards. Testing was also conducted for compliance to:

  • IEC 60601-1. Medical electrical equipment Part 1: General requirements for basic safety and . essential performance
  • 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
  • IEC 60601-1-6. Medical electrical equipment Part 1-6: General requirements for basic safety and ● essential performance - Collateral standard: Usability
  • IEC 62366, Medical Devices Application of usability engineering to medical devices ●
  • IEC 62304, Medical device software -- Software life cycle processes
  • ASTM E1965 - 98, Standard Specification for Infrared Thermometers for Intermittent Determination of Patient Temperature
  • ISO 80601-2-56 Medical electrical equipment -- Part 2-56: Particular requirements for basic safety ● and essential performance of clinical thermometers for body temperature measurement.
  • Conclusion: Wello Inc considers the welloStationX™ to be substantially equivalent to the predicate device listed above. This conclusion is based on the non-clinical data that demonstrates the device performs as intended in the specified use conditions and on the similarities in intended use, principles of operation, and functional design.