K Number
K181466
Device Name
Cadwell Zenith System
Date Cleared
2018-09-01

(89 days)

Product Code
Regulation Number
882.1400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Zenith is an electroneurodiagnostic device that accepts, measures, and stores electrical activity of the brain via scalp and intracranial electroencephalography (EEG) signals, and, utilizing an integrated switch matrix, relays stimulation signals to the patient. It can obtain, display and store electrophysiological data from the central nervous system, generated either spontaneously or elicited by well-defined stimuli. The data is used to perform neurodiagnostic evaluations, including EEG and direct cortical stimulation. Zenith Cadwell acquisition software. Zenith is used by or under the direction of a licensed physician, surgeon, or neurologist in a professional healthcare facility environment for pre-operative, intraoperative testing on patients of all ages.
Device Description
The Cadwell Zenith System is a high channel-count Electroencephalogram (EEG) system capable of cortical stimulation via the optional stimulator and built in switch matrix. The system is capable of acquiring, storing, and reviewing neurophysiological data and report generation. The Cadwell Zenith System can be configured in a portable or fixed room configuration. Carts are available for purchase with the system. The Cadwell Zenith System consists of one (1) or more Zenith amplifiers, an IOMAX Base Module, and an optional IOMAX Cortical Module. Additionally, a Patient Event Button, USB Photic Stimulator, and USB Footswitch can be purchased separately
More Information

Not Found

No
The document describes a standard electroneurodiagnostic device for acquiring and displaying EEG data and performing stimulation. There is no mention of AI, ML, or any advanced analytical capabilities beyond basic data acquisition and display. The performance studies focus on software validation, electrical safety, EMC, and compliance with relevant medical device standards, not on the performance of any AI/ML algorithms.

No
The device is described as an "electroneurodiagnostic device" used to "accepts, measures, and stores electrical activity of the brain" and "obtain, display and store electrophysiological data from the central nervous system," which is then "used to perform neurodiagnostic evaluations." Its purpose is to diagnose conditions, not to treat them.

Yes

The "Intended Use / Indications for Use" section explicitly states that the device is "an electroneurodiagnostic device" and that "The data is used to perform neurodiagnostic evaluations, including EEG and direct cortical stimulation."

No

The device description explicitly lists hardware components such as amplifiers, base modules, and optional cortical modules, indicating it is a system with both hardware and software.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are devices intended for use in the examination of specimens derived from the human body (such as blood, urine, or tissue) to provide information for diagnostic purposes.
  • Zenith's Function: The Zenith device directly measures and records electrical activity from the brain via scalp and intracranial electrodes. It also relays stimulation signals to the patient. This is a direct interaction with the patient's body, not the analysis of a specimen in vitro (outside the body).
  • Intended Use: The intended use describes the device as an "electroneurodiagnostic device" used for "neurodiagnostic evaluations, including EEG and direct cortical stimulation." This aligns with in vivo (within the living organism) testing.

Therefore, the Zenith device falls under the category of a medical device used for in vivo physiological measurement and stimulation, not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

Zenith is an electroneurodiagnostic device that accepts, measures, and stores electrical activity of the brain via scalp and intracranial electroencephalography (EEG) signals, and, utilizing an integrated switch matrix, relays stimulation signals to the patient. It can obtain, display and store electrophysiological data from the central nervous system, generated either spontaneously or elicited by well-defined stimuli. The data is used to perform neurodiagnostic evaluations, including EEG and direct cortical stimulation. Zenith Cadwell acquisition software.

Zenith is used by or under the direction of a licensed physician, surgeon, or neurologist in a professional healthcare facility environment for pre-operative, intraoperative testing on patients of all ages.

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

GWQ, GYC, GWF, ETN

Device Description

The Cadwell Zenith System is a high channel-count Electroencephalogram (EEG) system capable of cortical stimulation via the optional stimulator and built in switch matrix. The system is capable of acquiring, storing, and reviewing neurophysiological data and report generation. The Cadwell Zenith System can be configured in a portable or fixed room configuration. Carts are available for purchase with the system. The Cadwell Zenith System consists of one (1) or more Zenith amplifiers, an IOMAX Base Module, and an optional IOMAX Cortical Module. Additionally, a Patient Event Button, USB Photic Stimulator, and USB Footswitch can be purchased separately

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

central nervous system (brain)

Indicated Patient Age Range

patients of all ages.

Intended User / Care Setting

licensed physician, surgeon, or neurologist in a professional healthcare facility environment

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)

Software: The Cadwell acquisition software is MODERATE level of concern software. Software was designed and developed according to a robust software development process, and was rigorously verified and validated. Test results indicate that the Cadwell acquisition software complies with its predetermined specifications and the applicable guidance documents.

Electrical Safety: The Cadwell Zenith System was tested for performance in accordance with ANSI/AAMI ES60601-1: 2005/(R)2012, Am1: 2012, C1:2009/(R)2012 A2:2010/(R)2012, Medical electrical equipment – Part 1: General requirements for basic safety and essential performance. Test results indicate that the Cadwell Zenith System complies with the applicable standards.

Electromagnetic Compatibility: The Cadwell Zenith System was tested for performance in accordance with IEC 60601-1-2: 2014, Medical electrical equipment – Part 1-2: General requirements for basic safety and essential performance – Collateral standard: Electromagnetic disturbances – Requirements and tests. Test results indicate that the Cadwell Zenith System complies with the applicable standards.

Performance Testing – Bench: The Cadwell Zenith System was tested for performance in accordance with internal requirements and the following standards: IEC 60601-2-26: 2012, Medical electrical equipment – Part 2-26: Particular requirements for the basic safety and essential performance of electroencephalographs; IEC 60601-2-40: 2016, Medical electrical equipment – Part 2-40: Particular requirements for the safety of electromyographs and evoked response equipment; IEC 60601-1-6: 2013, Medical electrical equipment - Part 1-6: General requirements for basic safety and essential performance -Collateral standard: Usability; IEC 62366-1: 2015, Medical devices – Application of usability engineering to medical devices. Test results indicate that the Cadwell Zenith System complies with its predetermined specifications and the applicable standards.

Conclusion: Verification and validation activities were conducted to establish the performance and safety characteristics of the Cadwell Zenith System. The results of these activities demonstrate that the Cadwell Zenith System is as safe, as effective, and performs as well as or better than the predicate devices. Therefore, the Cadwell Zenith System is considered substantially equivalent to the predicate devices.

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.

K143440, K180181, K162199

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

Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which consists of a blue square with the letters "FDA" in white, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue.

September 1, 2018

Cadwell Industries, Inc. John Cadwell Jr Senior Vice President 909 North Kellogg Street Kennewick, Washington 99336

Re: K181466

Trade/Device Name: Cadwell Zenith System Regulation Number: 21 CFR 882.1400 Regulation Name: Electroencephalograph Regulatory Class: Class II Product Code: GWQ, GYC, GWF, ETN Dated: June 1, 2018 Received: June 4, 2018

Dear John Cadwell Jr:

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

1

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) 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.

Jay R. Gupta -S

For Carlos L. Peña, PhD, MS Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K181466

Device Name Cadwell Zenith System

Indications for Use (Describe)

Zenith is an electroneurodiagnostic device that accepts, measures, and stores electrical activity of the brain via scalp and intracranial electroencephalography (EEG) signals, and, utilizing an integrated switch matrix, relays stimulation signals to the patient. It can obtain, display and store electrophysiological data from the central nervous system, generated either spontaneously or elicited by well-defined stimuli. The data is used to perform neurodiagnostic evaluations, including EEG and direct cortical stimulation. Zenith Cadwell acquisition software.

Zenith is used by or under the direction of a licensed physician, surgeon, or neurologist in a professional healthcare facility environment for pre-operative, intraoperative testing on patients of all ages.

X Prescription Use (Part 21 CFR 801 Subpart D)

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

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Submission Date:01 June 2018
Submitter:Cadwell Industries, Inc.
909 North Kellogg Street
Kennewick, WA 99336
Submitter and
Application
CorrespondentMr. John Cadwell Jr.
Phone: +1 (800) 245-3001, Extension 222
Email: johnjr@cadwell.com
Manufacturing Site:Cadwell Industries, Inc.
909 North Kellogg Street
Kennewick, WA 99336
Trade Name:Cadwell Zenith System
Common and
Classification
Name:Electroencephalograph
Primary
Classification
Regulation:21 CFR §882.1400
Primary Product
Code:GWQ
Secondary Product
Codes:GYC, GWF, ETN
Substantially
Equivalent Devices:New Cadwell ModelPredicate
510(k) NumberPredicate
Manufacturer / Model
Cadwell Zenith SystemK143440,
K180181Natus Medical
Incorporated DBA Excel-
Tech Ltd. (XLTEK) /
Natus Quantum (primary)
K162199Cadwell Industries Inc. /
Cascade IOMAX
Interoperative Monitor

(secondary)

4

Device Description: The Cadwell Zenith System is a high channel-count Electroencephalogram (EEG) system capable of cortical stimulation via the optional stimulator and built in switch matrix. The system is capable of acquiring, storing, and reviewing neurophysiological data and report generation. The Cadwell Zenith System can be configured in a portable or fixed room configuration. Carts are available for purchase with the system. The Cadwell Zenith System consists of one (1) or more Zenith amplifiers, an IOMAX Base Module, and an optional IOMAX Cortical Module. Additionally, a Patient Event Button, USB Photic Stimulator, and USB Footswitch can be purchased separately Indications for Use: Zenith is an electroneurodiagnostic device that accepts, measures, displays, records, and stores electrical activity of the brain via scalp and intracranial electroencephalography (EEG) signals, and, utilizing an integrated switch matrix, relays stimulation signals to the patient. It can obtain, display and store electrophysiological data from the central nervous system, generated either spontaneously or elicited by welldefined stimuli. The data is used to perform neurodiagnostic evaluations, including EEG and direct cortical stimulation. Zenith is used with Cadwell acquisition software. Zenith is used by or under the direction of a licensed physician, surgeon, or neurologist in a professional healthcare facility environment for preoperative, intraoperative and post-operative testing on patients of all ages. Technology The Cadwell Zenith System employs the same technological Comparison: characteristics as the predicate device. Predicate Device Characteristic Proposed Device

| Population | Patients of all ages. | Patients of all ages, but is not
designed for fetal use |
|-------------------------|--------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------|
| System
Configuration | Computer based equipment with
dedicated hardware
peripherals/components, and custom
acquisition software. | Computer based equipment with
dedicated hardware
peripherals/components, and custom
acquisition software. |
| Modalities | Electroencephalogram (EEG)
External cortical stimulation
Photic stimulation
Video | Electroencephalogram (EEG)
External cortical stimulation
Photic stimulation

Pulse oximetry |

5

CharacteristicProposed DevicePredicate Device
Amplifier
Channels144 channels per amplifier, cascade-
able up to 576 channels128 channels per amplifier, cascade-
able up to 256 channels
• 144 referential channels per
amplifier• 128 referential channels per
amplifier
• 8 differential channels per
amplifier• Up to 8 configurable differential
channels per amplifier
• 0 DC channels per amplifier• 16 DC channels per amplifier
Number of
Amplifiers that
can Connect to
RecorderFour (4)Two (2)
Input Impedance1 GΩ>1000 ΜΩ
Input Noise25 mV peak-to-peak20 mV peak-to-peak
Maximum DC
Input Voltage
Offset> ±500 mV±300 mV
Common Mode
Rejection Ratio>110 dB at 60Hz>106 dB at 60 Hz
Sampling
Frequency1 MHz256, 512, 1024, 2048, 4096, 8192,
16384 Hz
Storage RateUp to 8 kHz
Sampling A/D
Resolution24 bits24 bits
Cortical stimulator
outputOutput mode: Low
Output type: Constant currentOutput mode: Low
Output type: Constant current

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Summary of Performance Testing:

| Software | The Cadwell acquisition software is MODERATE level of concern software. Software was designed and developed according to a robust software development process, and was rigorously verified and validated. Software information is provided in accordance with internal requirements and the following guidance documents:
FDA guidance: The content of premarket submissions for software contained in medical devices, 11 May 05. FDA guidance: Off-the-shelf software use in medical devices, 09 Sep 99. FDA guidance: General principles of software validation; Final guidance for industry and FDA staff, 11 Jan 02. FDA guidance: Content of premarket submissions for management of cybersecurity in medical devices, 02 Oct 14. IEC 62304: 2006, Am1: 2015, Medical device software - Software life cycle processes Test results indicate that the Cadwell acquisition software complies with its predetermined specifications and the applicable guidance documents. |
|----------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Electrical Safety | The Cadwell Zenith System was tested for performance in accordance with the following standard:
ANSI/AAMI ES60601-1: 2005/(R)2012, Am1: 2012, C1:2009/(R)2012 A2:2010/(R)2012, Medical electrical equipment – Part 1: General requirements for basic safety and essential performance. Test results indicate that the Cadwell Zenith System complies with the applicable standards. |
| Electromagnetic
Compatibility | The Cadwell Zenith System was tested for performance in accordance with the following standard:
IEC 60601-1-2: 2014, Medical electrical equipment – Part 1-2: General requirements for basic safety and essential performance – Collateral standard: Electromagnetic disturbances – Requirements and tests. Test results indicate that the Cadwell Zenith System complies with the |

applicable standards.

7

Performance The Cadwell Zenith System was tested for performance in accordance Testing – Bench with internal requirements and the following standards: IEC 60601-2-26: 2012, Medical electrical equipment – Part 2-26: ● Particular requirements for the basic safety and essential performance of electroencephalographs ● IEC 60601-2-40: 2016, Medical electrical equipment – Part 2-40: Particular requirements for the safety of electromyographs and evoked response equipment ● IEC 60601-1-6: 2013, Medical electrical equipment - Part 1-6: General requirements for basic safety and essential performance -Collateral standard: Usability • IEC 62366-1: 2015, Medical devices – Application of usability engineering to medical devices. Test results indicate that the Cadwell Zenith System complies with its predetermined specifications and the applicable standards. Conclusion Verification and validation activities were conducted to establish the performance and safety characteristics of the Cadwell Zenith System. The results of these activities demonstrate that the Cadwell Zenith System is as safe, as effective, and performs as well as or better than the predicate devices. Therefore, the Cadwell Zenith System is considered substantially

equivalent to the predicate devices.

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