K Number
K190465
Device Name
Evolve Breast Pump
Date Cleared
2019-10-18

(234 days)

Product Code
Regulation Number
884.5160
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Evolve breast pump is intended to be used by lactating women to express and collect milk from their breasts.
Device Description
The Evolve Breast Pump, is an electrically powered breast pump from an external AC-DC power supply; the device is provided non-sterile. The Evolve Breast Pump is intended to be used by lactating women to express and collect milk from their breasts. Pumping can be performed on one breast (single pumping) or on both breasts of a lactating woman at the same time (double pumping). The Evolve breast pump is designed as a multi-user breast pump and available in a corded model (external AC-DC power supply). The Evolve Breast Pump utilizes a DC-powered motor driving a reciprocating-type vacuum pump and an electromechanical solenoid which are controlled electronically to provide vacuum (suction) capability that extracts and collects milk from breasts of lactating women. The Evolve Breast Pump has a backlit, LCD display for user display. The subject device also has soft-touch buttons for the user to power the device on/off, switch between two different pumping modes - stimulation and expression - and to control vacuum speed and strength within each of the modes. Multiple vacuum speed and strength settings are available in both pumping modes. The Evolve Breast Pump is intended for repeated use by multiple users in home environment. The Evolve Breast Pump requires Hygeia's Personal Accessory System for users to express and collect milk from their breasts.
More Information

Not Found

No
The device description focuses on standard electromechanical components and electronic control for vacuum and modes, with no mention of adaptive learning, pattern recognition, or other AI/ML characteristics. The "Mentions AI, DNN, or ML" field is explicitly "Not Found".

No.
The device is a breast pump used to express and collect milk, not to treat a disease or condition.

No

The device is a breast pump, which is used to express and collect milk. Its purpose is not to diagnose any medical condition or disease.

No

The device description explicitly details hardware components such as a motor, vacuum pump, solenoid, LCD display, and buttons, and mentions electrical safety and electromagnetic compatibility testing, indicating it is a physical device with integrated software, not a software-only device.

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

Here's why:

  • Intended Use: The intended use is to "express and collect milk from their breasts." This is a physical process performed on the body, not a test performed on a sample taken from the body.
  • Device Description: The description details a mechanical device that uses vacuum to extract milk. It does not mention any components or processes related to analyzing biological samples.
  • Lack of IVD Characteristics: IVD devices are typically used to examine specimens such as blood, urine, or tissue to diagnose diseases, monitor conditions, or screen for health issues. The Evolve breast pump does none of these things.

The device is clearly described as a medical device used for a physiological function (lactation), not for in vitro diagnostic testing.

N/A

Intended Use / Indications for Use

The Evolve breast pump is intended to be used by lactating women to express and collect milk from their breasts.

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

HGX

Device Description

The Evolve Breast Pump, is an electrically powered breast pump from an external AC-DC power supply; the device is provided non-sterile.

The Evolve Breast Pump is intended to be used by lactating women to express and collect milk from their breasts. Pumping can be performed on one breast (single pumping) or on both breasts of a lactating woman at the same time (double pumping). The Evolve breast pump is designed as a multi-user breast pump and available in a corded model (external AC-DC power supply).

The Evolve Breast Pump utilizes a DC-powered motor driving a reciprocating-type vacuum pump and an electromechanical solenoid which are controlled electronically to provide vacuum (suction) capability that extracts and collects milk from breasts of lactating women.

The Evolve Breast Pump has a backlit, LCD display for user display. The subject device also has soft-touch buttons for the user to power the device on/off, switch between two different pumping modes - stimulation and expression - and to control vacuum speed and strength within each of the modes. Multiple vacuum speed and strength settings are available in both pumping modes.

The Evolve Breast Pump is intended for repeated use by multiple users in home environment.

The Evolve Breast Pump requires Hygeia's Personal Accessory System for users to express and collect milk from their breasts.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Breasts

Indicated Patient Age Range

Not Found

Intended User / Care Setting

lactating women / home 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)

The Evolve Breast Pump complies with voluntary standards for electrical safety, electromagnetic compatibility, and use in the home environment.

Risk/Hazard: Risk Analysis in accordance with ISO 14971:2007 was used to assess impact of modifications to the device.
Electrical Safety and Electromagnetic Compatibility (EMC):

  • Electrical safety testing per IEC 60601-1:2005 (3rd Edition) with US deviations per AAMI/ANSI ES60601-1:2005/(R)2012 and A1:2012 standard.
  • Electromagnetic compatibility testing per IEC 60601-1-2: 2014 (4th edition) standard, Medical Electrical Equipment Part 1 - 2.
    Firmware Testing: The software/firmware verification and validation was provided in accordance with the FDA Guidance document, "The Content of Premarket Submissions for Software Contained in Medical Devices," issued on May 11, 2005.

Performance Testing: The Evolve Breast Pump was tested to demonstrate it meets its performance specifications. The testing involved measurement of vacuum and cycles for minimum and maximum settings for both single and double pumping mode, and for stimulation and expression mode. Also, backflow protection was tested. Specifications were met and within required, acceptable range for pump operation, cycle rate, and vacuum pressure.

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.

K081932

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

§ 884.5160 Powered breast pump.

(a)
Identification. A powered breast pump in an electrically powered suction device used to express milk from the breast.(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 and Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

October 18, 2019

Hygeia II Medical Group, Inc. Brett Nakfoor CEO 6241 Yarrow Drive Carlsbad, CA 92011

Re: K190465

Trade/Device Name: Evolve Breast Pump Regulation Number: 21 CFR 884.5160 Regulation Name: Powered Breast Pump Regulatory Class: II Product Code: HGX Dated: September 18, 2019 Received: September 20, 2019

Dear Brett Nakfoor:

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.

1

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) 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 (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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

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/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.

Sharon Andrews Acting Director DHT3B: Division of Reproductive, Gynecology and Urology Devices OHT3: Office of GastroRenal, ObGyn, General Hospital and Urology Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K190465

Device Name Evolve breast pump

Indications for Use (Describe)

The Evolve breast pump is intended to be used by lactating women to express and collect milk from their breasts.

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 - K190465

In accordance to CFR Title 21, Sec. 807.92 the following summary is provided.

SUBMITTER:

Hygeia II Medical Group, Inc. 6214 Yarrow Drive, Suite A Carlsbad, CA 92011 Phone: (714) 515-7571

PRIMARY CONTACT PERSON:

Brett Nakfoor CEO Hygeia II Medical Group (714) 515-7571

SECONDARY CONTACT PERSON:

John Conklin Product Development Hygeia II Medical Group (714) 515-7571

DATE PREPARED: October 16, 2019

Device Information

Trade Name: Evolve Breast Pump Common Name: Powered Breast Pump Classification Name: Powered Breast Pump Classification Panel: Obstetrics/Gynecology Requlation: 21 CFR 884.5160 Device Classification: Class II Product Code: HGX Product Code Name: Pump, Breast, Powered

Predicate Device Information

Hygeia EnDeare Breast Pump, K081932 This predicate has not been subject to a design-related recall.

4

Device Description

The Evolve Breast Pump, is an electrically powered breast pump from an external AC-DC power supply; the device is provided non-sterile.

The Evolve Breast Pump is intended to be used by lactating women to express and collect milk from their breasts. Pumping can be performed on one breast (single pumping) or on both breasts of a lactating woman at the same time (double pumping). The Evolve breast pump is designed as a multi-user breast pump and available in a corded model (external AC-DC power supply).

The Evolve Breast Pump utilizes a DC-powered motor driving a reciprocating-type vacuum pump and an electromechanical solenoid which are controlled electronically to provide vacuum (suction) capability that extracts and collects milk from breasts of lactating women.

The Evolve Breast Pump has a backlit, LCD display for user display. The subject device also has soft-touch buttons for the user to power the device on/off, switch between two different pumping modes - stimulation and expression - and to control vacuum speed and strength within each of the modes. Multiple vacuum speed and strength settings are available in both pumping modes.

The Evolve Breast Pump is intended for repeated use by multiple users in home environment.

The Evolve Breast Pump requires Hygeia's Personal Accessory System for users to express and collect milk from their breasts.

Indications for Use

The Evolve breast pump is intended to be used by lactating women to express and collect milk from their breasts.

5

Comparison of Technological Characteristics

The Evolve Breast Pump has identical indications for use and uses the same fundamental technology as the legally marketed predicated devices to which substantial equivalency is claimed, EnDeare Breast Pump (K081932). The modifications that are subject to this submission include the device's form-factor, user interface, vacuum source - performance specification, and firmware:

  • a) Form-factor/dimension physical size of subject device is smaller and has a different shape than the predicate in order to improve aesthetics
  • b) User interface to improve aesthetics, the subject device has an LCD user display versus predicate device's printed indicators and subject device has button controls versus rotary knob controls on predicate device
  • c) Vacuum source/performance The subject device provides negative pressure vacuum (suction) through a DC-powered, reciprocating-based pump and an electromechanical vacuum release solenoid where vacuum speed and strength are controlled electronically. The predicate device provides negative pressure vacuum through a DCpowered, reciprocating-based pump with a mechanical vacuum release design. Thus, subject device has vacuum speed and strength controlled electronically while predicate has vacuum speed controlled electronically and vacuum strength controlled mechanically (by user).
  • d) Firmware The embedded logic of the subject device has been changed to handle modifications listed above; user interface changes, control and management of reciprocating pump and electromechanical solenoid
  • e) Backflow protection backflow protection mechanism changed from hydrophobic filter to diaphragm

A summary of the technological characteristics compared to the legally marketed predicate device (K081932) are shown in the following table.

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| | Evolve
K190465 | EnDeare
(Predicate Version)
K081932 | Comment | |
|-------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------|--|
| Indications for Use | The Evolve powered breast
pump is to be used by
lactating women to express
and collect milk from their
breasts. | The EnDeare powered breast
pump is indicated to express
and collect milk from the
breasts of lactating women. | Same | |
| Environment of
Use | Home | Hospital, Home | Subject device marketed for
home use | |
| User Interface - Controls | | | | |
| User Control | State-dependent controls:
On-Off button | State-dependent controls:
On-Off switch | Change to soft-touch button
versus a switch | |
| | Stimulation and Expression
Mode button | No Mode button | Subject device supports 2
pumping modes; Stimulation
& Expression, predicate has
1 mode. | |
| | Performance controls:
Strength and Speed
adjustment via buttons | Performance controls:
Speed and Strength
adjustment via rotary knob
and pressure collar | Change to soft-touch
buttons versus rotary
controls | |
| Visual Indicator | LCD
Backlit, liquid-crystal display | Printed graphics on pump
case | Addition of LCD display | |
| Pumping Options | Single pumping
Double pumping | Single pumping
Double pumping | Same | |
| Adjustable Suction
Level | Yes | Yes | Same | |
| Adjustable Speed
Level | Yes | Yes | Same | |
| Accessories | Personal Accessory Set:
● breast shield
● diaphragm
● valve
● tubing
● bottles
AC-DC power-adapter-cord | Personal Accessory Set:
● breast shield
● filter
● valves
● tubing
● bottles
AC power cord, rechargeable
battery | Same
Hygeia Personal Accessory
Set | |
| Cleaning | Breast pump - wipe with
clean, damp cloth
Tubing - replace if milk
appears in tubing
Breast pump kit and bottles –
wash and sanitize | Breast pump - wipe with
clean, damp cloth
Tubing - wash or sanitize only
if milk or condensation in
tubing
Breast pump kit and bottles –
wash and sanitize | Same except tubing shall be
replaced for subject device if
milk appears in tubing | |
| Specifications | | | | |
| | | | | |
| Power Source | AC-DC 100 - 240 Vac
adapter, 50/60 Hz | 100 - 120 Vac power cord,
50/60 Hz | Subject has AC-DC adapter
integrated into power cord,
predicate uses standard AC
power cord | |
| Batteries | None | Rechargeable, Nickel-metal
Hydride, 12.0V, 2200mAh | Predicate device offers
battery-powered model | |
| Rechargeable
Battery
operation/charge
time | NA | Operation time:
Approximately 2 hours
Charge time:
Approximately 3.5 hours | | |
| Software/firmware | Yes | Yes | Both devices have
embedded logic facilitating
device operation; subject
device has additional logic
for user display, solenoid
control | |
| Vacuum aggregate
type | Reciprocating pump | Reciprocating pump | Same | |
| Vacuum
Regulation type | Electronic | Mechanical | Subject device uses
electronically-controlled
regulator versus predicate
device's manual set-point
regulator | |
| Maximum vacuum
(mmHg) | -283 mmHg
(-20 mmHg) | -250 mmHg
(±20 mmHg) | Subject device provides
higher vacuum strength | |
| Vacuum range -
double and single
pumping (mmHg) | Stimulation
-75 to -175 mmHg
(±20 mmHg)
Expression
-140 to -283 mmHg
(±20 mmHg) | -50 to -250mmHg
(±20 mmHg) | Subject device provides an
overall wider vacuum range
than predicate | |
| Cycling Control
Mechanism | Electronic | Electronic | Same | |
| Cycle Speed
Range
(Cycles/Minute =
CPM) | Stimulation
75 to 92 CPM
(±8 CPM)
Expression
32 to 49 CPM
(±8 CPM) | 40 - 60 Cycles/Minute
(±10 CPM) | Subject device provides an
overall wider cycle speed
range than predicate | |
| Adjustable
Cycle Speed
Levels | Yes | Yes | Same | |
| Backflow
protection | Yes, silicone diaphragm | Yes, hydrophobic filter | Subject device provides
closed system via silicone
diaphragm design | |

7

The differences in technological characteristics do not raise different questions of safety and effectiveness.

8

Summary of Performance Data, Non-Clinical Testing

The Evolve Breast Pump complies with voluntary standards for electrical safety, electromagnetic compatibility, and use in the home environment.

The following performance data is provided in support of the substantial equivalence determination:

Risk/Hazard

  • Risk Analysis in accordance with ISO 14971:2007 was used to assess impact of . modifications to the device

Electrical Safety and Electromagnetic Compatibility (EMC)

  • Electrical safety testing per IEC 60601-1:2005 (3rd Edition) with US deviations per . AAMI/ANSI ES60601-1:2005/(R)2012 and A1:2012 standard
  • . Electromagnetic compatibility testing per IEC 60601-1-2: 2014 (4th edition) standard, Medical Electrical Equipment Part 1 - 2

Firmware Testing

  • . The software/firmware verification and validation was provided in accordance with the FDA Guidance document, "The Content of Premarket Submissions for Software Contained in Medical Devices," issued on May 11, 2005

9

K190465 Page 7 of 7

Performance Testing

The Evolve Breast Pump was tested to demonstrate it meets its performance specifications. The testing involved measurement of vacuum and cycles for minimum and maximum settings for both single and double pumping mode, and for stimulation and expression mode. Also, backflow protection was tested. Specifications were met and within required, acceptable range for pump operation, cycle rate, and vacuum pressure.

Conclusion

The performance testing demonstrates that the Evolve Breast Pump is substantially equivalent to the predicate device.