K Number
K192606
Manufacturer
Date Cleared
2020-01-17

(119 days)

Product Code
Regulation Number
882.1275
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

SAC2 is intended for use in clinical and research EEG/EP recordings from humans. It is used with external electrodes as the conductor between the scalp and recessed electrodes to reduce impedance between the electrode surface and the skin.

Device Description

SAC2 is intended for use in clinical and research EEG/EP recordings from humans. It is used with external electrodes as the conductor between the scalp and recessed electrodes to reduce impedance between the electrode surface and the skin. SAC2 is provided in an aluminum tube of 100g. It's characterized by light grey colour, no crystallization, no flocculation, no adverse smell, opaque. SAC2 function is of conductor between the electrode used and the patient's skin and of getting the impedance lower for a better recording of the signal. SAC2 is for external use with recording electrodes only. SAC2 is made of powders, Potassium Chloride and Sodium Chloride as conductors, combined with thickening agents and humectants, all in an aqueous solvent. The composition is the following: Water, Talc, Celite, Glycerol, CarboxyMethylCellulose, Sodium chloride, Potassium chloride, Phenoxyethanol, Ehylhexylglycerin The pH range is 8÷10, and Impedance at 10Hz is 50 ± 10 Ohm. The Conductivity is 20 mS/cm Shelf life of SAC2 is 3 years if stored properly in the closed aluminum tube kept away from the sunlight.

AI/ML Overview

The provided text describes the 510(k) summary for the SAC2 - Electrode cream. It does not contain information about a study involving human readers or AI assistance. The performance testing section focuses on bench tests (aging, long-term conductivity) and biocompatibility, not on a clinical effectiveness study with human subjects.

Here's a breakdown of the requested information based on the provided document:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance CriteriaReported Device PerformanceStandard/Methodology
Aging TestASTM F1980-16
Light grey colorComplies (light grey color)Visual inspection
No crystallizationComplies (no crystallization)Visual inspection
No flocculationComplies (no flocculation)Visual inspection
OpaqueComplies (opaque)Visual inspection
pH range8-10Internal testing
Impedance at 10Hz50 ± 10 OhmInternal testing, complies with ANSI/AAMIEC12:2000
Long Term Conductivity TestANSI/AAMIEC12:2000/(R)2015
DC Offset voltageDoes not exceed 100mV (after 7 days testing)Electrical testing
AC ImpedanceDoes not exceed 2000 Ohm (after 7 days testing)Electrical testing
Biocompatibility
CytotoxicityPassedISO 10993-5
IrritationPassedISO 10993-10
SensitizationPassedISO 10993-10

2. Sample size used for the test set and the data provenance

Not applicable for this type of product/study. The performance tests described are bench tests on the product itself, not on data from human subjects.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable. Ground truth for biocompatibility and bench testing is established through standardized laboratory procedures and instrument readings, not expert consensus.

4. Adjudication method for the test set

Not applicable. Adjudication is typically used in studies involving subjective interpretation (e.g., medical imaging), which is not the case for these performance tests.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

No, an MRMC comparative effectiveness study was not done. The document pertains to an electrode cream, not an AI software or system that assists human readers.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

No, a standalone algorithm performance study was not done. The device is a physical electrode cream, not an algorithm.

7. The type of ground truth used

The ground truth for the performance tests (aging, long-term conductivity) was established by objective measurements against defined parameters (e.g., color, pH, impedance, DC offset voltage) and the biological responses observed in standardized biocompatibility tests (cytotoxicity, irritation, sensitization). This is based on established industry standards like ASTM F1980-16, ANSI/AAMIEC12:2000, ISO 10993-5, and ISO 10993-10.

8. The sample size for the training set

Not applicable. This is a physical medical device, not an AI model requiring a training set.

9. How the ground truth for the training set was established

Not applicable. As noted above, this device does not involve a training set.

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January 17, 2020

Spes Medica S.r.l. Giorgio Facco Regulatory Affairs and Quality Assurance Via Europa - zona industriale Battipaglia (SA), 84091 Italy

Re: K192606

Trade/Device Name: SAC2 - Electrode Cream Regulation Number: 21 CFR 882.1275 Regulation Name: Electroconductive Media Regulatory Class: Class II Product Code: GYB Dated: September 16, 2019 Received: September 20, 2019

Dear Giorgio Facco:

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

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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,

For Vivek Pinto, Ph.D. Director DHT5B: Division of Neuromodulation and Physical Medicine Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K192606

Device Name SAC2 - Electrode cream

Indications for Use (Describe)

SAC2 is intended for use in clinical and research EEG/EP recordings from humans. It is used with external electrodes as the conductor between the scalp and recessed electrodes to reduce impedance between the electrode surface and the skin.

Type of Use (Select one or both, as applicable)
☑ Prescription Use (Part 21 CFR 801 Subpart D) ☐ Over-The-Counter Use (21 CFR 801 Subpart C)

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Image: Globe logoSAC2 – Electrode creamREV.2DateREV.01.16.2020
Traditional 510(k)Spes Medica S.r.l. Via Europa , Zona Industriale – 84091Battipaglia (SA)510(k) Summary
Page 1 of 7

510(k) Summary

Manufacturer's Name:Spes Medica S.r.l.via Europa (Zona Ind.le), 84091 Battipaglia (SA) - Italy
Official Correspondent:Giorgio FaccoQuality Assurance and Regulatory Affairs
Telephone Number:0039 0828 614191
Fax Number:0039 0828 341788
Trade Names:SAC2 - Electrode cream
Common or Usual Name:Media, Electroconductive
Classification Name:Electroconductive Media
Device Class:Class II
Product Code:GYB
Classification Regulation:882.1275
Predicate Device:Tech Dots – Adhesive and Conductive Gel510(k) number: K190050
Device Description:SAC2 is intended for use in clinical and research EEG/EP recordings from humans. Itis used with external electrodes as the conductor between the scalp and recessedelectrodes to reduce impedance between the electrode surface and the skin.SAC2 is provided in an aluminum tube of 100g.It's characterized by light grey colour, no crystallization, no flocculation, no adversesmell, opaque.SAC2 function is of conductor between the electrode used and the patient's skin andof getting the impedance lower for a better recording of the signal. SAC2 is forexternal use with recording electrodes only.SAC2 is made of powders, Potassium Chloride and Sodium Chloride as conductors,combined with thickening agents and humectants, all in an aqueous solvent.The composition is the following:Water, Talc, Celite, Glycerol, CarboxyMethylCellulose, Sodium chloride, Potassiumchloride, Phenoxyethanol, EhylhexylglycerinThe pH range is 8÷10, and Impedance at 10Hz is 50 ± 10 Ohm.

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SAC2 – Electrode creamREV.2DateREV.01.16.2020
510(k) Summary
Traditional 510(k)Spes Medica S.r.l. Via Europa , Zona Industriale – 84091Battipaglia (SA)Page 2 of 7
The Conductivity is 20 mS/cmShelf life of SAC2 is 3 years if stored properly in the closed aluminum tube keptaway from the sunlight.
Intended Use:SAC2 is intended for use in clinical and research EEG/EP recordings from humans. Itis used with external electrodes as the conductor between the scalp and recessedelectrodes to reduce impedance between the electrode surface and the skin.
Technological Comparison:SAC2 is a conductive electrode cream contained in an aluminum tube.The characteristics of SAC2 are substantially equivalent to the predicate device. Nonew questions of safety or effectiveness are raised.SAC2 employs the same technological characteristics as the predicate device withjust different appearance: the predicate device is a gel instead SAC2 is a cream.
To support the technological comparison the ingredients, pH, impedance, weightand conductivity of the SAC2 were evaluated internally and compared to thepredicate device.
Both devices are water based with salt as conductive material and with thickeningagents (Glycerin is used for both the products).
The impedance of the SAC2 is comparable to the predicate device: the impedanceevaluated by Spes Medica is 50 ± 10 Ohm. The pH of the SAC2 is between 8 and 10higher than the Predicate Device.
The predicate device is a gel while the SAC2 is a cream, the different texture wascreated just to allow the user to choose what he/she prefers to use during the exam(cream or gel). It's just different way of usability of the product.
Substantial Equivalence:SAC2 is equivalent to the device cleared under K190050 as is presented below inTable.

lt has been shown in this 510(k) submission that the differences between SAC2 and the predicate device Tech Dots do not raise any questions regarding its safety and effectiveness. The SAC2 device is substantially equivalent to the predicate device as it has the same intended use and similar technological characteristics as the previously cleared predicate devices.

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Image: Globe logoSAC2 – Electrode creamREV.2DateREV.01.16.2020
510(k) Summary
Traditional 510(k)Spes Medica S.r.l. Via Europa, Zona Industriale – 84091Battipaglia (SA)Page 3 of 7
ManufacturerSpes Medica S.r.l.Spes Medica S.r.l.
Trade NameSAC 2Tech Dots
510(k) numberNew DeviceK190050Discussion Differences
Product CodeGYBGYB
Indications for useSAC2 is intended for use in clinical and researchEEG/EP recordings from humans. It is used withexternal electrodes as the conductor between thescalp and recessed electrodes to reduce impedancebetween the electrode surface and the skinTech Dots are intended for use in clinical and researchEEG/EP recordings from humans. They are used withexternal electrodes as the conductor between thescalp and recessed electrodes to reduce impedancebetween the electrode surface and the skinSame as predicate device
Regulation NameMedia, ElectroconductiveMedia, ElectroconductiveSame as predicate device
Regulation Number882.1275882.1275Same as predicate device
Environment of useElectrophysiologicalElectrophysiologicalSame as predicate device
Intended userNeurologistsNeurologistsSame as predicate device
Target patientAdult and childrenAdult and childrenSame as predicate device
Where usedTopically on intact skinTopically on intact skinSame as predicate device
Conductive materialSalts (NaCl and KCI)Salt (NaCl)Same as predicate device
Thickening agentCarboxyMethylCellulose, GlycerolSodium Acrylates Copolymers, GlycerinEquivalent to predicate device
Sterilization methodProvide non sterileProvide non sterileSame as predicate device
Shelf-life3 years3 yearsSame as predicate device
Chemical SafetyNo OSHA PELNo OSHA PELSame as predicate device
PreservativePhenoxyethanol, EthylhexylglycerinNo preservativeSAC2 contains preservatives whichprevent the spread of bacteria whenthe tube is opened. The predicatedevice has a different packaging sopreservatives are not necessary.In both cases the products results tobe biocompatible, so for SAC2 no newquestions of safety oreffectiveness are raised.

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SAC2 – Electrode creamREV.2DateREV.01.16.2020
510(k) Summary
Traditional 510(k)Spes Medica S.r.l. Via Europa, Zona Industriale – 84091Battipaglia (SA)Page 4 of 7
ManufacturerSpes Medica S.r.l.Spes Medica S.r.l.
Trade NameSAC 2Tech DotsDiscussion Differences
510(k) numberNew DeviceK190050
Product CodeGYBGYB
BiocompatibilityTest in accordance with ISO 10993Test in accordance with ISO 10993Same as predicate device
CytotoxicityYesYesSame as predicate device
IrritationYesYesSame as predicate device
SensitizationYesYesSame as predicate device
Single UseYesYesSame as predicate device
pH range8÷104÷5The pH of SAC2 is basic, the pH ofthe predicate device is acid but inboth cases the products results tobe biocompatible, so for SAC2 nonew questions of safety oreffectiveness are raised.
Impedance50 ± 10 Ohm80 ± 10 OhmSAC2 has an impedance of 50±10Ohms which is lower than theimpedance of the predicate device.This can be consider as animprovement as lower impedancemeans better signal during recordingand more conductivity.Considering that, no new questions ofsafety or effectiveness are raised.
Conductivity20mS/cm2mS/cmSAC2 results to have a higher valueof conductivity comparing to thepredicate, this is an advantage(according to the intent of use) as thecream results to be more

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SAC2 – Electrode creamREV.2DateREV.01.16.2020
Traditional 510(k)Spes Medica S.r.l. Via Europa, Zona Industriale – 84091Battipaglia (SA)REV.510(k) Summary
Page 5 of 7
ManufacturerSpes Medica S.r.l.Spes Medica S.r.l.
Trade NameSAC 2Tech Dots
510(k) numberNew DeviceK190050Discussion Differences
Product CodeGYBGYB
conductive than the predicate device.Considering that, no new questions ofsafety or effectivenessare raised.
Weight100g per tube$0.14 \pm 0.01$ g per DotDifferent packaging and shapeThe different packaging was madeto give to the users an alternativeway to conduct exams. Thepredicate device is packaged as apre-set quantity for one electrode( $0.14\pm0.001$ g per dot), with SAC2the user can decide itself thequantity to apply with oneelectrode. Considering that, no newquestions of safety or effectivenessare raised.
CharacteristicsSalt BaseNon-irritatingNon toxicSalt BaseNon-irritatingNon toxicEquivalent to predicate device
PackagingAluminum tubeAluminum/PET/PEDifferent ways of packaging. Bothmaterials are validated.

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SAC2 – Electrode creamREV.2DateREV.01.16.2020
Traditional 510(k)Spes Medica S.r.l. Via Europa , Zona Industriale – 84091Battipaglia (SA)510(k) Summary
Page 6 of 7

Summary of Performance Testing-Biocompatibility

Spes Medica SAC2 is no invasive product, the Biocompatibility Evaluation testing summarized below was conducted on SAC2 to demonstrate compliance of this product to the following standards:

  • ISO 10993-5 Biological evaluation of medical devices -- Part 5: Tests for in vitro cytotoxicity
  • ISO 10993-10 Biological evaluation of medical devices -- Part 10: Tests for irritation and skin sensitization
Component NameType of contactMaterial
SkinBloodTissue
CreamYNNWater, Talc, Celite, Glycerol,CarboxyMethylCellulose, Sodium chloride, Potassiumchloride, Phenoxyethanol, Ethylhexylglycerin

Contact duration: >24h, <30days

Performance Testing-Bench Testing

Performance Testing was performed on device characteristics of Spes Medica SAC2. This performance mechanical testing consisted of

  • Aging test
    The aim of this test was to validate the shelf life of 3 years through an accelerated aging procedure according to the ASTM F1980-16 "Standard guide for accelerated aging of sterile barrier system for medical devices").

Pass/fail criteria was fixed at the beginning of the test and all the result of the parameters evaluated (colour, crystallization, flocculation, brightness, pH, impedance) comply according to the pass/fail criteria: SAC2 should be characterized by light grey colour, no crystallization, no flocculation, opaque. Also, the impedance was evaluated and was found out to comply according to the ANSI/AAMIEC12:2000/(R)2015.

  • Long term conductivity
    The aim of this test was to evaluate the electrical performances (in terms of AC Impedance and DC Offset Voltage) of the product SAC2 over time.

Pass/fail criteria were set at the beginning of the test according to ANSI/AAMIEC12:2000/(R)2015 : the DC Offset voltage should not exceed 100mV and AC Impedance should not exceed 2000 Ohm. The parameters of AC Impedance and DC Offset Voltage comply according to the ANSI/AAMIEC12:2000/(R)2015 limits even after 7 days testing.

Spes Medica SAC2 are tested internally for pH, impedance on a regular basis

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SAC2 – Electrode creamREV.2DateREV.01.16.2020
Spes Medica S.r.l. Via Europa , Zona Industriale – 84091Battipaglia (SA)510(k) Summary
Traditional 510(k)Page 7 of 7

Conclusion

All performance testing conducted as outlined above demonstrate that the device meets the performance and design specifications.

§ 882.1275 Electroconductive media.

(a)
Identification. Electroconductive media are the conductive creams or gels used with external electrodes to reduce the impedance (resistance to alternating current) of the contact between the electrode surface and the skin.(b)
Classification. Class II (performance standards).