K Number
K192693
Date Cleared
2020-05-07

(224 days)

Product Code
Regulation Number
868.5440
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Nuvo Nano Portable Oxygen Concentrator is for prescription use by patients requiring high concentrations of oxygen on a supplemental basis. It is small, portable, and is capable of continuous use in the home, institutional, and travel / mobile environments.

Device Description

The Nuvo Nano Portable Oxygen Concentrator (Nano POC) begins its operation with air being pulled into the external air intake filter. This filtered air enters the compressor via a suction resonator and fine filter. Pressurized air then exits the compressor. Next, an electronic valve system directs the air into one of two tubes that contain molecular sieve (sieve beds). The molecular sieve adsorbs (physically attracts) the nitrogen from the air as it is pushed through the sieve beds, this process is called pressure swing adsorption (PSA). As one tube is generating the product gas, the other is being purged of the adsorbed nitrogen. After passing through the oxygen storage tank, the rate of product gas being delivered to the patient is set by a restricting orifice and pulse dose valve based upon detection of a breath. It then passes through a fine particle filter and thru a sensor that detects the oxygen concentration of the product gas before it exits the device through a fire-resistant outlet. Once the product gas leaves the device, it travels to the patient via oxygen tubing and a cannula inserted in the nose. The Nano POC offers the user multiple options to power the device; a detachable lithium ion battery, replaceable by the patient, and an external AC/DC power supply. The device will charge the lithium ion battery when the battery and power supply are both attached. The device operates from 100V to 240V and at 50/60Hz. The device is approximately 8.3″ wide by 3.5″ deep by 6.5″ high (21.6cm x 8.9cm x 16.5cm). The device weighs about 4.7 pounds (2.1 kg) including the battery. The device provides an intermittent supply of oxygen enriched gas at a concentration between 87% and 96% to patients requiring longterm oxygen therapy without the higher cost of bottled oxygen. The device produces a product pressure of less than 170 kPa (25 psig) and flow is set by a controller that delivers pulsed flow rates nominally equivalent to continuous flow rates of 1 to 5 LPM. The device provides pulsed dose delivery of oxygen to the user through a selection of 5 settings; setting 1 delivering the least and setting 5 delivering the greatest amount of oxygen enriched product gas. Oxygen pulse volume per minute is controlled electronically by monitoring the user's breath rate and therefore adjusting bolus volume to deliver the same amount of oxygen per minute to the user. The device does not contain, nor does it produce, any latex, phthalates, harmful chemicals, animal tissue, blood components, or radioactive materials that the user or patient could physically contact. The user has short term surface contact with the device (PC + ABS cabinet and PET HMI overlay), but the nasal cannula has contact with the face for the duration of the treatment. The product gas also has prolonged contact with the respiratory airways. The device is not invasive nor implanted. The device is not life supporting, life sustaining, sterile, or radioactive. The device does not incorporate a medical substance, animal tissue or blood component. The device is reusable and should be used as often as prescribed, for the duration prescribed. Smoking cigarettes while undergoing treatment, especially during treatment, is a contraindication to the intended purpose of the device. Nidek Medical Products, Inc. warns against the use of oil or grease, using the device around an open flame, and using the device without a prescription from a doctor.

AI/ML Overview

The provided text describes the acceptance criteria and the studies performed for the Nidek Medical Products, Inc. Nuvo Nano Portable Oxygen Concentrator (POC).

1. Table of Acceptance Criteria and Reported Device Performance:

Acceptance Criteria CategorySpecific Metric (as per Predicate)Predicate Device Performance (Philips Respironics SimplyGo Mini)Proposed Device Performance (Nuvo Nano)Outcome
General
Power SupplyLithium Ion Battery, AC (100-240V, 50/60Hz), DC (12-16V)Lithium Ion Battery, AC (100-240V, 50/60Hz), DC (12-16V)Lithium Ion Battery, AC (100-240V, 50/60Hz)Similar (DC power supply not specified for Nuvo Nano but common for portable devices)
Battery OptionsStandard Battery, Extended BatteryStandard Battery, Extended BatteryStandard BatterySimilar (Nuvo Nano has only standard battery)
Watt-hour Rating97.9 Wh (per standard battery)97.9 Wh (per standard battery)99 WhSimilar
Battery DurationUp to 4.5 hours (setting 2 at 20 BPM – standard battery)Up to 4.5 hours (setting 2 at 20 BPM – standard battery)Up to 4 hoursSimilar
Battery Charge Time4 hours (max recharge for std battery)4 hours (max recharge for std battery)Not more than 4 hoursSimilar
Expected Service Life5 years – device and accessories5 years – device and accessories5 years – Nano System, 1 year – Molecular Sieve Beds, 500 cycles - BatterySimilar (specific component lifespan included)
Dimensions9.4 in x 8.3 in x 3.6 in (std battery)9.4 in x 8.3 in x 3.6 in (std battery)8.3 in x 3.5 in x 6.5 inSimilar (different dimensions but both portable)
Weight5.0 lbs (std battery)5.0 lbs (std battery)4.7 lbsSimilar (slightly lighter)
ClassificationIEC Class II Internally Powered Equipment, Type BF Applied Part, IP22IEC Class II Internally Powered Equipment, Type BF Applied Part, IP22IEC Class II Internally Powered Equipment, Type BF Applied Part, IP22Identical
Technology
Core TechnologyPressure Swing Adsorption (PSA)Pressure Swing Adsorption (PSA)Pressure Swing Adsorption (PSA)Identical
User InterfaceCapacitive Touch ScreenCapacitive Touch Screen2.8 inch (7.1 cm) color LCD with membrane switch controlsSimilar (different interface type)
Performance Specifications
Average Oxygen ContentAt least 87% (maximum 96%)At least 87% (maximum 96%)87% to 96% at all settingsIdentical
Inspiratory Trigger Sensitivity≤ 0.2 cm H2O≤ 0.2 cm H2O≤ 0.12 cm H2OSimilar (Nuvo Nano more sensitive)
Breathing FrequencyUp to 40 BPMUp to 40 BPM10 to 40 breaths per minuteIdentical
Flow Control Settings and Pulse VolumesPer ISO 80601-2-67 (detailed table provided)Specific pulse volumes per breath rate (detailed table provided)Specific pulse volumes per breath rate (detailed table provided)Similar (different pulse volume values but same principle and range of settings 1-5)
Sound Level43 dBA typical at setting 2, 49 dBA typical at setting 543 dBA typical at setting 2, 49 dBA typical at setting 549 dBA (on setting 2)Similar (Nuvo Nano reports 49 dBA at setting 2, predicate 43 dBA at setting 2, 49 dBA at setting 5)
Altitude CapabilityUp to 10,000 ftUp to 10,000 ft0 to 10,000 ft/3048 mIdentical
Storage Temperature-4 to 140 F / -20 to 60 C-4 to 140 F / -20 to 60 C-4 to 158 F / -20 to 70 CSimilar (wider range for Nuvo Nano)
Operating Temperature41 to 95 F / 5 to 35 C41 to 95 F / 5 to 35 C41 to 104 F / 5 to 40 CSimilar (wider range for Nuvo Nano)
Relative Humidity15% to 93%15% to 93%10% to 90%Similar
Alarms/Alerts
No breath / High Breath RateYesNo breath / High Breath RateNo breath detectedSimilar
Low Oxygen ConcentrationYesLow Oxygen ConcentrationLow O2 concentration (at < 87% and at < 50%)Similar
Low / Depleted BatteryYesLow Battery / Depleted BatteryLow Battery / Battery Depleted / Battery ExhaustedSimilar
Other battery warningsNone specifiedNot specifiedBattery Too Cold / Too HotNuvo Nano includes more specific battery warnings
Other system warningsNone specifiedNot specifiedSystem Too Cold / Too Hot, Low Input Voltage, Component Fail, Process FailNuvo Nano includes more comprehensive system warnings
Technical Fault Alarm / External Power Failure, No Flow AlarmTechnical Fault Alarm / External Power Failure, No Flow AlarmComponent Fail, Process FailSimilar (different nomenclature but comparable functionality)
Standards Compliance
EMCIEC 60601-1-2, 4th editionIEC 60601-1-2, 4th editionIEC 60601-1-2, 4th editionIdentical
General SafetyIEC 60601-1 3rd editionIEC 60601-1 3rd editionIEC 60601-1 3rd editionIdentical
Alarm SystemsIEC 60601-1-8IEC 60601-1-8IEC 60601-1-8Identical
Home HealthcareIEC 60601-1-11IEC 60601-1-11IEC 60601-1-11Identical
Biological EvaluationISO 10993-1ISO 10993-1ISO 10993-1 / ISO 10993-10 / ISO 10993-5Similar (Nuvo Nano specifies more parts of ISO 10993)
Conserving OxygenISO 18779ISO 18779ISO 18779Identical
Gas PathwaysNot specifiedNot specifiedISO 18562-1 / ISO 18562-2 / ISO 18562-3Nuvo Nano specifies these standards
Oxygen Conserving EquipISO 80601-2-67ISO 80601-2-67ISO 80601-2-67Identical
Oxygen ConcentratorsISO 80601-2-69ISO 80601-2-69ISO 80601-2-69Identical

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

The document primarily describes bench tests and adherence to international standards. It does not refer to 'test sets' in the context of clinical trials with patient data, but rather as test protocols for engineering and safety verification.

  • The tests are described as Bench Tests and Biocompatibility Tests.
  • Sample size: Not applicable in the context of clinical data for AI, as this is a hardware device. The "sample size" here would refer to the number of devices tested, which is not explicitly stated but implied to be sufficient for compliance with the listed standards.
  • Data provenance: Not applicable in the context of clinical data for AI. The data provenance is from the specific testing performed by the manufacturer or contracted labs to demonstrate compliance with the listed ISO and IEC standards. The country of origin of the data is not specified but would be where the manufacturer Nidek Medical Products, Inc. (Birmingham, Alabama, USA) or its testing facilities are located. These tests are prospective, meaning they are performed specifically for the regulatory submission to demonstrate the device's characteristics.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

This information is not applicable as the submission is for a portable oxygen concentrator, not an AI/ML-based diagnostic or imaging device requiring expert ground truth for image interpretation or diagnosis. The "ground truth" for this device is based on objective measurements and compliance with engineering and safety standards.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

This information is not applicable as it pertains to clinical data interpretation, typically in AI/ML studies, not hardware device performance testing against engineering standards.

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

This information is not applicable as this is a hardware medical device (portable oxygen concentrator), not an AI-assisted diagnostic tool. No MRMC study was performed or needed.

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

This information is not applicable as this is a hardware medical device, not an algorithm.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

The "ground truth" for the Nuvo Nano POC is established by:

  • Objective Measurements: Directly measuring physical device parameters such as oxygen concentration, flow rates, trigger sensitivity, sound level, battery performance, dimensions, and weight through standardized testing procedures.
  • Compliance with International Standards: Demonstrating adherence to relevant IEC and ISO standards for safety, performance, electromagnetic compatibility, usability, and biocompatibility. These standards define the "ground truth" for acceptable device characteristics.
  • Biocompatibility Testing: Evaluating materials in the gas pathway against ISO 10993 standards to ensure they are non-toxic and safe for contact with patients.

8. The sample size for the training set

This information is not applicable as this is a hardware medical device and does not involve AI model training with a "training set."

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

This information is not applicable as this is a hardware medical device and does not involve AI model training.

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

Nidek Medical Products, Inc. Olivia Mullen Compliance/ Regulatory Affairs 3949 Valley East Industrial Drive Birmingham, Alabama 35217

Re: K192693

Trade/Device Name: Nuvo Nano Portable Oxygen Concentrator Regulation Number: 21 CFR 868.5440 Regulation Name: Portable Oxygen Generator Regulatory Class: Class II Product Code: CAW Dated: May 1, 2020 Received: May 1, 2020

Dear Olivia Mullen:

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

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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,

Todd Courtney Assistant 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 Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K192693

Device Name

Nuvo Nano Portable Oxygen Concentrator

Indications for Use (Describe)

The Nuvo Nano Portable Oxygen Concentrator is for prescription use by patients requiring high concentrations of oxygen on a supplemental basis. It is small, portable, and is capable of continuous use in the home, institutional, and travel / mobile environments.

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 /page/3/Picture/0 description: The image shows the logo for NIDEK Medical. The word "NIDEK" is written in large, blue, sans-serif font. Below the word "NIDEK" is the word "Medical" written in a smaller, italicized, gray font. There is a horizontal line below the word "NIDEK".

5 510(k) Summary

510(k) SummaryThis summary of 510(k) safety and effectiveness is made in accordancewith the requirements of 21 CFR 807.92.
SubmitterNidek Medical Products, Inc.3949 Valley East Industrial DriveBirmingham, AL 35217, USAPhone - 205.856.7200Fax - 205.856.0533
Contact PersonOlivia MullenCompliance / Regulatory Affairsomullen@nidekmedical.comPhone - 205.856.7200 ext 220Fax - 205.856.0533
Date Submitted07 May 2019
Trade NameNuvo Nano Portable Oxygen Concentrator
Common NameOxygen Concentrator
Classification NameGenerator, Oxygen, Portable
Regulation Number21 CFR 868.5440
Prior PMA SubmissionNo, there has not been a submission for the Nuvo Nano from NidekMedical Products, Inc.
Equivalent LegallyMarketed DeviceRespironics SimplyGo Mini Oxygen ConcentratorK111885
DescriptionThe Nuvo Nano Portable Oxygen Concentrator (Nano POC) begins itsoperation with air being pulled into the external air intake filter. Thisfiltered air enters the compressor via a suction resonator and fine filter.Pressurized air then exits the compressor. Next, an electronic valvesystem directs the air into one of two tubes that contain molecularsieve (sieve beds). The molecular sieve adsorbs (physically attracts) thenitrogen from the air as it is pushed through the sieve beds, thisprocess is called pressure swing adsorption (PSA). As one tube isgenerating the product gas, the other is being purged of the adsorbednitrogen. After passing through the oxygen storage tank, the rate ofproduct gas being delivered to the patient is set by a restricting orificeand pulse dose valve based upon detection of a breath. It then passesthrough a fine particle filter and thru a sensor that detects the oxygenconcentration of the product gas before it exits the device through a

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Description (cont.) fire-resistant outlet. Once the product gas leaves the device, it travels to the patient via oxygen tubing and a cannula inserted in the nose. The Nano POC offers the user multiple options to power the device; a detachable lithium ion battery, replaceable by the patient, and an external AC/DC power supply. The device will charge the lithium ion battery when the battery and power supply are both attached. The device operates from 100V to 240V and at 50/60Hz. The device is approximately 8.3″ wide by 3.5″ deep by 6.5″ high (21.6cm x 8.9cm x 16.5cm). The device weighs about 4.7 pounds (2.1 kg) including the battery. The device provides an intermittent supply of oxygen enriched gas at a concentration between 87% and 96% to patients requiring longterm oxygen therapy without the higher cost of bottled oxygen. The device produces a product pressure of less than 170 kPa (25 psig) and flow is set by a controller that delivers pulsed flow rates nominally equivalent to continuous flow rates of 1 to 5 LPM. The device provides pulsed dose delivery of oxygen to the user through a selection of 5 settings; setting 1 delivering the least and setting 5 delivering the greatest amount of oxygen enriched product gas. Oxygen pulse volume per minute is controlled electronically by monitoring the user's breath rate and therefore adjusting bolus volume to deliver the same amount of oxygen per minute to the user. The device does not contain, nor does it produce, any latex, phthalates, harmful chemicals, animal tissue, blood components, or radioactive materials that the user or patient could physically contact. The user has short term surface contact with the device (PC + ABS cabinet and PET HMI overlay), but the nasal cannula has contact with the face for the duration of the treatment. The product gas also has prolonged contact with the respiratory airways. The device is not invasive nor implanted. The device is not life supporting, life sustaining, sterile, or radioactive. The device does not incorporate a medical substance, animal tissue or blood component. The device is reusable and should be used as often as prescribed, for the duration prescribed. Smoking cigarettes while undergoing treatment, especially during treatment, is a contraindication to the intended purpose of the device. Nidek Medical Products, Inc.

The Nano POC is for prescription use by patients requiring high Intended use concentrations of oxygen on a supplemental basis. It is small, portable, and is capable of continuous use in the home, institutional, and travel / mobile environments.

warns against the use of oil or grease, using the device around an open

flame, and using the device without a prescription from a doctor.

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Predicate DeviceProposed Device
Trade NamePhilips Respironics SimplyGo MiniNidek Medical Nuvo Nano
Model NumberSimplyGo Mini855
510(k) submitterRespironics, Inc.Nidek Medical Products, Inc.
510(k) numberK111885K192693
Common NameOxygen ConcentratorOxygen Concentrator
Classification NameGenerator, Oxygen, PortableGenerator, Oxygen, Portable
FDA Product CodeCAWCAW
Regulation Number21 CFR 868.544021 CFR 868.5440
Intended UseThe Philips Respironics SimplyGo MiniPortable Oxygen Concentrator is forprescription use by patients requiring highconcentrations of oxygen on a supplementalbasis. It is small, portable, and is capable ofcontinuous use in the home, institutional,and travel / mobile environments.The Nuvo Nano Portable OxygenConcentrator is for prescription use bypatients requiring high concentrations ofoxygen on a supplemental basis. It is small,portable, and is capable of continuous use inthe home, institutional, and travel / mobileenvironments.
ComparisonStatementThe proposed device has the same classification information and intendeduse as the predicate device.
General
Power SupplyLithium Ion BatteryAC Power (100 to 240 VAC, 50/60Hz)DC Power (12-16 VDC)Lithium Ion BatteryAC Power (100 to 240 VAC, 50/60Hz)
Battery OptionsStandard BatteryExtended BatteryStandard Battery
Watt-hour Rating97.9 Wh (per standard battery)99 Wh
Battery DurationUp to 4.5 hours (setting 2 at 20 BPM –standard battery)Up to 4 hours
Battery ChargeTime4 hours (max recharge for std battery)Not more than 4 hours
Expected ServiceLife5 years – device and accessories5 years – Nano System1 year – Molecular Sieve Beds500 cycles - Battery
Dimensions9.4 in x 8.3 in x 3.6 in (std battery)8.3 in x 3.5 in x 6.5 in
Weight5.0 lbs (std battery)4.7 lbs
Classification
IEC Class II Internally PoweredEquipmentIEC Class II Internally PoweredEquipment
Type BF Applied PartType BF Applied Part
IP22IP22
ComparisonStatementThe proposed device has similar general specifications as the predicatedevice.

Predicate Device Comparison

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Predicate Device Comparison

Predicate DeviceProposed Device
TechnologyPressure Swing Adsorption (PSA)Pressure Swing Adsorption (PSA)
User InterfaceCapacitive Touch Screen2.8 inch (7.1 cm) color LCD withmembrane switch controls
ComparisonStatementThe proposed device has similar technology to the predicate device.
PerformanceSpecifications
Average OxygenContentAt least 87% at all settings (maximum of96%)87% to 96% at all settings
Inspiratory TriggerSensitivity≤ 0.2 cm H2O≤ 0.12 cm H2O
Breathing FrequencyUp to 40 BPM10 to 40 breaths per minute
Flow Control Settingsand Pulse Volumes1 2 3 4 5 Breath Rate Pulse Volumes (mL) 15 11.0 22.0 33.0 44.0 55.0 20 11.0 22.0 33.0 44.0 50.0 25 8.8 17.6 26.4 35.2 40.0 30 7.3 14.7 22.0 29.3 33.3 35 6.3 12.6 18.9 25.1 28.6 40 5.5 11.0 16.5 22.0 25.0 per ISO 80601-2-671 2 3 4 5 Breath Rate Pulse Volumes (ml) 10 21 42 63 84 100 15 14 28 42 58 66.7 20 10.5 21 31.5 42 50 25 8.4 16.8 25.2 33.6 40 30 7 14 21 28 33.3 35 6 12 18 24 28.6 40 5.3 10.5 15.8 21 25 ±15% at Standard Temperature and Pressure, dry (STDP)± 25% over the rated environmental range STDP is 101.3kPa at an operating temperature of 20°C, dry
Sound Level43 dBA typical at setting 249 dBA typical at setting 549 dBA (on setting 2)
Altitude CapabilityUp to 10,000 ft0 to 10,000 ft/3048 m
Storage Temperature-4 to 140 F/-20 to 60 C-4 to 158 F/-20 to 70 C
OperatingTemperature41 to 95 F/5 to 35 C41 to 104 F/5 to 40 C
Relative Humidity15% to 93%10% to 90%
Alarms/Alerts
No breath / High Breath RateNo breath detected
Low Oxygen ConcentrationLow O2 concentration(at < 87% and at < 50%)
Low Battery / Depleted BatteryLow Battery / Battery Depleted /Battery Exhausted
Battery Too Cold / Too Hot
System Too Cold / Too Hot
Low Input Voltage

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Predicate Device Comparison

Alarms/AlertsPredicate DeviceProposed Device
Technical Fault Alarm / External PowerFailureComponent Fail(sieve bed, power supply, compressor, valvecheck, cooling fan, breath sensor, oxygensensor)
No Flow AlarmProcess Fail(gas supply, system startup, gas delivery, tankpressure)
ComparisonStatementThe proposed device has similar performance specifications to the predicatedevice.
StandardsCompliancePredicate DeviceProposed Device
EMCIEC 60601-1-2, 4th editionIEC 60601-1-2, 4th edition
General SafetyIEC 60601-1 3rd editionIEC 60601-1 3rd edition
Alarm SystemsIEC 60601-1-8IEC 60601-1-8
Home HealthcareIEC 60601-1-11IEC 60601-1-11
Biological EvaluationISO 10993-1ISO 10993-1 / ISO 10993-10 /ISO 10993-5
Conserving OxygenISO 18779ISO 18779
Gas PathwaysISO 18562-1 / ISO 18562-2 /ISO 18562-3
Oxygen ConservingEquipISO 80601-2-67ISO 80601-2-67
OxygenConcentratorsISO 80601-2-69ISO 80601-2-69
ComparisonStatementThe proposed device has the same standards compliance as the predicate device.

Technological The Nano POC is technologically equivalent to the referenced legally marketed device. Both devices share five basic components: 1) a motor Characteristics driven compressor which is manufactured by the same supplier and has the same operational characteristics, 2) air separation module comprised of an electronically activated control valve and two air separation columns of adsorbent molecular sieve, 3) a flame retardant thermoplastic enclosure, 4) a human-machine interface (HMI) that controls all functions of the device and 5) rechargeable lithium ion batteries and AC/DC power supply as power sources. Both devices have incorporated the same basic design and the same

technological characteristics, and utilize the same operating principle.

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TechnologicalCharacteristics(cont.)Both of them have been tested to the same electrical and electromagneticsafety standards for medical electrical equipment. Both devices aremanufactured under a quality system. The differences between thepredicate and subject devices, such as size, storage condition, operatingconditions, battery duration, alarm settings, and control panel indicatorsintroduce risks mitigated by the performance testing provided in thissubmission.
Additionally, the Nano POC uses identical materials in the gas pathway as

those found in the Kingon P2 (K190304), therefore the methods used to determine biocompatibility are applicable to the Nano POC.

Performance Data
Bench TestsStandardReportResults
Basic Safety and EssentialPerformance of OxygenConcentratorsISO 80601-2-69:2014R19012Pass
Basic Safety and EssentialPerformance of Oxygen-Conserving EquipmentISO 80601-2-67:2014R19020Pass
Basic Safety and EssentialPerformance of Medical ElectricalEquipmentIEC 60601-1:2006 + A1:2013R19013Pass
Electromagnetic Disturbances –requirements and testsIEC 60601-1-2:2015R19014Pass
Usability Engineering to MedicalDevicesIEC 62366-1:2015 + AC:2016R19021Pass
Alarm Systems in MedicalElectrical EquipmentIEC 60601-1-8:2007R19015Pass
UsabilityIEC 60601-1-6:2010R19020Pass
Medical Devices used in a HomeHealthcare EnvironmentIEC 60601-1-11:2015R19016Pass
Safety Requirements for lithiumbatteries used in portableapplicationsIEC 62133-2:2017EA3373IECPass
Exposure to RFID ReadersAIM 7351731:20171909ESU013-U1Pass
Biocompatibility Tests
Biological Evaluation of BreathingGas PathwaysISO 18562-1:2017R19011Pass
Emissions of Particulate MatterISO 18562-2:2017R19011Pass
Emissions of Volatile OrganicCompoundsISO 18562-3:2017R19011Pass
Biological Evaluation of MedicalDevicesISO 10993-1:2009 + AC:2010R19011Pass
Cytotoxicity TestsISO 10993-5:2009R19011Pass
Skin Sensitization / Irritation TestsISO 10993-10:2010R19011Pass

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ConclusionBased on information contained in this 510(k) submission, the Nuvo Nano POChas similar intended use, principle of operation, and technologicalcharacteristics as the predicate device identified. Performance testingcontained in this submission demonstrates the minor differences betweendevices do not raise different questions of safety or effectiveness. Therefore,in accordance with the 21 CFR 807, Nidek Medical Products, Inc. concludesthat the Nuvo Nano Portable Oxygen Concentrator is substantially equivalentto the referenced predicate device.

§ 868.5440 Portable oxygen generator.

(a)
Identification. A portable oxygen generator is a device that is intended to release oxygen for respiratory therapy by means of either a chemical reaction or physical means (e.g., a molecular sieve).(b)
Classification. Class II (performance standards).