K Number
K210130
Device Name
Stockert S5 System
Date Cleared
2021-04-05

(76 days)

Product Code
Regulation Number
870.4220
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Stöckert SS System is intended to be used during cardiopulmonary bypass for procedures lasting six (6) hours or less.
Device Description
The S5 System is configurable to user needs with different system components. The main configurable and optional system components consist of: Console, System Panel, Pumps, Bubble detector, Level control, Temperature monitor, Pressure control, Cardioplegia Control, Electronic gas blender, Serial Data interface, Venous line clamps (manual), Electrical venous occlude (EVO).
More Information

No
The document describes a cardiopulmonary bypass system with various hardware components and standard performance testing, with no mention of AI, ML, or related concepts.

Yes
The device is used during cardiopulmonary bypass, which is a medical procedure to support heart and lung function during surgery, directly indicating its therapeutic purpose.

No
The device description and intended use indicate that the Stöckert S5 System is used during cardiopulmonary bypass procedures, performing functions like pumping blood, regulating temperature, and controlling pressure. It does not mention analyzing patient data to diagnose a condition.

No

The device description explicitly lists multiple hardware components (Console, System Panel, Pumps, etc.), indicating it is a hardware system with integrated software, not a software-only device.

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

Here's why:

  • Intended Use: The intended use clearly states the device is used during cardiopulmonary bypass. This is a procedure performed on a patient, not on a sample taken from a patient for diagnostic purposes.
  • Device Description: The components listed are all related to managing blood flow, pressure, temperature, and other physiological parameters during surgery. None of the components are described as being used to analyze biological samples.
  • Lack of IVD Indicators: There is no mention of analyzing samples, detecting analytes, or providing diagnostic information based on laboratory testing.

IVD devices are specifically designed to examine specimens derived from the human body (such as blood, urine, or tissue) to provide information for the diagnosis, prevention, monitoring, treatment, or alleviation of disease. The Stöckert SS System's function is entirely focused on supporting a surgical procedure on a living patient.

N/A

Intended Use / Indications for Use

The Stöckert SS System is intended to be used during cardiopulmonary bypass for procedures lasting six (6) hours or less.

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

DTQ

Device Description

The S5 System is configurable to user needs with different system components. The main configurable and optional system components consist of:

Console
The Console provides a mobile chassis containing the power supply and several functional units that allow the speed-controlled pumping of blood and accessories for monitoring and safety.

System Panel
The S5 system panel contains the display and control modules for all of the monitoring, control and measuring devices and is, alongside the pump control panel, another interface between the operator and the S5 System.

Pumps
Pumps may be console or mast mounted and either roller or centrifugal pump type. Pumps provide speed-controlled pumping of flow in the ECC (Extra Corporeal Circulation) using a peristaltic (positive displacement) pump or using a roto-dynamic pump (non-occlusive), automatic clamping and pump control according to measured flow rate and direction

Bubble detector
Monitoring device that detects air bubbles and microbubbles in the ECC - if detected, a visual and acoustic alarm is triggered, and the pump stops.

Level control
The level monitor controls the blood level in the oxygenator/reservoir. Display, alarm generation and pump speed requlation based on detection of blood level in a venous reservoir within the ECC.

Temperature monitor
The temperature monitor allows the simultaneous measurement and display of up to four temperatures, as measured by connected temperature probes. Display and alarm generation based on measurement of temperature of flow within the ECC.

Pressure control
The pressure sensor module is used to measure and display the pressure in the extracorporeal circuit.

Display, alarm generation and pump speed requlation based on measurement of pressure in the ECC.

Cardioplegia Control
The Cardioplegia control unit can be used with the roller pumps RP 150 or a DRP 85 to deliver cardioplegic solutions or blood cardioplegia during an operation to the patient.

Electronic gas blender
May be connected to allow the operator to set, monitor, and display the gas flows required for ECC.

Serial Data interface
Transfer of data from non-proprietary external devices to a proprietary data management system.

Venous line clamps (manual)
Provides a separate control unit and line clamp.

Electrical venous occlude (EVO)
The clamp closes automatically when the stop link function to the arterial pump is activated.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

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)

No animal testing was submitted to support the substantial equivalence of the modified S5 System to the cleared S5 System.
In accordance with 21 CFR 820.30, LivaNova Deutschland GmbH. has conducted the following verification and validation testing of the S5 System design modifications to ensure that it can provide all the capabilities necessary to operate safely and effectively and that unchanged functions of the device continue to operate as intended:

  • Electrical safety
  • Electromagnetic compatibility (EMC)
  • Performance testing
  • Software verification and validation
  • Human Factors testing
  • Mechanical testing of the modified Sensor Holder
  • Performance testing of shipping containers

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.

K071318

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.

K062396, K060053

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

§ 870.4220 Cardiopulmonary bypass heart-lung machine console.

(a)
Identification. A cardiopulmonary bypass heart-lung machine console is a device that consists of a control panel and the electrical power and control circuitry for a heart-lung machine. The console is designed to interface with the basic units used in a gas exchange system, including the pumps, oxygenator, and heat exchanger.(b)
Classification. Class II (performance standards).

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Image /page/0/Picture/1 description: The image contains the logos of the U.S. Department of Health & Human Services and the U.S. Food & Drug Administration (FDA). The Department of Health & Human Services logo is on the left, featuring a stylized eagle emblem. To the right of it is the FDA logo, which includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG" in blue, with "ADMINISTRATION" written in a smaller font size below.

LivaNova Deutschland GmbH Florian Goetz Specialist Regulatory Affairs Lindberghstr. 25 Munich, Bavaria 80939 Germany

Re: K210130

Trade/Device Name: S5 System Regulation Number: 21 CFR 870.4220 Regulation Name: Cardiopulmonary Bypass Heart-Lung Machine Console Regulatory Class: Class II Product Code: DTQ Dated: March 18. 2021 Received: March 22, 2021

Dear Florian Goetz:

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/cdrl/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 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for

1

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 mediation-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.

Nicole M. Gillette -S

for Fernando Aguel Assistant Director DHT2B: Division of Circulatory Support, Structural and Vascular Devices OHT2: Office of Cardiovascular 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) K210130

Device Name Stöckert S5 System

Indications for Use (Describe)

The Stöckert SS System is intended to be used during cardiopulmonary bypass for procedures lasting six (6) hours or less.

Type of Use (Select one or both, as applicable)

X Prescription Use (Part 21 CFR 801 Subpart D)

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

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510(K) SUMMARY

Stöckert S5 System

APPLICANT

LivaNova Deutschland GmbH Lindberghstr. 25 80939 Munich Germany

Contact information
Primary contact personAlternate contact person
Florian GoetzMattia Ronchetti
Specialist Regulatory AffairsDirector Regulatory Affairs
Florian.Goetz@LivaNova.comMattia. Ronchetti@LivaNova.com

Date Prepared: March 18, 2021

APPLICATION CORRESPONDENT

LivaNova USA, Inc. 14401 West 65th Way Arvada, CO 80004 USA

Contact information

Celeste Kreul Senior Manager, Quality Engineering Tel: (303) 467-6476 E-mail: Celeste.kreul@livanova.com

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DEVICE INFORMATION

Proprietary Name:Stöckert S5 System
Common/Usual Name:Heart-Lung Machine
Classification Name:Console, Heart-Lung Machine,
Cardiopulmonary Bypass Console
Classification Panel:74 Cardiovascular
Device Class:Class II
Regulation Number:21 CFR §870.4220
Product Code:DTQ

PREDICATE DEVICE INFORMATION

The modified Stöckert S5 System is substantially equivalent in function and intended use to the Stöckert S5 System cleared in Premarket Notification K071318.

INDICATIONS FOR USE

The Stöckert S5 System is intended to be used during cardiopulmonary bypass for procedures lasting six (6) hours or less.

COMPARISON OF THE INDICATIONS FOR USE

It is noted that the 510(k) Summary of K071318 (the predicate S5 System) provides Indications for Use that are specific to the Pulse Mode Control module that was introduced with K071318 in addition to the Indications for Use for the entire S5 System.

The predicate S5 System as last cleared with K071318 on 07/06/2007 was found to be substantially equivalent to the previously cleared S5 System (K062396 on 09/28/2006) and the originally cleared S5 System (K060053 on 06/02/2006). The Indications for Use for the S5 System did not substantially change due to the additional wording specific to Pulse Mode Control.

Therefore, the modified S5 System's Indications for Use are the same as the predicate S5 System, with the exception that the Pulse Mode Control specific wording is not included, thus returning the Indication for Use to its original verbiage.

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DEVICE DESCRIPTION

The S5 System is configurable to user needs with different system components. The main configurable and optional system components consist of:

Console

The Console provides a mobile chassis containing the power supply and several functional units that allow the speed-controlled pumping of blood and accessories for monitoring and safety.

System Panel

The S5 system panel contains the display and control modules for all of the monitoring, control and measuring devices and is, alongside the pump control panel, another interface between the operator and the S5 System.

Pumps

Pumps may be console or mast mounted and either roller or centrifugal pump type. Pumps provide speed-controlled pumping of flow in the ECC (Extra Corporeal Circulation) using a peristaltic (positive displacement) pump or using a roto-dynamic pump (non-occlusive), automatic clamping and pump control according to measured flow rate and direction

Bubble detector

Monitoring device that detects air bubbles and microbubbles in the ECC - if detected, a visual and acoustic alarm is triggered, and the pump stops.

Level control

The level monitor controls the blood level in the oxygenator/reservoir. Display, alarm generation and pump speed requlation based on detection of blood level in a venous reservoir within the ECC.

Temperature monitor

The temperature monitor allows the simultaneous measurement and display of up to four temperatures, as measured by connected temperature probes. Display and alarm generation based on measurement of temperature of flow within the ECC.

Pressure control

The pressure sensor module is used to measure and display the pressure in the extracorporeal circuit.

Display, alarm generation and pump speed requlation based on measurement of pressure in the ECC.

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Cardioplegia Control

The Cardioplegia control unit can be used with the roller pumps RP 150 or a DRP 85 to deliver cardioplegic solutions or blood cardioplegia during an operation to the patient.

Electronic gas blender

May be connected to allow the operator to set, monitor, and display the gas flows required for ECC.

Serial Data interface

Transfer of data from non-proprietary external devices to a proprietary data management system.

Venous line clamps (manual)

Provides a separate control unit and line clamp.

Electrical venous occlude (EVO)

The clamp closes automatically when the stop link function to the arterial pump is activated.

A schematic of S5 System is provided on the following page.

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Image /page/7/Figure/0 description: The image shows a medical device with several labeled parts. The device is on wheels and has a control panel with multiple screens. There are also several IV poles attached to the device, along with other components such as pumps and a central display unit. The numbers in the image point to specific parts of the device.

Figure 1: Schematic of S5 System

ItemNameFunction
1S5 SystemPerform, control and monitor extracorporeal blood
circulation
2S5 consoleContains the electronic/power supply pack as well as the
fan and batteries for the emergency power supply

Table 1: Components of S5 System

Schematic

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ItemNameFunction
3S5 console tableSupports up to 4 pump housings or units (depending on the type of console)
4Main switchSwitches the power for the entire S5 system on and off
5S5 mast retaining flange (left/right)Side components for supporting the sliding T-bar handles and telescopic masts
6Push barMounting for the system panel (14)
7Telescope mast with Infusion rackMounting for additional equipment
9Telescope mast, movable with infusion rackMounting for disposable items/devices
10Horizontal mastStabilizes the mast system
11Crossbar for movable mastPermanently mounted on the back of the console for supporting the movable telescope mast
12Console casters with Parking brakesTransporting the S5 system
14S5 system panelDisplay and control modules, available in 3, 4 (standard), 5 or 6 module slots
15S5 electronics and power (E/P) packSystem connection panel (shown with cover closed) for connecting power supply, pumps, devices, etc.
16S5 roller pumpAvailable as single or double pump configuration, pumps
17S5 double roller pumpblood through the CPB circuit

TECHNOLOGICAL CHARACTERISTICS

The technological characteristics (i.e., design, material, performance, energy source) of the modified S5 System are similar to the cleared S5 System (K071318), with minor modifications to the hardware, software and labeling of the device.

Both devices employ mains electricity (AC-powered) console with roller pumps, centrifugal pumps, control panels, accessories and sensory equipment to provide mechanical circulatory support during open-heart surgery. The following are the technological differences between the subject and predicate devices:

  • The Blood Level Sensor has been changed to improve electromagnetic compatibility. ● The sensor holder and holder pads were modified to accommodate the new sensor.
  • Modifications to the graphical user interface were made to introduce new icons. .

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PERFORMANCE DATA - NON-CLINICAL TESTING

No animal testing was submitted to support the substantial equivalence of the modified S5 System to the cleared S5 System.

In accordance with 21 CFR 820.30, LivaNova Deutschland GmbH. has conducted the following verification and validation testing of the S5 System design modifications to ensure that it can provide all the capabilities necessary to operate safely and effectively and that unchanged functions of the device continue to operate as intended:

  • Electrical safety .
  • . Electromagnetic compatibility (EMC)
  • Performance testing .
  • Software verification and validation .
  • . Human Factors testing
  • Mechanical testing of the modified Sensor Holder .
  • Performance testing of shipping containers .

In support of the determination of substantial equivalence of the modified S5 System to the cleared S5 System, the following recognized Standards have been complied with:

StandardTitleFDA recognition number
IEC 60601-1 2005 A1:2012Medical electrical equipment - Part 1: General requirements for basic safety and essential performance19-4
IEC 60601-1-2 Edition 4.0 2014Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral Standard: Electromagnetic disturbances - Requirements and tests19-8
IEC 62366-1 Edition 1.0 2015Medical devices — Part 1: Application of usability engineering to medical devices5-114
60601-1-8:2006 and A1:2012Medical electrical equipment - Part 1-8: General requirements for basic safety and essential performance - Collateral Standard: General requirements, tests and guidance for alarm systems in medical electrical equipment and medical electrical systems5-76
IEC 62304 Edition 1.1 2015Medical device software — Software life cycle processes13-79
ISO 14971 Third Edition 2019Application of risk management to medical devices5-125

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SUMMARY

The modified S5 System is as safe and effective as the cleared S5 System. The modified S5 System has the same intended use and indications, similar technological characteristics, and the same principles of operation as its predicate device. The minor technological differences between the cleared and modified device do not raise different questions of safety or effectiveness. Performance and validation data demonstrate that the subject S5 System is as safe and effective as the predicate device. Thus, the modified S5 System is substantially equivalent to its predicate.