K Number
K211941
Device Name
9Line
Date Cleared
2022-01-27

(218 days)

Product Code
Regulation Number
870.2900
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
9Line patient leadwires are intended to be used to connect electrodes placed at appropriate sites on the patient to an ECG or EKG monitoring device for general monitoring and/or diagnostic evaluation by a health care professional. The device is intended for single-patient use.
Device Description
9Line is comprised of multiple patient leadwires that connect electrodes affixed to the patient's body either to an external trunk cable or directly into an electrocardiogram (ECG) monitor. Each leadwire connects to a separate patient electrode. Leadwires and electrode placement are color-coded in accordance with Association for the Advancement of Medical Instrumentation (AAMI) recommendations. The device transmits ECG signals from the patient for both diagnostic and monitoring purposes.
More Information

Not Found

No
The device description and performance studies focus on the physical and electrical properties of leadwires for transmitting ECG signals, with no mention of AI or ML for signal processing or analysis.

No
The device transmits ECG signals for monitoring and diagnostic purposes; it does not administer any treatment or therapy to the patient.

No

Explanation: The device is a patient leadwire that transmits ECG signals for monitoring and diagnostic purposes, but it does not perform the diagnostic evaluation itself. It serves as a connector to an ECG or EKG monitoring device, which is responsible for the diagnostic evaluation.

No

The device description explicitly states it is comprised of "multiple patient leadwires" and mentions "electrical & mechanical safety" testing, indicating it is a hardware device.

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

Here's why:

  • Intended Use: The intended use is to connect electrodes on a patient to an ECG/EKG monitor for general monitoring and diagnostic evaluation. This involves measuring electrical signals from the patient's body.
  • Device Description: The device transmits ECG signals from the patient.
  • Lack of In Vitro Activity: IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) in vitro (outside the body) to provide information for diagnostic purposes. This device works in vivo (within the body) by connecting to the patient directly.

The device is a medical device used for physiological monitoring, specifically electrocardiography, which is distinct from in vitro diagnostics.

N/A

Intended Use / Indications for Use

9Line patient leadwires are intended to be used to connect electrodes placed at appropriate sites on ECG or EKG monitoring device for general monitoring and/or diagnostic evaluation by a healthcare professional. The device is intended for single-patient use.

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

DSA

Device Description

9Line is comprised of multiple patient leadwires that connect electrodes affixed to the patient's body either to an external trunk cable or directly into an electrocardiogram (ECG) monitor. Each leadwire connects to a separate patient electrode. Leadwires and electrode placement are color-coded in accordance with Association for the Advancement of Medical Instrumentation (AAMI) recommendations.

The device transmits ECG signals from the patient for both diagnostic and monitoring purposes.
9Line is for prescription-use only. The product is sold non-sterile for single-patient use.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Upper body

Indicated Patient Age Range

Adults

Intended User / Care Setting

healthcare professional / Health care facility

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)

Non-Clinical Testing:

  • Biocompatibility, ISO 10993-5:2009 and ISO 10993-10:2010... Device is non-cytotoxic, non-sensitizing, and non-irritating.
  • Electrical & Mechanical Safety, IEC 60601-1 (Part 8.5.2.3) and ANSI/AAMI EC 53:2013... Device meets electrical and mechanical safety standards.

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.

K170536

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

§ 870.2900 Patient transducer and electrode cable (including connector).

(a)
Identification. A patient transducer and electrode cable (including connector) is an electrical conductor used to transmit signals from, or power or excitation signals to, patient-connected electrodes or transducers.(b)
Classification. Class II (performance standards).

0

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

January 27, 2022

Energetic Designs, Inc. % John Gillespy President FDA 510k Consultants, LLC 1100 Del Lago Circle #104 Palm Beach Gardens, Florida 33410

Re: K211941

Trade/Device Name: 9Line Regulation Number: 21 CFR 870.2900 Regulation Name: Patient Transducer And Electrode Cable (Including Connector) Regulatory Class: Class II Product Code: DSA Dated: December 22, 2021 Received: December 27, 2021

Dear John Gillespy:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal

1

statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/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,

Jennifer Shih Kozen Assistant Director Division of Cardiac Electrophysiology, Diagnostics and Monitoring Devices Office of Cardiovascular Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K211941

Device Name 9Line

Indications for Use (Describe)

9Line patient leadwires are intended to be used to connect electrodes placed at appropriate sites on ECG or EKG monitoring device for general monitoring and/or diagnostic evaluation by a healthcare professional. The device is intended for single-patient use.

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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510(k) Summary

| 1. 510(k) Submitter: | Energetic Designs, Inc.
1100 Del Lago Cir, Palm Beach Gardens, FL
33410 Phone: 386-243-4332
Email: john@fda510kconsultants.com |
|---------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 2. Company Contact: | John F. Gillespy, MBA |
| 3. Date of Submission: | June 17, 2021 |
| 4. 510(k) Preparer: | John F. Gillespy, MBA
FDA 510k Consultants, LLC
Palm Beach Gardens, FL 33410
Phone: 386-243-4332
Email: john@fda510kconsultants.com |
| 5. Device Classification: | Trade name: 9Line
Common name: ECG Disposable Lead Wires
Device: Cable, Transducer & Electrode, Patient,
(Including Connector)
Class: II
Regulation #: 870.2900
Product Code: DSA |
| 6. Predicate: | Applicant: APK Technology Co.
Device: ECG Disposable Lead Wires
510(k) Number: K170536 |

7. Indications For Use

9Line patient leadwires are intended to be used to connect electrodes placed at appropriate sites on the patient to an ECG or EKG monitoring device for general monitoring and/or diagnostic evaluation by a health care professional. The device is intended for single-patient use.

8. Device Description

9Line is comprised of multiple patient leadwires that connect electrodes affixed to the patient's body either to an external trunk cable or directly into an electrocardiogram (ECG) monitor. Each

Image /page/3/Picture/7 description: In the image, a coiled white cable with multiple colored clips is displayed. The clips are brown, red, white, green, and black. The clips are attached to the end of the cable. The cable is coiled in a circular shape.

leadwire connects to a separate patient electrode (see photo of product at right). Leadwires and electrode placement are color-coded in accordance with Association for the Advancement of Medical Instrumentation (AAMI) recommendations.

The device transmits ECG signals from the patient for both diagnostic and monitoring purposes.

4

9Line is for prescription-use only. The product is sold non-sterile for single-patient use.

9. Device Models

9Line models are shown below:

PART NUMBERDESCRIPTION (SNAP TERMINATION)
3SS-03030" 3 Lead Snap Single Patient Use AAMI
w/Shielded Systems Bonded Cable
3SS-05050" 3 Lead Snap Single Patient Use AAMI
w/Shielded Systems Bonded Cable
5SS-03030" 5 Lead Snap Single Patient Use AAMI
w/Shielded Systems Bonded Cable
5SS-05050" 5 Lead Snap Single Patient Use AAMI
w/Shielded Systems Bonded Cable
5VSS-03030" 5 V Leads Snap Single Patient Use AAMI
w/Shielded Systems Bonded Cable
5VSS-05050" 5 V Leads Snap Single Patient Use AAMI
w/Shielded Systems Bonded Cable
NK-3SS-03030" 3 Lead Snap Single Patient Use AAMI
w/Shielded Systems Bonded Cable
NK-3SS-05050" 3 Lead Snap Single Patient Use AAMI
w/Shielded Systems Bonded Cable
NK-6SS-03030" 6 Lead Snap Single Patient Use AAMI
w/Shielded Systems Bonded Cable
NK-6SS-05050" 6 Lead Snap Single Patient Use AAMI
w/Shielded Systems Bonded Cable
PART NUMBERDESCRIPTION (PINCH TERMINATION)
3PS-03030" 3 Lead Pinch Single Patient Use AAMI
w/Shielded Systems Bonded Cable
3PS-05050" 3 Lead Pinch Single Patient Use AAMI
w/Shielded Systems Bonded Cable
5PS-03030" 5 Lead Pinch Single Patient Use AAMI
w/Shielded Systems Bonded Cable
5PS-05050" 5 Lead Pinch Single Patient Use AAMI
w/Shielded Systems Bonded Cable
5VPS-03030" 5 V Leads Pinch Single Patient Use AAMI
w/Shielded Systems Bonded Cable
5VPS-05050" 5 V Leads Pinch Single Patient Use AAMI
w/Shielded Systems Bonded Cable
NK-3PS-03030" 3 Lead Pinch Single Patient Use AAMI
w/Shielded Systems Bonded Cable
NK-3PS-05050" 3 Lead Pinch Single Patient Use AAMI
w/Shielded Systems Bonded Cable
NK-6PS-03030" 6 Lead Pinch Single Patient Use AAMI
w/Shielded Systems Bonded Cable
NK-6PS-05050" 6 Lead Pinch Single Patient Use AAMI
w/Shielded Systems Bonded Cable

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11. Comparison To Predicate Device

The following table compares 9Line with the predicate device:

Comparison Table

CharacteristicsDevicePredicateComparison
Name9LineECG Disposable Lead
WiresNA
ApplicantEnergetic Designs IncAPK Technology CoNA
510k NumberApplied ForK170536NA
Device PhotoImage: 9Line device photoImage: ECG Disposable Lead Wires device photoNA
ClassificationIIIISame
Regulation Number870.2900870.2900Same
Product CodeDSADSASame
Intended UseConnect patient
electrodes with ECG for
monitoring or
diagnostic evaluation.Connect patient
electrodes with ECG for
monitoring or
diagnostic evaluation.Same
Indications For Use9Line patient leadwires
are intended to be used
to connect electrodes
placed at appropriate
sites on the patient to
an ECG or EKG
monitoring device for
general monitoring
and/or diagnostic
evaluation by a health
care professional. The
device is intended for
single-patient use.The ECG Disposable
Lead Wires are
intended to be used
with ECG. The lead wire
is used to connect
electrodes placed at
appropriate sites on the
patient to ECG for
general monitoring
and/or diagnostic
evaluation by health
care professional.Same
Target PopulationAdultsAdultsSame
Anatomical SiteUpper bodyUpper bodySame
Where UsedHealth care facilityHealth care facilitySame
ReuseSingle patient onlySingle patient onlySame
Rx/OTC/BothRxRxSame

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| System Description | ECG lead wires with
terminal connectors | ECG lead wires with
terminal connectors | Same |
|--------------------------------------|-----------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------|------------------|
| Design Concept | Lead wires transmit ECG
signals from patient to
trunk cable or
monitoring device | Lead wires transmit ECG
signals from patient to
trunk cable or
monitoring device | Same |
| Lengths | 30", 50" | 50" (per brochure) | Minor difference |
| Lead Sets | 3, 5, 6, 10 (by
combining two sets of
5 leads: one limb lead
set and one set of
vleads) | 3, 5, 6, 10 (brochure) | Same |
| Termination | Snap, Pinch | Snap, Pinch | Same |
| Multiple Models
Based on Features | Yes | Yes | Same |
| Peelable Ribbon | Yes | Yes | Same |
| Material
Composition | Medical-grade PVC
jacket | PVC | Same |
| Powered | No | No | Same |
| Components | | | |
| Shielded Lead Wires | Yes | Yes | Same |
| Patient Termination
Connector | Yes (Snap & Pinch) | Yes (Snap & Pinch) | Same |
| Trunk/Monitor
Connector | Yes | Yes | Same |
| Trunk Cable | No | No | Same |
| Accessories | None | None | Same |
| S&E Testing | | | |
| Biocompatibility | ISO 10993-5:2009
ISO 10993-10:2010 | ISO 10993-5:2009
ISO 10993-10:2010 | Same |
| Electrical Safety | IEC 60601-1:2005
MOD (Part 8.5.2.3) | IEC 60601-1:2005
MOD (Part 8.5.2.3) | Same |
| Mechanical Safety | ANSI/AAMI EC 53:
2013 | ANSI/AAMI EC 53:
2013 | Same |

Physical Characteristics

The subject device is comparable to the predicate in terms of design, function, materials, and performance. None of the differences raised different issues of safety and effectiveness.

Non-Clinical Testing

9Line passed the following non-clinical tests, all of which were performed to current FDArecognized standards:

  • . Biocompatibility, ISO 10993-5:2009 and ISO 10993-10:2010... Device is non-cytotoxic, non-sensitizing, and non-irritating.
  • Electrical & Mechanical Safety, IEC 60601-1 (Part 8.5.2.3) and ANSI/AAMI EC 53:2013... 510k Summary – Page 4

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Device meets electrical and mechanical safety standards.

Substantial Equivalence

9Line patient leadwires successfully followed the pathway to Substantial Equivalence in the FDA guidance document, "The 510(k) Program: Evaluating Substantial Equivalence in Premarket Notifications" (2014). The steps are summarized below:

  • The predicate device is legally marketed and was found substantially equivalent through 510(k) premarket submission.
  • The subject and predicate devices have the same intended use (and indications for use).
  • Technological differences between the subject and predicate were evaluated; none of the differences raised different issues of safety and effectiveness.
  • . The following methods for evaluation of the effects of different characteristics on safety and effectiveness were deemed acceptable—testing for biocompatibility, electrical safety, and mechanical performance. Evaluation methods were conducted to FDArecognized standards where applicable.
  • . Data from these tests demonstrated equivalence and support the indications for use.

In summary, all necessary testing has been performed and the results support the conclusion that 9Line patient leadwires is substantially equivalent to the legally marketed predicate, based on both (a) comparison of intended use, materials, technology, and design and (b) testing to FDA-recognized standards, and the device thus does not raise any concerns of safety or effectiveness.

Based on the information contained within this submission, the applicant concludes that 9Line is substantially equivalent to the identified predicate device.