K Number
K213463
Device Name
NightOwl
Manufacturer
Date Cleared
2021-12-16

(50 days)

Product Code
Regulation Number
868.2375
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The NightOwl is a wearable device intended for use in the recording, analysis, displaying, exporting, and storage of biophysical parameters to aid in the evaluation of sleep-related breathing disorders of adult patients suspected of sleep apnea. The device is intended for the clinical and home setting use under the direction of a Healthcare Professional (HCP).
Device Description
The NightOwl is prescribed by a Health Care Professional for the patient to use in the home as a 'home sleep apnea test' (HSAT). The NightOwl comprises a sensor that is worn on the fingertip (the "NightOwl Sensor") over-night whilst the subject is sleeping and cloud-based analysis software (the "NightOwl Software"). The NightOwl Sensor has a small biocompatible enclosure. The sensor has 2 LEDs, one in the red spectrum and the other in the infrared spectrum, and an accelerometer. The sensor is attached to the fingertip by single-use biocompatible adhesive tape, with the sensor window applied against the fingerprint area of the fingertip. The sensor measures the reflected red/infrared signals to record the photoplethysmograph (PPG) signal. The accelerometer is used to detect movement. The data recorded by the NightOwl Sensor can either be stored in on-board memory ("Offline" mode) or streamed via a Bluetooth link to an Ectosense app on a smartphone ("Streaming" mode) - if the data is stored on the device, the data is retrieved when the NightOwl sensor . is returned to the prescribing HCP and passed up to a cloud-based signal processing suite, the NightOwl Software. - If the device is used in Streaming mode, the data is stored by the Ectosense app . on the smartphone during the recording. At the end of the recording, it is then passed directly up to the cloud-based signal processing suite. - The NightOwl Software signal processing algorithms produce a number of sleep . and sleep-disordered breathing related traces and parameters. The trace and parameter information are passed to a company-managed database for storage and access by the prescribing Health Care Professional in the Ectosense Dashboard.
More Information

Not Found

Unknown
The summary mentions "signal processing algorithms" but does not explicitly state whether these algorithms utilize AI or ML. There is no mention of AI, DNN, or ML in the provided text.

No.
The device is intended for the recording, analysis, displaying, exporting, and storage of biophysical parameters to aid in the evaluation of sleep-related breathing disorders, not for treating or providing therapy.

Yes.
Explanation: The device is intended to "aid in the evaluation of sleep-related breathing disorders of adult patients suspected of sleep apnea," which clearly indicates a diagnostic purpose.

No

The device description explicitly states that the NightOwl comprises a sensor (hardware) and cloud-based analysis software. The sensor is a physical component worn on the fingertip with LEDs, an accelerometer, and memory.

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

Here's why:

  • IVDs analyze samples taken from the human body. The NightOwl is a wearable device that measures biophysical parameters on the body (fingertip). It records signals like photoplethysmography (PPG) and movement directly from the patient.
  • The intended use is for evaluating sleep-related breathing disorders. This involves analyzing physiological signals related to breathing and sleep patterns, not analyzing biological samples like blood, urine, or tissue.
  • The device description focuses on sensors and signal processing. It describes LEDs, an accelerometer, and software to process these signals. There is no mention of reagents, assays, or analysis of biological specimens.

The NightOwl falls under the category of a medical device used for physiological monitoring and diagnosis, specifically for sleep apnea. It is not designed to perform tests on samples in vitro (outside the body).

N/A

Intended Use / Indications for Use

The NightOwl is a wearable device intended for use in the recording, analysis, displaying, exporting, and storage of biophysical parameters to aid in the evaluation of sleep-related breathing disorders of adult patients suspected of sleep apnea.

The device is intended for the clinical and home setting use under the direction of a Healthcare Professional (HCP).

Product codes

MNR

Device Description

The NightOwl is prescribed by a Health Care Professional for the patient to use in the home as a 'home sleep apnea test' (HSAT).

The NightOwl comprises a sensor that is worn on the fingertip (the "NightOwl Sensor") over-night whilst the subject is sleeping and cloud-based analysis software (the "NightOwl Software").

The NightOwl Sensor has a small biocompatible enclosure. The sensor has 2 LEDs, one in the red spectrum and the other in the infrared spectrum, and an accelerometer. The sensor is attached to the fingertip by single-use biocompatible adhesive tape, with the sensor window applied against the fingerprint area of the fingertip. The sensor measures the reflected red/infrared signals to record the photoplethysmograph (PPG) signal. The accelerometer is used to detect movement.

The data recorded by the NightOwl Sensor can either be stored in on-board memory ("Offline" mode) or streamed via a Bluetooth link to an Ectosense app on a smartphone ("Streaming" mode)

  • if the data is stored on the device, the data is retrieved when the NightOwl sensor . is returned to the prescribing HCP and passed up to a cloud-based signal processing suite, the NightOwl Software.
  • If the device is used in Streaming mode, the data is stored by the Ectosense app . on the smartphone during the recording. At the end of the recording, it is then passed directly up to the cloud-based signal processing suite.
  • The NightOwl Software signal processing algorithms produce a number of sleep . and sleep-disordered breathing related traces and parameters. The trace and parameter information are passed to a company-managed database for storage and access by the prescribing Health Care Professional in the Ectosense Dashboard.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Fingertip

Indicated Patient Age Range

22 years old and older

Intended User / Care Setting

Healthcare Professional (HCP) / clinical and home setting

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

Clinical validation of the NightOwl performance using 1B rule was compared to the gold standard polysomnography (PSG) in the US population.

Summary of Performance Studies

Clinical Study: The clinical validation of the NightOwl performance using 1B rule was compared to the gold standard polysomnography (PSG) in the US population.

Key Results:

Endpoint Parameters1B rule performance of modified device (Subject)
Sensitivity at AHI cutoff 51.000
Specificity at AHI cutoff 50.823
Sensitivity at AHI cutoff 150.973
Specificity at AHI cutoff 150.886
Sensitivity at AHI cutoff 300.840
Specificity at AHI cutoff 300.979
pAHI correlation0.946

Key Metrics

Sensitivity at AHI cutoff 5: 1.000
Specificity at AHI cutoff 5: 0.823
Sensitivity at AHI cutoff 15: 0.973
Specificity at AHI cutoff 15: 0.886
Sensitivity at AHI cutoff 30: 0.840
Specificity at AHI cutoff 30: 0.979
pAHI correlation: 0.946

Predicate Device(s)

K191031

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 868.2375 Breathing frequency monitor.

(a)
Identification. A breathing (ventilatory) frequency monitor is a device intended to measure or monitor a patient's respiratory rate. The device may provide an audible or visible alarm when the respiratory rate, averaged over time, is outside operator settable alarm limits. This device does not include the apnea monitor classified in § 868.2377.(b)
Classification. Class II (performance standards).

0

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

December 16, 2021

Ectosense nv Bart Van Pee Product Manager Bosbessenlaan 19 A Rotselaar, Vlaams Brabant 3110 Belgium

Re: K213463

Trade/Device Name: NightOwl Regulation Number: 21 CFR 868.2375 Regulation Name: Breathing frequency monitor Regulatory Class: Class II Product Code: MNR Dated: October 26, 2021 Received: October 27, 2021

Dear Bart Van Pee:

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

1

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 (OS) 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,

Rachana Visaria, Ph.D. Assistant Director DHT1C: Division of 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

2

Indications for Use

510(k) Number (if known) K213463

Device Name NightOwl

Indications for Use (Describe)

The NightOwl is a wearable device intended for use in the recording, analysis, displaying, exporting, and storage of biophysical parameters to aid in the evaluation of sleep-related breathing disorders of adult patients suspected of sleep apnea.

The device is intended for the clinical and home setting use under the direction of a Healthcare Professional (HCP).

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

3

510(k) SUMMARY

NightOwl

1. SUBMITTER'S NAME, ADDRESS, TELEPHONE NUMBER, CONTACT PERSON AND DATE PREPARED

Ectosense nv Bosbessenlaan 19A Rotselaar Vlaams-Brabant 3110 Belgium Phone: +32 496 74 46 12

Contact Person: Bart Van Pee

Date Prepared: 15th of December 2021

2. DEVICE

Name of Device

NightOwl

Trade Name

NightOwl

Common or Usual Name

Ventilatory Effort Recorder

Classification Name/Product Code/CFR Reference

Class II, Ventilatory Effort Recorder, Product Code: MNR; 21 CFR 068.2375

4

3. PREDICATE DEVICE

Predicate: Ectosense's NightOwl (K191031)

4. DEVICE DESCRIPTION

The NightOwl is prescribed by a Health Care Professional for the patient to use in the home as a 'home sleep apnea test' (HSAT).

The NightOwl comprises a sensor that is worn on the fingertip (the "NightOwl Sensor") over-night whilst the subject is sleeping and cloud-based analysis software (the "NightOwl Software").

The NightOwl Sensor has a small biocompatible enclosure. The sensor has 2 LEDs, one in the red spectrum and the other in the infrared spectrum, and an accelerometer. The sensor is attached to the fingertip by single-use biocompatible adhesive tape, with the sensor window applied against the fingerprint area of the fingertip. The sensor measures the reflected red/infrared signals to record the photoplethysmograph (PPG) signal. The accelerometer is used to detect movement.

The data recorded by the NightOwl Sensor can either be stored in on-board memory ("Offline" mode) or streamed via a Bluetooth link to an Ectosense app on a smartphone ("Streaming" mode)

  • if the data is stored on the device, the data is retrieved when the NightOwl sensor . is returned to the prescribing HCP and passed up to a cloud-based signal processing suite, the NightOwl Software.
  • If the device is used in Streaming mode, the data is stored by the Ectosense app . on the smartphone during the recording. At the end of the recording, it is then passed directly up to the cloud-based signal processing suite.
  • The NightOwl Software signal processing algorithms produce a number of sleep . and sleep-disordered breathing related traces and parameters. The trace and parameter information are passed to a company-managed database for storage and access by the prescribing Health Care Professional in the Ectosense Dashboard.

5

5. INTENDED USE / INDICATIONS FOR USE

The NightOwl is a wearable device intended for use in the recording, analysis, displaying, exporting, and storage of biophysical parameters to aid in the evaluation of sleep-related breathing disorders of adult patients suspected of sleep apnea. The device is intended for the clinical and home setting use under the direction of a Healthcare Professional (HCP).

6. DEVICE MODIFICATIONS AND COMPARISON OF TECHNOLOGICAL

CHARACTERSITICS WITH THE PREDICATE DEVICE

We have now incorporated an alternative tuning of the NightOwl algorithm to include hypopnea as scored using the 1B rule. The HCP can now choose to display either the 1A-tuned or the 1B-tuned pAHI (or both) on the NightOwl Examination report. As per the American Academy of Sleep medicine (AASM):

1A rule: a hypopnea is scored when:

    1. There is an airflow reduction of 30% for at least 10 seconds
    1. There is an oxygen desaturation of at least 3 percent or an arousal.

1B rule: a hypopnea is scored when:

    1. There is an airflow reduction of 30% for at least 10 seconds
    1. There is an oxygen desaturation of at least 4 percent
CharacteristicNightOwl (K191031)NightOwl (K213463)Comparison
Intended Use/
Indications for
UseThe NightOwl is a wearable device intended for use in
the recording, analysis, displaying, exporting, and
storage of biophysical parameters to aid in the
evaluation of sleep-related breathing disorders of adult
patients suspected of sleep apnea. The device is
intended for the clinical and home setting use under the
direction of a Healthcare Professional (HCP).Equivalent
Intended
EnvironmentRecording in the home environment with the report
interpretation performed in the clinical setting.Equivalent
PrescriptionPrescription onlyEquivalent

6

| Target

Population22 years old and olderEquivalent
Channels1. PAT
  1. Pulse rate
  2. Oximetry
  3. Actigraphy | | Equivalent |
    | Sensors | Optical plethysmography sensor, accelerometer | | Equivalent |
    | Wearable sensor
    location | The photoplethysmography (PPG) sensor and accelerometer
    components are worn on the fingertip. | | Equivalent |
    | Sensor Software | Firmware is limited to control the recording and
    communications processes. No presentation of test results
    to the patient. Data analyzed and presented in a separate
    software suite. | | Equivalent |
    | Analysis Software
  • location | Analysis performed off the recording device, exclusively
    cloud-based by the NightOwl software. | | Equivalent |
    | Analysis Software
  • algorithm | pAHI calculation tuned to
    the AASM's '1A Rule' for
    the scoring of hypopnea | pAHI calculation tuned to
    the AASM's '1A Rule' for
    the scoring of hypopnea
    AND
    pAHI calculation tuned to
    the AASM's '1B Rule' for
    the scoring of hypopnea | Substantially equivalent
    Addition of pAHI
    calculation tuned to the
    AASM's '1B Rule' for the
    scoring of hypopnea
    The addition of the pAHI
    calculation tuned to the
    AASM's '1B Rule' for the
    scoring of hypopnea
    does not alter the
    device's intended use
    and does not introduce
    any change to the safety
    and effectiveness of the
    originally cleared device
    (predicate device). As
    such, the algorithm of
    the altered device
    remains substantially
    equivalent to that of the
    originally cleared device
    (predicate device). |
    | Data transfer | Data transfer through a smartphone by wireless connection. | | Equivalent |
    | Power Source
    recorder | Battery powered by coin cell | | Equivalent |
    | Patient
    isolation | Device has no galvanic connections to mains as it is a
    battery-operated device. | | Equivalent |
    | Sterilization | Non-sterile | | Equivalent |
    | Bio-
    compatibility | Assessed to ISO1099-1:2009 requirements for
    sensitization, irritation, and cytotoxicity | | Equivalent |
    | EMC | IEC 60601-1-2:2014 | | Equivalent |
    | Electrical
    Safety | IEC 60601-1:2005 +AMD1:2012 | Equivalent | |
    | Environmental
    Testing | IEC 60601-1-11:2010 | Equivalent | |

7

7. PERFORMANCE DATA

Software validation: In support of the substantial equivalence determination of the modification made to the device, software validation was performed.

Clinical Study: The clinical validation of the NightOwl performance using 1B rule was compared to the gold standard polysomnography (PSG) in the US population. The following table compares the performance of the subject and predicate devices.

| Endpoint Parameters | 1A rule performance of
originally cleared device
(Predicate K191031) | 1B rule performance of
modified device
(Subject) |
|------------------------------|----------------------------------------------------------------------------|--------------------------------------------------------|
| Sensitivity at AHI cutoff 5 | 0.936 | 1.000 |
| Specificity at AHI cutoff 5 | 0.727 | 0.823 |
| Sensitivity at AHI cutoff 15 | 0.978 | 0.973 |
| Specificity at AHI cutoff 15 | 0.704 | 0.886 |
| Sensitivity at AHI cutoff 30 | 0.964 | 0.840 |
| Specificity at AHI cutoff 30 | 0.844 | 0.979 |
| pAHI correlation | 0.909 | 0.946 |

8. CONCLUSIONS

Based on (i) the results of the clinical validation testing, (ii) the results of the software validation testing, and (iii) the unchanged product risk analysis, the NightOwl has been demonstrated to be substantially equivalent to the predicate device.