(136 days)
Not Found
No
The document explicitly states "Mentions AI, DNN, or ML: Not Found" and the description focuses on standard ECG analysis modules and tools, not AI/ML techniques.
No.
The device analyzes, edits, reviews, and reports ECG recordings to aid in diagnosis, but it does not directly treat or provide therapy to patients.
Yes
Explanation: The device description explicitly states, "The device provides the clinician an additional tool to aid in the interpretation of ECG data for diagnosis of heart rhythm disorders in adult and pediatric patients." While it also notes it's "not intended for use as the only diagnostic tool," its role in aiding diagnosis confirms it as a diagnostic device.
Yes
The device description explicitly states "CER-S is a stand-alone software medical device". The description of its function and components also focuses solely on software modules and data processing, with no mention of included hardware.
Based on the provided information, this device is not an In Vitro Diagnostic (IVD).
Here's why:
- IVDs analyze samples taken from the human body. The description clearly states that CER-S analyzes "digital continuous ECG recordings." ECG recordings are electrical signals measured on the body, not samples taken from the body (like blood, urine, or tissue).
- The intended use is for analyzing electrical activity of the heart. The purpose is to aid in the interpretation of ECG data for diagnosing heart rhythm disorders. This is a physiological measurement, not an analysis of a biological sample.
Therefore, CER-S falls under the category of a medical device that analyzes physiological signals, not an In Vitro Diagnostic device.
N/A
Intended Use / Indications for Use
CER-S is a stand-alone software medical device intended to analyze, edit, review and report digital continuous ECG recordings.
CER-S is intended for use in clinical and hospital settings only by qualified medical personnel or adequately trained professional personnel working under the supervision and responsibility of a clinician. Users must undergo a thorough software training before using the medical device.
The device provides the clinician an additional tool to aid in the interpretation of ECG data for diagnosis of heart rhythm disorders in adult and pediatric patients.
Note: This device does not provide an automated interpretation and is not intended for use as the only diagnostic tool.
CER-S analysis provides indications for evaluation of:
- Patients with rhythm disturbances (cardiac arrhythmias),
- Patients with transient myocardial ischemia,
- Patients with pacemaker (only if pacing detection is available from the input recording),
- Patients needing HRV evaluation,
- Newborn patients limited to QRS detection.
Product codes
DQK
Device Description
CER-S is a tool, designed to offer a framework for the interaction of different software-modules, providing advanced solutions for Continuous ECG Recording (CER).
Different modules provide:
ECG Beat detection and classification Analysis of ECG rhythm, arrhythmia detection interactive Viewer and set of tools to perform editing of ECG beats, Rhythm annotations and noise Windows interactive Continuous ECG Viewer interactive display/management of ECG Templates Holter-like report for analyzed Continuous ECG records, record exportation, in ISHNE format generation of aECG FDA HL7 XML (v. 2), for the submission of continuous ECG recording to the FDA ECG Warehouse.
Note: The automatic analysis is limited to data acquired from electrodes with conductive paste/gel (dry and dry/metal electrodes are not intended to be used) placed on standard location in compatible formats from any device used for the arrhythmia diagnostics such as Holter, event recorder, 12-lead ambulatory ECG devices when assessment of the rhythm is necessary.
Moreover, CER-S allows the automatic analysis for the following patch location:
- two-electrode patches positioned in the left upper chest area at a roughly inclined angle
- three-electrode triangular shape patches positioned on the patient's left upper chest area below the 1st rib, at an inclined angle
- three-electrode T-shaped patches positioned in the center-thoracic position between the upper part of the chest (manubrium) and the sternum
In all cases, patch placement must strictly follow the indication provided by the manufacturer of the certified-patch device.
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
Adult and pediatric patients. Newborn patients limited to QRS detection.
Intended User / Care Setting
Qualified medical personnel or adequately trained professional personnel working under the supervision and responsibility of a clinician. Users must undergo a thorough software training before using the medical device. Clinical and hospital settings only.
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 tests have been conducted on the Subject Device:
ECG performance testing, according to:
- ANSI/AAMI EC57:1998/(R)2003 and IEC 60601-2-47:2012 (Recognition Number 3-155)
- IEC 60601-2-25:2011 (Recognition Number 3-105)
Software development life cycle, according to: - IEC 62304:2006+A1:2015 (Recognition Number 13-79)
Usability engineering process, according to: - IEC 62366-1:2015+AMD1:2020 (Recognition Number 5-129)
Any potential hazards have been evaluated and controlled through Risk Management activities, according to: - ISO 14971:2019 (Recognition Number 5-125)
The testing demonstrated that CER-S is substantially equivalent to the predicate for the proposed intended use.
No clinical tests were performed to demonstrate the substantial equivalence of CER-S.
Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)
Not Found
Predicate Device(s)
Reference Device(s)
Not Found
Predetermined Change Control Plan (PCCP) - All Relevant Information
Not Found
§ 870.1425 Programmable diagnostic computer.
(a)
Identification. A programmable diagnostic computer is a device that can be programmed to compute various physiologic or blood flow parameters based on the output from one or more electrodes, transducers, or measuring devices; this device includes any associated commercially supplied programs.(b)
Classification. Class II (performance standards).
0
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April 25, 2022
CardioCalm Srl Fabio Badilini President Via Martiri della Liberta, nr. 40 Montichiari, Brescia 25018 Italy
Re: K213861
Trade/Device Name: CER-S Regulation Number: 21 CFR 870.1425 Regulation Name: Programmable Diagnostic Computer Regulatory Class: Class II Product Code: DQK Dated: March 24, 2022 Received: March 29, 2022
Dear Fabio Badilini:
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,
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
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Indications for Use
510(k) Number (if known) K213861
Device Name CER-S
Indications for Use (Describe)
CER-S is a stand-alone software medical device intended to analyze, edit, review and report digital continuous ECG recordings.
CER-S is intended for use in clinical and hospital settings only by qualified medical personnel or adequately trained professional personnel working under the supervision and responsibility of a clinician. Users must undergo a thorough software training before using the medical device.
The device provides the clinician an additional tool to aid in the interpretation of ECG data for diagnosis of heart thythm disorders in adult and pediatric patients.
Note: This device does not provide an automated interpretation and is not intended for use as the only diagnostic tool.
CER-S analysis provides indications for evaluation of:
- · Patients with rhythm disturbances (cardiac arrhythmias),
- · Patients with transient myocardial ischemia,
- · Patients with pacemaker (only if pacing detection is available from the input recording),
- · Patients needing HRV evaluation,
- · Newborn patients limited to ORS detection.
| 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 |
|---|
| required by 21 CFR 807.92 |
| (as required by 21 CFR 807.92) | |
|---|---|
| -- | -------------------------------- |
| Submitter | CardioCalm Srl
Corso Martiri della Libertà, nr. 40
25018 Montichiari (BS) | | |
|--------------------------|---------------------------------------------------------------------------------|----------|--------------|
| Telephone | + 39 030 9650782 | | |
| Fax | + 39 030 9650572 | | |
| Contact Person | Fabio Badilini
President & Legal Representative | | |
| Address | Corso Martiri della Libertà, nr. 40 | | |
| Telephone | + 39 030 9650782 | | |
| Fax | + 39 030 9650572 | | |
| Email | badilini@cardiocalm.com | | |
| Date Prepared | 17/11/2021 | | |
| Trade Name | CER-S | | |
| Common Name | Continuous ECG Recording - Suite | | |
| Panel Code | Cardiovascular/74 | | |
| Classification Name | Computer diagnostic, programmable | | |
| Class | Class II | | |
| Regulation Number | 21 CFR 870.1425 | | |
| Regulation Description | Programmable diagnostic computer | | |
| Product Code | DQK | | |
| Name of Predicate Device | | 510(k) # | Manufacturer |
| Name of Predicate Device | 510(k) # | Manufacturer |
|---|---|---|
| CER-S | K193177 | CardioCalm Srl |
| Reason for
Submission | Intention to introduce into commercial distribution a device, CER-S, that has undergone significant
changes that could affect the substantial equivalence with the predicate device. |
|--------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Device
Description | CER-S is a tool, designed to offer a framework for the interaction of different software-modules,
providing advanced solutions for Continuous ECG Recording (CER).
Different modules provide:
ECG Beat detection and classification Analysis of ECG rhythm, arrhythmia detection interactive Viewer and set of tools to perform editing of ECG beats, Rhythm annotations
and noise Windows interactive Continuous ECG Viewer interactive display/management of ECG Templates Holter-like report for analyzed Continuous ECG records, record exportation, in ISHNE
format generation of aECG FDA HL7 XML (v. 2), for the submission of continuous ECG
recording to the FDA ECG Warehouse. Note: The automatic analysis is limited to data acquired from electrodes with conductive paste/gel
(dry and dry/metal electrodes are not intended to be used) placed on standard location in
compatible formats from any device used for the arrhythmia diagnostics such as Holter, event
recorder, 12-lead ambulatory ECG devices when assessment of the rhythm is necessary.
Moreover, CER-S allows the automatic analysis for the following patch location: two-electrode patches positioned in the left upper chest area at a roughly inclined angle three-electrode triangular shape patches positioned on the patient's left upper chest area
below the 1st rib, at an inclined angle three-electrode T-shaped patches positioned in the center-thoracic position between the
upper part of the chest (manubrium) and the sternum In all cases, patch placement must strictly follow the indication provided by the manufacturer of the
certified-patch device. |
| Indications for
use | CER-S is a stand-alone software medical device intended to analyze, edit, review and report digital
continuous ECG recordings.
CER-S is intended for use in clinical and hospital settings only by qualified medical personnel or
adequately trained professional personnel working under the supervision and responsibility of a |
4
Traditional 510(k) Premarket Notification CER-S
| | clinician. Users must undergo a thorough software training before using the medical device.
The device provides the clinician an additional tool to aid in the interpretation of ECG data for
diagnosis of heart rhythm disorders in adult and pediatric patients.
Note: This device does not provide an automated interpretation and is not intended for use as the
only diagnostic tool.
CER-S analysis provides indications for evaluation of:
Patients with rhythm disturbances (cardiac arrhythmias), Patients with transient myocardial ischemia, Patients with pacemaker (only if pacing detection is available from the input recording), Patients needing HRV evaluation, Newborn patients limited to QRS detection. |
|--------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Technological
Characteristics
and Substantial
Equivalence | The fundamental scientific principles and technological characteristic, including the indications for
use and general design are equivalent to the predicate device, as summarized hereafter:
Software type, Holter Analyzer, working in Windows Operative System, as the predicate; Patient population, adults and pediatrics; User groups: qualified medical personnel or adequately trained professional personnel
working under the supervision and responsibility of a clinician., equivalent to predicate
device; Indications for use, equivalent to the predicate; Environmental use, equivalent to the predicate. The technological characteristics of the subject device and the predicate device are substantially
equivalent to the predicate.
As for the predicate device described below, the Subject device is a PC based SaMD, working in
Windows Operative System.
The following significant differences exist between the subject and predicate devices:
The subject device improves the performance in beat detection in recordings with low
amplitude and with noise; The subject device improves the performance of the beat measures in recording with
higher heart rate; The subject device allows HRV measurements in the frequency domain and Sinus
Tachycardia detection; Further minor changes in subject device are developed to enhance the usability of the software
and the graphic interface of some its components, which provides a smooth and faster editing of
automatically detected arrhythmic events. |
| Performance
Data | Non-clinical tests have been conducted on the Subject Device:
ECG performance testing, according to:
ANSI/AAMI EC57:1998/(R)2003 and IEC 60601-2-47:2012 (Recognition
Number 3-155) IEC 60601-2-25:2011 (Recognition Number 3-105) Software development life cycle, according to:
IEC 62304:2006+A1:2015 (Recognition Number 13-79) Usability engineering process, according to:
IEC 62366-1:2015+AMD1:2020 (Recognition Number 5-129) Any potential hazards have been evaluated and controlled through Risk Management
activities, according to:
ISO 14971:2019 (Recognition Number 5-125) The testing demonstrated that CER-S is substantially equivalent to the predicate for the proposed
intended use.
No clinical tests were performed to demonstrate the substantial equivalence of CER-S. |
| Conclusion | Based on the indications for use, technological characteristics, and comparison to predicate devices, the Subject device CER-S has been shown to be substantially equivalent to the legally marketed predicate devices. |