K Number
K221203
Device Name
AHI System
Manufacturer
Date Cleared
2022-07-14

(79 days)

Product Code
Regulation Number
870.2220
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The AHI System is intended for use by healthcare professionals managing patients 18 years or older who are receiving continuous physiological monitoring with electrocardiography (ECG) in hospitals. AHI provides a frequently updated binary output over time based on pattern analysis of a lead-II ECG waveform intended to describe a patient's hemodynamic status and indicate if a patient is showing signs of hemodynamic stability or instability. Signs of hemodynamic instability (HI) are defined as hypotension (systolic blood pressure <90 mmHg or mean arterial pressure (MAP) <70 mmHq) combined with tachycardia (heart rate ≥ 100 bpm). AHI-PI provides the clinician with physiological insight into a patient's likelihood of a future episode of HI. An episode of HI is defined as 10 continuous minutes or more where HI is present. The goal of this adjunctive monitoring method is to enable identification of patients who are showing HI or are likely to experience a future episode of HI, and to allow clinicians an opportunity to increase vigilance. This device is intended for adjunctive use with other physical vital sign parameters and patient information and is not intended to independently direct therapy.
Device Description
The AHI System is a multiparameter system designed to meet clinicians' need to identify patient hemodynamic status and predict patient hemodynamic instability episodes using two analytics:1. Analytic for Hemodynamic Instability (AHI): Utilizing data from a single existing lead of a non-invasive electrocardiograph (ECG), AH analyzes heart rate variability (HRV) and ECG morphology features to rapidly detect signs of hemodynamic stability and categorize each window of data as either "AHI Stable" or "AHI Unstable." Time trending of AHI outputs is also provided. 2. Analytic for Hemodynamic Instability Predictive Indicator (AH-P); Utilizing AH outputs from up to the most recent 30 minutes of EG data, AH-PI indicates the likelihood of a future episode of hemodynamic instability, defined as ten continuous minutes or more where signs of hemodynamic instability are present.
More Information

Unknown
The description mentions "pattern analysis" and "utilizing data... to rapidly detect signs" and "indicates the likelihood of a future episode," which are common applications for AI/ML. However, it does not explicitly state that AI or ML is used, nor does it provide details about training or test sets, which would be expected for an AI/ML device. The term "Analytic" is used, which could refer to various computational methods, not necessarily AI/ML.

No.
The device is intended to identify patients showing or likely to experience hemodynamic instability and to allow clinicians to increase vigilance, not to treat a condition. It is explicitly stated that this device is not intended to independently direct therapy.

Yes

The device provides a binary output and a predictive indicator (AHI-PI) to identify patients showing signs of hemodynamic instability or those likely to experience a future episode, which aids in diagnosis by alerting clinicians to a patient's physiological status.

Yes

The device description explicitly states it utilizes data from an existing ECG and performs analysis (HRV and ECG morphology features) and prediction based on this data. The performance studies section mentions "Software verification and validation testing," and there is no mention of any hardware components being part of the device itself, only that it uses data from an existing ECG.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples such as blood, urine, or tissue that have been taken from the human body to detect diseases or other conditions.
  • Device Function: The AHI System analyzes a physiological signal (ECG waveform) directly from the patient's body. It does not process samples taken from the body.
  • Intended Use: The intended use describes monitoring a patient's hemodynamic status based on real-time physiological data, not analyzing a biological sample.

Therefore, the AHI System falls under the category of a physiological monitoring device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The AHI System is intended for use by healthcare professionals managing patients 18 years or older who are receiving continuous physiological monitoring with electrocardiography (ECG) in hospitals.

AHI provides a frequently updated binary output over time based on pattern analysis of a lead-II ECG waveform intended to describe a patient’s hemodynamic status and indicate if a patient is showing signs of hemodynamic stability or instability. Signs of hemodynamic instability (HI) are defined as hypotension (systolic blood pressure

§ 870.2220 Adjunctive hemodynamic indicator with decision point.

(a)
Identification. An adjunctive hemodynamic indicator with decision point is a device that identifies and monitors hemodynamic condition(s) of interest and provides notifications at a clinically meaningful decision point. This device is intended to be used adjunctively along with other monitoring and patient information.(b)
Classification. Class II (special controls). The special controls for this device are:(1) Software description, verification, and validation based on comprehensive hazard analysis and risk assessment must be provided, including:
(i) Full characterization of technical parameters of the software, including algorithm(s);
(ii) Description of the expected impact of all applicable sensor acquisition hardware characteristics on performance and any associated hardware specifications;
(iii) Specification of acceptable incoming sensor data quality control measures;
(iv) Mitigation of impact of user error or failure of any subsystem components (signal detection and analysis, data display, and storage) on output accuracy; and
(v) The sensitivity, specificity, positive predictive value, and negative predictive value in both percentage and number form for clinically meaningful pre-specified time windows consistent with the device output.
(2) Scientific justification for the validity of the hemodynamic indicator algorithm(s) must be provided. Verification of algorithm calculations and validation testing of the algorithm must use an independent data set.
(3) Usability assessment must be provided to demonstrate that risk of misinterpretation of the status indicator is appropriately mitigated.
(4) Clinical data must support the intended use and include the following:
(i) The assessment must include a summary of the clinical data used, including source, patient demographics, and any techniques used for annotating and separating the data;
(ii) Output measure(s) must be compared to an acceptable reference method to demonstrate that the output represents the measure(s) that the device provides in an accurate and reproducible manner;
(iii) The data set must be representative of the intended use population for the device. Any selection criteria or limitations of the samples must be fully described and justified;
(iv) Where continuous measurement variables are displayed, agreement of the output with the reference measure(s) must be assessed across the full measurement range; and
(v) Data must be provided within the clinical validation study or using equivalent datasets to demonstrate the consistency of the output and be representative of the range of data sources and data quality likely to be encountered in the intended use population and relevant use conditions in the intended use environment.
(5) Labeling must include the following:
(i) The type of sensor data used, including specification of compatible sensors for data acquisition, and a clear description of what the device measures and outputs to the user;
(ii) Warnings identifying factors that may impact output results;
(iii) Guidance for interpretation of the outputs, including warning(s) specifying adjunctive use of the measurements;
(iv) Key assumptions made in the calculation and determination of measurements; and
(v) A summary of the clinical validation data, including details of the patient population studied (
e.g., age, gender, race/ethnicity), clinical study protocols, and device performance with confidence intervals for all intended use populations.

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July 14, 2022

Fifth Eye Inc. % Donna-Bea Tillman Senior Consultant Biologics Consulting 1555 King Street. Suite 300 Alexandria, Virginia 22314

Re: K221203

Trade/Device Name: AHI System Regulation Number: 21 CFR 870.2220 Regulation Name: Adjunctive hemodynamic indicator with decision point Regulatory Class: Class II Product Code: QNV,QNL Dated: June 17, 2022 Received: June 21, 2022

Dear Donna-Bea Tillman:

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

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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 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,

LCDR Stephen Browning 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

Submission Number (if known)

K221203

Device Name

AHI System (v 2.2.0)

Indications for Use (Describe)

The AHI System is intended for use by healthcare professionals managing patients 18 years or older who are receiving continuous physiological monitoring with electrocardiography (ECG) in hospitals.

AHI provides a frequently updated binary output over time based on pattern analysis of a lead-II ECG waveform intended to describe a patient's hemodynamic status and indicate if a patient is showing signs of hemodynamic stability or instability. Signs of hemodynamic instability (HI) are defined as hypotension (systolic blood pressure 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."

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510(k) Summary

Prepared on: 2022-06-14

Contact Details

Applicant NameFifth Eye Inc.
Applicant Address110 Miller Avenue, Suite 300 Ann Arbor MI 48104 United States
Applicant Contact Telephone734-260-4800
Applicant ContactMs. Jennifer Baird
Applicant Contact Emailjbaird@fiftheye.com
Correspondent NameBiologics Consulting
Correspondent Address1555 King Street, Suite 300 Alexandria VA 22314 United States
Correspondent Contact Telephone(410) 531- 6542
Correspondent ContactDr. Donna-Bea Tillman
Correspondent Contact Emaildtillman@biologicsconsulting.com

21 CFR 807.92(a)(2)

Device Trade NameAHI System (v 2.2.0)
Common NameAdjunctive hemodynamic indicator with decision point
Classification NameAdjunctive Hemodynamic Indicator With Decision Point
Regulation Number870.2220
Product CodeQNV

21 CFR 807.92(a)(3)

Predicate #Predicate Trade Name (Primary Predicate is listed first)Product Code
K212219AHI SystemQNV

21 CFR 807.92(a)(4)
The AHI System is a multiparameter system designed to meet clinicians' need to identify patient hemodynamic status and predict patient hemodynamic instability episodes using two analytics:1. Analytic for Hemodynamic Instability (AHI): Utilizing data from a single existing lead of a non-invasive electrocardiograph (ECG), AH analyzes heart rate variability (HRV) and ECG morphology features to rapidly detect signs of hemodynamic stability and categorize each window of data as either "AHI Stable" or "AHI Unstable." Time trending of AHI outputs is also provided.

  1. Analytic for Hemodynamic Instability Predictive Indicator (AH-P); Utilizing AH outputs from up to the most recent 30 minutes of EG data, AH-PI indicates the likelihood of a future episode of hemodynamic instability, defined as ten continuous minutes or more where signs of hemodynamic instability are present.

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Intended Use/Indications for Use

The AHI System is intended for use by healthcare professionals managing patients 18 years or older who are receiving continuous physiological monitoring with electrocardiography (ECG) in hospitals.

AHI provides a frequently updated binary output over time based on pattern analysis of a lead-ll ECG waveform intended to describe a patient's hemodynamic status and indicate if a patient is showing stability or instability or instability. Signs of hemodynamic instability (HI) are defined as hypotension (systolic blood pressure