K Number
K241088
Device Name
EndoTool IV (3.1)
Date Cleared
2024-12-11

(236 days)

Product Code
Regulation Number
868.1890
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
EndoTool IV 3.1 is a glucose management software system used by healthcare professionals in all inpatient care settings for adult and pediatric patients aged two years and above who weigh 12 kgs. or more. EndoTool adjusts and maintains a patient's glucose level within a configurable clinician-determined target range by recommending patient-specific intravenous insulin dosing, carbohydrate dosing for recovery or supplementation, and subcutaneous dosing for the transition from IV dosing. EndoTool IV 3.1 logic is not a substitute for but rather an adjunct to clinical reasoning. No medical decision should be based solely on the recommended guidance provided by this software system.
Device Description
EndoTool IV 3.1 is a software system for glucose management which uses the current and cumulative qlucose values provided by the user to calculate and recommend intravenous insulin or carbohydrate doses, to adjust and maintain the patient's glucose level within a provider-ordered target range. In addition, the application can recommend a subcutaneous Basal transition insulin dose when IV insulin therapy is no longer required.
More Information

No reference devices were used in this submission.

No
The document describes a software system that uses current and cumulative glucose values to calculate and recommend doses based on a configurable target range. It does not mention AI, ML, or any related concepts like training or test sets for such algorithms. The logic is described as an adjunct to clinical reasoning, not a system that learns or adapts autonomously.

No.
The device is a software system that recommends insulin and carbohydrate dosing; it does not directly administer treatment.

No

The device is a glucose management software system that recommends insulin and carbohydrate dosing to maintain glucose levels. It is not used for diagnosing medical conditions, but rather for managing an existing one.

Yes

The device description explicitly states "EndoTool IV 3.1 is a software system for glucose management". There is no mention of any accompanying hardware components or hardware-specific functions beyond processing user-provided glucose values.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are devices intended for use in the collection, preparation, and examination of specimens taken from the human body (such as blood, urine, tissue) to provide information for diagnostic, monitoring, or compatibility purposes.
  • EndoTool IV 3.1's Function: The description clearly states that EndoTool IV 3.1 is a glucose management software system that uses current and cumulative glucose values provided by the user to calculate and recommend dosing. It does not perform any tests on specimens taken from the body. It processes data that is likely obtained from other devices (like glucose meters or continuous glucose monitors), but the software itself is not performing the diagnostic test.
  • Intended Use: The intended use is to adjust and maintain a patient's glucose level by recommending dosing, not to diagnose a condition or analyze a biological sample.

Therefore, EndoTool IV 3.1 falls under the category of a clinical decision support software or a medical device software that assists healthcare professionals in managing a patient's condition based on existing data. It is not an IVD.

N/A

Intended Use / Indications for Use

EndoTool IV 3.1 is a glucose management software system used by healthcare professionals in all inpatient care settings for adult and pediatric patients aged two years and above who weigh 12 kgs. or more. EndoTool adjusts and maintains a patient's glucose level within a configurable clinician-determined target range by recommending patient-specific intravenous insulin dosing, carbohydrate dosing for recovery or supplementation, and subcutaneous dosing for the transition from IV dosing.

EndoTool IV 3.1 logic is not a substitute for but rather an adjunct to clinical reasoning. No medical decision should be based solely on the recommended guidance provided by this software system.

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

NDC

Device Description

EndoTool IV 3.1 is a software system for glucose management which uses the current and cumulative qlucose values provided by the user to calculate and recommend intravenous insulin or carbohydrate doses, to adjust and maintain the patient's glucose level within a provider-ordered target range. In addition, the application can recommend a subcutaneous Basal transition insulin dose when IV insulin therapy is no longer required.

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 aged two years and above who weigh 12 kgs. or more.

Intended User / Care Setting

Healthcare professionals in all inpatient care settings.

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)

The following performance data were provided in support of the substantial equivalence determination.

Sterilization & Shelf-life Testing

Not Applicable (Standalone Software)

Biocompatibility Testing

Not Applicable (Standalone Software)

Electrical safety and electromagnetic compatibility (EMC)

Not Applicable (Passive Device)

Software Verification and Validation Testing

Software verification and validation testing was conducted per IEC 62304.

Mechanical and acoustic Testing

Not Applicable (Standalone Software)

Animal Studv

Animal performance testing was not required to demonstrate the safety and effectiveness of the device.

Clinical Studies

Clinical testing was not required to demonstrate the safety and effectiveness of the EndoTool IV 3.1. Instead, substantial equivalence is based upon benchtop performance testing.

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.

K201619

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.

No reference devices were used in this submission.

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

§ 868.1890 Predictive pulmonary-function value calculator.

(a)
Identification. A predictive pulmonary-function value calculator is a device used to calculate normal pulmonary-function values based on empirical equations.(b)
Classification. Class II (performance standards).

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December 11, 2024

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services seal on the left and the FDA acronym and name on the right. The seal features a stylized depiction of a caduceus, a symbol associated with medicine and healthcare. The FDA acronym and name are written in blue, with the acronym in a square and the full name, "U.S. Food & Drug Administration," written out below.

Monarch Medical Technologies Tara Burnett Senior Vice President of Regulatory Affairs and Compliance 112 S. Tryon Street. Ste. 800 Charlotte, North Carolina 28284

Re: K241088

Trade/Device Name: EndoTool IV 3.1 Regulation Number: 21 CFR 868.1890 Regulation Name: Predictive Pulmonary-Function Value Calculator Regulatory Class: Class II Product Code: NDC Dated: October 29, 2024 Received: October 29, 2024

Dear Tara Burnett:

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 (the 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 available 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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device"

1

(https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30. Design controls; 21 CFR 820.90. Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review. the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 and Part 809); medical device reporting of medical device-related adverse events) (21 CFR Part 803) for devices or postmarketing safety reporting (21 CFR Part 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safetyreporting-combination-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 Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rue"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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).

2

Sincerely,

Joshua Balsam -S

Joshua M. Balsam, Ph.D. Branch Chief Division of Chemistry and Toxicology Devices OHT7: Office of In Vitro Diagnostics 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) K241088

Device Name EndoTool IV 3.1

Indications for Use (Describe)

EndoTool IV 3.1 is a glucose management software system used by healthcare professionals in all inpatient care settings for adult and pediatric patients aged two years and above who weigh 12 kgs. or more. Endo Tool adjusts and maintains a patient's glucose level within a configurable clinician-determined target range by recommending patient-specific intravenous insulin dosing, carbohydrate dosing for recovery or supplementation, and subcutaneous dosing for the transition from IV dosing.

EndoTool IV 3.1 logic is not a substitute for but rather an adjunct to clinical reasoning. No medical decision should be based solely on the recommended guidance provided by this software system.

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

This summary of 510(k) safety and effectiveness information is submitted in accordance with the requirements of 21 CFR §807.92:

l. SUBMITTER

Monarch Medical Technologies, LLC 112 S. Tryon Street, Ste. 800 Charlotte, NC 28284 Tel: +1.303.913.4822 Email: tara.burnett@monarchmedtech.com

Contact Person:Tara Burnett
Date Prepared:December 10, 2024

DEVICE ll.

Name of Device:EndoTool IV 3.1
Classification Name:Drug Dose Calculator
Regulation:21 CFR § 868.1890
Regulatory Class:Class II
Product Classification Code:NDC
510(k) Submission Number:K241088

PREDICATE DEVICE lll.

Predicate Manufacturer:Monarch Medical Technologies
Predicate Trade Name:EndoTool IV System
Predicate 510(k):K201619

No reference devices were used in this submission.

IV. DEVICE DESCRIPTION

EndoTool IV 3.1 is a software system for glucose management which uses the current and cumulative qlucose values provided by the user to calculate and recommend intravenous insulin or carbohydrate doses, to adjust and maintain the patient's glucose level within a provider-ordered target range. In addition, the application can recommend a subcutaneous Basal transition insulin dose when IV insulin therapy is no longer required.

V. INDICATIONS FOR USE

EndoTool IV 3.1 is a glucose management software system used by healthcare professionals in all inpatient care settings for adult and pediatric patients aged two years and above who weigh 12 kgs. or more. EndoTool adjusts and maintains a patient's glucose level within a configurable cliniciandetermined target range by recommending patient-specific intravenous insulin dosing,

carbohydrate dosing for recovery or supplementation, and subcutaneous dosing for the transition from IV dosing.

EndoTool IV 3.1 logic is not a substitute for but rather an adjunct to clinical reasoning. No medical decision should be based solely on the recommended guidance provided by this software system.

VI. COMPARISON OF TECHNOLOGICAL CHARACTERISTICS WITH THE PREDICATE DEVICE

The following characteristics were compared between the subject device and the predicate device in order to demonstrate substantial equivalence:

  • Indications for Use The predicate and subject device have equivalent indications for use, .

5

with minor updates to add clarification.

  • . Materials – The predicate and subject device are both software-only devices and therefore do not have any materials.
  • Design The predicate and subject device are equivalent in design. The subject device is . an updated version of the predicate software with minor changes to the interface and functionality.
  • . Energy Source – The predicate and subject device are software-only and are both intended to be operated using equivalent computers and operating systems.
  • Performance Testing The predicate and subject device have both been validated per IEC ● 62304 requirements and FDA software validation guidance.
FeatureEndoTool IV 3.1 SystemEndoTool IV System
Indications for UseEndoTool IV 3.1 is a glucose
management software system
used by healthcare professionals
in all inpatient care settings for
adult and pediatric patients aged
two years and above who weigh
12 kgs. or more. EndoTool
adjusts and maintains a patient's
glucose level within a configurable
clinician-determined target range
by recommending patient-specific
intravenous insulin dosing,
carbohydrate dosing for recovery
or supplementation, and
subcutaneous dosing for the
transition from IV dosing.
EndoTool IV 3.1 logic is not a
substitute for but rather an adjunct
to clinical reasoning. No medical
decision should be based solely
on the recommended guidance
provided by this software system.EndoTool IV is a glucose
management software system,
designed for use by healthcare
professionals in all patient care
settings to recommend
intravenous and subcutaneous
transition dosing, as well as
carbohydrates. Evaluating
current and cumulative glucose
levels, the software adjusts and
maintains the glucose level within
a configurable clinician-
determined target range. The
system is indicated for use in
adult and pediatric patients ages
2 years and above, who weigh 12
kgs. or more. EndoTool IV logic is
not a substitute for, but rather an
adjunct to clinical reasoning. No
medical decision should be
based solely on the
recommended guidance provided
by this software system.
Prescription UseYesYes
Product CodeNDCNDC
Classification868.1890868.1890
ClassIIII
Patient Range12 kg and 2yr or greater12 kg and 2yr or greater
Creates patient-specific
IV drug infusion profilesYesYes
Evaluates current glucose
valueYesYes
Evaluates cumulative
glucose valueYesYes
Calculates next dose of
insulin, glucose, or salineYesYes
Calculates carbohydrate
intakeYesYes
Calculates nutritional
bolusYesYes
Calculates meal intakeYesYes
User InputsYesYes
WeightYesYes
AgeYesYes
Dose titrationYesYes
Calculates infusion rate
calculationsYesYes
Data storage and analysisYesYes
GUI InterfaceYesYes
Alarm advisoriesYesYes
LabelingYesYes
User ManualYesYes
WarningsYesYes
PrecautionsYesYes
Instructions for UseYesYes
Intended UserHealthcare ProfessionalsHealthcare Professionals
Environment of UseWindows hosting environment
includes physical or virtual web
application server and database
server. These may be hosted on
client premises or in a private
virtual network in Monarch's Azure
hosting environment.Windows Hosting Environment
on Client's Servers.
MaterialsN/A – Standalone SoftwareN/A – Standalone Software
Design:
• Dimensional
Specifications• N/A – Standalone Software• N/A – Standalone Software
• Operating Principles• Algorithm B• Algorithm B
• Performance
Specifications• N/A – Installed at user facility
or in Azure private virtual
network by Monarch.• N/A – Installed at user facility
by Monarch.
• Ergonomics of
Patient-User Interface• N/A – Standalone Software• N/A – Standalone Software
• Packaging• N/A – Standalone Software• N/A – Standalone Software
• Sterilization Method• N/A – Standalone Software• N/A – Standalone Software
ConnectivityOn-line web-based applicationOn-line web-based application
and off-line, Server-based
Energy SourceN/A – Standalone SoftwareN/A – Standalone Software
Feature Comparison:
• Operating System• All• All
• Browser compatibility• Microsoft Edge, Google
Chrome• Internet Explorer, Microsoft
Edge, Google Chrome,
Mozilla Firefox
• Hardware
Requirementsserver, PC, printer, bar code
scanner (optional)server, PC, printer, bar code
scanner (optional)
Performance TestingValidated per IEC 62304
requirements and FDA software
validation guidance.Validated per IEC 62304
requirements and FDA software
validation guidance.

6

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VII. PERFORMANCE DATA

The following performance data were provided in support of the substantial equivalence determination.

Sterilization & Shelf-life Testing

Not Applicable (Standalone Software)

Biocompatibility Testing

Not Applicable (Standalone Software)

Electrical safety and electromagnetic compatibility (EMC)

Not Applicable (Passive Device)

Software Verification and Validation Testing

Software verification and validation testing was conducted per IEC 62304.

Mechanical and acoustic Testing

Not Applicable (Standalone Software)

Animal Studv

Animal performance testing was not required to demonstrate the safety and effectiveness of the device.

Clinical Studies

Clinical testing was not required to demonstrate the safety and effectiveness of the EndoTool IV 3.1. Instead, substantial equivalence is based upon benchtop performance testing.

VIII. CONCLUSIONS

The indications for use and performance of the EndoTool IV 3.1 are substantially equivalent to that of the predicate device (K201619), raising no safety or effectiveness issues, and performing as well as the predicate device.