K Number
K971149
Device Name
SVL-9130 DEFIBRILLATION ELECTRODE
Manufacturer
Date Cleared
1997-06-23

(87 days)

Product Code
Regulation Number
870.5310
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The SVL-9130 electrodes are single use and intended to be used in conjunction with semi-automatic external defibrillators (AED) to monitor and deliver defibrillation energy to the patient. The electrodes are intended to be used with AEDs that specify the use of disposable electrodes that meet AAMI DF-39 standards. These AEDs must have compatible electrode connectors. The VivaLink AED and the V2 are examples of such AEDs. The electrodes are intended for short term use and must be used before the expiration date listed on the packaging. The AEDs are used for emergency treatment of cardiac arrest patients who weigh more than 90 pounds. The user assesses the patient's condition and confirms that the patient is unconscious, pulseless and is not breathing prior to applying the electrodes to the skin.
Device Description
The SVL-9130 electrodes consists of a pair of hydrogel polymeric self-adhesive electrode pads of equal dimension. The electrode are packaged in such a way that the two conductive areas are in electrical contact.
More Information

Not Found

No
The document describes passive electrodes for use with an AED and does not mention any computational or algorithmic capabilities.

Yes
The electrodes are used in conjunction with a defibrillator to deliver defibrillation energy to a patient in cardiac arrest, which is a therapeutic intervention.

No
The electrodes are used with AEDs to monitor and deliver defibrillation energy, and the user assesses the patient's condition before applying them. There is no indication that the electrodes themselves provide a diagnosis.

No

The device description clearly states the device consists of physical electrode pads, which are hardware components.

Based on the provided text, the SVL-9130 electrodes are not an In Vitro Diagnostic (IVD) device.

Here's why:

  • IVD Definition: In Vitro Diagnostics are devices used to examine specimens taken from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • SVL-9130 Function: The SVL-9130 electrodes are applied externally to the patient's skin to monitor and deliver electrical energy for defibrillation. They do not analyze any specimens taken from the body.
  • Intended Use: The intended use clearly states they are for use with AEDs to monitor and deliver defibrillation energy to the patient's body.

Therefore, the SVL-9130 electrodes fall under the category of medical devices used for external therapeutic and monitoring purposes, not In Vitro Diagnostics.

N/A

Intended Use / Indications for Use

The SVL-9130 electrodes are single use and intended to be used in conjunction with semi-automatic external defibrillators (AED) to monitor and deliver defibrillation energy to the patient. The electrodes are intended to be used with AEDs that specify the use of disposable electrodes that meet AAMI DF-39 standards. These AEDs must have compatible electrode connectors. The VivaLink AED and the V2 are examples of such AEDs.

The electrodes are intended for short term use and must be used before the expiration date listed on the packaging.

The AEDs are used for emergency treatment of cardiac arrest patients who weigh more than 90 pounds. The user assesses the patient's condition and confirms that the patient is unconscious, pulseless and is not breathing prior to applying the electrodes to the skin.

Product codes

74 MKJ

Device Description

The SVL-9130 electrodes consists of a pair of hydrogel polymeric self-adhesive electrode pads of equal dimension. The electrode are packaged in such a way that the two conductive areas are in electrical contact.

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

Not Found

Intended User / Care Setting

Not Found

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 SVL-9130 electrodes meet all the specifications for single use hydrogel electrodes of the AAMI DF-39 specifications and SurVivaLink's internal specifications. In all instances, the SVL-9130 electrodes functioned as intended.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K940445, K914955

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.5310 Automated external defibrillator system.

(a)
Identification. An automated external defibrillator (AED) system consists of an AED and those accessories necessary for the AED to detect and interpret an electrocardiogram and deliver an electrical shock (e.g., battery, pad electrode, adapter, and hardware key for pediatric use). An AED system analyzes the patient's electrocardiogram, interprets the cardiac rhythm, and automatically delivers an electrical shock (fully automated AED), or advises the user to deliver the shock (semi-automated or shock advisory AED) to treat ventricular fibrillation or pulseless ventricular tachycardia.(b)
Classification. Class III (premarket approval)(c)
Date PMA or notice of completion of PDP is required. A PMA will be required to be submitted to the Food and Drug Administration by April 29, 2015, for any AED that was in commercial distribution before May 28, 1976, or that has, by April 29, 2015, been found to be substantially equivalent to any AED that was in commercial distribution before May 28, 1976. A PMA will be required to be submitted to the Food and Drug Administration by April 29, 2015, for any AED accessory described in paragraph (a) that was in commercial distribution before May 28, 1976, or that has, by April 29, 2015, been found to be substantially equivalent to any AED accessory described in paragraph (a) that was in commercial distribution before May 28, 1976. Any other AED and AED accessory described in paragraph (a), shall have an approved PMA or declared completed PDP in effect before being placed in commercial distribution.

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K971149

1997 - JUN 223 1997 - 1997 - 1997 - 1997

ATTACHMENT H: 510(K) SUMMARY

(

1

510(k) Summary

H-1. ADMINSTRATIVE INFORMATION

H-1.1 Name and address

| Submitted by: | SurVivaLink Corporation
5430 Feltl Road
Minneapolis, MN 55343 |

------------------------------------------------------------------------------------
Contact Person:Sew-Wah Tay, Ph.D.
Telephone No.:612-939-4181 ext. 142
Facsimile No .:612-939-4191

Date Prepared: March 26, 1997

H-1.2 Device Name

| Common or Usual Name: | Disposable Polymer (Hydrogel) External Monitoring and
Defibrillation Electrode |
|-----------------------|-----------------------------------------------------------------------------------|
| Device Name: | SVL-9130 |
| Trade Name: | SVL-9130 |

H-1.3 Classification Name

Disposable Single Use Accessory (Electrode) to:

a) Semi-automatic low energy DC defibrillator 21CFR§870.5300; Class II

b) Cardiac Monitor (Cardiotachometer and Rate Alarm) 21CFR§870.2300; Class II

Note: FDA has determined that Automatic External Defibrillators are currently classified as class III devices

H-1.4 Applicant

Applicant's Name:

SurVivaLink, Corporation 5430 Feltl Road Minneapolis, MN 55343

PREDICATE DEVICE H-2.

    1. SurVivaLink Model 9010 (9010) electrodes manufactured for SurVivaLink Corporation by Katecho Inc.models (K940445)
    1. Katecho K-Defib/Pace electrodes (K914955)

H-3. INDICATION FOR USE

The SVL-9130 electrodes are single use and intended to be used in conjunction with semi-automatic external defibrillators (AED) to monitor and deliver defibrillation energy to the patient. The electrodes are intended to be used with AEDs that specify the use of

2

disposable electrodes that meet AAMI DF-39 standards. These AEDs must have compatible electrode connectors. The VivaLink AED and the V2 are examples of such AEDs.

The electrodes are intended for short term use and must be used before the expiration date listed on the packaging.

The AEDs are used for emergency treatment of cardiac arrest patients who weigh more than 90 pounds. The user assesses the patient's condition and confirms that the patient is unconscious, pulseless and is not breathing prior to applying the electrodes to the skin.

H-4 DEVICE DESCRIPTION

The SVL-9130 electrodes consists of a pair of hydrogel polymeric self-adhesive electrode pads of equal dimension. The electrode are packaged in such a way that the two conductive areas are in electrical contact.

SUBSTANTIAL EQUIVALENCE H-5.

The Company's SVL-9130 electrodes covered by this submission are substantially equivalent to other legally marketed electrodes for semi-automatic low power DC defibrillators. Specifically, the SVL-9130 electrode is substantially equivalent to SVL-9010 electrodes (K940455) and Katecho's D-Defib/Pace electrodes (K 914955).

PERFORMANCE DATA H-6.

The SVL-9130 electrodes meet all the specifications for single use hydrogel electrodes of the AAMI DF-39 specifications and SurVivaLink's internal specifications. In all instances, the SVL-9130 electrodes functioned as intended.

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of an eagle or bird-like figure with three curved lines representing its body and wings. The logo is surrounded by text that reads "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUN 2 3 1997

Sew-Wah Tay, Ph.D. SurVivaLink Corporation 5420 Feltl Road · · · ······· Minneapolis, Minnesota 55343

Re: K971149 SurVivaLink 9130 Defibrillation Electrode Regulatory Class: III (three) Product Code: 74 MKJ Dated: March 27, 1997 Received: March 28, 1997

Dear Dr. Tay:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, qood manufacturing practice, labeling, and prohibitions aqainst misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations. Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Good Manufacturing Practice for Medical Devices: General (GMP) regulation (21 CFR Fart 820) and that, through periodic GMP inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP requlation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

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Page 2 - Sew-Wah Tay, Ph.D.

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market. "

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4646. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

Thomas J. Callahan

Thomas J. Callahan, Ph.D. Director Division of Cardiovascular, Respiratory, and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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8. INDICATION FOR USE

The SVL-9130 electrodes are single use and intended to be used in conjunction with semi-automatic external defibrillators (AED) to monitor and deliver defibrillation energy to the patient. The electrodes are intended to be used with AEDs that specify the use of disposable electrodes that meet AAMI DF-39 standards. These AEDs must have compatible electrode connectors. The VivaLink AED and the V2 are examples of such AEDs.

The electrodes are intended for short term use and must be used before the expiration date listed on the packaging.

The AEDs are used for emergency treatment of cardiac arrest patients who weigh more than 90 pounds. The user assesses the patient's condition and confirms that the patient is unconscious, pulseless and is not breathing prior to applying the electrodes to the skin.

Prescription use ✓

K12m

(Division Sign-Off) Division of Cardiovascular, Respiratory, and Neurological Devices

510(k) Number_kg7114