K Number
K992672
Date Cleared
1999-08-24

(14 days)

Product Code
Regulation Number
880.5725
Panel
HO
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use
  • Infusion of crystalloid, colloid, or blood product, including packed red blood cells, as volume replacement for patients suffering from blood loss due to trauma or surgery.
  • Infusion of warmed fluid to rewarm patients after surgery or for hypothermia.
  • Infusion of warmed fluid for irrigation in urology procedures.
Device Description

The Belmont Fluid Management System (7MS2000) combines advanced microprocessor technology with an efficient mechanical system to provide a high speed, simple and safe system for rapid infusion of warmed fluid. The Belmont FMS2000 infuses blood, replacement IV fluids or irrigation fluids warmed to physiologic temperature at userset rates from 10 to 500 milliliters per minute (ml/min). A low infusion rate at 2.5 ml/min (150 ml/hr) is also available without heating. The system monitors temperature, line pressure, and air in the fluid path to ensure safe operation and alarms at all unsafe conditions. A hardware override circuit prevents unsafe operation in case of system computer failure. A touch screen displays flow rate, total fluid infused, temperature, line pressure, alarm and status messages and proper procedures to proceed safely after an alarm situation. A battery backup allows for mobile transport of the patient and system. During battery operation, fluid warming is disabled while pump operation and safety monitoring remain active.

AI/ML Overview

The document describes the Belmont Fluid Management System (FMS2000), an infusion pump with a warmer. The submission is a 510(k) premarket notification for a modification to the disposable set used with the FMS2000. Therefore, the device itself (FMS2000) has not changed, and the study conducted is to verify the performance of the system with the modified disposable set and accessory kits.

Based on the provided information, I can extract the following details regarding acceptance criteria and the study:

1. Table of Acceptance Criteria and Reported Device Performance:

Acceptance Criteria (Performance Objective)Reported Device Performance
Ability of the system to pump fluids accurately over the full range of flow rate and operating conditions (different input fluid temperatures, different back pressure, change in ambient temperature, and change in fluid viscosity)."The Belmont FMS2000 performed within specification"
Ability of the system to warm cold fluids to physiological temperature over the full range of flow rate and operating conditions."The Belmont FMS2000 performed within specification"
Ability of the system to detect and alarm at unsafe or ineffective operating conditions (including operator errors, sensor failure, software/computer failure, and other internal system malfunctions)."The Belmont FMS2000 performed within specification"

Limitations: The document states that the FMS2000 "performed within specification" but does not explicitly list the quantitative "specifications" themselves (e.g., specific accuracy percentages for flow rate, temperature ranges, or alarm trigger thresholds).

2. Sample Size Used for the Test Set and Data Provenance:

The document describes "Nonclinical Tests and Results" to verify the performance. However, it does not specify the sample size for these tests (e.g., number of devices tested, number of test runs).

The data provenance is retrospective in the sense that it's a submission for a modification to an existing device (K972284), and the tests were performed by the manufacturer, Belmont Instrument Corporation. There's no information about the country of origin of the data beyond the manufacturer's location in the USA.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts:

The document describes nonclinical tests performed by the manufacturer. These are likely engineering and performance tests against pre-defined specifications, not assessments requiring expert "ground truth" in the medical sense (like a radiologist interpreting images). Therefore, this information is not applicable to this type of study.

4. Adjudication Method for the Test Set:

Given that these are nonclinical performance tests, an adjudication method (like 2+1, 3+1) is not applicable. The outcome of these tests would likely be pass/fail based on whether the device's measured performance met the engineering specifications.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and Effect Size:

No, a Multi-Reader Multi-Case (MRMC) comparative effectiveness study was not done. This type of study is typically used for diagnostic or screening devices where human readers interpret results, and the aim is to evaluate reader performance with and without AI assistance. The Belmont FMS2000 is an infusion pump, and the study described is for nonclinical performance verification.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done:

The FMS2000 is a physical medical device (an infusion pump), not an AI algorithm. "Standalone performance" in this context would refer to the device's inherent operational characteristics. The nonclinical tests described are essentially a standalone performance evaluation of the device's ability to pump, warm, and alarm according to its design specifications.

7. The Type of Ground Truth Used:

For the nonclinical performance tests, the "ground truth" would be the established engineering specifications or design requirements for the Belmont FMS2000 for parameters like:

  • Flow rate accuracy
  • Temperature regulation accuracy
  • Alarm trigger thresholds and response times

The accuracy of the device's measurements (e.g., flow rate, temperature) would be compared against verified measurement standards.

8. The Sample Size for the Training Set:

This question is not applicable. The Belmont FMS2000 is a hardware device with microprocessor control, not a machine learning model that typically requires a "training set."

9. How the Ground Truth for the Training Set Was Established:

This question is not applicable as there is no training set for this type of device.

§ 880.5725 Infusion pump.

(a)
Identification. An infusion pump is a device used in a health care facility to pump fluids into a patient in a controlled manner. The device may use a piston pump, a roller pump, or a peristaltic pump and may be powered electrically or mechanically. The device may also operate using a constant force to propel the fluid through a narrow tube which determines the flow rate. The device may include means to detect a fault condition, such as air in, or blockage of, the infusion line and to activate an alarm.(b)
Classification. Class II (performance standards).