← Product Code [OZW](/submissions/HO/subpart-g%E2%80%94general-hospital-and-personal-use-miscellaneous-devices/OZW) · K133263

# PROTEUS PATCH, PROTEUS INGESTIBLE SENSOR (ACCESSORY) (K133263)

_Proteus Digital Health, Inc. · OZW · Feb 7, 2014 · General Hospital · SESE_

**Canonical URL:** https://fda.innolitics.com/submissions/GU/subpart-g%E2%80%94general-hospital-and-personal-use-miscellaneous-devices/OZW/K133263

## Device Facts

- **Applicant:** Proteus Digital Health, Inc.
- **Product Code:** [OZW](/submissions/HO/subpart-g%E2%80%94general-hospital-and-personal-use-miscellaneous-devices/OZW.md)
- **Decision Date:** Feb 7, 2014
- **Decision:** SESE
- **Submission Type:** Special
- **Regulation:** 21 CFR 880.6305
- **Device Class:** Class 2
- **Review Panel:** General Hospital

## Indications for Use

The Proteus® Patch is a miniaturized, wearable data-logger for ambulatory recording of physiological and behavioral metrics such as heart rate, activity, body angle relative to gravity, and time-stamped, patient-logged events, including events signaled by swallowing the Ingestible Sensor accessory. The Proteus Patch enables unattended data collection for clinical and research applications. The Proteus Patch may be used in any instance where quantifiable analysis of event-associated physiological and behavioral metrics is desirable.

## Device Story

Proteus Patch is a wearable sensor collecting heart rate, activity, body angle, and ingestion events. Ingestible sensor, embedded in a tablet, activates in the stomach, communicating via volume conduction to the patch. Patch stores data and wirelessly transmits to a computing device for display. Used in clinical/research settings for unattended data collection. Healthcare providers use the output to analyze event-associated physiological and behavioral metrics, aiding clinical decision-making. Benefits include objective, time-stamped tracking of medication adherence and physiological response.

## Clinical Evidence

No clinical data provided. Substantial equivalence supported by bench testing, including accelerometer validation against known acceleration and heart rate quantification using a modified Hamilton-Tompkins algorithm per ANSI/AAMI EC 13 standards.

## Technological Characteristics

Wearable sensor with 3-axis accelerometer and biopotential amplifiers. Materials: LiMn coin cell battery. Sensing: Biopotential low-frequency (heart rate) and high-frequency (impedance) amplifiers; accelerometer for activity/body angle. Ingestible sensor uses bio-galvanic power and volume conduction. Connectivity: Wireless transmission to computing device. Form factor: Two-piece rectangular (98mm x 42mm x 11mm). Memory: 16 MB. Software: Modified Hamilton-Tompkins algorithm for heart rate.

## Regulatory Identification

An ingestible event marker is a prescription device used to record time-stamped, patient-logged events. The ingestible component links wirelessly through intrabody communication to an external recorder which records the date and time of ingestion as well as the unique serial number of the ingestible device.

## Special Controls

In combination with the general controls of the FD&C Act, the Proteus Personal Monitor including Ingestion Event Marker is subject to the following special controls:

*Classification.* Class II (special controls). The special controls for this device are:(1) The device must be demonstrated to be biocompatible and non-toxic;
(2) Nonclinical, animal, and clinical testing must provide a reasonable assurance of safety and effectiveness, including device performance, durability, compatibility, usability (human factors testing), event recording, and proper excretion of the device;
(3) Appropriate analysis and nonclinical testing must validate electromagnetic compatibility performance, wireless performance, and electrical safety; and
(4) Labeling must include a detailed summary of the nonclinical and clinical testing pertinent to use of the device and the maximum number of daily device ingestions.

## Predicate Devices

- Proteus® Patch Including Ingestible Sensor ([K131009](/device/K131009.md))

## Submission Summary (Full Text)

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>
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Image /page/0/Picture/1 description: The image shows the logo for Proteus Digital Health. The logo is in black and white and features the word "proteus" in a bold, sans-serif font. Below the word "proteus" is the phrase "DIGITAL HEALTH" in a smaller, sans-serif font. The logo is simple and modern, and it conveys a sense of innovation and technology.

FEB - 7 2014

# 510(k) Summary

Submitted by: Proteus Digital Health Inc. Address: 2600 Bridge Parkway, Suite 101 Redwood City, CA, 94065 Telephone: (650) 637-6109 Facsimile: (650) 362-1860

Contact Name:

、

Jafar Shenasa ishenasa@proteusdh.com

Date Submitted:

October 21, 2013

# Name of Device

Trade name: Common name: Classification name:

Proteus® Patch Including Ingestible Sensor Ingestible Event Marker Ingestible Event Marker (21 CFR 880.6305, Product Code OZW, DXH)

### Unmodified Device

Proteus® Patch Including Ingestible Sensor (K131009) .

### General Device Description

The Proteus Patch is a body-worn sensor that collects physiological and behavioral metrics such as heart tate, activity, body angle relative to gravity, and time-stamped user-logged events generated by swallowing the Proteus Ingestible Sensor. The Ingestible Sensor is embedded inside an inactive tablet (the Pill) for ease of handling and swallowing. Once the Ingestible Sensor reaches the stomach, it activates and communicates its presence and unique identifier to the Patch stores and wirelessly sends the physiological, behavioral, event, and ingestion data to a general computing device for display.

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### Intended Use

The Proteus® Patch is a miniaturized, wearable data-logger for ambulatory recording of physiological and behavioral metrics such as heart rate, activity, body angle telative to gravity, and time-stamped, patient-logged events, including events signaled by swallowing the Ingestible Sensor accessory. The Proteus Patch enables unattended data collection for clinical and research applications. The Proteus Patch may be used in any instance where quantifiable analysis of event-associated physiological and behavioral metrics is desirable.

| Parameter               | Values                                                                                                    |                                       |
|-------------------------|-----------------------------------------------------------------------------------------------------------|---------------------------------------|
| The Patch               |                                                                                                           |                                       |
| Shape                   | One-Piece Form Factor:<br>(Cleared under K131524)             Two-Piece Form Factor:<br>(Modified device) |                                       |
| Shape                   | One-piece: ovoid                                                                                          | Two-piece: Rectangular                |
| Size                    | 102mm x 56mm x 10mm                                                                                       | 98mm x 42mm x 11mm                    |
| Weight                  | 11g                                                                                                       | 16 g                                  |
| Battery type            | Lithium Manganese<br>(LiMn) Coin Cell                                                                     | Lithium Manganese<br>(LiMn) Coin Cell |
| Moisture susceptibility | Water-resistant                                                                                           | Water-resistant                       |
| Memory                  | 4 MB                                                                                                      | 16 MB                                 |
| Storage temperature     | Room Temperature                                                                                          | Room Temperature                      |
| Relative humidity       | Ambient                                                                                                   | Ambient                               |
| The Pill                |                                                                                                           |                                       |
| Shape                   | Round                                                                                                     |                                       |
| Size                    | 6.5mm x 2.0mm                                                                                             |                                       |
| Weight                  | 80mg                                                                                                      |                                       |
| Shape                   | Round                                                                                                     |                                       |

## Physical Characteristics

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# Technological Characteristics

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| Parameter                    | Sensor Technology                                 | Method                                              |
|------------------------------|---------------------------------------------------|-----------------------------------------------------|
| Heart rate                   | Biopotential low-<br>frequency amplifier          | Digitized R wave                                    |
| Activity                     | Accelerometer                                     | Digitized accelerometer output                      |
| Body angle                   | Accelerometer                                     | Double integration of<br>accelerometer output       |
| Manual event logging         | Patient activated<br>button                       | Digital pulse                                       |
| Inter-electrode<br>impedance | Biopotential high-<br>frequency amplifier         | Digitized impedance from small<br>auxiliary current |
| Ingestible Event<br>Marker   | Bio-galvanically<br>powered ingestible<br>circuit | Volume conduction<br>communication                  |

## Summary of Non-Clinical Performance Data

The three-axis accelerometer provided motion and angle relative to gravity data and was validated against a known acceleration applied against each of its three axes.

The biopotential low-frequency amplifier was used to quantify heart rate by measuring Rwave frequency based upon a modified Hamilton-Tompkins algorithm, tested using guidelines set forth in the ANSI/AAMI EC 13 standard.

The Ingestion Sensor was tested for activation time and lifetime after activation.

# Summary of Clinical Performance Data

No additional clinical data were required to confirm substantial equivalence to predicate device.

## Conclusion

Based on technological characteristics, risk evaluation, and design verification of the Proteus

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Patch Including Ingestible Sensor, Proteus Digital Health, Inc. believes that the product is safe and effective, and is substantially equivalent to predicate device.

Proteus Digital Health, Inc.

【

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Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized symbol that resembles an abstract human figure with outstretched arms.

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

February 7, 2014

Proteus Digital Health, Inc. Jafar Shenasa 2600 Bridge Parkway, Suite 101 Redwood City, CA 94065 US

Re: K133263

> Trade/Device Name: Proteus Patch, Proteus Ingestible Sensor (accessory) Regulation Number: 21 CFR 880.6305 Regulation Name: Ingestible Event Marker Regulatory Class: Class II Product Code: OZW, DXH Dated: January, 08, 2013 Received: January, 09, 2013

Dear Jafar Shenasa:

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. 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 

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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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. 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

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638 2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours,

# Owen P: Faris -S

for

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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# Indications for Use Statement

510(k) K133263 Number (if known)

Device Name Proteus® Patch including Ingestible Sensor

The Proteus Patch is a miniaturized, wearable data-logger for Indications ambulatory recording of physiological and behavioral metrics such as for Use heart rate, activity, body angle relative to gravity, and time-stamped, patient-logged events, including events signaled by swallowing the Ingestible Sensor accessory. The Proteus Patch enables unattended data collection for clinical and research applications. The Proteus Patch may be used in any instance where quantifiable analysis of event-associated physiological and behavioral metrics is desirable.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ (Per 21 CFR 801.109)

OR

Over-the-Counter Use _

PLEASE DO NOT WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED

Concurrence of CDRH, Office of Device Evaluation (ODE)

Digitally signed by
Owen P. Faris -S
Date: 2014.02.07
09:27:41 '-05'00'

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