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510(k) Data Aggregation

    K Number
    K241465
    Date Cleared
    2024-09-19

    (119 days)

    Product Code
    Regulation Number
    868.5330
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Parker Hannifin Corporation

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Midas Flowmeter is intended for use as a continuous flow conscious sedation system to deliver a mixture of nitrous oxide and oxygen gases to a patient. When used with the electronic automatic vacuum switch (eAVS), the Midas Flowmeter is used to control the scavenging of waste analgesic gas.

    Device Description

    The Midas Flowmeter is used within a healthcare environment during a nitrous oxide (N20)/oxygen (O2) conscious sedation system. The device is a digitally controlled, software driven, continuous flow device that precisely meters nitrous oxide and oxygen medical gases and delivers gas mixtures to a conscious, spontaneously breathing patient. The Midas Flowmeter uses electronic mechanisms to control the flowrate and mixture percentage of gases delivered to a patient. The optional eAVS is an accessory to the Midas Flowmeter. It is used within the nitrous oxide/oxygen conscious sedation system to allow removal of waste analgesic gases through a connected vacuum source. The eAVS connects the exhalation line of the patient's breathing circuit to vacuum tubing from the vacuum source and controls the vacuum flowrate (i.e., scavenging flowrate). The eAVS is specifically designed to work with the Midas Flowmeter and all functionality control of the eAVS has been integrated into the user interface of the Midas Flowmeter.

    AI/ML Overview

    The provided document is a 510(k) Premarket Notification from the FDA, which focuses on demonstrating substantial equivalence of a new medical device to existing predicate devices. It primarily discusses comparisons of technical characteristics and compliance with recognized standards.

    Crucially, this document does NOT contain explicit acceptance criteria tables or a detailed study report that proves the device meets specific performance metrics in a clinical or simulated environment with ground truth from experts, as would be expected for an AI/ML powered device.

    The document states:

    • "The characteristics of the Midas Flowmeter and optional eAVS do not require clinical investigation due to safety and efficacy being supported by non-clinical testing performed."
    • "The verification and validation testing of the Midas Flowmeter and optional eAVS was found to be acceptable and supports the claims of substantial equivalence."

    This indicates that the device's performance was evaluated through bench testing and compliance with recognized consensus standards, rather than a clinical study involving human readers or expert-established ground truth for a test set.

    Therefore, I cannot provide the requested information about acceptance criteria, study details, sample sizes for test/training sets, expert qualifications, adjudication methods, MRMC studies, or the type of ground truth used, because such a study (as described in the prompt) was not performed or detailed in this 510(k) submission.

    The document focuses on:

    • Comparison of Technical Characteristics: Showing the Midas Flowmeter and eAVS are similar in function, intended use, and technology to predicate devices (FlowStar Touch Digital Mixer Flowmeter and Nitronox Scavenger Plus).
    • Compliance with Standards: Listing various IEC, ISO, AAMI, and ASTM standards that the device was tested against to demonstrate safety and performance (e.g., IEC 60601-1 for basic safety, ISO 11195 for gas mixers).
    • Non-clinical Performance Data (Bench Testing): A bulleted list of "performance bench testing" categories like "Gas Flow Rate Adjustment," "Touchscreen Display," "Accuracies and Faults," and "Life Testing." However, it does not provide the specific acceptance criteria for these tests nor the detailed results in a quantitative manner as requested. It simply states that "The results of the testing demonstrated that the Midas Flowmeter and optional eAVS met all of the acceptance criteria for functional, operational, and performance characteristics..."

    In summary, none of the specific elements required to answer your prompt (e.g., table of acceptance criteria with reported performance, sample sizes for test sets, expert ground truth establishment, MRMC studies, standalone performance, training set details) are present in this 510(k) document because the device is a hardware system (a gas mixer) and was cleared based on non-clinical bench testing and adherence to recognized standards, not clinical performance studies with AI/ML components involving human expert review or data-driven ground truth.

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    K Number
    K223452
    Date Cleared
    2023-03-05

    (110 days)

    Product Code
    Regulation Number
    868.5430
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Parker Hannifin Corporation

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Nitronox® Scavenger Plus is intended to control the vacuum flowrate for scavenging of waste analgesic gas.

    Device Description

    The Nitronox® Scavenger Plus (Scavenger Plus) is used within a nitrous oxide/oxygen conscious sedation system to allow removal of waste analgesic gases through a connected vacuum source. The device is used during a dental or medical procedure in a healthcare facility environment. The device is not intended to be used for general anesthesia. The Scavenger Plus is operated by a licensed healthcare professional during conscious sedation of a patient.

    The Scavenger Plus connects the exhalation line of the patient's breathing circuit to vacuum tubing from the vacuum source and controls the vacuum flowrate (i.e., scavenging flowrate). The rate at which the gas is removed (i.e., scavenged) is specified by the Scavenger Plus, which uses a control knob and reservoir bag to limit the amount of vacuum applied to the exhalation line of the breathing circuit.

    AI/ML Overview

    The document provided is a 510(k) Premarket Notification from the FDA for a medical device called the "Nitronox® Scavenger Plus." This type of submission aims to demonstrate that a new device is as safe and effective as a legally marketed predicate device, rather than proving its absolute safety and efficacy through extensive clinical trials.

    The document discusses non-clinical performance data and states that clinical investigation was not required because safety and efficacy were supported by non-clinical testing. Therefore, the information typically associated with a study proving a device meets acceptance criteria for an AI/ML medical device (such as those involving test sets, training sets, expert adjudication, MRMC studies, and detailed ground truth establishment) is not present in this document.

    The acceptance criteria described in the document relate to engineering and operational performance of a physical gas-scavenging apparatus, not an AI/ML algorithm.

    Here's a breakdown of the relevant information provided, adapted to the questions where possible, and noting where information is absent due to the nature of the device and submission:

    Acceptance Criteria and Reported Device Performance

    The document describes performance criteria primarily related to pressure limits for gas scavenging.

    Acceptance CriteriaReported Device PerformanceComments
    Under normal operating conditions (75 L/min flow through the inlet), the pressure shall not exceed 3.0 cm H2O. (This is a standard from ISO 80601-2-13, Section 201.103.1.1.1)Under normal operating conditions (75 L/min flow through the inlet), the pressure did not exceed 3.0 cm H2O.The device met this ISO standard.
    Functional, operational, and performance characteristics (general)The Scavenger Plus met all of the acceptance criteria for functional, operational, and performance characteristics.Demonstrated through performance bench testing.

    Study Details (as inferable from the document, with many points being N/A for this type of device/submission)

    1. Sample size used for the test set and the data provenance:

      • Sample Size: Not applicable. This device is a physical gas scavenging apparatus, not an AI/ML algorithm that processes data. Testing was likely done on physical units of the device under controlled conditions. The number of samples/units tested is not specified but would be part of standard engineering verification.
      • Data Provenance: Not applicable in the context of "data" for an AI model. This refers to bench testing performed on the physical device. The location of testing is not specified, but it would be part of the manufacturer's quality system. The testing would be "prospective" in the sense that it was conducted specifically for this submission.
    2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

      • Not applicable. Ground truth for a physical device's performance usually relates to engineering specifications and physical measurements, rather than expert interpretation of complex data (like medical images). Compliance with standards like ISO 80601-2-13 is verified directly through measurement.
    3. Adjudication method (e.g. 2+1, 3+1, none) for the test set:

      • Not applicable. This is relevant for studies involving human interpretation or subjective assessments. Performance testing for this device is based on objective measurements against engineering specifications.
    4. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:

      • No. This is not an AI-assisted device. MRMC studies are used to evaluate diagnostic imaging devices or AI algorithms that assist human readers.
    5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

      • Not applicable. This is not an algorithm-only device. It's a physical medical device.
    6. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):

      • Engineering specifications and objective physical measurements: The "ground truth" for this device's performance is whether its physical output (e.g., pressure) meets predefined engineering and regulatory standards (e.g., ISO 80601-2-13).
    7. The sample size for the training set:

      • Not applicable. This is not an AI/ML device that requires a training set.
    8. How the ground truth for the training set was established:

      • Not applicable. No training set for an AI/ML model.

    In summary, the provided document details a 510(k) submission for a physical medical device. The "acceptance criteria" and "proof" primarily revolve around bench testing demonstrating compliance with established engineering standards and functional specifications, rather than complex data-driven analyses characteristic of AI/ML device evaluations. The FDA determined that the non-clinical testing was sufficient to establish substantial equivalence to a predicate device, thus no clinical trials were deemed necessary.

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    K Number
    K173530
    Device Name
    Indego(R)
    Date Cleared
    2018-01-31

    (77 days)

    Product Code
    Regulation Number
    890.3480
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Parker-Hannifin Corporation

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Indego® orthotically fits to the lower limbs and the trunk; the device is intended to enable individuals with spinal cord injury at levels T3 to L5 to perform ambulatory functions with supervision of a specially trained companion in accordance with the user assessment and training certification program. The device is also intended to enable individuals with spinal cord injury at levels C7 to L5 to perform ambulatory functions in rehabilitations in accordance with the user assessment and training certification program. Finally, the Indego® is also intended to enable individuals with hemiplegia (with motor function of 4/5 in at least one upper extremity) due to cerebrovascular accident (CVA) to perform ambulatory functions in rehabilitations in accordance with the user assessment and training certification program. The Indego is not intended for sports or stair climbing.

    Device Description

    Parker Hannifin's Indego® device is a wearable powered exoskeleton that actively assists individuals to stand and walk; these are patients with walking impairments resulting from lower extremity weakness or paralysis. The Indego consists of snap-together components weighing 26 pounds total. The hip component houses a rechargeable battery pack, central processor, and Bluetooth radio, while each upper leg component houses two motors as well as embedded sensors and controllers.

    In the original operational mode of the device, called Motion+, on-board microprocessors receive signals from integrated sensors which provide information on the user's posture and tilt. This allows the device to function in a manner similar to the Segway personal mobility device, which is controlled by the user's tilt. A user similarly controls the motions of the Indego by means of postural changes (e.g., to walk forward, the user just leans forward). Alternatively, the device can be placed in a second operating mode, referred to as Therapy+, in which the device responds to the motion of users who are able to initiate stepping on their own. When operating in Therapy+, the user walks normally while the system detects step initiation and assists the user. Therapy+ may be used only in a clinical setting under clinical supervision. The technology of the design links the low profile to advanced battery technology (smaller size), motors (smaller and more powerful), and micro controllers (state-of-the art). Visual cues from the LED lights on the hip and vibratory feedback inform both the patient and therapist or trained support person of the status and mode of operation.

    The Indego controls are self-contained, with crutches or a walker used solely for stability. Users can perform sit-to-stand and stand-to-sit transitions and walk along even or uneven terrain up to about five degree (5°) grades. Tall hip wings and a tall torso pad are provided to support users who may need additional trunk support while walking. A physical therapist can configure, operate, and monitor the device during therapy and training to make adjustments as needed. This is achieved through the support of a wireless application that will run on mobile/wifi connected smart devices such as an iPod or iPhone. The patient and physical therapist will be able to work in concert to actions of transitioning from sitting to standing to walking, stop walking, and return from standing to sitting. The untethered, free-roaming design of the device allows it to be utilized in multiple indoor and outdoor locations within a rehabilitation or personal setting.

    AI/ML Overview

    The provided text is a 510(k) Premarket Notification for the Indego® powered lower extremity exoskeleton. It details the device's indications for use, its description, and its comparison to predicate devices, along with non-clinical and clinical performance data.

    However, the document does not contain typical "acceptance criteria" and "reported device performance" in the format of a table with specific metrics for an AI/ML powered device. Instead, the document focuses on demonstrating substantial equivalence to predicate devices through various tests and clinical studies for a physical medical device (an exoskeleton).

    Therefore, I cannot directly provide a table of acceptance criteria and reported device performance as if it were an AI/ML algorithm being validated. The performance metrics discussed are for the physical functionality and safety of the exoskeleton, not for an algorithmic output.

    Similarly, the information requested regarding "sample size for the test set," "data provenance (e.g. country of origin of the data, retrospective or prospective)," "number of experts used to establish the ground truth," "adjudication method," "MRMC study," "standalone performance," "type of ground truth," "sample size for the training set," and "how the ground truth for the training set was established" are all highly relevant to the clinical validation of AI/ML algorithms. This document does not describe an AI/ML algorithm for which these questions would apply in the traditional sense. The "software verification and validation testing per FDA Guidance and IEC 62304" mentioned in section 9 refers to software for controlling the physical device, not an AI for diagnostic or prognostic purposes.

    Based on the provided text, here's what can be extracted and inferred regarding the closest relevant information, keeping in mind the context of a physical exoskeleton, not an AI/ML algorithm:


    No direct "acceptance criteria" table for an AI/ML device can be constructed as this document is for a physical medical device (exoskeleton) and does not describe an AI/ML algorithm's performance.

    The document does describe various non-clinical and clinical tests to demonstrate the safety and effectiveness of the Indego® exoskeleton. The "acceptance criteria" would be implied by the "PASS" status for non-clinical tests and the positive outcomes of the clinical studies.

    Here's an attempt to adapt the requested information based on the provided text, while acknowledging its original context:


    1. Table of Acceptance Criteria and Reported Device Performance (Adapted for Exoskeleton Functionality):

    Acceptance Criteria Category (Implied)Specific Performance Metric (Where Available)Reported Device Performance / Status
    Non-Clinical PerformanceMaximum Torque Testing (Knees & Hips)PASS (met defined specifications)
    Cleaning Chemical Compatibility TestingPASS (integrity over 5 years)
    Component Life Cycle TestingPASS (safe performance between servicing)
    Durability TestingPASS (meets IEC 60601-1 factors of safety)
    Battery Life Cycle TestingPASS (met specifications for charge, capacity, life)
    Storage and Transport TestingPASS (protected during shipping, met ISTA standards)
    Software PerformanceSoftware Verification and Validation TestingConformance to FDA Guidance & IEC 62304
    Electrical SafetyElectrical Safety TestingPassed ANSI/AAMI ES60601-1:2005/(R)2012
    Electromagnetic Compatibility (EMC)EMC TestingPassed IEC 60601-1-2:2014
    Clinical Performance (Safety & Effectiveness)Adverse Events (Trial-related)2 Reported (non-serious); Issue for one resolved with software update
    Serious Adverse Events (Trial-related)0 Reported
    Gait Deviations (CVA study)21 of 30 subjects had fewer reported gait deviations at end of Session 6 vs. Session 1
    Step Length (CVA study)Equal step length reported in 26 of 108 sessions that began unequal
    STEPS taken in Indego (CVA study)Increased 38% from Session 2 to Session 6
    Time walking in Indego (CVA study)Increased 18% (average)
    10-Meter Walk Test (CVA study)23 of 30 subjects improved times in Session 6
    Functional Ambulation Classification (FAC)Average FAC score of 5 (walking independently on level surfaces), no change observed
    Subjects successfully learned to use IndegoAll subjects in pilot studies learned within first session
    Improvements in gait parameters (Pilot Studies)Demonstrated in pilot studies

    2. Sample Size and Data Provenance for Test Set:

    • Test Set (Clinical Trials):
      • Main Multisite Clinical Trial: 30 subjects
      • Single-Site Pilot Study 1: 3 subjects
      • Single-Site Pilot Study 2: 3 subjects
      • Engineering Study: 6 subjects (ongoing)
      • Total unique subjects across all clinical studies: 42 individuals with CVA.
    • Data Provenance: The documents mention "eight clinical sites" for the main multisite trial but do not specify countries of origin other than "Shepherd Center (Atlanta, GA)" for the engineering study. The studies appear to be prospective clinical trials evaluating the device in use.

    3. Number of Experts and Qualifications for Ground Truth:

    • This section is not directly applicable in the AI/ML sense of establishing a "ground truth" for input data. The "ground truth" for the exoskeleton is the direct, observable performance of the device and the physiological responses of the users.
    • Clinical data collection and assessments involved "physical therapists" and "specially trained companion(s)" who supervised and assessed the users. Their specific qualifications (e.g., years of experience, board certification) are not detailed but are implied by their roles in a clinical setting.
    • The "IRB approved" and "Good Clinical Practice (GCP) compliant" nature of the studies indicates adherence to ethical and scientific standards in clinical research.

    4. Adjudication Method for the Test Set:

    • Not applicable in the context of AI/ML ground truth adjudication. Clinical trial data collection involves various assessments by clinicians. The document does not describe a formal multi-reader adjudication process for qualitative assessments but rather direct measurement and observation of physical outcomes by trained personnel.

    5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:

    • No, a MRMC study (typical for diagnostic or prognostic AI) was not done.
    • The clinical studies focus on the device's ability to facilitate ambulatory functions and improve gait parameters in individuals with neurological impairments (SCI, CVA). There is no comparison of human readers with vs. without AI assistance. The "assistance" itself is the physical exoskeleton.

    6. Standalone Performance (Algorithm Only):

    • Not applicable. The "device" is a physical exoskeleton designed for human-in-the-loop operation. Its performance is measured in conjunction with a user, not as a standalone algorithm. The "software" component controls the physical device's functions.

    7. Type of Ground Truth Used:

    • The "ground truth" is derived from directly observable functional performance and physiological measurements during use of the physical device by human subjects. This includes:
      • Functional Outcomes: Ability to sit, stand, walk, turn; walking speed (10MWT); Functional Ambulation Classification (FAC) scores.
      • Physiological/Gait Parameters: Gait deviations, step length, stride length.
      • Safety Data: Incidence of adverse events.
      • Expert Observation/Assessment: Assessments by physical therapists and trained companions.

    8. Sample Size for the Training Set:

    • Not applicable as this is not an AI/ML algorithm in the context typically discussed for "training sets." The device undergoes extensive non-clinical testing and clinical evaluation.
    • The document implies iterative design and testing for the physical device and its control software. For instance, the improvement in stand-to-sit transition after an adverse event suggests design modification based on observational data, akin to development cycles rather than a distinct "training set" for an AI model.

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

    • Not applicable for the same reasons as #8. The "training" here refers to device development and improvement, not algorithmic learning. System functionality and safety are established through engineering design principles, non-clinical validation (e.g., torque, durability, battery life tests), and iterative clinical testing.
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    K Number
    K171334
    Device Name
    Indego
    Date Cleared
    2017-09-08

    (123 days)

    Product Code
    Regulation Number
    890.3480
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Parker Hannifin Corporation

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Indego® orthotically fits to the lower limbs and the trunk; the device is intended to enable individuals with spinal cord injury at levels T3 to L5 to perform ambulatory functions with supervision of a specially trained companion in accordance with the user assessment and training certification program. The device is also intended to enable individuals with spinal cord injury at levels C7 to L5 to perform ambulatory functions in rehabilitations in accordance with the user assessment and training certification program. The Indego is not intended for sports or stair climbing.

    Device Description

    Parker Hannifin's Indego® device is a wearable powered exoskeleton that actively assists individuals to stand and walk; these are patients with walking impairments resulting from lower extremity weakness or paralysis. The Indego consists of snap-together components weighing 26 pounds total. The hip component houses a rechargeable battery pack, central processor, and Bluetooth radio, while each upper leg component houses two motors as well as embedded sensors and controllers. On-board microprocessors receive signals from integrated sensors which provide information on the user's posture and tilt. This allows the device to function in a manner similar to the Segway personal mobility device, which is controlled by the user's tilt. A user similarly controls of the Indego by means of postural changes (e.g., to walk forward, the user just leans forward). The technology of the design links the low weight and low profile to advanced battery technology (smaller size), motors (smaller and more powerful), and micro controllers (state-of-the art). Visual cues from the LED lights on the hip and vibratory feedback inform both the patient and therapist or trained support person of the status and mode of operation. The Indego controls are self-contained, with forearm crutches or a walker used solely for stability. Users can perform sit-to-stand and stand-to-sit transitions and walk along even or uneven terrain up to about five degree (5°) grades. Taller torso "wings" are provided to support users who may need additional trunk support while walking. A physical therapist can configure, operate, and monitor the device during therapy and training to make adjustments as needed. This is achieved through the support of a wireless application that will run on mobile/wifi connected smart devices such as an iPod or iPhone. The patient and physical therapist will be able to work in concert to achieve the actions of transitioning from sitting to standing, standing to walking, stop walking, and return from standing to sitting. The untethered, free roaming design of the device will allow it to be utilized in multiple indoor and outdoor locations in either a rehabilitation setting with a certified Indego Specialist or a personal setting with a trained support person.

    AI/ML Overview

    The provided text describes the Indego® powered lower extremity exoskeleton, and its substantial equivalence submission (K171334) to the FDA. The submission emphasizes clinical and non-clinical data to support expanded indications for use.

    Here's an analysis of the acceptance criteria and the study proving the device meets these criteria, based on the provided text:

    Key Takeaway: The device's "acceptance criteria" are not explicitly defined as specific numerical thresholds for performance metrics to achieve FDA clearance in the same way clinical trials for pharmaceuticals might state primary endpoints. Instead, the "acceptance criteria" are implicitly demonstrated by showing the device's safety and effectiveness for its intended use, comparable performance to predicate devices, and successful completion of various non-clinical and clinical tests. The primary measure of clinical success appears to be enabling ambulatory functions with minimal assistance (FIM score of 4 or higher) and demonstrating walking speed.


    1. Table of Acceptance Criteria and Reported Device Performance

    Since explicit acceptance criteria with numerical targets are not stated, the table below will summarize the demonstrated performance and implicitly infer the "acceptance criteria" based on the successful clearance. The core "acceptance criterion" appears to be demonstrating safety and effectiveness for the stated Indications for Use, with performance comparable or better than predicate devices.

    Acceptance Criterion (Inferred from Successful Submission)Reported Device Performance
    Non-Clinical Performance:
    Maximum Torque Testing: Meet defined specificationsPASS
    Cleaning Chemical Compatibility: No significant degradation over 5 yearsPASS
    Component Life Cycle: Safe performance between routine servicingPASS
    Durability Testing: Meet IEC 60601-1 factor of safetyPASS
    Battery Life Cycle: Meet specifications for charge, capacity, lifePASS
    Storage and Transport: Protected and not damaged per ISTA standardsPASS
    Software Verification & Validation: Conformance to FDA Guidance and IEC 62304Conforms to requirements
    Electrical Safety Testing: Meet ANSI/AAMI ES60601-1PASS
    Electromagnetic Compatibility Testing: Meet IEC 60601-1-2PASS
    Clinical Performance (Rehabilitation Use):
    Ease of learning to use the Indego (Pilot Study)All 16 subjects successfully learned within five 90-minute sessions.
    Proficiency in mobility (10 MWT & 6 MWT outcomes)Average walking speed of 0.34 m/s in 10 MWT (Pilot Study). All subjects completed 6 MWT (Pilot Study).
    Safety & Effectiveness for intended use (Multi-Site Trial)Concluded as safe and effective.
    Average walking speed ≥ 0.31 m/s for indoor surfaces (Multi-Site Trial)Average speed for indoor 10 MWT: 0.35 ± 0.10 m/s (T3-T6 SCI) and 0.38 ± 0.08 m/s (T7 and lower SCI). Met/exceeded.
    Ability to perform TUG test (Multi-Site Trial)Both T3-T6 and T7 and lower injury level groups performed with average FIM score of 4 (minimal contact assistance).
    WISCI Scores (Multi-Site Trial)Average WISCI score of 7 ± 1.1 (T3-T6) and ± 1.8 (T7 and lower), indicating assistance comparable to predicate.
    Safety Profile (Adverse Events)Pilot Study: 2 minor AEs, 0 SAEs. Multi-Site Trial: 46 trial-related AEs (20 device-related, all minor), 0 SAEs. Postmarket Clinical Data: 2 reported safety issues (no injuries).
    Clinical Performance (Personal Use):
    Adequacy/Success of Personal Use Training ProgramFour subjects and support persons successfully completed 40-hour program. Users rated training as adequate, confident in use.
    Safety Profile (Adverse Events)Personal Use Training Study: 7 minor AEs, 0 SAEs. Postmarket Personal Use Data: 1 fall (no injuries), no other AEs/SAEs reported.
    Achieve Minimal Assist or less (FIM Score 4 or higher) for personal use competencies75 of 98 subjects in combined clinical data achieved FIM score of 4 or higher. 32 of 39 T3-T6 SCI patients achieved FIM 4 or higher. Not relaxed for expanded indications.
    Ability to use in home & community (personal use)All five personal users reported training translated well; used for ADLs and various indoor/outdoor surfaces.

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

    The terms "test set" and "training set" are typically used in machine learning. However, for medical device clinical studies, we can interpret the clinical data used for evaluation (which serves a similar purpose to a "test set" in demonstrating performance) as follows:

    • Pilot Study: 16 subjects
    • Multi-Site Clinical Trial: 45 subjects
    • Postmarket Clinical Data (Rehabilitation Use): 37 subjects
    • Personal Use Training Program Study: 4 subjects (user and support person teams)
    • Postmarket Personal Use Data: 5 subjects (user and support person teams)

    Total unique subjects across all reported clinical studies: While there might be some overlap, the text states "TOTAL SCI SUBJECTS: 107" for Indego data (comparing to Ekso's 56). This suggests the aggregate number of unique individuals whose data contributed to the clinical evaluation is 107.

    Data Provenance:

    • The text doesn't explicitly state the country of origin for all clinical data. However, the contact information for the sponsor (Parker Hannifin) is in USA (Ohio), and the submission correspondent (Emergo) is in USA (Texas). The postmarket personal use data mentions "5 trained Indego personal users worldwide. One of these individuals is a European user... The other 4 are from the United States." This indicates a mix of US and implied international data for personal use.
    • The studies were prospective in nature, as they describe "Pilot Study", "Multi-Site Clinical Trial", and "Personal Use Training Program Study" which were IRB-approved and conducted according to GCP. Postmarket data would be collected retrospectively from existing users.

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

    This device is not an AI/ML diagnostic tool, so the concept of "ground truth" derived from expert consensus (e.g., radiologists interpreting images) isn't directly applicable in the same way.

    Instead, for this exoskeleton device, "ground truth" or clinical outcomes are established through:

    • Direct observation and measurement by trained clinical personnel (e.g., physical therapists, study coordinators) conducting the tests (10 MWT, 6 MWT, TUG, WISCI, FIM scores).
    • Patient self-report/feedback for aspects like ease of use and satisfaction with training.
    • Physician assessment for patient suitability and injury levels.

    The qualifications of the personnel involved are implied by references to "specially trained companion", "physical therapist," "Indego Specialist," and "clinicians." The training and certification programs for both clinicians and personal users (with support persons) indicate a standardized approach to application and performance assessment. No specific number of "experts" for a consensus ground truth committee is mentioned, as the data collection methods are objective measurement and direct clinical observation.


    4. Adjudication Method for the Test Set

    Given that this is a physical therapy/mobility device study, and not an image-based diagnostic study where multiple readers might interpret findings, a formal "adjudication method" like "2+1" or "3+1" (common for reconciling discordant image interpretations) is not applicable here. Performance measures (e.g., walking speed, distance, FIM scores) are objective and directly measured or scored by the trained clinical staff involved in the studies. Adverse events are recorded and investigated as part of standard clinical trial procedures.


    5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

    No, a Multi-Reader Multi-Case (MRMC) comparative effectiveness study was not done.

    MRMC studies are typically used to evaluate the impact of a diagnostic tool (like an AI algorithm) on human reader performance, usually in radiology, by comparing diagnostic accuracy or efficiency with and without AI assistance across multiple cases and readers. This exoskeleton is a treatment/assistive device, not a diagnostic one.

    The studies focused on the device's standalone performance and safety in enabling mobility for individuals with SCI, rather than assisting human readers in interpreting data. The "assistance" refers to the device assisting the patient, not AI assisting a human healthcare provider's diagnostic process.


    6. Standalone Performance (i.e. algorithm only without human-in-the loop performance)

    Again, this is not an AI/ML algorithm in the diagnostic sense, but a powered mechanical device. Therefore, a "standalone algorithm only" performance is not relevant.

    However, the "performance" of the device itself (independent of human diagnostic input, but certainly dependent on human operation and supervision) is extensively reported through:

    • Non-Clinical Performance Data: Maximum Torque Testing, Cleaning Chemical Compatibility Testing, Component Life Cycle Testing, Durability Testing, Battery Life Cycle Testing, Storage and Transport Testing, Software verification and validation testing, Electrical safety testing, Electromagnetic compatibility testing – all reported as "PASS."
    • Clinical Performance Data: The various functional mobility tests (10 MWT, 6 MWT, TUG, WISCI, FIM). These tests assess the patient's ability to ambulate with the device, which is essentially the device's functional performance in combination with the user. The device acts in conjunction with the user's postural changes and the supervision of a trained human.

    7. The Type of Ground Truth Used

    As discussed in #3, for this type of medical device, "ground truth" is established through:

    • Objective Clinical Measurements: Quantifiable outcomes from standardized mobility tests (e.g., 10 Meter Walk Test, 6 Minute Walk Test, Timed Up and Go Test).
    • Functional Independence Measures (FIM) and Walking Index for Spinal Cord Injury (WISCI) Scores: These are standardized clinical rating scales, where scores are determined by trained clinicians (Indego Specialists) based on observation of the patient's performance and the level of assistance required.
    • Adverse Event Reporting: Direct observation and documentation of any adverse events during use.
    • Patient and Trainer Feedback: Qualitative feedback on training adequacy and real-world use.

    Unlike diagnostic tools, there isn't a "true positive/negative" outcome like disease presence confirmed by biopsy. Instead, the "ground truth" is the demonstrated functional ability and safety of the patient using the device as measured by validated clinical instruments.


    8. The Sample Size for the Training Set

    The text refers to "training" in two contexts:

    1. Device training for users: Subjects undergo extensive training to learn how to use the Indego. This is training for the human user, not training data for an AI algorithm.
    2. Training data for the device itself: If the device contained adaptable AI/ML components that learn from data, this section would be relevant. However, the description of the Indego's "on-board microprocessors receive signals from integrated sensors which provide information on the user's posture and tilt" and "user similarly controls of the Indego by means of postural changes" suggests deterministic or rule-based control rather than a deep learning model that would require a large "training set" of performance data. There is no mention of a machine learning "training set" size for the device's internal algorithms.

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

    As there's no explicitly described "training set" for an AI/ML algorithm within the device. Thus, the method for establishing "ground truth for the training set" is not applicable in the context of an AI/ML model for this device. The device's control mechanisms appear to be based on pre-programmed logic derived from engineering principles and biomechanics, rather than learned from a large dataset.

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    K Number
    K161731
    Date Cleared
    2017-03-27

    (277 days)

    Product Code
    Regulation Number
    882.4100
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Parker Hannifin Corp.

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Cleveland Multiport Ventricular Catheter Set is indicated for gaining access to the ventricles of the brain for the removal of cerebrospinal fluid (CSF) or for injecting Cytarabine.

    Device Description

    The Cleveland Multiport Ventricular Catheter contains a main or central lumen for the insertion stylet which is surrounded by four minor lumens (equally spaced) that contain the microcatheters. The catheter includes a ribbed distal tip, a housing for locking the insertion stylet, and proximal male Luer fittings at the end of each micro-catheter. The ribbed distal tip of the main catheter allows the micro-catheters to retract into the main catheter, by stretching the catheter when the insertion stylet is fully inserted and locked. This stretched state allows the catheter tip outside diameter to reduce slightly for atraumatic insertion into the ventricles of the brain. Once the insertion stylet is removed the catheter tip returns to its relaxed state (larger outside diameter) and the micro-catheters deploy. The enlarged tip aids in backflow prevention during injection of fluids. The distal Luer fittings allow for connectivity to a standard syringe or infusion pumps for removal of CSF and/or infusion. The biocompatible metal insertion stylet provides temporary rigidity to the distal portion of the device during catheter insertion and is removed after placement. The Cleveland Multiport Ventricular Catheter has no software, power sources, or radiation emitting components.

    AI/ML Overview

    The provided text describes a 510(k) premarket notification for a medical device called the "Cleveland Multiport Ventricular Catheter Set." This submission is to demonstrate that the new device is substantially equivalent to legally marketed predicate devices. The document refers to various tests performed to support this claim, but it does not describe an AI/ML powered device, an acceptance criteria table with reported device performance in the context of AI/ML, nor does it include information about sample sizes for test sets, data provenance, number of experts, adjudication methods, MRMC studies, standalone algorithm performance, or ground truth establishment for AI/ML models.

    The information provided relates to the physical and functional aspects of a traditional medical device (a catheter) and its comparison to existing catheters. Therefore, most of the requested fields are not applicable to the given text.

    Here's an attempt to answer the applicable parts of your request based on the provided text, while explicitly stating when information is not available or not applicable:

    1. A table of acceptance criteria and the reported device performance

    The document lists various performance tests and their results, indicating that the device "passed" and "results demonstrate the Cleveland Multiport Ventricular Catheter is substantially equivalent to the predicate devices." The specific quantitative acceptance criteria are generally implied rather than explicitly stated as numerical thresholds in this summary, but the results confirm compliance.

    TestAcceptance Criteria (Implied from "passed")Reported Device Performance
    Joint and Bond Strength TestsWithstand minimum pull-off forces; exceed minimum tip loading requirements.All joints bonds were above the minimum pull-off force requirement. Tip loading exceeded the minimum load requirements. Withstood pull forces based on clinically relevant forces with a safety factor.
    Viscosity TestKinematic viscosity of Cytarabine and saline are comparable (within 2%).Kinematic viscosity of Cytarabine and saline are similar (within 2%). Bench testing using saline is acceptable.
    Depth MarkingDepth marks remain legible after swabbing.Depth gauge marks were not altered.
    Pressure Testing (Flow Burst, Infusate Pressure, Aspiration Flow Rate)Withstand pressure spikes; reach specified flow rate within specified time; inject fluid at maximum flow rate; linear pressure profile across all flow rates without leakage or kinking; withstand maximum pressure/spikes; capable of aspirating at clinically acceptable rate.Reached specified flow rate within specified time; capable of injecting fluid at its maximum flow rate. Reached a linear pressure profile across all flow rates without leakage and no kinking; withstood maximum pressure/spikes. Passed pressure-flow with suture tab attached. Capable of aspirating at its clinically acceptable aspiration rate.
    Reflux TestResists flow in the reverse direction.Resists flow in the reverse direction.
    Deployment and Retraction TestMinimal dimensional changes from deployment/retraction; meet maximum loads for insertion/removal of stylet.Met specified dimensional and maximum distance insertion and removal forces.
    Tissue Insertion TestWithstand insertion and removal from bovine brain tissue.Passed insertion and removal for bovine tissue.
    Bend Radius TestWithstand minimum bend radius without kinking.Withstands a minimum bend radius without kinking.
    Dimensional VerificationManufactured and reproduced to predetermined specifications.Manufactured and reproduced to predetermined specifications.
    Micro-Catheter Strength TestMinimum strength of micro-catheters PTFE material exceeds minimum force requirements.Micro-catheter material exceeds the minimum force requirements.
    Syringe Drop TestWithstand drop without damage to device or operation.Withstood drop without damage and operation verified.
    Surface InspectionFree from voids, cracks, or extraneous matter.Free from voids, cracks or extraneous matter along the effective length.
    Particulate TestingShedding of particulates below specified limit.Shedding of particulates are below a specified limit.
    Leakage under pressureFree of leaks during infusion and aspiration.Free of leaks during infusion and aspiration.
    Cadaver AssessmentCan be placed using conventional techniques and visualized using CT.Placed using conventional techniques and visualized on axial CT scan with successful infusion of CT dye.
    Stylet StrengthWithstand excessive loading on stylet handle without fracturing.Withstood pull forces based on clinically relevant forces with a safety factor.
    Stylet Corrosion ResistanceWithstand corrosion with extended exposure to sodium chloride.Withstood corrosion with extended exposure to sodium chloride.
    BiocompatibilityCompliance with ISO 10993 requirements for tissue contact, limited exposure (
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    K Number
    K152416
    Device Name
    Indego
    Date Cleared
    2016-02-26

    (184 days)

    Product Code
    Regulation Number
    890.3480
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Applicant Name (Manufacturer) :

    PARKER HANNIFIN CORPORATION

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Indego® orthotically fits to the lower limbs and the trunk; the device is intended to enable individuals with spinal cord injury at levels T7 to L5 to perform ambulatory functions with supervision of a specially trained companion in accordance with the user assessment and training certification program. The device is also intended to enable individuals with spinal cord injury at levels T4 to T6 to perform ambulatory functions in rehabilitation institutions in accordance with the user assessment and training certification program. The Indego is not intended for sports or stair climbing.

    Device Description

    Parker Hannifin's Indego® device is a wearable powered exoskeleton that actively assists individuals to stand and walk. Unique in design, the Indego consists of five (5) snap-together components (the lumbar/hip section, right and left upper leg sections, and right and left lower leg sections) weighing 26 pounds total. The hip component houses a rechargeable battery pack, central processor, and Bluetooth module, while each upper leg component houses two motors as well as embedded sensors and controllers.

    On-board microprocessors receive signals from integrated sensors which provide information on the user's posture and tilt. This allows the device to function in a manner similar to the Segway personal mobility device, which is controlled by the user's tilt. A user similarly controls the Indego by means of postural changes (e.g., to walk forward, the user just leans forward). The technology of the design links the low weight and low profile to battery technology (smaller size), motors (smaller and more powerful), and micro controllers. Visual cues from LED lights on the hip unit and vibratory feedback inform both the therapist and patient of the status and mode of operation.

    The Indego controls are self-contained, with crutches or a walker used solely for stability. Users can perform sit-to-stand and stand-to-sit transitions and walk along even or uneven terrain up to about five degree (5°) grades. Taller torso "wings" are provided to support users who may need additional trunk support while walking. A physical therapist can configure, operate, and monitor the device during therapy and training to make adjustments as needed. This is achieved through the support of a wireless application that will run on mobile/wifi connected smart devices such as an iPod or iPhone. Through the use of a Bluetooth connection, the Indego device's mode of operational parameters such as gait speed and step length/height, will be able to be changed or modified in real time. The device can be utilized in multiple indoor and outdoor locations within a rehabilitation setting or personal setting.

    AI/ML Overview

    The provided text describes the regulatory submission for the Indego exoskeleton device. It details the device, its intended use, and a comparison to a predicate device (ReWalk). The filing includes non-clinical and clinical performance data to demonstrate safety and effectiveness.

    Here's the breakdown of the acceptance criteria and study information:

    Acceptance Criteria and Device Performance

    CriteriaAcceptance CriteriaReported Device Performance
    Primary Safety & Effectiveness Criterion:Device is both safe and effective for the intended use for patients with SCI who are non-ambulatory or poorly ambulatory to stand up and walk under a variety of conditions.The clinical study concluded that the Indego device is safe and effective for its intended use. Adverse events reported were minor (bruising, redness, abrasion, swelling), primarily related to improper fitting or padding, with no unanticipated adverse events. The study demonstrated the ability of subjects to stand up and walk, as detailed in the performance metrics below.
    Primary Effectiveness Criterion (Walking Speed):The average walking speed for persons with SCI using the Indego device with stability aid will be equal to or greater than 0.31 m/s for indoor surfaces.Walking speed was captured during the study through a Ten Meter Walk Test (10MWT) on indoor surfaces, resulting in speeds of 0.38 m/s ± 0.08 m/s at the completion of the study. This meets the criterion.
    Ability to Perform Transitional Motions (TUG Test):Not explicitly stated as an acceptance criterion with a specific threshold, but the study aimed to measure this ability.Of the 40 enrolled subjects, 39 were able to complete the Timed Up-and-Go (TUG) Test with minimal contact assistance (FIM score of 4), and one (1) subject was able to complete with moderate contact assistance (FIM score of 3). This indicates successful performance of transitional motions.
    Sustained Walking Capacity:Not explicitly stated as an acceptance criterion.38 (thirty-eight) subjects were able to complete a single-session walk of 600 meters in length.
    Level of Assistance (WISC-II and FIM scores):Not explicitly stated as an acceptance criterion with specific thresholds, but measured to assess task-specific assistance needed.The WISC-II scores for all subjects averaged mean scores of 6 ± 1.0 (midpoint) and 7 ± 1.6 (final assessment). FIM scores, as noted above for the TUG test, support that all subjects were capable of managing all tested terrains and scenarios, including indoors/outdoors, various surfaces (tile, concrete, asphalt, grass, carpet), and navigating obstacles (sidewalks, ramps, curb cutouts, elevators, automatic doors, latch doors).
    Perceived Exertion (Borg Scale):Not explicitly stated as an acceptance criterion with a specific threshold.The averaged results of the Borg Rating of Perceived Exertion for indoor level ground walking at the end of their sessions was 10, which corresponds to an exertion level between "very light exercise" and "light exercise". This suggests the device allows for ambulation with reasonable perceived effort.
    Absence of Unanticipated Adverse Events:Absence of any Unanticipated Adverse Events (UAE).There were no Unanticipated Adverse Events (UAE) reported.
    Non-Clinical Performance Data:Meet all requirements for design characteristics, non-clinical performance testing, EMC/EMI testing, and electrical safety testing to confirm that the output meets the design inputs and specifications for the device.Indego device passed Maximum Torque Testing, Cleaning Chemical Compatibility Testing, Component Life Cycle Testing, Durability Testing, Battery Life Cycle Testing, Storage and Transport Testing, Software verification and validation testing, Electrical safety testing (ANSI/AAMI ES60601-1), and Electromagnetic compatibility testing (IEC 60601-1-2).

    Study Details:

    1. Sample size used for the test set and the data provenance:

      • Sample Size: 40 subjects.
      • Data Provenance: The document does not explicitly state the country of origin but implies a prospective clinical study ("The study was performed in compliance with Good Clinical Practices (GCP) with subjects enrolled in an IRB approved study that were consented for participation according to the intended use of the device..."). This suggests a controlled clinical trial setting.
    2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

      • The document does not mention the use of experts to establish a "ground truth" for the test set in the traditional sense of medical image analysis or diagnostic studies. Instead, the clinical study involved subjects using the device and their performance (walking speed, TUG test, level of assistance, perceived exertion) being measured directly. The "truth" here is the objective measurement of their functional abilities while using the device.
    3. Adjudication method (e.g., 2+1, 3+1, none) for the test set:

      • Not applicable in the context of this functional performance study. The data collected (e.g., walking speed, FIM scores, TUG test results) are objective measurements or standardized assessment scores, not subjective interpretations requiring adjudication.
    4. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:

      • No, a multi-reader multi-case (MRMC) comparative effectiveness study was not performed. This type of study typically applies to diagnostic or screening devices where human readers interpret medical images or data. The Indego is a powered exoskeleton for ambulation; its effectiveness is measured directly through functional performance metrics of the user.
    5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

      • The device, by its nature, inherently involves a human-in-the-loop. It is a wearable exoskeleton designed to assist individuals with spinal cord injury in performing ambulatory functions. Therefore, a standalone (algorithm only) performance assessment, independent of human interaction, is not relevant or applicable for this device. The software verification and validation were performed as part of non-clinical testing, but this is distinct from measuring "standalone performance" of a diagnostic algorithm.
    6. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):

      • The "ground truth" in this context is based on objective functional performance data using standardized clinical assessment tools (e.g., Ten Meter Walk Test, Timed Up-and-Go Test, WISC-II, FIM scores, Borg Rating of Perceived Exertion) and direct observation of subjects' abilities while using the device in a controlled clinical study environment.
    7. The sample size for the training set:

      • The document does not explicitly mention a "training set" in the machine learning sense for the device's algorithms. The device's internal microprocessors receive signals from integrated sensors and function based on the user's posture and tilt (similar to a Segway). The development of these control algorithms would have involved engineering design, testing, and potentially iterative refinement, but the document does not specify a distinct "training set" of data in the manner of AI/ML models.
    8. How the ground truth for the training set was established:

      • Given that a "training set" (as understood in machine learning) is not explicitly described, the method for establishing its "ground truth" is not detailed. The device likely relies on engineering principles and biomechanical models for its control algorithms, validated through non-clinical and clinical testing, rather than an AI model trained on a large dataset with established ground truth labels common in areas like image recognition. The "ground truth" for its functional performance is established through the clinical study mentioned above.
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