ELI 200+ AUDICOR

K031182 · Mortara Instrument, Inc. · DPS · Jul 25, 2003 · Cardiovascular

Device Facts

• Record ID: K031182
• Device Name: ELI 200+ AUDICOR
• Applicant: Mortara Instrument, Inc.
• Product Code: DPS · Cardiovascular
• Decision Date: Jul 25, 2003
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 870.2340
• Device Class: Class 2
• Attributes: 3rd-Party Reviewed

Intended Use

The ELI 200+ Audicor Option Electrocardiograph is intended to acquire, record and then store acquired cardiac data of symptomatic patients. The ELI 200+ Audicor Option can also be used to acquire both 12-lead ECG and heart sound data at the same time. The cardiac data is reviewed, confirmed, and used by trained medical personnel in the diagnosis of patients with LVH, acute and age undetermined MI and detection of S3/S4 heart sounds. The S3/S4 heart sound is useful in the identification of cardiac conditions associated with Left Ventricular dysfunction.

Device Story

The ELI 200+ Audicor is a portable, interpretive 12-lead electrocardiograph. It integrates Audicor Correlated Audioelectric Cardiography (COR) technology via a single-use, disposable Audicor Sensor and Adaptor. The sensor replaces the standard V4 electrode to simultaneously acquire electrical ECG signals and acoustic heart sound signals from the patient's skin. These signals are transferred to the electrocardiograph for acquisition, analysis, and display. Used in clinical settings by physicians or trained personnel, the device provides automated interpretations of ECG and heart sound data. Healthcare providers review and confirm these interpretations alongside other patient data to assist in diagnosing LVH, MI, and identifying S3/S4 heart sounds associated with left ventricular dysfunction. The device is not a sole diagnostic tool or a vital signs monitor.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Portable 12-lead interpretive electrocardiograph. Features Audicor COR technology for simultaneous ECG and acoustic signal acquisition. Includes single-use, disposable Audicor Sensor and Audicor Adaptor. Connectivity via patient leads to the main unit. Software-based interpretation of cardiac signals.

Indications for Use

Indicated for adult, typically symptomatic patients. Used to acquire, analyze, display, and print ECG and heart sound (COR) data for physician interpretation. Used in clinical settings by physicians or trained personnel under physician orders. Not for use as a vital signs physiological monitor. Used for evaluation of LVH, acute/age-undetermined MI, and detection of S3/S4 heart sounds.

Regulatory Classification

Identification

An electrocardiograph is a device used to process the electrical signal transmitted through two or more electrocardiograph electrodes and to produce a visual display of the electrical signal produced by the heart.

Predicate Devices

• ELI 200 by Mortara Instrument (K920626)
• Cardiovise Interpretive Software by Inovise (K001349)
• 1514A ECG/Phono System by HP

Submission Summary (Full Text)

{0}------------------------------------------------

JUL 2 5 2003

Image /page/0/Picture/1 description: The image shows a logo with a heart shape at the top and the word "Mortara" below it. The heart shape is white and is surrounded by a black border. The word "Mortara" is in a bold, sans-serif font and is also black. The logo is simple and clean, with a focus on the heart shape and the company name.

K031182

510(k) Notification: Mortara ELI 200+ Audicor

# 510(k): ELI 200+ Audicor Device Summary

# Submitter:

Date: February 5, 2003

Harlan Van Matre, Manager of Quality Assurance / Regulatory Affairs Mortara Instrument, Inc. 7865 N. 86" Street Milwaukee, WI 53224 Fax: [phone] Phone: [phone] Contact: Harlan Van Matre (see above)

| Trade Name: | ELI 200+ Audicor |
|----------------------|---------------------------------------------|
| Common Name: | Electrocardiograph |
| Classification Name: | Electrocardiograph<br>(Per 21 CFR 870.2340) |

# Legally marketed devices to which S. E. is claimed

The Mortara Instrument's ELI 200+ Audicor Electrocardiograph is a current tecli nology evolution of the Mortara ELI 200 and is substantially equivalent to these legally marketed predic ate devices:

- ELI 200 by Mortara Instrument (K920626) ●
- . Inovise's Cardiovise Interpretive Software (K001349)
- HP's 1514A ECG/Phono System ●

The proposed ELL 200+ Audicor is a direct evolution of this Mortara predicate d'uice. It will combine ELI 200 technologies with current technologies including Audicor Correlated Audioelect c Cardiography (COR) technology, resulting in the Mortara ELI 200+ Audicor.

# Description:

The ELI 200+ Audicor is an interpretive electrocardiograph that provides simult: neous 12-lead acquisition and is designed to be portable. It also employs Audicor Correlated Audicelectrir. Cardiography (COR) technology from Inovise Medical, Inc. that will enable acquisition of both 12-lear. ECG and heart sound data at the same time. This will be accomplished with a Mortara ELI 200+ electrocar iograph and the use of an Audicor Adaptor and Audicor Sensor. In use, the Audicor Sensor will replace tt = standard V4 electrode and connect to the Audicor Adaptor, enabling simultaneous acquisition of the ECG . gnal and an acoustical sional.

The Audicor sensor is a single-use, non-invasive, disposable medical device th: t has the ability to acquire a single-lead ECG (electrical) signal and a single-lead acoustic signal simultaneo: sly from the skin surface of a patient. It is designed to transfer these signals to an attached Audicor Adaptor, which itself connects and transfers the signals through patient leads to compatible cardiographs such as ine Mortara ELL 200+ electrocardiograph for acquisition and analysis.

### Intended use:

The ELI 200+ Audicor Option Electrocardiograph is intended to acquire, record ind then store acquired cardiac data of symptomatic patients. The ELI 200+ Audicor Option can also be used to acquire both 12-lead ECG and heart sound data at the same time. The cardiac data is reviewed, cor irmed, and used by trained medical personnel in the diagnosis of patients with LVH, acute and age undeter nined MI and detection of S3/S4 heart sounds. The S3/S4 heart sound is useful in the identification of carr.iac conditions associated with Left Ventricular dysfunction.

{1}------------------------------------------------

# 510(k) Notification: Mortara ELI 200+ Audicor

# Indications for use:

- . The device is indicated for use to acquire, analyze, display and orint ECG and heart sound (COR) data.
- The device is indicated for use to provide interpretation of the d sta for consideration by physicians.
- The device is indicated for use in a clinical setting, by a physici: n or by trained personnel . who are acting on the orders of a licensed physician. It is not inlended as a sole means of diagnosis.
- The interpretations of ECG and heart sound data (COR) offerer by the device are only significant when used in conjunction with physician overread as well as consideration of all other relevant patient data.
- . The device is indicated for use on adult populations, typically sumptomatic.
- The device is not intended to be used as a vital signs physiolog cal monitor. .
- . Evaluation of cardiac conditions such as LVH, Acute and Age Undetermined MI and detection of S3 and S4 heart sounds.

{2}------------------------------------------------

Public Health Service

Image /page/2/Picture/2 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract symbol that resembles an eagle or bird in flight, composed of three curved lines that suggest the head and wings.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUL 2 5 2003

Mortara Instrument, Inc. c/o Ms. Chantel Carson Group Ldr Engineer Underwriters Laboratories, Inc. 333 Pfingsten Road Northbrook, IL 60062-2096

Re: K031182

Trade Name: ELI 200+ Audicor Regulation Number: 21 CFR 870.2340 Regulation Name: Electrocardiograph Regulatory Class: Class II (two) Product Code: DPS Dated: July 8, 2003 Received: Jul 9, 2003

Dear Ms. Carson:

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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), 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 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

{3}------------------------------------------------

Page 2 – Ms. Chantel Carson

Please be advised that FDA`s issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); 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. This letter will allow you to begin marketing your device as described in your Section 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), please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). 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 [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

l. D. Zuber, MD

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

Enclosure

{4}------------------------------------------------

Page 1 of 1

510(k) Number (if known):

510(k) Number (if known):_____________________________________________________________________________________________________________________________________________________

ELI 200+ AUDICOR Device Name:

> The ELI 200+ with Audicor is a resting electrocardiograph that provides simultaneous 12-lead ECG acquisition and heart sound data (COR - Correlated Audioelectric Cardiography).

The ELI 200+ Audicor Option Electrocardiograph is intended to acquire, record and then store acquired cardiac data of symptomatic patients. The ELI 200+ Audicor Option can also be used to acquire both 12-lead ECG and heart sound data at the same time. The cardiac data is reviewed, confirmed, and used by trained medical personnel in the diagnosis of patients with LVH, Acute and Age Undetermined MI and detection of S3/S4 Heart Sounds. The S3 and S4 Heart Sounds are useful in the identification of cardiac conditions associated with Left Ventricular dysfunction.

This device is appropriate for the indications listed below:

- The device is indicated for use to acquire, analyze, display and print ECG and heart sound . (COR) data.
- . The device is indicated for use to provide interpretation of the data for consideration by physicians.
- . The device is indicated for use in a clinical setting, by a physician or by trained personnel who are acting on the orders of a licensed physician. It is not intended as a sole means of diagnosis.
- The interpretations of ECG and heart sound data (COR) offered by the device are only • significant when used in conjunction with physician overread as well as consideration of all other relevant patient data.
- . The device is indicated for use on adult populations, typically symptomatic.
- The device is not intended to be used as a vital signs physiological monitor. .
- Evaluation of cardiac conditions such as LVH, Acute and Age Undetermined MI and detection . of S3 and S4 heart sounds.

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

| Concurrence of CDRH, Office of Device Evaluation (ODE) | |
|--------------------------------------------------------|---------|
| (Division Sign-Off) | |
| Division of Cardiovascular Devices | |
| 510(k) Number | K031182 |

| Prescription Use (Per 21CFR801.109) | OR | Over-The-Counter Use (Optional Format 1-2-96) |
|-------------------------------------|----|-----------------------------------------------|
|-------------------------------------|----|-----------------------------------------------|

(Optional Format 1-2-96)