K051257 · Cas Medical Systems, Inc. · DQA · Dec 22, 2005 · Cardiovascular
Device Facts
Record ID
K051257
Device Name
ADULT CEREBRAL OXIMETER, MODEL 2040
Applicant
Cas Medical Systems, Inc.
Product Code
DQA · Cardiovascular
Decision Date
Dec 22, 2005
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 870.2700
Device Class
Class 2
Indications for Use
The non-invasive Adult Cerebral Oximeter Model 2040 should be used as an adjunct monitor of regional hemoglobin oxygen saturation of blood in the brain of an adult. The Cerebral Oximeter Monitor System should not be used as the sole basis for decisions as to the diagnosis or therapy. The value of data from the Cerebral Oximeter Monitoring System has not been demonstrated in disease states.
Device Story
The Model 2040 Cerebral Oximeter is a non-invasive monitor used in acute care settings (OR, ICU, ER) by healthcare professionals to assess brain oxygenation. It utilizes an optical transducer placed on the patient's forehead, containing a laser light source and photodiode detectors. The device employs diffuse reflectance spectroscopy to analyze light returning from the microvasculature, measuring oxygenated and deoxygenated hemoglobin. A patent-protected algorithm calculates absolute brain tissue oxygen saturation (StO2) and, when combined with pulse oximetry, provides absolute readings of brain venous oxygen saturation (SvO2). The system includes a laser interlock for safety. Clinicians use the displayed saturation values as an adjunct to other clinical information to monitor for potential neurological injury due to compromised brain oxygenation, aiding in clinical decision-making during surgical or acute care procedures.
Clinical Evidence
Clinical study conducted at Duke University Medical Center on healthy adult volunteers. Subjects underwent controlled hypoxic gas mixtures while monitored with the Model 2040 sensors on the forehead and reference internal jugular bulb/radial arterial catheters. Blood samples were analyzed via co-oximetry. Results showed strong correlation with reference values (StO2 bias 0.43 ± 3.78; SvO2 bias 0.63 ± 5.38) across SpO2 ranges of 70-100%.
Technological Characteristics
Optical transducer with laser light source and photodiode detectors; operates via diffuse reflectance spectroscopy. Class I laser product with laser interlock system. Graphic display monitor with user interface. Connectivity includes disposable probe attachment. Tested to UL60601-1, IEC60601-1, EN60601-1-2, and EN 865 standards.
Indications for Use
Indicated for use as an adjunct monitor of regional hemoglobin oxygen saturation in the brain of adult patients. Not for use as the sole basis for diagnosis or therapy. Clinical utility in specific disease states has not been demonstrated.
Regulatory Classification
Identification
An oximeter is a device used to transmit radiation at a known wavelength(s) through blood and to measure the blood oxygen saturation based on the amount of reflected or scattered radiation. It may be used alone or in conjunction with a fiberoptic oximeter catheter.
Hitachi Medical ETG-4000 / 1000 Optical Topography System (K042501 / 011320)
Submission Summary (Full Text)
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K051257
Image /page/0/Picture/1 description: The image shows the logo for CAS Medical Systems, Inc. The logo includes the company name in bold, uppercase letters, with the tagline "TECHNOLOGY APPLIED TO MEDICINE" underneath. The address "44 EAST INDUSTRIAL ROAD, BRANFORD, CONNECTICUT 06405" is printed below the tagline.
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203-488-6056 (FAX) 203-488-9438
DEC 2 2 2005
# 510(k) SUMMARY OF SAFETY AND EFFECTIVENESS
| Submitter: | CAS Medical Systems, Inc. |
|----------------------|--------------------------------------------------------------------------------------------------------------------------|
| Address: | 44 East Industrial Rd. Branford CT. 06405 USA |
| Contact: | Ron Jeffrey – Director, Regulatory Affairs<br>Phone - (203) 488-6056 Fax - (203) 488-9438<br>Email – rjeffrey@casmed.com |
| Prepared: | May 9, 2005 |
| Trade Name: | Adult Cerebral Oximeter Monitor |
| Common Name: | Model 2040 Monitor |
| Classification Name: | Cerebral Oximeter (870.2700) |
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#### EQUIVALENCE (Predicate Device)
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The Adult Cerebral Oximeter Monitor, Model 2040 is equivalent to the following devices:
- Somanetics Invos® 5100 / 3100A Cerebral Oximeter (K001842 / K960614);
- Spectros T-Stat™ 303 Microvascular Tissue Oximeter (K040684); な
- * Hitachi Medical ETG-4000 / 1000 Optical Topography System (K042501 / 011320).
#### DESCRIPTION
The Adult Cerebral Oximeter, model 2040 measures brain oxygenation allowing the clinician to accurately determine absolute levels of tissue and venous oxygenation in the brain. This measurement can be of significant value in numerous acute care (OR, ICU, ER) situations, providing health care professionals with information to guard against neurological injuries due to compromised brain oxygenation, which can occur during many surgical and clinical situations.
The 2040 Cerebral Oximeter consists of an optical transducer containing a laser light source and photodiode detectors, and a graphic display monitor with user interface. The non-invasive, reflection mode, optical transducer is placed on the forehead of the subject via a disposable probe attachment to determine cerebral oxygenation. The 2040 Cerebral Oximeter will be safe to use, since it is designed to operate as a Class I laser product, the safest FDA laser classification. Additional safety features include a laser interlock system designed to prevent laser operation in case the optical transducer is not securely attached to the subject. A patent-protected algorithm optimizes accuracy of the device in measurements of absolute brain tissue oxygen saturation and, in conjunction with pulse oximetry, in providing absolute readings of brain venous oxygen saturation ..
#### Adult Cerebral Oximeter Intended Use
The non-invasive Adult Cerebral Oximeter Model 2040 should be used as an adjunct monitor of regional hemoglobin oxygen saturation of blood in the brain of an adult. The Cerebral Oximeter Monitor System should not be used as the sole basis for decisions as to the diagnosis or therapy. The value of data from the Cerebral Oximeter Monitoring System has not been demonstrated in disease states.
#### Device Technological Characteristics Comparing Device to Predicates
The Adult Cerebral Oximeter, Model 2040 compares substantially to one or more of the predicates cited in that they use fundamentally the same optical operating principle, called diffuse reflectance spectroscopy. All monitors use light to probe a cross-section of the microvasculature of tissue (mixed bed of arterioles, capillaries and venuoles). The 2040 and predicates analyze light returning from tissue, after having passed through tissues, for hemoglobin in its oxygenated and dcoxygenated forms in the optically sampled region. All calculate tissue oxygen saturation (%St02), a value reflecting percentage of oxygenated hemoglobin in the sampled mircovasculature of tissue.
#### Nonclinical Performance Testing to Show Substantial Equivalence
The Adult Cerebral Oximeter, Model 2040 will be tested in accordance with the following standards as per CAS Product Performance Specifications prior to release to market. The following non-clinical tests will be performed:
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- UL60601-1 (w/ CSA 22.2 No. 60601-1) Safety testing for use of the UL Classified mark;
- IEC60601-1 Safety of Medical Electrical Equipment; .
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- EN60601-1-2: 2001 Safety of Medical Electrical Equipment with regard to EMC Emissions . and EMC Immunity;
- EN 865 Pulse Oximeters (CAS VP/VR 050022) Particular Requirements (as applicable); .
- Testing specified in the Reviewer Guidance for Premarket Notification Submissions (CAS . 21-07-0076)
- VP/VR 050012 System Validation Plan .
- VP/VR 050013 System IPX1 Verification Plan
- VP/VR 050014 Hardware Verification Plan .
## Clinical Testing to Show Substantial Equivalence
Clinical data on adult subjects was collected at the Duke University Medical Center in Durham, North Carolina. In this study, healthy adult volunteers were subjects for comparison using an internal jugular bulb catheter on the subject's right side and a radial arterial line on the left. Two sensors from the cerebral oximeter model 2040 were placed on the patient's forehead, on the right and left sides respectively. Hypoxic mixtures of gas were delivered and data was collected a different periods of ascending and descending concentrations in 5 minute intervals. At set points, blood samples were drawn simultaneously from the jugular bulb and the radial arterial catheters and analysis for oxygen tension was performed using a co-oximeter. The patient was monitored and protocol stopped if Sp02 values from a pulse oximeter reached <70%.
## Conclusions Drawn from Clinical and Nonclinical Testing
The model 2040 St02 showed a strong correlation with the reference St02 over the spectrum of Sp02 values between 70 and 100%. The bias and precision (1 standard deviation) for the model 2040 St02 compared to reference St02 derived from co-oximetry of arterial (Sa02) and jugular bulb (Sjb02) blood samples was 0.43 ± 3.78, based on the following expression:
Reference St02% = Sa02 x 0.3 + Sjb02 x 0.7
The cerebral oximeter St02 value represents oxygen saturation in the brain tissue microvasculature containing venous and arterial blood volume at a ratio of 70:30. The model 2040 Sv02 showed a strong correlation with the reference SjbO2 over the spectrum of Sp02 values between 70 and 100%. The bias and precision for the model 2040 Sv02 compared to reference Sjb02, derived from cooximetry of the jugular bulb blood samples was 0.63 ± 5.38. Sv02 was determined from the following expression:
Sv02 = (St02 - Sp02 x 0.3) / 0.7
In the above expression, Sp02 is arterial oxygen saturation from a pulse oximeter and St02 is determined by the cerebral oximeter.
Image /page/2/Picture/16 description: The image is a black and white photograph that appears to be a close-up of a dark, solid object. The object is rectangular in shape and takes up most of the frame. The left side of the object is a solid black, while the right side has a grainy texture that fades into white. The overall impression is one of darkness and contrast, with the solid black area dominating the image.
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Public Health Service
DEC 2 2 2005
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
Mr. Ron Jeffrey Director, Regulatory Affairs CAS Medical Systems, Inc. 44 East Industrial Road Branford, Connecticut 06405
Re: K051257
Trade/Device Name: Adult Cerebral Oximeter Monitor Regulation Number: 21 CFR 870.2700 Regulation Name: Oximeter Regulatory Class: II Product Code: DQA Dated: December 2, 2005 Received: December 5, 2005
Dear Mr. Jeffrey:
We have reviewed your Section 510(k) premarket notification of intent to market the device we have reviewed your Section 9 ro(x) premaine is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for use stated in the encrosule) to regally manatise provide Americal Device American be of Development commerce prior to May 26, 1776, the enactinent with the provisions of the Federal Food, Drug, devices that have been recuire approval of a premarket approval application (PMA). and Cosment Act (Act) that do not require subject to the general controls provisions of the Act. The You may, therefore, market the device, seeject to the of
general controls provisions of the Act include requirements for annual registration, listing of general controls provisions of the tice, labeling, and prohibitions against misbranding and adulteration.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), If your device is classified (600 acon controls. Existing major regulations affecting your device it may be subject to such additional vontrols. Title 21, Parts 800 to 898. In addition, FDA can be found in the Ood of Features concerning your device in the Federal Register.
Please be advised that FDA's issuance of a substantial equivalence determination does not mean Please be advised that i Dri 3 issuates of a occession of the requirements of the Act that TDA has made a decemmation that your is a your is the Federal agencies. You must or any rederal statutes and regulations and adding, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set CTN in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the elcotronic forth in the quality byovens (Sections 531-542 of the Act); 21 CFR 1000-1050.
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This letter will allow you to begin marketing your device as described in your Section 510(k) I mis letter will anow you to begin maneting of substantial equivalence of your device to a legally premarket notification: "The PDF 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 IT you desire specific advice ion your as (240) 276-0115. Also, please note the regulation entitled, Collider the Office of Compulation (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small other general international and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.
Sincerely yours,
Barbara Brehm
Mark Melkerson Acting Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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# Indications for Use
Adult Cerebral Oximeter, Model 2040
05/257
510(k) Number (if known):
Device Name:
Indications for Use:
The non-invasive Adult Cerebral Oximeter Model 2040 should The non-invasive Adult Sonitor of regional hemoglobin oxygen be used as an adjunts monin of an adult. The Cerebral Oximeter Monitor System should not be used as the sole Oximeler Monitor Oyoton is or the diagnosis or therapy. The value basis for decisions as to the critical oximeter Monitoring System has not been demonstrated in disease states.
Prescription Use (Part 21 CFR 801 Subpart D)
AND/OR
Over-the-Counter Use_ (21 CFR 807 Subpart C)
(Please do not write below this line – continue on another page if needed)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Xaubaro BneuuD
510(k) I
Page 1 of
Division of General, Restorative, and Neurological Devices
Kostas 7
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.