BERNOULLI MANAGEMENT SYSTEM, OXINET III AND LIFEGARD VUE

K091461 · Cardiopulmonary Corp. · MOD · Aug 14, 2009 · Anesthesiology

Device Facts

• Record ID: K091461
• Device Name: BERNOULLI MANAGEMENT SYSTEM, OXINET III AND LIFEGARD VUE
• Applicant: Cardiopulmonary Corp.
• Product Code: MOD · Anesthesiology
• Decision Date: Aug 14, 2009
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 868.5895
• Device Class: Class 2
• Attributes: Software as a Medical Device

Intended Use

The Bernoulli MS software is intended to be used on a central monitoring station on patients using supported devices in a hospital or hospital type environment. It is used to provide a secondary display of ventilator, respiratory monitor, IV infusion (including PCA) pump, feeding pump, and/or multi parameter monitor data (ECG, respiratory rate, pulse oximetry, ETCO2, blood pressure, cardiac output, temperature and associated derived outputs) to the central station, and to provide remote monitoring and alarm surveillance. The Bernoulli MS is intended to supplement and not replace any part of the current device monitoring procedures.

Device Story

Bernoulli Management System (MS) is a software-based central monitoring station; aggregates data from bedside medical devices including ventilators, infusion pumps, and multi-parameter monitors. Inputs: real-time physiological data (ECG, SpO2, ETCO2, BP, cardiac output, temperature) and device status/alarm signals. Operation: software interfaces with bedside devices to provide secondary display and remote alarm surveillance at a central station. Usage: hospital environment; operated by clinical staff. Output: visual representation of patient data and alarm notifications. Benefit: enables centralized oversight of multiple patients; supplements existing bedside monitoring procedures; does not replace primary monitoring.

Clinical Evidence

No clinical data provided; substantial equivalence established through device description and intended use analysis.

Technological Characteristics

Software-based central monitoring system; functions as a secondary display and alarm surveillance tool. Integrates with various bedside medical devices (ventilators, infusion pumps, multi-parameter monitors) to aggregate and display physiological data and derived outputs. Operates within a hospital network environment.

Indications for Use

Indicated for patients in hospital or hospital-type environments requiring secondary monitoring of data from ventilators, respiratory monitors, IV/feeding pumps, and multi-parameter monitors (ECG, SpO2, ETCO2, BP, cardiac output, temperature).

Regulatory Classification

Identification

A continuous ventilator (respirator) is a device intended to mechanically control or assist patient breathing by delivering a predetermined percentage of oxygen in the breathing gas. Adult, pediatric, and neonatal ventilators are included in this generic type of device.

Submission Summary (Full Text)

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Image /page/0/Picture/1 description: The image shows the seal of the Department of Health and Human Services (USA). The seal features an eagle-like symbol with three stylized lines representing the bird's body and wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES (USA)" is arranged in a circular pattern around the eagle symbol.

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

# AUG 1 4 2009

Mr. Jordan Schreck Quality Manager Cardiopulmonary Corporation 200 Cascade Boulevard Milford, Connecticut 06460

Re: K091461

Trade/Device Name: Bernoulli™ Management System Regulation Number: 21 CFR 870.2300 Regulation Name: Cardiac Monitor (Including Cardiotachometer and Rate Alarm), Regulatory Class: II Product Code: MSX, MOD Dated: May 12, 2009 Received: May 18, 2009

Dear Mr. Schreck:

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 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.

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### Page 2- Mr. Schreck

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

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to

http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/cdrl/mdr/ for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Anthony D. Winter for

Susan Runner, D.D.S., M.A. Acting Division Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

#### Enclosure

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CONFIDENTIAL

## APPENDIX B:

### Indications for Use Statement

510(k) Number

### (Pending)

Device Name

Bernoulli™ Management System

Indications for Use

The Bernoulli MS software is intended to be used on a central monitoring station on patients using supported devices in a hospital or hospital type environment. It is used to provide a secondary display of ventilator, respiratory monitor, IV infusion (including PCA) pump, feeding pump, and/or multi parameter monitor data (ECG, respiratory rate, pulse oximetry, ETCO2, blood pressure, cardiac output, temperature and associated derived outputs) to the central station, and to provide remote monitoring and alarm surveillance. The Bernoulli MS is intended to supplement and not replace any part of the current device monitoring procedures.

Concurrence of CDRH, Office of Device Evaluation (ODE)

L. Schuler

(Division Sign-Off) Division of Anesthesiology, General Hospital Infection Control, Dental Devices

Prescription Use X (Per 21 CFR 801.109)

510(k) Number: K091161 Over-The-Counter Use *_*_