Expression MR400 MRI Patient Monitoring System

K152330 · Invivo Corporation · MWI · Dec 23, 2015 · Cardiovascular

Device Facts

Record IDK152330
Device NameExpression MR400 MRI Patient Monitoring System
ApplicantInvivo Corporation
Product CodeMWI · Cardiovascular
Decision DateDec 23, 2015
DecisionSESE
Submission TypeSpecial
Regulation21 CFR 870.2300
Device ClassClass 2
AttributesPediatric

Intended Use

The Expression MR400 MRI Patient Monitoring System (Model MR400) is intended to monitor vital signs for patients undergoing MRI procedures and to provide signals for synchronization for the MRI scanner. The Expression MR400 MRI Patient Monitoring System (Model MR400) is intended for use by healthcare professionals. The Expression MR400 MRI Patient Monitoring System (Model MR400) provides monitoring for the following vital sign parameters: ECG, pulse oximetry (SpO2), non-invasive blood pressure (NIBP), and optionally, invasive blood pressure (IBP), carbon dioxide (CO2) and respiration rate, anesthetic agents, nitrous oxide (N2O), oxygen (02), and/or temperature.

Device Story

Multi-parameter patient monitoring system for MRI suites; monitors ECG, SpO2, NIBP, IBP, CO2, respiration, anesthetic agents, O2, N2O, and temperature. Inputs include physiological signals via wireless ECG/SpO2 modules and wired sensors (cuffs, probes, cannulas). System processes signals to display waveforms, numeric values, and alarms on a cart-mounted touchscreen. Provides synchronization signals for MRI scanners. Operated by healthcare professionals in MRI magnet rooms/suites. Output enables real-time patient status assessment and clinical decision-making during imaging. Benefits include continuous patient safety monitoring in high-field MRI environments.

Clinical Evidence

No clinical data was required. Substantial equivalence is supported by non-clinical verification, validation, and system-level performance testing, including hazard analysis and comparison against predicate specifications.

Technological Characteristics

Multi-parameter monitor with touchscreen cart. Wireless ECG/SpO2 modules (IP21 rated). Power: AC or internal battery. Parameters: ECG, SpO2, NIBP, IBP, CO2, anesthetic agents, O2, N2O, temperature. Connectivity: 10 user-selectable wireless networks. Software-based processing of physiological signals.

Indications for Use

Indicated for patients of all sizes (neonatal, infant, pediatric, adult, large adult) undergoing MRI procedures requiring vital sign monitoring and scanner synchronization. Intended for use by healthcare professionals.

Regulatory Classification

Identification

A cardiac monitor (including cardiotachometer and rate alarm) is a device used to measure the heart rate from an analog signal produced by an electrocardiograph, vectorcardiograph, or blood pressure monitor. This device may sound an alarm when the heart rate falls outside preset upper and lower limits.

Predicate Devices

Related Devices

Submission Summary (Full Text)

{0}------------------------------------------------ Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002 December 23, 2015 Invivo Corporation c/o Christine Trefethen Regulatory Manager Philips Medical Systems 3000 Minuteman Rd. Andover, MA 01801 Re: K152330 Trade/Device Name: Expression MR400 MRI Patient Monitoring System (Model MR400) Regulation Number: 21 CFR 870.2300 Regulation Name: Cardiac Monitor (Including Cardiotachometer and Rate Alarm) Regulatory Class: Class II Product Code: MWI Dated: November 24, 2015 Received: November 25, 2015 Dear Christine Trefethen: We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food. Drug. and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA), You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading. If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act 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 of medical devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in {1}------------------------------------------------ the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050. If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance. You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Sincerely yours, Mitchell Stein for Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health Enclosure {2}------------------------------------------------ ## Indications for Use 510(k) Number (if known) K152330 Page 1 of 1 Device Name Expression MR400 MRI Patient Monitoring System (Model MR400) Indications for Use (Describe) The Expression MR400 MRI Patient Monitoring System (Model MR400) is intended to monitor vital signs for patients undergoing MRI procedures and to provide signals for synchronization for the MRI scanner. The Expression MR400 MRI Patient Monitoring System (Model MR400) is intended for use by healthcare professionals. The Expression MR400 MRI Patient Monitoring System (Model MR400) provides monitoring for the following vital sign parameters: ECG, pulse oximetry (SpO2), non-invasive blood pressure (NIBP), and optionally, invasive blood pressure (IBP), carbon dioxide (CO2) and respiration rate, anesthetic agents, nitrous oxide (N2O), oxygen (02), and/or temperature. Type of Use (Select one or both, as applicable) | <div> <span style="font-size: 10px;"> <input checked="true" type="checkbox"/> </span> Prescription Use (Part 21 CFR 801 Subpart D) </div> | <div> <span style="font-size: 10px;"> <input type="checkbox"/> </span> Over-The-Counter Use (21 CFR 801 Subpart C) </div> | |---------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------| |---------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------| #### CONTINUE ON A SEPARATE PAGE IF NEEDED. This section applies only to requirements of the Paperwork Reduction Act of 1995. #### *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.* The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to: > Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov "An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number." {3}------------------------------------------------ Image /page/3/Picture/0 description: The image shows the Invivo logo. The logo consists of a purple circle with the letter "i" inside, followed by the word "Invivo" in purple. Below the word "Invivo" is the text "A Philips Company" in gray. Image /page/3/Picture/1 description: The image shows the word "PHILIPS" in large, bold, blue letters. The font is sans-serif and the letters are evenly spaced. The background is white, which makes the blue letters stand out. ### SPECIAL 510(K) SUMMARY # SUBMITTER INFORMATION | Establishment Name:<br>Establishment Address: | Invivo Corporation<br>12151 Research Parkway<br>Orlando, FL 32826 USA | |-----------------------------------------------|------------------------------------------------------------------------------------------------| | Company Phone: | (407) 252-0414 | | Company Fax: | (407) 249-2022 | | Person to contact<br>regarding questions: | Rusty Kelly<br>Sr. Manager Quality and Regulatory<br>(407)-252-0414<br>Rusty.Kelly@philips.com | | Establishment<br>Registration Number: | 1051786 | ## DEVICE IDENTIFICATION Date Summary Prepared: | Trade name: | Expression MR400 MRI Patient Monitoring<br>System (Model MR400) | |----------------------|-------------------------------------------------------------------------------------------------------| | Common name: | MRI patient monitoring system | | Classification name: | Cardiac monitor (including cardiotachometer and<br>rate alarm)<br>(21 CFR 870.2300, Product Code MWI) | August 11, 2015 {4}------------------------------------------------ #### IDENTIFICATION OF LEGALLY MARKETED PREDICATE DEVICE The Expression MR400 MRI Patient Monitoring System also referred to as the Expression MR400 or MR400, is substantially equivalent to the following predicate device: | Predicate Device | Manufacturer | 510(k) No. | Clearance Date | |-------------------------------------------------|--------------------|------------|----------------| | MRI Patient Monitoring System<br>(Model 865214) | Invivo Corporation | K124061 | Feb 22, 2013 | #### DEVICE DESCRIPTION The Expression MR400 is a multi-parameter patient monitoring system used to monitor the vital signs of patients in an MRI magnet room and throughout an MRI suite. The MR400's software simultaneously processes and displays multiple parameters, waveforms, measurement numeric values and alarms. All patient information is provided on a wheeled cart which consists of a patient monitor with a touch screen display. The device is powered by either AC line power or its internal battery. The standard and optional parameters which can be monitored by the MR400 include: - Electrocardiogram (ECG) - Heart rate (HR, ECG and SPO2 derived) ● - Blood oxygen saturation/pulse oximetry (SPO2) - End-tidal and fractional inspired CO2 (EtCO2 and FiCO2) ● - Invasive blood pressure (IBP) (P1 and P2) ● - Anesthetic agents (AGENT) ● - o Desflurane (DES) - o Enflurane (ENF) - o Halothane (HAL) - o Isoflurane (ISO) - o Sevoflurane (SEV) - Fractional inspired O2 (FiO2), and end-tidal and fractional inspired N2O (EtN2O ● and FiN2O) - Temperature (TEMP) ● - Non-invasive blood pressure (NIBP) - . Respiration rate (CO2-derived and/or bellows-derived) {5}------------------------------------------------ The MR400 consists of the following key components: - Cart with touchscreen display ● - Wireless ECG module . - Wireless SpO2 module ● - Batteries for both the Cart and Wireless Modules ● - Battery charger ● - Power cord ● Accessories to the MR400 are offered to accommodate various patient sizes-neonatal, infant, pediatric, adult, and large adult. Key accessories include: - . ECG lead cables and electrodes - SPO2 probes and clips ● - NIBP cuffs and hoses ● - IBP transducer - Temperature probe and sheath ● - Cannulas ● - Water traps ● - Chest pneumograph ● - Expression IP5 (optional secondary display for control room w/printer) ● ### INDICATIONS FOR USE The Expression MR400 MRI Patient Monitoring System (Model MR400) is intended to monitor vital signs for patients undergoing MRI procedures and to provide signals for synchronization for the MRI scanner. The Expression MR400 MRI Patient Monitoring System (Model MR400) is intended for use by healthcare professionals. The Expression MR400 MRI Patient Monitoring System (Model MR400) provides monitoring for the following vital sign parameters: ECG, pulse oximetry (SpO2), non-invasive blood pressure (NIBP), and optionally, invasive blood pressure (IBP), carbon dioxide (CO2) and respiration rate, anesthetic agents, nitrous oxide (N2O), oxygen (02), and/or temperature. #### TECHNOLOGICAL CHARACTERISTICS The modified device has the same fundamental scientific technology as the predicate device. {6}------------------------------------------------ | Technological<br>Characteristic | Predicate: MRI Patient<br>Monitoring System<br>(K124061) | Modified Device: Expression<br>MR400 MRI Patient<br>Monitoring System | Comparison | |--------------------------------------------------------|--------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------| | Cart | | | | | Display | Detachable, located on<br>top front of display | Permanently installed, located on<br>the rear of the display | Substantially<br>Equivalent | | Expression IP5 | Software is compatible<br>with the predicate device | Software was updated to be<br>compatible with the predicate<br>device and the Expression<br>MR400 | Substantially<br>Equivalent | | Printer | Integrated on side of<br>display | No printer permanently installed<br>on display. | Substantially<br>Equivalent | | Alarms Set Up,<br>Printer Set Up and<br>Monitor Set Up | Separate key on the<br>keypad which is visible to<br>the operator at all times | Collapsed within one Setup key<br>on the virtual keypad that is<br>visible to the operator at all times | Substantially<br>Equivalent | | Power Supply | External | Integrated | Substantially<br>Equivalent | | Internal Batteries | Four User-replaceable | Two Permanently installed and<br>two User-replaceable | Substantially<br>Equivalent | | Alarms | Vital Sign Alarms | Added user adjustable alarms for<br>extreme bradycardia, extreme<br>tachycardia, apnea and<br>desaturation | Substantially<br>Equivalent | | Non-Invasive Blood Pressure | | | | | NIBP Connector | Connector ports are for<br>unique predicate<br>accessories | Accommodate locking<br>connectors unique to the<br>modified device accessories | Substantially<br>Equivalent | | NIBP Hose | 3 meters in length | 5 meters in length | Substantially<br>Equivalent | | NIBP Data<br>Collection &<br>Measurement | Performed in the<br>processing unit within the<br>cart. | Performed in the processing unit<br>within the cart using the<br>picoNIBP OEM Module | Substantially<br>Equivalent | | CO2 | | | | | CO2 Connector | Connector ports are for<br>unique predicate<br>accessories | Accommodate locking<br>connectors unique to the<br>modified device accessories | Substantially<br>Equivalent | | CO2 Collection &<br>Measurement<br>CO2 cannula | Completed using<br>Excelitas CO2 Sensor<br>22 ft. in length | Completed using LoFloC5 Co2<br>Sensor<br>17ft. in length | Substantially<br>Equivalent | | ECG | | | | | ECG Cable Cover | Wire bundle enclosed in a<br>silicone foam trunk | Flat wire assembly enclosed in<br>Azote foam | Substantially<br>Equivalent | | Wireless ECG<br>Module- communication | 5 user-selectable<br>networks | 10 user-selectable networks.<br>(only 5 per module, either 1-5 or<br>6-10) | Substantially<br>Equivalent | | Wireless ECG<br>Module- battery | Operates on one (1) 3.7<br>VDC user-replaceable<br>lithium battery | Operates on two (2) 3.7 VDC<br>user-replaceable lithium batteries | Substantially<br>Equivalent | | Wireless ECG<br>Module- housing | Plastic covering, single<br>battery slot, Ingress<br>Protection IPX1 | Plastic housing made of same<br>materials as predicate, supports<br>two batteries, has eject buttons<br>for batteries, improved Ingress<br>Protection rating of IP21 | Substantially<br>Equivalent | | SPO2<br>Wireless SPO2<br>Module- communication | 5 user-selectable<br>networks | 10 user-selectable networks.<br>(only 5 per module, either 1-5 or<br>6-10) | Substantially<br>Equivalent | | Wireless SPO2<br>Module- housing | Plastic covering, single<br>battery slot, Ingress<br>Protection IPX1 | Plastic housing made of same<br>materials as predicate, has eject<br>button for battery, improved<br>Ingress Protection rating of IP21 | Substantially<br>Equivalent | {7}------------------------------------------------ #### SUMMARY OF NON-CLINICAL PERFORMANCE DATA Verification, validation, and testing activities establish the performance, functionality, and reliability characteristics of the modified device with respect to the predicate. Testing involved system level tests, performance tests, and safety testing from hazard analysis. Pass/Fail criteria were based on the specifications cleared for the predicate device and the specifications of the modified device. Results of the non-clinical testing demonstrate that the modified device operates as intended within the performance specifications and is substantially equivalent to the cleared device. The results do not raise issues regarding the safety and effectiveness of the device. Clinical data was not required to substantiate claims of safety and effectiveness. The modified device, the Expression MR400 MRI Patient Monitoring System, described in this submission is substantially equivalent to the cleared device, the MRI Patient Monitoring System (Model 865214).
Innolitics
510(k) Summary
Decision Summary
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