NPB-295 PULSE OXIMETER

K973147 · Nellcor Puritan Bennett, Inc. · DQA · Nov 14, 1997 · Cardiovascular

Device Facts

• Record ID: K973147
• Device Name: NPB-295 PULSE OXIMETER
• Applicant: Nellcor Puritan Bennett, Inc.
• Product Code: DQA · Cardiovascular
• Decision Date: Nov 14, 1997
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 870.2700
• Device Class: Class 2
• Attributes: Pediatric

Intended Use

The intended use of the NPB-295 Pulse Oximeter is the continuous, non-invasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate. For use with nconatal, pediatric and adult patients, in hospital-type, intra-hospital transport and home cnvironments. For prescription use only.

Device Story

NPB-295 Pulse Oximeter provides continuous, non-invasive monitoring of arterial hemoglobin oxygen saturation (SpO2) and pulse rate. Device uses compatible Nellcor sensors containing red and infrared LEDs; photodiode detects light absorption through tissue. Internal engine processes analog signals via oximetry algorithm to calculate SpO2, pulse rate, and pulse amplitude. Output displayed on device; includes 'blip bar' for pulse amplitude, visual/audible alarms for saturation/pulse/sensor search, and low battery alerts. Used in hospitals, transport, and home environments by clinicians or patients. Features serial port (EIA-232/RS-422) for real-time data output and nurse call interface. Powered by AC or internal rechargeable lead-acid battery. Flash ROM upgradable. Data output assists clinicians in patient status assessment and monitoring.

Clinical Evidence

In-vitro and non-invasive controlled hypoxia studies conducted to establish accuracy and verify that sensors meet published specifications when used with the NPB-295.

Technological Characteristics

Measures light absorption of tissue/blood via red and infrared LEDs and photodiode. Includes internal power supply (AC/rechargeable lead-acid battery), serial port (EIA-232/RS-422), and nurse call interface. Flash ROM upgradable. Oximetry algorithm processes analog sensor signals to derive SpO2, pulse rate, and pulse amplitude.

Indications for Use

Indicated for continuous, non-invasive monitoring of functional oxygen saturation (SpO2) and pulse rate in neonatal, pediatric, and adult patients in hospital, intra-hospital transport, and home settings. Prescription use only.

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.

Predicate Devices

• N-3000 Pulse Oximeter (K942347, K952316)

Submission Summary (Full Text)

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1

NOV I 4 1997

# Section 16. 510(k) Summary

# Section 16.a Date Summary Prepared

22 August 1997

## Section 16.b Company Information

Establishment:

Official Correspondent:

Nellcor Puritan Bennett Inc. 4280 Hacienda Drive Pleasanton, CA 94588

Roger D. Brown Regulatory Affairs Specialist Nellcor Puritan Bennett Inc. 11150 Thompson Avenue Lenexa, KS 66219 [phone] (direct phone) [phone] (fax)

### Section 16.c Name of Device

Proprietary:

Common/Usual:

Pulse Oximeter

NPB-295 Pulse Oximeter

Classification:

Oximeter (§870.2700/74DQA)

## Section 16.d Equivalent Devices

Substantial equivalence to the following legally marketed predicate devices with the same or similar indications for use has been demonstrated by a comparison of product features as described in the labeling and promotional literature for predicate devices and the NPB-295, as well as testing to accepted industry standards. In addition, in-vitro and non-invasive controlled hypoxia studies were conducted to establish the NPB-295's accuracy and to ensure that the sensors meet their currently published accuracy specifications with the NPB-295. The predicate devices are as follows:

1. N-3000 Pulse Oximeter, Nellcor Puritan Bennett Inc., K942347 and K952316

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### Section 16.e Device Description

The NPB-295 Pulse Oximeter is designed for continuous, non-invasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO₂) and pulse rate by use of one of a range of compatible Nellcor Puritan Bennett oxygen transducers (sensors). The or a range of compansio from of SpO₂ and pulse rate, and pulse amplitude by means of a "blip bar" presentation. The NPB-295 can be powered by an internal power supply operating on AC from a standard electrical utility receptacle (manually switchable from 115V to 230V) or alternatively by an integral sealed 6V rechargeable lead-acid battery. The NPB-295 is intended for prescription use with adult, pediatric and neonatal patients in hospital, hospital-type, intra-hospital transport and home environments.

Audible and visual alarms for high/low saturation, pulse rate and pulse search are The NPB-295 also includes adjustable alarm silence duration and other provided. configurable power on settings. The NPB-295 provides an audible low battery warning to alert the user of impending loss of power and consequent loss of monitoring capability. The NPB-295 Pulse Oximeter has visual indicators for pulse search, motion, power mode (i.e. battery or AC) and alarm silence in addition to alarm features.

In addition to the above mentioned device features, the instrument has been designed to satisfy the needs of both the user and the patient. A convenient carrying handle is incorporated into the case. There is also a serial port (EIA-232 and RS-422 interface) that provides ASCII output of real-time data every two seconds. This data can be printed on serial printers. TThere is also an interface for nurse call systems through the rear connector. The device is also Flash ROM upgradable.

## Section 16.f Intended Use

The intended use of the NPB-295 Pulse Oximeter is for continuous, non-invasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO3) and pulse rate of adult, pediatric and neonate patients. The environments of use are hospital, hospitaltype facilities, intra-hospital transport and the home. The intended use, patient population and environment of use are the same or similar to the predicate device, the N-3000 Pulse Oximeter.

## Section 16.g Technological Characteristics

The NPB-295 Pulse Oximeter measures functional oxygen saturation by calculating the light absorption of tissue, bone, and blood in the sampling light beam path during the pulsatile cycle. Red and infrared LED's are utilized as light sources. A photodiode acting as a photodetector senses the signal strength of the two wavelengths of light, which vary inversely with the amount of light transmitted through the tissue. The NPB-295 receives this electrical information from the sensor and processes the information by use of an oximetry algorithm to provide a real time value of SpO3, Pulse Rate and Pulse Amplitude.

The oximetry algorithm is contained in the NPB-295 "engine" (part of the instrument that processes the analog signals from the sensors) consists of electrical circuitry and processors that calculate the SpO2, pulse rate, and pulse amplitude. The NPB-295 uses the same SpO, and Pulse Rate software algorithm to process the information from the sensor as the predicate device, N-3000, cleared under K942347 and K952316.

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# Section 16.h Certification Statement

In accordance with the requirements of 21 CFR 807.87(j), the following certification is provided:

Nellcor Puritan Bennett Inc. believes that all data and information submitted in this premarket notification are truthful and accurate and no material fact has been omitted.

Roger D. Bu

Roger D. Brown Regulatory Affairs Specialist for Nellcor Puritan Bennett Inc.

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV I 4 1997

Mr. Roger D. Brown Nellcor Puritan Bennett Inc. 11150 Thompson Avenue Lenexa, Kansas 66219-2301

Re: K973147 NPB-295 Pulse Oximeter Regulatory Class: II (two) Product Code: 74 DQA Dated: Auqust 19, 1997 Received: August 22, 1997

Dear Mr. Brown:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). 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 (Premarket Approval), 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 895. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirements, as set ... forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in requlatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

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Page 2 - Mr. Roger D. Brown

This letter will allow you to begin marketing your device as described in your 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 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594–4648. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number [phone] or [phone] or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

Thomas J. Callahan

Thomas J. Callahan, Ph.D. Director Division of Cardiovascular, Respiratory, and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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| 510(k) Number (if known): | K973147 |
|---------------------------|---------|
|---------------------------|---------|

Device Name: NPB-295 Pulse Oximeter

Indications For Use:

The intended use of the NPB-295 Pulse Oximeter is the continuous, non-invasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2) and pulse rate. For use with nconatal, pediatric and adult patients, in hospital-type, intra-hospital transport and home cnvironments. For prescription use only.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use
(Per 21 CFR 801.109)

:

ﻧﻪ ﺩﺭ ﺍﺳ

OR

Over-The-Counter Use

(Optional Format 1-2-96)

th. A. Cill.

(Division Sign-Off) Division of Cardiovascular, Respiratory, and Neurological Devices K973147 510(k) Number _