K991054 · Nicolet Biomedical, Inc. · GWQ · Nov 3, 1999 · Neurology
Device Facts
Record ID
K991054
Device Name
BRAVO MULTI-MODALITY SYSTEM
Applicant
Nicolet Biomedical, Inc.
Product Code
GWQ · Neurology
Decision Date
Nov 3, 1999
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 882.1400
Device Class
Class 2
Indications for Use
The Bravo Multi-Modality System is intended to record and display EEG, EP, EMG and TCD data in the clinic and hospital (including the hospital room, operating room, emergency room, intensive care unit, neuro intensive care unit, critical care unit, etc.), and to import and display data from third-party monitoring devices such as vital signs monitors. It is intended to aid the diagnosis and monitoring of potential disorders of the central and peripheral nervous system and muscles.
Device Story
Bravo Multi-Modality System is a PC-based digital recorder for neurological and neurovascular data. Inputs: neuroelectric/neuromuscular signals via skin/muscle electrodes (EEG, EMG, EP); ultrasound signals via transducer (TCD); vital signs data from third-party monitors. Operation: passive recording for EEG/EMG; active stimulation (light, sound, electrical) for EP; ultrasound Doppler shift detection for TCD. System integrates multiple modalities on one platform. Used in clinics/hospitals by clinicians to aid diagnosis/monitoring of nervous system/muscle disorders. Output: displayed, analyzed, or stored physiological data. Clinical decision-making relies on human interpretation of system output.
Clinical Evidence
No clinical data provided. Device validation relies on nonclinical testing of program functions, user inputs, and recording of test signals to verify performance against expected outcomes.
Technological Characteristics
PC-based digital data recorder. Modalities: EEG, EMG, EP, TCD. Inputs: conductive electrodes, ultrasound transducers. Energy: electrical stimulation, ultrasound. Connectivity: imports data from third-party monitors. Software: multi-application concurrent execution on a single platform. Design and materials are consistent with predicate devices.
Indications for Use
Indicated for patients requiring diagnostic monitoring of central/peripheral nervous system and muscle disorders. Used in clinical and hospital settings (OR, ICU, etc.) to record EEG, EP, EMG, and TCD data.
Regulatory Classification
Identification
An electroencephalograph is a device used to measure and record the electrical activity of the patient's brain obtained by placing two or more electrodes on the head.
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Nov - 3 1999
K 991054
## 510(k) SUMMARY BRAVO MULTI-MODALITY SYSTEM
## (a) INFORMATION REQUIRED FOR ALL SUMMARIES
| | (1) Submitter's Name: | Nicolet Biomedical Inc. |
|--|--------------------------------|-------------------------------------------------------------------------------------------------------------|
| | Submitter's Address: | 5225 Verona Road, Bldg. 2<br>Madison, WI 53711 U.S.A. |
| | Submitter's Telephone Number: | (608) 273-5000 |
| | Contact Name: | Douglas E. Pfrang |
| | Date summary was prepared: | March 26, 1999 |
| | (2) Trade or proprietary name: | Bravo Multi-Modality System |
| | Common or usual name: | Electroencephalograph (EEG)<br>Evoked Potential (EP)<br>Electromyograph (EMG)<br>Transcranial Doppler (TCD) |
| | Classification name: | Electroencephalograph (84GWQ) |
| | | Evoked Potential Electrical Stimulator (84GWF) |
| | | Evoked Potential Photic Stimulator (84GWE) |
| | | Evoked Potential Auditory Stimulator (84GWJ) |
| | | Electromyograph (89GWP) |
| | | Nonfetal Ultrasonic Monitor (90JAF) IKN & OLT |
(3) Identification of the legally marketed devices to which equivalence is claimed.
- 1. Nicolet Spirit EMG/EP (FDA Log No. K905632)
- 2. Nicolet Voyageur EEG (FDA Log No. K921927)
- 3. Nicolet/EME Trans-Scan TCD (FDA Log No. K874685)
(4) Description of the device, including an explanation of how the device functions, the scientific (4) Dosenpton of the significant performance characteristics such as device design, material used, and physical properties.
The Bravo Multi-Modality System is a personal computer-based digital data recorder for continuously monitoring various types of neurological information, including: (i) neuroelectric and neuromuscular data pertaining to the patient's central and peripheral nervous system and muscles, and (ii) neurovascular data pertaining to blood flow in the patient's brain and related blood vessels.
The intended use of this device is to record and display EEG, EMG, EP and TCD signals; and to import and display data from third-party monitoring devices, such as vital signs monitors. EEG signals are passively recorded using electrically-conductive electrodes that are placed in electrical contact with the patient's skin or nervous system. EMG and EP signals are recorded using electrically-conductive electrodes that are placed in electrical contact with the patient's skin, nervous system or muscles. EMG signals are passively recorded, while EP
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signals are evoked using a light source, a sound source, or an electrical stimulator. TCD signals are actively recorded using a non-invasive ultrasound transducer that emits and records ultrasound energy. The ultrasound energy is applied externally to the skin, passes through the skin and body tissues, reflects off blood molecules moving in the blood stream, passes back through the body tissues and skin, and returns to the transducer. Movement of the blood molecules causes a frequency or "Doppler" shift in the returned ultrasound energy, which is detected and converted into a signal representing the velocity of the blood from which the ultrasound energy was reflected. Third-party monitoring devices, such as vital signs monitors, acquire and display a variety of physiological data from the patient. Importing and displaying such data is done by taking an output signal directly from such monitoring devices without any additional connections to the patient. Data obtained from the monitoring device is then displayed, analyzed or stored by the Bravo Multi-Modality System independently of how the third-party device handles the data.
(5) Statement of the intended use, including a description of the patient populations, and diseases or conditions, that the device is intended to diagnose, treat, prevent, cure, or mitigate. If different from the predicate device, an explanation of why the differences are not critical to the intended use when the device is used as labeled.
The Bravo Multi-Modality System is intended to record and display EEG, EP, EMG and TCD data in the clinic and hospital (including the hospital room, operating room, emergency room, intensive care unit, neuro intensive care unit, critical care unit, etc.), and to import and display data from third-party monitoring devices. It is intended to aid the diagnosis and monitoring of potential disorders of the central and peripheral nervous system and muscles. It differs from the predicate devices in that it contains multiple modalities in a single device, whereas each predicate device has a very limited number of modalities. Nevertheless, like the predicate devices, the Bravo Multi-Modality System is intended to involve competent human intervention before any impact on human health occurs (i.e., clinical judgment and experience must be used to check and interpret the system's output).
(6) Comparison between the technological characteristics of the new and predicate devices, such as design, material, chemical composition, energy source, etc.
The technological characteristics of the new and predicate devices are substantially equivalent because the hardware and software in the Bravo Multi-Modality System is largely based on the predicate devices. The design, material, chemical composition, energy source, etc., are essentially unchanged. The main difference is that advances in computer technology (i.e., hardware and software) have enabled multiple software applications to run concurrently on a single computer platform, thereby making possible a single integrated system with multimodality capabilities. Nevertheless, each modality, when compared to a predicate device of the same modality, has similar performance specifications, a similar set of user-adjustable parameters, and is designed to comply with substantially the same performance standards.
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## (b) INFORMATION REQUIRED IF EQUIVALENCE IS BASED ON PERFORMANCE
DATA
(1) Brief discussion of nonclinical tests.
Nonclinical tests consist of various tests to verify program function, such as testing user
uts and recording various test signals. Tests are ongoing, but in line to for a included tests collais of various tests to verify program function, such as testing used
inputs and recording various tests signals. Tests are ongoing, but indicate that the performing as expected. Test results are summarized below in indicate that the
(2) Brief discussion of clinical tests including, if applicable, a descriptions of the subjects, a
discussion of safety or effectiveness data obtained, a discussion of consis person of safety or effectiveness data obtained, a discussion of the subjects,
discussion of safety or effectiveness data obtained, a discussion of any adverse effects of complications, and any other relevant information.
Clinical tests will be used to validate the device's performance under simulated or actual
le stations in use conditions. Because each of the individual modalities was derived from an existing from an existing the decided data will be a primary validation tool. To provided for an existing
the device will be a primary validation tool. To provided tool and easting
and to vill be ev the device will be evaluated at different health care sites to solicit can annound with the mainting valiation, which in the studion, which is and and to was over of ovaluated at different health care sites to solicit common
(3) Conclusions drawn from nonclinical and clinical tests that demonstrate the device is as safe
(c){ca (1) as safe
Clinical and nonclinical results of testing the Bravo Multi-Modality System are showing
it it performs substantially as expected: i.e. that it is substantially as expected that it performs substantially as expected; i.e., that it is substantially equivalent to the predicate devices of safety as expected; 1.e., that it is
predicate devices in terms of safety and effectiveness.
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Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002
Mr. Douglas E. Pfrang Director, Regulatory and Legal Affairs Nicolet Biomedical, Inc. 5225 Verona Road, Building 2 Madison, Wisconsin 53711-4495
APR - 9 2012
Re: K991054
Trade/Device Name: Bravo Multi-Modality System Regulation Number: 21 CFR 882.1870 Regulation Name: Evoked response electrical stimulator Regulatory Class: II Product Code: GWF, GWQ, GWE, GWJ, OLT, JAF, IKN Dated (Date on orig SE ltr): August 4, 1999 Received (Date on orig SE Itr): August 5, 1999
Dear Mr. Pfrang:
This letter corrects our substantially equivalent letter of November 3, 1999.
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.
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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/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 Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.
Sincerely yours,
Kesia Alexander
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Malvina B. Eydelman, M.D. Director Division of Ophthalmic, Neurological, and Ear. Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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K991654 510(k) Number (if known):
Device Name: _Bravo Multi-Modality System
Indications For Use:
The Bravo Multi-Modality System is intended to record and display EEG, EP, EMG and TCD data in the clinic and hospital (including the hospital room, operating room, emergency room, intensive care unit, neuro intensive care unit, critical care unit, etc.), and to import and display data from third-party monitoring devices such as vital signs monitors. It is intended to aid the diagnosis and monitoring of potential disorders of the central and peripheral nervous system and muscles.
(PLEASE DO NOT WRITE BELOW THIS LINE. CONTINUE ON ANOTHER PAGE IF NECESSARY) Concurrence of CDRH, Office of Device Evaluation (ODE)
Mark A. Milken
for (Division Sign-Off)
Division of General Restorative Devices
510k) Number. K991054
**Prescription Use**
Per 21 CFR 801.109
OR
Over-The-Counter Use
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.