HiCardi+ H100

K232670 · MEZOO Co., Ltd. · DSH · Sep 20, 2024 · Cardiovascular

Device Facts

• Record ID: K232670
• Device Name: HiCardi+ H100
• Applicant: MEZOO Co., Ltd.
• Product Code: DSH · Cardiovascular
• Decision Date: Sep 20, 2024
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 870.2800
• Device Class: Class 2

Indications for Use

The HiCardi+ H100 is intended to record symptomatic cardiac events and continuous electrocardiogram (ECG) for 72 hours from ambulatory patients by attaching HiCardi+ H100 SmartPatch to the skin surface. ECG records are stored in SmartPatch for review by the clinician after the recording period (up to 72 hours) is completed. It is indicated for use on 22 years or older who may be symptomatic and/or asymptomatic or suffer from transient symptoms as palpitations, shortness, of breath, dizziness, light-headedness, fatique, or anxiety. The reported ECG metrics include preliminary indications of the irreqular beat and/or rhythm and heart rate measurement based on a single-lead ECG basis. The arrhythmia information addressed in the report does not contain diagnostic interpretation; the reported indication is provided for review by the intended user to make a diagnosis based on clinical judgment and experience.

Device Story

HiCardi+ H100 is a wearable, reusable ambulatory ECG recorder consisting of a SmartPatch sensor and LiveStudio PC-based review software. The SmartPatch attaches to the patient's skin to record single-lead ECG signals for up to 72 hours. Patients use an integrated Event Button to mark symptomatic events like palpitations or chest pain. After the recording period, data is transferred to the LiveStudio software. The software visualizes ECG data and provides preliminary automated indications of irregular beats, rhythms, and heart rate. Clinicians review these outputs, edit as necessary, and generate PDF reports to aid in clinical diagnosis. The device is intended for use in ambulatory settings. It benefits patients by providing continuous cardiac monitoring to capture transient symptoms, facilitating clinical decision-making without requiring inpatient stays.

Clinical Evidence

Bench testing only. No clinical trials were conducted. Performance was validated through bench testing against recognized standards including IEC 60601-1 (safety), IEC 60601-1-2 (EMC), IEC 60601-2-47 (ambulatory ECG), and ANSI/AAMI EC57 (arrhythmia detection). Biocompatibility was verified per ISO 10993-1.

Technological Characteristics

Wearable, reusable patch with detachable electrodes. Materials: Silver-Silver Chloride electrodes, hydrogel, skin adhesive (ISO 10993-1 compliant). Sensing: Single-lead ECG (Modified Lead II). Power: Rechargeable Li-ion battery. Connectivity: Wired data transfer to PC (no wireless telemetry). Software: PC-based review and report generation. Standards: IEC 60601-1, IEC 60601-1-2, IEC 60601-2-47, ANSI/AAMI EC12, ANSI/AAMI EC57.

Indications for Use

Indicated for patients 22 years or older, symptomatic or asymptomatic, experiencing transient symptoms including palpitations, shortness of breath, dizziness, light-headedness, fatigue, or anxiety. Contraindicated for patients with allergies to medical-grade adhesives/hydrogel, life-threatening arrhythmias, those requiring inpatient monitoring/immediate ECG analysis, handicapped persons unable to carry the device, patients with skin disease/disorders at contact sites, or those unable to read consent forms.

Regulatory Classification

Identification

A medical magnetic tape recorder is a device used to record and play back signals from, for example, physiological amplifiers, signal conditioners, or computers.

Predicate Devices

• ZIO® SkyRunner (SR) Electrocardiogram (ECG) Monitoring Service (K143513)

Submission Summary (Full Text)

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#### 09/20/2024

Mezoo Co., Ltd. Jessica Kim Regulatory Affairs Manager Room 808, 200 Gieopdosi-ro, Jijeong-myeon Gangwon-do, Seoul 26354 Korea, South

Re: K232670

Trade/Device Name: HiCardi+ H100 Regulation Number: 21 CFR 870.2800 Regulation Name: Medical Magnetic Tape Recorder Regulatory Class: Class II Product Code: MLO, DQK Dated: August 23, 2024 Received: August 23, 2024

Dear Jessica Kim:

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 (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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database available at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device" (https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

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Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30, Design controls; 21 CFR 820.90, Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review, the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 device-related adverse events) (21 CFR Part 803) for devices or postmarketing safety reporting (21 CFR Part 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR Part 4. Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rule"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-devices/device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

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# Kimberly N. Crowley -S

For: Jennifer Kozen Assistant Director DHT2A: Division of Cardiac Electrophysiology, Diagnostics, and Monitoring Devices OHT2: Office of Cardiovascular Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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## Indications for Use

510(k) Number (if known) K232670

Device Name HiCardi+ H100

#### Indications for Use (Describe)

The HiCardi+ H100 is intended to record symptomatic cardiac events and continuous electrocardiogram (ECG) for 72 hours from ambulatory patients by attaching HiCardi+ H100 SmartPatch to the skin surface. ECG records are stored in SmartPatch for review by the clinician after the recording period (up to 72 hours) is completed. It is indicated for use on 22 years or older who may be symptomatic or suffer from transient symptoms as palpitations, shortness, light-headedness, fatigue, or anxiety. The reported ECG metrics include preliminary indications of the irregular beat and/or rhythm and heart rate measurement based on a singlelead ECG basis. The arthythmia information addressed in the report does not contain diagnostic interpretation; the reported indication is provided for review by the intended user to make a diagnosis based on clinical judgment and experience.

X Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

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## 510(k) Summary

## SUBMITTER

#### Applicant:

MEZOO CO., LTD. #808, Medical Device Complex Center, 200 Gieopdosi-ro, Jijeong-myeon, Wonju-si, Gangwon-do, 26354 Republic of Korea

Phone number: [phone] Fax number: [phone]

#### Official Correspondent:

Boram Kim RA manager of MEZOO [e-mail] #808, Medical Device Complex Center, 200 Gieopdosi-ro, Jijeong-myeon, Wonju-si, Gangwon-do, 26354 Republic of Korea

Date Prepared: August 30, 2023

#### DEVICE

| Trade Name (Proprietary Name) | HiCardi+ H100 |
|-------------------------------|--------------------------------------------------------------------------------------------|
| Common Name | Wearable ECG ambulatory recorder |
| Classification Regulation | 870.2800: Recorder, Magnetic Tape, Medical<br>870.1425: Computer, Diagnostic, Programmable |
| Device Class | Class II |
| Product Code | MLO, DQK |

## PREDICATE DEVICE (Legally Marketed Device)

| Trade Name | ZIO® SkyRunner (SR) Electrocardiogram (ECG) Monitoring<br>Service |
|-------------------------|-------------------------------------------------------------------|
| 510(k) Submitter/Holder | iRhythm Technologies, Inc. |
| 510(k) Number | K143513 |

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## DEVICE DESCRIPTION

The HiCardi+ H100 consists of two components:

- . Patient-worn ECG patch (Sensor, SmartPatch);
- . Review & Report Generation Software (LiveStudio).

The SmartPatch is a wearable and reusable patch device intended to measure ECG signals from a patient for 72 hours. The SmartPatch is intended to record ECG signals and automatically indicate the irregular beat and/or rhythm of the recorded ECG data to aid the clinician in finalizing the ECG interpretation. The SmartPatch has an Event Button the patient can press to record symptoms, such as heart palpitations, dizziness, or chest pain, etc.

The LiveStudio is a review software operating on a personal computer (PC). The software visualizes the ECG data and preliminary indications from the SmartPatch for review, editing, and interpretation by the clinician. The LiveStudio provides tools to assist the clinician with their review. The final report includes the summary results of the review and can be documented by PDF formatted documents and printed by a printer connected to the PC.

## INDICATIONS FOR USE

The HiCardi+ H100 is intended to record symptomatic cardiac events and continuous electrocardiogram (ECG) for 72 hours from ambulatory patients by attaching HiCardi+ H100 SmartPatch to the skin surface. ECG records are stored in SmartPatch for review by the clinician after the recording period (up to 72 hours) is completed. It is indicated for use on 22 years or older who may be symptomatic and/or asymptomatic or suffer from transient symptoms as palpitations, shortness, of breath, dizziness, light-headedness, fatique, or anxiety. The reported ECG metrics include preliminary indications of the irreqular beat and/or rhythm and heart rate measurement based on a single-lead ECG basis. The arrhythmia information addressed in the report does not contain diagnostic interpretation; the reported indication is provided for review by the intended user to make a diagnosis based on clinical judgment and experience.

#### Contraindications

- The HiCardi+ H100 is contraindicated for patients with known allergies or hypersensitivity to ● medical-grade adhesives gel or hydrogel.
- . The HiCardi+ H100 is contraindicated for patients with potentially life-threatening arrhythmias, or who require inpatient monitoring or immediate analysis of their ECG.
- . The HiCardi+ H100 is contraindicated for a handicapped person who cannot carry a patch-type electrocardiograph.
- The HiCardi+ H100 is contraindicated for a person who shows a skin disease or functional disorder when the patch-type electrocardiograph comes into contact with it.
- . The HiCardi+ H100 is contraindicated for subjects who cannot read the consent form (illiterate, foreigners, etc.).

-

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HiCardi+ H100 510(k) Submission

## Substantial Equivalence Discussion

The Device Comparison Table in Section 11. Executive Summary/Predicate Comparison and the discussion of similarities and differences in Section 12. Substantial Equivalence Discussion show that the indications for use, technology, and performance of (MEZOO CO., LTD., HiCardi+ H100) are substantially equivalent with the predicate devices (iRhythm Technologies, Inc., ZIO® SkyRunner (SR) Electrocardiogram (ECG) Monitoring Service).

| Characteristics | Subject Device | Predicate Device |
|----------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------|
| | ECG Recording Characteristics | |
| ECG Channel | 1 channel | 1 channel |
| ECG Lead Vector | Modified Lead II recorder and<br>Modified Lead II analysis | Modified Lead II recorder and<br>Modified Lead II analysis |
| Recorder Power Supply | Rechargeable battery | Non-rechargeable battery |
| Recording Duration | Up to 3 days (The internal battery<br>of the SmartPatch is continuously<br>recharged when it is in the<br>charger.) | Up to 14 days |
| Electrode Detachable | Detachable, Non-integrated into<br>the device | Non-detachable, integrated into the<br>device |
| Electrode Materials | Silver-Silver Chloride conventional<br>electrodes/hydrogel, and skin<br>adhesive | Silver-Silver Chloride conventional<br>electrodes/hydrogel, and skin<br>adhesive |
| Recorder User Interface | Two Buttons<br>- Power On/Off Button for on/off<br>control<br>- Event Button for patient event<br>marking | Single button for on/off control/<br>Patient event marking |
| Wear | body-worn | body-worn |
| Sterile | No | No |
| Recording Type | Continuous | Continuous |
| Data Transmission Characteristics | | |
| Data Telemetry | No | Yes |
| Data Transfer / Analysis<br>Software Interface | Wireless technology for data<br>transfer is not applied.<br><br>Software interface suitable for the<br>host computer environment. | Bluetooth technology and cellular<br>phone technology & software<br>interface suitable for the host<br>computer environment. |
| Performance Characteristics | | |
| Performance Safety<br>Standards Compliance | IEC 60601-1<br>IEC 60601-1-2<br>IEC 60601-2-47<br>ISO 10993-1<br>ANSI/AAMI EC12<br>ANSI/AAMI EC57 | IEC 60601-1<br>IEC 60601-1-2<br>IEC 60601-2-47<br>ISO 10993-1<br>ANSI/AAMI EC12<br>ANSI/AAMI EC57 |
| Documentation Level<br>(or Software Level of<br>Concern before 2023) | Enhanced Documentation | Moderate |
| Physician Report Output | Yes, printable, with analysis<br>metrics for recorded ECG signal | Yes, printable, with analysis<br>metrics for recorded ECG signal |

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#### HiCardi+ H100 510(k) Submission

## PERFORMANCE DATA

Verification and validation activities established the safety and performance characteristics of the subject device with respect to the predicate. The following performance data were provided in support of the substantial equivalence determination.

#### Sterilization and Shelf-Life Testing

The HiCardi+ H100 and its standard accessories are not sterilized and do not have a shelf-life.

#### Biocompatibility Testing

#### ECG electrode

The biocompatibility assessment for ECG electrode was performed, included in-vitro cytotoxicity, irritation and sensitization according to the ISO 10993-1 standard. Please refer to Section 15. Biocompatibility in this submission for details.

#### Software Verification and Validation Testing

Software verification and validation activities were performed in accordance with IEC 62304 and FDA's quidance, General Principles of Software Validation, and documentation is provides as recommended by FDA's quidance, Guidance for the Content of Premarket Submissions for Software in Medical Devices and Content of Premarket Submissions for Management of Cybersecurity in Medical Devices. Please refer to Section 16. Software in this submission for details.

#### Electrical Safety and Electromagnetic Compatibility (EMC) Testing

The HiCardi+ H100 Wearable ECG ambulatory recorder substantially has been tested in accordance with the IEC 60601-1, IEC 60601-1-11, ISO 60601-2-47 standards for safety and the IEC 60601-1-2 standard for EMC. Please refer to Section 17. Electromagnetic Compatibility and Electrical Safety in this submission for details.

#### Bench Testing

Bench tests were conducted to verify that the subject device met all design specifications as was Substantially Equivalent (SE) to the predicate devices. The test results demonstrated that the proposed device complies with the following test report:

- . General Safety (IEC 60601-1)
- . Electromagnetic Compatibility (IEC 60601-1-2)
- . Usability / Human factor (IEC 60601-1-6, IEC 62366-1)
- . Home Healthcare (IEC 60601-1-11)
- . Ambulatory ECG (IEC 60601-2-47)
- . Li-ion Rechargeable Battery (IEC 62133-2)
- . Protection against water and solid foreign objects (IEC 60529)
- . Shock & Vibration Test Report (IEC 60068-2-27, 2-64)
- Temperature and Pressure for Operation and Storage (IEC 60068-2-13. 2-39) .

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- . Packaging Performance (ISTA 3A)
- Biocompatibility (ISO 10993-1, -5, -10, -23)
- . Disposable ECG electrodes Performance (ANSI/AAMI EC12)
- . Software Verification and Validation (IEC 62304)
- . Validation of heart rate detection and development of arrhythmia detection algorithm (IEC 60601-2-47, EC57)

Compliance to applicable standards includes IEC 60601-1-2, IEC 60601-1-6, IEC 62366-1, IEC 60601-1-11, IEC 60601-2-47 (EC57), IEC 62133-2, IEC 60068-2-27, IEC 60068-2-27, IEC 60068-2-64, IEC 60068-2-13, IEC 60068-2-39, ISTA 3A, ISO 10993-1, -5, -10 -23, ANSI/AAMI EC12, IEC 62304 requirements.

The bench test report of this submission showed that substantial equivalence has demonstrated to be suitable for the subject device. Please refer to Section 18. Performance Testing - Bench in this submission for details.

## Animal Study

Animal performance testing was not required for this device.

## Clinical Study

Clinical data was reviewed to demonstrate the substantial equivalence of the subject device.

## CONCLUSIONS

The comparison and performance data presented above support a determination of substantial equivalence of the MEZOO CO., LTD., HiCardi+ H100 to its predicate device, the iRhythm Technologies, Inc., ZIO® SkyRunner (SR) Electrocardiogram (ECG) Monitoring Service.

The minor differences between the current subject device (MEZOO CO., LTD., HiCardi+ H100) and the predicate devices (iRhythm Technologies, Inc., ZIO® SkyRunner (SR) Electrocardiogram (ECG) Monitoring Service) do not adversely affect the safety or effectiveness.

Therefore, it is concluded that the HiCard+ H100 is substantially equivalent to the identified predicate devices.