MODIFICATION TO NICO WITH MARS, MODEL 7300

{0}------------------------------------------------ Respironics Novametrix LLC NICO with MARS, Model 7300: NICO to Esprit Communications Interface Special 510(k) - Device Modification K041450 ## Section iv - 510 (k) Summary [ Refer to 21 C.F.R § 807.92 ] - Respironics Novametrix, LLC Submitted by: 5 Technology Drive Wallingford, CT 06492 - Contact Person: Kevin Mader Q.A. and Requlatory Manager Phone: 203-697-6466 5/28/2004 Date Prepared: NICO with MARS, Model 7300, monitor with NICO to Esprit Communications Proprietary Name: Interface multiparameter monitor (monitoring spirometer, CO2 monitor, pulse oximeter and Common Name: cardiac output monitor with partial rebreathing valve). - Class II, 21 C.F.R. 868.1850, 868.1400, 870.2700, 868.5675 Classification Name: NICO with MARS, Model 7300 [510(k) K030886] Predicate Device: The NICO with MARS, Model 7300, is a patient monitor capable of monitoring a Description of Device: patient's cardiac output, spirometry, carbon dioxide, and functional oxygen saturation and pulse rate. In addition, the Model 7300 is capable of communicating with a variety of patient information systems, including the Respironics Esprit ventilator. Intended Use of the Device: This monitor has the same intended use as the predicate monitor. For reference, the intended use of the NICO with MARS, Model 7300, monitor is to provide: - cardiac output monitoring via the method of partial rebreathing in adult ◆ patients receiving mechanical ventilation during general anesthesia and in the intensive care unit (ICU). - spirometric and carbon dioxide monitoring in neonatal, pediatric and . adult patients during general anesthesia and in the intensive care unit (ICU) and the emergency department (ED). Separate combination CO2/flow sensors are provided for adult, pediatric and neonatal use. - continuous, non-invasive monitoring of functional arterial oxygen ◆ saturation and pulse rate in neonatal, pediatric and adult patients during both no motion and motion conditions and for patients who are well or poorly perfused during general anesthesia and in the intensive care unit (ICU) and the emergency department (ED). The use of the NICO with MARS, Model 7300, monitor for cardiac output monitoring is contraindicated in patients in which a small rise (3-5 mmHg) in their arterial partial pressure of CO2 level cannot be tolerated. {1}------------------------------------------------ Respironics Novametrix LLC Respironics Novalnetix EEO NICO with MARS, Model 7300: NICO to Esprit Communications Interface Special 510(k) - Device Modification Technological Characteristics: The NICO with MARS monitor, Model 7300, uses flow seller ansocration and listics. The NICO with MARO monitor, filoseners and as such the pressure drop considered to be a fixed only of the flow. Combination CO./flow sensors are is proportional to the oqual o that are tailored for neonates, pediatric patients and adults. > The NICO with MARS monitor, Model 7300, uses an infrared absorption (IR) technique for monitoring CO2. The principle is based on the fact that CO2 technique for monitoring oo in energy of specific wavelengths, with the amount molecules absorb infrared light the CO2 concentration Solid state or energy absorbed boing an Soundstat) use a beam splitter to simultaneously CO2 sensors (such as the Ouphociaches) one which is absorbed by CO2 and one measure the in the wavelength which is not absorbed by CO2 is related to the which is not. "The wavelengan which is not to her light source is electronically pulsed intensity of the IR light 50aroot. Theo, with a chopper wheel) in order to eliminate effects of changes in electronic components. > The NICO with MARS monitor, Model 7300, measures oxygen saturation and The NOO with sensors that contain red and infrared light sources. Since oxygen pulse fate with sensors that containts of light at each wavelength (red and infrared) as compared with unsaturated blood, the amount of light absorbed at infrarca) as compared while and pulse can be used to calculate oxygen each wavelength by the blood from red (660 nm) and infrared (940 nm) LEDs is beamed through a pulsating vascular bed - the patient's finger, ear or toe, for example. The remaining light energy not absorbed by the sample cell reaches a example. The remaining light one of the sensor. The signal received by the photodiode is split into its red and infrared components, sampled, software photode to bplit into tea roumerical value for oxygen saturation and pulse rate and as a waveform, the plethysmogram. > Functional saturation represents the amount of oxyhemoglobin as a percentage r unctional Saturation reprobe sygenated. Dysfunctional hemoglobin (COHb and METHb) are not included in the measurement of functional saturation. Pulse rate is calculated by measuring the time interval between the peaks of the infrared light waveform. The NICO with MARS must be used in conjunction with the Novametrix SuperBright™ series of oxygen saturation sensors. MARS technology uses the computational power of digital signal processing to replace the pulse rate interval and rate-based decision tree algorithm of prior devices with a more robust frequency-based algorithm. A variation on the traditional rebreathing methods, the non-invasive differential Fick partial re-breathing technique is used in the NICO with MARS monitor. The change in VCO2 and the change in end-tidal CO2 in response to a change in ventilation is used to determine pulmonary capillary blood flow. This value is then corrected for the effect of shunt to determine cardiac output. The NICO with MARS monitor communicates with external devices via bidirectional serial communications. Essentially the serial port communicates diroundly bendrums of flow, pressure and CO2 and error message strings comprised of a mix of ASCII characters and scaled binary digits. Analog outputs are also provided for connections to chart recorders and other equipment. Supported communication interfaces include ASC11 character output, equipmont. Oopinion, Philips VueLink/Viridia, Spacelabs Flexport, Nellcor Model N-395, and the Respironics Esprit Ventilator. The monitor is also capable of printing trend graphs to an H.P .- compatible printer. {2}------------------------------------------------ Public Health Service Image /page/2/Picture/2 description: The image shows a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the edge. Inside the circle is a symbol consisting of three stylized, curved shapes that resemble a person. The symbol is black and the background is white. JUN 1 8 2004 Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850 Mr. Kevin Mader QA and Regulatory Manager Respironics Novametrix, LLC 5 Technology Drive Wallingford, CT 06492 Re: K041450 Trade/Device Name: NICO with MARS, Model 7300 Regulation Number: 868.1400 Regulation Name: Carbon Dioxide Gas Analyzer Regulatory Class: II Product Code: CCK Dated: May 28, 2004 Received: June 1, 2004 Dear Mr. Mader: We have reviewed your Section 510(k) premarket notification of intent to market the device we nave teviewed your soccion or career is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate 10) use stated in the encreativent of the enactment date of the Medical Device Amendments, or to Conimeres proc to May 20, 1978, are eccordance with the provisions of the Federal Food, Drug, devices that have been require approval of a premarket approval application (PMA). alla Costietic 7ter (71ct) market the device, subject to the general controls provisions of the Act. The 1 ou may, therefore, manel as tees, as tees, and include requirements for annual registration, listing of general controls pro resuring 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 If your device is classified (600 a0070) in. 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 be found in the Code of Fouctal oncerning your device in the Federal Register. Please be advised that FDA's issuance of a substantial equivalence determination does not mean Please be advised that I Dri 3 issuance or our device complies with other requirements of the Act that I DA has made a acted regulations administered by other Federal agencies. You must {3}------------------------------------------------ Page 2 – Mr. Kevin Mader comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); 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. This letter will allow you to begin marketing your device as described in your Section 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), please contact the Office of Compliance at (301) 594-4646. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). 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) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html. Sincercly vours. Chiu Lin, Ph.D. Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health Enclosure {4}------------------------------------------------ Respironics Novametrix LLC Respironics Novament LLC NICO with MARS, Model 7300: NICO to Esprit Communications Interface Special 510(k) - Device Modification ## Section ii Indications for Use K 041450 510(k) Number (if known): Device Name: NICO with MARS, Model 7300 with NICO to Esprit Communications Interface Indications for Use: The intended use of the NICO with MARS, Model 7300, monitor is to provide: - cardiac output monitoring via the method of partial rebreathing in adult patients receiving . cardiac output monitoring wa the methou of partial robreaking mechanical ventilation during general anesthesia and in the intensive care unit (ICU). - spirometric and carbon dioxide monitoring in neonatal, pediatic and addit patients during general . spirometric and carbort dioxide montoning in noonatel, penergency department (ED). Separate arresthesia and in the intensive oans are provided for adult, pediatric and neonatal use. - continuous, non-invasive monitoring of functional arterial oxygen saturation and pulse rate in . continuous, flon-invasive monitoring of function and motion and motion conditions and for neonatal, pediathic and adult patients during both he motion the intensive care unit (ICU) and the emergency department (ED). The use of the NICO with MARS, Model 7300, monitor for cardiac output monitoring is contraindicated in The Use of the NICO will MARO, Model 1 000, monten as a last al pressure of CO2 level cannot be tolerated. Prescription Use X (Per 21 CFR 801 Subpart D) AND/OR Over-The -Counter Use (21 CFR 807 Subpart C) (PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE) toa G. Harris thesiology, General Hospital, 510(k) Number. 501457