The C2 NerveMonitor System is intended for intra-operative monitoring and stimulation for localization and identification of cranial and peripheral motor and mixed motor sensory nerves during surgery, including spinal cord and spinal nerve roots. The C2 NerveMonitor device with the integrated user interface is only allowed for the surveillance, documentation and functional test of motor nerves. It can be used as an additional helping tool during surgical procedures for diagnostic issues. Its basic functions are similar to those of an EMG diagnostic device Indications for C2 NerveMonitor System Monitoring Procedures include: Intracranial, Extracranial, Intratemporal, Extratemporal, Neck Dissections, Thoracic Surgeries, and Upper and Lower Extremities. Indications for C2 NerveMonitor System monitoring of Spinal procedures include: Degenerative Treatments, Pedicle Screw Procedures, Fusion Cages, Rhizotomy, Orthopedic Surgery, Open and Percutaneous Lumbar and Cervical Surgical Procedures and Thoracic Surgical Procedures. The system is not intended for monitoring life preserving functions. The system may not be used for diagnosing brain death.
Device Story
C2 NerveMonitor System is a multi-channel intraoperative neurophysiological monitor; connects patient electrodes; supplies electrical stimulus for evoked responses. Inputs: electrical signals from nerves via probes/electrodes. Operation: system delivers electrical stimulus; monitors EMG activity; provides video/audio output of signals. Used in OR by surgeons/staff. Output: waveform graphs on LCD display; audio amplification of EMG signals; data storage on USB. Clinical utility: assists in nerve localization/identification during surgery; helps prevent nerve damage. Benefits: real-time feedback during complex procedures; aids surgical decision-making.
Clinical Evidence
Bench testing only. No clinical data provided.
Technological Characteristics
Multi-channel neurophysiological monitor; 4/8 channels; bandwidth 0.5Hz-5kHz; signal gain 1-1000. Electrical stimulation: monophasic, square pulse, 200μs duration, constant current (0.01-25mA). Materials: stainless steel (patient contact), polypropylene (insulation). 8.4" LCD display. Connectivity: USB storage. Power: 100-240V. Safety: EN 60601-1, Type BF, Class I. Software: Windows XP Embedded.
Indications for Use
Indicated for intra-operative monitoring/stimulation to localize/identify cranial, peripheral motor, and mixed motor-sensory nerves during intracranial, extracranial, intratemporal, extratemporal, neck, thoracic, and extremity surgeries, including spinal procedures (e.g., degenerative treatments, pedicle screw, fusion, rhizotomy, orthopedic). Contraindicated for monitoring life-preserving functions or diagnosing brain death.
Regulatory Classification
Identification
An evoked response electrical stimulator is a device used to apply an electrical stimulus to a patient by means of skin electrodes for the purpose of measuring the evoked response.
Neurosign 800 8 Channel Motor Nerve Monitor with accessories (K980148)
Neurosign 800 Motor Motor Nerve Monitor with accessories (K964869)
Submission Summary (Full Text)
{0}------------------------------------------------
Image /page/0/Picture/0 description: The image shows handwritten text. The text at the top reads "K111647". Below that, the text reads "P. 1 of 8". The text appears to be written in black ink on a white background.
OCT - 6 2011
# 510(k) Summary 807.92(c)
# SPONSOR
### 807.92(a)(1)
Company Name:
inomed Medizintechnik GmbH
Company Address
Im Hausgruen 29 79312 Emmendingen, Germany
Telephone: Fax:
+49-7641-9414-0 +49-7641-9414-94
Contact Person: Telephone:
Saschka Busch +49-7641-9414-87
Summary Preparation Date: August 24, 2011
### DEVICE NAME
Trade Name: Common/Usual Name: Classification Name: Regulation Number: Product Code: Device Class:
807.92(a)(2) C2 NerveMonitor System Nerve Stimulator/Monitor Evoked Response Electrical Stimulator 21 CFR 882.1870 GWF, ETN Class II
### PREDICATE DEVICE
807.92(a)(3)
| Company | Product | 510(k) # |
|-----------------|------------------------------------------------------------------|----------|
| Medtronic Xomed | Nerve Integrity Monitor 3.0 | K083124 |
| Magstim | Nerve Avalanche Thyroid/EMG Motor<br>Nerve Monitor | K083242 |
| Magstim | Neurosign 400 Motor Nerve Monitor | K991583 |
| Medtronic Xomed | Xomed Ball-Tip Monopolar<br>Stimulation probe | K992869 |
| Magstim | Neurosign 800. 8 Channel Motor<br>Nerve Monitor with accessories | K980148 |
| Magstim | Neurosign 800 Motor Motor Nerve<br>Monitor with accessories | K964869 |
{1}------------------------------------------------
### DEVICE DESCRIPTION
### 807.92(a)(4)
The C2 NerveMonitor System is a multi-channel intraoperative neurophysiological monitor capable of connecting various styles of patient monitoring electrodes and supplying stimulus for evoked responses. The EMG activity monitoring console uses both video and audio output.
Responses monitored with the device may originate from operator applied stimulus or from direct or indirect mechanical stimulus occurring during the course of surgery.
The following probes and electrodes include a metal tip, an insulated elastic shaft and a profected electrical pin connector to attach them to the NerveMonitor:
| Type | Description |
|--------|----------------------------------------|
| 522610 | Microfork probe |
| 522603 | Bipolar concentric stimulation probe |
| 522605 | Bipolar BCS stimulation probe, bayonet |
| 525603 | Monopolar MS probe length 4.5cm angled |
| 525608 | Monopolar MS probe flexible |
| 530626 | 2 SDN electrodes |
| 530627 | SDN electrode |
| 530666 | Electrode 15 mm bipolar |
## DEVICE INTENDED USE
## 807.92(a)(5)
The C2 NerveMonitor System is intended for intra-operative monitoring and stimulation for localization and identification of cranial and peripheral motor and mixed motor sensory nerves during surgery, including spinal cord and spinal nerve roots. The C2 NerveMonitor device with the integrated user interface is only allowed for the surveillance, documentation and functional test of motor nerves. It can be used as an additional helping tool during surgical procedures for diagnostic issues. Its basic functions are similar to those of an EMG diagnostic device
Indications for C2 NerveMonitor System Monitoring Procedures include:
Intracranial, Extracranial, Intratemporal, Extratemporal, Neck Dissections, Thoracic Surgeries, and Upper and Lower Extremities.
Indications for C2 NerveMonitor System monitoring of Spinal procedures include:
Degenerative Treatments, Pedicle Screw Procedures, Fusion Cages, Rhizotomy, Orthopedic Surgery, Open and Percutaneous Lumbar and Cervical Surgical Procedures and Thoracic Surgical Procedures.
The system is not intended for monitoring life preserving functions.
The system may not be used for diagnosing brain death.
Section / Page 5-3
K 111647
{2}------------------------------------------------
# COMPARISON OF TECHNICAL CHARACTERISTICS
807.92(a)(6)
| Device | Predicate Device<br>Nerve Integrity<br>Monitor 3.0 | Predicate Device<br>Neurosign Avalanche<br>Thyroid/EMG Motor<br>Nerve Monitor | Predicate Device<br>Neurosign 400<br>Motor Nerve<br>Monitor | Subject Device<br>C2 NerveMonitor<br>System |
|---------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Manufacturer | Medtronic Xomed | Magstim | Magstim | inomed<br>Medizintechnik<br>GmbH |
| 510(k) Number | K083124 | K083242 | K991583 | N/A |
| Device Class | II | II | II | II |
| Product code | ETN, GWF | ETN | ETN | GWF, ETN |
| Description | NIM 3.0 is a multi-<br>channel<br>intraoperative<br>neurophysiological<br>monitor capable of<br>connecting various<br>styles of patient<br>monitoring<br>electrodes and<br>supplying electrical<br>stimulus for evoked<br>responses. | Motor Nerve Monitor,<br>based upon standard<br>computer<br>components, running<br>Windows XP<br>embedded operating<br>system; information is<br>provided to the<br>surgeon via a<br>waveform graph of<br>EMG activity, and<br>audio amplification of<br>this signal so that the<br>surgeon hears this as<br>he/she is operating | Motor Nerve<br>Monitor, based<br>upon proprietary<br>hardware and<br>software;<br>information is<br>provided to the<br>surgeon via a<br>waveform graph of<br>EMG activity, and<br>audio amplification<br>of this signal so<br>that the surgeon<br>hears this as<br>he/she is operating | C2 is a multi-<br>channel<br>intraoperative<br>neurophysiologic<br>al monitor<br>capable of<br>connecting<br>various styles of<br>patient<br>monitoring<br>electrodes and<br>supplying<br>electrical stimulus<br>for evoked<br>responses. |
| Intended Use | The NIM 3.0 is<br>intended for<br>locating and<br>identifying cranial<br>and peripheral<br>motor<br>and mixed motor-<br>sensory nerves<br>during surgery,<br>including spinal<br>cord and<br>spinalnerve roots.<br>The APS electrode<br>is an accessory<br>intended for<br>providing automatic<br>periodic stimulation<br>to nerves when<br>used with the<br>Medtronic Nerve<br>Monitoring<br>Systems. | Intra-operative<br>monitoring and<br>stimulation of cranial<br>and peripheral motor<br>nerves | Intra-operative<br>monitoring and<br>stimulation of<br>cranial and<br>peripheral motor<br>nerves | The C2 is<br>intended for intra-<br>operative<br>monitoring and<br>stimulation for<br>localization and<br>identification of<br>cranial and<br>peripheral motor<br>and mixed motor<br>sensory nerves<br>during surgery,<br>including spinal<br>cord and spinal<br>nerve roots. The<br>system can<br>provide an<br>automatic<br>periodic<br>stimulation of<br>nerves. |
{3}------------------------------------------------
| Device | Predicate Device<br>Nerve Integrity<br>Monitor 3.0 | Predicate Device<br>Neurosign<br>Avalanche<br>Thyroid/EMG<br>Motor Nerve<br>Monitor | Predicate Device<br>Neurosign 400<br>Motor Nerve<br>Monitor | Subject Device<br>C2 NerveMonitor<br>System with<br>accessories |
|-------------------------------------|---------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------|
| Hardware<br>(main unit) | unknown | Standard PC<br>components | Proprietary<br>microprocessor<br>design | Standard PC<br>components |
| Headbox<br>Bandwidth<br>Signal Gain | 4/8 Channel<br>15Hz - 1,85kHz ±<br>3db<br>unknown | 2/4 Channel<br>8Hz - 8kHz ± 3dB<br>500 | 4 Channel<br>10Hz - 5kHz ± 3dB<br>477 | 4/8 Channel<br>0.5Hz - 5kHz ± 3dB,<br>1-1000 |
| Software | unknown | Windows XP<br>Embedded | C++ proprietary<br>code | Windows XP<br>Embedded |
| Screen | Touch screen<br>256Hx256W | 15" colour touch<br>screen | 6"<br>electroluminescent<br>display | 8,4" LCD display |
| Method of<br>control | Touch Screen | Touch screen - all<br>controls via<br>software except<br>power ON/OFF | Controls via<br>dedicated buttons<br>or via software<br>using menus<br>selected using<br>front-panel buttons | Front-panel dedicated<br>soft keys, rotary knobs |
| Manner of<br>Stimulation | Electrical<br>stimulation via a<br>probe | Electrical<br>stimulation via a<br>probe | Electrical<br>stimulation via a<br>probe | Electrical stimulation<br>via a probe |
| Stimulation<br>Range | 0.01mA - 30mA | 0.05mA - 10mA | 0.05mA - 5mA | 0.01mA - 25mA |
| Stimulation<br>Type | Monophasic,<br>square pulse,<br>duration 50-250μs | Square wave,<br>negative edge,<br>200μs pulse width,<br>constant current | Square wave,<br>negative edge,<br>200μs pulse width,<br>selectable from 100<br>to 500μs, constant<br>current, constant<br>voltage | Monophasic, square<br>pulse, negative edge,<br>duration 200μs,<br>constant current |
| Stimulation<br>Frequency | 1Hz, 4Hz, 7Hz,<br>10Hz | 3 or 30Hz | 3 or 30Hz | 1 - 30Hz |
| Stimulation<br>Probes | Monopolar, bipolar | Monopolar, bipolar,<br>concentric | Monopolar, bipolar,<br>concentric | Monopolar, bipolar,<br>concentric |
| Electrodes | Cranial and<br>peripheral motor<br>and mixed-motor-<br>sensory monitoring | Laryngeal<br>electrode; needle<br>electrodes | Laryngeal<br>electrode; needle<br>electrodes | Cranial and peripheral<br>motor and mixed-<br>motor-sensory<br>monitoring |
| Training<br>Required for<br>Use | Yes; both for<br>surgeon and OR<br>staff | Yes; both for<br>surgeon and OR<br>staff | Yes; both for<br>surgeon and OR<br>staff | Yes; both for surgeon<br>and OR staff |
| Display and<br>Storage | Waveform Signals<br>displayed on<br>screen, Storage on<br>USB Storage<br>Device | Waveform signals<br>displayed on<br>screen; stimulated<br>responses may be<br>optionally<br>automatically | Waveform signals<br>displayed on<br>screen; individual<br>screens may be<br>stored in non-<br>volatile memory | Waveform signals<br>displayed on screen;<br>individual screens may<br>be stored in non-volatile<br>memory; Storage on<br>USB Storage Device |
Section / Page 5-5
风 111647
{4}------------------------------------------------
| | | recorded to disc | | |
|-------------------------|----------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------|-----------------------------------------------------------|
| Print<br>Capacity | Waveform data can<br>be printed to a<br>external printer | Waveform data and<br>patient information<br>can be printed<br>using the internal<br>thermal printer or<br>via an external<br>Letter sized inkjet<br>printer for the<br>generation of<br>reports using<br>stored data and<br>annotated<br>comments | Waveform data can<br>be printed to a<br>proprietary external<br>thermal printer | Waveform data can be<br>printed on an external<br>printer |
| Power | 100-240V 50/60Hz | 110/230V 50/60Hz | 110/230V 50/60Hz | 100-240V 50/60Hz |
| Electrical<br>Safety | EN 60601-1, Type<br>BF, Class I | EN60601-1; Type<br>BF, Class I | EN60601-1; Type<br>BF, Class I | EN 60601-1; Type BF,<br>Class I |
| Compliance<br>Standards | CE-Mark | CE Mark; EN ISO<br>13485 | CE Mark; BS EN<br>9001; EN ISO<br>13485 | CE Mark,<br>EN ISO 13485 |
## Accessories: Probes
…
| Device | Predicate Device<br>Nerve Integrity<br>Monitor 3.0 with<br>accessories | Predicate Device<br>Neurosign Avalanche<br>Thyroid/EMG Motor<br>Nerve Monitor with<br>accessories | Predicate Device<br>Neurosign 400/800<br>Motor Nerve<br>Monitor with<br>accessories | Subject Device<br>C2 NerveMonitor<br>System with<br>accessories |
|---------------------------------------|------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|
| Manufacturer | Medtronic Xomed | Magstim | Magstim | inomed<br>Medizintechnik<br>GmbH |
| 510(k) Number | K083124, K992869 | K083242 | K991583,<br>K980148, K964869 | N/A |
| Device Class<br>Product code<br>Probe | II<br>ETN, GWF<br>82-25401, 82-<br>25100 | II<br>ETN<br>3600-00, 3602-00 | II<br>ETN<br>3600-00, 3602-00 | II<br>GWF, ETN<br>522610, 522603,<br>522605, 525603,<br>525608 |
| Manner of<br>Stimulation | Electrical stimulation<br>via a probe | Electrical stimulation via a<br>probe | Electrical stimulation<br>via a probe | Electrical stimulation |
| Stimulation<br>Range | 0.01mA - 30mA | 0.05mA - 10mA | 0.05mA - 5mA | 0.01mA - 25mA |
| Stimulation<br>Type | Monophasic, square<br>pulse, duration 50-<br>250μs | Square wave, negative<br>edge, 200μs pulse width,<br>constant current | Square wave,<br>negative edge, 200μs<br>pulse width,<br>selectable from 100 to<br>500μs, constant<br>current, constant<br>voltage | Monophasic,<br>square pulse,<br>negative edge,<br>duration 200μs,<br>constant current |
| Stimulation<br>Frequency | 1Hz, 4Hz, 7Hz, 10Hz | 3 or 30Hz | 3 or 30Hz | 1 - 30Hz |
| Stimulation<br>Probes | monopolar, bipolar | monopolar, bipolar,<br>concentric | monopolar, bipolar,<br>concentric | bipolar, concentric |
| Probe design | - tool holder<br>- touch proof | -tool holder<br>-touch proof connectors | -tool holder<br>- touch proof | - tool holder<br>- touch proof |
Section / Page 5-6
亿 川b47
)
{5}------------------------------------------------
| Device | Predicate Device<br>Nerve Integrity<br>Monitor 3.0 with<br>accessories | Predicate Device<br>Neurosign Avalanche<br>Thyroid/EMG Motor<br>Nerve Monitor with<br>accessories | Predicate Device<br>Neurosign 400/800<br>Motor Nerve<br>Monitor with<br>accessories | Subject Device<br>C2 NerveMonitor<br>System with<br>accessories |
|-----------------------------------|---------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------|
| | connectors<br>- cable assembly | - cable assembly | connectors<br>- cable assembly | connectors<br>- cable assembly |
| Probe<br>Dimensions | - cable assembly<br>- types: 1 / 64 mm<br>electrode<br>length | - 100 mm electrode<br>length | - 100 mm electrode<br>length | - cable assembly<br>- types:<br>1/45/85/130 mm<br>electrode<br>length |
| | - types: 0.6/1.1 mm<br>diameter | - types: 0.4/0.6 mm tip<br>diameter | - types: 0.4/0.6 mm<br>tip diameter | - types:<br>0.4/0.5/0.65/1.4<br>mm diameter<br>-angled |
| Tip Geometry | - fork electrode,<br>round tip, angled<br>bayonet type | - hemispherical tip,<br>bull's eye electrode,<br>straight, blunt tip | - hemispherical tip,<br>bull's eye electrode,<br>straight, blunt tip | - fork electrode,<br>hemispherical tip,<br>bull's eye<br>electrode, straight,<br>blunt tip round tip,<br>angled bayonet<br>type, straight, blunt<br>tip |
| Patient<br>contacting<br>material | - stainless steel | - stainless steel | - stainless steel | - stainless steel |
| Insulation<br>Material | Polypropylene | Polypropylene | Polypropylene | Polypropylene |
| Electrical<br>Insulation | Electrical insulation<br>on all surfaces not<br>intended to provide<br>electrical contact with<br>the patient | Electrical insulation on all<br>surfaces not intended to<br>provide electrical contact<br>with the patient | Electrical insulation<br>on all surfaces not<br>intended to provide<br>electrical contact with<br>the patient | Electrical<br>insulation on all<br>surfaces not<br>intended to provide<br>electrical contact<br>with the patient |
| Accessories: Electrodes | | | | |
| Device | Predicate Device<br>Nerve Integrity<br>Monitor 3.0 with<br>accessories | Predicate Device<br>Neurosign Avalanche<br>Thyroid/EMG Motor<br>Nerve Monitor with<br>accessories | Predicate Device<br>Neurosign 400/800<br>Motor Nerve<br>Monitor with<br>accessories | Subject Device<br>C2 NerveMonitor<br>System with<br>accessories |
| Manufacturer | Medtronic Xomed | Magstim | Magstim | inomed<br>Medizintechnik<br>GmbH |
| 510(k) Number | - | K083242 | K991583,<br>K980148, K964869 | N/A |
| Device Class | - | II | II | II |
| Product code<br>Electrodes | - | ETN<br>1699-00, 1705-00 | ETN<br>1699-00, 1705-00 | GWF, ETN<br>530626, 530627,<br>530666 |
| 510(k) Number | - | K083242 | K991583,<br>K980148, K964869 | To be defined |
| Electrode type | - | needle electrodes | needle electrodes | needle electrodes |
| Electrode<br>design | - | - tool holder<br>-touch proof connectors<br>- cable assembly | - tool holder<br>-touch proof connectors<br>- cable assembly | -PP tool holder<br>-touch proof connectors<br>- cable assembly |
| Probe<br>Dimensions | - | - needle 20 mm<br>- 0.45 mm diameter | - needle 20 mm<br>- 0.45 mm diameter | - needle 15/20 mm<br>- 0.45/5 mm<br>diameter |
| Geometry | - | - straight, needle tip | - straight, needle tip | - handle 20 mm<br>- straight,<br>45° angled<br>electrode, ground<br>electrode straight,<br>needle tip |
| Patient<br>contacting<br>material | - | - stainless steel | - stainless steel | - stainless steel |
| Insulation<br>Material | - | Polypropylene | Polypropylene | Polypropylene |
| Electrical<br>insulation | - | Electrical insulation on all<br>surfaces not intended to<br>provide electrical contact<br>with the patient | Electrical insulation<br>on all surfaces not<br>intended to provide<br>electrical contact<br>with the patient | Electrical insulation<br>on all surfaces not<br>intended to provide<br>electrical contact<br>with the patient |
. Section / Page 5-7
K111647
{6}------------------------------------------------
# Accessories: Electrodes
Section / Page 5-8 从111647
{7}------------------------------------------------
# NONCLINICAL AND CLINICAL TEST
807.92(b)
# SAFETY and EFFECTIVENESS
Preclinical testing verified the design of this device and that all specified requirements were fulfilled. The C2 NerveMonitor and all corresponding accessories are similar in their risks and benefits, as well as their manner of performance, to the predicate devices listed.
### CONCLUSION
### 807.92(b)(3)
The C2 NerveMonitor System with accessories are similar to the predicate devices in part or in whole in:
- . intended use, .
- materials and .
- technological characteristics .
The C2 NerveMonitor System introduces no new questions concerning safety and efficacy.
Section / Page 5-9
{8}------------------------------------------------
Image /page/8/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" arranged around the perimeter. Inside the circle is an abstract symbol resembling an eagle or bird in flight, composed of three stylized, curved strokes.
Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002
Inomed Medizintechnik GMBH c/o Mr. Saschka Busch IM Hausgruen 29 Emmendingen Germany 79312
- 6 2311 ೧೮೯
Re: K111647
Trade/Device Name: C2 NerveMonitor System Regulation Number: 21 CFR 882.1870 Regulation Name: Evoked Response Electrical Stimulator Regulatory Class: Class II Product Code: GWF, ETN Dated: August 30, 2011 Received: September 2, 2011
Dear Mr. Busch:
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 (reporting of medical
{9}------------------------------------------------
device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set device-related adverse overlis) (21 CFR Part 820); and if applicable, the electronic forum in the quality systems (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 11 you desire specific davide to: your von vernices/CDRH/CDRHOffices/usm115809.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 nove the regardions 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 Tou may obtain other generers, 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,
Ru. Then. h
Malvina B. Eydelman, Ma Director Division of Ophthalmic, Neurological, and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
{10}------------------------------------------------
# Indications for Use Statement
510(k) Number (if known): K | | | | 247
Device Name: C2 NerveMonitor System with accessories
Indications for Use:
The C2 NerveMonitor System is intended for intra-operative monitoring and stimulation for localization and identification of cranial and peripheral motor and mixed motor sensory nerves during surgery, including spinal cord and spinal nerve roots. The C2 NerveMonitor device with the integrated user interface is only allowed for the surveillance, documentation and functional test of motor nerves. It can be used as an additional helping tool during surgical procedures for diagnostic issues. Its basic functions are similar to those of an EMG diagnostic device
Indications for C2 NerveMonitor System Monitoring Procedures include:
Intracranial, Extracranial, Intratemporal, Extratemporal, Neck Dissections, Thoracic Surgeries, and Upper and Lower Extremities.
Indications for C2 NerveMonitor System monitoring of Spinal procedures include:
Degenerative Treatments, Pedicle Screw Procedures, Fusion Cages, Rhizotomy, Orthopedic Surgery, Open and Percutaneous Lumbar and Cervical Procedures and Thoracic Surgical Procedures.
The system is not intended for monitoring life preserving functions.
The system may not be used for diagnosing brain death.
Prescription Use (Part 21 CFR 801 Subpart D) Over-The-Counter Use (21 CFR 807 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)
AND/OR
Concurrence of CDRH, Office of Device Evaluation
**Prescription Use**
**(Per 21 CFR 801.109)**
*(Division Sign-Off)*
Division of Ophthalmic, Neurological and Ear, Nose and Throat Devices
510(k) Number K111647
Section / Page 4-2
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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.