The Trex HD is an Electroencephalograph intended to be used to acquire, display, store and archive electroencephalographic signals, intended for electroencephalographic (EEG) or level 1-2 polysomnographic (PSG) recordings. The Trex HD amplifier is designed to be used with Natus NeuroWorks™or Natus SleepWorks™ software.
Device Story
Trex HD is an electroencephalograph system for EEG and level 1-2 PSG recordings. It consists of a headbox with built-in amplifiers, A/D converters, digital signal processors, and storage. Inputs include 24 referential, 2 DC, 3 differential, and oximeter/photic connections. A new Video Interface Box enables wireless synchronization between EEG signals and external camcorder video frames via Bluetooth V2.0 EDR. The system connects to a computer running Natus NeuroWorks or SleepWorks software via USB. Used in clinical settings by healthcare professionals; the wireless video interface allows increased mobility for the camcorder within the recording room compared to the predicate. Output is displayed and stored on the host computer for clinical review, aiding in the diagnosis and monitoring of neurological or sleep-related conditions.
Clinical Evidence
No clinical data. Substantial equivalence was demonstrated through non-clinical bench testing, including signal quality verification, functionality verification, and video synchronization verification, alongside compliance with electrical safety (IEC 60601-1) and EMC standards.
Technological Characteristics
Headbox with 24 referential, 2 DC, and 3 differential inputs; 16-bit A/D resolution; sampling rates 200/256/512 Hz. Wireless interface uses Bluetooth V2.0 EDR (2.402-2.480 GHz, 8dBm, GFSK). Powered by 2 AA batteries. Connectivity via USB 2.0 to host PC. Software-selectable channel test signal. Compliant with IEC 60601-1, IEC 60601-2-26, and IEC 60601-1-2.
Indications for Use
Indicated for patients requiring electroencephalographic (EEG) or level 1-2 polysomnographic (PSG) recordings for signal acquisition, display, storage, and archiving.
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.
{0}------------------------------------------------
Image /page/0/Picture/0 description: The image shows the logo for "xltek", which is written in lowercase letters. Above the word "xltek" is a black graphic that looks like a mountain range. Below the word "xltek" is the phrase "a division of natus".
# 510K Summary
Date: Dec 27, 2013
FEB 1 4 2014
Submitted by: Natus Medical Incorporated DBA Excel-Tech Ltd. (XLTEK) 2568 Bristol Circle Oakville, Ontario Canada L6H 5S1
Contact Person: Sanjay Mehta Quality and Regulatory affairs Manager Natus Medical Incorporated Tel.: (905) 829-5300 ext 388 Fax .: (905) 829-5304 E-mail: sanjay mehta@natus.com
Propietary Name: Trex_HD
Common Name: Electroencephalograph
Classification Name; Full-montage standard electroencephalograph
Product code: GWQ, OLV
Device Class: II
Predicate Device: Trex (K042150)
#### Prior Submissions for the same device:
We reference K042150 as the predicate device only. There are no other submissions for the same device as presented here or any other communication from FDA related to it.
#### Description of the Modified (subject) device
The Trex HD headbox is similar to the cleared Trex headbox (K042150). It contains a complete data acquisition system that has built-in amplifiers, A/D Converters, Digital Signal Processors, and storage devices. Trex HD, as the predicate device, is composed of
- 24 Referential Inputs 1
- 2 DC Inputs
- 3 Differential Inputs
- Oximeter / Photic Connection 4
Same as predicate Same as predicate Same as predicate Same as predicate Same as predicate
- 5 Patient Event Switch Connection
{1}------------------------------------------------
Image /page/1/Picture/0 description: The image shows the logo for "xltek, a division of natus". The logo consists of a stylized "X" shape to the left of the word "xltek". Below the word "xltek" is a horizontal line, and below that is the text "a division of natus". The logo is simple and professional.
- 0
7 USB Connection
Video Interface box
Same as predicate New
Image /page/1/Picture/5 description: The image shows a Natus Xltek Trex HD device with several labeled components. The labels point to various parts of the device, including indicators for 'study in progress', connector ports, and electrode input locations. The device also features a 'Patient event' section with labeled DC inputs and a USB port.
| | Trex HD Amplifier |
|----|-----------------------------------|
| 1 | Power LED |
| 2 | Status LED |
| 3 | Oximeter / Photic Connection |
| 4 | Reference Input (forward) |
| 5 | Common Input (rear) |
| 6 | 24 Referential Inputs (two rows) |
| 7 | Patient Event Switch Connection |
| 8 | DC Inputs (rear row) |
| 9 | Differential Inputs (forward row) |
| 10 | USB Connection (bottom) |
#### Trex HD Video Interface Features
The wireless adapter is a part of Trex HD system. It connects to Camera (Camcorder) via LANC port. It is used to synchronize video frames with the EEG study recorded in Trex HD. It communicates wirelessly with the headbox and can store video synchronization internally in non-volatile memory in case the wireless communication is not possible.
{2}------------------------------------------------
Image /page/2/Picture/0 description: The image shows the logo for "xltek", which is described as a division of natus. The logo features a small triangle pointing upwards to the left of the word "xltek". The text is in a simple, sans-serif font and is black and white.
Image /page/2/Picture/2 description: The image shows a black Natus monitor. The monitor is rectangular with rounded edges and has a silver screw on top. The word "Natus" is printed in white on the side of the monitor.
Top view of the Video Interface Box
Image /page/2/Picture/4 description: The image shows a black Xltek Trex HD video interface device. The device has a clip on the top and a label with the text "REF 0057741". The device also has the words "Xltek Trex HD Video Interface" printed on the side. The device is sitting on a gray surface.
Bottom view of the Video Interface Box
| | Wireless Transceiver - F2M03GLA |
|---------------------|---------------------------------|
| Protocol | Bluetooth V2.0 EDR |
| Operating frequency | 2.402 - 2.480 GHz |
| Transmission power | 8dBm |
| Modulation | GFSK |
| FCCID | R47F2M03GL |
{3}------------------------------------------------
Image /page/3/Picture/0 description: The image shows the Xitek logo on the left side. On the right side, it shows the text "K131266: TREX HD", "510K SUMMARY", and "PAGE 4 of 11". The text indicates that this is page 4 of 11 of the 510K summary for TREX HD with the ID K131266.
### Hardware Set Up
The Trex HD headbox is designed to work with an XLTEK computer system running NeuroWorks (K090019) or SleepWorks software (K090277).
A camcorder can be used to record video. A (Trex HD) Video Interface Box is needed in order to synchronize video recording (on the camcorder) and EEG recording (on the Trex HD headbox).
Image /page/3/Figure/4 description: The image shows a diagram of a medical device setup. The diagram includes an XLTEK DT Computer connected via a USB to mini-USB cable to a camcorder and a USB 2.0 cable to a Trex HD Headbox. The camcorder is also connected to the Trex HD Video Interface Box via a LANC cable, and the Trex HD Headbox is connected to Patient Leads, with optional connections to a Patient Event Switch, Oximeter, and Photic Simulator.
{4}------------------------------------------------
#### Device-patient interaction. Accessories List:
The table below lists all accessories to the subject device. Accessories (1) to (8) enter in contact with the patient. Accessories (1) to (8) are to be connected at different regions of the scalpfface and body as illustrated on the image below. These sensors guarantees acquisition of the physiological signals and passively transfer them to the headbox. Characteristics of the sensors vary and are described (cleared) under their respective 510K submissions (see table).
Image /page/4/Figure/3 description: This image shows a diagram of a polysomnography (PSG) setup, which is a sleep study. The diagram includes various sensors attached to a person, such as EEG disc electrodes, body position sensors, respiratory effort sensor, and pulse oximeter sensor. The sensors are connected to a Trex HD Headbox, which is connected to a computer and other devices such as a camcorder and photic stimulator. A table provides descriptions and 510K numbers for the different components of the PSG setup.
{5}------------------------------------------------
Image /page/5/Picture/0 description: The image shows the text "K131266: TREX_HD 510K SUMMARY PAGE 6 of 11". The text is centered on the page. The text is in a sans-serif font. The text is black.
Image /page/5/Picture/1 description: The image shows the words "Indications for Use" in bold black font. The words are stacked on top of each other. The words are centered on the page.
The Trex HD is an Electroencephalograph intended to be used to acquire, display, store and archive electroencephalographic signals, intended for electroencephalographic (EEG) or level 1-2 polysomnographic (PSG) recordings. The Trex HD amplifier is designed to be used with Natus NeuroWorks™or Natus SleepWorks™ software.
| | Subject Device | Predicate Device | Comment |
|--------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| | Trex HD | Trex (K042150) | |
| Specification | Value | | |
| Indications for Use | The Trex HD is an<br>Electroencephalograph<br>intended to be used to<br>acquire, display, store and<br>archive<br>electroencephalographic<br>signals, intended for<br>electroencephalographic<br>(EEG) or level 1-2<br>polysomnographic (PSG)<br>recordings. The Trex HD<br>amplifier is designed to be<br>used with Natus<br>NeuroWorks™ or Natus<br>SleepWorks™ software. | The XLTEK TREX is<br>intended to be used as an<br>electroencephalograph: to<br>acquire, digitized, store<br>and archive<br>electroencephalographic<br>signals. | New<br>device<br>IFU<br>includes<br>reference<br>to PSG<br>recordings<br>. These<br>type of<br>recordings<br>, although<br>used for a<br>different<br>purpose<br>compared<br>to EEG<br>only, it is<br>technically<br>similar to<br>multiple<br>parameter<br>EEG<br>recordings<br>. No<br>impact on<br>safety/effe<br>ctiveness<br>of the<br>device |
| Technological Characteristics | | | |
| Patient Electrical Connections | | | |
| 24 Referential Inputs<br>(+ ground, +) | +/- 10 mV | +/- 10 mV | Same |
| | Subject Device<br>Trex HD | Predicate Device<br>Trex (K042150) | Comment |
| Specification | Value | | |
| reference) | | | |
| Resolution | 16 bit A/D | 16 bit A/D | Same |
| 4 Differential Inputs | +/- 10 mV | +/- 10 mV | Same |
| Resolution | 16 bit A/D | 16 bit A/D | Same |
| Common Mode<br>Rejection Ratio | -113 dB @ 60 Hz | -113 dB @ 60 Hz | Same |
| DC Removal | Infinite | Infinite | Same |
| Common Mode Input<br>Impedance | > 10 MOhms | > 10 MOhms | Same |
| Input Noise (peak to<br>peak) | 6.4 μV | 6.4 μV | Same |
| Input Noise (RMS) | 1.08 μV | 1.08 μV | Same |
| Input Bias Current | < 10 pA | < 10 pA | Same |
| Channel Crosstalk | 56 dB | 56 dB | Same |
| Electrode Connections<br>(including common<br>input) | Safety Touch | Safety Touch | Same |
| 4 Non-Isolated DC<br>Inputs | +/- 5 Volts | +/- 5 Volts | Same |
| Resolution | 16 bit A/D | 16 bit A/D | Same |
| Impedance (kOhm) | <2.5, <5, <10, <25 | <2.5, <5, <10, <25 | Same |
| Channel Test Signal | Software selectable | Software selectable | Same |
| Sampling Frequency | 200 Hz, 256 Hz, 512 Hz | 200 Hz, 256 Hz, 512 Hz | Same |
| | Physical Capabilities | | |
| | Subject Device<br>Trex HD | Predicate Device<br>Trex (K042150) | Comment |
| Specification | Value | | |
| Oximeter/Photic Stim<br>Connection | Yes (either/or) | Yes (either/or) | Same |
| Patient Event Button | Yes | Yes | Same |
| Interface Cable | USB 2.0 | USB 2.0 | Same |
| USB Cable Length | Standard Length: 68<br>inches (~ 147 cm)<br>Maximum Length: 15 feet<br>(4.6 m) | Standard Length: 68<br>inches (~ 147 cm)<br>Maximum Length: 15 feet<br>(4.6 m) | |
| | Subject Device<br>Trex HD | Predicate Device<br>Trex (K042150) | Comment |
| Specification | Value | | |
| Main Unit Weight (g) | 300 | 300 | Same |
| Main Unit Size (cm) | 10 x 15.5 x 2.5 (h x w x d) | 10 x 15.5 x 2.5 (h x w x d) | Same |
| Batteries | 2 AA | 2 AA | Same |
| | Safety | | |
| Leakage Current | <10 μA with 240 VAC on<br>all electrode inputs | <10 μA with 240 VAC on<br>all electrode inputs | Same |
| | Operating Parameters | | |
| Operating<br>Environmental Limits | Temperature: 10°C to<br>40°C<br>Humidity 30%-75%<br>Atmospheric Pressure: 700<br>hP-1060 hP | Temperature: 10°C to<br>40°C<br>Humidity 30%-75% non-<br>condensing<br>Atmospheric Pressure:<br>700 hP-1060 hP | Same |
| Transport and Storage<br>Temperature Range | - 40°C to 70°C | - 40°C to 70°C | Same |
| Transport and Storage<br>Humidity Range | 10-100%, including<br>condensation | 10-100%, non-<br>condensing | Same |
| Transport and Storage<br>Atmospheric Pressure<br>Range | 500 hPa-1060 hPa | 500 hPa-1060 hPa | Same |
| | Wireless Transceiver - F2M03GLA | | |
| Protocol | Bluetooth V2.0 EDR | Not Available | |
| Operating frequency | 2.402 - 2.480 GHz | Not Available | |
| Transmission power | 8dBm | Not Available | |
| Modulation | GFSK | Not Available | |
| FCCID | R47F2M03GL | Not Available | |
## Comparison to Predicate Device
{6}------------------------------------------------
Image /page/6/Picture/0 description: The image shows the logo for "xltek", with a stylized "X" symbol to the left of the text. Below the text is the phrase "a division of natus" in a smaller font. The logo is simple and uses a sans-serif font.
{7}------------------------------------------------
Image /page/7/Picture/0 description: The image shows the logo for "xltek", which is a division of natus. The logo features a stylized "X" symbol to the left of the word "xltek". The word "xltek" is written in a bold, sans-serif font. Below the word "xltek" is the phrase "a division of natus" in a smaller font.
The only difference between the subject device and the predicate (K042150) is the addition of the Video Interface box. The Video Interface box is intended to allow time synchronization (via wireless communication) between video images recorded in a separate camcorder and the physiological signals recorded on the Trex_HD headbox.
The wireless communication capability has been added to give flexibility for data acquisition. On the cleared version of the device (K042150) the camcorder could only be connected by cable to the computer imposing restrictions in the video acquisition. Now, with the subject device, the camcorder can be moved around the recording room giving more flexibility for the recording set up. The addition of this part to the subject device has no impact on safety or effectiveness of the subject device compared to the predicate, as demonstrated by the results of extensive testing.
{8}------------------------------------------------
Image /page/8/Picture/0 description: The image shows the logo for "xltek, a division of natus". The logo consists of a stylized "X" symbol to the left of the text "xltek". Below the text is the phrase "a division of natus" in a smaller font size. The logo is simple and modern, with a focus on the company name.
### Brief Summary of Performance Tests
Non-clinical:
Testing of the Natus Trex_HD was performed in compliance with Natus Corporation design control process. Testing included:
| Test | Results |
|------------------------------------------|---------|
| Trex HD Signal Quality Verification Test | Pass |
| Trex Functionality Verification Test | Pass |
| Video Synchronization Verification Test | Pass |
The device is in compliance with the following industrial standards
#### Safety Standard of Compliance and normative references
| Standards | Title |
|---------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------|
| CAN/CSA C22.2 No 601.1-M90<br>UL 60601-1:2003<br>IEC 60601-1:1988 + A1:1991 +<br>A2:1995 (EN 60601-1:1990<br>+A1:1992 +A2:1995) | Medical Electrical Equipment Part 1: General<br>Requirements for Safety |
| CAN/CSA C22.2 No. 60601-2-26-<br>04<br>IEC 60601-2-26: 2002 (EN<br>60601-2-26:2003) | Medical Electrical Equipment - Part 2-26: Particular<br>Requirements for the Safety of Electroencephalographs |
| CAN/CSA C22.2 No. 60601-1-4-<br>02<br>IEC 60601-1-4: 1996 + A1: 1999<br>(EN 60601-1-4:2001) | Medical Electrical Equipment - Part 1-4: General<br>Requirements for Safety - Collateral Standard:<br>Programmable Electrical Medical Systems |
| CAN/CSA C22.2 No. 60601-1-6-<br>05<br>IEC 60601-1-6: 2004 (EN 60601-<br>1-6:2004) | Medical Electrical Equipment - Part 1-6: General<br>requirements for safety - Collateral Standard: Usability |
| CAN/CSA C22.2 No. 60601-1-1-<br>02<br>IEC 60601-1-1: 2000 (EN 60601-<br>1-1:2001) | Medical Electrical Equipment - Part 1-1: General<br>Requirements for Safety - Collateral Standard: Safety<br>Requirements for Medical Electrical Systems |
#### EMC Standard of Compliance and normative references
| Standards | Title |
|-------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------|
| IEC 60601-1-2:2001 +A1:2004 /<br>EN 60601-1-2:2001 +A1:2006 | Medical Electrical Equipment Part 1-2:General<br>Requirements for Safety - Collateral Standard:<br>Electromagnetic Compatibility - Requirements and<br>Tests |
{9}------------------------------------------------
| Image: logo | xltek |
|---------------------|-------|
| a division of natus | |
| IEC 61000-4-2:2008 / EN 61000-<br>4-2:2009 | Electromagnetic Compatibility (EMC) Part 4-2: Testing<br>and Measurement Techniques - Electrostatic<br>Discharge Immunity Test |
|----------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| IEC 61000-4-3:2006 +A1:2007<br>+A2:2010 / EN 61000-4-3:2006<br>+A1:2008 +A2:2010 | Electromagnetic Compatibility (EMC) Part 4-3: Testing<br>and Measurement Techniques - Radiated, Radio-<br>frequency, Electromagnetic Field Immunity Test |
| IEC 61000-4-4:2004 +A1:2010 /<br>EN 61000-4-4:2004 +A1:2010 | Electromagnetic Compatibility (EMC) Part 4-4: Testing<br>and Measurement Techniques - Electrical Fast<br>Transient/Burst Immunity Test |
| IEC 61000-4-5:2005 / EN 61000-<br>4-5:2006 | Electromagnetic Compatibility (EMC) Part 4-5: Testing<br>and Measurement Techniques - Surge Immunity Test |
| IEC 61000-4-6:2008 / EN 61000-<br>4-6:2009 | Electromagnetic Compatibility (EMC) Part 4-6: Testing<br>and Measurement Techniques - Immunity to<br>Conducted Disturbances, Induced by Radio-frequency<br>Fields |
| IEC 61000-4-8:2009 / EN 61000-<br>4-8:2010 | Electromagnetic Compatibility (EMC) Part 4-8: Testing<br>and Measurement Techniques - Power Frequency<br>Magnetic Field Immunity Test |
| IEC 61000-4-11:2004 / EN<br>61000-4-11:2004 | Electromagnetic Compatibility (EMC) Part 4-11: Testing<br>and Measurement Techniques - Voltage Dips, Short<br>Interruptions and Voltage Variations Immunity Tests |
| IEC 61000-3-2:2005 +A1:2008<br>+A2:2009 / EN 61000-3-2:2006<br>+A1:2009 +A2:2009 | Electromagnetic Compatibility (EMC) Part 3-2: Limits -<br>Limits for Harmonic Current Emissions |
| IEC 61000-3-3:2008 / EN 61000-<br>3-3:2008 | Electromagnetic Compatibility (EMC) Part 3-3: Limits -<br>Limitation of Voltage Changes, Voltage Fluctuations<br>and Flicker in Public Low-voltage Supply Systems |
| CISPR 11:2009 +A1:2010 / EN<br>55011:2009 +A1:2010 | Industrial, Scientific and Medical (ISM) Radio-<br>Frequency Equipment - Electromagnetic Disturbance<br>Characteristics - Limits and Methods of Measurement |
#### Quality System Compliance:
- . ISO 13485:2003 Medical devices - Quality management systems - Requirements for regulatory purposes.
- SOR/98-282 Canadian Medical Device Regulations .
- 21 CFR Part 820 US Food and Drug Administration's Quality System Regulation .
- . 93/42/EEG European Medical Device Directives
- ISO 14971:2007 Medical Devices Application of Risk Management to Medical Devices .
- EN 980:2008 Medical Devices Symbols for Use of fabeling of medical device ●
- EN 1041:2008 Information supplied by the manufacturer of medical devices
- ISO 15223-1:2012,Medical Devices Symbols to be Used With Medical Device Labels, . Labeling, and Information to be Supplied - Part 1: General requirements
- IEC 62304:2006 Medical device software Software life-cycle processes .
{10}------------------------------------------------
| | K131266: TREX_HD |
|------------------------------------------|------------------|
| Image: xitek logo<br>a division of natus | 510k SUMMARY |
| | PAGE 11 of 11 |
Clinical: Clinical testing was not required to ensure safety and effectiveness of the modified device.
Based on the characteristics of the device as compared to the predicate and the results obtained during verification and other non-clinical testing we conclude that Trex HD is substantially equivalent to the predicate device.
### Conclusions
The substantial equivalence of the Natus Trex HD with Trex amplifier was demonstrated by testing in compliance with the Design Control process. The intended use and technology of the Trex_HD is similar to that of the predicate device XLTEK-Trex. Validation was performed to ensure no new questions of safety or effectiveness are raised.
{11}------------------------------------------------
Image /page/11/Picture/0 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" around the perimeter. Inside the circle is an abstract symbol resembling an eagle or bird in flight, with three stylized wing-like shapes.
#### DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
February 14, 2014
Natus Medical Incorporated DBA Excel-Tech Ltd. (XLTEK) c/o Mr. Daniel Ramirez 2568 Bristol Circle Oakville, Ontario Canada L6H 5S1
Re: K131266
Trade/Device Name: Trex HD Regulation Number: 21 CFR 882.1400 Regulation Name: Electroencephalograph Regulatory Class: Class II Product Code: GWQ Additional Product Code: OLV Dated: January 14, 2014 Received: January 17, 2014
Dear Mr. Ramirez:
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. Iisting 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
{12}------------------------------------------------
#### Page 2 - Mr. Daniel Ramirez
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 contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. 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/ResourcesforYou/Industry/default.htm.
Sincerely yours,
# Joyce M. Whang -S
for Carlos L. Peña, PhD, MS Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
{13}------------------------------------------------
#### DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration
#### Indications for Use
Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement on last page.
#### 510(k) Number (if known) K131266
#### Device Name Trex HD
#### Indications for Use (Describe)
The Trex HD is an Electroencephalograph intended to be used to acquire, display, store and archive electroencephic signals, intended for electroencephalographic (EEG) or level 1-2 polysomnographic (PSG) recordings. The Trex HD amplifier is designed to be used with Natus NeuroWorksTM or Natus SleepWorksTM software.
Type of Use (Select one or both, as applicable)
[x] Prescription Use (Part 21 CFR 801 Subpart D)
Over-The-Counter Use (21 CFR 801 Subpart C)
# PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.
#### FOR FDA USE ONLY
Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)
FORM FDA 3881 (1/14)
PSC Publishing Scrvices (301) 443-6740 EF
{14}------------------------------------------------
This section applies only to requirements of the Paperwork Reduction Act of 1995.
#### *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW."
The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:
> Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov
"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."
Predicate graph will load when search results are available.
Embedding visualization will load when search results are available.
PDF viewer will load when search results are available.
Loading panels...
Select an item from Submissions
Click any panel, subpart, regulation, product code, or device to see details here.
Section Matches
Results will appear here.
Product Code Matches
Results will appear here.
Special Control Matches
Results will appear here.
Loading collections...
Loading
My Alerts
You will receive email notifications based on the filters and frequency you set for each alert.
Sort by:
Create Alert
Search Filters
Agent Token
Create a read-only bearer token for Claude, ChatGPT, or other agents that can call HTTP APIs.
Copy this now. It will not be shown again.
Connected apps
Apps you authorized through browser sign-in. Disconnecting revokes their access immediately.
Learn the FDA Browser
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.