K Number
K012657
Device Name
HYGIA HEALTH SERVICES REPROCESSED NUTECH CALF WRAP
Date Cleared
2002-04-12

(242 days)

Product Code
Regulation Number
870.5800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Hygia Health Services Reprocessed NuTech® Calf Wrap is used as a non-invasive therapeutic method to be used by patients in the home or institutional setting in order to: - Prevent deep vein thrombosis . - Reduce wound healing time . - Treat and assist healing of venous leg ulcers . - Reduce edema caused by venous insufficiency in the lower extremities .
Device Description
The Hygia Health Services Reprocessed NuTech® Calf Wrap is a compressible limb device for the lower limb, that when attached to an approved controller, provides intermittent pneumatic compression of the gastrocnemius muscle. The garment is constructed out of brushed nylon with an elastic lining. The single inflation chamber is constructed from the garment itself. The device has an internal coating of a latex free polymer that creates an airtight seal. The inner lining is elastic, which allows for the inflation. The inflation tube is constructed of poly vinyl chloride (PVC), which terminates in a snap-lock connector. The hook fasteners are made of polyethylene. The garments are placed around the gastrocnemius muscle of the calf and secured with a hook and loop fastener. As the garment compress the muscle, venous pressure is increased, ejecting the blood upward toward the heart. After a rapid compression, the garment deflates allowing the veins to refill and bring oxygenated blood to the lower limbs. The pressure of compression is determined by the controller and is adjusted by altering the readout on the controller.
More Information

Not Found

Not Found

No
The device description and performance studies focus on mechanical compression and comparison to a predicate device, with no mention of AI or ML.

Yes

The device is described as a non-invasive therapeutic method used to prevent deep vein thrombosis, reduce wound healing time, treat and assist healing of venous leg ulcers, and reduce edema, which are all therapeutic functions.

No

The device is described as a therapeutic method for preventing deep vein thrombosis, reducing wound healing time, treating venous leg ulcers, and reducing edema. It provides intermittent pneumatic compression and does not mention any diagnostic functions.

No

The device description clearly details physical components like a compressible limb device, garment, inflation chamber, inflation tube, and fasteners, indicating it is a hardware device.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly describes a therapeutic method applied directly to the patient's body (non-invasive therapeutic method, prevent deep vein thrombosis, reduce wound healing time, treat and assist healing of venous leg ulcers, reduce edema). IVDs are used to examine specimens taken from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • Device Description: The device description details a physical garment that applies external pressure to the calf. This is consistent with a therapeutic device, not a device that analyzes biological samples.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, reagents, calibrators, controls, or any other components typically associated with in vitro diagnostics.

Therefore, the Hygia Health Services Reprocessed NuTech® Calf Wrap is a therapeutic medical device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Hygia Health Services Reprocessed NuTech® Calf Wrap is used as a non-invasive therapeutic method to be used by patients in the home or institutional setting in order to:

  • Prevent deep vein thrombosis .
  • Reduce wound healing time .
  • Treat and assist healing of venous leg ulcers .
  • Reduce edema caused by venous insufficiency in the lower extremities .

Product codes (comma separated list FDA assigned to the subject device)

JOW

Device Description

The Hygia Health Services Reprocessed NuTech® Calf Wrap is a compressible limb device for the lower limb, that when attached to an approved controller, provides intermittent pneumatic compression of the gastrocnemius muscle. The garment is constructed out of brushed nylon with an elastic lining. The single inflation chamber is constructed from the garment itself. The device has an internal coating of a latex free polymer that creates an airtight seal. The inner lining is elastic, which allows for the inflation. The inflation tube is constructed of poly vinyl chloride (PVC), which terminates in a snap-lock connector. The hook fasteners are made of polyethylene. The garments are placed around the gastrocnemius muscle of the calf and secured with a hook and loop fastener. As the garment compress the muscle, venous pressure is increased, ejecting the blood upward toward the heart. After a rapid compression, the garment deflates allowing the veins to refill and bring oxygenated blood to the lower limbs. The pressure of compression is determined by the controller and is adjusted by altering the readout on the controller.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

gastrocnemius muscle of the calf / lower extremities / lower limb

Indicated Patient Age Range

Not Found

Intended User / Care Setting

patients in the home or institutional setting

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Nonclinical Tests- Comparative bench testing was utilized to assess and prove similarity of function between the Hygia Health Services Reprocessed NuTech® Calf Wrap and the predicate device, the NuTech® Universal Calf Wrap. All tests found that functional and operational performance characteristics including compression, pressure control, and timing sequence were substantially equivalent. Safety and operational parameters regarding controller connections were also found to be equivalent.

Clinical Tests- Clinical tests were summarized in support of the premarket notification submission.

Test Conclusions- Clinical and nonclinical test results of the Hygia Health Services Reprocessed NuTech® Calf Wrap indicated substantial equivalence in all aspects to the predicate device, the NuTech® Universal Calf Wrap.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

Not Found

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 870.5800 Compressible limb sleeve.

(a)
Identification. A compressible limb sleeve is a device that is used to prevent pooling of blood in a limb by inflating periodically a sleeve around the limb.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image shows the logo for Hygia Health Services. The logo consists of a black square on the left side with three white concentric circles inside. To the right of the square is the word "HYGIA" in large, bold, black letters, and below that is the phrase "HEALTH SERVICES" in smaller, thinner, black letters.

1012657

APR 1 2 2002

510(k) Summary

Summary

Substantial Equivalence Summary for the Hygia Health Services Reprocessed NuTech® Calf Wrap

In accordance with 21 CFR Part 807.92, this summary is submitted by:

Hygia Health Services, Inc. 2800 Milan Court Suite 259 Birmingham, Alabama 35211

Date: July 31, 2001

.

Contact Person 1.

Geoff M. Fatzinger Director, Compliance and Regulatory Affairs (205) 943-6670

Name of Device 2.

Classification Name: Compressible Limb Sleeve Common or Usual Name: Intermittent Pneumatic Compressible Limb Sleeve Cardiovascular Review Panel: Class II Classification: Hygia Health Services Reprocessed NuTech® Calf Wrap. Proprietary Name:

HYGIA HEALTH SERVICES

MILAN COURT · · SUITE · 259 · · BIRMINGHAM , AL 35211 2800 2 0 5 - 9 4 3 - 6 6 7 0 - V O I C E

8-1

1

Image /page/1/Picture/0 description: The image shows the logo for Hygia Health Services. The logo consists of a square with three concentric circles on the left and the word "HYGIA" in large, bold letters on the right. Below the word "HYGIA" are the words "HEALTH SERVICES" in smaller letters.

3. Predicate Device

Classification Name: Compressible Limb Sleeve Intermittent Pneumatic Compressible Limb Sleeve Common Name: Class II Classification: NuTech® Universal Calf Wrap Proprietary Name:

Statement of Substantial Equivalence 4.

The Hygia Health Services Reprocessed NuTech® Calf Wrap employs no new technology other than the method used to reprocess the sleeve in order to allow the device to be utilized more than once. The Hygia Health Services Reprocessed als aon® Calf Wrap is substantially equivalent to the NuTech® Universal Calf Wrap in that the basis of operation for both of the devices is the intermittent inflation of a single inflation chamber, which is placed around the patient's mination on a muscle. The garments are then connected to a controller via a snap-lock connector. Inflation of the garment is accomplished using ambient air, and a controller cycle that functions to alternately inflate and deflate the device in a predetermined manner and interval.

The Hygia Health Services Reprocessed NuTech® Calf Wrap is substantially equivalent in function, operating parameters, and intended use to the NuTech® Universal Calf Wrap that is currently commercially available and in distribution. The predicate device, the NuTech® Universal Calf Wrap, is marked for "singlepatient use only". Hygia Health Services does not change the device in any way except to render the device 'reusable" by placing it through a scientifically validated thermal kill pasteurization process. The Hygia Health Services HLD protocol does not alter the device's efficacy, safety, composition, or intended use.

Description of the Device 5.

The Hygia Health Services Reprocessed NuTech® Calf Wrap is a compressible limb device for the lower limb, that when attached to an approved controller, provides intermittent pneumatic compression of the gastrocnemius muscle. The garment is constructed out of brushed nylon with an elastic lining. The single inflation chamber is constructed from the garment itself. The device has an internal coating of a latex free polymer that creates an airtight seal. The inner lining is elastic, which allows for the inflation. The inflation tube is constructed of poly vinyl chloride (PVC), which terminates in a snap-lock connector. The hook fasteners are made of polyethylene. The garments are placed around the gastrocnemius muscle of the calf and secured with a hook and loop fastener. As the garment compress the muscle, venous pressure is increased, ejecting the blood upward toward the heart. After a rapid compression, the garment deflates

2

Image /page/2/Picture/0 description: The image shows the logo for Hygia Health Services. The logo consists of a series of concentric circles on the left, followed by the word "HYGIA" in large, bold letters. Below the word "HYGIA" is the phrase "HEALTH SERVICES" in smaller letters. The logo is simple and professional, and it conveys a sense of health and well-being.

allowing the veins to refill and bring oxygenated blood to the lower limbs. The pressure of compression is determined by the controller and is adjusted by altering the readout on the controller.

Intended Use of Device 6.

The Hygia Health Services Reprocessed NuTech® Calf Wrap is designed to operate in the identical manner as the predicate device, the NuTech® Universal Calf Wrap. It is designed to apply compression to a patient's gastrocnemius muscle for the prevention of deep vein thrombosis (DVT) as well as the treatment of edema secondary to venous insufficiency. The device is used in both the home and institutional settings on patient populations for which this device applicable.

Technological Characteristics 7.

The technological characteristics of the Hygia Health Services Reprocessed NuTech® Calf Wrap are identical to the original NuTech® Universal Calf Wrap in overall design, materials, energy source, mode of operation, and performance characteristics. Hygia Health Services employs no new technological characteristics other than the scientifically validated thermal high-level disinfection process.

Performance Data 8.

Nonclinical Tests- Comparative bench testing was utilized to assess and prove similarity of function between the Hygia Health Services Reprocessed NuTech® Calf Wrap and the predicate device, the NuTech® Universal Calf Wrap. All tests found that functional and operational performance characteristics including compression, pressure control, and timing sequence were substantially equivalent. Safety and operational parameters regarding controller connections were also found to be equivalent.

Clinical Tests- Clinical tests were summarized in support of the premarket notification submission.

Test Conclusions- Clinical and nonclinical test results of the Hygia Health Services Reprocessed NuTech® Calf Wrap indicated substantial equivalence in all aspects to the predicate device, the NuTech® Universal Calf Wrap.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

APR 1 2 2002

Mr. Geoff M. Fatzinger, BS MS Director, Compliance and Regulatory Affairs c/o Hygia Health Services, Inc. 2800 Milan Court, Suite 259 Birmingham, AL 35211

K012657 Re:

Trade Name: Hygia Health Services Reprocessed NuTech® Calf Wrap Regulation Number: 21 CFR 870.5800 Regulation Name: Compressible Limb Sleeve Regulatory Class: Class II (two) Product Code: JOW Dated: February 7, 2002 Received: February 11, 2002

Dear Mr. Fatzinger:

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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such 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); good manufacturing practice requirements as set

4

Page 2 - Mr. Geoff M. Fatzinger, BS MS

. .

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) I mis letter will and w yourse finding of substantial equivalence of your device to a legally premance notification. The 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 and additionally 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of additionally 21 CF 1 1 1 1 - 1 - 4648. Additionally, for questions on the promotion and advertising of Compliance at (301) 594-639 Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). regulation on information on your responsibilities under the Act may be obtained 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

Sincerely yours,

onna-Bea Tillman, Ph.D. Acting Director Division of Cardiovascular and Respiratory Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

Indications for Use

Indications For Use

Applicant: Hygia Health Services, Inc.

510(k) Number: ·

K012657

Device Name: Hygia Health Services Reprocessed NuTech® Calf Wrap

Indications For Use:

The Hygia Health Services Reprocessed NuTech® Calf Wrap is used as a non-invasive therapeutic method to be used by patients in the home or institutional setting in order to:

  • Prevent deep vein thrombosis .
  • Reduce wound healing time .
  • Treat and assist healing of venous leg ulcers .
  • Reduce edema caused by venous insufficiency in the lower extremities .

PRECAUTIONS AND CONTRAINDICATIONS

Contraindications:

Wraps may not be recommended for patients with the following:

  • Congestive heart failure 1 .
  • Known or suspected deep vein thrombosis 2.
  • Severe arteriosclerosis or other ischemic vascular disease 3.
  • Any local leg condition in which the wrap would interfere such as 4. dermatitis, gangrene, recent skin graft, or untreated infected wounds

Precautions:

  • One must ensure that the wrap is applied properly. 1.
  • One must ensure that the wrap is correctly connected to the pump and that 2. . the connection is secure.
  • If numbness, tingling, or leg pain is experienced by the patient, the wrap 3. should be removed.

Division of Cardiovascular & Respiratory Devices
510(k) Number K012654

Prescrinting !! (Per 21 CFK 801.109)