(177 days)
The Hygia West Reprocessed Compression Garments operate in the identical manner as the predicate devices. They are designed for the prevention of deep vein thrombosis (DVT) as well as the treatment of edema secondary to venous insulficiency. The devices are used in both the home and institutional settings.
The Hygia West Reprocessed Huntleigh DVT Sleeve is to be used by patients in both the home and institutional settings used as a non-invasive therapeutic method to:
- Prevent deep vein thrombosis and resulting pulmonary embolism .
- Intra-operative compression therapy
The Llygia West Reprocessed Compression Garments are intermittent compressible limb devices that are placed around cither the patient's foot (with the compression chamber placed under the plantar arch), calf (gastrocnemius muscle), thigh, or a combination there of. The garments are constructed from materials that are common to the medical device industry. Depending on the type of device, the method of fastening to the patient may vary from a hook and loop closure system to a uni-body style that is slipped over the limb. In foot compression devices, as the garment compresses the plantar plexus, the veins collapse longitudinally; this action causes an increase in the venous pressure thus eiceting the blood upward. After compression, the devices deflate allowing the veins to refill bringing oxygenared blood to the lower limbs. In devices used on the calf or thigh the compression to the area causes the blood to be ejected upwards to the heart, as the compression relaxes the valves in the veins close allowing them to refill. This cyclical method removes deoxygenated or stale blood from the region allowing fresh blood to be received. On all devices the controller predetermines the inflation and deflation sequence. The operational characteristics such as the pressure of compression, hold time, and inflation time are determined by the controller. It is the responsibility of the end user to ensure that the device is connected to an approved controller and to ensure that the controller settings are accurate. Hygia West does not repair, refurhish, or reprocess the controlling unit. Hygia West guarantees 100% of our devices ONLY if it has heen connected to an approved, functional, and correctly adjusted controller.
Here's an analysis of the provided text regarding the acceptance criteria and study for the Hygia West Reprocessed Compression Garments:
1. Table of Acceptance Criteria and Reported Device Performance:
The document refers to the acceptance criteria implicitly through the concept of "substantial equivalence" to predicate devices. The study aims to demonstrate that the reprocessed devices perform identically to the original devices.
| Acceptance Criteria Category | Specific Acceptance Criteria (Inferred from "Substantial Equivalence") | Reported Device Performance |
|---|---|---|
| Functional Performance | Substantial equivalence in: | "All tests found that functional and operational performance characteristics including compression, pressure capabilities, safety, and operational parameters were substantially equivalent." |
| - Compression | - | |
| - Pressure capabilities | - | |
| - Safety | - | |
| - Operational parameters | - | |
| Biocompatibility | No adverse effects on biocompatibility after reprocessing. | "No signs of irritation or sensitization were found" in a "NTH level combination irritation/sensitization human skin patch test." |
| Intended Use | Identical intended use as predicate devices. | "The Hygia West Reprocessed Compression Garments operate in the identical manner as the predicate devices. They are designed for the prevention of deep vein thrombosis (DVT) as well as the treatment of edema secondary to venous insulficiency. The devices are used in both the home and institutional settings." |
| Technological Characteristics | Identical to predicate devices in: | "The technological characteristics of the Hygia West Reprocessed Compression Garments are identical to the predicate devices in overall design, materials, energy source, mode of operation, and performance characteristics." |
| - Overall design | - | |
| - Materials | - | |
| - Energy source | - | |
| - Mode of operation | - | |
| - Performance characteristics | - | |
| Process Validation | Demonstrated effectiveness of the reprocessing technology. | "Process validation information has been provided as part of this submission to demonstrate the effectiveness of this type of technology." (Specific results are not detailed in this summary). |
2. Sample Size Used for the Test Set and Data Provenance:
- Sample Size for Test Set: The document mentions "Comparative bench testing was utilized" and "a NTH level combination irritation/sensitization human skin patch test was conducted." However, no specific numerical sample sizes are provided for either the bench testing or the human skin patch test. The "NTH level" for the skin patch test is unclear without further context.
- Data Provenance: The data is generated by Hygia West, Inc. as part of their 510(k) submission. It represents prospective testing conducted by the manufacturer to demonstrate substantial equivalence for their reprocessed devices. The country of origin for the data is implicitly the USA, where Hygia West, Inc. is based and where the regulatory submission is made to the FDA.
3. Number of Experts Used to Establish the Ground Truth for the Test Set and Their Qualifications:
- Number of Experts: The document does not specify the number of experts used for establishing ground truth, nor does it detail any expert involvement in the testing process beyond the general statement of "testing was utilized."
- Qualifications of Experts: Not provided.
4. Adjudication Method for the Test Set:
- The document does not describe any adjudication method for the test set. The tests mentioned appear to be objective performance and biocompatibility tests rather than assessments requiring human adjudication of subjective interpretations.
5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and the Effect Size:
- No, an MRMC comparative effectiveness study was not done. The device in question is a reprocessed compression garment, and the studies performed are bench tests and a human skin patch test, not studies involving human readers interpreting medical cases. Therefore, there is no mention of "human readers" or "AI assistance."
6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done:
- This question is not applicable to the device described. The Hygia West Reprocessed Compression Garments are physical medical devices (compressible limb sleeves), not an AI algorithm or software. The "performance" refers to the physical function of the garment, not an algorithm's output.
7. The Type of Ground Truth Used:
- For functional performance, the ground truth appears to be the performance characteristics of the original, new predicate devices. The reprocessed devices are compared against these known, established performance metrics.
- For biocompatibility, the ground truth is established based on accepted standards for human skin irritation and sensitization, as evaluated by the "NTH level combination irritation/sensitization human skin patch test."
- For intended use and technological characteristics, the ground truth is the stated and established properties of the predicate devices.
8. The Sample Size for the Training Set:
- This question is not applicable, as the device is a reprocessed physical medical device, not an AI algorithm or machine learning model that requires a training set.
9. How the Ground Truth for the Training Set Was Established:
- This question is not applicable for the same reason as point 8.
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Ko31559
Image /page/0/Picture/1 description: The image shows the logo for Hygia West Medical Device Reprocessor. The logo features the words "Hygia West" in a bold, sans-serif font, with the words "Medical Device Reprocessor" in a smaller font below. To the left of the words is a graphic of three curved lines above three straight lines.
510(k) Summary
Summary
ı • '
Substantial Equivalence Summary for Hygia West Reprocessed Compression Garments.
In accordance with 21 CFR Part 807.92, this summary is submitted by:
Geolf M. Fatzinger
and
Hygia West, Inc. 9800 Evergreen Way Everett, Washington 98204
Dato: May 13, 2003
1. Contact Person
Geoff M. Fatzinger Director of Compliance and Regulatory Affairs Hygia West Corporate Office 425-353-1110
-
- Name of Device
Classification Name: Compressible Limb Sleeve Common or Usual Name: Intermittent Pneumatic Compressible Limb Sleeve Review Panel: Cardiovascular Classification: Class II Proprietary Names: Hygia West Reprocessed Novamedix ImPad Hygia West Reprocessed Huntleigh DVT Hygia West Reprocessed Huntleigh Foot Wrap Hygia West Reprocessed Kendall SCD
- Name of Device
Hygia West
9800 Evergreen Way ● Everett, WA. 98204 VOICE 425-353-1110 ● FAX 425-353-9116
.JuI [60] [60] Inc.
{1}------------------------------------------------
Proprietary Names (cont): Hygia West Reprocessed NuTech Plexipulse Hygia West Reprocessed NuTech Combo Hygia West Reprocessed NuTech Calf Wrap Hygia West Reprocessed Venodyne
Predicate Devices
:
| Classification Name: | Compressible Limb Sleeve |
|---|---|
| Common Name: | Intermittent Pneumatic Compressible Limb Sleeve |
| Classification: | Class II |
| Proprietary Name: | Novamedix ImPad® A-V Impulse System Rigid Sole Foot Cover |
| Classification Name: | Compressible Limb Sleeve |
| Common Name: | Intermittent Pneumatic Compressible Limb Sleeve |
| Classification: | Class II |
| Proprietary Name: | Hygia Health Services Reprocessed Novamedix ImPad® |
| 510(k) number: | K021509 |
| Classification Name: | Compressible Limb Sleeve |
| Common Name: | Intermittent Pneumatic Compressible Limb Sleeve |
| Classification: | Class II |
| Proprietary Name: | Huntleigh DVT Compression Sleeves |
| Classification Name: | Compressible Limb Sleeve |
| Common Name: | Intermittent Pneumatic Compressible Limb Sleeve |
| Classification: | Class II |
| Proprietary Name: | Hygia Health Services Reprocessed Huntleigh DVT |
| 510(k) number: | K012654 |
| Classification Name: | Compressible Limb Sleeve |
| Common Name: | Intermittent Pneumatic Compressible Limb Sleeve |
| Classification: | Class II |
| Proprietary Name: | Huntleigh Foot Wrap |
| Classification Name: | Compressible Limb Sleeve |
| Common Name: | Intermittent Pneumatic Compressible Limb Sleeve |
| Classification: | Class II |
| Proprietary Name: | Hygia Health Services Reprocessed Huntleigh Foot Wrap |
| 510(k) number: | K012651 |
Hygia West
9800 Evergreen Way · Everett, WA. 98204 VOICE 425-353-1110 ● ● FAX 425-353-9116
. . . . . . . . . . .
. Su I lesibal Inc.
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Predicate Devices (cont):
Classification Name: Compressible Limb Sleeve Intermittent Pneumatic Compressible Limb Sleeve Common Name: Class II Classification: NuTech Calf Wrap Proprietary Name:
Classification Name: Compressible Limb Sleeve Intermittent Pneumatic Compressible Limb Sleeve Common Name: Class II Classification: Hygia Health Services Reprocessed NuTech Calf Wrap Proprietary Name: K012657 510(k) number:
Classification Name: Compressible Limb Sleeve Intermittent Pneumatic Compressible Limb Sleeve Common Name: Classification: Class II Proprietary Name: NuTech Combo
Classification Name: Compressible Limb Sleeve Intermittent Pneumatic Compressible Limb Sleeve Common Namc: Classification: Class II Hygia Health Services Reprocessed NuTech Combo Proprietary Name: S10(k) number: K012956
Classification Name: Compressible Limb Sleeve Intermittent Pneumatic Compressible Limb Sleeve Common Name: Classification: Class II NuTech Plexipulse System Proprietary Name:
Classification Name: Compressible Limb Sleeve Intermittent Pneumatic Compressible Limb Sleeve Common Name: Class II Classification: Hygia Health Services Reprocessed NuTech Plexipulse Proprietary Name: 510(k) number: K0126S0
Classification Name: Compressible Limb Sleeve Intermittent Pneumatic Compressible Limb Sleeve Common Name: Class II Classification: Kendall SCD Proprietary Name:
Hygia West
9800 Evergreen Way · Everett, WA. 98204 VOICE 425-353-1110 ● FAX 425-353-9116
{3}------------------------------------------------
Predicate Devices (cont):
| Classification Name: Compressible Limb Sleeve | |
|---|---|
| Common Name: | Intermittent Pneumatic Compressible Limb Sleeve |
| Classification: | Class II |
| Proprietary Name: | Hygia Health Services Reprocessed Kendall SCD |
| 510(k) number: | K012417 |
Classification Name: Compressible Limb Sleeve Intermittent Pneumatic Compressible Limb Sleeve Common Name: Classification: Class II Microtek Medical Venodyne Slecve Proprietary Name:
Statement of Substantial Equivalence
The Hygia West Reprocessed Compression Garments employ no new technology other than the method used to reprocess the garment in order to allow the device to be utilized more than once. The Hygia West Reprocessed Compression Garments are substantially equivalent to the listed predicate devices in that the basis of operation of the devices is the intermittent inflation of a bladder or chamber, which is placed around the patient's lower limb. The devices are used on the calf, thigh, whole leg, or foot. The garments are then connected to an approved and device appropriate controller. Inflation of the device is accomplished using ambicnt air, and a controller cycle that functions to alternately inflate and deflate the device in a predetermined manner and interval.
The Hygia West Reprocessed Compression Garments are substantially equivalent in function, operating parameters, and intended use to the listed predicate devices that are currently commercially available and in distribution. The predicate devices are marked for "single-patient use only" as are the Hygia West devices. Hygia West does not change the devices in any way except to render the device "reusable" by placing it through a scientifically verified chemical free high-level disinfection process. The Hygia West high-level disinfection protocol does not alter the device's efficacy, safety, composition, or intended use. Hygia West employs very strict device protocols, unique and stringent testing procedures, innovative, and demanding quality measures that in many cases exceed those of the predicate device companies. Although our processes are very different, the core concept regarding the high-level disinfection process is identical to the method used by Hygia Health Services, Inc in their approved reprocessed devices.
Hygia West 9800 Evergreen Way · Everett, WA. 98204 VOICE 425-353-1110 ● FAX 425-353-9116
Relu Nedical Inc.
. . . .
{4}------------------------------------------------
న్. Description of the Devices
The Llygia West Reprocessed Compression Garments are intermittent compressible limb devices that are placed around cither the patient's foot (with the compression chamber placed under the plantar arch), calf (gastrocnemius muscle), thigh, or a combination there of. The garments are constructed from materials that are common to the medical device industry. Depending on the type of device, the method of fastening to the patient may vary from a hook and loop closure system to a uni-body style that is slipped over the limb. In foot compression devices, as the garment compresses the plantar plexus, the veins collapse longitudinally; this action causes an increase in the venous pressure thus eiceting the blood upward. After compression, the devices deflate allowing the veins to refill bringing oxygenared blood to the lower limbs. In devices used on the calf or thigh the compression to the area causes the blood to be ejected upwards to the heart, as the compression relaxes the valves in the veins close allowing them to refill. This cyclical method removes deoxygenated or stale blood from the region allowing fresh blood to be received. On all devices the controller predetermines the inflation and deflation sequence. The operational characteristics such as the pressure of compression, hold time, and inflation time are determined by the controller. It is the responsibility of the end user to ensure that the device is connected to an approved controller and to ensure that the controller settings are accurate. Hygia West does not repair, refurhish, or reprocess the controlling unit. Hygia West guarantees 100% of our devices ONLY if it has heen connected to an approved, functional, and correctly adjusted controller.
Hygia West has included a device specific summary including relevant comparisons in each individual device section. (Please see tab marked "Summary" in each chapter)
ર્. Intended Use of Device
The Hygia West Reprocessed Compression Garments operate in the identical manner as the predicate devices. They are designed for the prevention of deep vein thrombosis (DVT) as well as the treatment of edema secondary to venous insulficiency. The devices are used in both the home and institutional settings.
7. Technological Characteristics
The technological characteristics of the Hygia West Reprocessed Compression Garments are identical to the predicate devices in overall design, materials, energy source, mode of operation, and performance characteristics.
Hygia West 9800 Evergreen Way ● Everett, WA. 98204 VOICE 425-353-1110 ● FAX 425-353-9116
. . .
{5}------------------------------------------------
8. Performance Data
Non-clinical Tests- Comparative bench testing was utilized to assess and prove similarity of function between the Hygia West Reprocessed Compression Garments and the predicate devices. All tests found that functional and operational performance characteristics including compression, pressure capabilities, safety, and operational parameters were substantially equivalent.
છે. Biocompatibility
...
In order to ensure that the high-level disinfection program does not adversely affect the biocompatibility of the device, a NTH level combination irritation/sensitization human skin patch test was conducted. The detailed protocols of the study are included for each device in that specific device section. No signs of irritation or sensitization were found.
10. Process Validation
Process validation information has been provided as part of this submission to demonstrate the effectiveness of this type of technology,
l l . Conclusions
Test Conclusions- Non-clinical and biocompatibility test results indicated substantial equivalence in all aspects to the predicate devices.
Hygia West 9800 Evergreen Way · Everett, WA. 98204 VOICE 425-353-1110 ● FAX 425-353-9116
니 " 더
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Public Health Service
Image /page/6/Picture/2 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 with stylized wings.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
NOV 1 2 2003
ReNu Medical c/o Mr. Geoff M. Fatzinger Director of Compliance and Regulatory Affairs 9800 Evergreen Way Everett, WA 98204
Re: K031559
Trade Name: ReNu Medical Reprocessed Compressible Limb Sleeves Regulation Number: 21 CFR 870.5800 Regulation Name: Compressible Limb Sleeve Regulatory Class: Class II (two) Product Code: JOW Dated: May 13, 2003 Received: May 29, 2003
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
{7}------------------------------------------------
Page 2 – Mr. Geoff M. Fatzinger
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 forth in the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050. This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at (301) 594-4646. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers. International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html
Sincerely yours,
Image /page/7/Picture/4 description: The image shows a signature. The signature is in black ink and appears to be cursive. The signature is illegible, but it appears to start with the letter 'f' or 'p'. The signature is on a white background.
Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
{8}------------------------------------------------
INDICATIONS FOR USE
Applicant: Hygia West, Inc.
KO 31259 510(k) Number:
Device Name: Hygia West Reprocessed Huntleigh DVT Sleeve
Indications For Use:
The Hygia West Reprocessed Huntleigh DVT Sleeve is to be used by patients in both the home and institutional settings used as a non-invasive therapeutic method to:
- Prevent deep vein thrombosis and resulting pulmonary embolism .
- Intra-operative compression therapy ●
PRECAUTIONS AND CONTRAINDICATIONS
Contraindications:
Sleeves may not be recommended for patients with the following:
- Any local leg condition in which sleeves would interfere such as 1. dermatitis, gangrene, recent skin graft, untreated infected wounds.
-
- Congestive heart failure.
- Severe arteriosclerosis or other ischemic vascular disease 3.
- Pulmonary edema 4.
- ર : Known or suspected deep vein thrombosis or phlebitis
Qias Moli
ardiovascular Devices
510(k) Number K031559
p. 1/2
{9}------------------------------------------------
Indications for Use
Precautions:
-
- One must ensure that the sleeve is applied properly.
-
- One must ensure that the sleeve is correctly connected to the pump and that the connection is secure.
- If numbness, tingling, or leg pain is experienced by the patient, the sleeve 3. should be removed.
Elias Mdaa
(Division Sign-C Division of Cardiovascular Devices
K031559 510(k) Number p. 212
4-2
§ 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).