K Number
K122112
Date Cleared
2013-04-09

(266 days)

Product Code
Regulation Number
890.5650
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The 2004-0C and 2008-0C Massage Systems are powered inflatable tube massagers intended to temporarily relieve minor muscle aches and/or pains, and to temporarily increase circulation to the treated areas. The devices are intended for home use by people who are in good health.

Device Description

The device consists of an air compressor with manually adjustable pressure settings (i.e., the user manually adjusts the pressure, while the inflate/deflate cycle times remain constant) and a sleeve or garment containing four (2004-OC) or eight (2008-OC) discrete, segmented inflatable chambers externally applied to the limb. The pump consists of a compressor capable of a maximum pressure of 150 mmHg, and provides graduated, or gradient, pressurization to the chambers (e.g., sequential inflation of distal to proximal, with distal chambers inflated to a greater pressure than the proximal ones). An in-line check valve limits the output pressure to 80 mmHg, and a calibrated dial gauge displays pressure in the range of 0-125 mmHq. As each chamber is inflated, the pressure is held constant until all chambers are inflated, in order to prevent reverse gradient flow. Once all chambers are inflated, they are then all released simultaneously, and the cycle repeats. Pressures within the distal chambers have a default value set at the factory (60 mmHg distal), and can be adjusted by the user to distal pressures between 30 mmHg and 80 mmHg. Pressures decrease by 5 mmHg in each proximally sequential chamber. Garments are available in sizes to accommodate varying limb lengths. An adapter is available to support bilateral treatment.

AI/ML Overview

The provided text describes a 510(k) submission for the 2004-OC and 2008-OC Massage Systems. It details the device, its intended use, and a comparison to a predicate device, but it does not include a formal study demonstrating the device meets specific quantitative acceptance criteria.

Instead, the document states: "Before being released, every device is tested and must meet all performance specifications. In addition to aesthetic acceptance criteria, functional testing includes electrical leakage, inflation pressure in each segment, pressure adjustment, pressure gradient across the segments, air pressure gauge accuracy, and inflation/deflation cycle times."

This implies that internal quality control and performance verification are conducted for each device, but a structured clinical or performance study with defined acceptance criteria and statistical analysis, as typically required for demonstrating efficacy or substantial equivalence in certain medical devices, is not explicitly provided or referenced in the summary.

Therefore, many of the requested sections (2-9) cannot be filled with the provided information.

Here's a breakdown of what can be extracted based on the document:


1. Table of Acceptance Criteria and Reported Device Performance

ParameterAcceptance Criteria (Implied / Stated)Reported Device Performance (Internal Testing)
Electrical LeakageMust meet all performance specifications (implied acceptable levels)Each device tested and must meet all performance specifications
Inflation Pressure in each segmentMust meet all performance specifications (implied accurate output)Each device tested and must meet all performance specifications
Pressure AdjustmentMust meet all performance specifications (implied accurate adjustment)Each device tested and must meet all performance specifications
Pressure Gradient across segmentsMust meet all performance specifications (implied correct gradient)Each device tested and must meet all performance specifications
Air Pressure Gauge AccuracyMust meet all performance specifications (implied accurate display)Each device tested and must meet all performance specifications
Inflation/Deflation Cycle TimesMust meet all performance specifications (implied correct timing)Each device tested and must meet all performance specifications
Aesthetic AcceptanceMust meet aesthetic acceptance criteriaEach device tested and must meet aesthetic acceptance criteria
Maximum Pump Pressure150 mmHg (capable)Pump capable of a maximum pressure of 150 mmHg
Output Pressure Limit80 mmHg (in-line check valve)In-line check valve limits output pressure to 80 mmHg
Pressure Gauge Range0-125 mmHg (calibrated dial gauge)Calibrated dial gauge displays pressure in the range of 0-125 mmHg
Distal Chamber Pressure (factory)60 mmHg (default)Default value set at 60 mmHg distal
Distal Pressure (user adjustable)30 mmHg - 80 mmHgUser-adjustable to distal pressures between 30 mmHg and 80 mmHg
Pressure Decrease (proximally)5 mmHg per sequential chamberPressures decrease by 5 mmHg in each proximally sequential chamber

2. Sample size used for the test set and the data provenance

The document speaks to "every device is tested" for internal performance specifications before release, suggesting a 100% inspection or quality control process. It does not describe a distinct "test set" for a larger, formal validation study. Therefore, no information on sample size or data provenance (country of origin, retrospective/prospective) related to a specific validation study is available.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable. No formal ground truth establishment by external experts for a test set is described.

4. Adjudication method for the test set

Not applicable. No formal adjudication method for a test set is described.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

Not applicable. This device is a massage system, not an AI-assisted diagnostic tool.

6. If a standalone (i.e. algorithm only without human-in-the loop performance) was done

Not applicable. This is not an algorithmic device in the context of standalone performance evaluation for diagnostic or assistive tasks.

7. The type of ground truth used

For the internal performance specifications, the "ground truth" would be the engineering design specifications and calibrated measurement tools for parameters like pressure, cycle times, and electrical safety. It is not based on expert consensus, pathology, or outcomes data in the typical sense of a diagnostic or therapeutic device study.

8. The sample size for the training set

Not applicable. This is a physical medical device, not a machine learning algorithm that requires a training set.

9. How the ground truth for the training set was established

Not applicable. (See #8)

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11. 510(k) Summary

APPLICANT'S INFORMATION

Robert Freidenrich, CEO Bio Compression Systems, Inc 120 West Commercial Avenue Moonachie, NJ, 07074 201 939-0716 PH: 201 939-4503 FX: E-mail: Internet: http://www.biocompression.com Medical Establishment Registration No .:

2424387

SUBMITTER'S INFORMATION

Maureen Garner, President New World Regulatory Solutions, Inc. P.O. Box 5374 Toms River, NJ 08754 732-779-7422 PH: 732-270-4829 Fax: E-mail: Internet: www.newworldreg.com

DATE PREPARED: March 29, 2013

DEVICE INFORMATION

DEVICE NAME:2008-OC and 2004-OC Massage Systems
Classification Panel:Surgical, Orthopedic and Restorative Devices
Classification Number:890.5650
Product Nomenclature:Powered Inflatable Tube Massager
Product Code(s):IRP
Trade/Proprietary Name:2008-OC Massage System2004-OC Massage System
Common Name:2008-OC Massage System2004-OC Massage System

DEVICE CLASSIFICATION

Powered Inflatable Tube Massager Devices are classified as Class II devices, and reviewed by the Division of Surgical, Orthopedic and Restorative Devices.

PREDICATE DEVICE

DJS Massager (K112479; product code IRP) manufactured by Mego Afec AC LTD.

DEVICE DESCRIPTION

The device consists of an air compressor with manually adjustable pressure settings (i.e., the user manually adjusts the pressure, while the inflate/deflate cycle times remain constant) and a sleeve or garment containing four (2004-OC) or eight (2008-OC) discrete, segmented inflatable chambers externally applied to the limb.

The pump consists of a compressor capable of a maximum pressure of 150 mmHg, and provides graduated, or gradient, pressurization to the chambers (e.g., sequential inflation of distal to proximal, with distal chambers inflated to a greater pressure than the proximal ones).

APR 0 9 2013

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An in-line check valve limits the output pressure to 80 mmHg, and a calibrated dial gauge displays pressure in the range of 0-125 mmHq.

As each chamber is inflated, the pressure is held constant until all chambers are inflated, in order to prevent reverse gradient flow. Once all chambers are inflated, they are then all released simultaneously, and the cycle repeats. Pressures within the distal chambers have a default value set at the factory (60 mmHg distal), and can be adjusted by the user to distal pressures between 30 mmHg and 80 mmHg. Pressures decrease by 5 mmHg in each proximally sequential chamber.

Garments are available in sizes to accommodate varying limb lengths. An adapter is available to support bilateral treatment.

INDICATIONS FOR USE

The Model 2004-OC and 2008-OC Massage Systems are powered inflatable tube massagers intended to temporarily relieve minor muscle aches and to temporarily increase circulation to the treated areas. The device is intended for home use by people who are in good health.

TECHNOLOGICAL CHARACTERISTICS

The manufacturer believes that the technological characteristics of the 2004-OC Massage Systems are substantially similar to those of the predicate device.

PERFORMANCE DATA

Before being released, every device is tested and must meet all performance specifications. In addition to aesthetic acceptance criteria, functional testing includes electrical leakage, inflation pressure in each segment, pressure adjustment, pressure gradient across the segments, air pressure gauge accuracy, and inflation/deflation cycle times.

STATEMENT OF SUBSTANTIAL EQUIVALENCE

The Bio Compression Systems Model 2004-OC and 2008-OC Massage Systems and the predicate device all provide sequential inflation pressure from distal to proximal segments. Both the Bio Compression and predicate devices offer adjustable pressure ranges.

The Bio Compression devices have decreasing gradient pressures from distal to proximal segments, which prevent flow of lymph back into the limb, while predicate device does not have decreasing gradient pressures. The Bio Compression devices provide continuously adjustable pressure in the range between 30 to 80 mmHg. while the predicate device provides three pressure adjustments options in increments of low, medium and high pressure ranges within the 20 to 80 mmHg range. The Bio Compression devices have fixed cycle times that are fixed by a motorized valve, and are independent of garment size and number (one or two garments). The predicate device does not have a motorized valve and uses back pressure to trigger the cycle to the next chamber of the garment.

Both the Bio Compression devices and the applicant device operate within clinically-established parameters. The differences between the predicate and the applicant devices do not impact safety or effectiveness. A table illustrating the similarities and differences is provided below.

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Similarities and Differences with the Predicate Device

Parameter2004-OC2008-OCK112479DJS Massager
Intended UseTemporarily relieve minor muscle aches and/or pains, and to temporarily increasecirculation to the treated areas. The devices are intended for home use by peoplewho are in good health.
Principal ofOperationSequential pneumaticcompressionSameSame
Weight8 pounds8 pounds5.1 pounds
Dimensions, inches5.5H X 8 L X 12 W5.5H X 8 L X 12 W3.9 H X 10.2 L X 5.1 W
# of Segments ingarment484
Sequential segmentinflationYesYesYes
Distal to ProximalgradientYesYesNo
Inflation Time, eachsegment18 seconds5.5 secondsApprox. 10 (one garment)or 18 (two garments)seconds
Inflation Pressure30 - 80 mmHg distal,adjustable in 1 mmHgincrements30 - 80 mmHg distal,adjustable in 1 mmHgincrements20 - 80 mmHg, adjustablein 3 ranges: 20-30, 40-60and 70-80
Locking pressureadjustment knobYesYesYes
Pressure GaugeYes, 0 - 125 mmHgYes, 0 - 125 mmHgNo
Deflation Time18 seconds5.5 secondsApprox. 10 (one garment)or 18 (two garments)seconds
Pause time betweeninflation cyclesNone (deflation time ispause time)None (deflation time ispause time)Adjustable in 3 levels:10-20, 30-50 and 60-70seconds
Total Cycle Time90 seconds, fixed(one or two garments).50 seconds, fixed(one or two garments)Variable: Approx. 50(one garment) or 90seconds (two garments)
Garments AvailableSized leg andarm/shoulderSameSame
Fail-safe hoseconnectorsYesYesYes
Bilateral TreatmentOptionYesYesYes
Power Requirements115VAC, 50-60HzSameSame

Based upon safety and performance testing, compliance with voluntary standards, and comparison to the predicate devices, the manufacturer believes that the 2004-OC and 2008-OC Massage Systems are substantially equivalent to the predicate device, and do not raise any new questions of safety or effectiveness.

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Image /page/3/Picture/11 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 a stylized emblem featuring three curved shapes, resembling a stylized caduceus or a representation of human figures.

April 9, 2013

Bio Compression Systems, Inc. c/o Ms. Maureen N. Garner President 1983 Hazelwood Road Toms River, NJ 08754

Re: K122112/S001

Trade/Device Name: 2004-OC Massage System, 2008-OC Massage System Regulation Number: 21 CFR 890.5650 Regulation Name: Powered Inflatable Tube Massager Regulatory Class: Class II Product Code: IRP Dated: April 1, 2013 Received: April 2, 2013

Dear Ms. Garner:

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.

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G60 Silver Spring, MD 20993-002

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Page 2 - Ms. Maureen N. Garner

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 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 go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.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 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 vours.

Joyce M. Whang -S

for Victor Krauthamer, Ph.D. Acting Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known): K122112

Device Name: 2004-0C Massage System, 2008-0C Massage System

Indications For Use:

The 2004-0C and 2008-0C Massage Systems are powered inflatable tube massagers intended to temporarily relieve minor muscle aches and/or pains, and to temporarily increase circulation to the treated areas. The devices are intended for home use by people who are in qood health.

Prescription Use (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use X (21 CFR 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Joyce M Whang -

(Division Sign Off) Division of Neurological and Physical Medicine Devices (DNPMD)

510(k) Number _K122112

Page 1 of 1

§ 890.5650 Powered inflatable tube massager.

(a)
Identification. A powered inflatable tube massager is a powered device intended for medical purposes, such as to relieve minor muscle aches and pains and to increase circulation. It simulates kneading and stroking of tissues with the hands by use of an inflatable pressure cuff.(b)
Classification. Class II (performance standards).