K Number
K141064
Device Name
VESOFLOW PLUS DVT COMPRESSION DEVICE
Date Cleared
2014-12-04

(224 days)

Product Code
Regulation Number
870.5800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Caremed Supply Inc. VESOFLOW®PLUS SQS and IPCS Deep Vein Thrombosis (DVT) Compression Devices are intended to increase venous blood flow in at risk patients in order to help prevent deep vein thrombosis.
Device Description
VESOFLOW®PLUS that counteracts blood stasis and coagulation changes - two of the three major factors that promote deep vein thrombosis (DVT). VESOFLOW® PLUS is a non-invasive mechanical prophylactic system that massages the feet or legs in a wavelike, milking motion that promotes blood flow and deters thrombosis, helping to empty pooled or static blood from the valve cusps of the femoral vein. Fibrinolytic activity is increased, stimulating the release of a plasminogen activator. This therapy typically complements other prophylactic measures, such as antiembolic stockings and anticoagulants. VESOFLOW®PLUS is used to prevent pooling of blood in a limb by inflating periodically a sleeve around the limb. Therefore, VESOFLOW®PLUS is identified as a compressible limb sleeve.
More Information

Not Found

No
The document explicitly states "Mentions AI, DNN, or ML: Not Found" and the device description focuses on mechanical compression.

Yes
The device is described as a "non-invasive mechanical prophylactic system that massages the feet or legs in a wavelike, milking motion that promotes blood flow and deters thrombosis" and "This therapy typically complements other prophylactic measures". Its intended use is to "increase venous blood flow in at risk patients in order to help prevent deep vein thrombosis", indicating a direct therapeutic action to prevent a medical condition.

No

The device is described as a non-invasive mechanical prophylactic system intended to prevent deep vein thrombosis by promoting blood flow, not to diagnose a condition.

No

The device description explicitly states it is a "non-invasive mechanical prophylactic system" that "massages the feet or legs" by "inflating periodically a sleeve around the limb." This clearly indicates the presence of hardware components (sleeves, inflation mechanism) beyond just software.

Based on the provided information, the Caremed Supply Inc. VESOFLOW®PLUS SQS and IPCS Deep Vein Thrombosis (DVT) Compression Devices are not an In Vitro Diagnostic (IVD) device.

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body, such as blood, urine, or tissue, to provide information about a person's health. This information is used for diagnosis, monitoring, or screening.
  • VESOFLOW®PLUS Function: The description clearly states that the VESOFLOW®PLUS is a "non-invasive mechanical prophylactic system" that "massages the feet or legs in a wavelike, milking motion that promotes blood flow and deters thrombosis." It works by applying external compression to the limbs.
  • No Specimen Analysis: There is no mention of the device collecting or analyzing any biological specimens from the patient. Its function is purely mechanical and external.

Therefore, the VESOFLOW®PLUS falls under the category of a therapeutic or prophylactic medical device, not an IVD.

N/A

Intended Use / Indications for Use

The Caremed Supply Inc. VESOFLOW®PLUS SQS and IPCS Deep Vein Thrombosis (DVT) Compression Devices are intended to increase venous blood flow in at risk patients in order to help prevent deep vein thrombosis.

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

JOW

Device Description

VESOFLOW®PLUS that counteracts blood stasis and coagulation changes - two of the three major factors that promote deep vein thrombosis (DVT). VESOFLOW® PLUS is a non-invasive mechanical prophylactic system that massages the feet or legs in a wavelike, milking motion that promotes blood flow and deters thrombosis, helping to empty pooled or static blood from the valve cusps of the femoral vein. Fibrinolytic activity is increased, stimulating the release of a plasminogen activator. This therapy typically complements other prophylactic measures, such as antiembolic stockings and anticoagulants.

VESOFLOW®PLUS is used to prevent pooling of blood in a limb by inflating periodically a sleeve around the limb. Therefore, VESOFLOW®PLUS is identified as a compressible limb sleeve.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Feet or legs / limb

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

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)

A series of safety tests were performed to assess the safety and effectiveness of the VESOFLOW®PLUS SQS and IPCS Deep Vein Thrombosis (DVT) Compression Devices. All the test results demonstrate VESOFLOW®PLUS SQS and IPCS Deep Vein Thrombosis (DVT) Compression Devices meet the requirements of its pre-defined acceptance criteria and intended uses.

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.

K110977

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

Public Health Service

Image /page/0/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features the department's name encircling a symbol. The symbol consists of three stylized human profiles facing right, with flowing lines suggesting movement or connection. The text is arranged in a circular pattern around the symbol.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

December 4, 2014

Caremed Supply, Inc. % Michael Lee President AcmeBiotechs Co., Ltd. No.45, Minsheng Rd. Danshui Town New Taipei City, 251 TW

Re: K141064

Trade/Device Name: VESOFLOW PLUS DVT Compression Devices Regulation Number: 21 CFR 870.5800 Regulation Name: Compressible Limb Sleeve Regulatory Class: Class II Product Code: JOW Dated: October 20, 2014 Received: October 27, 2014

Dear Michael Lee,

We have reviewed vour Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food. Drug. and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act

1

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 of medical devicerelated adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education 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. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 Industry and Consumer Education 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,

M.A. Hillebrand

for

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Caremed Supply Inc. 510(k) Notification

VESOFLOW®PLUS DVT Compression Device Model: IPCS/SQS

Indications for Use

510(k) Number (if known): K141064

VESOFLOW®PLUS DVT Compression Device Device Name: Model Name: IPCS/SQS

Indications for Use:

The Caremed Supply Inc. VESOFLOW®PLUS SQS and IPCS Deep Vein Thrombosis (DVT) Compression Devices are intended to increase venous blood flow in at risk patients in order to help prevent deep vein thrombosis.

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 ANOTHER PAGE IF NEEDED)

AND/OR

Concurrence of CDRH, Office of Device Evaluation (ODE)

Page 1 of ____________________________________________________________________________________________________________________________________________________________________

3

VESOFLOW®PLUS DVT Compression Device Model: IPCS/SQS

510(k) Summary

Type of Submission:Traditional
Preparation Date:16th April 2014
Submitter:Caremed Supply Inc.
Address:7F., No. 2, Lane 235, Bao Chiao Rd., Xin
Tien Dist., New Taipei City 23145,
Taiwan
Phone:+886-2-29179808
Fax:+886-2-29186505
Contact:Tsung-Hsuan Liu
(oscar(a)caremed.com.tw)
Registration number:8022590

5.4 Identification of the Device:

Proprietary/VESOFLOW®PLUS DVT Compression
Trade name:Device, Model Name: IPCS/SQS
Classification Name:Sleeve, Limb, Compressible
Device Classification:II
Regulation Number:870.5800
Panel:Cardiovascular
Product Code:JOW

5.5 Identification of the Predicate Device:

Predicate Device Name:VESOFLOW
Manufacturer:Caremed Supply Inc.
Regulation number:870.5800
Product Code:JOW
510(k) Number:K110977

4

5.6 Intended Use and Indications for Use of the subject device.

The Caremed Supply Inc. VESOFLOW®PLUS SOS and IPCS Deep Vein Thrombosis (DVT) Compression Devices are intended to increase venous blood flow in at risk patients in order to help prevent deep vein thrombosis.

5.7 Device Description

VESOFLOW®PLUS that counteracts blood stasis and coagulation changes - two of the three major factors that promote deep vein thrombosis (DVT). VESOFLOW® PLUS is a non-invasive mechanical prophylactic system that massages the feet or legs in a wavelike, milking motion that promotes blood flow and deters thrombosis, helping to empty pooled or static blood from the valve cusps of the femoral vein. Fibrinolytic activity is increased, stimulating the release of a plasminogen activator. This therapy typically complements other prophylactic measures, such as antiembolic stockings and anticoagulants.

VESOFLOW®PLUS is used to prevent pooling of blood in a limb by inflating periodically a sleeve around the limb. Therefore, VESOFLOW®PLUS is identified as a compressible limb sleeve.

5.8 Non-clinical Testing

A series of safety tests were performed to assess the safety and effectiveness of the VESOFLOW®PLUS SQS and IPCS Deep Vein Thrombosis (DVT) Compression Devices.

Testing ItemStandard and regulations applied
BiocompatibilityISO 10993-1:2009/Cor. 1:2010(E) Biological evaluation of
medical devices – Part 1: Evaluation and testing with a risk
management process.
ISO 10993-5:2009 (E) Biological evaluation of medical devices
– Part 5: Tests for in vitro cytotoxicity.
ISO 10993-10:2010(E) Biological evaluation of medical devices
- Part 10: Tests for Tests for irritation and skin sensitization.
ISO 10993-12 Biological Evaluation Of Medical Devices -- Part
12: Sample Preparation And Reference Materials.
(Biocompatibility)
ISO/IEC 17025:2005 General Requirements for the Competence
of Testing and Calibration Laboratories.
USP 35 Biological reactivity tests, in vitro
SoftwareIEC 62304 First Edition 2006-05, Medical Device Software -
Software Life Cycle Processes. (Software/Informatics)
Electromagnetic
Compatibility &
Electrical SafetyEN 60601-1-2 : 2007/AC:2010 Medical electrical equipment -
Part 1-2: General requirements for basic safety and essential
performance - Collateral standard: Electromagnetic compatibility
  • Requirements and tests. |
    | IEC 60601-1-2 : 2007 Medical Electrical Equipment - Part 1-2:
    General Requirements For Basic Safety And Essential
    Performance - Collateral Standard: Electromagnetic
    Compatibility - Requirements And Tests. (General I (QS/RM)) | |
    | IEC 61000-3-2 : 2005+A1:2008+A2:2009 Electromagnetic
    compatibility (EMC) - Part 3-2: Limits - Limits for harmonic
    current emissions (equipment input current ≤16 A per phase). | |
    | IEC 61000-3-3 : 2008 Electromagnetic compatibility (EMC) -
    Part 3-3: Limits - Limitation of voltage changes, voltage
    fluctuations and flicker in public low-voltage supply systems, for
    equipment with rated current ≤16 A per phase and not subject to
    conditional connection. | |
    | IEC 61000-4-2 : 2008 Electromagnetic compatibility (EMC) -
    Part 4-2: Testing and measurement techniques - Electrostatic
    discharge immunity test. | |
    | IEC 61000-4-3 : 2006+A1:2007+A2:2010 Electromagnetic
    compatibility (EMC) - Part 4-3: Testing and measurement
    techniques - Radiated, radio-frequency, electromagnetic field
    immunity test | |
    | | |
    | | IEC 61000-4-4 : 2012 Electromagnetic compatibility (EMC) -
    Part 4-4: Testing and measurement techniques - Electrical fast
    transient/burst immunity test. |
    | | IEC 61000-4-5 : 2005+corr.October:2009 Electromagnetic
    compatibility (EMC) - Part 4-5: Testing and measurement
    techniques - Surge immunity test. |
    | | IEC 61000-4-6 : 2008 Electromagnetic compatibility (EMC) -
    Part 4-6: Testing and measurement techniques - Immunity to
    conducted disturbances, induced by radio-frequency fields. |
    | | IEC 61000-4-8 : 2009 Electromagnetic compatibility (EMC) -
    Part 4-8: Testing and measurement techniques - Power frequency
    magnetic field immunity test. |
    | | IEC 61000-4-11 : 2004 Electromagnetic compatibility (EMC) -
    Part 4-11: Testing and measurement techniques - Voltage dips,
    short interruptions and voltage variations immunity tests. |
    | | CISPR 11 : 2009+A1:2010 Industrial, scientific and medical
    equipment - Radio-frequency disturbance characteristics - Limits
    and methods of measurement. |
    | Performance | IEC 60068-2-14: 2009 Environmental testing - Part 2-14: Tests -
    Test N: Change of temperature.
    ISTA 2A Standard |
    | Risk Management | ISO14971 Medical Devices - Application Of Risk Management
    To Medical Devices. (General I (QS/RM))
    IEC 60812 Analysis Techniques For System Reliability -
    Procedure For Failure Mode And Effects Analysis (Fmea).
    (General I (OS/RM)) |

5

6

All the test results demonstrate VESOFLOW®PLUS SQS and IPCS Deep Vein Thrombosis (DVT) Compression Devices meet the requirements of its pre-defined acceptance criteria and intended uses.

7

5.9 Clinical Testing

No clinical test data was used to support the decision of safety and effectiveness.

5.10 Substantial Equivalence Determination

The VESOFLOW®PLUS SQS and IPCS Deep Vein Thrombosis (DVT) Compression Devices have similar intended use, materials, safety and similar technological characteristics with the predicate device. Information described above can demonstrate the VESOFLOW®PLUS SQS and IPCS Deep Vein Thrombosis (DVT) Compression Devices are substantial equivalent to the predicate device.

Model NameVESOFLOW®PLUS SQSVESOFLOW SQS
Dimension7.54"x 5.12"x7.95"9.8" x 8.9" x 8.1"
Weight2.8kg2.5kg
Pressure RangeCalf/Thigh : 45, 40 and 30mmHg
Foot: 130mmHgCalf/Thigh : 45, 40 and 30mmHg
Foot: 130mmHg
Input RatingAC 100-240V, 50/60HzAC 100-240V, 50/60Hz
Fuse Rating1A/250V1A/250V
Operating Humidity30-75%30-75%
Operation
Temperature15°C- 35°C15°C- 35°C
Applied PartGarment and Air HoseGarment and Air Hose
Applied Mode of
PressureSequentialSequential
Number of
Chambers in
Garment33
Inflation time per
chamber12 seconds12 seconds
Deflation time per
chamber48 seconds48 seconds
Pressure sequence45, 40 and 30 mmHg45, 40 and 30 mmHg

8

calf/thigh
Pressure Range
Calf/Thigh45, 40 and 30 mmHg45, 40 and 30 mmHg
Pressure Range Foot130 mmHg130 mmHg
Pre-Programmed
ControlsYesYes
Battery PackYesYes
Model NameVESOFLOW®PLUS IPCSVESOFLOW IPCS
Dimension7.54"x 5.12"x7.95"9.8" x 8.9" x 8.1"
Weight2.8kg2.5kg
Pressure Range40 and 130mmHg40 and 130mmHg
Input RatingAC 100-240V, 50/60HzAC 100-240V, 50/60Hz
Fuse Rating1A/250V1A/250V
Operating Humidity30-75%30-75%
Operation
Temperature15°C - 35°C15°C - 35°C
Applied PartGarment and Air HoseGarment and Air Hose
Applied Mode of
PressureIntermittentIntermittent
Number of
Chambers in
GarmentNoNo
Inflation time per
chamber
(Calf/Thigh)12 seconds12 seconds
Deflation time per
chamber
(Calf/Thigh)48 seconds48 seconds

9

| Inflation time per

chamber (Foot)3 seconds3 seconds
Deflation time per
chamber (Foot)30 seconds30 seconds
Pressure Range
Calf/Thigh40 mmHg40 mmHg
Pressure Range Foot130 mmHg130 mmHg
Pre-Programmed
ControlsYesYes
Battery PackYesYes

5.11 Similarity and difference

The difference between the proposed device and the predicate device is software driven. The proposed device has tested on safety and performance tests and the results were complied with the test requests. Therefore, the difference of proposed device and predicate device did not raise any problems of safety or effectiveness. The proposed device is substantially equivalent to the predicate device in intended use, design, and performance claims.

5.12 Conclusion

After analyzing bench tests, safety testing data, it can be concluded that VESOFLOW®PLUS SQS and IPCS Deep Vein Thrombosis (DVT) Compression Devices are as safe and effective as the predicate device.