K Number
K141390
Device Name
INTERMITTENT PNEUMATIC COMPRESSION DEVICE
Date Cleared
2014-11-18

(175 days)

Product Code
Regulation Number
870.5800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The LD Q-IPC III is a system to prevent DVT(Deep Vein Thrombosis) by improving the blood velocity of patients. Leg Compression The use of the product with Calf Cuff and Thigh Cuff is indicated for: 1. Deep vein thrombosis and pulmonary embolism prophylaxis. Foot Compression The use of the product with Foot Cuff is indicated for: 1. Circulation enhancement. 2. Deep vein thrombosis prophylaxis. 3. Edema-Acute. 4. Edema-Chronic. 5. Extremity pain incident to trauma or surgery. 6. Leg Ulcers. 7. Venous stasis /Venous insufficiency.
Device Description
The LD Q-IPC III Intermittent pneumatic compression device is a pneumatic compression device that noninvasively helps reduce the incidence of deep vein thrombosis, a potentially life threatening condition. The LD Q-IPC III Intermittent pneumatic compression device consists of the controller, the Tubing Sets and single-patient used cuff. The cuff includes calf cuffs, thigh cuffs and foot cuffs. The controller will deliver air to the cuffs and sequentially pressurize them. Cuffs will be pressurized from the distal air chamber to the proximal air chamber. After the compression, the controller will allow an interval time for vein refilling, before the controller starts to pressurize the cuffs again. The cycles will be repeated throughout the time the unit is in use or for the duration of the default operating time.
More Information

Not Found

No
The device description details a pneumatic compression system with a controller that sequentially pressurizes cuffs based on a fixed cycle time. There is no mention of adaptive algorithms, learning from data, or any other characteristics typically associated with AI/ML. The performance studies focus on electrical safety, biocompatibility, and software verification according to standard guidance, not AI/ML validation.

Yes
The device is indicated for various conditions like DVT prophylaxis, circulation enhancement, edema, and pain, which are therapeutic in nature.

No

The device description and intended use clearly state that the LD Q-IPC III is a "pneumatic compression device" used to prevent DVT, enhance circulation, and treat edema, among other therapeutic applications. It does not mention any function related to diagnosing medical conditions.

No

The device description explicitly states it consists of a controller, tubing sets, and cuffs, which are all hardware components. While software verification is mentioned, the device is clearly a physical system with software controlling its operation, not a software-only device.

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

Here's why:

  • Intended Use: The intended use clearly states that the device is a system to prevent DVT by improving blood velocity through leg and foot compression. This is a therapeutic and preventative function, not a diagnostic one.
  • Device Description: The description details a pneumatic compression device that physically applies pressure to the limbs. It does not involve analyzing biological samples (like blood, urine, or tissue) to provide diagnostic information.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological specimens.
    • Providing information about a patient's health status, disease, or condition based on in vitro analysis.
    • Using reagents or calibrators.

The device is a therapeutic medical device used for physical intervention (compression) to address a medical condition (DVT prophylaxis, circulation enhancement, edema, etc.).

N/A

Intended Use / Indications for Use

The LD Q-IPC III is a system to prevent DVT(Deep Vein Thrombosis) by improving the blood velocity of patients.

Leg Compression
The use of the product with Calf Cuff and Thigh Cuff is indicated for:

  1. Deep vein thrombosis and pulmonary embolism prophylaxis.
    Foot Compression
    The use of the product with Foot Cuff is indicated for:
  2. Circulation enhancement.
  3. Deep vein thrombosis prophylaxis.
  4. Edema-Acute.
  5. Edema-Chronic.
  6. Extremity pain incident to trauma or surgery.
  7. Leg Ulcers.
  8. Venous stasis /Venous insufficiency.

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

JOW

Device Description

The LD Q-IPC III Intermittent pneumatic compression device is a pneumatic compression device that noninvasively helps reduce the incidence of deep vein thrombosis, a potentially life threatening condition.

The LD Q-IPC III Intermittent pneumatic compression device consists of the controller, the Tubing Sets and single-patient used cuff. The cuff includes calf cuffs, thigh cuffs and foot cuffs.

The controller will deliver air to the cuffs and sequentially pressurize them. Cuffs will be pressurized from the distal air chamber to the proximal air chamber. After the compression, the controller will allow an interval time for vein refilling, before the controller starts to pressurize the cuffs again. The cycles will be repeated throughout the time the unit is in use or for the duration of the default operating time.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Leg, Foot

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)

The following testing was performed on the LD Q-IPC III in accordance with the requirements of the design control regulations and established quality assurance procedures.

IEC60601-1:2005+CORR.1(2006)+CORR.2(2007),Medical electrical equipment-Part 1:General requirements for basic safety, and essential performance.

IEC60601-1-2:2007, Medical electrical equipment-Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic compatibility-Requirements and tests.

ISO10993-1: 2009, Biological evaluation of medical devices-Part 1:Evaluation and testing within a risk management process

ISO10993-5:2009, Biological evaluation of medical devices-Part 5: Tests for In Vitro cytotoxicity. ISO10993-10:2010, Biological evaluation of medical devices-Part10: Tests for irritation and skin sensitization

In addition to the compliance of voluntary standards, the software verification has been carried out according to the FDA Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices.

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.

K123830

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/1 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 a stylized image of three human profiles facing to the right, with flowing lines representing hair or clothing.

Public Health Service

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

November 18, 2014

Wuhan Landing Medical Hi-Tech Co., Ltd Yan Liu Quality Manager 818 Gaoxin Rd East Lake High Tech Development Zone Floors 1 & 2, Units B & C & D, Building No. B7 Med Equipment Park Wuham, CH 430206

Re: K141390

Trade/Device Name: Intermittent pneumatic compression device Regulation Number: 21 CFR 870.5800 Regulation Name: Compressible Limb Sleeve Regulatory Class: Class II Product Code: JOW Dated: Undated Received: September 15, 2014

Dear Yan Liu,

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.

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

1

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 (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 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. Hilleman

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

Enclosure

2

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known)

K141390

Device Name

Intermittent pneumatic compression device

Indications for Use (Describe)

The LD Q-IPC III is a system to prevent DVT(Deep Vein Thrombosis) by improving the blood velocity of patients.

Leg Compression

  • The use of the product with Calf Cuff and Thigh Cuff is indicated for:
  1. Deep vein thrombosis and pulmonary embolism prophylaxis.

Foot Compression

The use of the product with Foot Cuff is indicated for:

    1. Circulation enhancement.
    1. Deep vein thrombosis prophylaxis.
    1. Edema-Acute.
    1. Edema-Chronic.
    1. Extremity pain incident to trauma or surgery.
    1. Leg Ulcers.
    1. Venous stasis /Venous insufficiency.

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)

3

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."

4

Section 5 - 510(k) Summary

Date of Summary Preparation: 9/9/2014

1. Submitter's Identifications

Submitter's Name: Wuhan Landing Medical Hi-Tech Co., LTD Address: Floors 1&2,Units B&C&D,Building No.B7 Medical Equipment Park,818 Gaoxin Road East Lake High Tech Development Zone 430206 Wuhan, Hubei,China Contact Person: Yan Liu Contact Email Address: fdalanding@sohu.com Telephone: +86-27-59263677 Fax: +86-27-59368637

2. Correspondent's Identifications

Correspondent's Name: Wuhan Landing Medical Hi-Tech Co.,LTD Address: Floors 1&2,Units B&C&D,Building No.B7 Medical Equipment Park,818 Gaoxin Road East Lake High Tech Development Zone 430206 Wuhan, Hubei,China Contact Person: Yan Liu Contact Email Address: fdalanding@sohu.com Telephone: +86-27-59263677 Fax: +86-27-59368637

3. Name of the Device

Device Classification Name: sleeve, limb, compressible Product Name: Compressible limb sleeve Trade Name: Intermittent pneumatic compression device Model: LD Q-IPC III Classification Panel: Cardiovascular Product Code: JOW Device Classification: Class II

4. The Predicate Devices

Veinoflow SCD, LBTK-M-I 5001 K123830

5. Device Description

The LD Q-IPC III Intermittent pneumatic compression device is a pneumatic compression device that noninvasively helps reduce the incidence of deep vein thrombosis, a potentially life threatening condition.

The LD Q-IPC III Intermittent pneumatic compression device consists of the controller, the Tubing Sets and single-patient used cuff. The cuff includes calf cuffs, thigh cuffs and foot cuffs.

The controller will deliver air to the cuffs and sequentially pressurize them. Cuffs will be

5

Wuhan Landing Medical Hi-Tech Co,LTD

pressurized from the distal air chamber to the proximal air chamber. After the compression, the controller will allow an interval time for vein refilling, before the controller starts to pressurize the cuffs again. The cycles will be repeated throughout the time the unit is in use or for the duration of the default operating time.

6. Intended Use of Device

The LD Q-IPC III is a system to prevent DVT(Deep Vein Thrombosis) by improving the blood velocity of patients.

Leg Compression

The use of the product with Calf Cuff and Thigh Cuff is indicated for:

    1. Deep vein thrombosis and pulmonary embolism prophylaxis.

Foot Compression

The use of the product with Foot Cuff is indicated for:

    1. Circulation enhancement.
    1. Deep vein thrombosis prophylaxis.
    1. Edema-Acute.
    1. Edema-Chronic.
    1. Extremity pain incident to trauma or surgery.
    1. Leg Ulcers.
    1. Venous stasis /Venous insufficiency.

7. Summary of Substantial Equivalence

Table : The difference between LD Q-IPC III and Predicate Veinoflow SCD (K123830)

New DevicePredicate Device
510(k) NumberK 141390K123830
Product Code:JOWJOW
Proprietary Name:Intermittent Pneumatic Compression DeviceVeinoflow SCD, LBTK-M-I 5001
Manufacturer:Wuhan Landing Medical Hi-Tech Co., LtdDalian Labtek Science & Development Co., Ltd
Indication for use:The LD Q-IPC III is a system to preventVeinoflow SCD system, Model LBTK-M-I 5001
DVT(Deep Vein Thrombosis) by improvingis a system to prevent DVT (Deep Vein
the blood velocity of patients. LD Q-IPC IIIThrombosis) by improving the blood velocity of
is indicated for Circulation enhancement,patients. LBTK-M-I 5001 is indicated for
Deep vein thrombosis and pulmonaryCirculation enhancement, Deep vein thrombosis
embolism prophylaxis, Edema-Acute,and pulmonary embolism prophylaxis,
Edema-Chronic, Extremity pain incident toEdema-Acute, Edema-Chronic, Extremity pain
trauma or surgery, Leg Ulcers, Venousincident to trauma or surgery, Leg Ulcers, Venous
stasis /Venous insufficiencystasis /Venous insufficiency
ComponentsPump controller, thigh cuffs, calf cuffs, foot
cuffs, air supply tubes, power linePump controller, thigh cuffs, calf cuffs, foot cuffs,
battery, air supply tubes, power line
Ingress of WaterOrdinaryOrdinary
protection
Compression typethigh cuffs & calf cuffs: Sequential, Gradient
foot cuffs: Uniformthigh cuffs & calf cuffs: Sequential, Gradient
foot cuffs: Uniform
Compression timeSingle thigh cuffs: 6s Compression
Dual thigh cuffs: 12s Compression
Single calf cuffs: 4s Compression
Dual calf cuffs: 8s Compression
Single foot cuffs: 2.5s Compression
Dual foot cuffs: 5s CompressionSingle thigh cuffs: 5.5s Compression
Dual thigh cuffs: 11s Compression
Single calf cuffs: 4s Compression
Dual calf cuffs: 8s Compression
Single foot cuffs: 2.5s Compression
Dual foot cuffs: 5s Compression
Deflation time2-3s2-3s
Default inflatable
Interval time48s48s
Adjustable
inflatable interval
time24s, 48s, 60s24s, 48s, 60s
Default Pressurethigh cuffs & calf cuffs: 45 mmHg
foot cuffs: 130 mmHgthigh cuffs & calf cuffs: 40 mmHg
foot cuffs: 130 mmHg
Adjustable
Pressurethigh cuffs & calf cuffs: 30-60 mmHg
foot cuffs: 120-140 mmHgthigh cuffs & calf cuffs: 30-60 mmHg
foot cuffs: 120-140 mmHg
Mode of operationContinuousContinuous
Application modeSingle thigh cuffs Compression
Dual thigh cuffs Compression
Single calf cuffs Compression
Dual calf cuffs Compression
Single foot cuffs Compression
Dual foot cuffs CompressionSingle thigh cuffs Compression
Dual thigh cuffs Compression
Single calf cuffs Compression
Dual calf cuffs Compression
Single foot cuffs Compression
Dual foot cuffs Compression
Simultanous single thigh cuffs and single calf
cuffs Compression
Bed HookYesYes
Power cord
storageYesYes
Audible/Visual
AlarmsLow Pressure, High Pressure, Pump Error,
Valve Error, System Error,No garment, Pump Error, Valve Error,
Temperature Error, Software Error, System Error,
High Pressure, Low Pressure, Low Battery
Controll
DimensionsLength: 280mm; Width: 145mm; Height:
250mmLength: 240mm; Width: 140mm; Height: 263mm
Controll Weight3kg3.5kg
Power
RequirementAC 100-240V, 60 VA, 50-60HzAC 100-240V, 50 VA, 50-60Hz
BatteryNoYes
Shipping UnitEachEach
StandardIEC60601-1IEC60601-1
ISO10993-1ISO10993-1
ISO10993-5ISO10993-5
ISO10993-10ISO10993-10
Non-sterileNon-sterileNon-sterile
Microprocessor
ControlYesYes

6

Wuhan Landing Medical Hi-Tech Co,LTD

7

Wuhan Landing Medical Hi-Tech Co,LTD

8. Substantial Equivalence:

The proposed devices of LD Q-IPC III have the same classification information, same indications and intended use, same design principle, similar product design and specifications, same performance effectiveness, performance safety as the predicate device. The differences only exist in battery, default pressure, and audible/visual alarms. These differences are slight and do not influence the effectiveness and safety of the device.

9. Non-Clinical Tests Performed:

The following testing was performed on the LD Q-IPC III in accordance with the requirements of the design control regulations and established quality assurance procedures.

IEC60601-1:2005+CORR.1(2006)+CORR.2(2007),Medical electrical equipment-Part 1:General requirements for basic safety, and essential performance.

IEC60601-1-2:2007, Medical electrical equipment-Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic compatibility-Requirements and tests.

ISO10993-1: 2009, Biological evaluation of medical devices-Part 1:Evaluation and testing within a risk management process

ISO10993-5:2009, Biological evaluation of medical devices-Part 5: Tests for In Vitro cytotoxicity. ISO10993-10:2010, Biological evaluation of medical devices-Part10: Tests for irritation and skin sensitization

In addition to the compliance of voluntary standards, the software verification has been carried out according to the FDA Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices.

10. Conclusion:

The proposed device LD Q-IPC III are determined to be Substantially Equivalent (SE) to the predicate device, Veinoflow SCD, LBTK-M-I 5001 in respect of safety and effectiveness.

--- End of this section ---