K Number
K142646
Device Name
XLR8 White Foam Dressing Kit and XLR8 White Foam Small Dressing Kit and
Date Cleared
2015-04-30

(225 days)

Product Code
Regulation Number
878.4780
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Genadyne XLR8 White Foam Dressing Kit is intended to be used in conjunction with the Genadyne A4-XLR8 Wound Vacuum System (K090638) to deliver negative pressure wound therapy to the wound. Genadyne A4-XLR8 Wound Vacuum System is indicated for patients who would benefit from a suction device particularly as the device may promote wound healing by the removal of excess exudates, infectious material and tissue debris. XLR8 White Foam Dressing is appropriate for use on the following wounds: - Pressure ulcers - Diabetic/Neuropathic Ulcers - Venous insufficiency Ulcers - Traumatic wounds - Post-operative and dehisced surgical wounds - Skin flap and grafts The Genadyne XLR8 White Foam Dressing Kit is a Rx only device.
Device Description
The Genadyne XLR8 White Foam Kit consists of a XLR8 Port, XLR8 Transparent Film and a XLR8 White Foam. Each component are packaged, sealed and sterilized individually and then bagged.
More Information

No
The summary describes a wound dressing kit used with a vacuum system and does not mention any AI or ML components or functionalities.

Yes
The device is intended to promote wound healing by removing excess exudates, infectious material, and tissue debris, which are therapeutic actions.

No

The device is a wound dressing kit used in conjunction with a wound vacuum system to promote wound healing by removing exudates, infectious material, and tissue debris. It does not perform any diagnostic functions.

No

The device description explicitly states that the kit consists of physical components (Port, Transparent Film, White Foam) which are packaged, sealed, and sterilized. This indicates a hardware-based medical device, not a software-only one.

Based on the provided information, the Genadyne XLR8 White Foam Dressing Kit is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use clearly states that the device is used in conjunction with a wound vacuum system to deliver negative pressure therapy to wounds. This is a therapeutic application, not a diagnostic one.
  • Device Description: The description details components like foam, film, and a port, which are consistent with a wound dressing system.
  • Lack of Diagnostic Elements: There is no mention of the device being used to analyze samples (like blood, urine, or tissue) or to provide information about a patient's health status or disease.
  • Performance Studies: The performance studies focus on biocompatibility and the physical performance of the dressing kit, not on diagnostic accuracy or analytical performance.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. The Genadyne XLR8 White Foam Dressing Kit's function is to aid in wound healing through physical means (negative pressure therapy), not through in vitro analysis.

N/A

Intended Use / Indications for Use

Genadyne XLR8 White Foam Dressing Kit is intended to be used in conjunction with the Genadyne A4-XLR8 Wound Vacuum System (K090638) to deliver negative pressure wound therapy to the wound. Genadyne A4-XLR8 Wound Vacuum System is indicated for patients who would benefit from a suction device particularly as the device may promote wound healing by the removal of excess exudates, infectious material and tissue debris.

XLR8 White Foam Dressing is appropriate for use on the following wounds:

  • Pressure ulcers
  • Diabetic/Neuropathic Ulcers
  • Venous insufficiency Ulcers
  • Traumatic wounds
  • Post-operative and dehisced surgical wounds
  • Skin flap and grafts

Product codes

OMP

Device Description

The Genadyne XLR8 White Foam Kit consists of a XLR8 Port, XLR8 Transparent Film and a XLR8 White Foam. Each component are packaged, sealed and sterilized individually and then bagged.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Prescription Use (Part 21 CFR 801 Subpart D)

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)

Summary of Non clinical Tests

Device: XLR8 White Foam Kit
Tests: ISO 10993-5 L929 Neutral Red Uptake Cytotoxicity Test
Rationale: Based on the criteria of the protocol and the ISO 10993-5 Guidelines, the test article meets the requirements of the tests and s not considered to have a cytotoxic effect.

Device: XLR8 White Foam Kit
Tests: ISO 10993-10 Kligman Maximization Test
Rationale: Based on the defined scoring system of Kligman, this is a Grade 1 reaction and the test article is classified as having weak allergenic potential. A Grade 1 sensitization rate is not considered significant and the test article meets the requirements of the ISO 10993-10 guidelines.

Device: XLR8 White Foam Kit
Tests: ISO 10993-10 Intracutaneous Injection Test
Rationale: The test article sites did not show a significantly greater biological reaction than the sites injected with the control article. Based on the criteria of the protocol, the test article meets the requirements of the ISO 10993-10 guidelines.

Device: XLR8 White Foam Kit
Tests: Bench Tests for Performance Evaluation
Rationale: Results from the bench test shows that the dressing kit components are all compatible and performs up to the acceptability criteria.

Device: XLR8 White Foam Kit
Tests: Stability Test
Rationale: Stability tests was performed on our foams and components with 2 year accelerated aging and continuous real time. Devices has passed and met all expectations of the stability tests in terms of bioburden, packaging, seal integrity and performance.

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

Not Found

Predicate Device(s)

K092992

Reference Device(s)

K090638

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4780 Powered suction pump.

(a)
Identification. A powered suction pump is a portable, AC-powered or compressed air-powered device intended to be used to remove infectious materials from wounds or fluids from a patient's airway or respiratory support system. The device may be used during surgery in the operating room or at the patient's bedside. The device may include a microbial filter.(b)
Classification. Class II.

0

Image /page/0/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized image of three faces in profile, stacked on top of each other. The faces are oriented to the right and are connected to form a single, flowing shape. The logo is surrounded by the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement.

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

April 30, 2015

Genadyne Biotechnologies Incorporated Mr. Chien-Ming (Andrew) Goh Vice President 16 Midland Avenue Hicksville, New York 11801

Re: K142646

Trade/Device Name: Genadyne XLR8 White Foam Dressing Kit Regulation Number: 21 CFR 878.4780 Regulation Name: Powered suction pump Regulatory Class: Class II Product Code: OMP Dated: March 27, 2015 Received: March 30, 2015

Dear Mr. Goh:

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 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

1

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 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/Resourcesfor You/Industry/default.htm. 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 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.

for

Sincerely yours,

David Krause -S

Binita S. Ashar, M.D., M.B.A., F.A.C.S. Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K142646

Device Name Genadyne XLR8 White Foam Dressing Kit

Indications for Use (Describe)

Genadyne XLR8 White Foam Dressing Kit is intended to be used in conjunction with the Genadyne A4-XLR8 Wound Vacuum System (K090638) to deliver negative pressure wound. Genadyne A4-XLR8 Wound Vacuum System is indicated for patients who would benefit from a suction device particularly as the device may promote wound healing by the removal of excess exudates, infectious material and tissue debris.

XLR8 White Foam Dressing is appropriate for use on the following wounds:

  • Pressure ulcers
  • Diabetic/Neuropathic Ulcers
  • · Venous insufficiency Ulcers
  • · Traumatic wounds
  • · Post-operative and dehisced surgical wounds
  • · Skin flap and grafts
Type of Use (Select one or both, as applicable)
-------------------------------------------------
For use in connection with a FEE-Only Retirement PlanFor use in connection with a FEE-Only Retirement PlanFor use in connection with a FEE-Based Retirement PlanFor use in connection with a FEE-Based Retirement Plan
For use in connection with a FEE-Only Retirement Plan
For use in connection with a FEE-Based Retirement Plan

|× | Prescription Use (Part 21 CFR 801 Subpart D)

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

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3

Traditional 510k Summary

General InformationDate: 4/29/2015
1.ApplicantGenadyne Biotechnologies, Inc.
16 Midland Ave,
Hicksville, NY 11801
(t) 516.487.8787
(f) 516.977-8974
2.Contact PersonMr. Chien-Ming GOH (Andrew)
Vice President
Genadyne Biotechnologies Inc.
16 Midland Ave,
Hicksville, NY 11801
(t) 516.217.0101
(f) 516.977.8974
3.Trade NameGenadyne XLR8 White Foam Dressing Kit
(Ref:PVA-FOAM1)
4.Common NameFoam Dressing
5.Classification NameNegative Pressure Wound Therapy Powered
Suction Pump and Accessories
6.Regulation Number21 CFR 878.4780
7.Product CodeOMP
8.Class in which Device has
been placedClass II
9.PanelGeneral & Plastic Surgery
10.Reason for Premarket
NotificationNew Device
11.Identification of Legally
Marketed Device Which We
Can Claim Substantial
Equivalence (Predicate
Device)A4-XLR8 Foam Dressing K092992
12.Brief Description of DeviceThe Genadyne XLR8 White Foam Kit consists of a
XLR8 Port, XLR8 Transparent Film and a XLR8
White Foam. Each component are packaged,
sealed and sterilized individually and then bagged

4

Indications for use 13. [21 CFR 807.92(a)(5)]

Genadyne XLR8 White Foam Dressing Kit is intended to be used in conjunction with the Genadyne A4-XLR8 Wound Vacuum System (K090638) to deliver negative pressure wound therapy to the wound. Genadyne A4-XLR8 Wound Vacuum System is indicated for patients who would benefit from a suction device particularly as the device may promote wound healing by the removal of excess exudates, infectious material and tissue debris.

XLR8 White Foam Dressing is appropriate for use on the following wounds:

  • Pressure ulcers ●
  • Diabetic/Neuropathic Ulcers .
  • Venous insufficiency Ulcers ●
  • Traumatic wounds ●
  • Post-operative and dehisced surgical ● wounds
  • . Skin flap and grafts

The Genadyne XLR8 White Foam Dressing Kit is a Rx only device.

14. Technological Characteristics

No.FoamPort TubingFilm
1.Materials
Used:Polyvinyl Alcohol
DressingSiliconePolyurethane
2.Size:20 cm x 15 cm x 1 cm
15 cm x 10 cm x 1 cm
7.5 cm x 10 cm x 1 cm31 inches26 x 30 cm

Table of Comparison to Predicate Devices:

ParametersPredicateNew
ParametersGenadyne
A4-XLR8 Foam DressingGenadyne
XLR8 White Foam Dressing Kit
510(k) NumberK092992TBD
Indications for UseGenadyne A4-XLR8 Foam Dressing is
intended to be used in conjunction with
the Genadyne A4 Wound Vacuum
System (K082676) to deliver negative
pressure wound therapy to the wound.Genadyne XLR8 White Foam Dressing
Kit is intended to be used in conjunction
with the Genadyne A4-XLR8 Wound
Vacuum System (K090638) to deliver
negative pressure wound therapy to the

5

| | Genadyne A4 Wound Vacuum System is
indicated for patients who would benefit
from a suction device, particularly as the
device may promote wound healing by
the removal of excess exudates,
infectious material and tissue debris.
A4-XLR8 Foam Dressing is appropriate
for use on the following
wounds:Pressure ulcers Diabetic/Neuropathic Ulcers Venous insufficiency ulcers Traumatic wounds Post-operative and dehisced surgical wounds Skin flap and graft | wound. Genadyne A4-XLR8 Wound
Vacuum System is indicated for patients
who would benefit from a suction device
particularly as the device may promote
wound healing by the removal of excess
exudates, infectious material and tissue
debris.
XLR8 White Foam Dressing is
appropriate for use on the following
wounds: Pressure ulcers Diabetic/Neuropathic Ulcers Venous insufficiency ulcers Traumatic wounds Post-operative and dehisced surgical wounds Skin flap and grafts |
|------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Foam Dressing
Material | Flexible Polyether and Polyester
Polyurethane Foam | Polyvinyl Alcohol Dressing |
| Hydrophobic | Yes | Yes |
| Sizes: | 7.5 cm X 10 cm x 3.3cm
12.5 cm x 18 cm x 3.3 cm
15 cm x 26 cm x 3.3 cm | 20 cm x 15 cm x 1 cm
15 cm x 10 cm x 1 cm
7.5 cm x 10 cm x 1 cm |
| For use with Negative
Pressure Wound
Therapy Systems | Yes | Yes |
| Sterile | Yes | Yes |
| Sterilization Method | EO | Gamma Radiation for White Foam, EO
for Silicone Port and Transparent Film |
| Kit Content | Silicone Tubing
Transparent Adhesive Film | Silicone Port
Transparent Adhesive Film |

15. Summary of Non clinical Tests

DeviceTestsRationale
XLR8 White Foam
KitISO 10993-5
L929 Neutral Red
Uptake
Cytotoxicity TestBased on the criteria of the protocol and the ISO
10993-5 Guidelines, the test article meets the
requirements of the tests and s not considered to
have a cytotoxic effect.
ISO 10993-10
Kligman
Maximization TestBased on the defined scoring system of Kligman,
this is a Grade 1 reaction and the test article is
classified as having weak allergenic potential. A
Grade 1 sensitization rate is not considered
significant and the test article meets the
requirements of the ISO 10993-10 guidelines.
ISO 10993-10
Intracutaneous
Injection TestThe test article sites did not show a significantly
greater biological reaction than the sites injected
with the control article. Based on the criteria of the
protocol, the test article meets the requirements
of the ISO 10993-10 guidelines.
Bench Tests for
PerformanceResults from the bench test shows that the
dressing kit components are all compatible and

6

Evaluationperforms up to the acceptability criteria.
Stability TestStability tests was performed on our foams and
components with 2 year accelerated aging and
continuous real time. Devices has passed and met
all expectations of the stability tests in terms of
bioburden, packaging, seal integrity and
performance.
  • Conclusion & 16. Determination of Substantial Equivalence
    Based on the information presented above, it is concluded that the XLR8 White Foam Dressing Kit is substantially equivalent to the predicate devices and is safe and effective to be used together with a negative pressure wound therapy device.