K Number
K160451
Device Name
V. A.C. VeraFlo Cleanse Choice Dressing System for use with the V.A.C. Ulta ...
Date Cleared
2016-06-20

(123 days)

Product Code
Regulation Number
878.4780
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The V.A.C. Ulta Negative Pressure Wound Therapy System is an integrated wound management system that provides Negative Pressure Wound Therapy with an instillation option. Negative Pressure Wound Therapy in the absence of instillation is intended to create an environment that promotes wound healing by secondary or tertiary (delayed primary) intention by preparing the wound bed for closure, reducing edema, promoting granulation tissue formation and perfusion, and by removing exudate and infectious material. The instillation option is indicated for patients who would benefit from vacuum assisted drainage and controlled delivery of topical wound treatment solutions and suspensions over the wound bed. The V.A.C. Uta Negative Pressure Wound Therapy System with and without is indicated for patients with chronic, acute, traumatic, sub-acute and dehisced wounds, partial-thickness burns, ulcers (such as diabetic, pressure and venous insufficiency), flaps and grafts.
Device Description
The V.A.C. VeraFlo Cleanse Choice Dressing System is intended for use with the V.A.C. Ulta Negative Pressure Wound Therapy System to deliver negative pressure wound therapy (NPWT) as well as facilitate the instillation of fluid to the wound. The V.A.C. VeraFlo Cleanse Choice Dressing System has the same basic components as the predicate V.A.C. VeraFlo Cleanse Dressing cleared under K103156. The only difference between the two systems is the configuration of the dressing. The subject system has a dressing that is designed with 3 separate layers. The predicate dressing, on the other hand, is a single spiral shaped rod configuration. The materials of the dressing are the same.
More Information

Not Found

No
The summary describes a negative pressure wound therapy system and dressing with no mention of AI or ML capabilities. The performance studies focus on mechanical properties and fluid distribution, not algorithmic performance.

Yes
The device is described as an "integrated wound management system" that "promotes wound healing," "reduces edema," and "removes exudate and infectious material," all of which are therapeutic actions aimed at treating a medical condition.

No

The V.A.C. Ulta Negative Pressure Wound Therapy System is described as an "integrated wound management system" that promotes wound healing and delivers topical wound treatment solutions. Its function is therapeutic, not diagnostic.

No

The device description explicitly details physical components (dressing system with multiple layers) and bench testing of mechanical properties, indicating it is a hardware-based medical device.

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

Here's why:

  • Intended Use: The intended use describes a system for wound management using negative pressure and instillation of topical solutions. This is a therapeutic and wound care application, not a diagnostic test performed on samples taken from the body.
  • Device Description: The description focuses on the physical components of a dressing system designed to be used with a negative pressure wound therapy system. This aligns with a medical device for treatment, not a diagnostic device.
  • Lack of IVD Characteristics: The text does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring specific substances (analytes) in those samples
    • Providing information for diagnosis, monitoring, or screening of diseases or conditions

The device is clearly described as a system for treating wounds, not for diagnosing conditions based on in vitro analysis.

N/A

Intended Use / Indications for Use

The V.A.C. Ulta Negative Pressure Wound Therapy System is an integrated wound management system that provides Negative Pressure Wound Therapy with an instillation option.

Negative Pressure Wound Therapy in the absence of instillation is intended to create an environment that promotes wound healing by secondary or tertiary (delayed primary) intention by preparing the wound bed for closure, reducing edema, promoting granulation tissue formation and perfusion, and by removing exudate and infectious material.

The instillation option is indicated for patients who would benefit from vacuum assisted drainage and controlled delivery of topical wound treatment solutions and suspensions over the wound bed.

The V.A.C. Ulta Negative Pressure Wound Therapy System with and without instillation is indicated for patients with chronic, acute, traumatic, sub-acute and dehisced wounds, partial-thickness burns, ulcers (such as diabetic, pressure and venous insufficiency), flaps and grafts.

The V.A.C. VeraFlo Cleanse Choice Dressing System is intended to be used with the V.A.C. Ulta Negative Pressure Wound Therapy System.

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

OMP

Device Description

The V.A.C. VeraFlo Cleanse Choice Dressing System is intended for use with the V.A.C. Ulta Negative Pressure Wound Therapy System to deliver negative pressure wound therapy (NPWT) as well as facilitate the instillation of fluid to the wound.

The V.A.C. VeraFlo Cleanse Choice Dressing System has the same basic components as the predicate V.A.C. VeraFlo Cleanse Dressing cleared under K103156. The only difference between the two systems is the configuration of the dressing.

The subject system has a dressing that is designed with 3 separate layers. The predicate dressing, on the other hand, is a single spiral shaped rod configuration. The materials of the dressing are the same.

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

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)

Bench Verification testing was performed to confirm:

  • mechanical properties (tensile testing)
  • the dressing, as part of the V.A.C. Ulta Negative Pressure Wound Therapy System creates negative pressure within the sealed wound bed
  • the dressing distributes instillation solution throughout the wound surface

Bench and animal testing have demonstrated that the subject V.A.C VeraFlo Cleanse Choice Dressing System is substantially equivalent to the predicate V.A.C VeraFlo Cleanse Dressing System (K103156).

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

Mechanical Properties (Tensile Strength): Pass (≥230kPa for predicate)

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.

VeraFlo Cleanse Dressing System (K103156)

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

§ 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.

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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 stylized eagle with three overlapping bodies, representing the department's commitment to health, human services, and well-being. The eagle is positioned to the right of the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA", which is arranged in a circular fashion around the left side of the logo.

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

June 20, 2016

Kci Usa, Inc. (kinetic Concepts, Inc.) % Melanie Avila Senior Manager, Regulatory Affairs Kci Usa, Inc. 6203 Farinon Drive San Antonio, Texas 78249

Re: K160451

Trade/Device Name: V. A.c. Veraflo Cleanse Choice Dressing System For Use With The V.a.c. Ulta ... Regulation Number: 21 CFR 878.4780 Regulation Name: Powered Suction Pump Regulatory Class: Class II Product Code: OMP Dated: February 16, 2016 Received: February 18, 2016

Dear Melanie Avila:

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 devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in

1

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,

David Krause -S

for

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) K160451

Device Name

V. A.C. VeraFlo Cleanse Choice Dressing System for use with the V.A.C. Ulta Negative Pressure Wound Therapy System

Indications for Use (Describe)

The V.A.C. Ulta Negative Pressure Wound Therapy System is an integrated wound management system that provides Negative Pressure Wound Therapy with an instillation option.

Negative Pressure Wound Therapy in the absence of instillation is intended to create an environment that promotes wound healing by secondary or tertiary (delayed primary) intention by preparing the wound bed for closure, reducing edema, promoting granulation tissue formation and perfusion, and by removing exudate and infectious material.

The instillation option is indicated for patients who would benefit from vacuum assisted drainage and controlled delivery of topical wound treatment solutions and suspensions over the wound bed.

The V.A.C. Uta Negative Pressure Wound Therapy System with and without is indicated for patients with chronic, acute, traumatic, sub-acute and dehisced wounds, partial-thickness burns, ulcers (such as diabetic, pressure and venous insufficiency), flaps and grafts.

Type of Use (Select one or both, as applicable)

☑ Prescription Use (Part 21 CFR 801 Subpart D)☐ Over-The-Counter Use (21 CFR 801 Subpart C)
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In accordance with 21 CFR 807.87(h) and 21 CFR 807.92, the 510(k) Summary for the V.A.C. VeraFlo Cleanse Choice Dressing System is provided below.

SUBMITTER 1.

KCI USA, Inc. 6203 Farinon Drive San Antonio, TX 78249

Contact Person: Melanie Avila Senior Manager, Regulatory Affairs KCI USA, Inc. Telephone: 210-515-4059 Fax: 210-255-6727 Email: melanie.avila@kci1.com Date Prepared: February 16, 2016

2. DEVICE

Name of Device: V.A.C. VeraFlo Cleanse Choice Dressing System for use with the V.A.C. Ulta Negative Pressure Wound Therapy (NPWT) System Common Name: Negative Pressure Wound Therapy Powered Suction Pump Classification Regulation: 21 CFR 878.4780 Regulatory Class: II Product Code: OMP Panel: General and Plastic Surgery

PREDICATE DEVICE 3.

Predicate Device: VeraFlo Cleanse Dressing System (K103156)

DEVICE DESCRIPTION 4.

The V.A.C. VeraFlo Cleanse Choice Dressing System is intended for use with the V.A.C. Ulta Negative Pressure Wound Therapy System to deliver negative pressure wound therapy (NPWT) as well as facilitate the instillation of fluid to the wound.

The V.A.C. VeraFlo Cleanse Choice Dressing System has the same basic components as the predicate V.A.C. VeraFlo Cleanse Dressing cleared under K103156. The only difference between the two systems is the configuration of the dressing.

The subject system has a dressing that is designed with 3 separate layers. The predicate dressing, on the other hand, is a single spiral shaped rod configuration. The materials of the dressing are the same.

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INDICATIONS FOR USE 5.

The V.A.C. VeraFlo Cleanse Choice Dressing System is intended to be used with the V.A.C. Ulta Negative Pressure Wound Therapy System. The indications for use as follows:

The V.A.C. Ulta Negative Pressure Wound Therapy System is an integrated wound management system that provides Negative Pressure Wound Therapy with an instillation option.

Negative Pressure Wound Therapy in the absence of instillation is intended to create an environment that promotes wound healing by secondary or tertiary (delayed primary) intention by preparing the wound bed for closure, reducing edema, promoting granulation tissue formation and perfusion, and by removing exudate and infectious material.

The instillation option is indicated for patients who would benefit from vacuum assisted drainage and controlled delivery of topical wound treatment solutions and suspensions over the wound bed.

The V.A.C. Ulta Negative Pressure Wound Therapy System with and without instillation is indicated for patients with chronic, acute, traumatic, sub-acute and dehisced wounds, partial-thickness burns, ulcers (such as diabetic, pressure and venous insufficiency), flaps and grafts.

Both the subject system and the predicate system are intended for use with the V.A.C. Ulta Negative Pressure Wound Therapy System. Both systems have the ability to deliver topical wound solutions and suspensions in the wound bed as well as delivery of negative pressure wound therapy. There is no change to the indications for use.

COMPARISON OF TECHNOLOGICAL CHARACTERISTICS 6.

Similarities 6.1.

The V.A.C VeraFlo Cleanse Choice Dressing System is nearly identical to that of the predicate V.A.C VeraFlo Cleanse Dressing System (cleared under K103156). Both systems have the same materials, sterilization, and packaging.

The subject V.A.C. VeraFlo Cleanse Choice Dressing System has the same basic components as the predicate V.A.C. VeraFlo Cleanse Dressing System cleared under K103156. Both dressings of these systems are made from the identical open cell, reticulated, grey polyurethane ester foam stock material.

6.2. Differences

The only difference between the proposed and the predicate system is the configuration of the dressing component. The subject system has a dressing that is provided in three separate layers in an oval shape to allow for flexibility in treating wounds of various depths. The predicate dressing is a tubular shaped rod and is split along the longitudinal axis by the user for ease of configuring.

For convenience purposes, the table below compares the subject and predicate systems.

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Proposed DevicePredicate Device
510(k) NumberK160451K103156
ApplicantSame as predicateKCI USA, Inc.
Trade nameV. A.C. VeraFlo Cleanse Choice
Dressing System for use with the
V.A.C. Ulta Negative Pressure
Wound Therapy SystemV. A.C. VeraFlo Cleanse Dressing System for use
with the V.A.C. Ulta Negative Pressure Wound
Therapy System
Classification
RegulationSame as predicate878.4780
Product CodeSame as predicateOMP
Indications for
UseSame as predicateThe V.A.C.Ulta Negative Pressure Wound Therapy
System is an integrated wound management system
that provides Negative Pressure Wound Therapy
with an instillation option.
The V.A.C.Ulta Negative Pressure Wound Therapy
System in the absence of instillation is intended to
create an environment that promotes wound healing
by secondary or tertiary (delayed primary) intention
by preparing the wound bed for closure, reducing
edema, promoting granulation tissue formation and
perfusion, and by removing exudate and infectious
material.
The instillation option is indicated for patients who
would benefit from vacuum assisted drainage and
controlled delivery of topical wound treatment
solutions and suspensions over the wound bed.
The V.A.C.Ulta Negative Pressure Wound Therapy
System with and without instillation is indicated for
patients with chronic, acute, traumatic, sub-acute and
dehisced wounds, partial-thickness burns, ulcers
(such as diabetic, pressure and venous insufficiency),
flaps and grafts.
Dressing
System
ComponentsSame as predicateV.A.C. VeraT.R.A.C. Pad Assembly
V.A.C. VeraFlo Cleanse Choice
Dressing has 3 layer designV.A.C. VeraFlo Cleanse Dressing has a tubular
shaped rod design
Same as predicateV.A.C. Ruler
Same as predicate3MTM CavilonTM Skin Prep
Same as predicateV.A.C. Advanced Drape
NPWT
Therapy
System DesignSame as predicateThe VeraFlo Cleanse Dressing System is intended
for use with the V.A.C. Ulta NPWT system.
The NPWT system consists of:
• Software controlled therapy unit
• Canister
Proposed DevicePredicate Device
Negative pressure tubing and sensing pad Instillation tubing and pad Foam wound dressing and polyurethane occlusive drape
NPWT System
Operating
PrincipleSame as predicateThe V.A.C. Ulta NPWT system delivers software
controlled negative pressure to the wound site. The
open cells of the foam dressing to which the therapy
unit is connected enable distribution of the negative
pressure across the surface of the wound, while the
tubing transfers accumulated fluids to the canister.
The NPWT system also provides automated delivery
of instillation fluids into the wound bed between
negative pressure therapy cycles.
MaterialsSkin contact material:
Same as predicateSkin contact material:
Occlusive drape (polyurethane film with acrylic
adhesive)
Wound contact material:
Same as predicateWound contact material:
Polyurethane ester foam
Same as predicate0.1% w/v carbon black colorant
Same as predicateDensity in lb/ft3: 5.1 - 6.3
Performance
TestingSame as predicateVerification testing was performed to confirm:
mechanical properties (tensile testing) the dressing, as part of the V.A.C. Ulta Negative
Pressure Wound Therapy System, delivers
negative pressure the dressing distributes instillation solution
throughout the wound surface
Mechanical
Properties
(Tensile
Strength)Pass≥230kPa
SterilizationSame as predicateGamma Irradiation to SAL of 10-6
Sterile
PackagingSame as predicateThermoformed tray of PETG with a Tyvek lid
Shelf lifeSame as predicate2 years

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7. PERFORMANCE DATA

Bench Verification testing was performed to confirm:

  • mechanical properties (tensile testing) ●
  • the dressing, as part of the V.A.C. Ulta Negative Pressure Wound Therapy System creates negative pressure within the sealed wound bed
  • the dressing distributes instillation solution throughout the wound surface

CONCLUSIONS 8.

The only difference between the proposed and the predicate dressing systems is the configuration of the dressing. The subject system has a dressing that is provided in three separate layers in an oval shape to allow for flexibility in treating wounds of various depths. The predicate dressing is a tubular shaped rod and is split along the longitudinal axis by the user for ease of configuring.

Bench and animal testing have demonstrated that the subject V.A.C VeraFlo Cleanse Choice Dressing System is substantially equivalent to the predicate V.A.C VeraFlo Cleanse Dressing System (K103156).