K Number
K172103
Device Name
Flowtron DVT5 Small Calf Garment
Date Cleared
2018-03-02

(233 days)

Product Code
Regulation Number
870.5800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
• To help prevent Deep Vein Thrombosis (DVT)
Device Description
The Flowtron Small Calf Garment is a wraparound Calf garment comprising of a bladder and surrounding material intended to apply cyclic compression to calf to improve return venous blood flow to prevent and reduce the risk of Deep Vein Thrombosis (DVT). The Flowtron Small Calf Garment is connected to an ArjoHuntleigh Flowtron pneumatic pump. The pump controls and generated the delivery of air to inflate and deflate the Calf Garment in a cyclic manner. Flowtron Calf Garments are configured with a custom design connector that means that they are only compatible with ArjoHuntleigh Flowtron pneumatic pumps
More Information

No
The description focuses on mechanical compression and pneumatic pump control, with no mention of AI or ML terms or functionalities.

Yes
The device is intended to "help prevent Deep Vein Thrombosis (DVT)" and "improve return venous blood flow to prevent and reduce the risk of Deep VeTnhrombosis (DVT)", which are therapeutic actions.

No
The device description states its purpose is to "apply cyclic compression to calf to improve return venous blood flow to prevent and reduce the risk of Deep Vein Thrombosis (DVT)." This describes a therapeutic or preventative action, not a diagnostic one (i.e., it doesn't detect, measure, or analyze a condition).

No

The device description explicitly details a physical garment with a bladder and surrounding material, connected to a pneumatic pump, indicating it is a hardware device, not software-only.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body (like blood, urine, tissue) to provide information about a person's health. This information is used for diagnosis, monitoring, or screening.
  • Device Description: The Flowtron Small Calf Garment is a physical device that applies external compression to the calf. It does not interact with or analyze any bodily fluids or tissues.
  • Intended Use: The intended use is to prevent DVT by improving blood flow through external compression, not by analyzing biological samples.

This device falls under the category of a therapeutic or preventative medical device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

  • To help prevent Deep Vein Thrombosis (DVT)

Product codes

JOW

Device Description

The Flowtron Small Calf Garment is a wraparound Calf garment comprising of a bladder and surrounding material intended to apply cyclic compression to calf to improve return venous blood flow to prevent and reduce the risk of Deep Vein Thrombosis (DVT).
The Flowtron Small Calf Garment is connected to an ArjoHuntleigh Flowtron pneumatic pump. The pump controls and generated the delivery of air to inflate and deflate the Calf Garment in a cyclic manner.
Flowtron Calf Garments are configured with a custom design connector that means that they are only compatible with ArjoHuntleigh Flowtron pneumatic pumps

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

calf

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

Testing to demonstrate equivalence included:

  • Performance testing of garments – Pressure cyclic test with Flowtron pneumatic pumps. Result: Passed
  • Evaluation of durability of garment fastening. Result: Passed
  • Evaluation at environmental extremes. Result: Passed
  • Evaluation of shelf life. Result: Passed
  • Evaluation of shipping and distribution. Result: Passed
  • Evaluation of biocompatibility. Result: Passed

Key Metrics

Not Found

Predicate Device(s)

K925717

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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).

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo features the letters 'FDA' in a blue square, followed by the words 'U.S. FOOD & DRUG ADMINISTRATION' in blue text.

March 2, 2018

Getinge (Suzhou) Co., Ltd. % David Movnham Regulatory Compliance Manager ArjoHuntleigh AB 35 Portmanmoor Road Cardiff, cf24 5hn Gb

Re: K172103

Trade/Device Name: Flowtron DVT5 Small Calf Garment Regulation Number: 21 CFR 870.5800 Regulation Name: Compressible Limb Sleeve Regulatory Class: Class II Product Code: JOW Dated: January 10, 2018 Received: January 19, 2018

Dear David Moynham:

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 of medical device-related adverse events) (21 CFR 803); good

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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.

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.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely.

Nicole G. Ibrahim -S

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

Enclosure

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Image /page/2/Picture/0 description: The image shows the logo for ArjoHuntleigh, a Getinge Group company. The text "ARJOHUNTLEIGH" is displayed in two colors, with "ARJO" in blue and "HUNTLEIGH" in gray. Below the company name, the text "GETINGE GROUP" is written in gray, indicating that ArjoHuntleigh is part of the Getinge Group.

Indications For Use

510(k) Number: K172103

Device Name: Flowtron DVT5 Small Calf Garment

Indications for Use:

  • . To help prevent Deep Vein Thrombosis (DVT)
    Prescription Use YES (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use NO (Part 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)

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510(k) Summary Flowtron DVT5 Small Calf Garments

ARJOHUNTLEIGH

GETINGE GROUP

K172103 page 1 of 2

| Name & Address: | Getinge (Suzhou) Co., Ltd.
No. 158 Fangzhou Road
Sip, Suzhou, Jiangsu,
Suzhou Jiangsu, CHINA 215024 | | |
|----------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------|---------------------------|
| Telephone: | +(44) 29 2044 7084 | | |
| Fax: | +(44) 29 2049 2520 | | |
| Prepared: | 01 December 2017 | | |
| Contact: | David Moynham – Regulatory Compliance Manager | | |
| Device Name: | Flowtron DVT5 Small Calf Garment | | |
| Common Name | Sleeve, Limb, Compressible | | |
| Classification | Class | Product Code | Classification Regulation |
| | II | JOW | 21 CFR 870.5800 |
| Classification Name: | Sleeve, Limb, Compressible | | |
| Predicate Device: | K925717, DVT10(S) Limb Compression Sleeves Calf Garments | | |
| Indications for Use: | • To help prevent Deep Vein Thrombosis (DVT) | | |
| Description : | The Flowtron Small Calf Garment is a wraparound Calf garment
comprising of a bladder and surrounding material intended to apply
cyclic compression to calf to improve return venous blood flow to
prevent and reduce the risk of Deep Vein Thrombosis (DVT). | | |
| | The Flowtron Small Calf Garment is connected to an ArjoHuntleigh
Flowtron pneumatic pump. The pump controls and generated the
delivery of air to inflate and deflate the Calf Garment in a cyclic
manner. | | |
| | Flowtron Calf Garments are configured with a custom design connector
that means that they are only compatible with ArjoHuntleigh Flowtron
pneumatic pumps | | |

Models

Model REFDeviceFeature
DVT5Flowtron Small Calf Garment Up to 36 cm (14")Smaller Size

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Image /page/4/Picture/0 description: The image contains the logo for ARJOHUNTLEIGH GETINGE GROUP. The text "ARJOHUNTLEIGH" is displayed in two colors, with "ARJO" in blue and "HUNTLEIGH" in gray. Below this, the words "GETINGE GROUP" are written in gray, indicating that ArjoHuntleigh is part of the Getinge Group.

Substantial Equivalence: The Flowtron DVT5 Small Calf Garment and the DVT10(S) Calf Garment included in the predicate device clearance are identical in materials, function and indications for use.

The only difference being the size of the Flowtron Calf Garment.

Full details of the verification and validation of the smaller calf garments have been included in the submission.

Testing to demonstrate equivalence included:

Testing conductedResult
Performance testing of garments – Pressure cyclic
test with Flowtron pneumatic pumps.Passed
Evaluation of durability of garment fastening.Passed
Evaluation at environmental extremes.Passed
Evaluation of shelf lifePassed
Evaluation of shipping and distributionPassed
Evaluation of biocompatibilityPassed

Technologies Summary: DVT garments are compression sleeves intended to be wrapped around patient calf. They inflate and deflate in a cyclic manner when connected to a Flowtron pneumatic pump. The garments are passive devices and do not contain any technologies. The Flowtron pneumatic pump is the active part of the system but is outside the scope of this application. The subject garment DVT5 is non-sterile and the predicate device is sterile. The differences in garments are the size aspect. The difference being

the size from DVT10(S) (Sleeves are extended in width, so that are suitable to fit a patient's calf of up to 17 inches circumference) to that of DVT5 (Small garment designed to fit calf circumferences up to 14inches).

Conclusion: The submission device and the predicate device are identical in in materials, function and indications for use.

The differences are the width and the height of the submission device.

The data detailed within submission including that drawn from the nonclinical tests demonstrate that the predicate and the submission device are substantially equivalent.