K Number
K181651
Device Name
Radial Medical Compression System
Date Cleared
2018-10-12

(112 days)

Product Code
Regulation Number
870.5800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Radial Medical Compression System is indicated for use in: - Preventing deep vein thrombosis (DVT) - Enhancing blood circulation - Diminishing post-operative pain and swelling - Reducing wound healing time - Treatment and assistance in healing: stasis dermatitis; venous stasis ulcers; arterial and diabetic leg ulcers - Treatment of chronic venous insufficiency - Reducing edema
Device Description
The Radial Medical Compression System (RMCS) is a light weight, mobile, sequential compression device (SCD) placed around the lower leg. The device is designed to provide sequential compression to the calf to augment blood flow. The system includes three components: the Cirvo sequential compression device, an inductive charging cradle and a smart device app (i.e. tablet or smartphone). The RMCS records the amount and duration of compression received during a therapy session as well as compliance with the prescribed therapy. Identified patient data, and compiled, de-identified data will be shared with the treating physician to facilitate clinical decision making. The Cirvo uses a mechanical system to sequentially compress the leg utilizing four tension zones tensioned in series. A circumferential sleeve of polyester material is placed around the calf, held in place using hook and loop straps. During the compression cycle, a reduction in the effective circumference of the sleeve exerts a radially inward force on the calf. The device has a compression cycle time of 6 seconds and a physician-determined dwell time between compression cycles. The range of compression cycle pressures of the Cirvo is 40-60 mmHg.
More Information

Not Found

No
The device description focuses on a mechanical compression system and data recording for compliance, with no mention of AI/ML for analysis or decision-making.

Yes
The device is indicated for medical conditions such as preventing DVT, treating chronic venous insufficiency, and assisting in healing various types of ulcers, which are all therapeutic uses.

No

The device description and intended use clearly state that it is a sequential compression device used to prevent DVT, enhance circulation, diminish pain/swelling, and aid in healing conditions. It records therapy data and compliance, but it does not perform any diagnostic functions or analyze patient data to determine a medical condition or predict an outcome.

No

The device description clearly states that the system includes a "Cirvo sequential compression device" which is a mechanical system utilizing a circumferential sleeve and tension zones to compress the leg. This is a hardware component, not software only.

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

Here's why:

  • IVDs are used to examine specimens from the human body. The Radial Medical Compression System is a physical device applied externally to the leg. It does not analyze blood, tissue, or any other biological sample.
  • The intended use is therapeutic and preventative. The indications for use focus on preventing DVT, enhancing circulation, reducing pain and swelling, and treating various venous and arterial conditions. These are all related to physical therapy and treatment, not diagnostic testing.
  • The device description details a mechanical compression system. It describes how the device applies pressure to the leg, not how it analyzes biological samples.
  • The performance studies measure physiological responses. The studies measure peak venous velocity, which is a measure of blood flow within the body, not a result of analyzing a specimen.

In summary, the Radial Medical Compression System is a therapeutic device that applies external compression to the leg. It does not perform any diagnostic testing on biological samples, which is the defining characteristic of an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The Radial Medical Compression System is indicated for use in:

  • Preventing deep vein thrombosis (DVT)
  • Enhancing blood circulation
  • Diminishing post-operative pain and swelling
  • Reducing wound healing time
  • Treatment and assistance in healing: stasis dermatitis; venous stasis ulcers; arterial and diabetic leg ulcers
  • Treatment of chronic venous insufficiency
  • Reducing edema.

Product codes

JOW

Device Description

The Radial Medical Compression System (RMCS) is a light weight, mobile, sequential compression device (SCD) placed around the lower leg. The device is designed to provide sequential compression to the calf to augment blood flow. The system includes three components: the Cirvo sequential compression device, an inductive charging cradle and a smart device app (i.e. tablet or smartphone). The RMCS records the amount and duration of compression received during a therapy session as well as compliance with the prescribed therapy. Identified patient data, and compiled, de-identified data will be shared with the treating physician to facilitate clinical decision making.

The Cirvo uses a mechanical system to sequentially compress the leg utilizing four tension zones tensioned in series. A circumferential sleeve of polyester material is placed around the calf, held in place using hook and loop straps. During the compression cycle, a reduction in the effective circumference of the sleeve exerts a radially inward force on the calf. The device has a compression cycle time of 6 seconds and a physician-determined dwell time between compression cycles. The range of compression cycle pressures of the Cirvo is 40-60 mmHg.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Calf

Indicated Patient Age Range

Age: 56 (33-78)

Intended User / Care Setting

User: Physician and patient
Where Used: Hospital, physician office, and home

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

A feasibility study was performed in which ten subjects with CEAP 3-6 venous insufficiency were recruited into an IRB approved study of venous flow augmentation. Subjects underwent DVT screening and those who passed the DVT screen went on to have measurement of peak venous velocity in cm/s at the popliteal and femoral veins for the following conditions: (1) baseline (2) Radial device in low setting (3) Radial device in high setting. In 5 patients, an additional measurement of peak venous velocity in cm/s at the popliteal and femoral veins was completed while wearing a commercially available portable intermittent pneumatic compression (IPC) device (Tactile Actitouch). A minimum of 3 peak venous velocities were taken for each condition.

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Clinical Performance Testing (Feasibility Study): 10 subjects. Both settings of the Radial device resulted in higher average peak venous velocities when compared to both baseline and the IPC device (p

§ 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 shows the logos of the Department of Health & Human Services and the Food and Drug Administration (FDA). The Department of Health & Human Services logo is on the left, and the FDA logo is on the right. The FDA logo includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

October 12, 2018

Radial Medical, Inc. % Mark Smutka Consultant Mark Smutka 10984 Northseal Square Cupertino. California 95014

Re: K181651

Trade/Device Name: Radial Medical Compression System Regulation Number: 21 CFR 870.5800 Regulation Name: Compressible Limb Sleeve Regulatory Class: Class II Product Code: JOW Dated: June 19, 2018 Received: June 22, 2018

Dear Mark Smutka:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Actinclude 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

1

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) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.html; good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; 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 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,

Fernando Aguel Fernando Aguel - 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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Indications for Use

510(k) Number (if known)

K181651

Device Name Radial Medical Compression System

Indications for Use (Describe)

The Radial Medical Compression System is indicated for use in:

  • · Preventing deep vein thrombosis (DVT)
  • Enhancing blood circulation
  • · Diminishing post-operative pain and swelling
  • · Reducing wound healing time
  • · Treatment and assistance in healing: stasis dermatitis; venous stasis ulcers; arterial and diabetic leg ulcers
  • · Treatment of chronic venous insufficiency
  • · Reducing edema

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)

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Premarket Notification 510(k) Summary

510(k) Number: K181651

Applicant Information:

Date Prepared:October 4, 2018
Name:Radial Medical, Inc.
Address: 2500 Grant Road
Mountain View, CA 94040
Contact Person:Mark Smutka, Consultant
msmutka@comcast.net
Mobile Number:(408) 981-7531

Device Information:

Trade Name:Radial Medical Compression System
Common Names:Compression Sleeve
Classification Name(s):Compressible Limb Sleeve
Product Code/ Regulation:JOW / 21 CFR 870.5800
Classification:Class II

Predicate Device:

  • Vasculaire Compression System 510(k) #K122609

Device Description:

The Radial Medical Compression System (RMCS) is a light weight, mobile, sequential compression device (SCD) placed around the lower leg. The device is designed to provide sequential compression to the calf to augment blood flow. The system includes three components: the Cirvo sequential compression device, an inductive charging cradle and a smart device app (i.e. tablet or smartphone). The RMCS records the amount and duration of compression received during a therapy session as well as compliance with the prescribed therapy. Identified patient data, and compiled, de-identified data will be shared with the treating physician to facilitate clinical decision making.

The Cirvo uses a mechanical system to sequentially compress the leg utilizing four tension zones tensioned in series. A circumferential sleeve of polyester material is placed around the calf, held in place using hook and loop straps. During the compression cycle, a reduction in the effective circumference of the sleeve exerts a radially inward force on the calf. The device has a compression cycle time of 6 seconds and a physician-determined dwell time between compression cycles. The range of compression cycle pressures of the Cirvo is 40-60 mmHg.

Indications for Use:

The Radial Medical Compression System is indicated for use in:

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  • Preventing deep vein thrombosis (DVT) ●
  • Enhancing blood circulation
  • Diminishing post-operative pain and swelling
  • Reducing wound healing time
  • Treatment and assistance in healing: stasis dermatitis; venous stasis ulcers; arterial and ● diabetic leg ulcers
  • Treatment of chronic venous insufficiency ●
  • Reducing edema. ●

Summary Comparison to Predicate:

The following table provides a summary of substantial equivalence between the subject device and the cited predicate. The subject device has the same intended use as the predicate device. Although the subject device has different technological characteristics than the predicate device, the differences do not raise different questions of safety or effectiveness.

Key AttributesSubject DevicePredicate Device
NameRadial Medical Compression
SystemVasculaire Compression System
K NumberK181651K122609
Indication for UseThe Radial Medical
Compression System is
indicated for use in:
Preventing deep vein
thrombosis (DVT) Enhancing blood
circulation Diminishing post-
operative pain and
swelling Reducing wound
healing time Treatment and
assistance in healing:
stasis dermatitis;
venous stasis ulcers;
arterial and diabetic
leg ulcers Treatment of chronic
venous insufficiency Reducing edemaThe Vasculaire Compression
System is indicated for use in:
Preventing deep vein
thrombosis (DVT) Enhancing blood
circulation Diminishing post-
operative pain and
swelling Reducing wound
healing time Treatment and
assistance in healing:
stasis dermatitis;
venous stasis ulcers;
arterial and diabetic
leg ulcers Treatment of chronic
venous insufficiency Reducing edema

Comparison to Predicate and Reference Devices

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| Target Population | Patients requiring compression
therapy. | Patients requiring compression
therapy. |
|--------------------|--------------------------------------------|--------------------------------------------|
| Where Used | Hospital, physician office, and
home | Hospital, physician office, and
home |
| Anatomical Site | Calf | Calf, or calf and foot |
| User | Physician and patient | Physician and patient |
| Sterility | Non-sterile | Non-sterile |
| Use | Single patient use | Single patient use |
| Power Source | Rechargeable battery | Rechargeable battery |
| Pressure Delivered | 40 – 60 mmHg | 50 – 150 mmHg |

The primary technical difference between the Cirvo and the predicate device is that the Cirvo uses a mechanical system to sequentially compress the leg using a system of pulleys and cables to tension four zones, tensioned in series, to apply pressure (Figure 1) and the Vasculaire uses a pneumatic pump to inflate a series of four bladder zones in series to apply pressure The therapy delivery mode is the same for both devices, sequentially compressing the calf from caudal to cranial to augment venous flow. The clinical effect of the Cirvo is similar to the effect of the predicate device.

Image /page/5/Picture/2 description: The image shows a medical device with upper and lower compression zones. The upper compression zone is located above the lower compression zone. The device has straps with numbers 1, 2, 3, and 4 on them, which are likely used to adjust the compression level.

Figure 1. Sequential compression mechanism of operation. Cirvo on lower leg. Four pulley zones tensioned in series from zone one to four (numbers) tension lower and upper compression zones via straps resulting in compression (arrows).

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Summary of Performance Testing

Functional and performance testing was successfully completed on the subject device. In addition, the subject device has been investigated with respect to biocompatibility, electrical safety, software validation, human factors and clinical requirements. The Radial Medical Compression System has been tested for electromagnetic compatibility and electrical safety.

Bench Testing

The following testing was performed to verify the performance specifications of the Radial Medical Compression System:

  • Device strap tensile test ■
  • Device drive cord tensile test
  • Device strap weld tensile test
  • Device hook and loop tensile test
  • I D-ring chassis strap and T-bar breakaway release tensile test
  • 트 Device shin plate tensile test
  • 트 Simulated use and reliability test
  • 트 Packaging test

In addition, device simulation testing was performed to compare the performance of the Radial Medical Compression System to the predicate device. Bench testing demonstrated that the two devices deliver equivalent pressures.

Biocompatibility

Materials in contact with the patient include the following:

MaterialDescriptionPart#Material Manufacturer
Velcro (inadvertent contact)Velcro strap (nylon)DG15BLTH-SHook-and-Loop
Polyester fabric (sealing the foam)Tek Stretch 4 fabricTS100BW/4WEastex Products, Inc.

Biocompatibility was considered according to ISO 10993-1:2009, Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process (Biocompatibility). Cytotoxicity testing, irritation and sensitization testing were performed and successfully completed.

Software

Radial Medical followed the FDA Guidance Document, "General Principles of Software Validation; Final Guidance for Industry and FDA Staff' (January, 2002) to classify the software as a "moderate level of concern". The software has been prepared in accordance with the FDA guidance document as well as IEC 62304.

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Electrical Safety Testing

Electrical safety testing was performed to demonstrate compliance with the following standards:

  • . IEC 60601-1:2006. Medical electrical equipment - Part 1: General requirements for basic safety and essential performance FDA recognition number: 19-4
  • . IEC/EN 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 (Edition 3). FDA recognition number: 19-2
  • IEC 60601-1-6:2013, Medical electrical equipment - Part 1-6: General requirements for basic safety and essential performance - Collateral standard: Usability
  • IEC60601-1-11: 2015, Medical electrical equipment Part 1-11: General requirements ● for basic safety and essential performance - Collateral Standard: Requirements for medical electrical equipment and medical electrical systems used in the home healthcare environment
  • . FCC Part 15 and Part 18 FCC Part 15, Subpart C (15.209), FCC Part 15, Subpart C (15.207), RSS-210 Issue 9, FCC Part 18 (Consumer Device), FCC Part 15, Subpart B, and Industry Canada ICES-003 Issue 5

In addition, coexistence testing with intentional radiators was successfully completed.

Human Factors Testing

Radial Medical performed human factors testing for the Radial Medical Compression System. Testing operations were performed according to FDA Guidance Document "Applying Human Factors and Usability Engineering to Medical Devices" (Feb. 3, 2016). The usability of the device was also evaluated in compliance with IEC 60601-1-6.

A Use Failure Modes and Effects Analysis (FMEA) was performed to evaluate potential safety issues related to the use or misuse of the device. The analysis revealed that there are no serious safety events that are related to the use or misuse of the product. As part of design testing of the products, formative usability testing was performed to evaluate overall usability and related human factors. The testing evaluated the Radial Medical Compression System performance when used by the intended patient population. The testing shows that the Radial Medical Compression System meets the requirements and expected performance of the intended users. The results also were used as input into the device design.

The device was also shown to be compliant with IEC 60601-1-11 for use in the home healthcare environment.

Clinical Performance Testing

A feasibility study was performed in which ten subjects with CEAP 3-6 venous insufficiency were recruited into an IRB approved study of venous flow augmentation. A baseline summary of subjects' demographics can be found below. Subjects underwent DVT screening and those

1 Provisionally accepted for publication in the Journal of Vascular Surgery

8

who passed the DVT screen went on to have measurement of peak venous velocity in cm/s at the popliteal and femoral veins for the following conditions: (1) baseline (2) Radial device in low setting (3) Radial device in high setting. In 5 patients, an additional measurement of peak venous velocity in cm/s at the popliteal and femoral veins was completed while wearing a commercially available portable intermittent pneumatic compression (IPC) device (Tactile Actitouch). A minimum of 3 peak venous velocities were taken for each condition.

DemographicAverage (Range)
Age56 (33-78)
Weight (lbs)170 (103-277)
BMI (kg/m²)26.6 (19.3-40.9)
Height (inches)66 (61-69)
Gender63% female

As shown below, both settings of the Radial device resulted in higher average peak venous velocities when compared to both baseline and the IPC device (p