K Number
K192358
Device Name
Pressure Therapy System PT1003
Date Cleared
2020-04-23

(238 days)

Product Code
Regulation Number
890.5650
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The device is air pressure massager intended to temporarily relieve minor muscle aches and/or pains, and to temporarily increase circulation to the treated areas.
Device Description
The system consists of an air pump, leg sleeves and hoses working together as one unit. The air pump is connected to the dedicated sleeves via a series of hoses; one sleeve has 4 compression chambers. The compression massage direction is from limb end to body center by inflating the air chambers sequentially and then deflating as one cycle, the pressure can be adjusted to avoid any discomfort to the patient. The sleeve works under the action of sensor and microprocessor. This software is to control the timing and the pressure reflected by the sensor, it cycles the airflow to reach the function of cycling compression of body parts.
More Information

No
The description mentions a microprocessor and sensor controlling timing and pressure, which is standard embedded system functionality, not indicative of AI/ML. There are no mentions of AI, ML, DNN, training data, or complex algorithms beyond basic control logic.

Yes.
The device is intended to temporarily relieve minor muscle aches and/or pains and to temporarily increase circulation, which are therapeutic claims.

No

The device is described as an "air pressure massager" intended to "temporarily relieve minor muscle aches and/or pains, and to temporarily increase circulation". Its function is described as cycling compression, and there is no mention of it being used to diagnose any condition or disease.

No

The device description explicitly states the system consists of an air pump, leg sleeves, and hoses working together as one unit, indicating significant hardware components beyond just software.

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

Here's why:

  • Intended Use: The intended use is to "temporarily relieve minor muscle aches and/or pains, and to temporarily increase circulation to the treated areas." This describes a physical therapy or massage device, not a device used to examine specimens derived from the human body to provide information for diagnosis, monitoring, or compatibility testing.
  • Device Description: The device description details an air pressure massager system with an air pump, leg sleeves, and hoses. This is a mechanical device that applies external pressure.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), using reagents, or providing diagnostic information based on the analysis of such samples.
  • Testing: The testing described focuses on electrical safety, electromagnetic compatibility, biological evaluation (irritation and sensitization), and functional performance (pressure, airflow, noise, modes). These are typical tests for a physical therapy or medical device that interacts externally with the body, not for an IVD.
  • Predicate Devices: The predicate devices listed are also air compression therapy systems, which are not IVDs.

In summary, the device's function, intended use, and testing all point to it being a physical therapy or medical device for external application, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The device is air pressure massager intended to temporarily relieve minor muscle aches and/or pains, and to temporarily increase circulation to the treated areas.

Product codes

IRP

Device Description

The system consists of an air pump, leg sleeves and hoses working together as one unit. The air pump is connected to the dedicated sleeves via a series of hoses; one sleeve has 4 compression chambers. The compression massage direction is from limb end to body center by inflating the air chambers sequentially and then deflating as one cycle, the pressure can be adjusted to avoid any discomfort to the patient. The sleeve works under the action of sensor and microprocessor. This software is to control the timing and the pressure reflected by the sensor, it cycles the airflow to reach the function of cycling compression of body parts.

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

Clinics, hospital, athlete training, and home environments

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

The Pt1003 pressure therapy system has been tested and met the following standards: AAMI ANSI ES 60601-1:2005/(R) 2012 and A1:2012, C1:2009/(R)2012 and A2:2010/(R)2012 (Consolidated Text) Medical electrical equipment - Part 1: General requirements for basic safety and essential performance (IEC 60601-1:2005, MOD)

IEC 60601-1-2 Edition 3: 2007-03. Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic compatibility - Requirements and tests

IEC 60601-1-11 Edition 2.0 2015-01, 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

ISO10993-5, Biological evaluations of medical devices -- Part 5: Tests for In Vitro cytotoxicity

ISO 10993-10, Biological evaluation of medical devices - Part 10: Tests for irritation and skin sensitization

Function test

  • Minimum and maximum air pressure test
  • Test the maximum electric current value
  • Test the maximum airflow value
  • Test the noise level
  • Test the modes A and B.

The test was done on PT1003 following the test procedure defined. When we compare the test data with the predicate device, we can found the test result is almost same.

Key Metrics

Not Found

Predicate Device(s)

K183169, K182668

Reference Device(s)

K181409

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 890.5650 Powered inflatable tube massager.

(a)
Identification. A powered inflatable tube massager is a powered device intended for medical purposes, such as to relieve minor muscle aches and pains and to increase circulation. It simulates kneading and stroking of tissues with the hands by use of an inflatable pressure cuff.(b)
Classification. Class II (performance standards).

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Image /page/0/Picture/0 description: The image shows 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.

April 23, 2020

Xiamen Senyang Co., Ltd. % Raymond Luo Technical Manager Shanghai SUNGO Management Consulting Co., Ltd. 13th F, 1500# Century Avenue Shanghai, China 200122

Re: K192358

Trade/Device Name: Pressure Therapy System PT1003 Regulation Number: 21 CFR 890.5650 Regulation Name: Powered Inflatable Tube Massager Regulatory Class: Class II Product Code: IRP Dated: September 12, 2019 Received: February 26, 2020

Dear Raymond Luo:

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 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

1

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) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

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/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

For Vivek J. Pinto, PhD Director DHT5B: Division of Neuromodulation and Physical Medicine Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K192358

Device Name Pressure Therapy System PT1003

Indications for Use (Describe)

The device is air pressure massager intended to temporarily relieve minor muscle aches and/or pains, and to temporarily increase circulation to the treated areas.

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

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

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

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510(K) Summary

A. Applicant:

Name: XIAMEN SENYANG CO., LTD. Address: 4-5 FLOOR, XINGBEI INDUSTRY, NO 95-99, WEST 2 ROAD, JIU TIANHU, XINGLIN XIAMEN, 361000, P.R. China

Official Contact Person Information Shanghai SUNGO Management Consulting Co., Ltd. Name: Raymond Luo Tel: 0086-21-68828050 Mail: fda.sungo@gmail.com

B. Subject device:

Trade name:Pressure Therapy System PT1003
Common name:Powered inflatable Tube Massage
Classification name:Massager, Powered Inflatable Tube
Regulation Medical SpecialtyPhysical Medicine
Regulation Number890.5650
Product CodeIRP
ClassificationClass II

C. Predicate device:

  1. Pulse 2.0, Pulse Pro 2.0 of NormaTec Industries, LP, K183169

  2. Rapid Reboot Compression Therapy System, Rapid Reboot Recovery Products, LLC, K182668

D. Reference device:

K181409, Pressure Therapy System PT1003, Rx Only

E. Indications for Use:

The device is air pressure massager intended to temporarily relieve minor muscle aches and to temporarily increase circulation to the treated areas.

F. Prescriptive

The Pressure Therapy System PT1003, and the predicate (K183169 and K182668) are OTC devices.

G. Device Description:

The system consists of an air pump, leg sleeves and hoses working together as one unit. The air pump is connected to the dedicated sleeves via a series of hoses; one sleeve has 4 compression chambers. The compression massage direction is from limb end to body center by inflating the air chambers sequentially and then deflating as one cycle, the pressure can be adjusted to avoid any discomfort to the patient. The sleeve works under the action of sensor and microprocessor. This software is to control the timing and the pressure reflected by the sensor, it cycles the airflow to reach the function of cycling compression of body parts.

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H. Substantial Equivalence Table

DeviceSubject DevicePredicate Device 01Predicate Device 02
ManufacturerXIAMEN SENYANG CO., LTD.NormaTec Industries, LP,Rapid Reboot Recovery Products, LLC
Model NamePt 1003Pulse 2.0, Pulse Pro 2.0Not Publicly Available
ClassificationClass II Device, IRP (21 CFR890.5650)Class II Device, IRP (21 CFR890.5650)Class II Device, IRP (21 CFR890.5650)
PrescriptiveNo. OTCNo. OTCNo. OTC
Indications for
useThe device is air pressure massagers intended to
temporarily relieve minor muscle aches and/or
pains, and to temporarily increase circulation to
the treated areas.The device is air pressure massagers intended to
temporarily relieve minor muscle aches and/or
pains, and to temporarily increase circulation to
the treated areas.The Rapid Reboot Compression Therapy System
is indicated for the temporary relief of minor
muscle aches and pains and for temporary
increase in circulation to the treated areas in
people who are in good health. The Rapid
Reboot Compression Therapy System simulates
kneading and stroking of tissues by using an
inflatable garment.
Intended use
EnvironmentClinics, hospital, athlete training, and
home environmentsClinics, hospital, athlete training, and
home environmentsClinics, hospital, athlete training, and home
environments
StandardAAMI ANSI ES
60601-1:2005/(R)2012 and A1:2012
IEC 60601-1-11.
IEC 60601-1-2
ISO10993-5& ISO10993-10AAMI ANSI ES
60601-1:2005/(R)2012 and A1:2012
IEC 60601-1-11.
IEC 60601-1-2
ISO10993-5& ISO10993-10IEC 60601-1:2014; IEC
60601-1-2:2014; EN ISO
10993-5:2009 & EN ISO
10993-10:2010
Software
Micro-processor
ControlMicroprocessorMicroprocessorMicroprocessor
Mode of
CompressionSequential Gradient, Peristaltic and
PulsingSequential Gradient, Peristaltic and
PulsingSequential Gradient, Peristaltic and
Pulsing
Power Source110 V, 60Hz15 VDC via an IEC 60601-1
compliant power supply (100- 240 VAC110 V, 60Hz
Therapy Time0-30Mininput) Integrated rechargeable battery
Stays on until the user turns it off or can be set
up to turn off in a range of 10 minutes to
continuous.User determines therapy time. Choose from 10,
20, or 30 minute session time, with option to add
additional 10 minutes to any therapy time.
Max Pressure
Min Pressure20-200mm Hg0-110mm Hg0-200 mmHg
Number of
Chambers4 Chambers for each unit5 or less4 Chambers for each unit
Compression
Applicator
Garments
Sleeve MaterialThermoplastic Urethane200 denier nylon with a polyurethane
laminate/extrusionNylon with a Polyurethane
laminate
TechnologyCompressor and valve system that
sequentially inflates cells of appliance.Compressor and valve system that
sequentially inflates cells of appliance.Compressor and valve system which
sequentially inflates cells of appliance
Cycle time70sNot Publicly Available1 min 20s
Patient ContactNon-conductive appliancesNon-conductive appliancesNon-conductive appliances
SizeSize 285175130mmSize: 4.4" x 3.8" x 8.1 "Size: 10" x 6.5" x 5"
Preprogrammed
modesModel Adjustable: The number of zones that are
enabled in the attachment can be changed
between one and five zones.Model Adjustable: The number of zones that are
enabled in the attachment can be changed
between one and five zones.2 modes: "A" mode inflates and deflates
chambers from bottom up (distal to proximal
chambers), one at a time. "B" mode also inflates
chambers from bottom up, but maintains
pressure in lower chambers as works its way to
top. Then all chambers release pressure at same
time once all chambers have sequentially
inflated

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Determination of Substantial Equivalence I.

The following factors of Pressure Therapy System PT1003 are substantially equivalent to currently marketed and cleared devices (K183169).

  • A Indications for Use: The Pressure Therapy System PT1003 indications for use are identical to the predicate, NormaTec Pulse 2.0, Pulse Pro 2.0, 510(k) K183169.
  • A Prescriptive: The Pressure Therapy System PT1003, and the predicate (K183169) are OTC devices.
  • Performance and Specifications: The Pressure Therapy System PT1003 have equivalent specifications of performance when compared to the predicate, NormaTec Pulse 2.0, Pulse Pro 2.0, 510(k) K183169.

  • Compliance with Standards: Both subject device and predicate device comply with the same standards expect the special standard related to the blue tooth function.

  • Intended Use Environment: Clinics, hospital, athlete training, and home environments, which are identical to the predicate.

  • Materials for patient contact are Non-conductive appliances.

The following factors of Pressure Therapy System PT1003 are different from currently marketed and cleared devices (K183169).

  • A Pressure range of the predicate device is 0-110mm Hg while current device is 20-200mm Hg. To ensure the pressure is safe, we identified another predicate device. K182668, which is also for OTC use and the pressure scope is 0 to 200mmHg.
  • A Design, Technology, and Principle of Operation: The proposed device has not got Bluetooth capability but this will not bring any new risk to the subjected device.

J. Performance characteristic

The Pt1003 pressure therapy system has been tested and met the following standards: AAMI ANSI ES 60601-1:2005/(R) 2012 and A1:2012, C1:2009/(R)2012 and A2:2010/(R)2012 (Consolidated Text) Medical electrical equipment - Part 1: General requirements for basic safety and essential performance (IEC 60601-1:2005, MOD)

IEC 60601-1-2 Edition 3: 2007-03. Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic compatibility - Requirements and tests

IEC 60601-1-11 Edition 2.0 2015-01, 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

ISO10993-5, Biological evaluations of medical devices -- Part 5: Tests for In Vitro cytotoxicity

ISO 10993-10, Biological evaluation of medical devices - Part 10: Tests for irritation and skin sensitization

Function test

  • Minimum and maximum air pressure test
  • Test the maximum electric current value
  • Test the maximum airflow value
  • Test the noise level
  • Test the modes A and B.

The test was done on PT1003 following the test procedure defined. When we compare the test data with the predicate device, we can found the test result is almost same.

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K. Conclusion

The Pt1003 Pressure Therapy System has substantially equivalent intended use as the cleared NormaTec Pulse 2.0, Pulse Pro 2.0, (K183169) and has substantially equivalent technological and performance characteristics. The pressure scope is safe by compare with the predicate device Rapid Reboot Recovery Products, LLC, K182668. After analyzing laboratory testing to applicable standards, it is concluded that Pt1003 Pressure Therapy System is as safe and effective as the predicate device, has few technological differences, but there are no new indications for use and does not raise any new safety and/or effectiveness concerns. Consequently, it is substantially equivalent to the predicate device.