K Number
K212359
Device Name
PWD Negative Pressure Wound Therapy System
Date Cleared
2022-09-21

(419 days)

Product Code
Regulation Number
878.4780
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Applied Tissue Technologies PWD™ Platform Wound Dressing Negative Pressure System comprised of the; PWD™ Dressing, PWD™ Negative Pressure Wound Therapy Pump, and the PWD™ Wound Exudate Canister is indicated in patients who would benefit from a suction device (Negative Pressure Wound Therapy) as it creates an environment that may promote wound healing by removing excess wound exudate. The Applied Tissue Technologies Platform Wound Dressing is appropriate for use on the following wounds: exudating, chronic, sub-acute and dehisced wounds, partial thickness burns, ulcers (such as diabetic, pressure and venous insufficiencies), flaps, grafts and closed surgical incisions. PWD Negative Pressure Wound Therapy System is suitable for use both in a hospital and homecare setting.
Device Description
The Applied Tissue Technologies PWD™ Platform Wound Dressing Negative Pressure System consists of the PWD™ Dressing, PWD™ Negative Pressure Wound Therapy Pump and the Wound exudate canister. The system provides a negative pressure wound dressing therapy in a moist environment to facilitate the wound healing process. The dressing has an access port through which fluids can be drawn from the wound site. The same port can also be utilized to administer negative pressure wound therapy using the negative pressure pump if required. The negative pressure pump is used with a collection cannister to collect the exudate. The PWD Platform Wound Dressing is supplied in five different shapes and sizes, all having the same intended use.
More Information

Not Found

No
The description focuses on the mechanical function of a negative pressure wound therapy system and does not mention any AI/ML components or capabilities.

Yes
The device is described as creating an environment that "may promote wound healing by removing excess wound exudate" and facilitating "the wound healing process," which are therapeutic actions.

No

The device is a Negative Pressure Wound Therapy (NPWT) system designed to treat wounds by promoting healing through the removal of exudate and creation of a moist environment. It does not provide information about a patient's health status or diagnose a condition.

No

The device description explicitly lists hardware components: PWD™ Dressing, PWD™ Negative Pressure Wound Therapy Pump, and the PWD™ Wound Exudate Canister.

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

Here's why:

  • Intended Use: The intended use is to provide negative pressure wound therapy to promote wound healing by removing excess wound exudate. This is a therapeutic intervention applied directly to the wound, not a diagnostic test performed on a sample taken from the body.
  • Device Description: The device consists of a dressing, a pump, and a canister. These components are used to apply negative pressure and collect wound fluid, which is a physical treatment process.
  • Lack of Diagnostic Elements: There is no mention of analyzing biological samples (like blood, urine, tissue, etc.) to diagnose a condition, monitor a disease, or determine compatibility. The focus is on the physical treatment of the wound itself.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic purposes. This device does not fit that description.

N/A

Intended Use / Indications for Use

The Applied Tissue Technologies PWD™ Platform Wound Dressing Negative Pressure System comprised of the; PWD™ Dressing, PWD™ Negative Pressure Wound Therapy Pump, and the PWD™ Wound Exudate Canister is indicated in patients who would benefit from a suction device (Negative Pressure Wound Therapy) as it creates an environment that may promote wound healing by removing excess wound exudate. The Applied Tissue Technologies Platform Wound Dressing is appropriate for use on the following wounds: exudating, chronic, acute, traumatic, sub-acute and dehisced wounds, partial thickness burns, ulcers (such as diabetic, pressure and venous insufficiencies), flaps, grafts and closed surgical incisions.

PWD Negative Pressure Wound Therapy System is suitable for use both in a hospital and homecare setting.

Product codes

OMP

Device Description

The Applied Tissue Technologies PWD™ Platform Wound Dressing Negative Pressure System consists of the PWD™ Dressing, PWD™ Negative Pressure Wound Therapy Pump and the Wound exudate canister. The system provides a negative pressure wound dressing therapy in a moist environment to facilitate the wound healing process. The dressing has an access port through which fluids can be drawn from the wound site. The same port can also be utilized to administer negative pressure wound therapy using the negative pressure pump if required. The negative pressure pump is used with a collection cannister to collect the exudate. The PWD Platform Wound Dressing is supplied in five different shapes and sizes, all having the same intended use. The five sizes are identified as follows.

PWD TM Platform Wound Device Dressing Sizes
DescriptionCatalog/REF #
1" RoundAT1070-01
2" RoundAT1071-01
3" RoundAT1072-01
1" x 3" OblongAT1073-01
3" x 5" OblongAT1074-01

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Body surface where wound is present

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Hospital and Homecare setting.

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 testing of the PWD™ Platform Wound Dressing Negative Pressure System was performed to evaluate device vapor transmission characteristics, ability to maintain negative pressure, and the ability to remove exudate. Biocompatibility testing was conducted on the dressing component according to the ISO 10993 standard series. The Pump and the Cannister are not tissue contacting. Test results of all nonclinical testing were acceptable and demonstrate that the device is safe and effective for its intended use. A summary of the Non-clinical Bench tests is provided in the following Table:

Performance Test SummaryDescriptionReference StandardsAcceptance CriteriaResults
Water Vapor Transmission RateMeasures the passage of water vapor through the membrane/adhesive barrierASTM 1249Must be at least equivalent to commercially available NPWT dressingPass
Exudate Throughput Properties Under Negative PressureSimulated Use testing using various exudate types to confirm acceptable fluid flow when connected to the Pump and Canister systemN/ASystem must demonstrate the ability to remove exudates of various types from the wound bedPass
Maintenance of Negative PressureSimulated use testing from under moist conditions to demonstrate maintenance of negative pressureNAThe PWD must maintain negative pressure at the wound bed for the test durationPass
UsabilityUsability testing for both health care and home use environmentsNAUsers must demonstrate the ability to correctly use the devicePass
Electrical SafetyComplies with applicable safety standardsIEC 60601-1, IEC 60601-1-2, IEC 60601-1-11Requirements for electrical safety per the applicable safety standards is metPass
Electro-magnetic CompatibilityComplies with applicable safety standardsComplies with IEC 60601-2-3Requirements for electromagnetic compatibility per the applicable safety standards is metPass

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

Not Found

Predicate Device(s)

K172005, K191460

Reference Device(s)

Not Found

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/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: a symbol on the left and the agency's name on the right. The symbol on the left is a stylized depiction of a human figure, while the text on the right reads "FDA U.S. FOOD & DRUG ADMINISTRATION" in blue letters. The words "FOOD & DRUG" are larger than the other words.

September 21, 2022

Applied Tissue Technologies LLC % Ms. Michele Lucey President Lakeshore Medical Device Consulting LLC 128 Blye HIll Landing Newbury, New Hampshire 03255

Re: K212359

Trade/Device Name: PWD Negative Pressure Wound Therapy System Regulation Number: 21 CFR 878.4780 Regulation Name: Powered suction pump Regulatory Class: Class II Product Code: OMP Dated: August 19, 2022 Received: August 23, 2022

Dear Ms. Lucey:

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

Long Chen, Ph.D. Assistant Director DHT4A: Division of General Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: 06/30/2023 See PRA Statement below.

510(k) Number (if known) K212359

Device Name

PWD™ Platform Wound Dressing Negative Pressure System

Indications for Use (Describe)

The Applied Tissue Technologies PWD™ Platform Wound Dressing Pressure System comprised of the; PWD™ Dressing, PWD™ Negative Pressure Wound Therapy Pump, and the PWD™ Wound Exudate Canister is indicated in patients who would benefit from a suction device (Negative Pressure Wound Therapy) as it creates an environment that may promote wound healing by removing excess wound exudate. The Applied Tissue Technologies Platform Wound Dressing is appropriate for use on the following wounds: exudating, chronic, sub-acute and dehisced wounds, partial thickness burns, ulcers (such as diabetic, pressure and venous insufficiencies), flaps, grafts and closed surgical incisions.

PWD Negative Pressure Wound Therapy System is suitable for use both in a hospital and homecare setting.

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)
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

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3

K212359 Traditional 510(k) SUMMARY

Submitter Information

Submitters' Name:Applied Tissue Technologies LLC
Address:99 Derby Street, Suite 200
Hingham, MA 02043
Telephone:781-366-3848
Contact Person:Ms. Michele Lucey
President, Lakeshore Medical Device Consulting LLC
Address128 Blye Hill Landing,
Newbury, NH 03255
Telephone603-748-1374
Emaillucey_m@msn.com
Date Prepared:September 20, 2022
Device Trade Name:PWD™ Platform Wound Dressing Negative Pressure
System
Classification:Class II
Product Code(s):OMP
Regulation Number(s):21 CFR 878-4780 Powered Suction Pump
Predicate Device (Primary):PICO 7 Single Use Negative Pressure
Wound Therapy System K172005
Predicate Device (Secondary)PWD™ Platform Wound Device K191460

Indications for Use:

The Applied Tissue Technologies PWD™ Platform Wound Dressing Negative Pressure System comprised of the; PWD™ Dressing, PWD™ Negative Pressure Wound Therapy Pump, and the PWD™ Wound Exudate Canister is indicated in patients who would benefit from a suction device (Negative Pressure Wound Therapy) as it creates an environment that may promote wound healing by removing excess wound exudate. The Applied Tissue Technologies Platform Wound Dressing is appropriate for use on the following wounds: exudating, chronic, acute,

4

K212359

traumatic, sub-acute and dehisced wounds, partial thickness burns, ulcers (such as diabetic, pressure and venous insufficiencies). flaps, grafts and closed surgical incisions.

PWD Negative Pressure Wound Therapy System is suitable for use both in a hospital and homecare setting.

Device Description/Technological Characteristics:

The Applied Tissue Technologies PWD™ Platform Wound Dressing Negative Pressure System consists of the PWD™ Dressing, PWD™ Negative Pressure Wound Therapy Pump and the Wound exudate canister. The system provides a negative pressure wound dressing therapy in a moist environment to facilitate the wound healing process. The dressing has an access port through which fluids can be drawn from the wound site. The same port can also be utilized to administer negative pressure wound therapy using the negative pressure pump if required. The negative pressure pump is used with a collection cannister to collect the exudate. The PWD Platform Wound Dressing is supplied in five different shapes and sizes, all having the same intended use. The five sizes are identified as follows.

PWD TM Platform Wound Device Dressing Sizes
DescriptionCatalog/REF #
1" RoundAT1070-01
2" RoundAT1071-01
3" RoundAT1072-01
1" x 3" OblongAT1073-01
3" x 5" OblongAT1074-01

Performance Data:

Bench testing of the PWD™ Platform Wound Dressing Negative Pressure System was performed to evaluate device vapor transmission characteristics, ability to maintain negative pressure, and the ability to remove exudate. Biocompatibility testing was conducted on the dressing component according to the ISO 10993 standard series. The Pump and the Cannister are not tissue contacting. Test results of all nonclinical testing were acceptable and demonstrate that the device is safe and effective for its intended use. A summary of the Non-clinical Bench tests is provided in the following Table:

Performance Test Summary
Test NameDescriptionReference
StandardsAcceptance CriteriaResults
Water Vapor
Transmission
RateMeasures the
passage of water
vapor through the
membrane/adhesive
barrierASTM 1249Must be at least
equivalent to
commercially
available NPWT
dressingPass
ExudateSimulated UseN/ASystem mustPass

5

Performance Test Summary
Test NameDescriptionReference
StandardsAcceptance CriteriaResults
Throughput
Properties
Under
Negative
Pressuretesting using various
exudate types to
confirm acceptable
fluid flow when
connected to the
Pump and Canister
systemdemonstrate the
ability to remove
exudates of various
types from the wound
bed
Maintenance of
Negative
PressureSimulated use testing
from under moist
conditions to
demonstrate
maintenance of
negative pressureNAThe PWD must
maintain negative
pressure at the wound
bed for the test
durationPass
UsabilityUsability testing for
both health care and
home use
environmentsNAUsers must
demonstrate the
ability to correctly use
the devicePass
Electrical
SafetyComplies with
applicable safety
standardsIEC 60601-
1, IEC
60601-1-2,
IEC 60601-
1-11Requirements for
electrical safety per
the applicable safety
standards is metPass
Electro-
magnetic
CompatibilityComplies with
applicable safety
standardsComplies
with IEC
60601-2-3Requirements for
electromagnetic
compatibility per the
applicable safety
standards is metPass

Substantial Equivalence:

The Indications for Use statement for the PWD™ Platform Wound Dressing Negative Pressure System is the same as the PICO 7 Single Use Negative Pressure Wound Therapy System.

The following table provides the evidence to further support the claim for substantial equivalence:

6

Substantial Equivalence Comparison Chart
Feature /
SpecificationPWD™ Platform
Wound Dressing
Negative Pressure
SystemPICO 7 Single
Use Negative
Pressure Wound
Therapy SystemPWDTM
Platform Wound
DressingComparison
Regulatory
Clearance/
Approval
ReferenceN/APrimary
K172005Secondary
K191460N/A
Product CodeOMPOMPOMPSame
Regulation
Number21 CFR 878.478021 CFR
878.478021 CFR 878.4780Same
Regulation NamePowered Suction
PumpPowered Suction
PumpPowered Suction
PumpSame
Anatomical
locationBody surface where
wound is presentBody surface where
wound is presentBody surface
where wound is
presentSame
Where used
(environment)The Negative Pressure
Wound Therapy System
is suitable for use in
both hospital and
homecare
settings.The Negative
Pressure Wound
Therapy System is
suitable for use in
both hospital
and homecare
settings.The Negative
Pressure Wound
Therapy System is
suitable for use in
both hospital and
homecare settings.Same
Indications
for UseThe Applied Tissue
Technologies PWD™
Platform Wound
Dressing Negative
Pressure System
comprised of the;
PWD™ Dressing,
PWD™ Negative
Pressure Wound
Therapy Pump, and the
PWD™ Wound
Exudate Canister is
indicated in patients
who would benefit from
a suction device
(Negative Pressure
Wound Therapy) as it
creates an environment
that may promote
wound healing by
removing excess woundPICO 7 is
indicated for
patients who would
benefit from a
suction device
(Negative Pressure
Wound Therapy) as
it may promote
wound healing via
removal of low to
moderate levels of
exudate and
infectious
materials.
Appropriate wound
types include:
Chronic
Acute
Traumatic
Subacute and
dehisced woundsThe Applied
Tissue
Technologies
PWDTM Platform
Wound Dressing is
intended to be
used in
conjunction with
the Invia Motion
Negative Pressure
Wound Therapy
(NPWT) system
and is indicated in
patients who
would benefit
from a suction
device (NPWT) as
it creates an
environment that
may promote
wound healing by

7

Substantial Equivalence Comparison Chart
Feature /
SpecificationPWD™ Platform
Wound Dressing
Negative Pressure
SystemPICO 7 Single
Use Negative
Pressure Wound
Therapy SystemPWDTM
Platform Wound
DressingComparison
exudate. The Applied
Tissue Technologies
Platform Wound
Dressing is appropriate
for use on the following
wounds: exudating,
chronic, acute,
traumatic, sub-acute
and dehisced wounds,
partial thickness burns,
ulcers (such as diabetic,
pressure and venous
insufficiencies), flaps,
grafts and closed
surgical incisions.
PWD Negative
Pressure Wound
Therapy System are
suitable for use both in
a hospital and homecare
setting.Partial-thickness
burns, Ulcers (such
as diabetic or
pressure)
Flaps and grafts
Closed surgical
incisions
PICO Single Use
Negative Pressure
Wound Therapy
System is suitable
for use
in both a hospital
and homecare
setting.removing excess
wound exudate.
The Applied
Tissue
Technologies
Platform Wound
Dressing is
appropriate for
use on the
following
wounds:
exudating,
chronic, acute,
traumatic, sub-
acute and
dehisced wounds,
partial-thickness
burns, ulcers
(such as: diabetic,
pressure and
venous
insufficiencies),
flaps and grafts
Maximum
Duration of
a single dressing7 Days7 Days3 DaysSame as the
primary
predicate
Negative
Pressure to the
wound surface
requirements in
mmHgFixed setting at -80
mmHg (nominal) to the
wound surfaceFixed setting at -80
mmHg to the wound
surface-80 mmHgSame
Multiple Dressing
Shapes for Wound
Sizes (area = L x
W)1-3" Round
1 x 3" Oblong
3 x 5" Oblong10 x 20 cm to 25 x
25 cm1-3" Round
1 x 3" Oblong
3 x 5" OblongPWD is
smaller than
the predicate
for overall
dimensions.
The dressing
is sized for
the wound

8

Substantial Equivalence Comparison Chart
Feature /
SpecificationPWD™ Platform
Wound Dressing
Negative Pressure
SystemPICO 7 Single
Use Negative
Pressure Wound
Therapy SystemPWD™
Platform Wound
DressingComparison
size. Same as
the Secondary
Predicate
Dressing
Configura
tionClear polyurethane
embossed occlusive
drape with negative
pressure/instillation
tubingClear polyurethane
occlusive drape
dressing with foam
or gauze filler,
negative
pressure/instillation
tubing - filler is cut
to sizeClear
polyurethane
embossed
occlusive drape
with negative
pressure/instillat
ion tubingSame as the
secondary
predicate
Access PortFor attachment to the
negative pressure pump.
For removal of fluids.For attachment to the
negative pressure
pump. For removal
of fluidsFor attachment to
the negative
pressure pump.
For removal of
fluids.Same
Collection PackThe dressing tubing is
connected to the
canister/tubing set
during negative pressure
wound therapy for
collection of fluids. The
fluids are removed from
the wound site and
secured within the
cannister without
requiring additional
dressing changesNo Cannister, relies
on dressing changes
for removal of
exudate, frequency
dependent on the
level of exudateThe dressing
tubing is
connected to the
canister/tubing set
during negative
pressure wound
therapy for
collection of
fluids. The fluids
are removed from
the wound site
and secured
within the
cannister without
requiring
additional
dressing changesSame as the
secondary
predicate.
PumpPWD™ Negative
Pressure Wound
Therapy PumpPICO 7NASame
Pump TypeCustom designed pump
controlled by a
microprocessorCustom designed
pump controlled by
a microprocessorNASame

9

Substantial Equivalence Comparison Chart
Feature /
SpecificationPWD™ Platform
Wound Dressing
Negative Pressure
SystemPICO 7 Single
Use Negative
Pressure Wound
Therapy SystemPWD™
Platform Wound
DressingComparison
How SuppliedPWD Dressing is
supplied Sterile Single
Use Only. The pump
and cannister are
supplied non-sterile
single use onlyThe system is
supplied sterile,
single use onlyPWD Dressing is
supplied Sterile
Single Use Only.The PWD
pump and
cannister are
supplied
nonsterile –
similar to
other systems
with the same
intended use.
This
difference
does not raise
new questions
of safety.
Tissue
Contact
MaterialsPolymers and AdhesivePolymers and
AdhesivePolymers and
AdhesiveSame as the
secondary
predicate
Additives -
antimicrobial,
animal originNoNoNoSame
SterilizationEto at an SAL 10-6EtoEto at an SAL 10-6Same.
Electrical Safety
TestingComplies with IEC
60601-1, IEC 60601-1-
2, IEC 60601-1-11Complies with IEC
60601-1, IEC 60601-
1-2, IEC 60601-1-11NASame
Electromagnetic
CompatibilityComplies with IEC
60601-2-3Complies with IEC
60601-2-3NASame
MR SafetyPump is MR UnsafePump is MR UnsafeNASame

Conclusion:

When considering design, feature, materials, and performance characteristics the PWD™

PNegPlatform Wound Dressing Negative Pressure System is substantially equivalent to the predicate device, the PICO 7 Single Use Negative Pressure Wound Therapy System K172005