K Number
K230677
Device Name
Cork Medical VERSA Negative Pressure Wound System (VCMPP-100)
Manufacturer
Date Cleared
2023-12-06

(271 days)

Product Code
Regulation Number
878.4780
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The VERSA Negative Pressure Wound Therapy System is indicated for use in patients who would benefit from negative pressure wound therapy particularly as the device may promote wound healing by the removal of excess exudates, infectious material, and tissue debris. The VERSA Negative Pressure Wound Therapy System is only intended to be used with the Cork NPWT Wound Dressing Kit (K132004). The VERSA Negative Pressure Wound Therapy System is not intended for home use environments.
Device Description
Cork Medical has developed a negative pressure wound therapy pump with the same intended use as its predicate device, Cork Medical Products Nisus Negative Pressure Wound Therapy System (K140022) but with a compacted footprint compared to the predict device. The VERSA Negative Pressure Wound Therapy System interface utilizes a single membrane switch keypad to power the device and switch between continuous and intermittent therapy modes. One button power on and off the pump and the other button switches pressure settings from 75 mm/Hg and 125 mm/Hg continuous and a 10 second hold on this button switches the pump to a variable intermittent mode, unlike its predecessor Cork NPWT System (K140022) which uses multiple buttons and menus to adjust settings.
More Information

No
The device description and performance studies focus on basic pump functionality and pressure settings, with no mention of AI or ML.

Yes
The device is indicated for promoting wound healing by removing excess exudates, infectious material, and tissue debris, which are therapeutic actions.

No

The device is a negative pressure wound therapy system designed to promote wound healing by removing excess exudates and infectious material, which is a treatment function, not a diagnostic one.

No

The device description explicitly states it is a "negative pressure wound therapy pump" and describes physical components like a "single membrane switch keypad" and buttons, indicating it is a hardware device with integrated software, not a software-only device.

Based on the provided text, the VERSA Negative Pressure Wound Therapy System is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use clearly states the device is for "negative pressure wound therapy" to promote wound healing by removing exudates, infectious material, and tissue debris. This is a therapeutic treatment applied directly to a wound on a patient's body.
  • Device Description: The description details a pump that applies negative pressure to a wound.
  • Mechanism of Action: The device works by physically applying negative pressure to a wound, not by analyzing biological samples in vitro (outside the body).
  • Performance Studies: The performance studies focus on the device's ability to maintain pressure, detect leaks and blocks, and manage battery life – all related to its function as a therapeutic pump. There are no studies related to analyzing biological samples.

IVD devices are used to examine specimens (like blood, urine, or tissue) taken from the human body to provide information for diagnosis, monitoring, or screening. The VERSA system does not perform this function.

N/A

Intended Use / Indications for Use

The VERSA Negative Pressure Wound Therapy System is indicated for use in patients who would benefit from negative pressure wound therapy particularly as the device may promote wound healing by the removal of excess exudates, infectious material, and tissue debris.

The VERSA Negative Pressure Wound Therapy System is only intended to be used with the Cork NPWT Wound Dressing Kit (K132004).

The VERSA Negative Pressure Wound Therapy System is not intended for home use environments.

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

OMP

Device Description

Cork Medical has developed a negative pressure wound therapy pump with the same intended use as its predicate device, Cork Medical Products Nisus Negative Pressure Wound Therapy System (K140022) but with a compacted footprint compared to the predict device.

The VERSA Negative Pressure Wound Therapy System interface utilizes a single membrane switch keypad to power the device and switch between continuous and intermittent therapy modes. One button power on and off the pump and the other button switches pressure settings from 75 mm/Hg and 125 mm/Hg continuous and a 10 second hold on this button switches the pump to a variable intermittent mode, unlike its predecessor Cork NPWT System (K140022) which uses multiple buttons and menus to adjust settings.

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

The VERSA Negative Pressure Wound Therapy System is a prescribed device to be used under the guidance of licensed healthcare professionals. The VERSA NPWT System Instructions for use provide information regarding safe and effective operation of the VERSA Negative Pressure Wound Therapy System.
The VERSA Negative Pressure Wound Therapy System is not intended for home use 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 (study type, sample size, AUC, MRMC, standalone performance, key results)

The VERSA Negative Pressure Wound Therapy System underwent bench performance testing to establish basic functionality. The bench performance tests conducted are:

  • . Continuous Mode Typical Pressure (75-mmHg) Test
  • . Continuous Mode Typical Pressure (125-mmHg) Test
  • . Intermittent Mode Test
  • Low Battery Test .
  • Leak Alarm .
  • Block Alarm .
  • Canister full .
  • Flow Rate Testing .
  • One-Year Aged Canister Testing .
  • Post-Storage Conditional Testing .
  • Battery Run-Time Testing .

The testing results show the VERSA NPWT System functioned as expected. Performance tests used simulated wound exudate. Pressure measurements were taken using a wound test bed fixture.

No clinical testing is required to support these 510(k) submissions. No clinical testing has been performed.

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

Not Found

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.

K140022

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.

K132004

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.

0

Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

December 6, 2023

Cork Medical Antonio Williams Quality/Regulatory Engineer 8000 Castleway Drive Indianapolis. Indiana 46112

Re: K230677

Trade/Device Name: Cork Medical VERSA Negative Pressure Wound System (VCMPP-100) Regulation Number: 21 CFR 878.4780 Regulation Name: Powered suction pump Regulatory Class: Class II Product Code: OMP Dated: November 1, 2023 Received: November 6, 2023

Dear Antonio Williams:

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 (the 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 available 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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device" (https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

1

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30, Design controls; 21 CFR 820.90, Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review, the QS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 Part 803) for devices or postmarketing safety reporting (21 CFR Part 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 Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 mediation-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, Yu-chieh Chiu -S

Yu-Chieh Chiu, Ph.D. Assistant Director DHT4B: Division of Infection Control and Plastic and Reconstructive Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

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Indications for Use

510(k) Number (if known) K230677

Device Name VERSA Negative Pressure Wound Therapy System

Indications for Use (Describe)

The VERSA Negative Pressure Wound Therapy System is indicated for use in patients who would benefit from negative pressure wound therapy particularly as the device may promote wound healing by the removal of excess exudates, infectious material, and tissue debris.

The VERSA Negative Pressure Wound Therapy System is only intended to be used with the Cork NPWT Wound Dressing Kit (K132004).

The VERSA Negative Pressure Wound Therapy System is not intended for home use environments.

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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3

510(k) Summary

807.92(c)

SPONSOR807.92(a)(1)
Company Name:Cork Medical
Company Address:8000 Castleway Drive
Indianapolis, IN 46250
Telephone:317-361-4387
Fax:866-271-2580
Contact Person:Antonio Williams
Date Prepared:11/01/2023
DEVICE NAME807.92(a)(2)
Trade Name:VERSA Negative Pressure Wound
Therapy System
Common / Usual Name:VERSA NPWT System
Classification Name:Negative Pressure Wound Therapy
Powered Suction Pump
Regulation Number:21 CFR 878.4780
Product Code:OMP
Device Class:Class II
Panel:General & Plastic Surgery

PREDICATE DEVICE

807.92(a)(3)

CompanyTrade Name510(k) Number
Cork MedicalCork Medical Products Nisus Negative Pressure
Wound Therapy SystemK140022

DEVICE DESCRIPTION

807.92(a)(4)

Cork Medical has developed a negative pressure wound therapy pump with the same intended

4

use as its predicate device, Cork Medical Products Nisus Negative Pressure Wound Therapy System (K140022) but with a compacted footprint compared to the predict device.

The VERSA Negative Pressure Wound Therapy System interface utilizes a single membrane switch keypad to power the device and switch between continuous and intermittent therapy modes. One button power on and off the pump and the other button switches pressure settings from 75 mm/Hg and 125 mm/Hg continuous and a 10 second hold on this button switches the pump to a variable intermittent mode, unlike its predecessor Cork NPWT System (K140022) which uses multiple buttons and menus to adjust settings.

INDICATIONS FOR USE

807.92(a)(5)

The VERSA Negative Pressure Wound Therapy System is indicated for use in patients who would benefit from negative pressure wound therapy particularly as the device may promote wound healing by the removal of excess exudates, infectious material, and tissue debris.

The VERSA Negative Pressure Wound Therapy System is only intended to be used with the Cork NPWT Wound Dressing Kit (K132004).

The VERSA Negative Pressure Wound Therapy System is not intended for home use environments.

PHYSICIAN ORDERS

Caution: Federal Law (USA) restricts this device to sale by or on the order of a licensed physician.

Use of the VERSA NPWT System must be prescribed by a physician per the stated indications for use. As a condition of use, the VERSA NPWT System should only be used by qualified and authorized personnel.

The user must have the necessary knowledge of the specific medical application for which negative pressure wound therapy is being used.

Prior to placement of the VERSA NPWT System, the medical professional treating the wound must assess how to best use the system for an individual wound. It Is important to carefully assess the wound and patient to ensure clinical indications for negative pressure wound therapy are met.

USER

The VERSA Negative Pressure Wound Therapy System is a prescribed device to be used under the guidance of licensed healthcare professionals. The VERSA NPWT System Instructions for use provide information regarding safe and effective operation of the VERSA Negative Pressure Wound Therapy System.

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USE ENVIRONMENT

VERSA NPWT System is designed for the following environmental conditions:

Operating Temperature: 18ºC to 34ºC (65ºF to 94ºF) Operating Relative Humidity: 10% - 95% Operating Pressure: 700-hPA – 1060-hPA (10.15-atm – 15.37-atm) atmospheric pressure

PREDICATE PRODUCT COMPARISON TABLE

807.92(a)(6)

Subject DevicePredicate Device
CompanyCork MedicalCork Medical
Device NameVERSA Negative Pressure
Wound Therapy SystemCork Medical Products Nisus
Negative Pressure Wound
Therapy System
510(k) NumberK230677K140022
Regulation Number / Product Code21 CFR 878.4780 / OMP21 CFR 878.4780 / OMP
Indications for UseThe VERSA Negative Pressure
Wound Therapy System is
indicated for use in patients who
would benefit from negative
pressure wound therapy
particularly as the device may
promote wound healing by the
removal of excess exudates,
infectious material, and tissue
debris.The Cork Medical Products
Nisus Negative Pressure
Wound Therapy System is
indicated for use in patients
who would benefit from
negative pressure wound
therapy particularly as the
device may promote wound
healing by the removal of
excess exudates, infectious
material, and tissue debris.
Features· Compact size
· 2 continuous pressure
settings of 75mm/Hg and 125
mm/Hg
• Disposable batteries
· Variable intermittent mode· Multiple keys for navigation
including power, menu/select,
exit, up arrow, down arrow,
left arrow, right arrow
· Continuous Setting
· Variable Intermittent
Suction Capacity2 liters / minute4 liters / minute
Maximum Vacuum
Pressure170 mm/Hg220-mmHg
Power Requirements3 x 1.5 V (3 AA battery)18 VDC, 2A
Battery TypeLi-ionLi-ion
Dimensions4.6" (H) x 2.4" (W) x 2.0" (D)
Device
4.6" (H) x 2.4" (W) x 3.0" (D)
with Canister151 x 108 x 71-mm (~6
x 4.3 x 2.8-inches)
Weight0.6 lb0.575-kg (~1.27-lb)
ReusableYesYes
SterileNon-sterileNon-sterile
ComplianceIEC 60601-1-2 ed 4.0 (2014-02)
IEC 60601-1:2005, AMD1:2012
CSA C22.2#60601-1:2014 Ed.3
AAMI ES60601-1:2005+C1;A2:2010
IEC 60601-1-8:2006, AMD1:2012 for use in
conjunction with IEC 60601-1:2005, AMD1:2012
IEC 60601-1-6:2010, AMD1:2013 for use in
conjunction with IEC 62366:2007, AMD1:2014 and
IEC 60601-1:2005, COR1:2006, COR2:2007, AMD1:2012
IEC 60601-1-11:2015 for use in
conjunction with IEC 60601-1:2005, AMD1:2012IEC 60601-1, 3rd Edition (AAMI
IES 60601-1, CAN/CSA C22.2
No. 60601-1-08, EN 60601-1)
IEC 60601-1-2
IEC 60601-1-6/IEC 62366
IEC 60601-1-11
Storage & Shipping Conditions-30°C (-22°F) without relative
humidity control to 60°C (140°F)
up to 90% relative humidity
(non-condensing)-25°C (-13°F) without relative
humidity control to 44°C (111°F)
up to 93% relative humidity
(noncondensing)
Environmental ConditionsOperating Temperature: 18°C to
34°C (65°F to 94°F)
Operating Relative Humidity:
10% - 95%
Operating Pressure: 700-hPA –
1060-hPA (10.15-atm – 15.37-
atm) atmospheric pressureOperating Temperature: 18°C to
34°C (65°F to 94°F)
Operating Relative Humidity:
10% - 95%
Operating Pressure: 700-hPA –
1060-hPA (10.15-atm – 15.37-
atm) atmospheric pressure
AccessoriesCanisters:
One canister size 100 ml
Features: hydrophobic
membrane filter, liquid
solidifier
Bench Testing completed
utilized accessories previously
cleared under (K132004)Canisters:
One canister size 250mL
Features: hydrophobic
membrane filter, liquid
solidifier (cleared with
application)
Wound Dressing Kit: Cork
NPWT Wound Dressing Kit
(K132004)
Bench Testing utilized canisters
in application, and accessories
cleared on separate application.

6

7

NONCLINICAL TESTS

807.92(b)(1)

The VERSA Negative Pressure Wound Therapy System underwent bench performance testing to establish basic functionality. The bench performance tests conducted are:

  • . Continuous Mode Typical Pressure (75-mmHg) Test
  • . Continuous Mode Typical Pressure (125-mmHg) Test
  • . Intermittent Mode Test
  • Low Battery Test .
  • Leak Alarm .
  • Block Alarm .
  • Canister full .
  • Flow Rate Testing .
  • One-Year Aged Canister Testing .
  • Post-Storage Conditional Testing .
  • Battery Run-Time Testing .

The testing results show the VERSA NPWT System functioned as expected. Performance tests used simulated wound exudate. Pressure measurements were taken using a wound test bed fixture.

Software Verification and Validation Testing

Software verification and validation testing were conducted, and documentation was provided as recommended by FDA's Guidance for Industry and FDA Staff, "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices." The software for this device was considered as a "moderate" level of concern. The corresponding software documentation required for a 510(k) submission is included per "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices" as published by the FDA.

Electrical safety and electromagnetic compatibility (EMC)

Electrical safety and EMC testing were conducted on the VERSA Negative Pressure Wound Therapy System. The system complies with the IEC 60601-1: 2005, IEC 60601-1-6: 2010, and IEC 60601-1-11: 2010 standards for safety and the IEC 60601-1-2: ed 4.0 (2014-02) standard for EMC.

8

CLINICAL TESTS

No clinical testing is required to support these 510(k) submissions. No clinical testing has been performed.

CONCLUSIONS

Cork Medical concludes, based on nonclinical testing, that the VERSA Negative Pressure Wound Therapy System is as safe, as effective, and performs as well as the predicate device, Cork Medical Products Nisus Negative Pressure Wound Therapy System (K140022).

807.92(b)(2)

807.92(b)(3)