K Number
K962788
Date Cleared
1997-04-30

(287 days)

Product Code
Regulation Number
890.5225
Reference & Predicate Devices
N/A
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The CLINI-DYNE rotational/low air loss system is a patient rotation, pressure relieving support system used for the treatment and prevention of decubitus ulcers, urinary tract blockage, to aid circulation and for complications associated with immobility.

Device Description

The CLINI-DYNE Rotational Therapy System consists of an electromechanical inflation pump control unit which is connected to a mattress with cells (air filled bladders) through hose assemblies connected to the inflation pump. The system affords programmed patient position changes by gently turning the patient from supine to left side or right side and back to supine position when staff is unable to do so or needs assistance.

AI/ML Overview

The provided text describes a Premarket Notification [510(K)] Summary for the GAYMAR INDUSTRIES, INC. CLINI-DYNE Rotational Therapy System. This document focuses on demonstrating substantial equivalence to a predicate device (CLA 1400 System) rather than reporting on a study demonstrating the device meets pre-defined acceptance criteria in the way a clinical trial for a novel AI device would.

Therefore, the requested information elements related to AI device performance studies (like sample size for test sets, expert consensus, MRMC studies, standalone performance, training sets, etc.) are not applicable to this document. This is a regulatory submission for a medical device that predates the common application of AI in medical imaging or diagnosis.

However, I can extract information related to the device's technical specifications and safety testing, which serve as a form of "acceptance criteria" for demonstrating substantial equivalence.

Here's the information that can be extracted from the provided text, adapted to the requested format where possible:


1. Table of Acceptance Criteria and Reported Device Performance

For this type of 510(k) submission, "acceptance criteria" are typically defined by demonstrating that the new device is as safe and effective as the predicate device. The performance is compared feature-by-feature for substantial equivalence.

Feature / Acceptance Criteria CategoryPredicate Device (CLA-1400) PerformanceCLINI-DYNE (CLD-1000) PerformanceAcceptance (Substantial Equivalence)
Biocompatibility
Primary Skin IrritationPassPassMet
Delayed Contact SensitizationPassPassMet
CytotoxicityPassPassMet
Tissue Interface TestingPassPassMet
FlammabilityPassPassMet
UL ApprovalsUL 544UL 2601-1 (pending)Considered Met (with pending approval)
Alerts (Audible)YesYesMet
Audible Alert Silence30 minutesNoDifference (See Note 1)
Head of Bed Elevation AlertYesNo*Difference (See Note 1)
Out of Rotation AlertYesNo*Difference (See Note 1)
Siderail UP/Down AlertYesNo*Difference (See Note 1)
Alerts (Visual)YesYesMet
Alerts (Hi/low pressure)YesYesMet
Alerts (Out of range)YesYesMet
Rotation Angle0-45°0-40°**Substantially Equivalent
CPR Deflate MechanismQuick-disconnect feature of hose from pumpRemove panel at mattressSubstantially Equivalent

NOTE 1: The document notes "See Substantial Equivalence" for these differences, implying that despite the direct difference, the total package of features and safety data still allows for a claim of substantial equivalence for the intended use.


2. Sample size used for the test set and the data provenance

  • Not Applicable. This document describes a Traditional 510(k) for a physical medical device (Rotational Therapy System). The "test set" and "data provenance" as understood in AI/ML performance studies (e.g., patient data, image sets) are not relevant here. The "testing" involved physical and electrical safety standards (e.g., biocompatibility on materials, flammability, UL standards).

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

  • Not Applicable. Ground truth in the context of expert consensus on data interpretation is not relevant for this device's regulatory submission. Safety and performance were assessed against established technical standards and by comparison to a predicate device.

4. Adjudication method for the test set

  • Not Applicable. Adjudication methods (e.g., 2+1, 3+1) are used for resolving disagreements among multiple experts interpreting data, which is not applicable to the type of testing described here.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

  • Not Applicable. MRMC studies are used for evaluating diagnostic performance, often in conjunction with AI. This document is for a physical patient support system.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

  • Not Applicable. This is not an AI algorithm.

7. The type of ground truth used

  • For Biocompatibility, Tissue Interface Testing, and Flammability: The "ground truth" was established by standardized laboratory testing procedures against pass/fail criteria for physical and chemical properties.
  • For UL Approvals: "Ground truth" is compliance with Underwriters Laboratories (UL) standards.
  • For comparative features: "Ground truth" is the demonstrated performance and characteristics of the predicate device (CLA-1400).

8. The sample size for the training set

  • Not Applicable. This device does not involve a "training set" in the context of AI/ML.

9. How the ground truth for the training set was established

  • Not Applicable. This device does not involve a "training set."

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Image /page/0/Picture/1 description: The image shows the word "GAYMAR" in bold, black letters. The letters are sans-serif and appear to be a standard font. To the right of the word, there is a small circle with an R inside, indicating a registered trademark.

GAYMAR INDUSTRIES, INC.

APR 30 1997 K962788

Premarket Notification [510(K)] Summary

Submitter:Peter Scott
Phone:716/662-2551, ext. 676
FAX:716/662-8763
Date Summary
Prepared:January 30, 1997
Device Name:CLINI-DYNE Rotational Therapy System
Common Name:Rotation/Low Air Loss System
Classification Name:Alternating Pressure Air Flotation Mattress per
21 CFR, Section 880.5550
Predicate Device:CLA 1400 System

Intended use of Device:

The CLINI-DYNE rotational/low air loss system is a patient rotation, pressure relieving support system used for the treatment and prevention of decubitus ulcers, urinary tract blockage, to aid circulation and for complications associated with immobility.

Description: The CLINI-DYNE Rotational Therapy System consists of an electromechanical inflation pump control unit which is connected to a mattress with cells (air filled bladders) through hose assemblies connected to the inflation pump. The system affords programmed patient position changes by gently turning the patient from supine to left side or right side and back to supine position when staff is 10 CENTRE DRIVE ORCHARD PARK, NY 14127 unable to do so or needs assistance.

(716) 662-2551 / (800) 828-7341 FAX #: (716) 662-6120

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Substantial Equivalence:

The following tables, CLINI-DYNE substantial equivalence matrix and the safety testing comparison table, summarize the technological characteristics and the nonclinical performance data upon which the substantial equivalence submission was made to the Food and Drug Administration.

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CLINI-DYNE SUBSTANTIAL EQUIVALENCE MATRIX

7/11/96

ి లేదా పెళ్ళి
మూలాలు
మూలాలు
మూలాలు
మూలాలు

CLA-1400(Predicate)CLD-1000
PERFORMANCE
Patient Support SurfaceOverlayBlowerMattressElectro-mechanical reciprocatingpump
Air Source
Pressure controlmechanismMicroprocessor controlledpressure relief valveMicroprocessor controlledpressure relief valve
Voltage120v 60Hz Nominal120v 60Hz Nominal
Ambient60-90°F60-90°F
Tissue interface pressuremeasurementsPressure reliefPressure relief
Rotation angle0-45°0-40° **
Safety
Maximum allowablepressure controlled byMechanical relief valve (55-60mmHg)Mechanical relief valve (56 mmHg)
CPR Deflate mechanismQuick-disconnect feature of hosefrom pumpRemove panel at mattress
Physicalcharacteristics
Construction (Patientsupport surface)Air filled cells used as an overlayAir filled cells contained in a foamcrib used as a mattress
Function &Intended uses
Type of therapy providedTreatment of the diseases ofimmobility and treatment ofpressure ulcersTreatment of the diseases ofimmobility and treatment ofpressure ulcers
(Primary) TargetpopulationAcute care and alternate caresettingsAcute care and alternate caresettings
Life Expectancy (pump)Reusable*Reusable*
Life Expectancy (cell)Resusable*Reusable*
Product LabelingRefer to TAB C - LABELINGRefer to TAB B - LABELING
ApprovalsUI 544UL 2601-1 (submitted)
  • Cleanable using suggested disinfectants and cleaning agents.

** Dependent on physical characteristics of the patient. (40° minimum when set at maximum angle setting for each patient.)

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COMPARISON OF MAJOR CHARACTERISTICS

Characteristic

CLA-1400 (PREDICATE)

Cl

CLD-1000

Alerts
Audible Alertsyesyes
Alert Silence (minutes)30no
Head of Bed Elevation Alertyesno*
Out of Rotation Alertyesno*
Siderail UP/Down Alertyesno*
Visual Alertsyesyes

Rotation

Automatic Left Onlyyesyes
Automatic Left to Rightyesyes
Automatic Right Onlyyesyes
Center Only (no rotation)yesyes
Manual Left Onlyyesyes
Manual Right Onlyyesyes
Var.Angle, Min.range (degrees)0-450-45
Variable Rateyesyes
Rotation Cycle Times (minutes)90, 30, 10, 260, 45, 30, 15

Cushion

Placed onto Hospital Bedyesno (mattress replacement)
CPR Deflateyesyes
Low Air Lossyesyes
Pressure Relievingyesyes
Support Surface Inflation Controlyesyes
Disposable Coversyesno**
Disposable Support Surfaceyesno**
Footboard/Foot Support Cushionyesyes

Air Control Pump

120 Volt ACyesyes
60 Hzyesyes
Amperage1-51
Control Panel Lock-outyesyes
Microprocessor Controlyesyes
U.L. Listedyesyes
Weight (lbs.)2519
  • See Substantial Equivalence

**Reusable mattress

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VI. SAFETY SUMMARY

Safety Testing Comparison Table

CLA 1400CLD 1000
Biocompatibility
a) primary skin irritationpasspass
b) delayed contact sensitizationpasspass
c) cytotoxicitypasspass
Tissue Interface Testingpasspass
Flammabilitypasspass
UL ApprovalsUL 544UL 2601-1(pending)

Alerts

a)hi/low pressureyesyes
b)out of rangeyesyes

§ 890.5225 Powered patient rotation bed.

(a)
Identification. A powered patient rotation bed is a device that turns a patient who is restricted to a reclining position. It is intended for medical purposes to treat or prevent bedsores, to treat severe and extensive burns, urinary tract blockage, and to aid circulation.(b)
Classification. Class II (special controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 890.9.