K Number
K963099
Device Name
HEELBO PULLOVER PONCHO AND PULLOVER PONCHO WITH POCKET
Manufacturer
Date Cleared
1996-11-01

(84 days)

Product Code
Regulation Number
880.6760
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Heelbo Pullover Poncho and Pullover Poncho with Pocket are intended to help prevent a patient from slumping or sliding forward while seated in a wheelchair or geriatric chair. The Heelbo Pullover Poncho's are also intended to limit the patient's movement while lying on a bed and to prevent the patient from falling out of bed or climbing over the side rails.
Device Description
The Heelbo Pullover Poncho and Pullover Poncho with Pocket are poncho-style safety vests. The Heelbo Pullover Poncho and Pullover Poncho with Pocket are intended to help prevent a patient from slumping or sliding forward while seated in a wheelchair or geriatric chair. The Heelbo Pullover Poncho's are also intended to limit the patient's movement while lying on a bed and to prevent the patient from falling out of bed or climbing over the side rails. The Heelbo Pullover Poncho has two straps that secure to the bed frame, wheelchair or geri-chair frame while the Pullover Poncho with Pocket has four straps that secure the bed frame, wheelchair or geri-chair frame. The Pullover Poncho with pocket provides the patient with a pocket to put personal items in. Both Heelbo Poncho restraints are available in a poly/cotton blend or a polyester mesh material and are available in five sizes to accommodate a wide range of patients. Both styles of pullover poncho are machine washable for continued use.
More Information

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No
The device description and intended use describe a physical restraint device with no mention of software, data processing, or AI/ML technologies.

No
The device is described as a safety vest intended to prevent slumping, sliding, falling out of bed, or climbing over side rails, not to treat a disease or condition.

No

Explanation: The device description clearly states its purpose is to prevent patients from slumping, sliding, falling, or moving excessively, which are all related to physical restraint and positioning, not diagnosis. There is no mention of it being used to identify or analyze medical conditions.

No

The device description clearly indicates it is a physical garment (poncho-style safety vest) made of fabric with straps, not software.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health.
  • Device function: The Heelbo Pullover Poncho and Pullover Poncho with Pocket are physical restraints designed to prevent patients from slumping, sliding, or falling. They do not involve testing any biological samples.

The provided information clearly describes a physical restraint device, not a diagnostic test.

N/A

Intended Use / Indications for Use

The Heelbo Pullover Poncho and Pullover Poncho with Pocket are intended to help prevent a patient from slumping or sliding forward while seated in a wheelchair or geriatric chair. The Heelbo Pullover Poncho's are also intended to limit the patient's movement while lying on a bed and to prevent the patient from falling out of bed or climbing over the side rails.

Product codes

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Device Description

The Heelbo Pullover Poncho and Pullover Poncho with Pocket are poncho-style safety vests. The Heelbo Pullover Poncho and Pullover Poncho with Pocket are intended to help prevent a patient from slumping or sliding forward while seated in a wheelchair or geriatric chair. The Heelbo Pullover Poncho's are also intended to limit the patient's movement while lying on a bed and to prevent the patient from falling out of bed or climbing over the side rails. The Heelbo Pullover Poncho has two straps that secure to the bed frame, wheelchair or geri-chair frame while the Pullover Poncho with Pocket has four straps that secure the bed frame, wheelchair or geri-chair frame. The Pullover Poncho with pocket provides the patient with a pocket to put personal items in.

Both Heelbo Poncho restraints are available in a poly/cotton blend or a polyester mesh material and are available in five sizes to accommodate a wide range of patients. Both styles of pullover poncho are machine washable for continued use.

Mentions image processing

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Mentions AI, DNN, or ML

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Input Imaging Modality

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Anatomical Site

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Indicated Patient Age Range

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Intended User / Care Setting

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Description of the training set, sample size, data source, and annotation protocol

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Description of the test set, sample size, data source, and annotation protocol

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Summary of Performance Studies

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Key Metrics

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Predicate Device(s)

Heelbo Pullover Poncho and Pullover Poncho with Pocket

Reference Device(s)

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Pre-determined Change Control Plan (PCCP) - All Relevant Information

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§ 880.6760 Protective restraint.

(a)
Identification. A protective restraint is a device, including but not limited to a wristlet, anklet, vest, mitt, straight jacket, body/limb holder, or other type of strap, that is intended for medical purposes and that limits the patient's movements to the extent necessary for treatment, examination, or protection of the patient or others.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 880.9.

0

Image /page/0/Picture/1 description: The image shows the number 0004. The first two zeros are followed by the number 4. To the left of the first zero is a small image of a square with a triangle in it.

Image /page/0/Picture/2 description: The image shows a handwritten number that appears to be "K963099". The number is written in a bold, black font, and the digits are clearly legible. The number is likely a serial number, product code, or other identifier.

Image /page/0/Picture/3 description: The image shows the text "Heelbo, Inc." in a bold, sans-serif font. The text is black and appears to be the name of a company. The word "Heelbo" is followed by a comma and then "Inc."

1134 N. Homan Ave. Chicago, IL 60651 312/489-7711

Telex RCA 297-248 800/323-5444 Fax 312/489-7744

NOV 1 1996

Heelbo, Inc. Pullover Poncho and Pullover Poncho with Pocket

510(k) Summary

1. 1. Submitter's name, Address and Contact Person

Submitter Heelbo, Inc. 1134 N. Homan Chicago, IL 60651 Contact Person Joseph S. Tokarz, Manager, Regulatory Affairs Hollister Incorporated 2000 Hollister Drive Libertyville, IL 60048 (847)680-2849, Fax (847)918-3860 Ph

Date Summary Prepared - October 30, 1996

2. Name of Device:

Heelbo Pullover Poncho and Pullover Poncho with Pocket

3. Name of Predicate Device(s)

Heelbo Pullover Poncho and Pullover Poncho with Pocket

4. Description of Device

The Heelbo Pullover Poncho and Pullover Poncho with Pocket are poncho-style safety vests. The Heelbo Pullover Poncho and Pullover Poncho with Pocket are intended to help prevent a patient from slumping or sliding forward while seated in a wheelchair or geriatric chair. The Heelbo Pullover Poncho's are also intended to limit the patient's movement while lying on a bed and to prevent the patient from falling out of bed or climbing over the side rails. The Heelbo Pullover Poncho has two straps that secure to the bed frame, wheelchair or geri-chair frame while the Pullover Poncho with Pocket has four straps that secure the bed frame, wheelchair or geri-chair frame. The Pullover Poncho with pocket provides the patient with a pocket to put personal items in.

Both Heelbo Poncho restraints are available in a poly/cotton blend or a polyester mesh material and are available in five sizes to accommodate a wide range of patients. Both styles of pullover poncho are machine washable for continued use.

The following chart shows product availability:

1

Image /page/1/Picture/1 description: The image shows a logo or symbol next to the number 0005. The logo appears to be a square with a checkmark inside. The number 0005 is written in a simple, sans-serif font and is likely a reference number or identifier.

Image /page/1/Picture/2 description: The image shows the text "Heelbo, Inc." in a bold, sans-serif font. The text is black and appears to be the name of a company or organization. The comma after "Heelbo" is slightly raised, and the "Inc." is abbreviated with a period.

1134 N. Homan Ave Chicago, IL 60651 312/489-7711

Telex RCA 297-248
800/323-5444
Fax 312/489-7744

Heelbo, Inc. Pullover Poncho and Pullover Poncho with Pocket

Size of VestMaterialColor
x-smallPoly/Cotton blendWhite
smallPoly/Cotton blendYellow
mediumPoly/Cotton blendBlue
largePoly/Cotton blendGreen
x-largePoly/Cotton blendBeige
x-smallPolyester MeshWhite bias on white breezewear
smallPolyester MeshYellow bias on white breezewear
mediumPolyester MeshBlue bias on white breezewear
largePolyester MeshGreen bias on white breezewear
x-largePolyester MeshBeige bias on white breezewear

5. Statement of Intended Use

The Heelbo Pullover Poncho and Pullover Poncho with Pocket are intended to help prevent a patient from slumping or sliding forward while seated in a wheelchair or geriatric chair. The Heelbo Pullover Poncho's are also intended to limit the patient's movement while lying on a bed and to prevent the patient from falling out of bed or climbing over the side rails.

6. Statement of Technological Characteristics of the Device

The Heelbo Pullover Poncho and Pullover Poncho with Pocket are poncho-style safety vests. The Heelbo Pullover Poncho and Pullover Poncho with Pocket are intended to help prevent a patient from slumping or sliding forward while seated in a wheelchair or geriatric chair. The Heelbo Pullover Poncho's are also intended to limit the patient's movement while lying on a bed and to prevent the patient from falling out of bed or climbing over the side rails. The Heelbo Pullover Poncho has two straps that secure to the bed frame, wheelchair or geri-chair frame while the Pullover Poncho with Pocket has four straps that secure the bed frame, wheelchair or geri-chair frame. The Pullover Poncho with pocket provides the patient with a pocket to put personal items in.

The subject devices are identical in intended use, design, materials, manufacturing process, physical and mechanical specifications and issues of safety and effectiveness to the devices prior to the submission of this notification. The only difference is that the product labeling has been revised to comply with the Agency's labeling requirements set forth in the draft Guidance on the Content of Premarket Notification [510(k)] Submissions for Protective Restraints dated December 1995.

2

Image /page/2/Picture/1 description: The image shows the text "Heelbo, Inc." in a bold, sans-serif font. The text is arranged on a single line, with "Heelbo" followed by a comma and then "Inc." The text is black against a white background.

1134 N. Homan Ave. Chicago, IL 60651 312/489-7711

Telex RCA 297-248 800/323-5444 Fax 312/489-7744

Heelbo, Inc. Pullover Poncho and Pullover Poncho with Pocket

7. Biocompatibility Assessment

The subject devices are identical in components materials to the predicate devices. The suppliers of the materials used in the fabrication of these devices have stated that there is a history of safe use of their materials in the clothing and garment industry. In addition, Heelbo, Inc., is not aware of any reports or complaints of skin irritation associated with these materials.

8. Conclusion

Based upon the information presented above it is concluded that the proposed Heelbo Pullover Poncho and Pullover Poncho with Pocket are safe and effective for their intended use and are substantially equivalent to the predicate devices.