K Number
K963466
Device Name
PEDIATRIC LIMB HOLDER
Date Cleared
1997-02-13

(163 days)

Product Code
Regulation Number
880.6760
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The DeRoyal Industries, Inc. Pediatric Limb Holder is indicated for use, at the discretion of a responsible licensed healthcare professional, to limit pediatric patient limb movements thereby enabling examination of the patient or others. The Pediatric Limb Holder can be used with an OR table, gurney, bed, or stretcher.
Device Description
The DeRoyal Industries, Inc. Pediatic Limb Holder is a protective restraint device that is intended for medical purposes to limit pediatric patient limb movements thereby enabling examination or protection of the patient or others. Device Design/Materials UsedPhysical Properties: The DeRoyal Pediatric Limb Holder is designed similar to those marketed by other manufacturers. The Pediatic Limb Holder is primarily comprised of polyester straps with hook and loop fasteners.
More Information

Not Found

Not Found

No
The device description and intended use clearly describe a physical restraint device made of straps and fasteners, with no mention of software, data processing, or any technology that would involve AI or ML.

No
The device is described as a "protective restraint device" used to limit limb movements for examination or protection, not for treating a disease or condition.

No
The device is described as a "protective restraint device" used to limit limb movements "thereby enabling examination of the patient or others." It does not detect, diagnose, or monitor any medical condition.

No

The device description explicitly states it is comprised of "polyester straps with hook and loop fasteners," indicating it is a physical hardware device, not software.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections.
  • Device Function: The DeRoyal Pediatric Limb Holder is a physical restraint device used to limit patient movement. It does not involve testing samples from the body.
  • Intended Use: The intended use is to limit limb movements for examination or protection, not for diagnostic testing.
  • Device Description: The description focuses on the physical components and function of a restraint device.

Therefore, the DeRoyal Pediatric Limb Holder falls under the category of a medical device, but not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The DeRoyal Industries, Inc. Pediatric Limb Holder is indicated for use, at the discretion of a responsible licensed healthcare professional, to limit pediatric patient limb movements thereby enabling examination of the patient or others. The Pediatric Limb Holder can be used with an OR table, gurney, bed, or stretcher.

Product codes

Not Found

Device Description

The DeRoyal Industries, Inc. Pediatic Limb Holder is a protective restraint device that is intended for medical purposes to limit pediatric patient limb movements thereby enabling examination or protection of the patient or others.

Device Design/Materials UsedPhysical Properties: The DeRoyal Pediatric Limb Holder is designed similar to those marketed by other manufacturers. The Pediatic Limb Holder is primarily comprised of polyester straps with hook and loop fasteners.

Materials: Primarily comprised of 100% polyester twill tape and white webbing. Materials also include blue purr foam or white kodel. Fasteners are made of hook and loop.

Size: Infant, child, teen

Vehicles for Attachment: OR Table, gurney, bed, or stretcher

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

limb

Indicated Patient Age Range

pediatric

Intended User / Care Setting

responsible licensed healthcare professional

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)

Not Found

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

Not Found

Predicate Device(s)

Not Found

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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

K963466

DeRoyal Industries, Inc. Pediatric Limb Holder

FEB 1 3 1997

510(k) Summary

SUMMARY OF THE SAFETY AND EFFECTIVENESS INFORMATION UPON WHICH AN EQUIVALENCE DETERMINATION COULD BE BASED

SUBMITTER INFORMATION

NAME:DeRoyal Industries, Inc.TELEPHONE:(423) 938-7828
ADDRESS:200 DeBusk Lane
Powell, TN 37849CONTACT:Camille Matlock
DATE OF PREPARATION:August 30, 1996

DEVICE NAMES

DeRoyal Industries, Inc. Pediatric Limb Holder NAME: Pediatric Limb Holder COMMON/USUAL NAME: CLASSIFICATION NAME (if known): Restraint, Protective (80FMQ)

PREDICATE OR LEGALLY MARKETED DEVICES

J.T. Posey Company DeRoyal Industries, Inc.

DEVICE DESCRIPTION

The DeRoyal Industries, Inc. Pediatic Limb Holder is a protective restraint device that is intended for medical purposes to limit pediatric patient limb movements thereby enabling examination or protection of the patient or others.

Device Design/Materials UsedPhysical Properties: The DeRoyal Pediatric Limb Holder is designed similar to those marketed by other manufacturers. The Pediatic Limb Holder is primarily comprised of polyester straps with hook and loop fasteners.

DEVICE INTENDED USE

The DeRoyal Industries, Inc. Pediatric Limb Holder is indicated for use, at the discretion of a responsible licensed healthcare professional, to limit pediatric patient limb movements thereby enabling examination of the patient or others. The Pediatric Limb Holder can be used with an OR table, gurney, bed, or stretcher.

CharacteristicDeRoyal DeviceOther Devices
MaterialsPrimarily comprised of 100% polyester twill
tape and white webbing. Materials also include
blue purr foam or white kodel. Fasteners are
made of hook and loop.Same
SizeInfant, child, teenSame
Vehicles for AttachmentOR Table, gurney, bed, or stretcherSame
Length of useDoctor must prescribe every 24 hoursSame
Level of Patient ActivityLimb Interference by Pediatric PatientSame

TECHNOLOGICAL COMPARISON WITH PREDICATE OR LEGALLY MARKETED DEVICE(S)