K Number
K974868
Device Name
SIGMA PLUS MONOPLACE HYPERBARIC CHAMBER
Date Cleared
1998-07-02

(185 days)

Product Code
Regulation Number
868.5470
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The monoplace hyperbaric chamber is indicated for use for the following clinical medical conditions in accordance with guidelines established by the Undersea and Hyperbaric Medical Society, as follows: 1. Air or Gas Embolism 2. Carbon Monoxide / Smoke Inhalation 3. Compromised Skin Grafts and Flaps 4. Crush Injuries / Acute Traumatic Ischemias 5. Decompression Sickness 6. Enhanced Healing in Selected Problem Wounds 7. Exceptional Blood Loss (Anemia) 8. Gas Gangrene (Clostridial Myonecrosis) 9. Intracranial Abscess 10. Necrotizing Soft Tissue Infections 11. Radiation Tissue Damage (Osteoradionecrosis) 12. Refractory Osteomyelitis 13. Thermal Burns
Device Description
The Perry Baromedical Corporation SIGMA Plus Monoplace Hyperbaric Chamber is substantially equivalent to the Perry Baromedical Corporation SIGMA I Monoplace Hyperbaric Chamber, [510(k) K832127]. The SIGMA Plus has the same intended use and the same technological characteristics as the SIGMA I predicate device. The scope and operation of the SIGMA Plus is identical to that of the SIGMA I in the following areas: - The critical component of both systems consists of an ASME pressure vessel that is designed, fabricated, and tested in accordance with the requirements of the ASME Boiler and Pressure Vessel Code, Section VIII, Division I; and ASME PVHO-1, Safety Standard for Pressure Vessels for Human Occupancy. - The pressure vessel consists of certified metal components constructed of materials in conformance with the ASME Boiler and Pressure Vessel Code, Section II - Materials. In addition to the metal parts, the pressure retaining boundary consists of an acrylic plastic cylinder, designed and constructed to the requirements of ASME PVHO-1, Safety Standard for Pressure Vessels for Human Occupancy. - The pressure vessel is protected from accidental over pressurization by an ASME "UV" stamped pressure relief valve. - The medium used for pressurization of the chamber is either compressed pure oxygen or compressed breathing air. - Treatment capacity of the chamber is one (1) patient. - Communication between the patients / attendants is through an intrinsically safe communications system. - The SIGMA I and SIGMA Plus chambers are used to provide Hyperbaric Oxygen Therapy, prescribed by a licensed physician, where medical grade oxygen is administered to patients while under pressure; either by the patient breathing the chamber atmosphere, (when pressurized with oxygen), or by the patient breathing oxygen from a breathing hood or breathing mask, (when pressurized with breathing air); The breathing of oxygen at elevated pressure promotes the movement of oxygen into the patient's tissues. - The chamber pressurization and depressurization control system is completely pneumatic, with no electrical or electronic components. Differences do exist between the SIGMA Plus and the SIGMA I Monoplace chamber; they include: - The PVHO-1 acrylic cylinder in the SIGMA Plus chamber is 40" inside diameter, and the PVHO-1 acrylic cylinder in the SIGMA I chamber is 25.25" inside diameter. Both acrylic cylinders are designed with a 20 to 1 safety factor. - The pneumatic controls for the SIGMA Plus chamber are mounted in a control box that is suspended from a moveable arm, allowing use from either side of the chamber; while the pneumatic controls for the SIGMA I chamber are mounted in a panel on one side of the chamber. - The SIGMA Plus Monoplace Hyperbaric Chamber has painted fiberglass cosmetic covers on the sides and ends of the chamber; the SIGMA I Monoplace Hyperbaric Chamber has a wheeled aluminum support chassis.
More Information

Not Found

No
The device description explicitly states that the chamber pressurization and depressurization control system is completely pneumatic, with no electrical or electronic components. There is no mention of AI or ML in the intended use, device description, or any other section.

Yes
The device is a monoplace hyperbaric chamber used to administer hyperbaric oxygen therapy for various medical conditions, promoting the movement of oxygen into the patient's tissues, which is a therapeutic action.

No

The device description clearly states its purpose is to provide Hyperbaric Oxygen Therapy for various medical conditions, and it describes how it administers oxygen under pressure to patients. The text does not mention any diagnostic functions such as detection, monitoring, or analysis of medical conditions.

No

The device description clearly details a physical hyperbaric chamber constructed with ASME pressure vessels, acrylic cylinders, and pneumatic controls. It is a hardware device for delivering hyperbaric oxygen therapy.

Based on the provided text, 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 description clearly states that the monoplace hyperbaric chamber is used for Hyperbaric Oxygen Therapy. This involves administering oxygen to a patient while they are under increased pressure within the chamber. This is a treatment applied directly to the patient's body, not a test performed on a sample taken from the body.
  • Intended Use: The listed clinical conditions are all treated by altering the patient's physiological environment (increased oxygen and pressure), not by analyzing biological samples.

Therefore, the monoplace hyperbaric chamber is a therapeutic device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The monoplace hyperbaric chamber is indicated for use for the following clinical medical conditions in accordance with guidelines established by the Undersea and Hyperbaric Medical Society, as follows:

  1. Air or Gas Embolism
  2. Carbon Monoxide / Smoke Inhalation
  3. Compromised Skin Grafts and Flaps
  4. Crush Injuries / Acute Traumatic Ischemias
  5. Decompression Sickness
  6. Enhanced Healing in Selected Problem Wounds
  7. Exceptional Blood Loss (Anemia)
  8. Gas Gangrene (Clostridial Myonecrosis)
  9. Intracranial Abscess
  10. Necrotizing Soft Tissue Infections
  11. Radiation Tissue Damage (Osteoradionecrosis)
  12. Refractory Osteomyelitis
  13. Thermal Burns

Product codes

73 CBF

Device Description

The Perry Baromedical Corporation SIGMA Plus Monoplace Hyperbaric Chamber is substantially equivalent to the Perry Baromedical Corporation SIGMA I Monoplace Hyperbaric Chamber, [510(k) K832127]. The SIGMA Plus has the same intended use and the same technological characteristics as the SIGMA I predicate device. The scope and operation of the SIGMA Plus is identical to that of the SIGMA I in the following areas:

  • The critical component of both systems consists of an ASME pressure vessel that is designed, fabricated, and tested in accordance with the requirements of the ASME Boiler and Pressure Vessel Code, Section VIII, Division I; and ASME PVHO-1, Safety Standard for Pressure Vessels for Human Occupancy.
  • The pressure vessel consists of certified metal components constructed of materials in conformance with the ASME Boiler and Pressure Vessel Code, Section II - Materials. In addition to the metal parts, the pressure retaining boundary consists of an acrylic plastic cylinder, designed and constructed to the requirements of ASME PVHO-1, Safety Standard for Pressure Vessels for Human Occupancy.
  • The pressure vessel is protected from accidental over pressurization by an ASME "UV" stamped pressure relief valve.
  • The medium used for pressurization of the chamber is either compressed pure oxygen or compressed breathing air.
  • Treatment capacity of the chamber is one (1) patient.
  • Communication between the patients / attendants is through an intrinsically safe communications system.
  • The SIGMA I and SIGMA Plus chambers are used to provide Hyperbaric Oxygen Therapy, prescribed by a licensed physician, where medical grade oxygen is administered to patients while under pressure; either by the patient breathing the chamber atmosphere, (when pressurized with oxygen), or by the patient breathing oxygen from a breathing hood or breathing mask, (when pressurized with breathing air); The breathing of oxygen at elevated pressure promotes the movement of oxygen into the patient's tissues.
  • The chamber pressurization and depressurization control system is completely pneumatic, with no electrical or electronic components.

Differences do exist between the SIGMA Plus and the SIGMA I Monoplace chamber; they include:

  • The PVHO-1 acrylic cylinder in the SIGMA Plus chamber is 40" inside diameter, and the P VHO-1 acrylic cylinder in the SIGMA I chamber is 25.25" inside diameter. Both acrylic cylinders are designed with a 20 to 1 safety factor.
  • The pneumatic controls for the SIGMA Plus chamber are mounted in a control box that is suspended from a moveable arm, allowing use from either side of the chamber; while the pneumatic controls for the SIGMA I chamber are mounted in a panel on one side of the chamber.
  • The SIGMA Plus Monoplace Hyperbaric Chamber has painted fiberglass cosmetic covers on the sides and ends of the chamber; the SIGMA I Monoplace Hyperbaric Chamber has a wheeled aluminum support chassis.

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

Licensed physician (prescriber).
Care setting is not explicitly stated but implied to be a medical facility where hyperbaric oxygen therapy is administered.

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)

K832127

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 868.5470 Hyperbaric chamber.

(a)
Identification. A hyperbaric chamber is a device that is intended to increase the environmental oxygen pressure to promote the movement of oxygen from the environment to a patient's tissue by means of pressurization that is greater than atmospheric pressure. This device does not include topical oxygen chambers for extremities (§ 878.5650).(b)
Classification. Class II (performance standards).

0

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December 24, 1997

K974868

7 555 GARDES ROWN REFERA BEACH Frorton 33404 - 3411 LSA

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510(k) SUMMARY Page 1 of 3

Food and Drug Administration Center for Devices and Radiological Health Document Mail Center (HFZ-401) 9200 Corporate Blvd. Rockville, Maryland 20850

Document Control Clerk Attention:

SIGMA Plus Monoplace Hyperbaric Chamber Summary of Safety & Subject: Effectiveness Information

Gentlemen:

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

Substantial Equivalence: The Perry Baromedical Corporation SIGMA Plus Monoplace Hyperbaric Chamber is substantially equivalent to the Perry Baromedical Corporation SIGMA I Monoplace Hyperbaric Chamber, [510(k) K832127]. The SIGMA Plus has the same intended use and the same technological characteristics as the SIGMA I predicate device. The scope and operation of the SIGMA Plus is identical to that of the SIGMA I in the following areas:

  • The critical component of both systems consists of an ASME pressure vessel that is l designed, fabricated, and tested in accordance with the requirements of the ASME Boiler and Pressure Vessel Code, Section VIII, Division I; and ASME PVHO-1, Safety Standard for Pressure Vessels for Human Occupancy.
  • The pressure vessel consists of certified metal components constructed of materials in 2 conformance with the ASME Boiler and Pressure Vessel Code, Section II - Materials. In addition to the metal parts, the pressure retaining boundary consists of an acrylic plastic cvlinder, designed and constructed to the requirements of ASME PVHO-1, Safety Standard for Pressure Vessels for Human Occupancy.
  • The pressure vessel is protected from accidental over pressurization by an ASME "UV" 3 stamped pressure relief valve.

1

Image /page/1/Picture/0 description: The image shows a logo with a circular design on the left and the text "PERRY BAROMEDICAL" on the right. The circular design consists of a semi-circular arc and several smaller circles arranged in a pattern. The text is stacked vertically, with "PERRY" on top of "BAROMEDICAL". The font appears to be a serif typeface.

Research and Children 年来看到了 - 大 - 大 - 大 - 大 - 大 - 大 -ﺍﯾﻦ ﺍﺳﺖ.

SIGMA Plus 510(k) Summary Page 2 of 3

  • The medium used for pressurization of the chamber is either compressed pure oxygen or 4 compressed breathing air.
  • Treatment capacity of the chamber is one (1) patient. 5
  • Communication between the patients / attendants is through an intrinsically safe 6 communications system.
  • The SIGMA I and SIGMA Plus chambers are used to provide Hyperbaric Oxygen 7 Therapy, prescribed by a licensed physician, where medical grade oxygen is administered to patients while under pressure; either by the patient breathing the chamber atmosphere, (when pressurized with oxygen), or by the patient breathing oxygen from a breathing hood or breathing mask, (when pressurized with breathing air); The breathing of oxygen at elevated pressure promotes the movement of oxygen into the patient's tissues.
  • The chamber pressurization and depressurization control system is completely pneumatic, 8 with no electrical or electronic components.

Differences do exist between the SIGMA Plus and the SIGMA I Monoplace chamber; they include:

  • l The PVHO-1 acrylic cylinder in the SIGMA Plus chamber is 40" inside diameter, and the P VHO-1 acrylic cylinder in the SIGMA I chamber is 25.25" inside diameter. Both acrylic cylinders are designed with a 20 to 1 safety factor.
  • 2 The pneumatic controls for the SIGMA Plus chamber are mounted in a control box that is suspended from a moveable arm, allowing use from either side of the chamber; while the pneumatic controls for the SIGMA I chamber are mounted in a panel on one side of the chamber.
  • 3 The SIGMA Plus Monoplace Hyperbaric Chamber has painted fiberglass cosmetic covers on the sides and ends of the chamber; the SIGMA I Monoplace Hyperbaric Chamber has a wheeled aluminum support chassis.

2

Image /page/2/Picture/0 description: The image shows the logo for Perry Baromedical. The logo consists of a semi-circular shape with several dots emanating from the open side. To the right of the shape is the text "Perry Baromedical" stacked on two lines.

! : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SIGMA Plus 510(k) Summary Page 3 of 3

:

The changes to the SIGMA I system resulting in the SIGMA Plus Monoplace Hyperbaric Chamber enhance its ease of operation, and do not adversely effect the safety and effectiveness of the device. The basic treatment method is identical, only the chamber size has been increased.

None of the above information is confidential and all may be made available to the public upon written request.

Perry Baromedical Corporation

Aarons Dock

12-24-17
Date

James P. Dodson Quality Assurance Manager

12-24-71
Date

3

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

2 1998

Mr. James P. Dodson Perry Baromedical Corp. 7555 Garden Road Riviera Beach, FL 33404-3411

Re : K974868 SIGMA Plus Monoplace Hyperbaric Chamber Regulatory Class: II (two) Product Code: 73 CBF Dated: April 3, 1998 Received: April 6, 1998

Dear Mr. Dodson:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we 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, Druq, and Cosmetic Act (Act). You may, therefore, market the device, subject to the general controls provisions of the Act. 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.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or requlations.

4

Page 2 - Mr. James P. Dodson

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4648. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597, or at its internet address "http://www.fda.gov/cdrh/dsma/dsmamain.html".

Sincerely yours,

Thomas J. Callahan

Thomas J. Callahan, Ph.D. Director Division of Cardiovascular, Respiratory, and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Operations & Maintenance Manual Addenda

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PERRY BAROMEDICAL CORPORATION 7555 Garden Rd "B" Riviera Beach FL 33404 (561) 840-0395

April 1, 1998

FDA Indications for Use Statement Subject :

The monoplace hyperbaric chamber is indicated for use for the following clinical medical I he monopiace nyperbare chamber is marcated for accords.
cpndconditions accordance with guidelines established by the Undersea and Hyperbaric Medical Society, as follows:

  • Air or Gas Embolism 1.
  • Carbon Monoxide / Smoke Inhalation 2.
  • Compromised Skin Grafts and Flaps 3.
  • Crush Injuries / Acute Traumatic Ischemias 4.
  • Decompression Sickness 5.
  • Enhanced Healing in Selected Problem Wounds ର.
  • Exceptional Blood Loss (Anemia) 7.
  • Gas Gangrene (Clostridial Myonecrosis) 8.
  • Intracranial Abscess ರು
  • Necrotizing Soft Tissue Infections 10.
  • Radiation Tissue Damage (Osteoradionecrosis) l l .
  • Refractory Osteomyelitis l 2.
  • Thermal Burns 13.

Mark Kramer

(Division Sign-Off Division of Continuascular, Respirato and Neurolo ne .. Dev 510(k) ivumber

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