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510(k) Data Aggregation

    K Number
    K213313
    Date Cleared
    2022-02-09

    (128 days)

    Product Code
    Regulation Number
    870.5800
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    Veinoflow SCD, LBTK-M-I 5006 is a system to prevent DVT (Deep Vein Thrombosis) by improving the blood velocity of patients. LBTK-M-I 5006 is indicated for Circulation Enhancement, Deep Vein Thrombosis Prophylaxis, Edema -Acute, Edema - Chronic, Extremity Pain Incident to Trauma or Surgery, Leg ulcers, Venous Stasis / Venous Insufficiency.

    Device Description

    Veinoflow SCD, Model LBTK-M-I 5006, is a pneumatic pump system that supplies compressed air to inflate garments that are attached to a patent's lower limbs. It consists of a pump controller, specially designed inflation and deflation garments for feet and legs, air supply tubes, and power line. The inflation and deflation garments have 3 types: ① leg garments, ② calf garments, ③ foot cuffs. The system offers sequential inflation and propels the vein blood from limb to heart, therefore enhancing the blood circulation. The controller can automatically detect the external garment type, and provides pressure correspondingly. The pressure value is preset and adjustable. The controller has a self test system, when there is any error, it will alarm both in visual and audio.

    AI/ML Overview

    This document does not describe acceptance criteria for the performance of an AI/ML device in terms of diagnostic accuracy or clinical outcomes. Instead, it is a 510(k) summary for a medical device called "Veinoflow SCD" (Model: LBTK-M-I 5006), which is an intermittent pneumatic compression device.

    The study described is focused on demonstrating substantial equivalence to a predicate device (Veinoflow SCD, Model: LBTK-M-I 5001, K123830), primarily through non-clinical testing of safety and performance characteristics. This type of regulatory submission does not typically involve the kinds of studies (e.g., multi-reader multi-case studies, standalone algorithm performance) that would be conducted for AI/ML-driven diagnostic or prognostic devices seeking to establish clinical performance.

    Here's an analysis based on the provided text, addressing your questions where applicable and noting where the information is not present:


    1. Table of Acceptance Criteria and Reported Device Performance

    The acceptance criteria here are based on compliance with established international standards for medical devices and demonstration that differences from the predicate device do not raise new safety or effectiveness concerns.

    Acceptance Criteria (Standard / Characteristic)Reported Device Performance (Veinoflow SCD, Model: LBTK-M-I 5006)
    Electrical Safety: Conformance to ANSI AAMI ES60601-1: 2005/(R)2012 And A1:2012, C1:2009(R)2012 And A2:2010/(R)2012 (Consolidated Text) Medical Electrical Equipment - Part 1: General Requirements For Basic Safety And Essential Performance (IEC 60601-1:2005, MOD)Passed the tests of ANSI AAMI ES60601-1. Demonstrated to conform to the standard. Differences in controller dimensions and weight from predicate do not affect performance and do not raise new safety/effectiveness issues.
    Electromagnetic Compatibility (EMC): Conformance to ANSI AAMI IEC 60601-1-2:2014, Medical Electrical Equipment -- Part 1-2: General Requirements For Basic Safety And Essential Performance -- Collateral Standard: Electromagnetic Disturbances -- Requirements And TestsPassed the tests of IEC 60601-1-2. Demonstrated to conform to the standard. Differences in controller dimensions and weight from predicate do not affect performance and do not raise new safety/effectiveness issues.
    Battery Safety: Conformance to IEC 62133-2 Edition1.0 2017-02 Secondary cells and batteries containing alkaline or other non-acid electrolytes - Safety requirements for portable sealed secondary cells, and for batteries made from them, for use in portable applications - Part 2: Lithium systemsThe battery used by the proposed device has passed the test of the IEC 62133-2 standard. Difference in battery specifications (11.1V 5000mAh Lithium Ion vs. 14.8V 3100mAhr Lithium Ion for predicate) does not raise any safety or effectiveness issues as the new battery passed testing.
    Biocompatibility (Cytotoxicity): Conformance to ISO 10993-5:2009/(R) 2014, Biological Evaluation Of Medical Devices -- Part 5: Tests For In Vitro Cytotoxicity.Demonstrated to conform to the standard.
    Biocompatibility (Irritation and Skin Sensitization): Conformance to ISO 10993-10 Third Edition 2010-08-01, Biological Evaluation Of Medical Devices - Part 10: Tests For Irritation And Skin Sensitization.Demonstrated to conform to the standard.
    Functional Equivalence: Differences in design features (e.g., controller dimensions, weight, default inflation interval, battery) must not affect the fundamental performance or indications for use, and must not raise new questions of safety or effectiveness.Controller Dimensions/Weight: Length: 185mm; Width: 165mm; Height: 250mm; Weight: 2.5kg (vs. Predicate: Length: 240mm; Width: 140mm; Height: 263mm; Weight: 3.5kg). Conclusion: These differences don't affect performance and don't raise new safety/effectiveness issues. Default Inflatable Interval Time: 60s (vs. Predicate: 48s). Conclusion: Adjustable interval times (24s, 48s, 60s) are the same for both devices, allowing user choice. This difference doesn't raise new safety/effectiveness issues.

    2. Sample Size Used for the Test Set and Data Provenance

    This document does not describe a "test set" in the context of AI/ML evaluation (i.e., a dataset used to evaluate diagnostic performance). The testing mentioned is for device safety and electrical performance (e.g., electrical safety, EMC, biocompatibility, battery safety) according to international standards. Therefore, information on sample size and data provenance in this context is not applicable or not provided. The provenance of the device manufacturer is China.


    3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

    Not applicable. As noted above, this device is not an AI/ML diagnostic device requiring an expert-adjudicated ground truth.


    4. Adjudication Method for the Test Set

    Not applicable.


    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and the Effect Size of How Much Human Readers Improve with AI vs. Without AI Assistance

    Not applicable. This is not an AI-assisted device.


    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 (Expert Consensus, Pathology, Outcomes Data, etc.)

    The "ground truth" in this context is compliance with established engineering and safety standards (e.g., IEC 60601-1 for electrical safety, ISO 10993 for biocompatibility) and the functional specifications of the device as tested against these standards. It's not a clinical ground truth for a diagnostic outcome.


    8. The Sample Size for the Training Set

    Not applicable. This device does not involve a "training set" in the AI/ML sense.


    9. How the Ground Truth for the Training Set Was Established

    Not applicable.

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    K Number
    K123830
    Date Cleared
    2013-08-16

    (247 days)

    Product Code
    Regulation Number
    870.5800
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    Veinoflow SCD system, Model LBTK-M-1 5001 is a system to prevent DVT (Deep Vein Thrombosis) by improving the blood velocity of patients. LBTK-M-I 5001 is indicated for Circulation Enhancement, Deep Vein Thrombosis Prophylaxis, Edema -Acute, Edema - Chronic, Extremity Pain Incident to Trauma or Surgery, Leg ulcers, Venous Stasis / Venous Insufficiency.

    Device Description

    Veinoflow SCD, Model LBTK-M-I 5001, is a pneumatic pump system that supplies compressed air to inflate garments that are attached to a patent's lower limbs. It consists of a pump controller, specially designed inflation and deflation garments for feet and legs, air supply tubes, and power line. The inflation and deflation garments have 3 types: ① thigh-calf garments, ② calf garments, and ③ foot cuffs. The system offers sequential inflation and propels the vein blood from limb to heart, therefore enhance the blood circulation. The controller can automatically detect the external garment type, and provides pressure correspondingly. The pressure value and inflatable interval time are preset and adjustable. The controller has a self test system, when there is any error, it will alarm both in visual and audio.

    AI/ML Overview

    This document describes the Veinoflow SCD, Model LBTK-M-I 5001, an intermittent pneumatic compression device intended to prevent Deep Vein Thrombosis (DVT) by improving blood velocity. The submission is a 510(k) for a new device, seeking substantial equivalence to a predicate device.

    1. Table of Acceptance Criteria and Reported Device Performance:

    The document doesn't explicitly define 'acceptance criteria' in terms of success/failure rates for clinical outcomes but focuses on demonstrating substantial equivalence to a predicate device through functional and safety testing. The "reported device performance" is essentially a comparison of its technical specifications and tested safety features against recognized standards and the predicate device.

    Feature/TestAcceptance Criteria (Implied by Predicate)Reported Device Performance (Veinoflow SCD)
    Intended UsePrevent DVT, Circulation Enhancement, DVT Prophylaxis, Edema (acute/chronic), Extremity Pain (Trauma/Surgery), Leg ulcers, Venous Stasis/InsufficiencySame as predicate device.
    ComponentsPump controller, multi-cavity thigh-calf garments, calf garments, foot cuffs, battery, air supply tubes, power lineSame as predicate device.
    Compression TypeThigh-calf & calf garments: Sequential, Gradient; Foot Cuffs: UniformSame as predicate device.
    Compression TimeMatch predicate timingsSame as predicate device (Single thigh-calf: 5.5s, Dual thigh-calf: 11s, Single calf: 4s, Dual calf: 8s, Single foot cuff: 2.5s, Dual foot cuffs: 5s).
    Deflation Time2-3sSame as predicate device (2-3s).
    Default Inflatable Interval Time48sSame as predicate device (48s).
    Adjustable Inflatable Interval Time24s, 48s, 60sSame as predicate device (24s, 48s, 60s).
    Default Pressure (Thigh-calf & Calf Garments)40 mmHgSame as predicate device (40 mmHg).
    Default Pressure (Foot Cuffs)120 mmHg130 mmHg. Note: Although different, the submission states it can be adjusted to the same pressure as the predicate, and the adjustable range is the same.
    Adjustable Pressure (Thigh-calf & Calf Garments)20-60 mmHg30-60mmHg. Note: Different range, but the submission states this is covered by the predicate device's adjustable pressure range.
    Adjustable Pressure (Foot Cuffs)120-140 mmHgSame as predicate device (120-140 mmHg).
    Alarm FunctionalityCuff connection Error, Pressure Error, System Error, Power ErrorNo garment, Pump Error, Valve Error, Temperature Error, Software Error, System Error, High Pressure, Low Pressure, Low Battery. Note: Different/more detailed alarms, considered a safety enhancement.
    Biocompatibility TestingCompliance with ISO 10993-1, -5, -10Passed (ISO 10993-1: 2009, ISO 10993-5: 2009, ISO 10993-10: 2010).
    Electrical Safety TestingCompliance with IEC 60601-1Passed (IEC 60601-1: 2005).
    Electromagnetic Compatibility (EMC) TestingCompliance with IEC 60601-1-2Passed (IEC 60601-1-2: 2007).
    Bench Testing (Garments/System)Match predicate performance/safetyPassed: Pressure testing, Inflation/deflation time, Anti-stretch test of garment materials, Anti-stretch test of air chamber welding point, Air leakage test, Burst testing of garment, Bladder fatiguing test, Velcro adhesion test. The new device also has more safety testing on garments compared to the predicate.

    2. Sample Size Used for the Test Set and Data Provenance:

    The document describes bench testing for the device, including:

    • Pressure testing
    • Inflation/deflation time
    • Anti-stretch test of garment materials
    • Anti-stretch test of air chamber welding point
    • Air leakage test
    • Burst testing of garment
    • Bladder fatiguing test
    • Velcro adhesion evaluation test
    • Biological compatibility test
    • Electromagnetic compatibility test
    • Electrical Safety test

    The sample size for these tests is not specified in the provided text. The data provenance is also not explicitly stated as retrospective or prospective clinical data, as the study focuses on bench testing and technical comparison, not patient outcomes. The manufacturer is Dalian Labtek Science & Development Co., Ltd. from Dalian, China, so the testing likely occurred there.

    3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts:

    This information is not provided. The study relies on objective technical measurements and comparisons to recognized standards and the predicate device's specifications, rather than expert consensus on a test set.

    4. Adjudication Method for the Test Set:

    This information is not provided. Given the nature of the bench testing, an adjudication method for a test set (e.g., 2+1, 3+1) is not applicable or described.

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was Done:

    No, a Multi-Reader Multi-Case (MRMC) comparative effectiveness study was not done. This device is a physical medical device (intermittent pneumatic compression system), not an AI-assisted diagnostic tool, so such a study would not be relevant.

    6. If a Standalone Study (algorithm only without human-in-the-loop performance) was Done:

    This question is not applicable. The device is a physical system, not an algorithm.

    7. The Type of Ground Truth Used:

    The "ground truth" for this submission is established through:

    • Compliance with recognized international standards: ISO 10993 (biocompatibility) and IEC 60601 (electrical safety, EMC).
    • Comparison against the predicate device's specifications and performance: The predicate device is "The Venous Assist System DVT-2600" (K112677). The new device is deemed substantially equivalent based on matching or exceeding the predicate's technical characteristics and safety features.
    • Bench testing results: Demonstrating that the device meets functional and safety requirements through objective measurements (e.g., pressure, timing, material integrity).

    8. The Sample Size for the Training Set:

    This question is not applicable. This device is not an AI/machine learning algorithm requiring a training set.

    9. How the Ground Truth for the Training Set was Established:

    This question is not applicable, as there is no training set mentioned for this device.

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    K Number
    K121718
    Device Name
    A-V FOOT PUMP
    Date Cleared
    2012-08-17

    (67 days)

    Product Code
    Regulation Number
    870.5800
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    A-V Hand & Foot Pump, Model LBTK-M-I 1000, is intended for use to enhance blood circulation in the arteries and veins in patents. The indications vary depending on whether pump is used with the foot pad or hand pad.
    A. Foot use

    • Acute Edema
    • Chronic Edema
    • Circulation Enhancement
    • Deep Vein Thrombosis and Pulmonary Embolism Prophylaxis
    • Leg Pain Incident to Trauma or Surgery
    • Leg Ulcers
    • Venous Stasis/Venous Insufficiency
      B. Hand use
    • Acute Edema
    • Chronic Edema
    • Circulation Enhancement
    • Pain Incident to Trauma or Surgery
    Device Description

    A-V Hand & Foot Pump, Model LBTK-M-I 1000, consists of a pump controller connected by air supply hoses to specially designed inflation pads. The pump controller is microprocessor controlled, with a liquid crystal display, power switch, two air output sockets, function keys of "Left impulse run/pause", "Pressure adjustment", "Left preset settings", "Increase key-press", "Decrease key-press", "Right preset settings", "Impulse interval control", "Right Impulse run/pause", and so on. The pulse pressure, pulse duration, and pulse interval can be displayed by the screen. The inflation pads include foot pad, hand pad and undercast foot pad. The pads have one air chamber, through which the air energy is transferred to the body. The pads are non-sterile and for single patient use only. The inflation pad is rapidly inflated by a controlled impulse of air from the controller. After each impulse the controller automatically allows the inflation pad to deflate. To deliver the impulse pressure effectively to the extremity, the inflation pad must be retained in the correct position. The system has built-in alarms and displays to alert attention to adjustment requirements and to assist with rapid troubleshooting.

    AI/ML Overview

    The provided document is a 510(k) summary for a medical device called the "A-V Hand & Foot Pump, Model LBTK-M-I 1000." This document describes the device, its intended use, and its substantial equivalence to a predicate device.

    It does not contain information related to an AI-based device, nor does it present any clinical study data comparing the device's performance against acceptance criteria in the context of diagnostic accuracy or reader improvement.

    The "Performance data" section only lists engineering and biocompatibility tests, not clinical performance for diagnosis or treatment. The "Effectiveness" section claims similarity to a predicate device in intended use and operation, but again, no specific performance criteria or studies are presented.

    Therefore, I cannot fulfill the request for information regarding acceptance criteria, device performance, sample sizes, ground truth, expert qualifications, adjudication methods, MRMC studies, or standalone algorithm performance. This document pertains to a physical medical device and its safety/effectiveness based on engineering and biocompatibility testing, not an AI/algorithm-driven device with clinical performance metrics.

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