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510(k) Data Aggregation

    K Number
    K190423
    Date Cleared
    2019-03-19

    (25 days)

    Product Code
    Regulation Number
    870.5800
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Applicant Name (Manufacturer) :

    Devon Medical Products (Jiangsu) Ltd

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Devon24D deep vein thrombosis prevention system is intended to be an easy to use portable system, prescribed by a physician, to help prevent the onset of DVT in patients by stimulating blood flow in the extremities (simulating muscle contractions).

    This device can be used in the home or clinical settings to:

    • Aid in the prevention of DVT

    • Enhance blood circulation

    • Diminish post-operative pain and swelling

    • Reduce wound healing time

    • Aid in the treatment of: stasis dermatitis, venous stasis ulcers, arterial and diabetic leg ulcers, chronic venous insufficiency and reduction of edema in the lower limbs

    • As a prophylaxis for DVT by persons expecting to be stationary for long periods of time

    Device Description

    Not Found

    AI/ML Overview

    I apologize, but the provided text does not contain information about acceptance criteria or a study that proves the device meets those criteria. The document is an FDA 510(k) clearance letter for the Devon 24D Deep Vein Thrombosis Prevention Therapy System, confirming its substantial equivalence to previously marketed devices and outlining its indications for use. It does not include details about specific performance metrics, test sets, or ground truth establishment.

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    K Number
    K182578
    Date Cleared
    2019-02-21

    (155 days)

    Product Code
    Regulation Number
    870.5800
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Devon Medical Products (Jiangsu) Ltd

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Devon 62 DVT Prevention Therapy Device is a prescription device intended to be used preventatively to increase venous blood flow in patients at risk of deep vein thrombosis due to the associated risk factors for thrombus formation during: trauma, critical care, general medicine, general surgery, as well as neurological, orthopedic, obstetric conditions and treatments.

    Device Description

    The Devon 62 Deep Vein Thrombosis (DVT) Prevention Therapy Device is a pneumatic compression device that noninvasively helps reduce the incidence of deep vein thrombosis, a potentially life-threatening condition. The Devon 62 DVT Prevention Therapy Device, with a pair of extension tubing, is for use with Cirona DVT calf-thigh and foot garments (sleeves). The device alternatively inflates the two garments and mimic the natural walking pace to enhance circulation. The compression supplied by the device provides a 60-second automatically timed cycle consisting of an approximately 12-second inflation period followed by a 48-second period of relaxation. A pressure of 40mmHg is used for the calf, calfthigh and foot treatments. This pressurization enhances venous flow and fibrinolytic activity in order to ultimately prevent early blood clotting.

    AI/ML Overview

    The provided text is a 510(k) summary for the Devon 62 Deep Vein Thrombosis (DVT) Prevention Therapy Device. This document focuses on demonstrating substantial equivalence to a predicate device rather than detailing extensive clinical studies with acceptance criteria for device performance. As such, it does not contain the level of detail typically found in reports of diagnostic or AI-driven device performance.

    Therefore, many of the requested categories cannot be fully addressed from the provided text. However, based on the information present, here's what can be extracted:

    1. A table of acceptance criteria and the reported device performance

    The document lists "Function Performance Tests" with the implied acceptance criteria being that the device performs "as intended" and is "substantially equivalent to the predicate." Specific numerical acceptance criteria are not provided in this summary.

    Test CategorySpecific TestReported Performance (Implied Acceptance)
    Function Performance TestsTR68.J001: System Level Software TestDevice performing as intended, substantially equivalent to the predicate.
    TR68.J002: Pressure Accuracy TestDevice performing as intended, substantially equivalent to the predicate.
    TR68.J003: Cycle Time TestDevice performing as intended, substantially equivalent to the predicate.
    TR68.J004: Alarm Function TestDevice performing as intended, substantially equivalent to the predicate.
    TR68.J005: Pressure Sensor CalibrationDevice performing as intended, substantially equivalent to the predicate.
    TR68.J006: Battery Life TestDevice performing as intended, substantially equivalent to the predicate.
    Electrical SafetyIEC 60601-1:2005 + A1:2012Tests conducted according to standards, device is substantially equivalent.
    EMCIEC 60601-1-2: 2014Tests conducted according to standards, device is substantially equivalent.

    2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

    The document mentions "samples of the device underwent function and mechanical testing" but does not specify the sample size for these tests. There is no information regarding data provenance (country of origin, retrospective/prospective) as these are non-clinical performance tests.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

    This information is not applicable and not provided. The performance tests described are related to direct device function (software, pressure, cycle time, alarms, battery life), not diagnostic accuracy requiring expert interpretation.

    4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

    This information is not applicable and not provided, as the tests are for device functional performance, not for ground truth establishment by experts.

    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

    No MRMC comparative effectiveness study was performed or described. This device is a DVT prevention therapy device, not an AI-driven diagnostic or interpretative tool designed to assist human readers.

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

    This concept is not applicable. The Devon 62 DVT Prevention Therapy Device is a physical medical device (pneumatic compression device) that operates autonomously to apply pressure. It does not involve algorithms for diagnostic interpretation or human-in-the-loop performance testing in the sense of AI-driven tools.

    7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

    The "ground truth" for the performance tests would be the pre-defined engineering specifications and expected operational parameters of the device (e.g., specific pressure levels, cycle timings, alarm conditions, battery duration). These are intrinsic to the device's design and manufacturing standards, not external clinical data.

    8. The sample size for the training set

    This information is not applicable and not provided. This device is not an AI/machine learning device that requires a training set.

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

    This information is not applicable. As stated above, this is not an AI/machine learning device.

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    K Number
    K182150
    Date Cleared
    2018-12-18

    (132 days)

    Product Code
    Regulation Number
    870.5800
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Applicant Name (Manufacturer) :

    Devon Medical Products (Jiangsu) Ltd

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Devon 52 Series Sequential Compression Device is a compression device based on sequential pneumatic compression technique which is intended for the treatment of the following conditions:

    • Lymphedema
    • Venous stasis ulcers
    • Venous insufficiency
    • Peripheral edema
    Device Description

    The Devon 52 Series Sequential Compression Device is a compression device based on sequential pneumatic compression technique.

    AI/ML Overview

    This document is a 510(k) clearance letter for the Devon 52 Sequential Compression Device, which is a medical device. It does not contain information about acceptance criteria, device performance, or studies in the way you've requested for an AI/software device.

    Specifically, the document refers to a physical medical device (compressible limb sleeve) that operates based on a "sequential pneumatic compression technique" for treating conditions like Lymphedema and Venous stasis ulcers. It is not an AI/software device and therefore does not have the types of studies, ground truth establishment, or performance metrics typically associated with AI model validation.

    Therefore, I cannot provide a table of acceptance criteria and reported device performance or information about sample sizes, expert ground truth establishment, adjudication methods, MRMC studies, or standalone performance, as these are not relevant to the content of this 510(k) clearance letter for a physical medical device.

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    K Number
    K173528
    Date Cleared
    2018-02-06

    (83 days)

    Product Code
    Regulation Number
    870.5800
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Applicant Name (Manufacturer) :

    Devon Medical Products (Jiangsu) Ltd.

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Devon 24R deep vein thrombosis prevention system is intended to be an easy to use portable system, prescribed by a physician, to help prevent the onset of DVT in patients by stimulating blood flow in the extremities (simulating muscle contractions).

    This device can be used in the home or clinical settings to:

    · Aid in the prevention of DVT

    • · Enhance blood circulation
    • · Diminish post-operative pain and swelling
    • · Reduce wound healing time

    · Aid in the treatment of: stasis dermatitis, venous stasis ulcers, arterial and diabetic leg ulcers, chronic venous insufficiency and reduction of edema in the lower limbs

    · As a prophylaxis for DVT by persons expecting to be stationary for long periods of time

    Device Description

    Not Found

    AI/ML Overview

    The provided document is a 510(k) clearance letter from the FDA for a medical device called the "Devon 24R Deep Vein Thrombosis (DVT) Prevention Therapy System."

    This document focuses on the regulatory clearance process, specifically demonstrating substantial equivalence to a predicate device.

    It does not contain any information about the acceptance criteria, device performance metrics, or study details such as sample sizes, expert qualifications, ground truth establishment, or clinical study methodologies (like MRMC studies) related to the device's efficacy or accuracy.

    Therefore, I cannot fulfill your request for the information about acceptance criteria and the study proving the device meets those criteria based solely on the provided text. The document is administrative and does not detail performance testing results.

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    K Number
    K172030
    Device Name
    Devon 51
    Date Cleared
    2017-11-27

    (145 days)

    Product Code
    Regulation Number
    870.5800
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Devon Medical Products (Jiangsu) Ltd.

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Devon 51 Series Sequential Compression Device is a compression device based on sequential pneumatic Compression technique which is intended for the treatment of the following conditions:

    • Lymphedema
    • Venous stasis ulcers
    • Venous insufficiency
    • Peripheral edema
      The device is intended for both home and hospital use.
    Device Description

    The Devon 51 Sequential Compression device is a gradient compression pneumatic device used for treatment and management of venous or lymphatic disorders. The application of gradient compression is effective by increasing blood flow and encouraging extracellular fluid clearance. The system consists of a pump and a pair of four-chambered garments. The garments are available in different types and sizes. The pump provides cycles of compressed air at certain adjustable pressures and which sequentially inflates the garment from distal to proximal. When activated, air flows into the garment chambers, and the pump provides gradient pressurization to the chambers (with distal chambers inflated to a greater pressure than the proximal ones.) After each chamber is inflated, the pressure is held constant until all chambers are inflated in order to prevent reverse gradient flow. Once all chambers are inflated, they are then all released simultaneously, and the cycle repeats until the set therapy time is reached.

    AI/ML Overview

    The provided text describes the regulatory clearance (K172030) of the "Devon 51 Sequential Compression Device" by the FDA. The document focuses on demonstrating substantial equivalence to a predicate device ("CircuFlow 5200", K101523) rather than presenting a standalone study with acceptance criteria and a detailed analysis of device performance against those criteria in a typical clinical study format.

    Therefore, much of the requested information, particularly regarding specific numerical performance metrics, sample sizes for test sets (in a clinical sense), expert involvement for ground truth, adjudication methods, MRMC studies, or standalone algorithm performance, is not present in the provided document. The document details engineering and safety tests rather than clinical performance studies against specific clinical acceptance criteria.

    However, I can extract the available information and highlight what is not present.


    1. Table of Acceptance Criteria and Reported Device Performance

    The provided text does not present a table of specific clinical acceptance criteria with corresponding performance metrics. Instead, it lists functional and mechanical performance tests conducted to verify the device design met its requirements, and concludes that the device performed as intended and is substantially equivalent to the predicate.

    Functional Performance TestAcceptance Criterion (Implicit)Reported Device Performance
    Devon 51 Cycle Time TestDevice operates within specified cycle times."The conclusions drawn from the performance tests demonstrate that the device is performing as intended..."
    Devon 51 Reverse Pressure TestDevice prevents reverse pressure flow."The conclusions drawn from the performance tests demonstrate that the device is performing as intended..."
    Devon 51 Sleeve Integrity TestSleeves maintain integrity under operation."The conclusions drawn from the performance tests demonstrate that the device is performing as intended..."
    Devon 51 Treatment Time TestDevice operates accurately for set treatment times."The conclusions drawn from the performance tests demonstrate that the device is performing as intended..."
    Devon 51 Pressure Sensor Calibration TestPressure sensors are accurately calibrated."The conclusions drawn from the performance tests demonstrate that the device is performing as intended..."
    Biocompatibility (Cytotoxicity, Sensitization, Irritation)No adverse biological reactions.Not explicitly stated for Devon 51, but stated as identical garment material and processing as predicate, which did undergo these tests. Implies acceptance via equivalence.
    Electrical Safety (IEC 60601-1 series)Meets relevant electrical safety standards.Passed these tests.
    Electromagnetic Compatibility (IEC 60601-1-2)Meets relevant EMC standards.Passed these tests.

    2. Sample Size for the Test Set and Data Provenance

    The document does not describe a "test set" in the context of clinical data for performance evaluation. The "tests" mentioned are engineering and safety verification tests.

    • Sample Size for Test Set: Not applicable in the context of clinical or AI performance evaluation. The number of physical units tested for the functional/mechanical tests is not specified, only that "samples of the device underwent function and mechanical testing."
    • Data Provenance: Not applicable, as this refers to engineering/safety tests, not clinical data.

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

    Not applicable. The ground truth for functional/mechanical tests is typically established by engineering specifications and objective measurements, not expert human review.

    4. Adjudication Method for the Test Set

    Not applicable. No human expert adjudication process is described for the engineering/safety performance tests.

    5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

    No MRMC study was conducted or reported. This device is a mechanical compression device, not an imaging analysis AI tool, so an MRMC study is not relevant or expected.

    6. Standalone (Algorithm Only) Performance Study

    Not applicable. This device is a physical medical device, not an AI algorithm.

    7. Type of Ground Truth Used

    For the functional/mechanical tests, the "ground truth" would be the device's technical specifications and engineering standards it was designed to meet (e.g., specific cycle times, pressure ranges, absence of reverse flow, structural integrity). For biocompatibility, the ground truth is established by standardized biological tests.

    8. Sample Size for the Training Set

    Not applicable. This is not an AI/machine learning device.

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

    Not applicable. This is not an AI/machine learning device.


    Summary of the Study that Proves the Device Meets Acceptance Criteria:

    The "study" described in the document is a series of engineering and safety verification tests conducted on samples of the Devon 51 Sequential Compression Device. These tests included:

    • Functional Performance Tests:
      • Cycle Time Test (TR66.J002)
      • Reverse Pressure Test (TR66.J004)
      • Sleeve Integrity Test (TR66.J006)
      • Treatment Time Test (TR66.J009)
      • Pressure Sensor Calibration Test (TR66.J007)
        The conclusion for these tests was that the device performed as intended, demonstrating that it met its functional and performance design requirements.
    • Biocompatibility: The device uses the identical garment material, manufacturing process, and direct body contact method as its predicate device (CircuFlow 5200). The predicate device had previously undergone and passed biocompatibility tests (Cytotoxicity, Sensitization, Irritation) in accordance with FDA Good Laboratory Practice. Therefore, new testing was not deemed necessary for the Devon 51, establishing equivalence for biocompatibility.
    • Electrical Safety and Electromagnetic Compatibility (EMC): These tests were conducted according to recognized international standards:
      • IEC 60601-1:2005+C1:2006+C2:2007+A1:2012 (General requirements for basic safety and essential performance)
      • IEC 60601-1-2: 2014 (EMC requirements)
      • IEC 60601-1-6:2010 (Usability including IEC 62366)
      • IEC 60601-1-11:2015 (Requirements for home healthcare environment)
        The implication is that the device passed these tests, thereby meeting the safety and performance standards established by these regulations.

    The overall conclusion reached by Devon Medical Products in their 510(k) submission is that, based on the information provided, the Devon 51 Sequential Compression Device is substantially equivalent to the predicate device (CircuFlow 5200, K101523) in terms of technology, function, operating parameters, and indication for use, and does not raise any new questions of safety or effectiveness. This substantial equivalence is the primary basis for its market clearance.

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    K Number
    K170814
    Device Name
    Devon 24
    Date Cleared
    2017-07-11

    (116 days)

    Product Code
    Regulation Number
    870.5800
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Devon Medical Products (Jiangsu) Ltd.

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Devon 24 deep vein thrombosis prevention system is intended to be an easy to use portable by a physician, to help prevent the onset of DVT in patients by stimulating blood flow in the extremities (simulating muscle contractions).

    This device can be used in the home or clinical settings to:

    • · Aid in the prevention of DVT
    • · Enhance blood circulation
    • · Diminish post-operative pain and swelling
    • · Reduce wound healing time

    · Aid in the treatment of: stasis dermatitis, venous stasis ulcers, arterial and diabetic leg ulcers, chronic venous insufficiency and reduction of edema in the lower limbs

    · As a prophylaxis for DVT by persons expecting to be stationary for long periods of time

    Device Description

    The Devon 24 deep vein thrombosis prevention therapy system (referred as Devon 24 below) is an easy to use portable pneumatic compression system that noninvasively helps prevent the onset of DVT in patients by stimulating blood flow in the extremities (simulating muscle contractions). The Devon 24 system consists of a pair of pumps and sleeve assemblies.

    The device will alternatively inflate and deflate the garment (sleeve) to stimulate blood flow in the extremities (muscle contraction). The device provides a 40mmHg pressure and followed by a deflation period once it reaches the desired pressure, each cycle time is 50 seconds.

    AI/ML Overview

    This document, a 510(k) Premarket Notification for the Devon 24 Deep Vein Thrombosis Prevention Therapy System, primarily focuses on demonstrating substantial equivalence to a predicate device rather than providing a detailed study proving the device meets specific acceptance criteria with quantifiable performance metrics. Therefore, many of the requested sections regarding the study design and results cannot be fully addressed from the provided text.

    Based on the information available in the document:

    1. Table of Acceptance Criteria and Reported Device Performance:

    The document lists various performance tests conducted, but it does not explicitly state quantitative acceptance criteria or the specific numerical results for each test. Instead, it offers a general conclusion that "The conclusions drawn from the performance tests demonstrate that the device is performing as intended, and is substantially equivalent to the predicate."

    Test NameAcceptance Criteria (Not explicitly stated with values)Reported Device Performance (General Conclusion)
    Pressure Accuracy TestWould typically involve a target pressure range and tolerance (e.g., ±X mmHg)"Device is performing as intended"
    Pressure Sensor Calibration TestWould involve accuracy and linearity requirements for the sensor"Device is performing as intended"
    Cycle Time TestSpecific duration for inflation/deflation cycle (e.g., 50 seconds ±Y seconds)"Device is performing as intended" (document states 50-second cycle time)
    Alarm Function TestAlarms activate under specified fault conditions"Device is performing as intended"
    Battery Life TestSpecific duration of operation on a full charge"Device is performing as intended"
    Garment Burst TestingWithstand a certain pressure without bursting (e.g., >X mmHg)"Device is performing as intended"
    BiocompatibilityPass cytotoxicity, sensitization, irritation testsPassed; uses same material as predicate, which previously passed these tests.
    Electrical Safety & EMCConformity to IEC 60601 series standardsConforms to IEC 60601-1, -1-2, -1-6, -1-11.
    Software Verification & ValidationMeet "moderate" level of concern V&V requirementsDocumentation provided, considered adequate for "moderate" level of concern.

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

    • Sample Size for Test Set: Not explicitly stated. The document mentions "samples of the device" for performance and mechanical testing, but the number of units tested is not provided.
    • Data Provenance: The tests were conducted internally by Devon Medical Products (Jiangsu) Ltd. in China. The document does not specify if the data involved human subjects or was entirely bench-top testing. Given the type of tests listed, they appear to be primarily bench-top (in-vitro) engineering and functional tests.

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

    • Not Applicable. For the engineering and functional tests performed (pressure, cycle time, alarms, battery, burst, electrical safety, software V&V), ground truth is established through measurement instruments and compliance with technical standards and specifications, not through expert human interpretation as would be the case for diagnostic imaging or clinical outcomes.

    4. Adjudication Method for the Test Set:

    • Not Applicable. Adjudication methods like "2+1" or "3+1" are relevant for subjective assessments, typically in clinical studies or when human interpretation of data is required to establish a consensus ground truth. The tests described are objective engineering and functional measurements.

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

    • No. The document explicitly states: "No animal study or clinical study was conducted." MRMC studies are clinical studies involving human readers/observers.

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

    • Not Applicable. This device is a physical medical device (intermittent pneumatic compression system), not an algorithm or AI software for diagnosis or image analysis. Its "standalone" performance refers to its functional operation as demonstrated by the engineering tests for pressure, cycle time, etc., which were reported as "performing as intended."

    7. The Type of Ground Truth Used:

    • Engineering Specifications and Standard Compliance. For the performance tests, the "ground truth" is defined by the device's design specifications (e.g., target pressure, cycle time) and adherence to recognized international standards for electrical safety and electromagnetic compatibility (IEC 60601 series). For biocompatibility, the ground truth was the results of previously conducted biocompatibility tests on the predicate device's materials, per FDA Good Laboratory Practice.

    8. The Sample Size for the Training Set:

    • Not Applicable. This information pertains to machine learning algorithms. The Devon 24 is a mechanical/electronic device, not an AI or imaging device that uses a "training set."

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

    • Not Applicable. See point 8.
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