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510(k) Data Aggregation

    K Number
    K210967
    Date Cleared
    2021-05-11

    (41 days)

    Product Code
    Regulation Number
    890.5650
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    Air Pressure Therapy System: VU-IPC06

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

    Air Pressure Therapy System VU-IPC06 is intended for home to temporarily relieve minor muscle aches and/or pains, and to temporarily increase circulation to the treated areas.

    Device Description

    Air Pressure Therapy System has a pump. The pump is connected to the dedicated cuff via the hose series, one cuff has 8 compression chambers. The pump compresses and inflates air into the chambers continuously to produce compression from the body tail end to body center and release the air after compression as one cycle process. Cycle time and pressure can be adjusted by purpose to avoid any discomfort.

    Air Pressure Therapy System intermittent pneumatic compression could be used in family for improving blood circulation in treated areas, in exercise rehabilitation field for muscle relaxation before exercise and muscle rehabilitation after exercise to relieve muscle soreness.

    AI/ML Overview

    The provided text is a 510(k) summary for the "Air Pressure Therapy System: VU-IPC06". This document focuses on demonstrating substantial equivalence to a predicate device, rather than providing details of a clinical study proving its own independent performance against acceptance criteria.

    The submission explicitly states:

    • "Performance Testing - Clinical: NOT Applicable." (Page 4)
    • "Performance Testing - Animal: NOT Applicable." (Page 4)

    Therefore, the document does not contain the information requested regarding acceptance criteria and a study that proves the device meets those criteria. Instead, it relies on a comparison to a predicate device (NormaTec Pulse and NormaTec Pulse Pro, K160608) to establish substantial equivalence.

    The table below summarizes what could be considered acceptance criteria based on standard compliance and a comparison of the subject device's performance to its predicate. However, it's crucial to understand these are not acceptance criteria from an independent performance study of the subject device but rather a demonstration of similarity to a cleared device.


    Summary of Device Comparison (No Independent Performance Study Provided)

    1. Table of Acceptance Criteria and Reported Device Performance

    Since no independent performance study is reported for the subject device against acceptance criteria, the table below reflects a comparison to the predicate device, which is the basis for its 510(k) clearance. The "acceptance criteria" here implicitly refer to being "as safe and effective" as the predicate.

    Feature/CharacteristicPredicate Device (K160608) PerformanceSubject Device (K210967) PerformanceDifferences/Conclusion
    Indications for UseTemporarily relieve minor muscle aches and/or pains, and to temporarily increase circulation to the treated areas.Temporarily relieve minor muscle aches and/or pains, and to temporarily increase circulation to the treated areas.Same
    Pressure Range30-110mmHg30-110mmHgSame
    Regulation Number21 CFR 890.565021 CFR 890.5650Same
    Classification NameMassager, Powered Inflatable TubeMassager, Powered Inflatable TubeSame
    Regulation ClassClass IIClass IISame
    Product CodeIRPIRPSame
    Rx or OTCOTCOTCSame
    Mode of CompressionSequential Gradient, Peristaltic and PulsingSequentialSame (Subject device's "Mode A" is same as predicate; other modes are variations in inflation order)
    Safety FeatureButton on display allows user to stop or pause therapy session at any time.Button on display allows user to stop or pause therapy session at any time.Same
    TechnologyCompressor and valve system which sequentially inflates inflatable chambers.Compressor and valve system which sequentially inflates inflatable chambers.Same
    Treatment TimeUser controlled 10 minutes to 175 minutes or continuous1-99minSimilar; subject device's shorter maximum time is deemed not to raise adverse impact on safety/effectiveness.
    Standards ComplianceES 60601-1, IEC 60601-1-2, IEC 60601-1-11ANSI AAMI ES60601-1, IEC 60601-1-2, IEC 60601-1-11, ISO 10993-5, ISO 10993-10Similar (Subject device additionally lists ISO 10993-5, ISO 10993-10 for biocompatibility, which are standard for medical devices in direct contact with skin.)

    Note: The differences identified (e.g., treatment time, specific modes of compression) are evaluated to ensure they do not raise adversely impact or safety and effectiveness compared to the predicate, rather than meeting specific performance thresholds for the device itself.

    2. Sample Size Used for the Test Set and the Data Provenance:
    Not applicable, as no clinical performance study on a test set (human subjects or patient data) was conducted or reported for the substantially equivalent device.

    3. Number of Experts Used to Establish the Ground Truth for the Test Set and the Qualifications of Those Experts:
    Not applicable, as no clinical performance study was conducted.

    4. Adjudication Method for the Test Set:
    Not applicable, as no clinical performance study was conducted.

    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:
    Not applicable. This device is not an AI-assisted diagnostic tool.

    6. If a Standalone (i.e. algorithm only without human-in-the-loop performance) was done:
    Not applicable, as this is a physical medical device (air pressure therapy system), not an algorithm or software-only device.

    7. The type of ground truth used:
    Not applicable, as no clinical performance study was conducted. The "ground truth" for this 510(k) submission is the demonstrated safety and effectiveness of the predicate device based on its prior clearance and generally accepted standards for this type of device.

    8. The sample size for the training set:
    Not applicable, as no algorithm training or performance study was conducted or reported.

    9. How the ground truth for the training set was established:
    Not applicable, as no algorithm training or performance study was conducted or reported.

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