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510(k) Data Aggregation

    K Number
    K231912
    Device Name
    Therm-X
    Date Cleared
    2023-07-27

    (28 days)

    Product Code
    Regulation Number
    890.5650
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    Therm-X (Therm-X Home and Therm-X AT) combines cold, heat, contrast, and compression therapy. Therm-X is intended to treat post-surgical and acute injuries to reduce edema, swelling, and pain for which cold and compression are indicated. It is intended to treat post-surgical medical and/or surgical conditions for which localized thermal therapy (hot or cold) are indicated.

    Therm-X Home systems also provide DVT therapy. Therm-X Home systems with DVT therapy are intended to reduce the risk of the formation of deep venous thrombosis (DVT) by aiding blood flow back to the heart via lower extremity limb compression.

    Therm-X (Therm-X Home and Therm-X AT) is intended to be used by, or on the order of, licensed health care professionals in rehabilitation facilities, outpatient clinics, athletic training settings.

    Device Description

    Therm-X is an AC powered, software-controlled multimodality device, designed to be used in a clinical or home-use setting, and under the direction, prescription, or supervision of a licensed healthcare professional. The device is available in two configurations: Therm-X Home and Therm-X AT.

    Therm-X (Therm-X Home and Therm-X AT) features iceless cold therapy, heat therapy, and contrast (alternating heat and cold) therapy. The Therm-X Home system also provides DVT prophylaxis therapy and continuous therapy for users who wish to receive treatment over an extended period of time.

    Therm-X consists of various reusable inflatable wraps for thermal treatment of the back, elbow, hand/wrist, shoulder, ankle, hip, lower leg, or knee and DVT prophylactic treatment applied to the foot or calf. Multi-patient use garments are available for all anatomical areas that can be cleaned and disinfected in between uses to be reused for different patients. Single-patient use garments are available for thermal treatment of the back, hand/wrist, shoulder, neck, ankle, hip, and knee and can be disposed of after patient treatment is concluded. The thermal garments are flexible coolant circulating garments that apply to the body to deliver cold, heat, or contrast therapy in combination with or without pneumatic compression. The foot and calf DVT prophylactic garments apply pneumatic compression alone and are intended for use by the Therm-X Home system only.

    Therm-X is controlled by an intuitive touch screen computer interface, allowing the user to manage the therapy modalities as well as easily adjust and monitor treatment times, temperature, and compression settings. Therm-X AT and Therm-X Home models provide an optional password protection feature that allows for a user to use only stored cycles, giving health care providers an ability to ensure compliance to a chosen cycle. The device also provides functionality to allow the health care provider to assign a date at which the user will be able to access a second stored cycle instead of the first. The Therm-X device also allows users to change treatment pressure and temperatures to less extreme therapies (e.g. changing a warm cycle to a lower warm temperature or changing a cold cycle to a higher cold temperature).

    The Therm-X is approximately 15 lbs. when filled with coolant and has a handle placed on the top of the device. It has a centralized coolant reservoir accessible through a cap located at the back of the device that supplies its coolant and radiator systems. The reservoir, pumps, fans, circuit board, and other components of the Therm-X are located inside a covered enclosure made out of plastic and metal components, accessible only using a specialized tool.

    AI/ML Overview

    The Therm-X device, a powered inflatable tube massager combining cold, heat, contrast, and compression therapy, has demonstrated substantial equivalence to its predicate device (Therm-X, K193550) through a series of verification and validation tests. The modifications in the current submission include the addition of four new anatomical garment types and one XL version of an existing garment, and an expanded range of operating temperatures for the device, and a slight difference in continuous edema pressure levels.

    Here is a summary of the acceptance criteria and performance, along with details of the supporting studies:

    1. Table of Acceptance Criteria and Reported Device Performance

    The provided document describes modifications to the Therm-X device as compared to its predicate (Therm-X, K193550). The acceptance criteria are implicit in the "Comparison" column, where the new device is either "identical" or the differences are deemed to "not affect the intended use or raise different questions of safety and effectiveness". For the purpose of this table, the predicate device's characteristics serve as the acceptance criteria.

    CharacteristicAcceptance Criteria (Predicate Therm-X, K193550)Reported Device Performance (Subject Therm-X)Device Meets Criteria?
    Indications for UseTreats post-surgical/acute injuries to reduce edema, swelling, pain; localized thermal therapy.Therm-X Home systems also provide DVT therapy.Used by/on order of licensed healthcare professionals in rehabilitation facilities, outpatient clinics, athletic training settings, and home settings.Identical. Treats post-surgical/acute injuries to reduce edema, swelling, pain; localized thermal therapy.Therm-X Home systems also provide DVT therapy.Used by/on order of licensed healthcare professionals in rehabilitation facilities, outpatient clinics, athletic training settings, and home settings.Yes
    Intended UsersHealth Care Professionals and lay users (under prescription)Identical. Health Care Professionals and lay users (under prescription).Yes
    Number of PatientsOneTwo (via a split umbilical hose accessory).Yes (Difference validated not to affect safety/effectiveness)
    Two Programmable CyclesAvailable for all Therm-X ModelsIdentical. Available for all Therm-X Models.Yes
    Continuous Treatment CycleAvailable on Therm-X HomeIdentical. Available on Therm-X Home.Yes
    Heat Therapy SettingsDefault: 105°F, 107°F, 110°F; Custom: 105°F - 110°FDefault, continuous: 105°F, 107°F; Custom, continuous: 105°F - 107°FIdentical. Default: 105°F, 107°F, 110°F; Custom: 105°F - 110°FDefault, continuous: 105°F, 107°F; Custom, continuous: 105°F - 107°FYes
    Cold Therapy SettingsDefault: 34°F, 45°F, 55°F; Custom: 34°F - 55°FDefault, continuous: 40°F, 45°F, 50°F; Custom, continuous: 40°F – 50°FIdentical. Default: 34°F, 45°F, 55°F; Custom: 34°F - 55°FDefault, continuous: 40°F, 45°F, 50°F; Custom, continuous: 40°F – 50°FYes
    Edema Pressure Levels (Continuous)Four levels (Lite, Low, Medium, High). For continuous treatment, three levels (Lite, Low, Medium, High)Three levels (Lite, Low, Medium). No "High" pressure during Continuous treatment, and "Lite" treatment is allowed during continuous treatment.Yes (Difference validated not to affect safety/effectiveness)
    Static or Intermittent PressureBothIdentical. Both.Yes
    DVT OnlyAvailable for Therm-X Home ModelIdentical. Available for Therm-X Home Model.Yes
    DVT PressureCalf: 50 - 70 mmHg; Foot: 90 - 130 mmHgIdentical. Calf: 50 - 70 mmHg; Foot: 90 - 130 mmHg.Yes
    Cycle Length (H/C/Comp)Default: 10 or 20 min; Custom: 3 - 40 minContinuous: 10 - 40 min active, 30-60 min restIdentical. Default: 10 or 20 min; Custom: 3 - 40 minContinuous: 10 - 40 min active, 30-60 min rest.Yes
    Contrast TherapyAvailable for Therm-X AT Model only (Heat: 105°F, Cold: 38°F)Identical. Available for Therm-X AT Model only (Heat: 105°F, Cold: 38°F).Yes
    Cycle Length (Contrast)Heat: 3-10 min; Cold: 3-10 min; Total: 6-60 minIdentical. Heat: 3-10 min; Cold: 3-10 min; Total: 6-60 min.Yes
    DVT Cycle LengthNo specified time interval, can be stopped at any timeIdentical. No specified time interval, can be stopped at any time.Yes
    Edema Compression combined with thermal therapyYes (Lite, Low, Medium, High must be combined with cold, heat, or contrast therapy)Identical. Yes (Lite, Low, Medium, High must be combined with cold, heat, or contrast therapy).Yes
    DVT Inflation/DeflationInflation: Up to 120 secs; Deflation: Up to 30 secsIdentical. Inflation: Up to 120 secs; Deflation: Up to 30 secs.Yes
    Power DownAvailableIdentical. Available.Yes
    Password ProtectionAvailableIdentical. Available.Yes
    Store Cycle Usage DataAvailableIdentical. Available.Yes
    Dimensions15" L x 10.5" W x 9" HIdentical. 15" L x 10.5" W x 9" H.Yes
    Weight15 lbs. when full of coolantIdentical. 15 lbs. when full of coolant.Yes
    Chilling MechanismThermoelectricIdentical. Thermoelectric.Yes
    Heating MechanismThermoelectricIdentical. Thermoelectric.Yes
    Reservoir Fluid Capacity650 mLIdentical. 650 mL.Yes
    User InterfaceTouch ScreenIdentical. Touch Screen.Yes
    Recommended Coolant90% Distilled Water, 10% Isopropyl AlcoholIdentical. 90% Distilled Water, 10% Isopropyl Alcohol.Yes
    Line Voltage100-240 VACIdentical. 100-240 VAC.Yes
    Line Frequency50/60 HzIdentical. 50/60 Hz.Yes
    Electrical Safety StandardsANSI/AAMI ES60601-1:2005/(R)2012, CAN/CSA C22.2 No. 60601-1:2014, Type B, IEC 60601-1-2Identical. ANSI/AAMI ES60601-1:2005/(R)2012, CAN/CSA C22.2 No. 60601-1:2014, Type B, IEC 60601-1-2.Yes
    Operating Temperature60°F - 80°F (16°C – 27°C)40°F - 130°F (4.4°C – 54.4°C).Yes (Difference validated not to affect safety/effectiveness)
    Storage Temperature33°F - 122°F (1°C - 50°C)Identical. 33°F - 122°F (1°C - 50°C).Yes
    Operating HumidityBelow 60% Non-condensingIdentical. Below 60% Non-condensing.Yes
    Storage HumidityBelow 60% Non-condensingIdentical. Below 60% Non-condensing.Yes
    Operating Atmospheric Pressure/Altitude700 hPa – 1060 hPa (max. elevation of 9,842 ft. 6 in (3000 m))Identical. 700 hPa – 1060 hPa (max. elevation of 9,842 ft. 6 in (3000 m)).Yes
    Types of GarmentsVarious anatomical thermal garments for: Back, Elbow, Shoulder, Knee, Ankle, Hip. DVT Garments: Calf and Foot.Various anatomical thermal garments for: Back, Elbow, Hand, Shoulder, XL Shoulder, Knee, Half-Leg, Ankle, Hip, Neck. DVT Garments: Calf and Foot.Yes (Difference validated not to affect safety/effectiveness)
    Patient Contacting MaterialThermal garment (reusable): 30 denier nylon coated in urethane.Thermal garment (disposable): 200 denier nylon coated in urethane.DVT: 200 denier nylon coated in urethane.Identical. Thermal garment (reusable): 30 denier nylon coated in urethane.Thermal garment (disposable): 200 denier nylon coated in urethane.DVT: 200 denier nylon coated in urethane.Yes
    Multi-Patient/Single-Patient Use WrapsMulti-Patient Use and Single-Patient Use AvailableIdentical. Multi-Patient Use and Single-Patient Use Available.Yes
    BiocompatibilityCytotoxicity (ISO 10993-5), Sensitization (ISO 10993-10), Irritation (ISO 10993-10)Identical. Cytotoxicity (ISO 10993-5), Sensitization (ISO 10993-10), Irritation (ISO 10993-10). Verification results indicated materials comply with the standard.Yes
    Sterile/Non-SterileNon-sterile onlyIdentical. Non-sterile only.Yes
    Cleaning/Disinfection ValidationYes - for Multi-patient use reusable wrapsIdentical. Yes - for Multi-patient use reusable wraps.Yes
    Human Factors Training ValidationYes - for Multi-patient use reusable wrapsIdentical. Yes - for Multi-patient use reusable wraps.Yes
    Expected Life of garmentsBased on frequency of use and continued functional performanceIdentical. Based on frequency of use and continued functional performance. Accelerated aging test performed to confirm safe use.Yes
    Validation of repeated cleaning/disinfectionYes - for Multi-patient use reusable wrapsIdentical. Yes - for Multi-patient use reusable wraps.Yes

    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 refers to a clinical testing study that was "IRB approved" and conducted "on healthy volunteer human subjects who provided informed consent." This indicates a prospective study design.

    • Sample Size: The exact number of human subjects is not specified in the provided text. It mentions "healthy volunteer human subjects."
    • Data Provenance: The country of origin of the data is not specified. The mention of "IRB approved studies" implies a research institution setting.

    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)

    For the clinical testing for skin temperature, the "ground truth" was established by direct measurement of the skin temperature using the device on human subjects. This is not a situation where a human expert consensus is used to establish ground truth for a diagnostic interpretation. The study was to measure the lowest skin temperature the device could generate.

    • Number of experts: Not applicable in the context of diagnostic "ground truth" establishment, as it was a direct physical measurement.
    • Qualifications of those experts: Not applicable.

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

    Not applicable. The clinical study described was to measure skin temperature directly, not to adjudicate results from interpretive tasks.

    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. The Therm-X device is a physical therapy device (powered inflatable tube massager) and does not involve AI or human readers for diagnostic interpretation. Therefore, an MRMC comparative effectiveness study regarding "human readers improve with AI vs without AI assistance" is not relevant to this device.

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

    Not applicable. The Therm-X device is a physical therapy device and does not inherently involve an algorithm for diagnostic interpretation in a standalone fashion. Its software controls the physical modalities (temperature, compression, cycles). Software validation ensures the software operates as intended, but this is not "standalone algorithm performance" in the context of diagnostic AI.

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

    For the human clinical study mentioned:

    • Type of Ground Truth: The ground truth for the performance related to skin temperature was direct physical measurement ("lowest skin temperature ... measured") on human subjects under "worst case conditions."

    For other tests:

    • Performance - Bench: Predetermined specifications/performance criteria.
    • Electromagnetic Compatibility / Electrical Safety: Conformance to international standards (IEC 60601-1, IEC 60601-1-2, IEC 60601-1-11).
    • Biocompatibility: Conformance to international standards (ISO 10993-1, ISO 10993-5, ISO 10993-10).
    • Cleaning, Disinfection & Shelf Life Testing: Validation of instructions and accelerated aging tests against expected performance and absence of deterioration.
    • Software Validation: Conformance to performance requirements and specifications, and FDA Guidance documents (e.g., General Principles of Software Validation, Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices/Device Software Functions).
    • Human Factors / Usability: Adequacy for safe and effective use by intended users in intended environments.

    8. The sample size for the training set

    Not applicable. The Therm-X device does not appear to involve machine learning or AI that would require a "training set" in the typical sense for diagnostic algorithms. The software validation ensures its functionality based on established design specifications.

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

    Not applicable, as there is no mention or indication of an AI model requiring a training set in the document.

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