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510(k) Data Aggregation

    K Number
    K113199
    Date Cleared
    2012-07-30

    (273 days)

    Product Code
    Regulation Number
    878.4780
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    K082676

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

    Kevo NPWT- αHemo30 Foam Dressing Kit is intended to be used in conjunction with the Genadyne A4 Wound Vacuum System (K082676) to deliver negative pressure wound therapy to the wound. Kevo NPWT- αHemo30 Foam Dressing Kit is indicated for patients who would benefit from a suction device, particularly as the device may promote wound healing by removal of excess exudates, infectious material and tissue debris.

    Kevo NPWT - αHemo30 Foam Dressing Kit is appropriate for use on the following wounds:

    • Pressure Ulcers .
    • Diabetic/Neuropathic Ulcers .
    • Venous Insufficiency Ulcers .
    • Traumatic Wounds .
    • Post-Operative and Dehisced Surgical Wounds .
    • Skin Flaps and Grafts .

    Caution: Federal (USA) law restricts this device to sale by or on the order of a physician.

    Device Description

    The Kevo NPWT- α.Hemo30 Foam Dressing Kit is manufactured using a reticulated flexible polyether and polyurethane hydrophobic foam material. The single-use dressing is housed in a Tyvek/Mylar Peel Pouch which is sterilized using EtO.

    The Kevo NPWT- αHemo30 Foam Dressing Kit is available in three sizes; 1) small, 2) medium and 3) large:

    Small: 100mm x 80mm x 30mm Medium: 125mm x 190mm x 30mm Large: 150mm x 250mm x 30mm

    AI/ML Overview

    This document describes the 510(k) summary for the Kevo NPWT-αHemo30 Foam Dressing Kit. This is a medical device submission, and the "acceptance criteria" and "device performance" here refer to demonstrating substantial equivalence to a predicate device, not typical AI model performance metrics. The information is extracted and presented as requested, adapted to the nature of this submission.

    Analysis of the Kevo NPWT-αHemo30 Foam Dressing Kit (K113199) Submission

    The provided document describes a 510(k) submission for the Kevo NPWT-αHemo30 Foam Dressing Kit, which is a medical device and not an AI/software device. Therefore, the questions related to AI model performance, AI-assisted human reading, training sets, and expert adjudication are not directly applicable in the context of this submission.

    The "acceptance criteria" and "device performance" in this context refer to demonstrating substantial equivalence to a predicate device, the Genadyne A4-XLR8 Foam Dressing Kit (K092992), through a series of bench tests and comparisons of physical and material properties.

    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance Criteria (Demonstrating Substantial Equivalence to Predicate)Reported Device Performance (Kevo NPWT-αHemo30 Foam Dressing Kit)
    Dimensions unchanged after 72 hours of suction pressureDressings appeared unchanged after undergoing long periods of suction pressures.
    Variation in suction pressures to be Bacterial Endotoxins, ISO 10993 -1 Rabbit Pyrogen, ISO11137-1:2006 (Radiation Sterilization), ISO 11737-1 2006 (Microorganism Population), ANSI/AAMI/ISO 11737-2:1998 (Sterility Test), USP 32 NF Sterility Tests, ISO 17025:2005 (Testing/Calibration Labs), ASTM F1980-07 (Accelerated Aging).
    Foam compositionReticulated flexible polyether-based polyurethane foam (Identical to predicate).
    Foam codeIdentical (A30M) to predicate.
    Foam manufacturerCrest Foam Industries (Identical to predicate).
    Foam converter/kitterKeystone Solutions Group (Identical to predicate).
    Processing and Sterilization methodsIdentical to predicate.
    Hydrophobic propertyYes (Identical to predicate).
    Sizes availableSmall, Medium, Large (Identical to predicate).
    Use with negative pressure wound therapy (NPWT)Yes (Identical to predicate).
    SterilityYes (Identical to predicate).
    Prescription onlyYes (Identical to predicate).
    Use environmentAcute, Extended, and Home Care Settings by Healthcare Professionals (Identical to predicate).

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

    • Sample Size: The document does not specify a precise numerical "sample size" for the foam dressings tested in the bench studies. It refers to "3 different conditions" for the core bench tests but doesn't quantify the number of dressings per condition.
    • Data Provenance: The data comes from prospective bench tests conducted specifically for this 510(k) submission. The country of origin for the data collection is implied to be within the US, given the submission is to the FDA from a US company (Ann Arbor, MI).

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

    • This question is not applicable as the ground truth for this medical device (a foam dressing) is established through objective physical and chemical bench testing, not expert interpretation of outputs like in AI/imaging studies. The "ground truth" is adherence to predefined engineering specifications and performance benchmarks compared to the predicate device.

    4. Adjudication Method for the Test Set

    • Not applicable. As there are no human interpretations or subjective assessments requiring adjudication in these bench tests, no adjudication method was used.

    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 submission is for a foam dressing, not an AI-assisted diagnostic tool. No MRMC study was conducted.

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

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

    7. The Type of Ground Truth Used

    • The "ground truth" for this device's substantial equivalence is based on objective physical and chemical measurements from bench testing (e.g., dimensional stability, pressure variation, fluid removal rates, biocompatibility, sterilization parameters) and direct comparison of material properties and manufacturing processes to the legally marketed predicate device.

    8. The Sample Size for the Training Set

    • Not applicable. This is a physical medical device, not an AI model, so there is no "training set."

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

    • Not applicable. As there is no training set for a physical device, ground truth establishment for such a set is irrelevant.
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    K Number
    K092992
    Date Cleared
    2010-06-29

    (274 days)

    Product Code
    Regulation Number
    878.4780
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    K082676

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

    Genadyne A4-XLR8 Foam Dressing is intended to be used in conjunction with the Genadyne A4 Wound Vacuum System (K082676) to deliver negative pressure wound therapy to the wound. Genadyne A4 Wound Vacuum System is indicated for patients who would benefit from a suction device, particularly as the device may promote wound healing by the removal of excess exudates, infectious material and tissue debris.

    A4-XLR8 Foam Dressing is appropriate for use on the following wounds:

    • Pressure ulcers
    • Diabetic/Neuropathic Ulcers
    • Venous insufficiency ulcers
    • Traumatic wounds
    • Post-operative and dehisced surgical wounds
    • Skin flap and grafts

    Caution: Federal law restricts this device to sale by or on the order of a physician.

    Device Description

    Genadyne A4-XLR8 Foam Dressing is manufactured using a reticulated flexible polyether and polyurethane hydrophobic foam material. The single-use dressing is housed in a Tyvek/Mylar Peel Pouch which is sterilized using EtO.

    Genadyne A4-XLR8 Foam Dressing is available in three sizes; 1) small, 2) medium and 3) large.

    AI/ML Overview

    Here's an analysis of the provided text regarding the acceptance criteria and supporting study for the Genadyne A4-XLR8 Foam Dressing:

    The document provided is a 510(k) Summary for a medical device called the "A4-XLR8 Foam Dressing." This type of submission focuses on demonstrating substantial equivalence to a legally marketed predicate device rather than proving clinical efficacy from scratch. Therefore, the "acceptance criteria" and "study" described are often focused on showing that the new device performs comparably to the predicate device, especially in terms of safety and basic functionality relevant to its intended use.

    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance Criteria / TestReported Device Performance (Results)
    L929 MEM Elution Test (ISO 10993-5)Non-cytotoxic, meets ISO 10993-5 requirements.
    L929 MEM Elution Test (ISO 10993-10)Non-cytotoxic, meets ISO 10993-5 (likely a typo, should be ISO 10993-10) requirements.
    Kligman Maximization Test (ISO 10993-10)Grade I sensitization rate (not significant), meets ISO 10993-10 requirements.
    Intracutaneous Injection Test (ISO 10993-10)Negligible irritant, meets ISO 10993-10 requirements.
    Kinetic Limulus Amebocyte Lysate Test (LAL) (USP 32, NF 27:2009)Contains 0.00689 EU/mL. Correlation coefficient for linear regression was -0.999.
    Inhibition and Enhancement Testing, LAL Kinetic Method (USP 32, NF 27:2009)No inhibition or enhancement present. Correlation coefficient for linear regression was -0.999 (standard), -0.996 (sample 1), -0.997 (sample 2), -0.998 (sample 3).
    Bacteriostasis & Fungistasis / Direct Transfer (USP 32, NF 27:2009)Non-bacteriostatic and non-fungistatic.
    Bioburden Validation – Exhaustive Recovery (ANSI/AAMI/ISO 11737-1:2006)100% recovery, recovery factor 1.
    Accelerated Aging (ASTM F1980-07)4-months of real-time testing completed (at time of filing).
    Residual EtO, ECh, and EG (ISO 10993-10)Ethylene Oxide: Not Detected. Ethylene Chlorohydrin: Not Detected. Ethylene Glycol: 1.18mg, 1.71mg, 1.43mg, 1.65mg, 1.34mg, 1.31mg.
    Comparative Bench Test: Dimensions (before/after 72h suction)Both dressings (subject & predicate) appeared unchanged.
    Comparative Bench Test: Suction PressuresDifference in suction pressures between devices: ± 5mmHg. Pressure distribution uniform across both dressings.
    Comparative Bench Test: Fluid Removal Rates (using plasma over 72h continuous suction)Fluid removal rate found to be substantially equivalent.

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

    The provided text describes bench testing rather than clinical testing with human subjects.

    • Sample Size for Bench Testing:
      • For the comparative bench test, the exact number of units of each dressing (Genadyne A4-XLR8 Foam Dressing and Smith & Nephew Renasys F NPWT Foam Dressing) tested is not explicitly stated. It mentions "Genadyne collected data on 3 different conditions," which likely implies multiple measurements or samples for each condition. Without a specific number, it is inferred to be a sufficient sample size for engineering bench testing.
    • Data Provenance: The comparative bench test was an in-house study conducted by Genadyne Biotechnologies, Inc. This indicates it was done by the manufacturer, likely in a controlled laboratory setting. No specific country of origin for the data is mentioned beyond "in-house," but the company is located in Great Neck, NY, USA. The nature of the tests (bench tests) means they are prospective experiments designed to evaluate specific physical and chemical properties.

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

    This section is not applicable to this submission. The tests performed are primarily laboratory-based (biocompatibility, chemical residues, physical performance under vacuum). These types of tests establish "ground truth" through adherence to recognized standards (ISO, USP, ASTM) and objective measurements, not through expert human interpretation of medical data (like imaging or pathology).

    4. Adjudication Method for the Test Set

    This section is not applicable. Since the tests are objective measurements against defined standards or direct comparisons of physical properties (e.g., measuring dimensions, pressure, fluid volume), there is no need for expert adjudication in the way it would be used for clinical interpretations or subjective assessments.

    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

    This section is not applicable. The device being reviewed is a foam dressing for negative pressure wound therapy, not an AI or imaging diagnostic or assistive device. Therefore, an MRMC study is irrelevant to this product.

    6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

    This section is not applicable. The device is a physical medical dressing, not an algorithm or an AI system. "Standalone performance" in this context would refer to the dressing's intrinsic properties and performance characteristics as measured in bench tests, which are covered extensively in item 1.

    7. The Type of Ground Truth Used

    The "ground truth" for the tests performed can be categorized as:

    • Objective Measurement against Standards: For biocompatibility tests (L929 MEM Elution, Kligman Maximization, Intracutaneous Injection), endotoxin tests (LAL), sterility-related tests (Bacteriostasis & Fungistasis, Bioburden Validation), and material property tests (Residual EtO/ECh/EG), the ground truth is established by adherence to specified international (ISO) and national (USP, ANSI/AAMI) standards, with results being quantitative measurements or qualitative assessments of compliance.
    • Direct Comparative Measurement: For the "Comparative Bench Test," the ground truth is the directly measured performance of the predicate device (Smith & Nephew Renasys F NPWT Foam Dressing Kit). The subject device's performance is then compared to this benchmark to demonstrate "substantial equivalence." This involves objective measurements of dimensions, suction pressures, and fluid removal rates.

    8. The Sample Size for the Training Set

    This section is not applicable. The device is a passive medical device, not an AI or machine learning system that requires a "training set."

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

    This section is not applicable, as there is no training set for this type of device.

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