OXYGEN TREATMENT HOOD

K011592 · Amron International Diving Supply, Inc. · CBF · Jun 19, 2002 · Anesthesiology

Device Facts

• Record ID: K011592
• Device Name: OXYGEN TREATMENT HOOD
• Applicant: Amron International Diving Supply, Inc.
• Product Code: CBF · Anesthesiology
• Decision Date: Jun 19, 2002
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 868.5470
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The Amron International Treatment Hood is intended to provide a means to administer gas/oxygen/air to a patient by a clinician in clinical multiplace or monoplace chamber systems.

Device Story

Amron International Treatment Hood (Model 8891) is a patient-interface device for hyperbaric oxygen therapy. Assembly consists of a reusable neck ring, tubular latex neck seal, and transparent vinyl hood with viewing window. Device is placed over patient's head within a hyperbaric chamber. Supply and exhaust tubes connect to ports on the neck ring to circulate gas, which cools the patient and defogs the optical window. Operated by clinicians in clinical settings. Provides controlled gas delivery to the patient.

Clinical Evidence

Bench testing only. Evaluated performance at various flow rates and ATA, including oxygen and carbon dioxide levels, flow characteristics, sealing, fogging, patient cooling effect, and noise levels.

Technological Characteristics

Cylindrical vinyl hood (12" diameter x 12" high) with viewing window; reusable neck ring with latex neck seal; 22 mm supply/exhaust connectors; multi-access port. Operates via gas circulation within hyperbaric chambers. No electronic or software components.

Indications for Use

Indicated for patients requiring administration of gas, oxygen, or air within clinical multiplace or monoplace hyperbaric chamber systems.

Regulatory Classification

Identification

A hyperbaric chamber is a device that is intended to increase the environmental oxygen pressure to promote the movement of oxygen from the environment to a patient's tissue by means of pressurization that is greater than atmospheric pressure. This device does not include topical oxygen chambers for extremities (§ 878.5650).

Predicate Devices

• Sea-Long Medical Treatment Hood (K010659)

Submission Summary (Full Text)

{0}------------------------------------------------

Image /page/0/Picture/0 description: The image shows the logo for AMRON International. The word "AMRON" is in large, bold, sans-serif font, with a wave-like design extending from the right side of the "N". Below "AMRON" is the word "INTERNATIONAL" in a smaller, bold, sans-serif font, set against a solid black rectangle. The logo is simple and professional, with a focus on the company name.

# 510(k) Summary for Amron International Treatment Hood (K011592)

### Date

March 27, 2002

# To

Food and Drug Administration Center for Devices and Radiological Health Office of Device Evaluation Document Mail Center (HFZ-401) 9200 Corporate Blvd. Rockville, Maryland 20850

# Submitter

Amron International Diving Supply, Inc. 759 West Fourth Avenue Escondido. CA 92025 Phone: [phone] Fax: [phone] Contact: Scott Ritchie

# Name of Device

Proprietary Name: Amron Treatment Hood Common/Usual Name: Treatment Hood

# Equivalent Device

Sea-Long Medical Treatment Hood, 510(k) No. K010659

### Device Description

The Amron International Oxygen Treatment Hood, Model 8891, was designed for easy use and cost effective operation within a multiplace or monoplace hyperbaric chamber. The hood assembly is placed over a person's head for treating a person with a qas such as oxygen.

The assembly includes a reusable neck ring which fits over a user's head, a tubular latex neck seal with one end connected to the neck ring and the other configured to fit around the user's neck, and a transparent hood fastened to a hood ring that can be sealed against the neck ring.

Supply and exhaust tubes direct gas into and out the hood through ports located on the neck ring, The supply and exhaust locations allow oxygen to circulate easily throughout the hood increasing performance while reducing noise levels. Supply gas also helps cool the user reducing potential overheating and continuously defogs the hood's optical window.

{1}------------------------------------------------

Image /page/1/Picture/0 description: The image shows the logo for AMRON International. The word "AMRON" is in large, bold, black letters, with a wave design extending from the right side of the "N". Below "AMRON" is the word "INTERNATIONAL" in smaller, bold, white letters against a black background. The logo appears to be for a company named AMRON International.

# 510(k) Summary for Amron International Treatment Hood (K011592)

### Intended Use

The Amron International Treatment Hood is intended to provide a means to administer gas/oxygen/air to a patient by a clinician in clinical multiplace or monoplace chamber system.

# Technological Characteristics of Amron Hood Compared to Predicate Device

Non-clinical tests were run for performance at different flow rates and ATA. Oxygen and carbon dioxide levels, flow characteristics, sealing, fogging, cooling effect on patient, and noise level were also evaluated.

The Amron International Treatment Hood was found to be functionally identical to the Sea-Long Treatment Hood and their technological characteristics are the same.

| Technological<br>Characteristics | Amron Treatment Hood<br>(K011592) | Sea-Long Treatment Hood<br>(K010659) |
|--------------------------------------------|---------------------------------------------------------------------------------------|--------------------------------------|
| Physical Size & Shape of<br>Treatment Hood | 12"Ø x 12" High<br>cylinder shape | Same |
| Vinyl Hood with Ring | Clear vinyl hood attached to<br>hood ring with viewing window | Same |
| Neck Ring | Offset neck ring with o-ring | Same |
| Supply & Exhaust Connectors | Molded in 22 mm connectors<br>located on front of neck ring | Same |
| Multi-Access Port | Molded in and located on front<br>of neck ring between supply &<br>exhaust connectors | Same |
| Neck Seal | Attached to neck ring and seals<br>around patient's neck | Same |
| Intended Use | For use in hyperbaric Oxygen<br>Therapy (HOT) | Same |

{2}------------------------------------------------

#### DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image is a black and white seal for the Department of Health & Human Services USA. The seal is circular with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" around the perimeter. In the center of the seal is a stylized image of three faces in profile, stacked on top of each other.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850 .

# JUN 1 9 2002

Amron International Diving Supply, Inc. c/o Ms. Norma F. Ockwig 759 West Fourth Avenue Escondido, CA 92025

Re: K011592

Amron Oxygen Treatment Hood Regulation Number: 868.5470 Regulation Name: Hyperbaric Chamber Regulatory Class: II (two) Product Code: CBF Dated: undated Received: March 29, 2002

Dear Ms. Ockwig:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food. Drug. and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

{3}------------------------------------------------

#### Page 2 - Ms. Norma Ockwig

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

This letter will allow you to begin marketing your device as described in your Section 510/k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at [phone]. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely vours.

N. Olatunji

Donna-Bea Tillman, Ph.D. Acting Director Division of Cardiovascular and Respiratory Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

{4}------------------------------------------------

Page 1 of 1

# 510(k) Number (if known): K011592

Device Name: Amron International Treatment Hood

Indications for Use:

The Amron International Treatment Hood is intended to provide a means to administer gas/oxygen/air to a patient by a clinician in clinical multiplace or monoplace chamber systems.

# (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurence of CDRH, Office of Device Evaulation (ODE)

| Prescription Use |
|----------------------|
| (Per 21 CFR 801.109) |

Division of Cardiovascular & Respiratory Devices
510(k) Number K011592