SHAPE TO FIT COMPRESSION WEAR

K101906 · Tsung Hau Technology Co., Ltd. · DWL · Sep 17, 2010 · General Hospital

Device Facts

• Record ID: K101906
• Device Name: SHAPE TO FIT COMPRESSION WEAR
• Applicant: Tsung Hau Technology Co., Ltd.
• Product Code: DWL · General Hospital
• Decision Date: Sep 17, 2010
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 880.5780
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

Help prevent edema and leg discomfort, and help prevent deep vein thrombosis in individuals subjected to immobility.

Device Story

Shape to Fit Compression Socks are medical support stockings designed for over-the-counter use. Constructed from nylon and spandex using circular knit machines, these knee-high socks provide controlled, uniform graduated compression. The device exerts higher pressure at the ankle (15-20 mmHg or 20-30 mmHg) with a gradual decrease toward the proximal end. Users select socks based on ankle and calf circumference. By applying external pressure, the socks encourage circulatory wellness, alleviate leg swelling, and help prevent deep vein thrombosis in immobile individuals.

Clinical Evidence

Bench testing only; no clinical data provided.

Technological Characteristics

Medical support stocking (21 CFR 880.5780, Class II, Product Code DWL). Materials: nylon and spandex. Manufacturing: circular knit machines. Compression profile: graduated, 15-20 mmHg or 20-30 mmHg at the ankle. Form factor: knee-high.

Indications for Use

Indicated for individuals subjected to immobility to help prevent edema, leg discomfort, and deep vein thrombosis; also indicated to encourage circulatory wellness and alleviate swelling in legs and prevent deep varicose veins.

Regulatory Classification

Identification

Medical support stocking to prevent the pooling of blood in the legs: A medical support stocking to prevent the pooling of blood in the legs is a device that is constructed of elastic material and designed to apply controlled pressure to the leg and that is intended for use in the prevention of pooling of blood in the leg. Medical support stocking for general medical purposes: A medical support stocking for general medical purposes is a device that is constructed of elastic material and designed to apply controlled pressure to the leg and that is intended for medical purposes other than the prevention of pooling of blood in the leg.

Special Controls

*Classification.* Class II (special controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 880.9.(b) *Medical support stocking for general medical purposes* —(1)*Identification.* A medical support stocking for general medical purposes is a device that is constructed of elastic material and designed to apply controlled pressure to the leg and that is intended for medical purposes other than the prevention of pooling of blood in the leg.(2) *Classification.* Class I. The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 880.9. The device is also exempt from the current good manufacturing practice requirements of the quality management system regulation in part 820 of this chapter, except for requirements concerning records and complaint files under § 820.35 of this chapter.

Predicate Devices

• Supolar Netex Stockings (K062873)
• Therafirm anti-embolism stockings, Knit-Rite Inc (K091141)
• Jobst Institute Inc. (K032325)

Submission Summary (Full Text)

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# 510(k) SUMMARY

### 510(K) SUMMARY

### 510 (K) Number K101906 Device Name: Shape to Fit Compression Socks

Indications for Use: Help prevent edema and leg discomfort, and help prevent deep vein thrombosis in individuals subjected to immobility.

#### Over-The-Counter Use

Classification Name: Medical Support Stocking (21 CFR 880.5780, Product Code DWL. This submission covers the indication that Shape to Fit Compression Socks(including same products offered for OEM applications) help encourage circulatory wellness and prevent, ankles and feet, and alleviate swelling in legs and help prevent deep varicose veins. These products fall under the device classification of medical support stockings (21 CFR 880.5780), Class II medical device, Product Code DWL. Shape to Fit Compression Socks (including same products offered for OEM applications) that belong to this category, and they are substantially equivalent to (K062873) Medical Support Stocking(Brand Name Supolar Netex Stockings), Therafirm anti-embolism stockings, Knit-Rite Inc ( K091141) and Jobst Institute Inc. (K032325).

Shape to Fit Compression Socks and their substantial equivalents, mentioned above, are compression socks knitted by circular knit machines with nylon and spandex. They all include knee-high which are sized based on ankle and calf circumference fit. Shape to Fit Compression Socks provide controlled, uniform graduated compression, as is provided in all of these substantially equivalent products, starting with more compression circumferentially at the ankle at approximately 15 mmHg to 20 mmHg / 20 mmHg to 30 mmHg (based on average ankle size) then gradually decreases up to the proximal end.

The Shape to Fit products being submitted are substantially equivalent to the predicate product in material content, function and indication and as such can be considered as safe and effective as the referenced, predicate products. This statement is to assure that Shape to Fit Compression Socks is safe and effective when worn for their intended purpose and fit properly according to the guidelines. See Section on Performance Testing -for nonclinical testing that demonstrates that the device is safe, effective, and performs in comparison to predicate devices.

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Image /page/1/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized symbol that resembles three overlapping human figures or abstract shapes.

#### DEPARTMENT OF HEALTH & HUMAN SERVICES

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

Ms. Peggy Kuo Overseas Manager Tsung Hau Technology Company, Limited 3F Building A, No. 248-21, Sinsheng Road Taiwan, R.O.C. China (Taiwan) 806 KH

SEP 1 7 2010

Re: K101906

Trade/Device Name: Shape to Fit Compression Socks Regulation Number: 21 CFR 880.5780 Regulation Name: Medical Support Stocking Regulatory Class: II Product Code: DWL Dated: August 26, 2010 Received: August 26, 2010

Dear Ms. Kuo:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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.

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Page 2- Ms. Kuo

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to

http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR.Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act 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/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours.

Wh for

Anthony D. Watson, B.S., M.S., M.B.A. Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation

Center for Devices and

Radiological Health

Enclosure

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K101906

### SEP 1 7 2010

# INDICATION FOR USE

# Indications for Use

## 510(k) Number (if known):K 101906

Device Name: Shape to Fit Compression Socks

#### Indications for Use:

Help prevent edema and leg discomfort, and help prevent deep vein thrombosis in individuals subjected to immobility

Prescription Use _____________________________________________________________________________________________________________________________________________________________ ( Part 21 CFR 801 Subpart D) (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODB

C. Office of Device Evaluation (ODE)

Al C. A
9/7/10

(Division Sign-Off) (Division Sign-On)
Division of Anesthesiology, General Hospital
Division of Anesthesiology, General Devises Division of Amorol, Dental Devices

510(k) Number: K/01906