Normatec 3

K220217 · NormaTec Industries, LP · IRP · Feb 25, 2022 · Physical Medicine

Device Facts

• Record ID: K220217
• Device Name: Normatec 3
• Applicant: NormaTec Industries, LP
• Product Code: IRP · Physical Medicine
• Decision Date: Feb 25, 2022
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 890.5650
• Device Class: Class 2
• Attributes: Therapeutic, 3rd-Party Reviewed

Intended Use

The Normatec 3 is an air pressure massager intended to temporarily relieve minor muscle aches and to temporarily increase circulation to the treated areas.

Device Story

Normatec 3 is a powered inflatable tube massager for temporary muscle ache relief and circulation increase. Device uses external power supply or internal lithium-ion battery to drive a compressor and valve system; sequentially inflates/deflates appliance cells to simulate manual kneading/stroking. Operated by users in clinics, hospitals, athlete training, or home environments via on-device buttons or Bluetooth-connected mobile app (Android/iOS). App serves as alternative user interface for setting treatment time, intensity (pressure), and attachment selection. Output is mechanical pressure applied to limbs/hips. Healthcare providers or patients use device to manage muscle recovery; benefits include temporary pain relief and improved circulation.

Clinical Evidence

Bench testing only. No clinical data provided. Performance, functionality, and reliability were established through non-clinical verification and validation testing, demonstrating the device is as safe and effective as the predicate.

Technological Characteristics

Powered inflatable tube massager; 15 VDC power supply (IEC 60601-1) or internal lithium-ion battery (IEC 62133-2). Materials: 200 denier nylon with polyurethane laminate/extrusion; molded ABS (94V0) housing. Sequential gradient, peristaltic, and pulsing inflation/deflation. Pressure range 0-110 mmHg. Bluetooth connectivity for app-based control. Complies with AAMI ANSI ES60601-1, IEC 60601-1-2, IEC 60601-1-11, IEC 60601-1-6, and ANSI C63.27-2017.

Indications for Use

Indicated for adults in good health for temporary relief of minor muscle aches/pains and temporary increase in circulation to treated areas (leg, arm, hip).

Regulatory Classification

Identification

A powered inflatable tube massager is a powered device intended for medical purposes, such as to relieve minor muscle aches and pains and to increase circulation. It simulates kneading and stroking of tissues with the hands by use of an inflatable pressure cuff.

Predicate Devices

• NormaTec Pulse 2.0 and Pulse Pro 2.0 (K183169)

Submission Summary (Full Text)

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February 25, 2022

NormaTec Industries, LP % Prithul Bom Responsible Third Party Official Regulatory Technology Services, LLC 1000 Westgate Drive, Suite 510k Saint Paul, Minnesota 55114

Re: K220217

Trade/Device Name: Normatec 3 Regulation Number: 21 CFR 890.5650 Regulation Name: Powered inflatable tube massager Regulatory Class: Class II Product Code: IRP Dated: January 25, 2022 Received: January 26, 2022

Dear Prithul Bom:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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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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 of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely.

for Heather Dean, PhD Assistant Director, Acute Injury Devices Team DHT5B: Division of Neuromodulation and Physical Medicine Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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### Indications for Use

510(k) Number (if known) K220217

Device Name Normatec 3

Indications for Use (Describe)

The Normatec 3 is an air pressure massager intended to temporarily relieve minor muscle aches and to temporarily increase circulation to the treated areas.

| Type of Use (Select one or both, as applicable) | |
|-------------------------------------------------|--|
|-------------------------------------------------|--|

Prescription Use (Part 21 CFR 801 Subpart D)

X Over-The-Counter Use (21 CFR 801 Subpart C)

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## NormaTec Industries, LP

| Date of Preparation: | February 22, 2022 |
|---------------------------------------------------------|---------------------------------------------------------|
| 480 Pleasant Street<br>Suite A200<br>Watertown MA 02472 | Tel - 800.355.0960<br>Fax - 866.279.2579 |
| Official Contact: | Steve Henderson, Quality Systems and Regulatory Manager |
| Proprietary or Trade<br>Name: | Normatec 3 |
| Subject Device: | Normatec 3 |
| Common/Usual Name: | Massager, Powered Inflatable Tube |
| Classification Name | Powered inflatable tube massager |
| Regulation Number: | 21 CFR 890.5650 |
| Product Code: | IRP |
| Regulation Medical<br>Speciality: | Physical Medicine |
| Predicate Device: | K183169 – NormaTec Pulse 2.0 and Pulse Pro 2.0 |
| Classification Name | Powered inflatable tube massager |
| Common/Usual Name | Massager, Powered Inflatable Tube |
| Regulation Number: | 21 CFR 890.5650 |
| Product Code | IRP |
| Regulation Medical<br>Speciality: | Physical Medicine |

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### Device Description

The Normatec 3 is a powered inflatable tube massager (Product Code "IRP"). It is intended to temporarily relieve minor muscle aches and/or pains, and to temporarily increase circulation to the treated areas. It simulates manual kneading and stroking of tissues by the use of an inflatable pressure cuff. The devices are to be used by people who are in good health. The devices are powered from an external IEC 60601-1 compliant power supply and can also be powered by an internal IEC 62133-2 compliant lithium-ion battery.

The user interface on the Normatec 3 is a series of buttons with one small display the treatment time. The user interface provides for:

- Starting and stopping the massage treatment; .
- Adjusting time and intensity (pressure) of the treatment; .
- Selection of Attachment in use (Leg, Arm, Hip); .
- . Selection of Zone Boost which provides an increase of 10 mm Hg to the Zone selected

In addition to the user interface on the devices the proposed devices have Bluetooth capability that allows the use of a NormaTec app to control the device. The Bluetooth app allows the user to use a compatible Android or iOS phone to select and set device parameters listed above for convenience.

Intended User

ОТС

Patient Population

Adults

#### Indications for Use

The NormaTec Normatec 3 is an air pressure massager intended to temporarily relieve minor muscle aches and/or pains, and to temporarily increase circulation to the treated areas.

#### Intended Use Environment:

Clinics, hospital, athlete training, and home environments.

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#### 510(k) Summary Page 3 of 9

### Table 1 – Table of Device Comparisons and Differences

| | Predicate Device | Proposed New Device | Comment | Characteristic | Pulse 2.0 / Pulse<br>Pro 2.0 | Normatec 3 |
|---------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------|------------|
| Model Name<br>510(k) Number | NormaTec Pulse 2.0 and Pulse Pro 2.0<br>510(k) K183169 | Normatec 3<br>510(k) K220217 | N/A | Power On - The system recalls and displays the last used settings for: | | |
| Manufacturer | NormaTec Industries, LP | Same | N/A | Treatment time | X | X |
| Prescriptive | No, OTC | Same | N/A | Treatment mode | X | N/A |
| Indications for use | The NormaTec Pulse 2.0 and Pulse<br>Pro 2.0 are air pressure massagers<br>intended to temporarily relieve minor<br>muscle aches and/or pains, and to<br>temporarily increase circulation to the<br>treated areas. | The NormaTec Normatec 3 is an air<br>pressure massager intended to<br>temporarily relieve minor muscle aches<br>and/or pains, and to temporarily<br>increase circulation to the treated<br>areas. | N/A | Therapy mode<br>Rehab mode - Recalls zone focus<br>Custom - recalls all settings<br>Recovery Flush | Pulse 2.0 – N/A<br>Pulse Pro 2.0 – X | N/A |
| Intended Use<br>Environment | Clinics, hospital, athlete training, and<br>home environments | Same | N/A | Rehab<br>Preset NormaTec PULSE time / PULSE pressure values<br>Leg appliance - Foot/ankle, calf, knee, lower quad, upper quad<br>Arm appliance - Hand/wrist, forearm, elbow, bicep, shoulder<br>Hip appliance - Quadriceps, hip | Pulse 2.0 – N/A<br>Pulse Pro 2.0 – X | N/A |
| Power Source(s) | 15 VDC via an IEC 60601-1<br>compliant power supply (100- 240 VAC<br>input)<br>Integrated rechargeable battery | Same | N/A | Appliance Type | Pulse 2.0 – N/A<br>Pulse Pro 2.0 – X | X |
| Software / Firmware<br>Micro-processor<br>Control | Microprocessor | Same | N/A | Pressure Level | X | X |
| Technology | Compressor and valve system that<br>sequentially inflates cells of appliance.<br>Bluetooth communication ability. | Same | N/A | Number of zones | X | X |
| Compliance with<br>Voluntary standards | AAMI ANSI ES60601-1, IEC 60601-1-<br>2, IEC 60601-1-11 and ANSI C63.27-<br>2017. | Same and includes IEC 60601-1-6<br>compliance | The additional testing of 60601-1-6<br>compliance does not raise any new<br>device safety concerns | Rest time | X | x |
| | Predicate Device | Proposed New Device | Comment | Time | | |
| Device Pressure<br>Range | 0-110 mmHg | Same | N/A | Add time<br>Before treatment<br>During treatment | X | X |
| Pressure Levels | Level 1: 40 mm Hg max<br>Level 2: 50 - 60 mm Hg max<br>Level 3: 60 - 70 mm Hg max<br>Level 4: 70 - 80 mm Hg max<br>Level 5: 80 mm Hg max<br>Level 6: 80 - 90 mm Hg max<br>Level 7: 100 mm Hg max | Same | N/A | Decrease time<br>Before treatment<br>During treatment | X | x |
| ZoneBoost | Provides an increase of 10 mm Hg to<br>the Zone selected | Same | N/A | Continuous mode | X | N/A |
| Treatment Time | Stays on until the user turns it off or<br>can be set up to turn off in a range of<br>10 minutes to continuous | Stays on until the user turns it off or<br>can be set up to turn off in a range of<br>15 minutes to 60 minutes | Changed setup times for treatment of<br>new device to a max of 60 minutes<br>instead of continuous to match user<br>typical sessions with device. | Counter | X | X |
| Inflation/Deflation<br>Cycle Type | Sequential Gradient, Peristaltic and<br>Pulsing | Same | N/A | Count down - 1 second increments | X | X |
| Appliance Contact<br>Surface Material | 200 denier nylon with a polyurethane<br>laminate/extrusion | Same | N/A | Count up (continuous mode) - 1 second increments | X | N/A |
| Number of Inflatable<br>appliance segments | 5 or less | Same | N/A | Compliance - Trip meter | Pulse 2.0 – N/A<br>Pulse Pro 2.0 – X | X |
| Weight | 3.6 pounds (incl. battery) | Same | N/A | Chronometer Odometer - cannot be reset by User | X | X |
| Dimensions<br>(W x H x D) | 4.4" x 3.8" x 8.1" | 4.17 x 3.66 x 8.25 | N/A | Pressure | | |
| Housing Materials<br>and Constructions | Molded ABS enclosure (94V0) | Same | N/A | | | |
| Patient contact | Non-conductive appliances | Same | N/A | | | |

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## K220217

# 510(k) Summary
Page 4 of 9

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## Differences Between Models

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K220217

# 510(k) Summary
Page 6 of 9

| Characteristic | Pulse 2.0 / Pulse<br>Pro 2.0 | Normatec 3 |
|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------|------------|
| Increase level | | |
| Before treatment | × | × |
| During treatment | | |
| Decrease level | | |
| Before treatment | × | × |
| During treatment | | |
| Characteristic | Pulse 2.0 / Pulse<br>Pro 2.0 | Normatec 3 |
| Treatment Mode – Can ONLY be changed before treatment begins | | |
| NormaTec Pulse | X | X |
| Sequential | X | N/A |
| Rest Time | | |
| View or change rest time – before treatment | X | N/A |
| # of Zones | | |
| Change number of zones – before treatment | X | N/A |
| Treatment | | |
| Starting | X | X |
| Pause | X | X |
| Un-pause | X | X |
| End - If timer reaches 0:0000, treatment will continue until Rest period<br>is reached. | X | X |
| Remote operation via Bluetooth app | X | X |
| Battery Charging | | |
| Displays battery level | X | X |
| Displays when battery is charging | X | X |
| Power off | | |
| No treatment in process | X | X |
| Treatment is process | X | X |
| Appliance type | | |
| Select appliance – boot, arm, hip<br>NOTE: If hip appliance is selected, treatment mode defaults to 2-zone<br>treatment | X | X |
| Therapy Mode | | |
| Recovery Flush<br>Preset NormaTec PULSE time / PULSE pressure values<br>Appliance type applicable - boot, arm, hip | Pulse 2.0 – N/A<br>Pulse Pro 2.0 – X | N/A |
| Rehab<br>Preset NormaTec PULSE time / PULSE pressure values<br>Leg appliance - Foot/ankle, calf, knee, lower quad, upper quad<br>Arm appliance - Hand/wrist, forearm, elbow, bicep, shoulder<br>Hip appliance - Quadriceps, hip | Pulse 2.0 – N/A<br>Pulse Pro 2.0 – X | N/A |
| Characteristic | Pulse 2.0 / Pulse<br>Pro 2.0 | Normatec 3 |
| Custom Settings<br>Allows user to program NormaTec PULSE pressure and time values for<br>each zone<br>Pressure range – 30-110 mmHg, user can select in 10 mmHg<br>increments<br>Time range - 15 seconds to 4 minutes, user can select in 15 second<br>increments | Pulse 2.0 – N/A<br>Pulse Pro 2.0 - Χ | N/A |
| Display Settings Adjustment | | |
| Brightness controls | Pulse 2.0 – N/A<br>Pulse Pro 2.0 - Χ | N/A |

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#### 510(k) Summary Page 7 of 9

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K220217

#### 510(k) Summary Page 8 of 9

### Determination of Substantial Equivalence

The Normatec 3 is substantially equivalent to currently marketed and cleared devices (K183169) because:

#### Indications for Use

The Normatec 3 indications for use are identical to the predicate, NormaTec Pulse 2.0 and Pulse Pro 2.0, 510(k) K183169.

#### Prescriptive

The Normatec 3 and the predicate (K183169) are OTC devices.

#### Design, Technology, and Principle of Operation

The Normatec 3 has equivalent design and features when compared to the predicate and have similar technology to the predicate, NormaTec Pulse 2.0 and Pulse Pro 2.0 510(k) K183169.

The proposed device has Bluetooth capability that allows the use of a NormaTec app to control the device. In addition to the user interface on the devices, the proposed device has Bluetooth capability that allows the use of a NormaTec app to control the device. The Bluetooth app allows the user to use a compatible Android or iOS phone to select and set device parameters listed above for convenience.

#### Performance and Specifications

The Normatec 3 has equivalent specifications of performance when compared to the predicate, NormaTec Pulse 2.0 and Pulse Pro 2.0 510(k) K183169.

#### Compliance with Standards

The predicate devices are compliant with AAM ANSI ES60601-1, IEC 60601-1-2, IEC 60601-1-11 and ANSI C63.27-2017.

The Normatec 3 complies with AAM ANSI ES60601-1, IEC 60601-1-2, IEC 60601-1-2, IEC 60601-1-11 and ANSI C63.27-2017.

#### Materials

The patient-contacting materials of the Normatec 3 are the inflatable appliances that are identical to the predicate, NormaTec Pulse 2.0 and Pulse Pro 2.0 510(k) K183169.

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#### Intended Use Environment

Clinics, hospital, athlete training, and home environments, which are identical to the predicate.

#### Features

The Normatec 3 has equivalent features when compared to the predicate, NormaTec Pulse 2.0 and Pulse Pro 2.0 510(k) K183169.

### Conclusion

The Normatec 3 is substantially equivalent to the predicate, NormaTec Pulse 2.0 and Pulse Pro 2.0 510(k) K183169 in:

- Patient population, .
- Environment of use, .
- . Technology characteristics,
- Materials, ●
- Specifications / performance, and .
- Compliance with international standards. .

The inclusion of the Bluetooth capability and associated app does not affect the equivalency of the proposed devices and the predicate. The app functions only as an alternative user interface. No additional features are provided or unlocked by the app. Nor is the therapy provided by the devices affected by using the app.

Other minor differences as detailed in the substantial equivalence table do not raise questions of safety and effectiveness.

#### Indications for Use

The Normatec 3 Indications for Use and Contraindications are identical to the predicate NormaTec Pulse 2.0 and Pulse Pro 2.0 510(k) K183169.

Verification and Validation activities required that establish the performance, functionality, and reliability characteristics of the Normatec 3 with respect to the predicate were performed. Testing performed demonstrated that the proposed device meets defined requirements and performance claims.

The summary includes the conclusions drawn from the nonclinical tests (discussed above) that demonstrate that the device is as safe, as effective, and performs as well as the predicate device according to 807.92(b)(3).