MODEL 1100 COLD THERAPY DEVICE

K955057 · Smith and Nephew Donjoy, Inc. · ILO · Mar 8, 1996 · Physical Medicine

Device Facts

• Record ID: K955057
• Device Name: MODEL 1100 COLD THERAPY DEVICE
• Applicant: Smith and Nephew Donjoy, Inc.
• Product Code: ILO · Physical Medicine
• Decision Date: Mar 8, 1996
• Decision: SN
• Submission Type: Traditional
• Regulation: 21 CFR 890.5720
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The application of ice after surgery or injury to reduce swelling and pain is a well established treatment with well know indications and contraindications. Devices approved for market, such as the Breg Inc. Polar Care 500, the Burke/Nutech Inc. Sports Therapy 1000, and the Smith & Nephew DonJoy, Inc. Model 1100 device, are essentially more convenient and safer means to apply ice.

Device Story

Cold therapy device; consists of ice/water tank, submersible water pump, console with temperature control/indicator, and circulation pad. Pump circulates chilled water through pad; console positioned along tubing for patient access. Device allows temperature settings above 32F (0C) for safer, extended treatment compared to ice bags. Used in clinical or home settings; operated by patient or clinician. Output is localized cold therapy to affected area; aids in pain management and swelling reduction.

Clinical Evidence

No clinical data provided. Relies on established literature regarding the benefits of cold therapy for post-surgical and injury-related morbidity, blood flow, and bone metabolism.

Technological Characteristics

System includes water tank, submersible pump, console, and circulation pad. Leakage current limit: 100uA. Temperature control mechanism allows settings above 32F (0C). Insulated tubing connects components.

Indications for Use

Indicated for patients requiring cold therapy to reduce swelling and pain following surgery or injury.

Regulatory Classification

Identification

A water circulating hot or cold pack is a device intended for medical purposes that operates by pumping heated or chilled water through a plastic bag and that provides hot or cold therapy for body surfaces.

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 § 890.9.

Reference Devices

• Breg Inc. Polar Care 500
• Burke/Nutech Inc. Sports Therapy 1000
• Smith & Nephew DonJoy, Inc. Model 1100

Submission Summary (Full Text)

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MAR - 8 1996
K9SS057

# L. SUMMARY OF SAFETY AND EFFECTIVENESS

The application of ice after surgery or injury to reduce swelling and pain is a well established treatment with well know indications and contraindications. Devices approved for market, such as the Breg Inc. Polar Care 500, the Burke/Nutech Inc. Sports Therapy 1000, and the Smith & Nephew DonJoy, Inc. Model 1100 device, are essentially more convenient and safer means to apply ice. More convenient because of less bulk for example, and safer because the treatment temperature can be set above the melting temperature of ice, 32F (0C), allowing extended safe treatment. A bag of ice in contrast, will necessarily be at 32F (0C) without option.

The device consists of a tank containing ice and water, a water pump to circulate cold water, a console containing a means to control and indicate temperature and a pad through which the cold water circulates. The pump, contained in a waterproof case, is submerged in the ice water bath and connected to the console via insulated tubing through which the chilled water flows to and from the pad. The console is located along this tubing about halfway between the pad and the water bath for easy access by the patient. Leakage current for the device shall not exceed 100uA.

To our knowledge, no new safety issues regarding the use of these and like devices approved for market, have been raised. To the contrary, the literature continues to study the benefits of cold therapy. Some recent publications follow:

Bert, Stark, Maschka, Chock. The Effect of Cold Therapy on Morbidity Subsequent to Arthroscopic Lateral Retinacular Release, *Orthopaedic Review*, Vol. XX, No. 9, September 1991

Ho, Coel, Kagawa, Richardson. The Effect of Ice on Blood Flow and Bone Metabolism in Knees, *The American Journal of Sports Medicine*, Vol. 22, No. 4, 1994

Ho, Illgen, Meyer, Comparison of Various Icing Times in Decreasing Bone Metabolism and Blood Flow in the Knee, *The American Journal of Sports Medicine*, Vol. 23, 1995

Grana WA, Cold Modalities (Chapter 7) in: Orthopedic Sports Medicine, Ed. Delee, Drez Vol 1, 1994

Smith & Nephew DonJoy Inc.

Dan W. Miller
Director of Regulatory Affairs and Quality Assurance

Smith & Nephew DonJoy 510K Premarket Submission
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