K Number
K111941

Validate with FDA (Live)

Date Cleared
2012-05-25

(322 days)

Product Code
Regulation Number
890.5880
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The intended use of the CHOYANG Thermal Massager (Model: CY-7000) is to provide patients with muscle relaxation therapy by delivering heat and soothing massage.

Device Description

The CHOYANG Thermal Massager (Model: CY-7000) is an electrically powered, motorized multi-functional physical therapy table. It is intended function and use is to provide patients with muscle relaxation therapy by delivering heat and soothing massage. The massage function is delivered by way of two independent carriages. Each carriage has five infrared lights. During use, these carriages traverse from lower torso to upper torso and apply light pressure as well as heat to the supine user.

AI/ML Overview

The provided document describes the safety and effectiveness of the CHOYANG Thermal Massager (Model: CY-7000) by demonstrating its substantial equivalence to two predicate devices, rather than through a study with specific acceptance criteria and performance metrics for the device itself.

The "study" in this context is a substantial equivalence comparison to legally marketed predicate devices.

Here's a breakdown of the requested information based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

The document does not specify quantitative acceptance criteria. Instead, it asserts that the new device is "as safe and effective as the predicate devices" based on bench and clinical evaluation, and a comparison of technical specifications and intended use. The "reported device performance" is essentially its similarity to the predicates.

ItemCHOYANG Thermal Massager (New Device)Predicate Device 1 (HY7000 Thermassage Energy Product)Predicate Device 2 (CERAGEM-RH1 Automatic Thermal Massager)Conclusion (Acceptance)
Safety Standard ComplianceComplies with EN 60601-1-2--
Intended UseTo provide patients with muscle relaxation therapy by delivering heat and soothing massage.To provide patients with muscle relaxation therapy by delivering heat and soothing massage. Additionally, the infrared lamps provide topical heating for: - temporary relief of minor muscle and joint pain and stiffness - the temporary relief of minor joint pain associated with arthritis - the temporary increase in local circulation where applied - relaxation of muscle-(Implicit in classification as "Multi-function physical therapy table" and "Therapeutic massager" as well as the similarity to Predicate 1's use)Substantially equivalent in primary intended use (muscle relaxation, heat, massage). Differences in secondary infrared claims for Predicate 1 are noted but do not preclude substantial equivalence for the new device's stated indications.
Rated input voltage120V a.c120V a.c120V a.cEquivalent
Supply Frequency50-60Hz50Hz60HzFunctionally equivalent for typical mains power
Rated input power250W269W290WComparable range, deemed equivalent
Degree of protectionType BF applied partType BF applied partType BF applied partEquivalent
Ambient temperature40~70℃40~70℃30~60℃Overlapping and comparable, deemed equivalent
Weight64Kg74Kg87KgComparable range, deemed equivalent
Safe working loadMax. 150KgMax. 150KgMax. 140KgEquivalent or exceeds predicate
Massage rollerJadeGeranium CerramicJadeDifferent material from one predicate but similar to other, deemed equivalent in function
Mode Set-UpAuto Mode, Semi-Auto ModeAuto Mode, Semi-Auto ModeAuto Mode, Semi-Auto ModeEquivalent
Remote ButtonsRubber Pad TypeRubber Pad TypeRubber Pad TypeEquivalent
Operating time36min34min40minComparable range, deemed equivalent

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

The document does not describe a "test set" in the sense of a dataset used for performance evaluation of an AI/software device. The evaluation is based on bench testing for safety (EN 60601-1-2) and a comparison of specifications and intended use to predicate devices.

  • Sample size: Not applicable for a typical test set using patient data. The "sample" is of the device itself (one unit of CY-7000) for bench testing.
  • Data provenance: Bench test reports were performed by SGS Testing Korea. The comparison data for predicate devices is from their respective 510(k) submissions.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable. There is no "ground truth" derived from expert consensus on a test set of data for this type of device submission. The substantial equivalence is determined by regulatory review based on engineering, safety, and functional comparisons.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

Not applicable. There was no expert adjudication process for determining ground truth in a test set.

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 is a physical thermal massager, not an AI-assisted diagnostic device.

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

Not applicable. This is a physical thermal massager.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

Not applicable in the context of an AI/software device. The "ground truth" for the submission is the documented performance, safety standards compliance, and intended use of the predicate devices, against which the new device is compared. The determination of "safe and effective" for the new device is made through this comparison and adherence to relevant standards.

8. The sample size for the training set

Not applicable. This is a physical thermal massager, not an AI/software device that requires a training set.

9. How the ground truth for the training set was established

Not applicable.

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Image /page/0/Picture/1 description: The image shows a logo with the word "CHOYANG" in a stylized font. The word is positioned to the right of a curved, swooping shape that resembles a crescent or an arc. The logo is set against a white background, and the text and shape are in black.

MAY 2 5 2012

Exhibit 5 510(k) Summary

CHOYANG Thermal Massager (Model: CY-7000)

    1. Submitter and US Official Correspondent
Submitter:Choyang Medical Instrument Co., Ltd.
Address:66-3 Yogwang-ri, Chubu-myeon, Geumsan-gunChungcheongnam-do, 312-943, Korea
Tel: +82-41-754-8070~3Fax: +82-41-754-8075
Contact: Jung Hyun, Quality Assurance ManagerEmail: jh0158@nate.com
US Official Correspondent:Shin Kuk Yoo, Consultant
Telephone No.:714-313-7442
Fax No.:8 01-303-7455
Email:skyone@LSKBioPartners.com

2. Establishment Registration Number

The firm will be registered and listed prior to distribution of medical device in United States.

3. Device Information

Proprietary/Trade Name:CHOYANG Thermal Massager (Model: CY-7000)
Common/Usual Name:Multi-function physical therapy table, Therapeutic massager
Classification Name:Table, Physical therapy, Multi-function
Product Code:JFB
Subsequent Product Code:ISA
Device Class:Class II per regulation 21 CFR 890.5880, 21 CFR 890.5660

4. New or modification

:

This notification is for a new device for the USA market.

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5. Equivalent Legally Marketed Device

Predicate #1
Manufacturer:Migun Medical Instrument Co., Ltd.
Device Name:HY7000 Thermassage Energy Product
510(k) Number:K041200 (Decision Date - June 17, 2004)
Classification:Table, Physical Therapy, Multi FunctionJFB (Classification Product Code)Class II per regulation 21 CFR 890.5880

Predicate #2

Manufacturer:CERAGEM Co., Ltd.
Device Name:CERAGEM-RH1 Automatic Thermal Massager
510(k) Number:K062476 (Decision Date - Oct. 31, 2006)
Classification:Table, Physical Therapy, Multi Function
JFB (Classification Product Code)
Class II per regulation 21 CFR 890.5880

ଚ. Description of the Device

The CHOYANG Thermal Massager (Model: CY-7000) is an electrically powe red, motorized multi-functional physical therapy table. It is intended function and use is to provide patients with muscle relaxation therapy by delivering heat and soothing massage. The massage function is delivered by way of two independent carriages. Each carriage has five infrared lights. During use, these carriages traverse from lower torso to upper torso and apply light pressure as well as heat to the supine user.

7. Indications for use

The intended use of the CHOYANG Thermal Massager (Model: CY-7000) is to provide patients with muscle relaxation therapy by delivering heat and soothing massage.

8. Safety, EMC and Performance Data

The compliance of the CHOYANG Thermal Massager (Model: CY-7000) has been satisfied with the applicable requirements of the EN 60601-1-2. The tests have been performed by SGS Testing Korea.

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9. Safety and Effectiveness, comparison to Predicate

The results of bench and clinical evaluation indicate that the new device is as safe and effective as the predicate devices.

10. Substantial Equivalence Chart

.

NoItemCHOYANG ThermalMassagerHY7000 ThermassageEnergy ProductCeragem-RH1 AutomaticMassager
1510K NumberNoneK041200K062476
2ManufacturerChoyang MedicalInstrument Co., Ltd.Migun MedicalInstrument Co., Ltd.CERAGEM Co., Ltd.
3Regulation NumberCFR 890.5880,CFR 890.5880,CFR 890.5880,
4Product codeJFB, ISAJFB, ISA, ILYJFB, ISA, ILY
5ClassificationClass II(21CFR 890.5880)Class II(21CFR 890.5880)Class II(21CFR 890.5880)
6Rated input voltage120V a.c120V a.c120V a.c
7Supply Frequency50-60Hz50Hz60Hz
8Rated input power250W269W290W
9Degree of protectionType BF applied partType BF applied partType BF applied part
10Ambient temperature40~70℃40~70℃30~60℃
11Weight64Kg74Kg87Kg
12Safe working loadMax. 150KgMax. 150KgMax. 140Kg
13Massage rollerJadeGeranium CerramicJade
14Mode Set-UpAuto ModeSemi-Auto ModeAuto ModeSemi-Auto ModeAuto ModeSemi-Auto Mode
15Remote ButtonsRubber Pad TypeRubber Pad TypeRubber Pad Type
16Operating time36min34min40min
17Intended UseThe intended use of theCHOYANG ThermalMassager is to providepatients with muscleThe intended use of the device is to provide patientswith muscle relaxation therapy by delivering heat andsoothing massage. Additionally, the infrared lampsprovide topical heating for;
relaxationtherapy by- temporary relief of minor muscle and joint pain and
deliveringheat andstiffness
soothing massage.- the temporary relief of minor joint pain associated
with arthritis
- the temporary increase in local circulation where
applied
- relaxation of muscle

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11. Conclusion

In accordance with the Federal Food, Drug and Cosmetic Act, 21 CFR Part 807 and based on the information provided the above comparison table, the Choyang Medical Instrument Co., Ltd. concludes that the CHOYANG Thermal Massager (Model: CY-7000) is safe and effective and substantially equivalent to the predicate devices as described above.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features the department's name in a circular arrangement around a stylized symbol. The symbol consists of three abstract shapes that resemble human figures or elements of a design. The logo is presented in black and white.

Public Health Service

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

MAY 25 2012

Choyang Medical Instrument Co., Ltd. % LSK BioPartners, Inc. Mr. Shin Kuk Yoo 8 East Broadway, Suite 611 Salt Lake City, Utah 84111

Re: K11941

Trade/Device Name: Choyang Thermal Massager (Model: CY-7000) Regulation Number: 21 CFR 890.5880 Regulation Name: Multi-function physical therapy table Regulatory Class: Class II Product Code: JFB Dated: May 15, 2012 Received: May 17, 2012

Dear Mr. Shin Kuk Yoo:

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.

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

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Page 2 - Mr. Shin Kuk Yoo

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 (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours.

Euil Keith

Mark N. Melkerson Director Division of Surgical, Orthopedic and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Exhibit 4 Indications for Use

510(k) number (if known):
K111994

Device Name: CHOYANG Thermal Massager (Model: CY-7000)

Indications for Use:

The intended use of the CHOYANG Thermal Massager (Model: CY-7000) is to provide patients with muscle relaxation therapy by delivering heat and soothing massage.

Prescription Use

(Part 21 CFR 801 Subpart D)

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

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

AND/OR

Concurrence of CDRH, Office of Device Evaluation (ODE)

Vernon H. Clark

(Division Sign-Off) Division of Surgical, Orthopedic, and Restorative Devices

510(k) Number K111941

§ 890.5880 Multi-function physical therapy table.

(a)
Identification. A multi-function physical therapy table is a device intended for medical purposes that consists of a motorized table equipped to provide patients with heat, traction, and muscle relaxation therapy.(b)
Classification. Class II (performance standards).