Li-Battery powered OTC TENS/EMS Combination Stimulator
K201335 · Everyway Medical Instruments Co.,Ltd · NUH · Oct 24, 2020 · Neurology
Device Facts
| Record ID | K201335 |
| Device Name | Li-Battery powered OTC TENS/EMS Combination Stimulator |
| Applicant | Everyway Medical Instruments Co.,Ltd |
| Product Code | NUH · Neurology |
| Decision Date | Oct 24, 2020 |
| Decision | SESE |
| Submission Type | Traditional |
| Regulation | 21 CFR 882.5890 |
| Device Class | Class 2 |
| Attributes | Therapeutic |
Intended Use
TENS: intended for temporary relief of pain associated with sore and aching muscles in the low back as well as upper and lower extremities (arm and/or leg) due to strain from exercise or normal household and work activities. (Choose TENS Modes B/N/M/SD1/SD2 as adjustable mode and P1 to P12 preset programs only for EV-906A). EMS: intended to stimulate healthy muscles in order to improve or facilitate muscle performance. (Choose EMS Modes C/S/A as adjustable mode and P13 to P24 preset programs only for EV-906A).
Device Story
Li-Battery powered OTC TENS/EMS Combination Stimulator (models EV-906/EV-906A) delivers electrical pulses to muscles/nerves via skin electrodes. Device operates as TENS for pain relief or EMS for muscle performance. User selects adjustable modes (B/N/M/SD1/SD2 for TENS; C/S/A for EMS) or preset programs (P1-P12 for TENS; P13-P24 for EMS on EV-906A). Intended for OTC use; patient self-operates device to manage pain or improve muscle function. Output intensity and parameters are controlled by user to achieve desired therapeutic effect.
Clinical Evidence
No clinical data provided; bench testing only.
Technological Characteristics
Li-battery powered; TENS/EMS combination stimulator; adjustable modes and preset programs; electrical stimulation via skin electrodes; Class II device.
Indications for Use
Indicated for temporary relief of pain in low back and extremities due to strain from exercise or daily activities (TENS) and for stimulation of healthy muscles to improve or facilitate muscle performance (EMS).
Regulatory Classification
Identification
A transcutaneous electrical nerve stimulator for pain relief is a device used to apply an electrical current to electrodes on a patient's skin to treat pain.
Related Devices
- K202317 — Li-Battery powered OTC TENS/EMS, model EV-804, model EV-805, & model EV-806 · Everyway Medical Instruments Co.,Ltd · Nov 13, 2020
- K192589 — Everyway OTC TENS/EMS Combination · Everyway Medical Instruments Co.,Ltd · Dec 19, 2019
- K202470 — Li-Battery powered OTC TENS/EMS, model EM-6000, EM-6100, EM-6200 & EM-6300 · Everyway Medical Instruments Co.,Ltd · Nov 25, 2020
- K172809 — OTC Combo TENS/EMS System · Well-Life Healthcare Limited · Oct 18, 2017
- K212184 — TENS and EMS Stimulation (OTC) · Changsha Yuwen Medical Equipment Co., Ltd. · Apr 1, 2022
Submission Summary (Full Text)
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October 24, 2020
Everyway Medical Instruments Co., Ltd Paul Hung Official Correspondent 3FL., No.5, Lane 155, Section 3, Peishen Rd. Shenkeng District, New Taipei City, Taiwan 22203
Re: K201335
Trade/Device Name: Li-Battery powered OTC TENS/EMS Combination Stimulator, models EV-906/EV-906A Regulation Number: 21 CFR 882.5890 Regulation Name: Transcutaneous electrical nerve stimulator for pain relief Regulatory Class: Class II Product Code: NUH, NGX Dated: May 19, 2020 Received: May 20, 2020
Dear Paul Hung:
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 Actinclude 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 comply with all the Act's
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requirements, including, but not limited to: registration and listing (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-devices/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 (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 (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
Heather Dean, PhD Acting Assistant Director DHT5B: Division of Neuromodulation and Physical Medicine Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health
Enclosure
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# Indications for Use
510(k) Number (if known) K201335
#### Device Name
Li-Battery powered OTC TENS/EMS Combination Stimulator, models EV-906/EV-906A.
#### Indications for Use (Describe)
TENS: intended for temporary relief of pain associated with sore and aching muscles in the low back as well as upper and lower extremities (arm and/or leg) due to strain from exercise or normal household and work activities. (Choose TENS Modes B/N/M/SD1/SD2 as adjustable mode and P1 to P12 preset programs only for EV-906A).
EMS: intended to stimulate healthy muscles in order to improve or facilitate muscle performance. (Choose EMS Modes C/S/A as adjustable mode and P13 to P24 preset programs only for EV-906A).
Type of Use (Select one or both, as applicable)
| <span></span> Prescription Use (Part 21 CFR 801 Subpart D) | <span></span> Over-The-Counter Use (21 CFR 801 Subpart C) |
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