K Number
K020750
Device Name
DIGITAL ELECTRICAL MUSCLE STIMULATOR, MODEL EV-807 DIGITAL EMS
Date Cleared
2002-10-31

(238 days)

Product Code
Regulation Number
890.5850
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
EV-807 Digital EMS is an electrically powered muscle stimulator intended for use for medical purposes to repeatedly contract muscles by passing electrical currents through electrodes contacting the affected body area. In particular, this device is indicated for use for: - Relaxing muscle spasms. a - Increasing local blood circulation. - - Immediate post-surgical stimulation of calf muscles to prevent venous thrombosis. - Muscle re-education. । - Maintaining or increasing range of motion. - - Preventing or retarding disuse atrophy
Device Description
EV-807 Digital EMS is a battery operated pulse generator that sends electrical impulses through electrodes to the body and reaches the underlying or muscle group. The device is provided with two controllable output channels, each independent of each other. An electrode pair can be connected to each output channel. The electronics of the EVERYWAY EV-807 DIGITAL EMS create electrical impulses whose intensity, pulse width, pulse rate, contraction, relaxation and ramp may be altered with the switches. Press buttons are very easy to use and the slide cover prevents accidental changes in the setting.
More Information

No
The description focuses on electrical impulse generation and control via manual settings (switches and buttons), with no mention of adaptive algorithms, learning, or data processing that would indicate AI/ML.

Yes
The device is intended for medical purposes such as relaxing muscle spasms, increasing local blood circulation, preventing venous thrombosis, muscle re-education, maintaining or increasing range of motion, and preventing or retarding disuse atrophy. These are all therapeutic applications.

No

This device is described as an electrically powered muscle stimulator for therapeutic purposes (e.g., relaxing muscle spasms, increasing local blood circulation, muscle re-education). It sends electrical impulses to the body to contract muscles. It does not perform any diagnostic function such as identifying, diagnosing, or monitoring a disease or condition.

No

The device description explicitly states it is a "battery operated pulse generator" and mentions "electronics," "output channels," and "electrodes," indicating it is a hardware device that delivers electrical impulses.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections.
  • Device Function: The EV-807 Digital EMS is an electrical muscle stimulator that applies electrical currents to the body through electrodes. It directly interacts with the body's muscles and nervous system for therapeutic purposes.
  • Intended Use: The intended uses listed (relaxing muscle spasms, increasing blood circulation, preventing venous thrombosis, muscle re-education, maintaining range of motion, preventing disuse atrophy) are all related to physical therapy and rehabilitation, not diagnostic testing of biological samples.

Therefore, the EV-807 Digital EMS falls under the category of a therapeutic medical device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

EV-807 Digital EMS is an electrically powered muscle stimulator intended for use for medical purposes to repeatedly contract muscles by passing electrical currents through electrodes contacting the affected body area. In particular, this device is intended for use for:

  • Relaxing muscle spasms. -
  • Increasing local blood circulation. -
  • Immediate post-surgical stimulation of calf muscles to prevent venous ﮯ thrombosis.
  • -Muscle re-education.
  • Maintaining or increasing range of motion. a
  • Preventing or retarding disuse atrophy

Product codes

IPF

Device Description

EV-807 Digital EMS is a battery operated pulse generator that sends electrical impulses through electrodes to the body and reaches the underlying or muscle group. The device is provided with two controllable output channels, each independent of each other. An electrode pair can be connected to each output channel.

The electronics of the EVERYWAY EV-807 DIGITAL EMS create electrical impulses whose intensity, pulse width, pulse rate, contraction, relaxation and ramp may be altered with the switches. Press buttons are very easy to use and the slide cover prevents accidental changes in the setting.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Not Found

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K010665

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 890.5850 Powered muscle stimulator.

(a)
Identification. A powered muscle stimulator is an electrically powered device intended for medical purposes that repeatedly contracts muscles by passing electrical currents through electrodes contacting the affected body area.(b)
Classification. Class II (performance standards).

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510(k) Summary

As Required by 21 section 807.92 ( c )
1-Submitter Name: Everyway Medical Instruments Co., Ltd
2-Address:3FL., No. 5, Lane 155, Sec. 3, PeiShen Rd., Shen Ken
Hsiang
Taipei Hsien
Taiwan, R.O.C.
3-Phone:886-2-2662-0038OCT 31 2002
4-Fax:886-2664-5566
5-Contact Person: Mr Robert Tu (General Manager)
6-Date summary prepared: February 27th, 2002
7- Official Correspondent: Mansour Consulting
8- Address:1308 Morningside Park Dr
Alpharetta, GA 30022 USA
9- Phone:(678) 908-8180
10- Fax:(425) 795-9341
11- Contact person: Jay Mansour, president
12-Device Trade or Proprietary Name: EV-807 Digital EMS
13-Device Common or usual name: Powered Muscle Stimulator
14-Device Classification Name: Stimulator, Muscle, Powered
15-Substantial Equivalency is claimed against the following device:
TransAmerica Medical Systems, 510k #K010665 (refer to Appendix
for FDA website printout)

This notification for EV-807 is of the ABBREVIATED type as per the declaration of conformity included in this summary

16-Description of the Device: EV-807 Digital EMS is a battery operated pulse generator that sends electrical impulses through electrodes to the body and reaches the underlying or muscle group. The device is provided with two controllable output channels, each independent of each other. An electrode pair can be connected to each output channel.

The electronics of the EVERYWAY EV-807 DIGITAL EMS create electrical impulses whose intensity, pulse width, pulse rate, contraction, relaxation and ramp may be altered with the switches. Press buttons are very easy to use and the slide cover prevents accidental changes in the setting.

17-Intended use of the device: (Indications for use typed on a separate FDA form) EV-807 Digital EMS is an electrically powered muscle stimulator intended for use for medical purposes to repeatedly contract muscles by passing electrical currents through electrodes contacting the affected body area. In particular, this device is intended for use for:

  • Relaxing muscle spasms. -
  • Increasing local blood circulation. -
  • Immediate post-surgical stimulation of calf muscles to prevent venous ﮯ thrombosis.
  • -Muscle re-education.
  • Maintaining or increasing range of motion. a
  • Preventing or retarding disuse atrophy

18-Safety and effectiveness of the device:

This device is safe and effective as the predicate device Transamerica Digital EMS. Indeed, it is identical. The same device which was cleared by 510k #K010665 for the distributor TransAmerica Medical Systems is submitted here

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for the original manufacturer in Taiwan EVERYWAY MEDICAL INSTRUMENTS CO., LTD. Refer to the tabulated comparison (Paragraph 19 below)

19-Summary comparing technological characteristics with other predicate device:

FDA file reference number510k #K010665
Attachments inside notification submission file510k summary print out
TECHNOLOGICAL CHARACTERISTICSComparison result
Indications for useIdentical
Target populationIdentical
DesignIdentical
MaterialsIdentical
PerformanceIdentical
SterilityIdentical
BiocompatibilityIdentical
Mechanical safetyIdentical
Chemical safetyIdentical
Anatomical sitesIdentical
Human factorsIdentical
Energy used and/or deliveredIdentical
Compatibility with environment and other devicesIdentical
Where usedIdentical
Standards metIdentical
Electrical safetyIdentical
Thermal safetyIdentical
Radiation safetyIdentical

2

This is to declare and confirm that Everyway Medical Instruments Co., Ltd. conforms in its manufacturing of Electrical Muscle Stimulator EV-807 Digital EMS to the following recognized standards: Standards met and standards tested against

Inapplicable requirements or deviationsN/A.
Identification of any way(s) in which the standard was adapted for the application of the device, i.e., identification of an alternative series of tests that were performed
Specification of any deviations from each applicable standard
Specification of the differences that may exist between the tested device and the device to be marketed and justification of the test results
Name and address of any test laboratory or certification body involved in determining the conformance of the device with the standard and reference to any accreditations of those organizationsFor QSR: Not applicable
For ISO 9002: 1994, EN 46002, ISO 13488 and CE Mark:
TUV Rheinland Product Safety GmbH-
Am Grauen Stein -D-51105 Koln.
TUV Rheinland Product Safety GmbH-
Am Grauen Stein -D-51105 Koln.
Supervision of product and design: QSR (FDA's Quality System Requirements) DIN EN ISO 9002/08.1994 DIN EN 46002/09.1996 EE Directive 93/42 (CE Mark) ISO 13488/12.1996
Technical standards: EN 60601-1:1990+A1:1993+A2:1995 EN60601-1-2:1993
Name, Signature and positionRobert Tu/ General Manager
Date02/27/2002

.0.9 וועוויוויי וויפולי וויפול וויינטורי איני איני איני איני איני איני איני איני אינער איז דער יידע.
דער

QTJ, OO STUBMUATSHI JASIDEM YAWYAAVA

THE ARRENCE OF CORRESSIONAL

    1. 3

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DEFARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized depiction of an eagle or bird with three curved lines representing its wings or feathers. The bird is positioned above the text "DEPARTMENT OF HEALTH" which is part of a circular border around the logo.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

OCT 31 2002

• Mr. Jay Mansour Representing Everyway Medical Instruments Co., Ltd. Mansour Consulting, L.L.C. 1308 Morningside Park Drive Alpharetta, Georgia 30022

Re: K020750

Trade/Device Name: EV-807 Digital Electrical Muscle Stimulator Regulation Number: 21 CFR 890.5850 Regulation Name: Powered Muscle Stimulator Regulatory Class: Class II Product Code: IPF Dated: July 26, 2002 Received: August 1, 2002

Dear Mr. Mansour:

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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such 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 requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice

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Page 2 - Mr. Jay Mansour

requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4659. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers. International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours.

Mark N Millican

Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative, and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Page

NUMBER 510 (k) KNOWN) ( IC

DEVICE NAME: Digital Electrical Muscle Stimulator (EV-807 Digital EMS)

INDICATIONS FOR USE:

EV-807 Digital EMS is an electrically powered muscle stimulator intended for use for medical purposes to repeatedly contract muscles by passing electrical currents through electrodes contacting the affected body area. In particular, this device is indicated for use for:

  • Relaxing muscle spasms. a
  • Increasing local blood circulation. -
  • Immediate post-surgical stimulation of calf muscles to prevent venous thrombosis.
  • Muscle re-education. ।
  • Maintaining or increasing range of motion. -
  • Preventing or retarding disuse atrophy

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

OR

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Prescription Use (Per 21 CFR 801.109)

(Division Sign-Off)

Di icin 7 astorative , and Neurological Devices

510(k) Number K020736

Over-The-Counter-Use (Optional Format 1-2-90