K Number
K022226
Device Name
ALTUS MEDICAL FAMILY OF COOLGLIDE LASERS, MODELS COOLGLIDE I, COOLGLIDE II, AND FUTURE MODELS
Date Cleared
2002-10-08

(90 days)

Product Code
Regulation Number
878.4810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The family of Altus Medical CoolGlide Aesthetic Lasers are intended for use in the medical specialties of general and plastic surgery, dermatology, endoscopic/laproscopic general surgery, gastroenterology, gynecology, otorhinolaryngology (ENT), neurosurgery, oculoplastics, orthopedics, pulmonary/thoracic surgery and urology for surgical and aesthetic applications. 1064nm: Dermatology: The Altus Medical Aesthetic CoolGlide laser systems are intended for the coagulation and hemostasis of benign vascular lesions such as, but not limited to, port wine stains, hemangiomas, warts, telangiectasia, rosacea, venus lake, leg veins, spider veins and poikiloderma of civatte; and treatment of benign cutaneous lesions, such as warts, scars, striae, and psoriasis. The lasers are also intended for the treatment of benign pigmented lesions such as, but not limited to, lentigos (age spots), solar lentigos (sun spots), café au lait macules, seborrheic keratoses, nevi, chloasma, verrucae, skin tags, keratoses, tattoos (significant reduction in the intensity of black and/or blue/black tattoos) and plaques. Additionally, the lasers are indicated for pigmented lesions to reduce lesion size, for patients with lesions that would potentially benefit from aggressive treatment, and for patients with lesions that have not responded to other laser treatments. The CoolGlide lasers are also indicated for the treatment of wrinkles such as, but not limited to, periocular and perioral wrinkles. The CoolGlide lasers are also indicated for the removal of unwanted hair, for stable long term, or permanent, hair reduction through selective targeting of melanin in hair follicles, and for the treatment for pseudofolliculitis barbae (PFB). The lasers are also indicated for the reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral part of the scar. The CoolGlide lasers are indicated for use on all skin types (Fitzpatrick I-VI), including tanned skin. The intended use of the integral cooling system in the Altus CoolGlide laser handpiece is to provide cooling of the skin, for the reduction of pain during laser treatment, to allow for the use of higher fluences for laser treatments such as hair removal and vascular lesions, and to reduce the potential side effects of laser treatments. Surgical Applications: The lasers are indicated for the incision/excision and cutting, ablation, coagulation/hemostatis of soft tissue in the performance of surgical applications in endoscopy/laproscopy, gastroenterology, general surgery, head and neck/otorhinolaryngology (ENT), neurosurgery, oculoplastics, orthopedics, plastic surgery, pulmonary/thoracic surgery, gynecology (e.g. menorrhagia) and urology. Indications for use (532nm): For coagulation and hemostasis of vascular and cutaneous lesions in dermatology including, but not limited to, the following general categories: vascular lesions [angiomas, hemangiomas (port wine), telangiectasia (facial or extremities telangiectasias, venous anomalies, leg veins)}; benign pigmented lesions (nevi, lentigines, chloasma, café-au-lait, tattoos (red and green ink); verrucae; skin tags; keratoses: plaques: cutaneous lesion treatment (hemostasis, color lightening, blanching, flattening, reduction of lesion size).
Device Description
Family of Altus Medical CoolGlide Aesthetic Lasers are comprised of the following main components: - a laser system console (including software and control electronics); - a control and display panel; - a permanently attached fiberoptic-coupled handpiece; - a skin cooling device integrated into the handpiece; - a footswitch (or finger-operated exposure switch (handswitch) option integrated into the handpiece) - a remote interlock connector (disables laser when treatment room door is opened).
More Information

Not Found

No
The document describes a laser system with a control console, handpiece, and cooling system. There is no mention of AI or ML in the intended use, device description, or any of the provided sections. The device appears to be a traditional laser system for aesthetic and surgical applications.

Yes
The Altus Medical CoolGlide Aesthetic Lasers are intended for use in various medical specialties for surgical and aesthetic applications, treating a range of conditions such as vascular lesions, pigmented lesions, wrinkles, and hair removal. This falls under the definition of a therapeutic device as it is used to treat or manage diseases or health conditions.

No

The Altus Medical CoolGlide Aesthetic Lasers are described as being used for surgical and aesthetic applications, including coagulation, hemostasis, treatment of lesions, hair removal, and incision/excision. These are all therapeutic or aesthetic treatments, not diagnostic procedures.

No

The device description explicitly lists multiple hardware components including a laser system console, handpiece, cooling device, footswitch/handswitch, and remote interlock connector. While the console includes software, the device is fundamentally a hardware-based laser system.

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

Here's why:

  • Intended Use: The intended use clearly describes the device as a laser system for surgical and aesthetic applications on the human body. It focuses on treating various lesions, wrinkles, hair, and performing surgical procedures.
  • Device Description: The description details the physical components of a laser system designed for external or internal application to tissue.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens derived from the human body (like blood, urine, tissue samples) to provide information for diagnosis, monitoring, or screening.

IVD devices are used in vitro (outside the body) to analyze biological samples. This device is used in vivo (on or in the body) for treatment and surgical procedures.

N/A

Intended Use / Indications for Use

The family of Altus Medical CoolGlide Aesthetic Lasers are intended for use in the medical specialties of general and plastic surgery, dermatology, endoscopic/laproscopic general surgery, gastroenterology, gynecology, otorhinolaryngology (ENT), neurosurgery, oculoplastics, orthopedics, pulmonary/thoracic surgery and urology for surgical and aesthetic applications.

1064nm:
Dermatology:
The Altus Medical Aesthetic CoolGlide laser systems are intended for the coagulation and hemostasis of benign vascular lesions such as, but not limited to, port wine stains, hemangiomas, warts, telangiectasia, rosacea, venus lake, leg veins, spider veins and poikiloderma of civatte; and treatment of benign cutaneous lesions, such as warts, scars, striae, and psoriasis. The lasers are also intended for the treatment of benign pigmented lesions such as, but not limited to, lentigos (age spots), solar lentigos (sun spots), café au lait macules, seborrheic keratoses, nevi, chloasma, verrucae, skin tags, keratoses, tattoos (significant reduction in the intensity of black and/or blue/black tattoos) and plaques.

Additionally, the lasers are indicated for pigmented lesions to reduce lesion size, for patients with lesions that would potentially benefit from aggressive treatment, and for patients with lesions that have not responded to other laser treatments.

The CoolGlide lasers are also indicated for the treatment of wrinkles such as, but not limited to, periocular and perioral wrinkles.

The CoolGlide lasers are also indicated for the removal of unwanted hair, for stable long term, or permanent, hair reduction through selective targeting of melanin in hair follicles, and for the treatment for pseudofolliculitis barbae (PFB).

The lasers are also indicated for the reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral part of the scar.

The CoolGlide lasers are indicated for use on all skin types (Fitzpatrick I-VI), including tanned skin.

The intended use of the integral cooling system in the Altus CoolGlide laser handpiece is to provide cooling of the skin, for the reduction of pain during laser treatment, to allow for the use of higher fluences for laser treatments such as hair removal and vascular lesions, and to reduce the potential side effects of laser treatments.

Surgical Applications:
The lasers are indicated for the incision/excision and cutting, ablation, coagulation/hemostatis of soft tissue in the performance of surgical applications in endoscopy/laproscopy, gastroenterology, general surgery, head and neck/otorhinolaryngology (ENT), neurosurgery, oculoplastics, orthopedics, plastic surgery, pulmonary/thoracic surgery, gynecology (e.g. menorrhagia) and urology.

Indications for use (532nm):
For coagulation and hemostasis of vascular and cutaneous lesions in dermatology including, but not limited to, the following general categories: vascular lesions [angiomas, hemangiomas (port wine), telangiectasia (facial or extremities telangiectasias, venous anomalies, leg veins)}; benign pigmented lesions (nevi, lentigines, chloasma, café-au-lait, tattoos (red and green ink); verrucae; skin tags; keratoses: plaques: cutaneous lesion treatment (hemostasis, color lightening, blanching, flattening, reduction of lesion size).

Product codes (comma separated list FDA assigned to the subject device)

GEX

Device Description

Family of Altus Medical CoolGlide Aesthetic Lasers are comprised of the following main components:

  • a laser system console (including software and control electronics);
  • a control and display panel;
  • a permanently attached fiberoptic-coupled handpiece;
  • a skin cooling device integrated into the handpiece;
  • a footswitch (or finger-operated exposure switch (handswitch) option integrated into the handpiece)
  • a remote interlock connector (disables laser when treatment room door is opened).

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

medical specialties of general and plastic surgery, dermatology, endoscopic/laproscopic general surgery, gastroenterology, gynecology, otorhinolaryngology (ENT), neurosurgery, oculoplastics, orthopedics, pulmonary/thoracic surgery and urology

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): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K991798, K991234, K003202, K014040, K000811, K014130, K013461, K013043, K013748, K012806, K014035, K003715, K013825, K020021

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 878.4810 Laser surgical instrument for use in general and plastic surgery and in dermatology.

(a)
Identification. (1) A carbon dioxide laser for use in general surgery and in dermatology is a laser device intended to cut, destroy, or remove tissue by light energy emitted by carbon dioxide.(2) An argon laser for use in dermatology is a laser device intended to destroy or coagulate tissue by light energy emitted by argon.
(b)
Classification. (1) Class II.(2) Class I for special laser gas mixtures used as a lasing medium for this class of lasers. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 878.9.

0

OCT 0 8 2002

KO22226 Attachment 17 510(k) Summary for the Family of Altus Medical CoolGlide Aesthetic Lasers

【. General Information

| Submitter: | Altus Medical, Inc.
821 Cowan Road
Burlingame, CA 94010 |
|----------------------------------------|---------------------------------------------------------------|
| Contact Persons: | Kathy Maynor
Mike Levernier |
| Summary Preparation Date: July 5, 2002 | |

II. Names

Device Names:Family of Altus Medical CoolGlide Aesthetic Lasers
Primary Classification Name:Laser Powered Surgical Instrument (and Accessories

III. Predicate Devices

  • Family of CoolGlide Aesthetic Lasers, manufactured by Altus Medical (K991798, ● K991234, K003202 and K014040);
  • NLite Pulsed Dye Laser, manufactured by ICN (K000811, K014130, and K013461); .
  • . Vbeam and Clearbeam Pulsed Dye Lasers, manufactured by Candela (K013043 and K013748);
  • . PhotoGenica Pulsed Dye Laser, manufactured by Cynosure (K012806);
  • CoolTouch I and CoolTouch II Nd:YAG lasers, manufactured by ICN (K014035 and . K003715); and
  • . Smoothbeam Diode Laser, manufactured by Candela (K013825).
  • . Lyra Surgical Laser System, manufactured by Laserscope (K020021)

IV. Product Description

Family of Altus Medical CoolGlide Aesthetic Lasers are comprised of the following main components:

  • · a laser system console (including software and control electronics);
  • · a control and display panel;
  • · a permanently attached fiberoptic-coupled handpiece;
  • · a skin cooling device integrated into the handpiece;
  • · a footswitch (or finger-operated exposure switch (handswitch) option integrated into the handpiece)
  • · a remote interlock connector (disables laser when treatment room door is opened).

1

V. Indications for Use

The family of Altus Medical CoolGlide Aesthetic Lasers are intended for use in the medical specialties of general and plastic surgery, dermatology, endoscopic/laproscopic general surgery, gastroenterology, gynecology, otorhinolaryngology (ENT), neurosurgery, oculoplastics, orthopedics, pulmonary/thoracic surgery and urology for surgical and aesthetic applications.

1064nm:

Dermatology:

The Altus Medical Aesthetic CoolGlide laser systems are intended for the coagulation and hemostasis of benign vascular lesions such as, but not limited to, port wine stains, hemangiomas, warts, telangiectasia, rosacea, venus lake, leg veins, spider veins and poikiloderma of civatte; and treatment of benign cutaneous lesions, such as warts, scars, striae, and psoriasis. The lasers are also intended for the treatment of benign pigmented lesions such as, but not limited to, lentigos (age spots), solar lentigos (sun spots), café au lait macules, seborrheic keratoses, nevi, chloasma, verrucae, skin tags, keratoses, tattoos (significant reduction in the intensity of black and/or blue/black tattoos) and plaques.

Additionally, the lasers are indicated for pigmented lesions to reduce lesion size, for patients with lesions that would potentially benefit from aggressive treatment, and for patients with lesions that have not responded to other laser treatments.

The CoolGlide lasers are also indicated for the treatment of wrinkles such as, but not limited to, periocular and perioral wrinkles.

The CoolGlide lasers are also indicated for the removal of unwanted hair, for stable long term, or permanent, hair reduction through selective targeting of melanin in hair follicles, and for the treatment for pseudofolliculitis barbae (PFB).

The lasers are also indicated for the reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral part of the scar.

The CoolGlide lasers are indicated for use on all skin types (Fitzpatrick I-VI), including tanned skin.

The intended use of the integral cooling system in the Altus CoolGlide laser handpiece is to provide cooling of the skin, for the reduction of pain during laser treatment, to allow for the use of higher fluences for laser treatments such as hair removal and vascular lesions, and to reduce the potential side effects of laser treatments.

2

Surgical Applications:

The lasers are indicated for the incision/excision and cutting, ablation, coagulation/hemostatis of soft tissue in the performance of surgical applications in endoscopy/laproscopy, gastroenterology, general surgery, head and neck/otorhinolaryngology (ENT), neurosurgery, oculoplastics, orthopedics, plastic surgery, pulmonary/thoracic surgery, gynecology (e.g. menorrhagia) and urology.

Indications for use (532nm):

For coagulation and hemostasis of vascular and cutaneous lesions in dermatology including, but not limited to, the following general categories: vascular lesions [angiomas, hemangiomas (port wine), telangiectasia (facial or extremities telangiectasias, venous anomalies, leg veins)}; benign pigmented lesions (nevi, lentigines, chloasma, café-au-lait, tattoos (red and green ink); verrucae; skin tags; keratoses: plaques: cutaneous lesion treatment (hemostasis, color lightening, blanching, flattening, reduction of lesion size).

VI. Rationale for Substantial Equivalence

The family of Altus Medical CoolGlide Aesthetic Lasers share the same general indications for use, and therefore is substantially equivalent to the currently marketed Altus Medical family of CoolGlide Aesthetic Nd:YAG Lasers (K991798, K991234, K003202 and K014040), the NLite Pulsed Dye Laser, manufactured by ICN (K000811, K014130, and K013461), the Vbeam and Clearbeam Pulsed Dye Lasers, manufactured Candela (K013043 and K013748), the PhotoGenica Pulsed Dye Laser, manufactured by Cynosure (K012806), the CoolTouch I and CoolTouch II Nd: YAG lasers, manufactured by ICN (K014035 and K003715), the Smoothbeam Diode Laser, manufactured by Candela (K013825), and the Lyra Surgical Laser System, manufactured by Laserscope (K020021).

VII. Safety and Effectiveness Information

The new indications for use in dermatology, endoscopic/laproscopic general surgery, gastroenterology, general surgery, gynecology, otorhinolaryngology, neurosurgery, oculoplastics, orthopedics, plastic surgery, pulmonary.thoracic surgery, and urology are based upon the indications for use for predicate laser systems.

Technologically, the CoolGlide family of aesthetic lasers is identical to the previous predicate CoolGlide family (K014040). Therefore the risks and benefits for the CoolGlide laser family are comparable to the predicate devices.

We therefore believe that there are no questions of safety or effectiveness raised by the introduction of this device.

3

VIII. Conclusion

The family of Altus Medical CoolGlide Aesthetic Lasers were found to be substantially equivalent to the currently marketed Altus Medical family of CoolGlide Aesthetic Nd:YAG Lasers (K991798, K991234, K003202 and K014040), the NLite Pulsed Dye Laser, manufactured by ICN (K000811, K014130, and K013461), the Vbeam and Clearbeam Pulsed Dye Lasers, manufactured Candela (K013043 and K013748), the PhotoGenica Pulsed Dye Laser, manufactured by Cynosure (K012806), the CoolTouch I and CoolTouch II Nd:YAG lasers, manufactured by ICN (K014035 and K003715), the Smoothbeam Diode Laser, manufactured by Candela (K013825), and the Lyra Surgical Laser System, manufactured by Laserscope (K020021). The family of Altus Medical CoolGlide Aesthetic Lasers share similar indications for use, design features, and similar functional features as, and thus are substantially equivalent to, the currently marketed predicate devices.

4

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/4/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features a stylized eagle with three lines forming its body and wings, symbolizing health, services, and humanity. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

OCT 0 8 2002

Altus Medical, Inc. Michael Levernier Vice President, Clinical Development 821 Cowan Road Burlingame, California 94010

Re: K022226

Trade/Device Name: Family of Altus Medical CoolGlide Aesthetic Lasers Regulation Number: 878.4810 Regulation Name: Laser surgical instrument for use in general and plastic surgery and in dermatology Regulatory Class: Class II Product Code: GEX Dated: July 5, 2002 Received: July 10, 2002

Dear Mr. Levernier:

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 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.

5

Page 2 – Mr. Michael Levernier

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 vour device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 vours,

Styph Rurle

A 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

6

Attachment 2 Indications For Use Statement as Requested by FDA

510(k) Number (if Known): _

510(k) Number (if Known): ____________________________________________________________________________________________________________________________________________________

Device Name: Family of Altus Medical CoolGlide Aesthetic Lasers

Indications For Use:

The family of Altus Medical CoolGlide Aesthetic Lasers are intended for use in the medical specialties of general and plastic surgery, dermatology, endoscopic/laproscopic general surgery, gastroenterology, gynecology, otorhinolaryngology (ENT), neurosurgery, oculoplastics, orthopedics, pulmonary/thoracic surgery and urology for surgical and aesthetic applications.

1064nm:

Dermatology:

The Altus Medical Aesthetic CoolGlide laser systems are intended for the coagulation and hemostasis of benign vascular lesions such as, but not limited to, port wine stains, hemangiomas, warts, telangiectasia, rosacea, venus lake, leg veins, spider veins and poikiloderma of civatte; and treatment of benign cutaneous lesions, such as warts, scars, striae, and psoriasis. The lasers are also intended for the treatment of benign pigmented lesions such as, but not limited to, lentigos (age spots), solar lentigos (sun spots), café au lait macules, seborrheic keratoses, nevi, chloasma, verrucae, skin tags, keratoses, tattoos (significant reduction in the intensity of black and/or blue/black tattoos) and plaques.

Additionally, the lasers are indicated for pigmented lesions to reduce lesion size, for patients with lesions that would potentially benefit from aggressive treatment, and for patients with lesions that have not responded to other laser treatments.

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

Concurrence of CDRH, Office, of Device Evaluation (ODE)

(Division Sign-Off)
Division of General, Restorative and Neurological Devices
510(k) NumberK022226
------------------------
Prescription Use (Per 21 CFR 801.109)OROver-The-Counter Use
-----------------------------------------------------------------

(Optional Format 1-2-96)510(k) Submission: Family of Altus Medical Modified CoolGlide Aesthetic Lasers

7

The CoolGlide lasers are also indicated for the treatment of wrinkles such as, but not limited to, periocular and perioral wrinkles.

The CoolGlide lasers are also indicated for the removal of unwanted hair, for stable long term, or permanent, hair reduction through selective targeting of melanin in hair follicles, and for the treatment for pseudofolliculitis barbae (PFB).

The lasers are also indicated for the reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral part of the scar.

The CoolGlide lasers are indicated for use on all skin types (Fitzpatrick I-VI), including tanned skin.

The intended use of the integral cooling system in the Altus CoolGlide laser handpiece is to provide cooling of the skin, for the reduction of pain during laser treatment, to allow for the use of higher fluences for laser treatments such as hair removal and vascular lesions, and to reduce the potential side effects of laser treatments.

Surgical Applications:

lasers are indicated for the incision/excision and cutting, ablation, The coagulation/hemostatis of soft tissue in the performance of surgical applications in endoscopy/laproscopy, gastroenterology, general surgery, surgery, head and neck/otorhinolaryngology (ENT), neurosurgery, oculoplastics, orthopedics, plastic surgery, pulmonary/thoracic surgery, gynecology (e.g. menorrhagia) and urology.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Styt Rurda

(Division Sign-Off) Division of General, Restorative and Neurological Devices

510(k) Number_KO22226

Prescription Use
(Per 21 CFR 801.109)

OR

Over-The-Counter Use

(Optional Format 1-2-96)

8

532mm:

For coagulation and hemostasis of vascular and cutaneous lesions in dermatology including, but not limited to, the following general categories: vascular lesions [angiomas, hemangiomas (port wine), telangiectasia (facial or extremities telangiectasias, venous anomalies, leg veins)]; benign pigmented lesions (nevi, lentigines, chloasma, café-au-lait, tattoos (red and green ink); verrucae; skin tags; keratoses; plaques; cutaneous lesion treatment (hemostasis, color lightening, blanching, flattening, reduction of lesion size).

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Stypt. Diode

(Division Sign-Off) Division of General, Restorative and Neurological Devices

510(k) Number_KOZ222226

OR

Prescription Use
(Per 21 CFR 801.109)

Over-The-Counter Use -------

(Optional Format 1-2-96)