K Number
K023967
Date Cleared
2003-01-27

(59 days)

Product Code
Regulation Number
878.4810
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Palomar Q-YAGTM Nd:YAG laser system is indicated at the 1064 nm wavelength for skin resurfacing with or without adjuvant preparation.

Device Description

The complete system consists of a power supply unit, a cooling unit, a foot switch, and the hand piece that connects the laser unit and cooling unit using an umbilical cord. In standard use, the hand piece is held against the treatment area and the light pulse is delivered when the foot switch and hand switch is depressed. Laser parameters and other system features are controlled from a display panel located on the front of the power supply unit.

AI/ML Overview

This document is a 510(k) summary for the Palomar Q-YAG™ Nd:YAG Laser System. It focuses on establishing substantial equivalence to a predicate device rather than presenting a study demonstrating the device meets specific performance acceptance criteria for a diagnostic AI/ML device.

Therefore, the requested information regarding acceptance criteria, performance data, sample sizes, expert qualifications, adjudication methods, MRMC studies, standalone performance, and ground truth establishment is not available in the provided text.

The document states:

  • Intended Use: The Palomar Q-YAG™ is indicated for laser skin resurfacing with or without adjuvant preparation.
  • Performance Data: "The differences in the specifications of the laser and the predicate device do not result in different performance or raise new questions of safety or efficacy." This indicates that direct performance data against specific acceptance criteria for a diagnostic task was not a requirement or was not included in this submission summary. The basis for clearance is substantial equivalence.
  • Conclusion: "Based on the foregoing, the Palomar Q-YAGTM Nd:YAG Laser System is substantially equivalent to the legally-marketed claimed predicate device, i.e., the Thermolase SoftLight."

This type of submission focuses on demonstrating that the new device is as safe and effective as a legally marketed predicate device, especially by showing that differences in specifications do not lead to different performance or new safety/efficacy concerns. It does not typically involve detailed studies with acceptance criteria, ground truth, and statistical analyses of diagnostic performance as would be expected for an AI/ML-driven diagnostic device.

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JAN 2 7 2003

Attachment 4

510(K) Summary of Safety and Effectiveness

This 510(K) Summary of Safety and Effectiveness for the Q-YAGTM Nd:YAG Laser System is submitted in accordance with the requirements of Safe Medical Device Act (SMDA) of 1990 and follows the Office of Device Evaluation (ODE) guidance concerning the organization and content of a 510(K) summary.

Applicant:Palomar Medical Technologies, Inc.
Address:82 Cambridge St.Burlington, MA 01803
Contact Person:Marcy Moore
Telephone:919-363-2432
Preparation Date:11/25/02
Device Trade Name:Palomar Q-YAGTM Nd:YAG Laser System
Common Name:Q:Switched Nd:YAG
Classification Name:Laser surgical instrument for use in General andPlastic Surgery and in Dermatology(see: 21 CFR 878-4810).Product Code: GEXPanel: 79
Legally-Marketed Predicate Device:ThermoLase SoftLightK971207
System Description:The complete system consists of a power supplyunit, a cooling unit, a foot switch, and the handpiece that connects the laser unit and cooling unitusing an umbilical cord. In standard use, the handpiece is held against the treatment area and the lightpulse is delivered when the foot switch and handswitch is depressed. Laser parameters and othersystem features are controlled from a display panel

located on the front of the power supply unit.

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023967 2/2

Intended Use of the Device:

The Palomar Q-YAG™ is indicated for laser skin resurfacing with or without adjuvant preparation.

The differences in the specifications of the

laser and the predicate device do not result in

Performance Data:

Conclusion:

different performance or raise new questions of safety or efficacy. Based on the foregoing, the Palomar Q-YAGTM

Nd:YAG Laser System is substantially equivalent to the legally-marketed claimed predicate device, i.e., the Thermolase SoftLight.

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Image /page/2/Picture/2 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 symbol. The symbol consists of three stylized human profiles facing to the right, stacked on top of each other. The profiles are rendered in black, contrasting with the white background.

JAN 2 7 2003

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Palomar Medical Technologies, Inc. Marcy Moore Manager of Clinical Studies 131 Kelekent Lane Cary, North Carolina 27511

Re: K023967

Trade/Device Name: Palomar Q-YAGTM Nd:YAG Laser System 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: November 27, 2002 Received: November 29, 2002

Dear Ms. Moore:

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

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Page 2 -- Ms. Marcy Moore

(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. 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), please contact the Office of Compliance at (301) 594-4659. 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.

Miriam C. Provost

for 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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INDICATION FOR USE STATEMENT

KO23967 510(K) Number:

Device Name: Palomar Q-Y AGTM Nd: Y AG Laser System

Indications for Use:

The Palomar Q-YAGTM Nd:YAG laser system is indicated at the 1064 nm wavelength for skin resurfacing with or without adjuvant preparation.

(Please do not write below this line - Continue on another page if needed)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use V

OR Over-the-Counter Use --(per 21 CFR 801.109)

Miriam C. Provost

Ivision Sign-Off) Division of General, Restorative and Neurological Vevices

Number K023967

§ 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.