K Number
K030181
Date Cleared
2003-04-17

(90 days)

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

The International Biophysics Corporation Laser Peel system is intended for coagulation, vaporization, ablation, or cutting of soft tissue (skin) in dermatology, plastic surgery (including aesthetic surgery), oral surgery, and ophthalmology.

Device Description

The International Biophysics Corporation Laser Peel System is an Er:YAG laser producing emission at a wavelength of 2940 nm. The laser consist of two interconnected sections: The cabinet which houses the power supply, the cooling system and the electronics, and; the umbilical cables and the hand piece, which houses the laser.

AI/ML Overview

The provided text is a 510(K) Summary for the International Biophysics Corporation Laser Peel System. This document is a premarket notification to the FDA, demonstrating substantial equivalence to previously marketed devices. It is not a study that proves device performance against acceptance criteria in the manner typically understood for clinical trials or AI/software evaluations.

Therefore, many of the requested categories are not applicable to this type of regulatory submission. The document explicitly states "None Required" for both nonclinical and clinical performance data.

Here's a breakdown based on the provided text, highlighting what is (and isn't) present:

1. Table of acceptance criteria and the reported device performance

Acceptance CriteriaReported Device Performance
Not applicable. This document is a 510(k) summary demonstrating substantial equivalence for a medical device (laser system), not a study against specific performance acceptance criteria.Not applicable. The document states "None Required" for both nonclinical and clinical performance data, as its purpose is to show substantial equivalence to predicate devices, not novel performance metrics.

2. Sample size used for the test set and the data provenance

Not applicable. No test set or related data provenance is mentioned as this is a 510(k) summary for a physical medical device, not a data-driven AI/software product requiring a test set.

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

Not applicable. No test set or ground truth establishment by experts is mentioned.

4. Adjudication method for the test set

Not applicable. No test set or adjudication method is mentioned.

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. No MRMC study was done. This device is a laser system, not an AI or imaging diagnostic tool that would involve human readers or AI assistance.

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

Not applicable. This device is a laser system, not an algorithm.

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

Not applicable. Ground truth is not relevant for this type of regulatory submission. The submission relies on demonstrating substantial equivalence to predicate devices, not on validating performance against a ground truth.

8. The sample size for the training set

Not applicable. This device is a physical laser system, not a machine learning model, so there is no training set.

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

Not applicable. As there is no training set, there is no ground truth for a training set to be established.

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K 030181

Attachment I

510(K) Summary International Biophysics Corporation Laser Peel System

APR 1 7 2003

This 510(K) Summary of safety and effectiveness for the IBC Laser Peel System is submitted in accordance with the requirements of SMDA 1990 and following guidance concerning the organization and content of a 510(K) summary.

Applicant:International Biophysics Corporation
Address:4020 S. Industrial Drive, Suite 160Austin, Texas 78744
Contact Person:Len Hickey, Manager of Regulatory Affairs
Telephone:Telefax:(512) 326-3244(512) 326-3299
Preparation Date:01/07/03
Device Trade Name:International Biophysics Corporation (IBC) Laser Peel
Common Name:Erbium:YAG laser devise
Classification Name:Instrument, Powered, Laser79-GEX21 CFR 878-48
Legally Marketed PredicateDeviceSchwartz Electro-Optics TriLase 2940, K#954013Cell Robotics Er:YAG Laser System, K#970461Asceplion-Meditec Dermastar Er: Y AG Laser System, K#014057
Description of the DeviceThe International Biophysics Corporation Laser PeelSystem is an Er:YAG laser producing emission at a wavelengthof 2940 nm. The laser consist of two interconnected sections:The cabinet which houses the power supply, the cooling systemand the electronics, and; the umbilical cables and the hand piece,which houses the laser.
Intended Use of the DeviceThe International Biophysics Corporation Laser PeelSystem is intended for coagulation, vaporization, ablation, orcutting of soft tissue(skin) in dermatology, plastic surgery(including aesthetic surgery), oral surgery, and opthamology.

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Nonclinical PerformanceData:None Required
Clinical Performance dataNone Required
Conclusion:The International Biophysics Corporation Laser PeelSystem is substantially equivalent to other existing legallymarketed laser systems currently in commercialdistribution.
Additional Information:None requested at this time

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Image /page/2/Picture/1 description: The image is a black and white logo for the Department of Health & Human Services - USA. The logo features a stylized eagle with three horizontal lines representing its wings. The eagle is facing to the right. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle.

APR 1 7 2003

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Len Hickey Manager of Regulatory Affairs International Biophysics Corporation 4020 S. Industrial Drive, Suite 160 Austin, Texas 78744

Re: K030181 Trade/Device Name: International Biophysics Corporation (IBC) Laser Peel Regulation Number: 21 CFR 878.4810 Regulation Name: Laser surgical instrument for use in general and plastic surgery and in dermatology Regulatory Class: II Product Code: GEX Dated: January 7, 2003 Received: January 17, 2003

Dear Mr. Hickey:

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.

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Page 2 - Mr. Len Hickey

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. 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) you may obtain. 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.

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

510(K) Number: K030181

Device Name: International Biophysics Corporation Laser Peel System

Indications for Use:

The International Biophysics Corporation Laser Peel system is intended for coagulation, vaporization, ablation, or cutting of soft tissue (skin) in dermatology, plastic surgery (including aesthetic surgery), oral surgery, and ophthalmology.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Mark A. Millman

ision Sign-Off) sion of General, Restorative urological Devices

510
j(k) Number K030181

Prescription Use OR
(per 21 CFR 801.109)

Over-the-Counter Use ------------

§ 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.