K Number
K050036
Device Name
FES CYCLE ERGOMETER, MODEL RT300-S
Date Cleared
2005-06-27

(171 days)

Product Code
Regulation Number
882.5810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The RT300-S (adult version) and RT300-SP (pediatric version) are intended for general rehabilitation for: - a. Relaxation of muscle spasms - b. Prevention or retardation of disuse atrophy - c. Increasing local blood circulation - d. Maintaining or increasing range of motion The RT300-SP (pediatric version), is intended for population ages 4 to 12 years.
Device Description
The RT300-S is a Functional Electrical Stimulation (FES) cycle ergometer which is composed of: - a motorized cycle ergometer (RTI part number SA100047 for adults and SA100044 for children) - an FES controller / stimulator (RTI part number SA100090) - a stimulation cable which connects the controller / stimulator to cutaneous electrodes (RTI part number SA100091) - cutaneous electrodes (12 electrodes for 6 stimulation channels, RTI part number FA100015) This system allows a person with impaired lower extremity movement to undertake cycle ergometry both actively (utilizing FES evoked lower extremity muscle contractions) and passively (utilizing power developed by the ergometer's motor).
More Information

Not Found

No
The summary describes a functional electrical stimulation (FES) cycle ergometer and its components. There is no mention of AI, ML, or any related concepts in the intended use, device description, or performance studies. The testing focuses on system operation and equivalence to a predicate device, not on the performance of an AI/ML algorithm.

Yes
The device is described as a Functional Electrical Stimulation (FES) cycle ergometer intended for general rehabilitation, with specific indications for conditions like muscle spasms, disuse atrophy, increased local blood circulation, and maintaining/increasing range of motion, all of which align with therapeutic purposes. Additionally, it lists a predicate device that is explicitly called "THERAPEUTIC ALLIANCES, INC."

No

The device description and intended use indicate that the RT300-S is a Functional Electrical Stimulation (FES) cycle ergometer used for rehabilitation purposes, such as muscle relaxation, preventing disuse atrophy, increasing circulation, and maintaining range of motion. It does not mention any diagnostic capabilities or functions.

No

The device description explicitly lists multiple hardware components including a motorized cycle ergometer, an FES controller/stimulator, a stimulation cable, and cutaneous electrodes. This indicates it is a hardware-based medical device with software control, not a software-only device.

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 RT300-S and RT300-SP are functional electrical stimulation (FES) cycle ergometers. They apply electrical stimulation to muscles to facilitate movement and rehabilitation.
  • Intended Use: The intended uses listed (relaxation of muscle spasms, prevention of disuse atrophy, increasing local blood circulation, maintaining or increasing range of motion) are all related to physical rehabilitation and therapeutic intervention, not diagnostic testing of biological samples.
  • Device Description: The components described (cycle ergometer, FES controller, stimulation cable, electrodes) are consistent with a physical therapy or rehabilitation device, not an IVD.
  • Lack of Biological Sample Analysis: There is no mention of collecting or analyzing biological samples from the patient.

Therefore, the RT300-S and RT300-SP fall under the category of therapeutic or rehabilitation devices, not in vitro diagnostics.

N/A

Intended Use / Indications for Use

The RT300-S (adult version) and RT300-SP (pediatric version) are intended for general rehabilitation for:

    1. Relaxation of muscle spasms
    1. Prevention or retardation of disuse atrophy
    1. Increasing local blood circulation
    1. Maintaining or increasing range of motion

Product codes

GZI

Device Description

The RT300-S is a Functional Electrical Stimulation (FES) cycle ergometer which is composed of:

  • a motorized cycle ergometer (RTI part number SA100047 for adults and ← SA100044 for children)
  • an FES controller / stimulator (RTI part number SA100090) ଧ
  • a stimulation cable which connects the controller / stimulator to cutaneous ತಿ electrodes (RTI part number SA100091)
  • cutaneous electrodes (12 electrodes for 6 stimulation channels, RTI part ਬ number FA100015)
    This system allows a person with impaired lower extremity movement to undertake cvcle ergometry both actively (utilizing FES evoked lower extremity muscle contractions) and passively (utilizing power developed by the ergometer's motor).

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

The RT300-SP (pediatric version), is intended for population ages 4 to 12 years.

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)

Non clinical testing to determine equivalence has been primarily composed of the following tests:

  • Review of user documentation for predicate device
  • Review of 510(k) submission for predicate device
  • Output characteristic measurement of new device
  • Conduct of system testing

Clinical Test:

  • Testing with able bodied subjects: The RT300-S was tested on able bodied subjects to confirm correct operation of the system including correct detection of electrode off conditions with varying skin impedances.
  • Testing with spinal cord injured subjects: The RT300-S is being utilized in clinical studies involving spinal cord injured subjects.

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

Not Found

Predicate Device(s)

K841112

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 882.5810 External functional neuromuscular stimulator.

(a)
Identification. An external functional neuromuscular stimulator is an electrical stimulator that uses external electrodes for stimulating muscles in the leg and ankle of partially paralyzed patients (e.g., after stroke) to provide flexion of the foot and thus improve the patient's gait.(b)
Classification. Class II (performance standards).

0

K050036

JUN 27 2005

RT300-S Summary of Safety and Effectiveness

(1) Submitter's name, address, telephone number, a contact person, and the date the summary was prepared:

Andrew Barriskill Restorative Therapies Inc 2363 Boston St Baltimore, MD 21224

Phone: 310 691-5467

Prepared on June 24th 2005.

(2) Name of the device, including the trade or proprietary name if applicable, the common or usual name, and the classification name:

Proprietary name: RT300-S, RT300-SP (FES cycle ergometer) Powered Muscle Stimulator Common name: Classification name:Powered Muscle Stimulator

(3) Identification of the legally marketed device to which the submitter claims equivalence:

THERAPEUTIC ALLIANCES, INC. product: "ERGYS", K841112, a class 2 device

(4) A description of the device that is the subject of the premarket notification submission.

The RT300-S is a Functional Electrical Stimulation (FES) cycle ergometer which is composed of:

  • a motorized cycle ergometer (RTI part number SA100047 for adults and ← SA100044 for children)
  • an FES controller / stimulator (RTI part number SA100090) ଧ
  • a stimulation cable which connects the controller / stimulator to cutaneous ತಿ electrodes (RTI part number SA100091)
  • cutaneous electrodes (12 electrodes for 6 stimulation channels, RTI part ব number FA100015)

This system allows a person with impaired lower extremity movement to undertake cvcle ergometry both actively (utilizing FES evoked lower extremity muscle contractions) and passively (utilizing power developed by the ergometer's motor).

(5) Statement of the intended use of the device:

1

The RT300-S (adult version) and RT300-SP (pediatric version) are intended for general rehabilitation for:

    1. Relaxation of muscle spasms
    1. Prevention or retardation of disuse atrophy
    1. Increasing local blood circulation
    1. Maintaining or increasing range of motion

The RT300-SP (pediatric version), is intended for population ages 4 to 12 years.

(6) Technological Characteristics

The function of the RT300-S is the same as the predicate device however there are certain technological similarities and differences as described below:

TechnologyRT300-SPredicate
Power source (energy
used)Mains powerMains power
ControllerBased on Pocket PC
running custom software.Uses custom controller
running custom software.
Stimulator (energy
delivered)0-140mA charge
balanced stimulator0-140mA charge
balanced stimulator
FlywheelUses motor to create
flywheel effect with
reduced weight and
space.Uses heavy mechanical
flywheel.
SeatingAllows user to remain in
their own seating, e.g
wheelchair eliminating
the need for transfer.Includes a dedicated
seating arrangement.
Passive cyclingUtilizes motor to provide
assistance during
passive cycling.Requires manual
assistance to provide
power during passive
cycling.

(b) Performance data

Non clinical testing to determine equivalence has been primarily composed of the following tests:

Test or procedureDescription
Review of user documentation for
predicate deviceEnsure that equivalent functionality is
specified and implemented in the new
device.
Review of 510(k) submission forConfirm technical specifications for

2

| predicate device | completion of predicate details in
comparison tables |
|----------------------------------------------------|--------------------------------------------------------------------------------------------------|
| Output characteristic measurement of
new device | Confirm technical specifications for
completion of new device details in
comparison tables |
| Conduct of system testing | Conduct system testing to verify
performance to specification. |

Clinical TestDescription
Testing with able bodied subjectsThe RT300-S was tested on able bodied
subjects to confirm correct operation of the
system including correct detection of
electrode off conditions with varying skin
impedances.
Testing with spinal cord injured
subjectsThe RT300-S is being utilized in clinical
studies involving spinal cord injured subjects.

RTI concludes that:

The RT300-S has the same intended use as the predicate device.

The RT300-S has the same output characteristics as the predicate device. The different technological characteristics do not raise new questions of safety and effectiveness. The safety and effectiveness of using a motor to simulate the oredicate device's mechanical flywheel and provide passive cycling assistance has been extensively demonstrated in particular by the ongoing clinical use of the motorized ergometer without the stimulation component both in the European Infotoneous in the U.S.A. The safety and effectiveness of the controller has been demonstrated over the development period of the RT300-S.

In conclusion, RTI's clinical and non clinical testing has demonstrated that the RT300-S is as safe and effective as the predicate device.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract symbol that resembles an eagle or bird-like figure with three wave-like lines beneath it.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUN 2 7 2005

Mr. Andrew Barriskill Restorative Therapies Incorporated 2263 Boston Street Baltimore, Maryland 21224

Re: K050036

Trade/Device Name: RT300-S and RT300-SP Regulation Number: 21 CFR 882.5810 Regulation Name: External functional neuromuscular stimulator Regulatory Class: II Product Code: GZI Dated: April 26, 2005 Received: April 26, 2005

Dear Ms. Barriskill:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your becamined the device is substantially equivalent (for the indications forchered above and in sure) to legally marketed predicate devices marketed in interstate for use stated in the encreativent of the enactment date of the Medical Device Amendments, or to coninered prior to May 20, 1977) in accordance with the provisions of the Federal Food, Drug, de necs that have been require approval of a premarket approval application (PMA). and Cosmetic rece (110) that the device, subject to the general controls provisions of the Act. The r ou may, uterefore, thanks of the Act include requirements for annual registration, listing of general condolo provisions of ractice, 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 your device is elaborired dontrols. 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 I least be advised that I Driv issuality over device complies with other requirements of the Act that I Dr has Intatutes and regulations administered by other Federal agencies. You must or any 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 Of It Fart 6077, accems (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.

4

Page 2 - Mr. Andrew Barriskill

This letter will allow you to begin marketing your device as described in your Section 510(k) This letter will anow you to oegin maneting of substantial equivalence of your device to a legally premarket notification: "The PDT intoclassification 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 If you desire specific acrite for your as (240) 276-0120 . Also, please note the regulation entitled, Colliact the Office of Compuner as (21 t minication" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small other general informational 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/industry/support/index.html.

Sincerely yours,

Muriam C. Provost

Miriam C. Provost, Ph.D. Acting Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

Indications for Use

510(k) Number (if known):

Device Name:__________________________________________________________________________________________________________________________________________________________________

Indications For Use:

The RT300-S (adult version) and RT300-SP (pediatric version) are intended for general rehabilitation for:

  • a. Relaxation of muscle spasms
  • b. Prevention or retardation of disuse atrophy
  • c. Increasing local blood circulation
  • d. Maintaining or increasing range of motion

The RT300-SP (pediatric version), is intended for population ages 4 to 12 years.

Prescription Use × AND/OR Over-The-Counter Use (Part 21 CFR 801 Subpart D) (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Page 1 of

Muriam C. Provost
(Division Signer or Designee)

(Division Sign-Off) Division of General, Restorative and New of General, Resto

510(k) Number_________________________________________________________________________________________________________________________________________________________________