K Number
K062616
Device Name
WELLNESSPRO 2010
Date Cleared
2007-07-06

(304 days)

Product Code
Regulation Number
882.5890
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Wellness Pro 2010 is an Electrotherapy Unit that is used for the following: 1. Relief of chronic, intractable pain. 2. Adjunctive treatment of post surgical or post-traumatic acute pain
Device Description
The Wellness Pro 2010 is designed to provide electrical stimulation, for the relief of chronic, intractable pain and as an adjunctive treatment of post-surgical or post-traumatic acute pain, in a single compact, lightweight user friendly package. Stimulation does not always cause sensation to relieve pain. The WellnessPro 2010 has 2 modes of waveforms: Continuous and Premodulated. The device gives the clinician ability to store frequencies or to choose from a set of 250 frequencies that allow quick and easy selection, for prescription of stimulation regimens that can be later stored in any of the 1000 available memory slots. The Wellness Pro 2010 package is comprised of the following items: - 1. 7.5 Volt medical power adapter, conforming to industry standards. - 2. Four industry standard wires for electrodes conforming to FDA standard, - 3. Four standard commercially available and FDA approved, round 50(mm) self adhesive electrodes. - 4. An instruction Manual.
More Information

Not Found

No
The summary describes a standard electrotherapy unit with pre-set and customizable frequency options and memory storage. There is no mention of AI or ML in the device description, intended use, or performance studies.

Yes
The device is described as an "Electrotherapy Unit" and its intended uses include "Relief of chronic, intractable pain" and "Adjunctive treatment of post surgical or post-traumatic acute pain," which are therapeutic indications.

No

The "Intended Use / Indications for Use" section states that the device is an "Electrotherapy Unit" used for the "Relief of chronic, intractable pain" and "Adjunctive treatment of post surgical or post-traumatic acute pain". These are therapeutic uses, not diagnostic ones.

No

The device description explicitly lists hardware components included in the package, such as a power adapter, wires for electrodes, and electrodes. This indicates it is a hardware device with integrated software for control and functionality.

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

Here's why:

  • Intended Use: The intended use is for the relief of pain through electrical stimulation. This is a therapeutic application, not a diagnostic one.
  • Device Description: The device is described as an "Electrotherapy Unit" that provides electrical stimulation. This aligns with a therapeutic device, not one used for in vitro testing of biological samples.
  • 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, etc.) to provide information for diagnosis, monitoring, or screening.

IVD devices are specifically designed to perform tests on biological samples outside of the body to gain diagnostic information. This device's function is to apply electrical stimulation to the body for pain relief.

N/A

Intended Use / Indications for Use

The Wellness Pro 2010 is an Electrotherapy Unit that is used for the following:

  1. Relief of chronic, intractable pain.
  2. Adjunctive treatment of post surgical or post-traumatic acute pain

Product codes

84GZJ, GZJ

Device Description

The Wellness Pro 2010 is designed to provide electrical stimulation, for the relief of chronic, intractable pain and as an adjunctive treatment of post-surgical or post-traumatic acute pain, in a single compact, lightweight user friendly package. Stimulation does not always cause sensation to relieve pain.

The WellnessPro 2010 has 2 modes of waveforms: Continuous and Premodulated. The device gives the clinician ability to store frequencies or to choose from a set of 250 frequencies that allow quick and easy selection, for prescription of stimulation regimens that can be later stored in any of the 1000 available memory slots.

The Wellness Pro 2010 package is comprised of the following items:

    1. 7.5 Volt medical power adapter, conforming to industry standards.
    1. Four industry standard wires for electrodes conforming to FDA standard,
    1. Four standard commercially available and FDA approved, round 50(mm) self adhesive electrodes.
    1. An instruction Manual.

Waveform Description

The Continuous mode produces a continuous train of impulses. The stimulation parameters are not automatically interrupted nor vay. The continuous mode is quite versatile because it may be applied with a variety of rate settings.

The Premodulated mode produces an amplitude-modulated impulse. The current intensity is modulated: The frequency remains the same while the intensity is modulated, (the Amplitude Modulation Frequency).

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

K060669, K041575

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 882.5890 Transcutaneous electrical nerve stimulator for pain relief.

(a)
Identification. A transcutaneous electrical nerve stimulator for pain relief is a device used to apply an electrical current to electrodes on a patient's skin to treat pain.(b)
Classification. Class II (performance standards).

0

K062616

JUL - 6 2007

510(k) Summary

Wellness Pro 2010

IntelSource Group, Inc. 3104 E. Camelback Road #528 Phoenix, AZ 85016 Phone: 888-880-7888 Fax: 480-452-1518

Contact: Mathew Wolfson TEL: 602-790-8034 FAX: 480-452-1518

Summary Prepared: Revised February 26, 2007

Trade Name: Wellness Pro 2010

Common Name: TENS device

Classification Name: Transcutaneous Electrical Nerve Stimulator for Pain Relief. 21 CFR 882.5890, Class II, Product Code 84GZJ (prescription) or Stimulator, Nerve, Transcutaneous, for Pain Relief.

Predicate Device Identification:

21CFR:882.5890 Product Code: GZJ Device Class: II Legally Marketed Device: Medrelief ST-100, ST-150, ST-200, ST-300 Manufacturer: Healthonics, Inc. K#: K060669

21CFR:882.5890 Product Code: GZJ Device Class: II Legally Marketed Device: Fenzian Treatment System Manufacturer: Eumedic, Ltd K#: K041575

1

Device Description

The Wellness Pro 2010 is designed to provide electrical stimulation, for the relief of chronic, intractable pain and as an adjunctive treatment of post-surgical or post-traumatic acute pain, in a single compact, lightweight user friendly package. Stimulation does not always cause sensation to relieve pain.

The WellnessPro 2010 has 2 modes of waveforms: Continuous and Premodulated. The device gives the clinician ability to store frequencies or to choose from a set of 250 frequencies that allow quick and easy selection, for prescription of stimulation regimens that can be later stored in any of the 1000 available memory slots.

The Wellness Pro 2010 package is comprised of the following items:

    1. 7.5 Volt medical power adapter, conforming to industry standards.
    1. Four industry standard wires for electrodes conforming to FDA standard,
    1. Four standard commercially available and FDA approved, round 50(mm) self adhesive electrodes.
    1. An instruction Manual.

Waveform Description

The Continuous mode produces a continuous train of impulses. The stimulation parameters are not automatically interrupted nor vay. The continuous mode is quite versatile because it may be applied with a variety of rate settings.

Image /page/1/Figure/10 description: The image shows a square wave pattern. The wave alternates between a high and low state, creating a series of rectangular pulses. The pattern appears to repeat consistently across the image, with each pulse having a similar width and amplitude. The image is black and white.

Variations of this mode look like this:

Image /page/1/Figure/12 description: The image shows a graph with a repeating pattern. The pattern consists of a series of rapid, high-frequency oscillations that last for 3 to 3.5 seconds, followed by a period of low activity that lasts for 0.5 to 1 second. This pattern repeats twice in the image.

It is still the same continuous mode with a continuous train of impulses (3-3.5 sec) with a small pause (0.5-1 sec) in between.

2

The Premodulated mode produces an amplitude-modulated impulse. The current intensity is modulated: The frequency remains the same while the intensity is modulated, (the Amplitude Modulation Frequency).

Image /page/2/Figure/1 description: The image shows two identical waveforms separated by a small gap. Each waveform is labeled as lasting for "4 sec". The waveforms appear to be square waves with varying amplitudes, increasing and then decreasing over the 4-second duration.

Variations of this mode looks like this:

Image /page/2/Figure/3 description: The image shows a graph with time on the x-axis. There are two sections labeled "3 sec" and two sections labeled "1 sec". The graph shows a series of square waves with varying amplitudes and frequencies. The square waves are clustered into two groups, each lasting 3 seconds, separated by a 1-second interval of relatively constant value.

The next variation is just a combination of the previously described modes

Image /page/2/Figure/5 description: The image shows a waveform with time markers. The waveform consists of a series of square waves with varying amplitudes and frequencies. The time markers indicate segments of 3 seconds and 1 second.

Note: In order to name these modes and variations, we simply label them as variations 1,2,3,4 and 5. All wave variations have same indications of use. See Below.

Indications for use

There is no clinical basis or benefit for selecting one variation over the other. It is up to the physician to choose the correct placement, regimen and waveform variation to be used for symptomatic relief and management of chronic, intractable pain, post- traumatic acute pain, post-surgical acute pain.

Intended Use

The WellnessPro 2010 is an Electrotherapy Unit that is used for the following:

    1. Relief of chronic, intractable pain.
    1. Adjunctive treatment of post-surgical or post-traumatic acute pain

3

Declaration of Conformity

  • ISO 10993 .
  • UL 60601-1-1: 2003 ●
  • IEC 60601-2-10: 1987 .
  • IEC 60601-1-1: 1998 = A1 = A2:1995 ●
  • EN 60601-1-2:2001 ●

Summary of Safety and Effectiveness

The WellnessPro 2010 is substantially equivalent to the Healthonics, Inc - MedRelief ST-100, ST-150, ST-200 and ST-300 devices as well as the Eumedic, Ltd - Fenzian Treatment System because of similar indication for use and unit characteristics.

The WellnessPro 2010 does not raise new issues of safety and effectiveness based on the above similarities.

Basis for substantial equivalence

The Wellness Pro 2010 is equivalent in function and intended use to the predicate devices. Both offer similar user options and functions. However the Wellness Pro 2010 offers simplified user interface, memory slot options and does not have a frequency range as great as the Medrelif ST series.

Non-Clinical Data:

  1. Risk Analysis results demonstrate acceptable and mitigated potential hazards.

  2. The device meets the requirements for EMC, Radiated Emissions, Electrostatic Discharge, Radiated Immunity and device safety: UL 60601-1-1: 2003, IEC 60601-2-10: 1987, EC 60601-1-1: 1998 = A1 = A2:1995, EN 60601-1-2:2001, ISO 10993.

Conclusion:

The device is designed and labeled and verified for performance and safety. The performance is equivalent to legally marketed predicate devices. Risk Analysis does not demonstrate any design or performance potential hazards that are not adequately mitigated.

4

DEPARTMENT OF HEALTH & HUMAN SERVICES · USA

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUL - 6 2007

IntelSource Group, Inc. % Mr. Mathew Wolfson 3104 E. Camelback Road, #528 Phoenix, AZ 85016

RE: K062616

Trade/Device Name: Wellness Pro 2010 Regulation Number: 21 CFR 882.5890 Regulation Name: Transcutaneous electrical nerve stimulator for pain relief Regulatory Class: II Product Code: GZJ Dated: June 22, 2007 Received: July 2, 2007

Dear Mr. Wolfson:

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. Iisting 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 (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.

5

Page 2 - Mr. Mathew Wolfson

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 (240) 276-0120. 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 from the Division of Small Manufacturers, International and Consumer Assistance at toll-free number (800) 638-2041 or (240) 276-3150 or the Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

for Peter

Mark N. Melkerson
Director

Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

6

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

:

Device Name: Wellness Pro 2010

Indications for Use:

The Wellness Pro 2010 is an Electrotherapy Unit that is used for the following:

  1. Relief of chronic, intractable pain.

  2. Adjunctive treatment of post surgical or post-traumatic acute pain

Prescription Use (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

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

510(k) Number1-062616
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