K Number
K081541
Device Name
DERMABLATE EFFECT
Date Cleared
2009-02-23

(266 days)

Product Code
Regulation Number
878.4810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Dermablate Effect Er:YAG laser with handpiece of larger spot sizes is intended for use for coagulation, vaporization, ablation or cutting of soft tissue (skin) in dermatology, plastic surgery, oral surgery and ophthalmology (skin around the eyes). The Dermablate Effect Er:YAG laser with fractional handpiece is intended for dermatological and skin resurfacing procedures. The Dermablate Effect can be equipped optionally with the following modules: Asclepion Pulsed Light (APL) and Acoustic Wave (AW). The Asclepion Pulsed Light is intended for permanent hair reduction, treatment of vascular and pigmented lesions and inflammatory acne. The Acoustic Wave is intended for the activation of connective tissue.
Device Description
The Dermablate Effect is a pulsed Er:YAG laser emitting a wavelength of 2940 nm, that can optionally be equipped with a pulsed light module (APL) and an acoustic wave module (AW).
More Information

MCL 30 Dermablate, Lux2940 Erbium Fractional Handpiece, Profile ProFractional Handpiece, Photosilk Plus, Cellactor SC1, D-Actor 200

Not Found

No
The summary does not mention AI, ML, or any related concepts like image processing or specific algorithms typically associated with AI/ML in medical devices. The device description focuses on the laser technology and optional modules.

Yes.
The device is intended for various medical procedures such as coagulation, vaporization, ablation, and cutting of soft tissue, as well as skin resurfacing, hair reduction, and treatment of vascular/pigmented lesions and inflammatory acne, which are all therapeutic applications.

No

Explanation: The device description and intended use clearly state that the Dermablate Effect Er:YAG laser is for "coagulation, vaporization, ablation or cutting of soft tissue" and "dermatological and skin resurfacing procedures." The additional modules are for hair reduction, treatment of lesions, acne, and activation of connective tissue. These are all therapeutic or procedural actions, not diagnostic ones. There is no mention of the device being used to identify or characterize diseases or conditions.

No

The device description clearly states it is a pulsed Er:YAG laser, which is a hardware device. It also mentions optional hardware modules (APL and AW).

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

Here's why:

  • Intended Use: The intended use clearly describes procedures performed directly on the patient's body (coagulation, vaporization, ablation, cutting of soft tissue, hair reduction, treatment of lesions, acne, activation of connective tissue). IVDs are used to examine specimens taken from the body (like blood, urine, tissue samples) to diagnose or monitor conditions.
  • Device Description: The device is a laser system, pulsed light module, and acoustic wave module, all designed for direct application to the patient.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, reagents, or any of the typical components or processes associated with in vitro diagnostics.

Therefore, the Dermablate Effect is a therapeutic device used for various dermatological and surgical procedures, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Dermablate Effect Er:YAG laser with handpiece of larger spot sizes is intended for use for coagulation, vaporization, ablation or cutting of soft tissue (skin) in dermatology, plastic surgery, oral surgery and ophthalmology (skin around the eyes).

The Dermablate Effect Er:YAG laser with fractional handpiece is intended for dermatological and skin resurfacing procedures.

The Dermablate Effect can be equipped optionally with the following modules: Asclepion Pulsed Light (APL) and Acoustic Wave (AW).

The Asclepion Pulsed Light is intended for permanent hair reduction, treatment of vascular and pigmented lesions and inflammatory acne.

The Acoustic Wave is intended for the activation of connective tissue.

Product codes

GEX, ISA

Device Description

The Dermablate Effect is a pulsed Er:YAG laser emitting a wavelength of 2940 nm, that can optionally be equipped with a pulsed light module (APL) and an acoustic wave module (AW).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

soft tissue (skin), skin around the eyes

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

Clinical Performance Data: Fractional Er:YAG histological report of Prof. D. Cassuto

The Dermablate Effect is another safe and effective device Conclusion: for coagulation, vaporization, ablation, cutting of soft tissue, for fractional dermatological and skin resurfacing procedures, for permanent hair reduction, the treatment of vascular and pigmented lesions and inflammatory acne and for the activation of connective tissue.

Additional Information :

Software Description

Tables of comparison and 510(k) summaries for D-Actor 200 Vibration Massage System, Lux2940 Erbium Fractional Handpiece, Profile ProFractional Handpiece

Fractional Er:YAG histological report of Prof. D. Cassuto

Biocompatibility test reports for all handpieces

Professional User Guide with treatment parameters for different applications in all modules

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

Not Found

Predicate Device(s)

MCL 30 Dermablate, Lux2940 Erbium Fractional Handpiece, Profile ProFractional Handpiece, Photosilk Plus, Cellactor SC1, D-Actor 200

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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

K 081541

510(k) SUMMARY ASCLEPION LASER TECHNOLOGIES GmbH Dermablate Effect

FEB 2 3 2009

This 510(k) summary of safety and effectiveness for the Asclepion Laser Technologies -GmbH Dermablate Effect is submitted in accordance with the requirements of 21 CFR 907.92 and follows Office of Device Evaluation Guidance concerning the organization and content of a 510(k) summary.

| Applicant: | ASCLEPION LASER TECHNOLOGIES GmbH
Bruesseler Str. 10
07747 Jena, Germany |
|---------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person: | Mrs. Antje Katzer
Product Management and
International Regulatory Affairs |
| Phone:
Fax:
e-mail: | +49 3641 77 00 309
+49 3641 77 00 302
antje.katzer@asclepion.com |
| Preparation Date: | February 13th, 2009 |
| Device Name: | Dermablate Effect |
| Common Name: | Dermablate Effect |
| Classification Name: | Instrument, surgical, powered, laser
79-GEX
21 CFR 878.481 |
| Equivalent Devices: | MCL 30 Dermablate
Lux2940 Erbium Fractional Handpiece
Profile ProFractional Handpiece
Photosilk Plus
Cellactor SC1
D-Actor Vibration Massage System |
| Device Description: | The Dermablate Effect is a pulsed Er:YAG laser emitting a
wavelength of 2940 nm, that can optionally be equipped
with a pulsed light module (APL) and an acoustic wave
module (AW). |

1

| Intended Use: | The Dermablate Effect Er:YAG laser with handpiece of larger
spot sizes is intended for use for coagulation, vaporization,
ablation or cutting of soft tissue (skin) in dermatology,
plastic surgery, oral surgery and ophthalmology (skin
around the eyes).

The Dermablate Effect Er:YAG laser with fractional
handpiece is intended for dermatological and skin
resurfacing procedures.

The Dermablate Effect can be equipped optionally with the
following modules: Asclepion Pulsed Light (APL) and
Acoustic Wave (AW).

The Asclepion Pulsed Light is intended for permanent hair
reduction, treatment of vascular and pigmented lesions and
inflammatory acne.

The Acoustic Wave is intended for the activation of
connective tissue. |
|-------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Comparison to: | The Dermablate Effect is substantially equivalent to the
MCL 30 Dermablate (with regard to the Er:YAG laser
module with handpiece of larger spotsizes), to the Lux2940
Erbium Fractional Handpiece and the Profile ProFractional
Handpiece (with regard to the Er:YAG laser module with
fractional handpiece) to the Photosilk Plus (with regard to
the APL module) and to the class 1 products Cellactor SC1
and D-Actor 200 (with regard to the AW module) with the
same principles of operation, and the same indications for use. |
| Nonclinical Performance Data: | None |

Clinical Performance Data: Fractional Er:YAG histological report of Prof. D. Cassuto

The Dermablate Effect is another safe and effective device Conclusion: for coagulation, vaporization, ablation, cutting of soft tissue, for fractional dermatological and skin resurfacing procedures, for permanent hair reduction, the treatment of vascular and pigmented lesions and inflammatory acne and for the activation of connective tissue.

2

Additional Information :

Software Description

Tables of comparison and 510(k) summaries for D-Actor 200 Vibration Massage System, Lux2940 Erbium Fractional Handpiece, Profile ProFractional Handpiece

Fractional Er:YAG histological report of Prof. D. Cassuto

Biocompatibility test reports for all handpieces

Professional User Guide with treatment parameters for different applications in all modules

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with three stripes extending from its wing. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Asclepion Laser Technologies GmbH % Mrs. Antie Katzer Product Management and International Regulatory Affairs Bruesseler Str. 10 07747 Jena, Germany

Re: K081541

Trade/Device Name: Dermablate Effect 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, ISA

FEB 2 3 2009

Dated: February 16, 2009 Received: February 18, 2009

Dear Mrs. Katzer:

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

4

Page 2 - Mrs. Antje Katzer

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 Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance. please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at (240) 276-3474. For questions regarding of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at (240) 276-3464. You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely vours.

Mark N. Melkerson Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

INDICATIONS FOR USE STATEMENT

510(k) Number: K081541

Device Name: Dermablate Effect

Indications for Use:

The Dermablate Effect Er:YAG laser with handpiece of larger spot sizes is intended for use for coagulation, vaporization, ablation or cutting of soft tissue (skin) in dermatology, plastic surgery, oral surgery and ophthalmology (skin around the eyes).

The Dermablate Effect Er:YAG laser with fractional handpiece is intended for dermatological and skin resurfacing procedures.

The Dermablate Effect can be equipped optionally with the following modules: Asclepion Pulsed Light (APL) and Acoustic Wave (AW).

The Asclepion Pulsed Light is intended for permanent hair reduction, treatment of vascular and pigmented lesions and inflammatory acne.

The Acoustic Wave is intended for the activation of connective tissue.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ AND/OR (Part 21 CFR 801 Subpart D)

Over-The-Counter
(21 CFR 801 S

Over-The-Counter Use (21 CFR 801 Subpart C)

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

Concurence of CDRH, Office of Device Evaluation (ODE)
(Division Sign-Off)
Division of General, Restorative,
and Neurological Devices
510(k) Number K081541