K Number
K090754
Device Name
LIPOCONTROL
Manufacturer
Date Cleared
2011-01-21

(672 days)

Product Code
Regulation Number
878.4810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
LIPOCONTROL is indicated for: Laser assisted lipolysis. LIPOCONTROL should be used to melt small amount of fat from small areas only such as chins or upper arms. LIPOCONTROL should not be used to melt larger volumes or areas of fat and on areas such as thighs, buttocks, or abdomen.
Device Description
The medical device LIPOCONTROL is based on the use of a laser module allowing the emission of a beam of coherent light at 970nm ±10nm at a maximum power of 25W. The laser module consists of laser diodes assembled in series and optically aligned in order to focus in an optical fibre of 200um or more. The optical fibre is screwed onto the SMA 905 connector of the laser module. LipoControl contains a localisation system. This localisation system is based on a magnetic sensor (LipoBird), positioned on the handpiece and a field transmitter. With this localization system, an informative function and a safety function are built-in: The informative function is a 2D map (display on the device screen) which indicates the area where the energy is deposited and the total amount of energy delivered. The safety function is on the delivered power. Maximum output power and output fiber speed displacement are chosen by physician and delivered when footswitch is pressed and the output fiber speed displacement is over the pre-defined limit. If it the output fiber speed displacement is below the pre-defined limit then the delivered power is diminished. The 2D map can be displayed only if the treatment surfaces are inclined less than 35 decree relative to the observation plane defined by the user. The user can divide the treated area in adiacent areas with an andle less than 35 degree or use the device without these optional functions. The LipoControl includes the power supplies necessary to supply the laser and to ensure its temperature control using Peltier elements built on a ventilated radiator. In addition, the LIPOCONTROL includes the whole of electronics and the functions allowing the parameter setting of the laser and the safe functioning of the device. The adjustments of the parameters are done using a LCD (Liquid Crystal Display) screen and a touch screen controlled by a PC.
More Information

No
The device description details a laser system with a magnetic localization system for tracking and power regulation. While it uses sensors and a 2D map display, there is no mention of AI or ML algorithms for image processing, data analysis, or decision-making beyond simple threshold-based power adjustment.

Yes.

The device is indicated for laser-assisted lipolysis to melt small amounts of fat, and the clinical study section confirms its use for this purpose, with safety and efficacy assessed, indicating a therapeutic intent.

No

Explanation: The device, LIPOCONTROL, is described as a laser for lipolysis, which is a therapeutic intervention to melt fat. Its functions include emitting a laser beam, localization for energy deposition, and power regulation, all of which are treatment-oriented rather than diagnostic. The "localization system" and "2D map" are for guiding treatment and displaying energy delivery, not for diagnosing a medical condition.

No

The device description clearly outlines hardware components including a laser module, optical fiber, magnetic sensor, field transmitter, power supplies, Peltier elements, ventilated radiator, electronics, LCD screen, and touch screen. While software is used for parameter setting and safe functioning, it is integral to the operation of the hardware components.

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

Here's why:

  • Intended Use: The intended use is "Laser assisted lipolysis," which is a surgical procedure performed on the body to melt fat. This is a therapeutic intervention, not a diagnostic test performed on samples taken from the body.
  • Device Description: The device is a laser system designed to deliver energy to tissue. It includes components like a laser module, optical fiber, and a localization system. These are all related to performing a physical procedure, not analyzing biological samples.
  • Lack of IVD Characteristics: There is no mention of the device being used to test or analyze biological samples (like blood, urine, tissue, etc.) to provide information about a person's health status, disease, or condition.

IVD devices are specifically designed to be used in vitro (outside the body) to examine specimens derived from the human body. This device operates in vivo (within the body) to perform a therapeutic procedure.

N/A

Intended Use / Indications for Use

LIPOCONTROL is indicated for: Laser assisted lipolysis. LIPOCONTROL should be used to melt small amount of fat from small areas only such as chins or upper arms. LIPOCONTROL should not be used to melt larger volumes or areas of fat and on areas such as thighs, buttocks, or abdomen.

Product codes (comma separated list FDA assigned to the subject device)

ORK, GEX

Device Description

The medical device LIPOCONTROL is based on the use of a laser module allowing the emission of a beam of coherent light at 970nm ±10nm at a maximum power of 25W. The laser module consists of laser diodes assembled in series and optically aligned in order to focus in an optical fibre of 200um or more. The optical fibre is screwed onto the SMA 905 connector of the laser module. LipoControl contains a localisation system. This localisation system is based on a magnetic sensor (LipoBird), positioned on the handpiece and a field transmitter. With this localization system, an informative function and a safety function are built-in: The informative function is a 2D map (display on the device screen) . which indicates the area where the energy is deposited and the total amount of energy delivered. The safety function is on the delivered power. Maximum output power . and output fiber speed displacement are chosen by physician and delivered when footswitch is pressed and the output fiber speed displacement is over the pre-defined limit. If it the output fiber speed displacement is below the pre-defined limit then the delivered power is diminished. The 2D map can be displayed only if the treatment surfaces are inclined less than 35 degree relative to the observation plane defined by the user. The user can divide the treated area in adiacent areas with an andle less than 35 degree or use the device without these optional functions. The LipoControl includes the power supplies necessary to supply the laser and to ensure its temperature control using Peltier elements built on a ventilated radiator. In addition, the LIPOCONTROL includes the whole of electronics and the functions allowing the parameter setting of the laser and the safe functioning of the device. The adjustments of the parameters are done using a LCD (Liquid Crystal Display) screen and a touch screen controlled by a PC.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Small areas such as chins or upper arms.

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)

Performance data - Bench Test: LIPOCONTROL applications conform to Guidance on the content and organization of a premarket notification for a medical laser (June 1995) and to Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices (May 2005). Thus. LIPOCONTROL (with localization system) device conforms to safety and electromagnetic compliance standards: - IEC 60601-1 (2005) Medical electrical equipment Part 1: General . requirements for basic safety and essential performance - IEC 60601-2-22 (2007) Medical electrical equipment Part 2-22: . Particular requirements for the basic safety and essential performance of surgical, cosmetic, therapeutic and diagnostic laser equipment - IEC 60825-1 (2007) Safety of laser products Part 1: Equipment . classification and requirements - 21 CFR 1040.10 and 1040.11: Performance standards for light-. emitting products_(lasers products and specific purpose laser products) - IEC 60601-1-2 (2007) Medical electrical equipment Part 1-2: . General requirements for basic safety and essential performance -Collateral standard: Electromagnetic compatibility - Requirements and tests - FCC part 15 (2007) . Accuracy of the localization system has been checked in normal conditions and in worst case situations (influence of electrical noise and of magnetic distorsion); it is in good agreement with theoretical accuracy claimed by the supplier of the localization module. Accuracy of the energy mapping display has been checked according to internal specifications. It complies with the mathematical model of projection in 2D plan of 3D data and to the energy pattern defined by OSYRIS MEDICAL. Power requlation according to the speed displacement has been checked. When the speed is below the set value, the power is regulated linearly depending on the speed. When the speed is above the set value, the power set is delivered. Verification of the stop of power delivery if the probe is outside the screen has been checked.

Performance data - Confirmatory Clinical Test: A feasibility study has been conducted on 4 subjects in order to demonstrate the feasibility and interest of using LIPOCONTROL with tracking system ability and energy mapping features on smaller treatment areas to melt small amount of fat.
Scope and duration: In the study, 4 subjects were treated. 2 patients were treated on the chin, 2 patients on the upper arms using the Lipocontrol. 1 month follow up has been performed.
Measurements assessments: Feasibility was assessed by validating that the investigator was able to define the ROI (region of interest) using the Lipocontrol, and by comparing the ROI recorded by the system to the one plotted on transparencies. The interest of using Lipocontrol technology was assessed by reviewing the videos. Safety and efficacy of the procedure were assessed using subjects questionnaires, and by evaluating side effects.
Results: The results show that the Lipocontrol can be used on chin and upper arms. The treatment area can be flat or curved with up to 35 degree angle. The results show the interest of the Lipocontrol: The tracking function and the power regulation associated with the canula tracking allow limiting the risk of accidental use of the laser, when the canula is not in the monitoring area. The power regulation allows having a better control of the energy delivery, avoiding excess of energy in a single point when canula is static, and regulating the power proportionally to the speed of the canula when the canula is moving, allowing a better homogeneity of the energy delivered, and a reduction of undesired local energy accumulation. The Lipocontrol allows applying a predefined value of energy per surface area, in each part of the tissue. Safety and efficacy of the procedure were evaluated at 1 week follow up and at 1 month follow up: Subject recovery time was less than 1 week . Minor and transitional pain or heat sensation was observed. No serious adverse event occurred during the study . Minor and transitional side effects occurred during the study. On average, subjects are very satisfied with both the procedure and the clinical result. Performance data based on bench tests and on clinical tests demonstrate the safety and effectiveness of LIPOCONTROL for its intended use.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K073617

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

K083379, K082185, K022354

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

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.

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K090754 P81 of 4

510(k) SUMMARY OF SAFETY AND EFFECTIVENESS

As required by section 807.92(c)

JAN 2 1 2011

5.1 GENERAL INFORMATION

Trade NameLIPOCONTROL
Classification NameLASER INSTRUMENT, SURGICAL, POWERED
ClassII
Product CodeORK
CFR section878.4810
Device panelGeneral & Plastic Surgery
Legally marketed
predicate devicesPHARAON LIPO manufactured by OSYRIS MEDICAL and
cleared as K073617
SMARTLIPO MPX laser with SMARTSENSE manufactured
by CYNOSURE and cleared as K083379
GE logic E9, manufactured by GE Healthcare and cleared
as K082185
CTG 2000sa, manufactured by ULTRAGUIDE and cleared
as K022354
SubmitterOSYRIS Medical
60, avenue Halley
59650 VILLENEUVE D'ASCQ FRANCE
ContactsPr JAOUAD ZEMMOURI CEO
jaouad.zemmouri@osyris.com
Phone ; +33 (0)3 20 67 90 00
Fax: +33 (0)3 20 04 46 24
Regulatory contact : Dr Isabelle DRUBAIX (Idée
Consulting) idrubaix@nordnet.fr

5.2 Device Description

The medical device LIPOCONTROL is based on the use of a laser module allowing the emission of a beam of coherent light at 970nm ±10nm at a maximum power of 25W. The laser module consists of laser diodes assembled in series and optically aligned in order to focus in an optical fibre of 200um or more. The optical fibre is screwed onto the SMA 905 connector of the laser module.

LipoControl contains a localisation system. This localisation system is based on a magnetic sensor (LipoBird), positioned on the handpiece and a field transmitter. With this localization system, an informative function and a safety function are built-in :

1

K090754 pg 2 of 4

  • The informative function is a 2D map (display on the device screen) . which indicates the area where the energy is deposited and the total amount of energy delivered.
  • The safety function is on the delivered power. Maximum output power . and output fiber speed displacement are chosen by physician and delivered when footswitch is pressed and the output fiber speed displacement is over the pre-defined limit. If it the output fiber speed displacement is below the pre-defined limit then the delivered power is diminished.

The 2D map can be displayed only if the treatment surfaces are inclined less than 35 decree relative to the observation plane defined by the user. The user can divide the treated area in adiacent areas with an andle less than 35 degree or use the device without these optional functions.

The LipoControl includes the power supplies necessary to supply the laser and to ensure its temperature control using Peltier elements built on a ventilated radiator.

In addition, the LIPOCONTROL includes the whole of electronics and the functions allowing the parameter setting of the laser and the safe functioning of the device. The adjustments of the parameters are done using a LCD (Liquid Crystal Display) screen and a touch screen controlled by a PC.

5.3 Indications for use

LIPOCONTROL is indicated for: Laser assisted lipolysis.

LIPOCONTROL should be used to melt small amount of fat from small areas only such as chins or upper arms. LIPOCONTROL should not be used to melt larger volumes or areas of fat and on areas such as thighs, buttocks, or abdomen.

5.4 Performance data - Bench Test

LIPOCONTROL applications conform to Guidance on the content and organization of a premarket notification for a medical laser (June 1995) and to Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices (May 2005).

Thus. LIPOCONTROL (with localization system) device conforms to safety and electromagnetic compliance standards:

  • IEC 60601-1 (2005) Medical electrical equipment Part 1: General . requirements for basic safety and essential performance
  • IEC 60601-2-22 (2007) Medical electrical equipment Part 2-22: . Particular requirements for the basic safety and essential performance of surgical, cosmetic, therapeutic and diagnostic laser equipment
  • IEC 60825-1 (2007) Safety of laser products Part 1: Equipment . classification and requirements

2

K090754 P830f4

  • 21 CFR 1040.10 and 1040.11: Performance standards for light-. emitting products_(lasers products and specific purpose laser products)
  • IEC 60601-1-2 (2007) Medical electrical equipment Part 1-2: . General requirements for basic safety and essential performance -Collateral standard: Electromagnetic compatibility - Requirements and tests
  • FCC part 15 (2007) .

Accuracy of the localization system has been checked in normal conditions and in worst case situations (influence of electrical noise and of magnetic distorsion); it is in good agreement with theoretical accuracy claimed by the supplier of the localization module.

Accuracy of the energy mapping display has been checked according to internal specifications. It complies with the mathematical model of projection in 2D plan of 3D data and to the energy pattern defined by OSYRIS MEDICAL.

Power requlation according to the speed displacement has been checked. When the speed is below the set value, the power is regulated linearly depending on the speed. When the speed is above the set value, the power set is delivered.

Verification of the stop of power delivery if the probe is outside the screen has been checked.

5.5 Performance data - Confirmatory Clinical Test

A feasibility study has been conducted on 4 subjects in order to demonstrate the feasibility and interest of using LIPOCONTROL with tracking system ability and energy mapping features on smaller treatment areas to melt small amount of fat.

Scope and duration:

In the study, 4 subjects were treated. 2 patients were treated on the chin, 2 patients on the upper arms using the Lipocontrol. 1 month follow up has been performed.

Measurements assessments:

Feasibility was assessed by validating that the investigator was able to define the ROI (region of interest) using the Lipocontrol, and by comparing the ROI recorded by the system to the one plotted on transparencies.

The interest of using Lipocontrol technology was assessed by reviewing the videos.

Safety and efficacy of the procedure were assessed using subjects questionnaires, and by evaluating side effects.

3

K690754 PJ840f4

Results:

The results show that the Lipocontrol can be used on chin and upper arms. The treatment area can be flat or curved with up to 35 degree angle.

The results show the interest of the Lipocontrol:

  • The tracking function and the power regulation associated with . the canula tracking allow limiting the risk of accidental use of the laser, when the canula is not in the monitoring area.
  • The power regulation allows having a better control of the . energy delivery, avoiding excess of energy in a single point when canula is static, and regulating the power proportionally to the speed of the canula when the canula is moving, allowing a better homogeneity of the energy delivered, and a reduction of undesired local energy accumulation.
  • . The Lipocontrol allows applying a predefined value of energy per surface area, in each part of the tissue.

Safety and efficacy of the procedure were evaluated at 1 week follow up and at 1 month follow up:

  • Subject recovery time was less than 1 week .
  • Minor and transitional pain or heat sensation was observed. .
  • No serious adverse event occurred during the study .
  • Minor and transitional side effects occurred during the study. �
  • On average, subjects are very satisfied with both the procedure . and the clinical result.
  • Performance data based on bench tests and on clinical tests demonstrate the safety and effectiveness of LIPOCONTROL for its intended use.

5.6 Substantial equivalence

LIPOCONTROL has the same intended use, design and function as predicate devices PHARAON LIPO manufactured by OSYRIS and cleared under K073617.

Summary preparation date: January 05, 2011

4

Image /page/4/Picture/1 description: The image shows the seal for the Department of Health & Human Services USA. The seal is circular, with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" arranged around the perimeter. In the center of the seal is an abstract symbol that resembles a stylized caduceus or a representation of human figures.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

JAN 2 1 201

Osyris Medical % Ms. Blandine Bouvet Parc Scientifique de la Haute Borne 60 Avenue Halley 59650 Villeneuve D'Ascq, France

Re: K090754

Trade/Device Name: LipoControl Regulation Number: 21 CFR 878.4810 Regulation Name: Laser surgical instrument for use in general and plastic surgery and in dermatology Regulatory Class: Class II Product Code: ORK, GEX Dated: January 11, 2011 Received: January 20, 2011

Dear Ms. Bouvet:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you; however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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.

5

Page 2 - Ms. Blandine Bouvet

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportalProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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 (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours,

Sincerely yours,

Mark N. Melkerson Director Division of Surgical, Orthopedic And Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

6

OS®RIS MEDICAL

INDICATIONS FOR USE

510(k) Number (if known): K090754

Device Name: LIPOCONTROL

Indications for Use: LIPOCONTROL is indicated for: Laser assisted lipolysis

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Net RP Orden for mkm

Division Sign Division of Surgical, Orthopedic, and Restorative Devices

510(k) Number K090754

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