K Number
K092431
Device Name
BODY COMPOSITION ANALYZER, MODEL: IOI 353
Date Cleared
2009-10-08

(62 days)

Product Code
Regulation Number
870.2770
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
This device is intended to estimate PBF(Percentage of Body Fat), MBF(Mass of Body Fat), LBM(Lean Body Mass), TBW(Total Body Water), BMI(Body Mass Index), BMR(Basic Metabolic Rate), Segmental LBM, ICW(Intra-Cellular Water), ECW(Extra-Cellular Water), and ratio of ECW/TBW using the BIA(Bio-electrical Impedance Analysis) method. The device measures or calculates the impedance, BMI(Body Mass Index), weight, and WHR(Waist to Hip Ratio) of the user. This device is intended for use only in healthy subjects between the age of 7-89.
Device Description
The ioi 353 is body composition analyzer is intended for use only in healthy subjects between the age of 7-89. The device employs BIA(Bio-electrical Impedance Analysis) method and 8 electrodes placed on hands and feet, and then measure body composition using an experimentally derived algorithm. The device is powered by AC adapter.
More Information

Not Found

No
The description explicitly states the device uses an "experimentally derived algorithm" and does not mention AI, ML, or related terms.

No.
The device is intended to estimate various body composition parameters and is not used for treating or preventing any medical condition.

No

Explanation: The "Intended Use / Indications for Use" section states that the device is "intended to estimate PBF... using the BIA method" and measures or calculates various body metrics. It also explicitly states, "This device is intended for use only in healthy subjects." Diagnostic devices are used to identify or determine the nature of a disease or condition, which is not indicated here.

No

The device description explicitly states it employs the BIA method using 8 electrodes placed on hands and feet, indicating the presence of hardware components beyond just software.

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 ioi 353 body composition analyzer uses Bio-electrical Impedance Analysis (BIA) by placing electrodes on the hands and feet. It measures electrical impedance and calculates body composition parameters based on this measurement and algorithms.
  • No Sample Analysis: The device does not analyze samples taken from the body. It interacts directly with the body to take measurements.

Therefore, the ioi 353 falls under the category of a medical device that performs measurements on the body, rather than an in vitro diagnostic device that analyzes samples from the body.

N/A

Intended Use / Indications for Use

This device is intended to estimate PBF(Percentage of Body Fat), MBF(Mass of Body Fat), LBM(Lean Body Mass), TBW(Total Body Water), BMI(Body Mass Index), BMR(Basic Metabolic Rate), Segmental LBM, ICW(Intra-Cellular Water), ECW(Extra-Cellular Water), and ratio of ECW/TBW using the BlA(Bioelectrical Impedance Analysis) method. The device measures or calculates the impedance, BMI(Body Mass Index), weight, and WHR(Waist to Hip Ratio) of the user.

This devices is intended for use only in healthy subjects between the age of 7-89.

Product codes

MNW

Device Description

The ioi 353 is body composition analyzer is intended for use only in healthy subjects between the age of 7-89. The device employs BIA(Bio-electrical Impédance Analysis) method and 8 electrodes placed on hands and feet, and then measure body composition using an experimentally derived algorithm. The device is powered by AC adapter.

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

age of 7-89

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 and clinical tests: Modified device ioi 353 meets the requirements of IEC 60601-1, EN 60601-1-2 and in-house test criteria. The ioi 353 was not clinically tested because the ioi 353 measures/outputs/determines the same quantities, uses the same frequencies, and uses the same electrode pattern and number of electrodes as the GAIA 359 PLUS.

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

Not Found

Predicate Device(s)

K071884

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.2770 Impedance plethysmograph.

(a)
Identification. An impedance plethysmograph is a device used to estimate peripheral blood flow by measuring electrical impedance changes in a region of the body such as the arms and legs.(b)
Classification. Class II (special controls). The device, when it is a body composition analyzer which is not intended to diagnose or treat any medical condition, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 870.9.

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Attachment 4

: : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : :

510(k) Summary

[As Required by 21 CFR 807.92]

OCT - 8 2009

Date Prepared:September 08, 2009
Submitter:Jawon Medical Co., Ltd.
#1208-12, Sinsang-Li, Jinryang-Eup, Kyungsan-city, Kyungsang-Bukdo,
712-830, Republic of Korea
Tel: 82-53-856-0993
Establishment Registration Number: 9616164
Contact Person:MI Consulting Co., Ltd. (Mr. HL Jung)
RM 431, Life Officetel, 61-3, Yoido-dong, Youngdeungpo-gu, Seoul, 150-731,
Republic of Korea
Tel: 82-2-6264-9001
Fax: 82-2-6269-9001
Trade Name:Body Composition Analyzer Model ioi 353
Common Name:Body Fat Analyzer / Body Fat Monitor / Body Composition Monitor
Classification Name:Body Composition Analyzer (Impedance plethysmograph) / MNW
Predicate Device:Body Composition Analyzer Models GAIA 359 PLUS and XBIA 500
(K071884)
Device Description:The ioi 353 is body composition analyzer is intended for use only in healthy
subjects between the age of 7-89. The device employs BIA(Bio-electrical
Impédance Analysis) method and 8 electrodes placed on hands and feet, and
then measure body composition using an experimentally derived algorithm.
The device is powered by AC adapter.
Intended use:This device is intended to estimate PBF(Percentage of Body Fat), MBF(Mass
of Body Fat), LBM(Lean Body Mass), TBW(Total Body Water), BMI(Body
Mass Index), BMR(Basic Metabolic Rate), Segmental LBM, ICW(Intra-
Cellular Water), ECW(Extra-Cellular Water), and ratio of ECW/TBW using the
BIA(Bio-electrical Impedance Analysis) method. The device measures or
calculates the impedance, BMI(Body Mass Index), weight, and WHR(Waist to

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K092431
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Hip Ratio) of the user.

This device is intended for use only in healthy subjects between the age of 7-89.

Technologic characteristics: Modified device ioi 353 has the same intended use and technology characteristics as predicate device GAIA 359 PLUS or XBIA 500. The differences in this submission don't raise new questions concerning either safety or effectiveness.

Non-clinical and clinical tests: Modified device ioi 353 meets the requirements of IEC 60601-1, EN 60601-1-2 and in-house test criteria. The ioi 353 was not clinically tested because the ioi 353 measures/outputs/determines the same quantities, uses the same frequencies, and uses the same electrode pattern and number of electrodes as the GAIA 359 PLUS.

Conclusions: Based on non-clinical tests, the modified device ioi 353 is as safe, as effective, and perform as well as the predicate device GAIA 359 PLUS or XBIA 500. Accordingly the modified devices are substantially equivalent to the predicate device.

2

Image /page/2/Picture/0 description: The image shows the seal of the Department of Health & Human Services - USA. The seal is circular and contains the department's name around the perimeter. In the center of the seal is an abstract image of an eagle.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

Jawon Medical Co., Ltd. c/o Mr. H. L. Jung Mi Consulting Co., Ltd. Room 431, Life Officetel. 61-3 Yoido-dong, Youngdeungpo-gu Seoul, 150-731 REPUBLIC OF KOREA

OCT - 8 2009

Re: K092431

Trade/Device Name: Jawon Medical Body Composition Analyzer Model ioi 353 Regulation Number: 21 CFR §870.2770 Regulation Name: Impedance plethysmograph Regulatory Class: II Product Code: MNW Dated: September 8, 2009 Received: September 14, 2009

Dear Mr. Jung:

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), i 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.

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

3

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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/ReportaProblem/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,

Janine M. Morris

Acting Director, Division of Reproductive. Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

Attachment 1

Indications for Use Statement

510(k) Number (if known):

KO92431

Device Name: Jawon Medical Body Composition Analyzer Model ioi 353

Indications for Use:

This device is intended to estimate PBF(Percentage of Body Fat), MBF(Mass of Body Fat), LBM(Lean Body Mass), TBW(Total Body Water), BMI(Body Mass Index), BMR(Basic Metabolic Rate), Segmental LBM, ICW(Intra-Cellular Water), ECW(Extra-Cellular Water), and ratio of ECW/TBW using the BlA(Bioelectrical Impedance Analysis) method. The device measures or calculates the impedance, BMI(Body Mass Index), weight, and WHR(Waist to Hip Ratio) of the user.

This devices is intended for use only in healthy subjects between the age of 7-89.

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

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

(PLEASE NO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Ayym Wh

Page 1 of 1

(Divisid Division of Reproductive, Abdomin and Radiological Devi 510(k) Number

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