K Number
K102368
Device Name
NON-ABLATIVE WRINKLE TREATMENT HANDPIECE
Manufacturer
Date Cleared
2010-09-07

(18 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Non-ablative treatment of mild to moderate facial wrinkles and rhytides for skin phototypes I-IV Non-ablative treatment of mild to moderate facial wrinkles for skin phototypes I-IV
Device Description
The purpose of this submission is to modify the Cleaning / Disinfection methods of the Non-Ablative Wrinkle Treatment Handpiece cleared as Ellman Non-Ablative Wrinkle Treatment Handpiece under K101967. The device is identical to the device cleared under K101967 Ellman International Non-Ablative Wrinkle Treatment Handpiece except for the modified Cleaning/Disinfection method.
More Information

No
The summary explicitly states that the device is identical to the predicate device except for the cleaning/disinfection method, and there are no mentions of AI, ML, or related concepts.

Yes
The device is intended for "Non-ablative treatment of mild to moderate facial wrinkles and rhytides," which describes a therapeutic action to treat a medical condition (wrinkles and rhytides).

No
Explanation: The device is intended for non-ablative treatment of facial wrinkles, which is a therapeutic purpose, not a diagnostic one.

No

The device description explicitly states it is a "Non-Ablative Wrinkle Treatment Handpiece," which is a hardware component. The submission is for modifying the cleaning/disinfection methods of this hardware device.

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 non-ablative treatment of facial wrinkles and rhytides. This is a therapeutic/cosmetic application performed directly on the patient's skin.
  • Device Description: The device is a handpiece used for wrinkle treatment. This is a physical device applied externally.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens (like blood, urine, tissue) in vitro (outside the body) to provide information for diagnosis, monitoring, or screening.

IVD devices are specifically designed to perform tests on biological samples to provide diagnostic or other health-related information. This device's function is to treat a physical condition on the skin.

N/A

Intended Use / Indications for Use

The device has the following "Indications For Use":

  • Non-ablative treatment of mild to moderate facial wrinkles and rhytides for skin . phototypes I-IV

Product codes

GEI

Device Description

The purpose of this submission is to modify the Cleaning / Disinfection methods of the Non-Ablative Wrinkle Treatment Handpiece cleared as Ellman Non-Ablative Wrinkle Treatment Handpiece under K101967. The device is identical to the device cleared under K101967 Ellman International Non-Ablative Wrinkle Treatment Handpiece except for the modified Cleaning/Disinfection method.
The proposed method is:
Method:
Disinfect Handpiece and Cable prior to and after each procedure by wiping exterior surfaces with a lint free cloth soaked in liquid solution containing 70% Isopropyl Alcohol. Ensure surface remains wet for at least 5 minutes. An additional application of 70% Isopropyl Alcohol should be applied if the surface appears dry during the 5 minute period.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

facial

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

Ellman International has presented a successfully executed test protocol as part of this submission to demonstrate that the methods described above achieve an adequate log reduction of inoculated challenge organisms on the test devices.

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

As defined in SGS Protocol # 09A1006547 and demonstrated in SGS Report# 09A1006548

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

Not Found

Predicate Device(s)

K101967

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4400 Electrosurgical cutting and coagulation device and accessories.

(a)
Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.(b)
Classification. Class II.

0

510(K) Summary

102368

Page 1, 2

Date Prepared [21CFR 807.92(a)(1)] 8/19/2010

Submitter's Information [21CFR 807.92(a)(1)]

Mr. Jonathan Achenbach Sr. Dir. R&D, Clinical & Regulatory Affairs Ellman International Inc. 333 Royal Ave. Oceanside, NY. 11572 Telephone: 516-594-3333

SEP. 0'7 2010

The establishment registration number for Ellman International is 2428235

Trade Name, Common Name, Classification [21 CFR 807.92(a)(2)]

Trade Name

Non-Ablative Wrinkle Treatment Handpiece

Device common, usual or Classification Names

Device: Electrosurgical, cutting & coagulation & accessories

Regulation Description: Electro surgical cutting and coagulation device and accessories

Class

Classification: Class II Product Code: GEI

Device Description [21 CFR 807.92(a)(4)]

The purpose of this submission is to modify the Cleaning / Disinfection methods of the Non-Ablative Wrinkle Treatment Handpiece cleared as Ellman Non-Ablative Wrinkle Treatment Handpiece under K101967. The device is identical to the device cleared under K101967 Ellman International Non-Ablative Wrinkle Treatment Handpiece except for the modified Cleaning/Disinfection method.

The proposed method is:

Method:

Disinfect Handpiece and Cable prior to and after each procedure by wiping exterior surfaces with a lint free cloth soaked in liquid solution containing 70% Isopropyl Alcohol. Ensure surface

1

remains wet for at least 5 minutes. An additional application of 70% Isopropyl Alcohol should be applied if the surface appears dry during the 5 minute period.

Ellman International has presented a successfully executed test protocol as part of this submission to demonstrate that the methods described above achieve an adequate log reduction of inoculated challenge organisms on the test devices.

Further to this, Ellman International has presented substantial evidence to support the claims made in method above to provide an effective alternate cleaning and disinfection to the existing instructions for use.

Intended Use [21 CFR 807.92(a)(5)}

:

ﺮ ﺍ

The device has the following "Indications For Use"

  • Non-ablative treatment of mild to moderate facial wrinkles and rhytides for skin . phototypes I-IV

Technological Characteristics [21 CFR 807.92(a)(6)}

Ellman International maintains that the subject device is identical to the predicate device except for the modified cleaning and disinfection method.

Labels, Labeling [21 CFR XXXX]

Per section "Product Labels"

Performance Data [21 CFR 807.92(b)(1)]

As defined in SGS Protocol # 09A1006547 and demonstrated in SGS Report# 09A1006548

Predicate Devices [21 CFR 807.92(a)(3)(1)|

The device is substantially equivalent to the Non-Ablative Wrinkle Treatment Handpiece cleared as Ellman Non-Ablative Wrinkle Treatment Handpiece under K101967.

Consideration for Special 510(k) Status

In accordance with the FDA guidance document: The New 510(k) Paradigm - Alternate Approaches to Demonstrating Substantial Equivalence in Premarket Notifications - Final Guidance Attachment 2, Ellman Internal maintains that this change in the cleaning and disinfection method is a "Device Modification" and therefore requests that the FDA considers it as such.

As there are no technological, structural, design or intended use changes for the subject device, Ellman International believes that no further data or clinical study is required to support the position that the device is safe and effective to use with the changes delineated in the instructions for use.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/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" arranged around the perimeter. Inside the circle is a stylized representation of a human figure embracing a globe, symbolizing the department's mission to protect the health of all Americans.

Public Health Service

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

Ellman International, Inc. % Mr. Jonathan Achenbach Sr. Director R & D. Clinical And Regulatory Affairs 3333 Royal Avenue Oceanside, New York 11572

SEP 0 7 2010

Re: K102368

Trade/Device Name: Non-Ablative Wrinkle Treatment Handpiece Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical cutting and coagulation device and accessories Regulatory Class: Class II Product Code: GEI Dated: August 19, 2010 Received: August 20, 2010

Dear Mr. Achenbach:

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.

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

3

Page 2 - Mr. Jonathan Achenbach

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/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/ResourcesforYou/Industry/default.htm.

Sincerely yours.

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

Enclosure

4

"INDICATIONS FOR USE" Statement

KI 02368 510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

SEP 0 7 2010

Device Name: _________ Non-Ablative Wrinkle Treatment Handpiece

The Device has the following "Indications for Use":

Non-ablative treatment of mild to moderate facial wrinkles for skin phototypes I-IV

Prescription Use X (per 21 CFR 801.109)

ない

OR

Over-The Counter Use

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

(Optional Format 1-2-96)

Division Sign-(ft)

(Division Sign Division of Surgeal. Orthopedic, and Restorative را vices

510(k) Number K102368