K Number
K110068
Device Name
MODEL PM3030
Date Cleared
2011-12-08

(332 days)

Product Code
Regulation Number
882.5890
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
This device is intended for the relief of pain associated with sore or aching muscles of the lower back, arms, or legs due to strain from exercise or normal household and work activities.
Device Description
The PM3030 is a small, battery operated, three (3) output mode TENS device for pain relief intended for OTC use. The output modes are intended for application to the following areas: Shoulder/Arm, Lower Back and Ley/Foot. The accessories include an electrode cord / cable and electrodes pads (Long Life) which are placed on the specific body part. As above the device is battery powered there is no connection to AC mains supply.
More Information

No
The summary describes a standard TENS device with different output modes for specific body areas. There is no mention of AI, ML, or any features that would suggest adaptive or learning capabilities. The performance studies focus on waveform characteristics, not algorithmic performance.

Yes
The device is described as a TENS device intended for the relief of pain, which is a therapeutic purpose.

No
Explanation: This device, a TENS unit, is intended for pain relief by stimulating muscles, not for diagnosing medical conditions. Its function is therapeutic, not diagnostic.

No

The device description explicitly states it is a "small, battery operated, three (3) output mode TENS device" and mentions accessories like electrode cords and pads, indicating it is a hardware device with software control, not a software-only 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 relief of pain associated with sore or aching muscles. This is a therapeutic purpose, not a diagnostic one.
  • Device Description: The device is described as a TENS (Transcutaneous Electrical Nerve Stimulation) device. TENS devices deliver electrical impulses to the body for pain relief. This is a physical therapy modality, not a diagnostic test.
  • Lack of Diagnostic Elements: There is no mention of analyzing biological samples (blood, urine, tissue, etc.) or providing information about a patient's health status or disease.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device does not fit that description.

N/A

Intended Use / Indications for Use

This device is intended for the relief of pain associated with sore or aching muscles of the lower back, arms, or legs due to strain from exercise or normal household and work activities.

Product codes

NUH

Device Description

The PM3030 is a small, battery operated, three (3) output mode TENS device for pain relief intended for OTC use.

The output modes are intended for application to the following areas: Shoulder/Arm, Lower Back and Ley/Foot. The specifications of each mode will be discussed in greater detail later in this section.

The accessories include an electrode cord / cable and electrodes pads (Long Life) which are placed on the specific body part.

As above the device is battery powered there is no connection to AC mains supply.

The device has been tested to and meets the requirements of the following recognized consensus standards:

  • IEC 60601-1 Medical Electrical Equipment Part 1: General Requirements for . Safety, 1988; Amendment 1, 1991-11, Amendment 2, 1995
  • IEC 60601-1-2, Medical Electrical Equipment Part 1-2: General Requirements for Safety - Collateral standard: Electromagnetic:Compatibility - Requirements and Tests (Edition 2:2001 with Amendment 1:2004; Edition 2.1 (Edition 2:2001 consolidated with Amendment 1:2004)).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

lower back, arms, or legs

Indicated Patient Age Range

Adult

Intended User / Care Setting

Clinics, hospital and home environments

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

Performance testing has been performed that shows equivalent waveform characteristics.

Key Metrics

Not Found

Predicate Device(s)

K060846

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

Omron OTC TENS

Premarket Notification 510(k) Section 5 - 510(k) Summary

510(k) Summary Page 1 of 6 7-Jan-11

| Omron Healthcare, Inc.
1200 Lakeside Dr.

Bannockburn, IL 60015Tel - 847-247-5626
Fax - 847-680-6911
Official Contact:Mirna DiPano - Director of Quality & Regulatory
Proprietary or Trade Name:PM3030
Common/Usual Name:Stimulator, nerve, transcutaneous, over-the-counter
Classification Name/Code:NUH - stimulator, nerve, transcutaneous, over-the-counter
21 CFR 882.5890
Device:PM3030
Predicate Devices:Endurance Therapeutics, Model T1040, 510(k) K060846

Device Description:

The PM3030 is a small, battery operated, three (3) output mode TENS device for pain relief intended for OTC use.

The output modes are intended for application to the following areas: Shoulder/Arm, Lower Back and Ley/Foot. The specifications of each mode will be discussed in greater detail later in this section.

The accessories include an electrode cord / cable and electrodes pads (Long Life) which are placed on the specific body part.

As above the device is battery powered there is no connection to AC mains supply.

The device has been tested to and meets the requirements of the following recognized consensus standards:

  • IEC 60601-1 Medical Electrical Equipment Part 1: General Requirements for . Safety, 1988; Amendment 1, 1991-11, Amendment 2, 1995

1

Omron OTC TENS

510(k) Summary Page 2 of 6 7-Jan-11

  • IEC 60601-1-2, Medical Electrical Equipment Part 1-2: General Requirements for Safety - Collateral standard: Electromagnetic:Compatibility - Requirements and Tests (Edition 2:2001 with Amendment 1:2004; Edition 2.1 (Edition 2:2001 consolidated with Amendment 1:2004)).

Indications for Use:

This device is intended for the relief of pain associated with sore or aching muscles of the lower back, arms, or legs due to strain from exercise or normal household and work activities.

Environment of Use: Clinics, hospital and home environments

Contraindications:

  • Do not use this device if you have a cardiac pacemaker, implanted defibrillator, or other implanted metallic or electronic device. Such use could cause electric shock, burns, electrical interference, or death.
  • · Do not use this device together with a life-supporting medical electronic device such as an artificial heart or lung.
  • · Do not use this device together with a body-worn medical electronic device such as an ECG.

2

Premarket Notification 510(k) Section 5 – 510(k) Summary

Omron OTC TENS

510(k) Summary Page 3 of 6 7-Jan-11

Summary of substantial equivalence

AttributeModel PM3030Predicate
Endurance Model T1040
K060846
Product CodeNUHNUH, NGX, GZX
CFR882.5890882.5890, 890.5850
Indications for UseThis device is intended
for the relief of pain
associated with sore or
aching muscles of the
lower back, arms, or legs
due to strain from
exercise or normal
household and work
activities.To be used for temporary relief of
pain associated with sore and aching
muscles in the
lower back due to strain from
exercise or normal household work
activities choose
Manual modes 1, 2, 3, 4, 5, 6 or
Auto 4
To be used for temporary relief of
pain associated with sore and aching
muscles in the
upper extremities (arm) due to strain
from exercise or normal household
work activities
choose Manual modes 1, 2, 3, 4, 5,
6 or Auto 1 or Auto 3
To be used for temporary relief of
pain associated with sore and aching
muscles in the
lower extremities (leg) due to strain
from exercise or normal household
work activities
choose Manual modes 1, 2, 6 or
Autol or Auto 4
Used to stimulate healthy muscles
in order to improve and facilitate
muscle
performance choose Manual Mode
1 or Auto Mode 2
Prescription
Patient PopulationAdultNot specified
Prescriptive or OTCOTCOTC
Environment of useClinics, hospital and home environmentsNot specified
Contraindications - do not use if you have a cardiac pacemaker, implanted defibrillator or other implanted metallic or electronic deviceYesYes
Warnings standardYesYes
Precautions - standardYesYes
Adverse reactions - standardYesYes
Power source2 - AAA3 - AAA
Number of Output modes310
Number of output channels11
WaveformBiphasic
ShapeRectangular
Maximum Output Voltage (max)
500 ohm35.4 V40.7
2k ohm46.7 V105.1
10k ohm50.8 V154.1
Maximum Output Current (max)
500 ohm4.4 mA81.4
2k ohm1.7 mA47.8
10k ohm0.4 mA15.4
Maximum Phase charge (500 ohm)133 microC16.9 microC
Maximum Current Density (500 ohm)0.095 mA/cm²2.71 mA/cm²
Maximum Average Current (500 ohm)3.5 mANot specified
Maximum Average Power Density (500 ohm)89 mW/cm²10.2 mW/cm²
Frequency (Hz)