K Number
K113231
Device Name
WARP10,WARP75
Date Cleared
2012-02-27

(117 days)

Product Code
Regulation Number
890.5500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
WARP-75 is a hand held device used for the treatment of chronic pain by emitting energy in the Near-IR spectrum for the temporary relief of minor muscle and joint pain, arthritis and muscle spasm; relieving stiffness; promoting relaxation of muscle tissue; to temporarily increase local blood circulation where applied.
Device Description
The Quantum WARP Light Delivery System (WARP-75) is used for applying therapy for the mitigation of chronic pain. Quantum Devices, Inc manufactures this light delivery system. These devices are solid state and hand held for . placement directly over the skin where the treatment is to occur.
More Information

Not Found

No
The summary describes a light therapy device with no mention of AI or ML capabilities, image processing, or data analysis.

Yes
The device is described as a "therapy for the mitigation of chronic pain" and is used for "treatment of chronic pain by emitting energy". These terms clearly indicate a therapeutic purpose.

No

The device is described as being used for "treatment of chronic pain" and "applying therapy," indicating a therapeutic rather than diagnostic purpose.

No

The device description explicitly states it is a "hand held device" and a "light delivery system," indicating it is a physical hardware device that emits energy.

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

Here's why:

  • Intended Use: The intended use clearly states that the device is used for the treatment of chronic pain by emitting energy. IVDs are used for the diagnosis of diseases or conditions by examining samples from the human body (like blood, urine, tissue).
  • Device Description: The description details a hand-held device that applies light therapy directly to the skin. This is a therapeutic device, not a diagnostic one that analyzes biological samples.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples.
    • Detecting specific analytes (e.g., proteins, DNA, antibodies).
    • Providing diagnostic information.

The device described is a therapeutic device used for pain relief, not a diagnostic device used for identifying a disease or condition.

N/A

Intended Use / Indications for Use

WARP-75 is a hand held device used for the treatment of chronic pain by emitting energy in the Near-IR spectrum for the temporary relief of minor muscle and joint pain, arthritis and muscle spasm; relieving stiffness; promoting relaxation of muscle tissue; to temporarily increase local blood circulation where applied.

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

ILY

Device Description

The Quantum WARP Light Delivery System (WARP-75) is used for applying therapy for the mitigation of chronic pain. Quantum Devices, Inc manufactures this light delivery system. These devices are solid state and hand held for . placement directly over the skin where the treatment is to occur.

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

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)

Testing for the Quantum WARP 75 Light Delivery Systems has been carried out to ensure that the temperature at the skin surface where the device is applied is acceptable per IEC 60601-1 Part 42.3 (UL2601-1.

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.

K032229

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.

Not Found

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

§ 890.5500 Infrared lamp.

(a)
Identification. An infrared lamp is a device intended for medical purposes that emits energy at infrared frequencies (approximately 700 nanometers to 50,000 nanometers) to provide topical heating.(b)
Classification. Class II (special controls). The device, when it is an infrared therapeutic heating lamp, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 890.9.

0

510(k) SUMMARY OF SAFETY AND EFFECTIVENESS K113231

This summary of the 510(k) safety and effectiveness information is be submitted in accordance with the requirements of 21 CFR 807.92.

| Applicant: | Quantum Devices, Inc.
112 Orbison Street
Barneveld, WI 53507

Phone: 608-924-3000
FAX: 608-924-3007 |
|-----------------|---------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person: | Glenn Ignatius
President
Quantum Devices, Inc.
112 Orbison Street
Barneveld, WI 53507

Phone: 608-924-3000
FAX: 608-924-3007 |
| Prepared on: | February 23, 2012 |
| Model No./Name: | Quantum WARP 75 Light Delivery Systems |
| Classification: | Lamp, Infrared - 89 ILY
Physical Medicine Device, 21 CFR 890.5500 |

Description:

The Quantum WARP Light Delivery System (WARP-75) is used for applying therapy for the mitigation of chronic pain. Quantum Devices, Inc manufactures this light delivery system. These devices are solid state and hand held for . placement directly over the skin where the treatment is to occur.

Statement of Intended Use for the WARP-75:

WARP-75 is a hand held device used for the treatment of chronic pain by emitting energy in the Near-IR spectrum for the temporary relief of minor muscle and joint pain, arthritis and muscle spasm; relieving stiffness; promoting relaxation of muscle tissue; to temporarily increase local blood circulation where applied.

1

Testing Summary:

Testing for the Quantum WARP 75 Light Delivery Systems has been carried out to ensure that the temperature at the skin surface where the device is applied is acceptable per IEC 60601-1 Part 42.3 (UL2601-1.

Substantial Equivalence:

The Quantum WARP 75 Light Delivery System is substantially equivalent to the Quantum WARP 10 Light Delivery System, K032229.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features a stylized caduceus, a symbol often associated with medicine and healthcare, with three lines forming the shape of a bird. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged in a circular fashion around the caduceus.

Public Health Service

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

FEB 2 7 2012

Quantum Devices, Inc. % Waxler Regulatory Consultancy, LLC Morris Waxler, Ph.D. 1920 Arlington Place Madison, Wisconsin 53726

Re: K113231

Trade/Device Name: Quantum WARP 75 Light Delivery Systems Regulation Number: 21 CFR 890.5500 Regulation Name: Infrared lamp Regulatory Class: Class II Product Code: ILY Dated: February 15, 2012 Received: February 21, 2012

Dear Dr. Waxler:

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 - Morris Waxler, Ph.D.

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 of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) 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 vours.

erely yours,

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

Enclosure

4

Statement of Indication for Use

510(k) Number (if known): K113231

Quantum WARP 75 Light Delivery Systems Device Name:

Indications for Use:

WARP-75 is a hand held device used for the treatment of chronic pain by emitting energy in the Near-IR spectrum for the temporary relief of minor muscle and joint pain, arthritis and muscle spasm; relieving stiffness; promoting relaxation of muscle tissue; to temporarily increase local blood circulation where applied.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

OR____________________________________________________________________________________________________________________________________________________________________________ Prescription Use (Per 21 CFR 801.109)

(Division Sign-Off) (Division Sign of Surgical, Orthopedic, and Restorative Devices

510(k) Number /