K Number
K121305
Date Cleared
2012-09-25

(147 days)

Product Code
Regulation Number
882.5890
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Interferential Stimulation (INF) is used for symptomatic relief and management of chronic (Iongterm) intractable pain and/or as an adjunctive treatment in the management of postsurgical and post-traumatic acute pain.

External electrical neuromuscular stimulation (NMES) using biphasic output is indicated as therapeutic adjunct for: prevention or retardation of muscle disuse atrophy; relaxation of muscle spasm; muscle reeducation; maintaining and increasing the range of motion; increasing local blood circulation and as immediate postsurgical stimulation of caff muscles to prevent venous thrombosis.

Transcutaneous Electrical Nerve Stimulation (TENS) is used for the symptomatic relief and management of chronic (long-term) intractable pain and/or as an adjunctive treatment in the management of post-surgical and post-traumatic acute pain problems.

Device Description

The Impulse 3 is a portable two channel, battery operated combination electrical neuromuscular stimulator (NMES), interferential stimulator (INF), and transcutaneous electrical nerve stimulator (TENS) unit for pain control, and muscle stimulation. This device, supporting symmetric biphasic, pulsed sine, and asymmetrical biphasic waveforms can be used with the preprogrammed protocols or can be manually configured. A graphical display is provided to provide the user a verbose interface to assist in programming the configurable protocols.

The device is supplied with electrodes and electrode leads, non-replaceable batteries, wall adapter, instruction manual, and carrying case.

AI/ML Overview

The provided text describes a 510(k) premarket notification for the Sterling Medical Impulse 3 Stimulator. This type of submission focuses on demonstrating substantial equivalence to a legally marketed predicate device, rather than proving enhanced effectiveness through clinical studies. Therefore, the information typically found in a clinical study report for an AI/ML device (e.g., sample size, expert qualifications, adjudication methods, effect size of AI assistance, standalone performance) is not directly applicable or available in this document.

Instead, the acceptance criteria for this device are based on demonstrating that its technological characteristics and performance are substantially equivalent to existing predicate devices, and that any differences do not raise new questions of safety or effectiveness. The study that proves this is a non-clinical performance summary based on bench testing and comparison to the specifications of predicate devices.

Here's a breakdown of the requested information based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria are implicitly defined by the parameters of the predicate devices. The device performance is reported by comparing its specifications directly against those of the predicate devices. Due to the extensive nature of the comparison, only a summary of key parameters is provided below. The full details are elaborated in the tables within the original document.

Parameter CategoryAcceptance Criteria (based on predicate ranges/values)Reported Device Performance (Impulse 3)
General Device Parameters
Power Source (Primary)Comparable to predicate lithium-ion/AA/9V batteries2x 750mA, 3.7V, Li-ion, rechargeable
Patient Leakage Current (Normal Condition)≤ 11µA (predicate range)7µA
Patient Leakage Current (Single Fault)≤ 116µA (predicate range)98µA
Avg DC Current (device on, no pulses)≤ 1µA (predicate)1µA
Output ModesTENS, NMES, INF (combination of predicates)3 (TENS, NMES, INF)
Number of Output Channels2 or 4 (predicate range)2
Regulated Current/VoltageRegulated Current (all predicates)Regulated Current
Software/Firmware/Microprocessor ControlYes (all predicates)Yes
Automatic No-Load TripYes or No (some predicates have it)Yes (turns off after 1 minute)
Automatic Shut OffYes (all predicates)Yes (after prescribed program)
User Override ControlYes (all predicates)Yes
Indicator DisplaysOn/Off, Low Battery, Voltage/Current (all predicates)Yes (all)
Timer Range1-60 minutes (all predicates)1-60 minutes
Compliance to Voluntary StandardsYes (all predicates)Yes
Compliance to 21 CFR 898Yes (all predicates)Yes
Weight4.48 oz. to 11.4 oz. (predicate range)6.50 oz.
DimensionsComparable to predicate devices3.1" x 4.8" x 1.3"
Housing MaterialsPlastic, ABS plasticABS 94 HB Plastic Body
TENS Mode Parameters
WaveformPulsed asymmetrical biphasic (predicates)Pulsed asymmetrical biphasic
ShapeRectangular (predicates)Rectangular
Max Output VoltageVaries, e.g., 27.5V-96V @ 500Ω (predicate range)40.6V @ 500Ω (within range)
Max Output CurrentVaries, e.g., 43mA-96mA @ 500Ω (predicate range)81.3mA @ 500Ω (within range)
Pulse Duration10-450µs (predicate range)50-300µs
Frequency1-120 pps (all predicates)1-120 pps
Max Phase Charge16.5µC - 24.0µC @ 500Ω (predicate range)21.7µC @ 500Ω (within range)
Max Current Density0.42mA/cm² - 0.74mA/cm² @ 500Ω (predicate range)0.70mA/cm² @ 500Ω (within range)
Max Avg Current1.98mA - 3.60mA (predicate range)2.61mA (within range)
Max Avg Power Density2.18mW/cm² - 6.91mW/cm² (predicate range)4.81mW/cm² (within range)
Burst Mode (Pulses per burst, Bursts per second, Burst duration, Duty Cycle)Comparable to Sterling TENS & QuadStar IIComparable
Effect of battery/charger voltage variationsNone, output not affected (QuadStar II baseline)None, output not affected
INF Mode Parameters
WaveformSymmetrical biphasic (predicates)Symmetrical biphasic
ShapeSinusoidal, Square (predicates)Sinusoidal
Max Output VoltageVaries, e.g., 17.1V-40.6V @ 500Ω (predicate range)26.7V @ 500Ω (within range)
Max Output CurrentVaries, e.g., 34mA-66mA @ 500Ω (predicate range)53mA @ 500Ω (within range)
Pulse Duration250µs (predicates)250µs
Frequency4000-4150Hz (predicates)4000-4150Hz
Max Phase Charge4.28µC-5.73µC @ 500Ω (predicate range)4.72µC @ 500Ω (within range)
Max Current Density1.37mA/cm² - 1.92mA/cm² @ 500Ω (predicate range)1.92mA/cm² @ 500Ω (within range)
Max Avg Current34.2mA - 45.8mA (predicate range)37.8mA (within range)
Max Avg Power Density23.4mW/cm²-42.0mW/cm² (predicate range)36.3mW/cm² (within range)
NMES AC Mode Parameters
WaveformPulsed symmetrical biphasic (predicates)Pulsed symmetrical biphasic
ShapeRectangular (predicates)Rectangular
Max Output VoltageVaries, e.g., 28.6V-66.4V @ 500Ω (predicate range)26.4V @ 500Ω (comparable)
Max Output CurrentVaries, e.g., 53mA-64mA @ 500Ω (predicate range)53mA @ 500Ω (comparable)
Pulse Duration50-400µs (predicate range)50-300µs
Frequency1-120 pps (predicates)1-120 pps
Max Phase Charge31.7µC-34.3µC @ 500Ω (predicate range)31.7µC @ 500Ω (within range)
Max Current Density0.62mA/cm² - 0.72mA/cm² @ 500Ω (predicate range)0.72mA/cm² @ 500Ω (within range)
Max Avg Current3.8mA - 4.13mA (predicate range)3.8mA (within range)
Max Avg Power Density4.74mW/cm² - 5.11mW/cm² (predicate range)5.11mW/cm² (within range)
Burst Mode ON/OFF Time0-99 seconds / 0-99 seconds (predicates)1-99 seconds / 0-99 seconds
NMES Russian Mode Parameters
WaveformGated symmetrical biphasic (predicates)Gated symmetrical biphasic
ShapeRectangular (predicates)Rectangular
Max Output VoltageVaries, e.g., 28.7V-36.6V @ 500Ω (predicate range)26.4V @ 500Ω (comparable)
Max Output CurrentVaries, e.g., 57mA-17.3mA @ 500Ω (predicate range)53mA @ 500Ω (comparable)
Pulse Duration400µs (predicates)400µs
Frequency50Hz (predicates)50Hz
Max Phase Charge21.1µC-23.0µC @ 500Ω (predicate range)21.1µC @ 500Ω (within range)
Max Current Density1.6mA/cm² - 1.9mA/cm² @ 500Ω (predicate range)1.9mA/cm² @ 500Ω (within range)
Max Avg Current26.4mA - 28.7mA (predicate range)26.4mA (within range)
Max Avg Power Density33.0mW/cm²-35.5mW/cm² (predicate range)35.5mW/cm² (within range)
Burst Mode ON/OFF Time1-99 seconds / 0-99 seconds (predicates)1-99 seconds / 0-99 seconds

2. Sample size used for the test set and the data provenance

  • Test Set Sample Size: Not applicable in the context of an electrical stimulator 510(k) submission based on bench testing. The "test set" here refers to the device itself and its measured output parameters.
  • Data Provenance: The data comes from the technical specifications and measurements of the Sterling Medical Impulse 3 Stimulator and the predicate devices. This is non-clinical, controlled bench testing data, not human patient data.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

  • Number of Experts: Not applicable. The "ground truth" for electrical stimulation parameters is established through engineering measurements and adherence to industry standards, not expert medical opinion.
  • Qualifications of Experts: N/A.

4. Adjudication method for the test set

  • Adjudication Method: Not applicable. The "test set" involves comparing technical specifications and measurements, which are quantitative and objectively verifiable, not subjective interpretations requiring adjudication.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

  • MRMC Study: No. This is not a diagnostic device involving human readers or AI assistance.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

  • Standalone Performance: Not applicable. This device is an electrical stimulator, not an algorithm, and does not have "human-in-the-loop" performance in the sense of a diagnostic AI. Its performance is inherent in its electrical output and functional controls.

7. The type of ground truth used

  • Ground Truth Type: Engineering specifications, measured electrical parameters (voltage, current, pulse duration, frequency, etc.), and compliance with voluntary standards (e.g., IEC 60601-1). The "ground truth" is established by these objective, quantifiable technical measures.

8. The sample size for the training set

  • Training Set Sample Size: Not applicable. This device does not use an AI/ML algorithm that requires a training set.

9. How the ground truth for the training set was established

  • Ground Truth Establishment for Training Set: Not applicable, as there is no training set for an AI/ML algorithm.

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SEP 2 5 2012

510(k) Summary 5

ADMINISTRATIVE INFORMATION

Manufacturer Name:Armstrong Industries, Inc.
Contact Person:Ralph Armstrong, President and CEO
Official Correspondent:John Stanley, Vice President and General Manager
Establishment Registration Number:K121305
Performance Standard(s):Guidance Document for Powered Muscle Stimulator510(k), issued June 9, 1999.
Name of Device:
Trade Name:Sterling Medical Impulse 3 Stimulator
Common Name:TENS, NMES, and INF External stimulator
Regulation Numbers:21 CFR 882.5890
Regulation Class:II
Panel Name:Neurology
Product Code:GZJ, IPF, LIH

ldentification of Predicate Device(s):

ManufacturerDevice510(k) Number
Biomedical Life Systems, Inc.BMLS04-1 (QuadStar II)K041388
Newwave Medical, LLCSmartwave IF 2000K003631
Newwave Medical, LLCSmartwave MS 2000K041063
Armstrong Industries, Inc.Sterling TENSK891118

Intended Use Statement

The Impulse 3, when in interferential stimulation (INF) mode, may be used for symptomatic relief and management of chronic (long-term) intractable pain and/or as an adjunctive treatment in the management of postsurgical and post-traumatic acute pain.

The Impulse 3, when in neuromuscular stimulation (NMES) mode, may be used as therapeutic adjunct for: prevention or retardation of muscle disuse atrophy; relaxation of muscle spasm; muscle reeducation; maintaining and increasing the range of motion; increasing local blood

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circulation and as immediate postsurgical stimulation of calf muscles to prevent venous thrombosis.

The Impulse 3, when in Transcutaneous Electrical Nerve Stimulation (TENS) mode, may be used for the symptomatic relief and management of chronic (long-term) intractable pain and/or as an adjunctive treatment in the management of post-surgical and post-traumatic acute pain problems.

This is a prescription device and should be used under medical supervision.

Device Description

The Impulse 3 is a portable two channel, battery operated combination electrical neuromuscular stimulator (NMES), interferential stimulator (INF), and transcutaneous electrical nerve stimulator (TENS) unit for pain control, and muscle stimulation. This device, supporting symmetric biphasic, pulsed sine, and asymmetrical biphasic waveforms can be used with the preprogrammed protocols or can be manually configured. A graphical display is provided to provide the user a verbose interface to assist in programming the configurable protocols.

The device is supplied with electrodes and electrode leads, non-replaceable batteries, wall adapter, instruction manual, and carrying case.

Predicate Device Comparison

The Impulse 3 unit has similar intended use, operating principles, and modes of operation. Based on the predicate product comparison, Sterling Medical has determines that no new issues of safety and effectiveness have been raised with this 510(k) submission.

ParameterThis submissionPredicate devicePredicate devicePredicate devicePredicate device
510(k) NumberK121305K041388K041063K891118K003631
Device Name and ModelSterlingMedicalImpulse 3QuadStar IISmartwave MS2000Sterling TENSSmartwave IF2000
ManufacturerArmstrongIndustries, Inc.BioMedical LifeSystems, Inc.NewwaveMedical, LLCArmstrongIndustries, Inc.NewwaveMedical, LLC
Primary Power Source: Number, Size,and Type of Batteries2x 750mA,3.7V, LC14500,Li-ion,rechargeable,not userreplaceable4x AA Batteries,LR69V Battery9V Battery9V Battery
Optional Power Source and BatteryChargerWall adapter,In: 100-240vac,50-60Hz,Out: 9V, 1.3A,UL60601approvedWall adapter,In: 120vac,60Hz,Out: 9V, 1.0AWall adapter,In: 100 -120vac, 50-60Hz,Out: 9V, 1.0AN/AWall adapter,In: 100 -120vac, 50-60Hz,Out: 9V, 1.0A
Method of Line Current IsolationTransformercoupled-Transformercoupled--
Patient Leakage Current- Normal Condition$7\mu A$$11\mu A$$3.2\mu A$N/A$3.2\mu A$

Comparison to the 510(k) Cleared Predicate Devices:

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Single fault condition$98μA$$116μA$$6.5μA$$6.5μA$
Average DC current through electrodeswhen device is on but no pulses arebeing applied (µA)$1μΑ$$1μΑ$$1μA$$1 μΑ$
Number of Output Modes3, TENS, NMES,and INF3, TENS, NMES,and INF1, NMES1, TENS1, INF
Number of output channels24222
Output Channels: Synchronous orAlternating?TENS -SynchronousINF -SynchronousNMES - BothTENS -SynchronousINF -SynchronousNMES - BothNMES - BothTENS -SynchronousINF -Synchronous
Output Channels: Method of ChannelisolationTransformerCoupledTransformerCoupledTransformerCoupledTransformerCoupledTransformerCoupled
Regulated Current or RegulatedVoltage?RegulatedCurrentRegulatedCurrentRegulatedCurrentRegulatedCurrentRegulatedCurrent
Software/Firmware/MicroprocessorControl?YesYesYesYesYes
Automatic Overload Trip?NoNoNoNoNo
Automatic No-Load Trip?Yes, If the unitis not used, itwill turn itselfoff after 1minute.NoYes, If the unitis not used, itwill turn itselfoff after 10minutes.NoYes, If the unitis not used, itwill turn itselfoff after 10minutes.
Automatic Shut Off?Yes, the unitturns off afterthe prescribedprogram.Yes, the unitturns off afterthe prescribedprogram.Yes, the unitturns off afterthe prescribedprogram.Yes, the unitturns off afterthe prescribedprogram.Yes, the unitturns off afterthe prescribedprogram.
User Override Control?Yes, the usercan turn theunit offYes, the usercan turn theunit offYes, the usercan turn theunit offYes, the usercan turn theunit offYes, the usercan turn theunit off
Indicator Display: On/Off Status?YesYesYesYesYes
Indicator Display: Low Battery?YesYesYesYesYes
Indicator Display: Voltage/CurrentLevel ?YesYesYesControl dialsare numberedYes
Timer Range (minutes)1 to 60 minutes1 to 60 minutes1 to 60 minutes1 to 60 minutes1 to 60 minutes
Compliance with Voluntary Standards?YesYesYesYesYes
Compliance with 21 CFR 898?YesYesYesYesYes
Weight (lb., oz)6.50 oz.11.4 oz.6.24 oz.4.48 oz.6.24 oz.
Dimensions (in.) [W x H x D]3.1" x 4.8" x1.3"6.3" x 2.75" x1.25"4.7" x 2.8" x1.0"3.66" x 2.44" x1.10"4.7" x 2.8" x1.0"
Housing Materials and ConstructionABS 94 HBPlastic BodyWith MoldedRubber SidesPlasticABS plasticinjectionmoldedPlasticABS plasticinjectionmolded

Table for the Comparison of Output Specifications for TENS Mode:

.

ParameterImpulse 3QuadStar IISmartwave MS2000Sterling TENSSmartwave IF2000
Mode or Program NameTENSTENSN/ATENSN/A
Waveform (e.g., pulsed monophasic,biphasic)PulsedasymmetricalbiphasicPulsedasymmetricalbiphasicN/APulsedassymetricalbiphasicN/A
Shape (e.g., rectangular, spike, rectifiedsinusoidal)RectangularRectangularN/ARectangularN/A
Maximum Output Voltage (volts)(+/-5%)40.6V @ 500Ω50.2V @ 2kΩ53.4V @ 10kΩ48V @ 500Ω86V @ 2kΩ96V @ 10kΩN/A27.5V @ 500ΩN/A
Maximum Output Current (specifyunits) (+/- 5%)81.3mA @500Ω25.1mA @ 2kΩ5.3mA @ 10kΩ96mA @ 500Ω43mA @ 2kΩ9.6mA @ 10kΩN/A55mA @ 500ΩN/A
Duration of primary (depolarizing)50 to 300µs in10 to 250µs inN/A50 to 450µs, >N/A

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phase (µs)steps of 5µssteps of 5µs300µs limitsVoltage
Pulse Duration (µs)50 to 300µs insteps of 5µs10 to 250µs insteps of 5µs50 to 450µs, >300µs limitsVoltage
Frequency (Hz) [or Rate (pps)]1 to 120 pps insteps of 1 pps1 to 120 pps insteps of 1 pps1 to 120 pps
For multiphasic waveforms only:Symmetrical phased?NoNoNo
For multiphasic waveforms only: PhaseDuration (include units) (state range, ifapplicable)(both phases, ifasymmetrical)2ms20 to 500µs100 to 1000µs
Net Charge (microcoulombs (µC) perpulse (If zero, state method ofachieving 0 net)0 net DC, + and- pulses cancel0 net DC, + and- pulses cancel0 net DC, + and- pulses cancel
Maximum Phase Charge (µC)21.7µC @ 500Ω24.0µC @ 500Ω16.5µC
Maximum Current Density (mA/cm2,r.m.s.)0.70mA/cm2 @500 Ω0.74mA/cm2 @500 Ω0.42mA/cm2 @500 Ω
Maximum Average Current (averageabsolute value), mA2.61mA3.60mA1.98mA
Maximum Average Power Density(W/cm2), (using smallest electrodeconductive surface area)4.81mW/cm26.91mW/cm22.18mW/cm2
Burst Mode: Pulses per burst787
Burst Mode: Bursts per second222
Burst Mode: Burst duration (seconds)0.085ms (7pulses @ 85Hz)0.250ms (8pulses @ 32Hz)0.085ms (7pulses @ 85Hz)
Burst Mode: Duty Cycle0.42%0.4%0.42%
Burst Mode: ON Time (seconds)If selected,burst mode isconstantIf selected,burst mode isconstantIf selected,burst mode isconstant
Burst Mode: OFF Time (seconds)N/AN/AN/A
Effect on Maximum Phase Charge(representative) as battery voltagevaries from 5.5V to 8.4VNone, outputnot affected bybatteryvariations
Effect on Maximum Phase Charge(representative) as charger voltagevaries from 6.75V to 11.25V, nobatteries.None, outputnot affected bybatteryvariations
Additional Features (specify, ifapplicable)

Table for the Comparison of Output Specifications for INF Mode:

1999 - 1999 - 1999

:

ParameterImpulse 3QuadStar IISmartwave MS 2000Sterling TENSSmartwave IF 2000
Mode or Program NameINFINFN/AN/AINF
Waveform (e.g., pulsed monophasic, biphasic)Symmetrical biphasicSymmetrical biphasicN/AN/ASymmetrical biphasic
Shape (e.g., rectangular, spike, rectified sinusoidal)SinusoidalSquareN/AN/ASinusoidal
Maximum Output Voltage (volts)(+/- 5%)26.7V @ 500Ω33.2V @ 2kΩ35.4V @ 10kΩ17.1V @ 500Ω26.4V @ 2kΩ29.2V @ 10kΩN/AN/A32.4V @ 500Ω38.0V @ 2kΩ40.6V @ 10kΩ
Maximum Output Current (specify units) (+/- 5%)53mA @ 500Ω16.6mA @ 2kΩ3.5mA @ 10kΩ34mA @ 500Ω13.2mA @ 2kΩ2.9mA @ 10kΩN/AN/A66mA @ 500Ω19.1mA @ 2kΩ4.1mA @ 10kΩ
Duration of primary (depolarizing) phase (μs)125μs125μsN/AN/A125μs
Pulse Duration (μs)250μs250μsN/AN/A250μs
Frequency (Hz) [or Rate (pps)]4000Hz – 4150Hz in steps4000Hz – 4150Hz in stepsN/AN/A4000Hz – 4150Hz in steps

.

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of 1Hzof 1Hzof 1Hz
For multiphasic waveforms only:Symmetrical phased?YesYesYes
For multiphasic waveforms only: PhaseDuration (include units) (state range, ifapplicable)(both phases, ifsymmetrical)250 $\mu$ s250 $\mu$ s250 $\mu$ s
Net Charge (microcoulombs ( $\mu$ C) perpulse (If zero, state method ofachieving zero net charge)0 net DC, + and- pulses cancel0 net DC, + and- pulses cancel0 net DC, + and- pulses cancel
Maximum Phase Charge ( $\mu$ C)4.72 $\mu$ C @ 500 $\Omega$4.28 $\mu$ C @ 500 $\Omega$5.73 $\mu$ C @ 500 $\Omega$
Maximum Current Density (mA/cm $²$ , r.m.s.)1.92mA/cm $²$ @500 $\Omega$1.37mA/cm $²$ @500 $\Omega$1.83mA/cm $²$ @500 $\Omega$
Maximum Average Current (averageabsolute value), mA37.8mA34.2mA45.8mA
Maximum Average Power Density(W/cm $²$ ), (using smallest electrodeconductive surface area)36.3mW/cm $²$23.4mW/cm $²$42.0mW/cm $²$
Burst Mode: Pulses per burstN/AN/AN/A
Burst Mode: Bursts per secondN/AN/AN/A
Burst Mode: Burst duration (seconds)N/AN/AN/A
Burst Mode: Duty CycleN/AN/AN/A
Burst Mode: ON Time (seconds)N/AN/AN/A
Burst Mode: OFF Time (seconds)N/AN/AN/A
Effect on Maximum Phase Charge(representative) as battery voltagevaries from 5.5V to 8.4VNone, outputnot affected bybatteryvariations
Effect on Maximum Phase Charge(representative) as charger voltagevaries from 6.75V to 11.25V, nobatteries.None, outputnot affected bybatteryvariations
Additional Features (specify, ifapplicable)

1121305

Table for the Comparison of Output Specifications for NMES AC Mode:

·

ParameterImpulse 3QuadStar IISmartwave MS2000*Sterling TENSSmartwave IF2000
Mode or Program NameNMESNMESNMESN/AN/A
Waveform (e.g., pulsed monophasic,biphasic)Pulsedsymmetricalbiphasic (AC)Pulsedsymmetricalbiphasic (AC)Pulsedsymmetricalbiphasic (AC)
Shape (e.g., rectangular, spike, rectifiedsinusoidal)RectangularRectangularRectangular
Maximum Output Voltage (volts)(+/-5%)26.4V @ 500Ω36.4V @ 2kΩ40.8V @ 10kΩ32V @ 500Ω60V @ 2kΩ66.4V @ 10kΩ28.6V @ 500Ω35.5V @ 2kΩ38.3V @ 10kΩ
Maximum Output Current (specifyunits) (+/- 5%)53mA @ 500Ω18.2mA @ 2kΩ4.1mA @ 10kΩ64mA @ 500Ω30.0mA @ 2kΩ6.6mA @ 10kΩ57.2mA @ 500Ω17.8mA @ 2kΩ3.8mA @ 10kΩ
Duration of primary (depolarizing)phase (µs)50 to 300µs insteps of 5µs50 to 400µs insteps of 5µs50 to 300µs insteps of 50µs
Pulse Duration (µs)50 to 300µs insteps of 5µs50 to 400µs insteps of 5µs50 to 300µs insteps of 50µs
Frequency (Hz) [or Rate (pps)]1 to 120 pps insteps of 1 pps1 to 120 pps insteps of 1 pps1 to 120 pps insteps of 1 pps
For multiphasic waveforms only:Symmetrical phased?YesYesYes

:

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For multiphasic waveforms only: Phase Duration (include units) (state range, if applicable)(both phases, if asymmetrical)Second phase identical in width and shape but opposite polarity.Second phase identical in width and shape but opposite polarity.Second phase identical in width and shape but opposite polarity.
Net Charge (microcoulombs (µC) per pulse (If zero, state method of achieving zero net charge)Zero net DC, + and - pulses cancelZero net DC, + and - pulses cancelZero net DC, + and - pulses cancel
Maximum Phase Charge (µC)31.7µC @ 500Ω32.0µC @ 500Ω34.3µC @ 500Ω
Maximum Current Density (mA/cm², r.m.s.)0.72mA/cm2 @ 500 Ω0.63mA/cm² @ 500 Ω0.62mA/cm² @ 500 Ω
Maximum Average Current (average absolute value), mA3.8mA3.84mA4.13mA
Maximum Average Power Density (W/cm²), (using smallest electrode conductive surface area)5.11mW/cm24.92mW/cm²4.74mW/cm²
Burst Mode: Pulses per burstN/AN/AN/A
Burst Mode: Bursts per secondN/AN/AN/A
Burst Mode: Burst duration (seconds)N/AN/AN/A
Burst Mode: Duty CycleN/AN/AN/A
Burst Mode: ON Time (seconds)1 to 99 seconds0 to 99 seconds1 to 99 seconds
Burst Mode: OFF Time (seconds)0 to 99 seconds0 to 99 seconds0 to 99 seconds
Effect on Maximum Phase Charge (representative) as battery voltage varies from 5.5V to 8.4VNone, output not affected by battery variationsNone, output not affected by battery variations
Effect on Maximum Phase Charge (representative) as charger voltage varies from 6.75V to 11.25V, no batteries.None, output not affected by battery variations
Additional Features (specify, if applicable)

Table for the Comparison of Output Specifications for NMES Russian Mode:

ParameterImpulse 3QuadStar IIMS2000Sterling TENSSmartwave IF 2000
Mode or Program NameNMESNMESNMESN/AN/A
Waveform (e.g., pulsed monophasic, biphasic)Gated symmetrical biphasic (Russian)Does not supportGated symmetrical biphasic (Russian)N/AN/A
Shape (e.g., rectangular, spike, rectified sinusoidal)RectangularN/ARectangularN/AN/A
Maximum Output Voltage (volts)(+/- 5%)26.4V @ 500Ω36.4V @ 2kΩ40.8V @ 10kΩN/A28.7V @ 500Ω34.6V @ 2kΩ36.6V @ 10kΩN/AN/A
Maximum Output Current (specify units) (+/- 5%)53mA @ 500Ω18.2mA @ 2kΩ4.1mA @ 10kΩN/A57mA @ 500Ω17.3mA @ 2kΩ3.7mA @ 10kΩN/AN/A
Duration of primary (depolarizing) phase (μs)200μsN/A200μsN/AN/A
Pulse Duration (μs)400μsN/A400μsN/AN/A
Frequency (Hz) [or Rate (pps)]50HzN/A50HzN/AN/A
For multiphasic waveforms only: Symmetrical phased?YesN/AYesN/AN/A
For multiphasic waveforms only: Phase Duration (include units) (state range, if applicable)(both phases, if asymmetrical)Second phase identical is width and shape but opposite polarity.N/ASecond phase identical is width and shape but opposite polarity.N/AN/A
Net Charge (microcoulombs (μC) perZero net DC, +N/AZero net DC. +N/AN/A

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K12/305

pulse (If zero, state method ofachieving zero net charge)and - pulsescanceland - pulsescancel
Maximum Phase Charge (μC)21.1μC @ 500Ω23.0μC @ 500Ω
Maximum Current Density (mA/cm², r.m.s.)1.9mA/cm² @ 500Ω1.6mA/cm² @ 500Ω
Maximum Average Current (average absolute value), mA26.4mA28.7mA
Maximum Average Power Density (W/cm²), (using smallest electrode conductive surface area)35.5mW/cm233.0mW/cm²
Burst Mode: Pulses per burst5050
Burst Mode: Bursts per second5050
Burst Mode: Burst duration (seconds)10mSec10mSec
Burst Mode: Duty Cycle50%50%
Burst Mode: ON Time (seconds)1 to 99 seconds1 to 99 seconds
Burst Mode: OFF Time (seconds)0 to 99 seconds0 to 99 seconds
Effect on Maximum Phase Charge (representative) as battery voltage varies from 5.5V to 8.4VNone, output not affected by battery variations
Effect on Maximum Phase Charge (representative) as charger voltage varies from 6.75V to 11.25V, no batteries.None, output not affected by battery variations
Additional Features (specify, if applicable)

Performance Summary (non-clinical)

Compliance to applicable voluntary standards includes IEC 60601-1, Medical Electrical Equipment Part 1: General Requirements for Safety, 1988, Amendment 1, 1991-11, Amendment 2, 1995.

Testing has been included in the premarket notification to demonstrate equivalence to the predicate devices and meets the "Guidance Document for Powered Muscle Stimulators," dated June 9, 1999.

Conclusion

The Sterling Medical Impulse 3 combination stimulator has the same intended use and similar technological characteristics as the BMLS04-1 (K041388) marketed by Biomedical Life Systems, Inc. In addition, the Impulse 3 supports three modes and has the same intended use and similar technological characteristics as the single mode predicate devices. The Impulse 3 in neuromuscular (NMES) mode has the same intended use and similar technological characteristics as the MS 2000 (K041063) marketed by Newwave Medical, LLC. The Impulse 3 in interferential (INF) mode has the same intended use and similar technological characteristics as the IF 2000 (K003631) marketed by Newwave Medical, LLC. The Impulse 3 in transcutaneous electrical nerve stimulator (TENS) mode has the same intended use and similar technological characteristics as the Sterling TENS (K891118) marketed by Armstrong Industries, Inc.

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Bench testing contained in this submission demonstrates that any differences in their technological characteristics to not raise any new questions of safety or effectiveness. Therefore, the Sterling Medical Impulse 3 is substantially equivalent to the predicate devices.

and the same of the same of the same of

:

.

:

.

Children Children Children

.

.

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Image /page/8/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" around the top half of the circle. The bottom half of the circle contains the words "OF HEALTH & HUMAN" on the left and "SERVICES • USA" on the right. Inside the circle is an abstract image of an eagle.

DEPARTMENT OF HEALTH & HUMAN SERVICES

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

SEP 25 2012

Armstrong Industries, Inc. c/o Mr. Ralph Armstrong President and CEO 7290 Virginia Pkwy, Suite 3000 McKinney, TX 75071

Re: K121305

Trade/Device Name: Sterling Medical Impulse 3 Stimulator Regulation Number: 21 CFR 882.5890 Regulation Name: Transcutaneous Electrical Nerve Stimulator for Pain Relief Regulatory Class: II Product Code: GZJ, IPF, LIH Dated: Not Dated Received: September 6, 2012

Dear Mr. Armstrong:

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 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

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Page 2 - Mr. Ralph Armstrong

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/CDRH0ffices/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.

Kesia Alexander

Malvina B. Eydelman, M.D. Director Division of Ophthalmic, Neurological, and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use Statement 4

510(k) Number (if known): __K121305

Device Name: Sterling Medical Impulse 3 Stimulator

Indications for Use:

Interferential Stimulation (INF) is used for symptomatic relief and management of chronic (Iongterm) intractable pain and/or as an adjunctive treatment in the management of postsurgical and post-traumatic acute pain.

External electrical neuromuscular stimulation (NMES) using biphasic output is indicated as therapeutic adjunct for: prevention or retardation of muscle disuse atrophy; relaxation of muscle spasm; muscle reeducation; maintaining and increasing the range of motion; increasing local blood circulation and as immediate postsurgical stimulation of caff muscles to prevent venous thrombosis.

Transcutaneous Electrical Nerve Stimulation (TENS) is used for the symptomatic relief and management of chronic (long-term) intractable pain and/or as an adjunctive treatment in the management of post-surgical and post-traumatic acute pain problems.

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

Over-The-Counter Use · (Part 21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ØDE)

Elll Cl

(Division Sign-Off) Division of Ophthalmic, Neurological and Ear, Nose and Throat Devices

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510(k) Number K121305

§ 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).