K Number
K122493
Device Name
GENESISPLUS
Manufacturer
Date Cleared
2013-05-15

(272 days)

Product Code
Regulation Number
878.4810
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Cutera GenesisPlus Nd.YAG laser is intended for use in the medical specialties of general and plastic surgery, dermatology, endoscopic.laproscopic.laproscopic.label specialites of general otorhinolaryngology (ENT), neurosurgery, oculoplastics, pulmonary.hnoracis surgery, podiaty and urology for surgical and aesthetic applications.

Dermatology:
The Cutera GenesisPlus faser is intended for the coagulation and hemostasis of benign vascular lesions such as, but not limited to, rosaceal diffuse redness, poikiloderma of civatte, scar reduction (including hypertropic and keloid scars), and warts.

The Cutera GenesisPlus laser is also indicated for the treatment of wrinkles such as, but not limited to, periocular and perioral wrinkles.

The GenesisPlus laser is indicated for use on all skin types (Fitzpatrick I-VI), including tanned skin.

Podiatry:
Podiatry (ablation, vaporization, incision, excision, and coagulation of soft tissue) including:

  • Matrixectomy .
  • Periungual and subungual warts .
  • . Plantar warts
  • . Radical nail excision
  • Neuromas

The Cutera GenesisPlus laser is indicated for use for the temporary increase of clear nail in patients with onychomycosis (e.g., dermatophyton rubrum and T. mentagrophytes, and/or yeast Condida Albicans, etc.).

Device Description

The Cutera GenesisPlus Laser unit and controls are contained in a single console. Electrical power is supplied to the console by the facility's power source. Laser energy produced within the device is delivered to the tissue by means of a handpiece using a fiber optic delivery system with an optical lens at the aperture. The user activates laser emission by means of a footswitch.

The Cutera GenesisPlus Laser is designed to provide laser energy for use in a variety of dermatology and podiatry procedures.

AI/ML Overview

The Cutera GenesisPlus Laser System, under K122493, is not an AI/ML device. Therefore, the questions related to AI/ML device performance, such as sample sizes for test and training sets, ground truth establishment methods, expert qualifications, adjudication methods, and MRMC studies, are not applicable.

This submission describes a medical laser system and focuses on demonstrating substantial equivalence to a previously cleared predicate device (Cutera GenesisPlus under K103626) by comparing technical specifications and intended uses. The clinical study mentioned did not involve AI/ML performance metrics but rather evaluated the safety and effectiveness of updated treatment parameters for the podiatry indication concerning onychomycosis.

Here's the information that is applicable from your request:

1. A table of acceptance criteria and the reported device performance

The acceptance criteria for substantial equivalence are based on demonstrating that the revised Cutera GenesisPlus Laser System is as safe and effective as the predicate device (K103626) and shares similar technological characteristics and indications for use. No specific numerical performance metrics or thresholds are provided as "acceptance criteria" in the context of an algorithmic performance study, as this is a laser device modification, not an AI system.

However, the comparison tables demonstrate that the revised device either matches or has slightly modified parameters (e.g., fluence, spot size, pulse duration, repetition rate for the clear nail indication) that were deemed acceptable based on a clinical study for safety and effectiveness.

Comparison of Technical Specifications for Dermatology Indications for Use:

FeaturesCutera GenesisPlus Laser (K103626)Cutera GenesisPlus Laser (revised)
Wavelength1064nm Nd:YAG1064nm Nd:YAG
Aiming Beam630-680nm (≤ 2.5mW)630-680nm (≤ 2.5mW)
Energy per Pulse20-3500 mJ20-3500 mJ
Fluence25.5J/cm2 (with 1mm spot)25.5J/cm2 (with 1mm spot)
Power≤ 100W≤ 100W
Spot SizeUp to 13mmUp to 13mm
Pulse Duration100-3000μs100-3000μs
Output modePulsedPulsed
Repetition Rate5-100 Hz5-100 Hz
Laser MediaFlashlamp pumped solid state rodFlashlamp pumped solid state rod
User InterfaceLCD color touchscreenLCD color touchscreen

Comparison of Technical Specifications for Temporary Increase of Clear Nail Indication for Use:

FeaturesCutera GenesisPlus Laser (K103626)Cutera GenesisPlus Laser (revised)
Wavelength1064nm Nd:YAG1064nm Nd:YAG
Aiming Beam630-680nm (≤ 2.5mW)630-680nm (≤ 2.5mW)
Fluence25.5J/cm2 (with 1mm spot)15-18 J/cm2
Power≤ 100W≤ 100W
Spot Size1.0-1.5mm5mm
Pulse Duration100μs0.3ms
Output modePulsedPulsed
Repetition Rate20 Hz2-3Hz
Burst Mode Sequence½ second on, ½ second offNot applicable
Laser MediaFlashlamp pumped solid state rodFlashlamp pumped solid state rod
User InterfaceLCD color touchscreenLCD color touchscreen
Laser activationFootswitchFootswitch
Delivery Devices (How Supplied)Non-sterile, reusable, cleanableNon-sterile, reusable, cleanable

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

The document states, "A clinical study was conducted to evidence that the change to the treatment parameters for the podiatry indication is safe and effective." However, it does not specify the sample size, data provenance, or whether the study was retrospective or prospective. This information would typically be detailed in the full clinical study report, which is not provided in this summary.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

Not applicable, as this is a laser device and not an AI/ML system requiring expert-established ground truth for algorithmic performance. The clinical study would have involved physicians treating patients and evaluating outcomes.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

Not applicable, as this is a laser device and not an AI/ML system. Adjudication methods refer to how disagreements among independent readers are resolved to establish a definitive ground truth for AI model evaluation.

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

Not applicable, as this is a laser device and not an AI/ML system.

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

Not applicable, as this is a laser device and not an AI/ML system.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

For the clinical study mentioned for the temporary increase of clear nail in patients with onychomycosis, the "ground truth" would be related to clinical outcomes data, specifically the assessment of "temporary increase of clear nail." This would be determined by a clinician based on visual inspection and possibly other diagnostic methods (e.g., microscopy, culture) if the study protocol included them, though the summary does not detail the specific assessment methods.

8. The sample size for the training set

Not applicable, as this is a laser device and not an AI/ML system.

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

Not applicable, as this is a laser device and not an AI/ML system.

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K122493

Attachment 6 510(K) Summary Cutera GenesisPlus Laser System

MAY 1 5 2013

This 510(K) Summary of safety and effectiveness for the Cutera GenesisPlus Laser is submitted in accordance with the requirements of the SMDA 1990 and fide case guidance concerning the organization and content of a 510(K) summany

Applicant:Cutera, Inc.
Address:3240 Bayshore Blvd.Brisbane, CA 94005
Contact Person:Connie Hoy
Telephone:Fax:Email:415-657-5592 - phone415-715-3592 - faxchoy@cutera,com
Preparation Date:August 10, 2012
Device Trade Name:Cutera GenesisPlus Laser System
Common Name:Nd:YAG Laser
Classification Name:Instrument, Surgical, Powered, laser79-GEX, 21 CFR 878-48
LegallyMarketedPredicateDevice:Cutera GenesisPlus under K103626
Description of the CuteraGenesisPlus Laser:The Cutera GenesisPlus Laser unit and controls arecontained in a single console. Electrical power is supplied tothe console by the facility's power source. Laser energyproduced within the device is delivered to the tissue bymeans of a handpiece using a fiber optic delivery systemwith an optical lens at the aperture. The user activateslaser emission by means of a footswitch.The Cutera GenesisPlus Laser is designed to provide laserenergy for use in a variety of dermatology and podiatryprocedures.
Intended use of the CuteraGenesisPlus Laser System:The Cutera GenesisPlus Nd:YAG laser is intended for usein the medical specialties of general and plastic surgery,dermatology, endoscopic.laproscopic general surgery,gastroenterology, gynecology, otorhinolaryngology (ENT),neurosurgery, oculoplastics, orthopedics,pulmonary.thoracic surgery, podiatry and urology forsurgical and aesthetic applications.

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Attachment 6 510(K) Summarv Cutera GenesisPlus Laser System

Specific Indications:

Dermatology:

The Cutera GenesisPlus laser is intended for the coagulation and hemostasis of benign vascular lesions such as, but not limited to, rosacea/ diffuse redness, poikiloderma of civatte, scar reduction (including hypertropic and keloid scars), and warts.

The Cutera GenesisPlus laser is also indicated for the treatment of wrinkles such as, but not limited to, periocular and perioral wrinkles.

The GenesisPlus laser is indicated for use on all skin types (Fitzpatrick I-VI), including tanned skin.

Podiatry:

Podiatry (ablation, vaporization, incision, excision, and coagulation of soft tissue) including:

  • . Matrixectomy
  • Periungual and subungual warts .
  • . Plantar warts
  • . Radical nail excision
  • . Neuromas

The Cutera GenesisPlus laser is indicated for use for the temporary increase of clear nail in patients with onychomycosis (e.g., dermatophytes, Trichophyton rubrum and T. mentagrophytes, and/or yeast Candida Albicans, etc.).

Performance Data:

None

Results of Clinical Study:

A clinical study was conducted to evidence that the change to the treatment parameters for the podiatry indication is safe and effective. The study demonstrated safety and effectiveness for use for the temporary increase of clear nail.

Summary of Technological Characteristics:

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Attachment 6 510(K) Summary Cutera GenesisPlus Laser System

FeaturesCutera GenesisPlus Laser(K)103626)Cutera GenesisPlus Laser(revised)
Wavelength1064nm Nd:YAG1064nm Nd:YAG
Aiming Beam630-680nm(≤ 2.5mW)630-680nm(≤ 2.5mW)
Energy per Pulse20-3500 mJ20-3500 mJ
Fluence25.5J/cm2 (with 1mm spot)25.5J/cm2 (with 1mm spot)
Power≤ 100W≤ 100W
Spot SizeUp to 13mmUp to 13mm
Pulse Duration100-3000μs100-3000μs
Output modePulsedPulsed
Repetition Rate5-100 Hz5-100 Hz
Laser MediaFlashlamp pumped solid state rodFlashlamp pumped solid state rod
User InterfaceLCD color touchscreenLCD color touchscreen

Comparison of Technical Specification for Dermatology indications for use:

Comparison of Technical Specification for temporary increase of clear nail indication for use: .

FeaturesCutera GenesisPlus Laser(K)103626)Cutera GenesisPlus Laser(revised)
Wavelength1064nm Nd:YAG1064nm Nd:YAG
Aiming Beam630-680nm(≤ 2.5mW)630-680nm(≤ 2.5mW)
Fluence25.5J/cm2 (with 1mm spot)15-18 J/cm2
Power≤ 100W≤ 100W
Spot Size1.0-1.5mm5mm
Pulse Duration100μs0.3ms
Output modePulsedPulsed
Repetition Rate20 Hz2-3Hz
Burst ModeSequence½ second on½ second offNot applicable
Laser MediaFlashlamp pumped solid state rodFlashlamp pumped solid state rod
User InterfaceLCD color touchscreenLCD color touchscreen
Laser activationFootswitchFootswitch
Delivery Devices(How Supplied)Non-sterile, reusable, cleanableNon-sterile, reusable, cleanable

Conclusion:

The Cutera GenesisPlus Laser is substantially equivalent to the previously cleared Cutera GenesisPlus Laser (K103626). The Cutera GenesisPlus Laser is substantially equivalent in terms of indication for use and technology based on technical characteristics.

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Image /page/3/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized graphic of an abstract human figure with three flowing lines extending from its body. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged in a circular pattern around the graphic.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-002

May 15, 2013

Cutera, Inc. % Ms. Connie Hoy 3240 Bayshore Boulevard Brisbane, California 94005

Re: K122493

Trade/Device Name: Cutera GenesisPlus Laser System Regulation Number: 21 CFR 878.4810 Regulation Name: Laser surgical instrument for use in general and plastic surgery and in dermatology Regulatory Class: Class II Product Code: PDZ: GEX Dated: April 22, 2013 Received: April 23, 2013

Dear Ms. Hoy:

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

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Page 2 - Ms. Connie Hoy

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 (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/ResourcesforYou/Industrv/default.htm.

Sincerely yours,

FOR

Peter D. Rúmm -S

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

Enclosure

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Indications for Use

510(k) Number (if known):___ K 122493

Device Name : Cutera GenesisPlus Laser System

Indications for Use:

The Cutera GenesisPlus Nd.YAG laser is intended for use in the medical specialties of general and plastic surgery, dermatology, endoscopic.laproscopic.laproscopic.label specialites of general otorhinolaryngology (ENT), neurosurgery, oculoplastics, pulmonary.hnoracis surgery, podiaty and urology for surgical and aesthetic applications.

Dermatology:

The Cutera GenesisPlus faser is intended for the coagulation and hemostasis of benign vascular lesions such as, but not limited to, rosaceal diffuse redness, poikiloderma of civatte, scar reduction (including hypertropic and keloid scars), and warts.

The Cutera GenesisPlus laser is also indicated for the treatment of wrinkles such as, but not limited to, periocular and perioral wrinkles.

The GenesisPlus laser is indicated for use on all skin types (Fitzpatrick I-VI), including tanned skin.

Podiatry:

Podiatry (ablation, vaporization, incision, excision, and coagulation of soft tissue) including:

  • Matrixectomy .
  • Periungual and subungual warts .
  • . Plantar warts
  • . Radical nail excision
  • Neuromas �

The Cutera GenesisPlus laser is indicated for use for the temporary increase of clear nail in patients with onychomycosis (e.g., dermatophyton rubrum and T. mentagrophytes, and/or yeast Condida Albicans, etc.).

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

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Neil R Ogden 2013.05.09 15:16:48 -04'00' Page 1 of 1

(Division Sign-Off) for MXM Division of Surgical Devices 510(k) Number_________________________________________________________________________________________________________________________________________________________________

§ 878.4810 Laser surgical instrument for use in general and plastic surgery and in dermatology.

(a)
Identification. (1) A carbon dioxide laser for use in general surgery and in dermatology is a laser device intended to cut, destroy, or remove tissue by light energy emitted by carbon dioxide.(2) An argon laser for use in dermatology is a laser device intended to destroy or coagulate tissue by light energy emitted by argon.
(b)
Classification. (1) Class II.(2) Class I for special laser gas mixtures used as a lasing medium for this class of lasers. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 878.9.