K Number
K123636
Device Name
H200 WIRELESS HAND REHABILITATION SYSTEM WITH OPTIONAL INTELLI-CONNECT EARPIECE TRIGGERING DEVICE
Manufacturer
Date Cleared
2013-05-01

(159 days)

Product Code
Regulation Number
882.5810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The NESS H200® Wireless Hand Rehabilitation System is an electrical stimulation device indicated for the following uses: Functional Electrical Stimulation (FES): - Improvement of hand function and active range of motion in patients with hemiplegia due to stroke or upper limb paralysis due to C5 spinal cord injury NeuroMuscular Electrical Stimulation (NMES): - Maintenance and/or increase of range of motion - - Prevention and/or retardation of disuse atrophy l - Increase of local blood circulation - - Reduction of muscle spasm — - Muscle re-education | The Intelli-Connect is an optional accessory device used exclusively with the H200 Wireless System. The Intelli-Connect is used to trigger the H200 Wireless Orthosis through simple jaw movements.
Device Description
The NESS H200 System consists of the following components: - Functional Stimulation (FS) Orthosis with a Radio Frequency (RF) Stim Unit . - Control Unit . - . Intelli-Connect triggering device optional accessory, consisting of an earpiece, a charger and connecting cable The Intelli-Connect Earpiece triggering device is fitted over the ear and detects clicks of the teeth to wirelessly trigger the stimulation unit of the H200 Wireless orthosis. Software built into the Intelli-Connect earpiece is designed to register and work exclusively with the patient's orthosis. The Earpiece is rechargeable with a lithium-polymer battery. It is FCC identified and meets part 15 of the FCC regulations. Once the earpiece is turned on, Intelli-Connect will trigger stimulation when teeth are clicked together.
More Information

Not Found

No
The summary describes a device that uses electrical stimulation and a jaw-movement triggered switch. There is no mention of AI or ML algorithms for data analysis, pattern recognition, or adaptive control. The software mentioned appears to be for basic device function and registration.

Yes
The device is indicated for various therapeutic uses such as improvement of hand function, prevention of disuse atrophy, increase of local blood circulation, and reduction of muscle spasm.

No

This device is an electrical stimulation device intended for therapeutic purposes like improving hand function, maintaining range of motion, and preventing atrophy. It does not perform diagnostic functions.

No

The device description explicitly lists hardware components including a Functional Stimulation (FS) Orthosis with an RF Stim Unit, a Control Unit, and the Intelli-Connect triggering device which consists of an earpiece, charger, and connecting cable. The performance studies also include testing for hardware-specific requirements like electrical safety, EMC, battery safety, and mechanical properties.

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

Here's why:

  • Intended Use: The intended use clearly describes the device as an electrical stimulation system for rehabilitation purposes, specifically for improving hand function and addressing issues related to muscle function and range of motion. This is a therapeutic and rehabilitative use, not a diagnostic one.
  • Device Description: The description details components like an orthosis, control unit, and a triggering device that uses jaw movements. These are all consistent with a physical therapy or rehabilitation device, not a device used to test samples from the human body.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens derived from the human body (like blood, urine, tissue, etc.) to provide information for diagnosis, monitoring, or screening.
  • Performance Studies: The performance studies focus on electrical safety, EMC, battery safety, biocompatibility, software functionality, and user specifications. These are typical tests for a medical device used for physical intervention, not for a diagnostic device.

In summary, the NESS H200® Wireless Hand Rehabilitation System is a therapeutic medical device, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The NESS H200® Wireless Hand Rehabilitation System is an electrical stimulation device indicated for the following uses:

Functional Electrical Stimulation (FES):

  • Improvement of hand function and active range of motion in patients with hemiplegia । due to stroke or upper limb paralysis due to C5 spinal cord injury
    NeuroMuscular Electrical Stimulation (NMES):
  • Maintenance and/or increase of range of motion -
  • Prevention and/or retardation of disuse atrophy l
  • Increase of local blood circulation -
  • Reduction of muscle spasm —
  • Muscle re-education |

The Intelli-Connect is an optional accessory device used exclusively with the H200 Wireless System. The Intelli-Connect is used to trigger the H200 Wireless Orthosis through simple jaw movements.

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

GZI, IPF

Device Description

The NESS H200 System consists of the following components:

  • Functional Stimulation (FS) Orthosis with a Radio Frequency (RF) Stim Unit .
  • Control Unit .
  • . Intelli-Connect triggering device optional accessory, consisting of an earpiece, a charger and connecting cable

The Intelli-Connect Earpiece triggering device is fitted over the ear and detects clicks of the teeth to wirelessly trigger the stimulation unit of the H200 Wireless orthosis. Software built into the Intelli-Connect earpiece is designed to register and work exclusively with the patient's orthosis. The Earpiece is rechargeable with a lithium-polymer battery. It is FCC identified and meets part 15 of the FCC regulations. Once the earpiece is turned on, Intelli-Connect will trigger stimulation when teeth are clicked together.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Hand, upper limb

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)

PurposeTestingResults
Verify that the Intelli-Connect complies with 60601-1 general requirements for basic safety and essential performancePower input, leakage current, dielectric strength, mechanical strength, physical stability, excessive temperature, humidity, ingress of liquids, cleaning, mechanical abuse, stress reliefPass
Verify that Intelli-Connect system complies with EMC requirements of 60601-1-2Radiated emissions, AC mains, electrostatic discharge, immunity to surge, RF field immunity, magnetic field immunity, interruptions immunityPass
Verify that the battery satisfies IEC 62133:2202Vibration, temperature cycling, external short circuit, free fall, crash hazardPass
Verify conformance with FCC Part 15 Class BField strength, bandwidth, spurious emissions, AC mains emissions, antenna requirement,Pass
Verify conformance to biocompatibility (ISO 10993) requirementsSensitization, cytotoxicity, irritationPass
Verify software meets requirementsHardware verification, module verification, internal peripherals, settings, accelerometers, initialization, watch dog timer, charging, battery capacity, registration, LED behavior, state machine, trigger commandsPass
Verify user specifications are metWeight, charge access, insertion, donning and doffing, handling, talking, with glasses, consistent detection, roll and pitch, fit, cleaningPass

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.

K111767

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

§ 882.5810 External functional neuromuscular stimulator.

(a)
Identification. An external functional neuromuscular stimulator is an electrical stimulator that uses external electrodes for stimulating muscles in the leg and ankle of partially paralyzed patients (e.g., after stroke) to provide flexion of the foot and thus improve the patient's gait.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image shows the logo for Bioness. The logo consists of a symbol that looks like a stylized flower or starburst to the left of the word "Bioness" in a sans-serif font. Below "Bioness" is the tagline "LiveOn."

MAY 0 1 2013

Section 5 510(k) Summary

K123636 Summary NESS H200® Wireless Hand Rehabilitation System with optional Intelli-Connect Earpiece Triggering Device

Company nameBioness Inc.
ContactKim Tompkins
VP of Regulatory and Clinical Affairs
Bioness, Inc.
25103 Rye Canyon Loop, Valencia, CA 91355 USA
Office phone: (661) 362-5968
Fax: (661) 362-6661
Email: Kim.Tompkins@bioness.com
Date preparedApril 23, 2013
Trade nameNESS H200® Wireless Hand Rehabilitation System with optional
Intelli-connect, trade name subject to change
Classification nameExternal functional neuromuscular stimulator
ClassII
Panel identificationNeurology
Product codeGZI and IPF
Regulation number882.5810 External functional neuromuscular stimulators
890.5850 Powered muscle stimulators
Predicate deviceNESS H200 Wireless Hand Device K111767

Purpose: This is a product line extension to add an optional hands-free trigger for functional stimulation of the H200 Wireless System.

Device description

The NESS H200 System consists of the following components:

  • Functional Stimulation (FS) Orthosis with a Radio Frequency (RF) Stim Unit .
  • Control Unit .
  • . Intelli-Connect triggering device optional accessory, consisting of an earpiece, a charger and connecting cable

The Intelli-Connect Earpiece triggering device is fitted over the ear and detects clicks of the teeth to wirelessly trigger the stimulation unit of the H200 Wireless orthosis. Software built into the Intelli-Connect earpiece is designed to register and work exclusively with the patient's orthosis. The Earpiece is rechargeable with a lithium-polymer battery. It is FCC identified and meets part 15 of the FCC regulations. Once the earpiece is turned on, Intelli-Connect will trigger stimulation when teeth are clicked together.

1

Image /page/1/Picture/0 description: The image shows the logo for Bioness. The logo consists of a star-like symbol on the left, followed by the word "Bioness" in a sans-serif font. Below the word "Bioness" is the text "LiveOn" in a smaller font. The logo is simple and modern, and the use of the star-like symbol suggests innovation and technology.

Section 5 510(k) Summary

Indications for use

The NESS H200® Wireless Hand Rehabilitation System is an electrical stimulation device indicated for the following uses:

Functional Electrical Stimulation (FES):

  • Improvement of hand function and active range of motion in patients with hemiplegia । due to stroke or upper limb paralysis due to C5 spinal cord injury
    NeuroMuscular Electrical Stimulation (NMES):

  • Maintenance and/or increase of range of motion -

  • Prevention and/or retardation of disuse atrophy l

  • Increase of local blood circulation -

  • Reduction of muscle spasm —

  • Muscle re-education |

The Intelli-Connect is an optional accessory device used exclusively with the H200 Wireless System. The Intelli-Connect is used to trigger the H200 Wireless Orthosis through simple jaw movements.

Substantial Equivalence

The H200 Wireless System is identical to the previously cleared system. The optional Intelli-Connect triggering device detailed in this submission was designed for use in the same target population. This accessory allows potentially more independence in the target population by allowing patients to turn on/off their H200 functional stimulation unit unassisted-contributing to more independence. A comparison of the predicate and subject triggering follows:

| | H200 Wireless
handheld triggering device
K111767 (Predicate) | H200 Wireless
with Intelli-Connect
(Subject) |
|------------------------------------------|--------------------------------------------------------------------------------|-----------------------------------------------------------------------------------|
| Effect of the trigger
detection | Triggering the pre-determined
stimulation sequence at the
H200W orthosis | Same |
| Communication with
the H200W orthosis | Wireless, using proprietary RF
communication protocol | Same |
| Registration to the
H200W system | Wireless, using proprietary RF
communication protocol | Same |
| Power source | Rechargeable battery | Same |
| Trigger event | Pressing button on the control unit
with the unaffected hand | Detecting vibrations
associated with tooth
clicking without using a
hand |

2

Image /page/2/Picture/0 description: The image shows the logo for Bioness LiveOn. The logo consists of a stylized star-like symbol on the left, followed by the word "Bioness" in a bold, outlined font. Below "Bioness" is the word "LiveOn" in a smaller font with a plus sign next to it.

Performance Testing Summary

PurposeTestingResults
Verify that the Intelli-
Connect complies with
60601-1 general
requirements for basic safety
and essential performancePower input, leakage current, dielectric
strength, mechanical strength, physical
stability, excessive temperature, humidity,
ingress of liquids, cleaning, mechanical
abuse, stress reliefPass
Verify that Intelli-Connect
system complies with EMC
requirements of 60601-1-2Radiated emissions, AC mains, electrostatic
discharge, immunity to surge, RF field
immunity, magnetic field immunity,
interruptions immunityPass
Verify that the battery
satisfies IEC 62133:2202Vibration, temperature cycling, external short
circuit, free fall, crash hazardPass
Verify conformance with
FCC Part 15 Class BField strength, bandwidth, spurious
emissions, AC mains emissions, antenna
requirement,Pass
Verify conformance to
biocompatibility (ISO 10993)
requirementsSensitization, cytotoxicity, irritationPass
Verify software meets
requirementsHardware verification, module verification,
internal peripherals, settings, accelerometers,
initialization, watch dog timer, charging,
battery capacity, registration, LED behavior,
state machine, trigger commandsPass
Verify user specifications are
metWeight, charge access, insertion, donning
and doffing, handling, talking, with glasses,
consistent detection, roll and pitch, fit,
cleaningPass

Conclusion

The H200 Wireless System with optional Intelli-Connect does not raise any new questions of safety and effectiveness and therefore is substantially equivalent to the cleared H200 Wireless System (K111767 SE 9.15.11).

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the seal of the Department of Health & Human Services - USA. The seal is circular, with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. In the center of the seal is an abstract symbol that resembles an eagle or a bird in flight. The image is in black and white.

Public Health Service

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

May 01,2013

Bioness, Inc. % Kim Tompkins 25103 Rye Canyon Loop Valencia, CA 91355

Re: K123636

Trade/Device Name: NESS H200 Wireless Hand Rehabilitation System with optional Intelli-Connect Earpiece Triggering Device

Regulation Number: 21 CFR 882.5810 Regulation Name: External functional neuromuscular stimulator Regulatory Class: Class II Product Code: GZI, IPF Dated: March 15. 2013 Received: March 22, 2013

Dear Ms. Tompkins:

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 device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set

4

Page 2 - Kim Tompkins

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,

Joyce M. Whang -S

for Victor Krauthamer, Ph.D. Acting Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

Attachment A

Indications for Use

510(k) Number (if known): K123636

Device Name: Bioness H200 Wireless Hand Rehabilitation System with

Indications for Use:

The [NESS] H200 Wireless System is an electrical stimulation device indicated for the following uses:

  • . Functional Electrical Stimulation (FES).
    • Improvement of hand function and active range of motion in patients with o hemiplegia due to stroke or upper limb paralysis due to C5 spinal cord injury.
  • NeuroMuscular Electrical Stimulation (NMES). .
    • Maintenance and/or increase of hand range of motion. O
    • Prevention and/or retardation of disuse atrophy. o
    • Increase in local blood circulation. O
    • Reduction of muscle spasm. 0
    • Re-education of muscles. O

The Intelli-Connect is an optional accessory device used exclusively with the H200 Wireless Orthosis through simple jaw movements.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ × (Part 21 CFR 801 Subpart D)

AND/OR

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Joyce M. Whang -S

Division of Neurological and Physical Medicine Devices 510(k) Number: K123636

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