K Number
K123860
Device Name
INMODE SR IPL DEVICE
Manufacturer
Date Cleared
2013-04-02

(109 days)

Product Code
Regulation Number
878.4810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The InMode SR IPL Device wavelengths (515-1200nm) are indicated for use for the following treatments: - . The treatment of benign pigmented epidermal lesions, including dyschromia, hyperpigmentation, melasma, ephelides (freckles); - The treatment of benign cutaneous vascular lesions, including port wine stains, . facial, truncal and leg telangiectasias, rosacea, erythema of rosacea, angiomas and spider angiomas, poikiloderma of Civatte, superficial leg veins and venous malformations.
Device Description
The InMode SR IPL device is designed to deliver optical energy to the skin via a pre-cooled sapphire block. The good optical contact between sapphire block and skin is achieved by using water based gel. The device provides individual adjustment of light fluence and pulse duration to achieve maximum efficiency and safety for each patient. The hand piece has integrated skin cooling to enhance safety and comfort of the treatment. The InMode SR IPL device consists of an AC/DC power supply unit, water cooling system, controller, user interface including a LCD screen and functional buttons and IPL hand piece. The IPL hand piece is connected to the console via a cable. The hand piece comprises a flash lamp, reflector, water flow tube and cooled sapphire output window (10 x 30 mm).
More Information

Not Found

No
The document describes a standard IPL device with adjustable parameters and cooling, with no mention of AI or ML in the device description, intended use, or specific sections for AI/ML mentions.

Yes
The device is indicated for the treatment of various benign pigmented epidermal lesions and benign cutaneous vascular lesions, which are therapeutic applications.

No

The device description focuses on delivering optical energy for treatment purposes of previously diagnosed conditions, not on identifying or diagnosing conditions.

No

The device description clearly outlines multiple hardware components including a power supply, cooling system, controller, user interface with LCD screen, and an IPL hand piece with a flash lamp, reflector, and sapphire output window. This is not a software-only device.

Based on the provided information, the InMode SR IPL Device is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens (like blood, urine, or tissue) taken from the human body to provide information for diagnosis, monitoring, or screening.
  • Device Function: The InMode SR IPL Device delivers optical energy directly to the skin for therapeutic treatment of various skin conditions. It does not analyze any biological samples taken from the patient.
  • Intended Use: The intended use clearly describes treatments applied directly to the skin, not the analysis of in vitro samples.
  • Device Description: The description details the components involved in generating and delivering light energy to the skin, not components for sample handling or analysis.

Therefore, the InMode SR IPL Device falls under the category of a therapeutic device that interacts directly with the patient's body, rather than an IVD device that analyzes samples outside the body.

N/A

Intended Use / Indications for Use

The InMode SR IPL Device wavelengths (515-1200mm) are indicated for use for the following treatments:

  • The treatment of benign pigmented epidermal lesions, including dyschromia, hyperpigmentation, melasma, ephelides (freckles);
  • The treatment of benign cutaneous vascular lesions, including port wine stains, facial, truncal and leg telangiectasias, rosacea, erythema of rosacea, angiomas and spider angiomas, poikilodenna of Civatte, superficial leg veins and venlous malformations.

Product codes

ONF

Device Description

The InMode SR IPL device is designed to deliver optical energy to the skin via a pre-cooled sapphire block. The good optical contact between sapphire block and skin is achieved by using water based gel. The device provides individual adjustment of light fluence and pulse duration to achieve maximum efficiency and safety for each patient. The hand piece has integrated skin cooling to enhance safety and comfort of the treatment.

The InMode SR IPL device consists of an AC/DC power supply unit, water cooling system, controller, user interface including a LCD screen and functional buttons and IPL hand piece. The IPL hand piece is connected to the console via a cable. The hand piece comprises a flash lamp, reflector, water flow tube and cooled sapphire output window (10 x 30 mm).

Following are the InMode SR IPL device specifications:

Wavelength: 515 - 1200 nm Energy Density (Fluence): 10-30 J/cm-Pulse Duration: 4-27 msec Pulse repetition rate: up to 1 Hz Spot/scan size: 10 x 30 mm Skin cooling: Continuous contact cooling

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Skin (Epidermal, Cutaneous)

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Prescription Use

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)

Non-Clinical Performance Data: Not Applicable
Clinical Performance Data: Not Applicable

The InMode SR IPL device underwent performance testing, including software validation testing, electrical and mechanical safety testing according to IEC 60601-1, electromagnetic compatibility testing according to IEC 60601-1-2 and safety and essential performance testing of non-laser light source equipment according to IEC 60601-2-57. These performance tests demonstrated that the minor differences in the device software and specifications meet the system requirements and do not raise new safety or effectiveness concerns.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K032460

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

0

510(K) SUMMARY

INMODE SR DEVICE

510(k) Number K123860

Applicant Name:

Company Name:
Address:

InMode M,D Ltd. Tavor Building, Shaar Yokneam Yokneam 20692 Israel Tel: +972-4-9097470 Fax: +972-4-9097471 E-mail: ahava@asteinrac.com

Contact Person:

Official Correspondent: Ahava Stein

Company Name:A. Stein – Regulatory Affairs Consulting Ltd.
Address:20 Hata'as Str., Suite 102
Kfar Saba 44425
Israel
Tel: +972-9-7670002
Fax: +972-9-7668534
E-mail: ahava@asteinrac.com

Date Prepared: December 6, 2012

Trade Name: InMode SR IPL Device

Classification Name: CFR Classification section 878.4810; (Product code ONF)

Classification: Class II Medical Device

Predicate Device:

The InMode SR IPL device is substantially equivalent to the following predicate devices.

| Manufacturer
|
A MICH A LIGHT
Device | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
510(k) |
|------------------|------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| ৫
Sciton | יחח .
્ર
Profile | K032460
A AND ALL AND A |

1

Device Description:

The InMode SR IPL device is designed to deliver optical energy to the skin via a pre-cooled sapphire block. The good optical contact between sapphire block and skin is achieved by using water based gel. The device provides individual adjustment of light fluence and pulse duration to achieve maximum efficiency and safety for each patient. The hand piece has integrated skin cooling to enhance safety and comfort of the treatment.

The InMode SR IPL device consists of an AC/DC power supply unit, water cooling system, controller, user interface including a LCD screen and functional buttons and IPL hand piece. The IPL hand piece is connected to the console via a cable. The hand piece comprises a flash lamp, reflector, water flow tube and cooled sapphire output window (10 x 30 mm).

Following are the InMode SR IPL device specifications:

Wavelength: 515 - 1200 nm Energy Density (Fluence): 10-30 J/cm-Pulse Duration: 4-27 msec Pulse repetition rate: up to 1 Hz Spot/scan size: 10 x 30 mm Skin cooling: Continuous contact cooling

Intended Use/Indication for Use:

The InMode SR IPL Device wavelengths (515-1200mm) are indicated for use for the following treatments:

  • · The treatment of benign pigmented epidermal lesions, including dyschromia, hyperpigmentation, melasma, ephelides (freckles);
  • · The treatment of benign cutaneous vascular lesions, including port wine stains, facial, truncal and leg telangiectasias, rosacea, erythema of rosacea, angiomas and spider angiomas, poikilodenna of Civatte, superficial leg veins and venlous malformations.

Performance Standards:

The InMode SR IPL Device has been tested and complies with the following voluntary recognized 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, (Second Edition, 2001), Medical Electrical Equipment Part 1-2: General . Requirements for Safety - Collateral Standard: Electromagnetic Compatibility --Requirements and Tests
  • IEC 60601-1-4 Medical electrical equipment -- Part 1-4:General requirements for safety -. Collateral Standard: Programmable electrical medical systems
  • IEC 60601-2-57 standard; Medical Electrical Equipment Part 2-57: Particular . Requirements for the Basic Safety and Essential Performance of Non-Laser Light Source Equipment Intended for Therapeutic, Diagnostic, Monitoring and Cosmetic/Aesthetic Use

Non-Clinical Performance Data:

2

Not Applicable

Clinical Performance Data:

Not Applicable

Substantial Equivalence:

The indications for use and technological characteristics of the InMode SR IPL device are substantially equivalent to the indications for use and technological characteristics of the Profile BBL device.

The design and components in the InMode SR IPL device, including the console (with power supply, software, cooling system and control and display panel) and the water-cooled hand piece (with cable and connector to console) are similar to the design and components found in the Profile BBL device.

The performance specifications (including wavelength, fluence, pulse duration, pulse repetition rate, spot size and cooling) in InMode SR IPL device are similar to performance specifications in the Profile BBL device.

DeviceInMode SRProfile BBL
CompanyInMode MDSciton
510(k) No.K123860K032460
Intended UseTreatment of benign cutaneous
vascular lesions, including port
wine stains, facial, truncal and leg
telangiectasias, rosacea, erythema
of rosacea, engiomas and spider
angiomas, poikiloderma of Civatte,
superficial leg veins and venous
malformationsTreatment of benign cutaneous
vascular lesions, including port
wine stains, facial, truncal and leg
telangiectasias, rosacea, erythema
of rosacea, engiomas and spider
angiomas, poikiloderma of Civatte,
superficial leg veins and venous
malformations
Wavelength515-1200nm
580-1200nm515-1400nm
560-1400nm
590-1400nm
Energy density10-30 J/cm²10-30 J/cm²
Pulse duration5-30ms10-30ms
Pulse repetition rate1ppsUp to 1pps
Pulse sequenceSingle PulseSingle pulse
Delay between sub-
pulsesN/AN/A
Spot size10x30mm10x50mm maximal, 7mm round
minimal
Cooling methodContact Cooling (10°C-25°C)Contact Cooling (10°C-35°C)

Comparison Table 1 - Indication for Use Treatment of Vascular Lesions .

Comparison Table 2 - Indication for Use Treatment of Pigments Lesions

| 10.00 | Complete on and can and change and and and and | | A . Comments of the comments of the called of
and an annual procession and the first and succession of an and and and the collection and the color of the closes of the close | Comments of the American Company of Children Comments of Children Comments of Children Comments of Children Comments of Children Comments of Children Comments of Children Com |
|-------|------------------------------------------------|--------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| | 041100 | | -FINA MOTOR, I' | |
| | 1 | CONSTITUTION | ANNUA A A B A A
מרצית שירות המידע שמועד הראשונה ארצות הראשונים של מיני ארצות הראשונים של מיני או שיינו או שיינו או שיינו או שיינו או שיינו או שיינו או שיינו או שיינו או שיינו או שיינו או שי | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |

3

CompanyInMode MDSciton
510(k) No.K123860K032460
Intended UseTreatment of benign pigmented
lesions including dyschromia,
hyperpigmentation, melasma,
ephelides (freckles)Treatment of benign pigmented
lesions including dyschromia,
hyperpigmentation, melasma,
ephelides (freckles)
Wavelength515-1200nm
580-1200nm515-1400nm
560-1400nm
590-1400nm
Energy density10-30 J/cm²10-30 J/cm²
Pulse duration5-30ms10-30ms
Pulse repetition
rate1ppsUp to 1pps
Pulse sequenceSingle PulseSingle pulse
Delay between sub-
pulsesN/AN/A
Spot size10x30mm10x50mm maximal, 7mm round
minimal
Cooling methodContact Cooling (10°C-25°C)Contact Cooling (10°C-35°C)

The safety features in the InMode SR IPL device are substantially equivalent to the safety features found in the predicate device. Any minor differences in the technological characteristics do not raise new safety or effectiveness concerns. Furthermore, the new InMode SR IPL device underwent performance testing, including software validation testing, electrical and mechanical safety testing according to IEC 60601-1, electromagnetic compatibility testing according to IEC 60601-1-2 and safety and essential performance testing of non-laser light source equipment according to IEC 60601-2-57. These performance tests demonstrated that the minor differences in the device software and specifications meet the system requirements and do not raise new safety or effectiveness concerns.

Consequently, it can be concluded that the InMode SR IPL device is substantially equivalent to the predicate Profile BBL device and therefore, may be legally marketed in the USA.

Conclusions:

Based on the performance testing and comparison to predicate devices, the InMode SR IPL device is substantially equivalent to the predicate device listed above.

4

Image /page/4/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of an eagle or bird-like figure with three curved lines forming its body and wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the bird symbol.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Letter dated: April 2, 2013

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

Inmode MD, Limited % A. Stein-Regulatory Affairs Consulting, Limited Ms. Ahava Stein General Manager 20 Hata'as Street, Suite 102 Kfar Saba, Israel 44425

Re: K123860

Trade/Device Name: InMode SR IPL Device 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: ONF Dated: February 28, 2013 Received: March 07, 2013

Dear Ms. Stein:

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.

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

5

Page 2 - Ms. Ahava Stein

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/ucm 1 1 5809.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/cdrh/mdr/ 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/cdrh/industry/support/index.html.

Sincerely yours.

Mark N. Melkerson -S

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

6

INDICATIONS FOR USE

510(k) Number: K123860

Device Name: InMode SR IPL Device

Intended Use Statement:

The InMode SR IPL Device wavelengths (515-1200nm) are indicated for use for the following treatments:

  • . The treatment of benign pigmented epidermal lesions, including dyschromia, hyperpigmentation, melasma, ephelides (freckles);
  • The treatment of benign cutaneous vascular lesions, including port wine stains, . facial, truncal and leg telangiectasias, rosacea, erythema of rosacea, angiomas and spider angiomas, poikiloderma of Civatte, superficial leg veins and venous malformations.

Prescription Use V (Per 21 C.F.R. 801 Subpart D) OR

Over-The-Counter Use (Optional Format 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 Ogdens 2013.03.27 17:05:37 -04'00' (Division Sign-Off) for MXM

Division of Surgical Devices 510(k) Number K123860

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