K Number
K123980
Manufacturer
Date Cleared
2013-03-05

(69 days)

Product Code
Regulation Number
878.4410
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Misonix SonicOne Ultrasonic Would Care System and Accessories are indicated for use in the debridement of wounds, such as, but not limited to, burn wounds, diabetic ulcers. bedsores and vaginal ulcers. soft tissue debridement and cleansing of the surgical site in applications in which, in the physician's judgment would require the use of an ultrasonic aspirator with sharp debridement.

Device Description

The SonicOne Plus Ultrasonic Wound Care System and Accessories is comprised of a generator, which feeds a 22.5 kHz electrical signal to a piezoelectric crystals mounted in a hand-held handpiece; the crystals then vibrate at the same frequency. The titanium tip attached to the handpiece amplifies the vibration. An irrigation unit is provided to introduce irrigation solution to the operative site. Accessories include Probe tips, Wrenches, Sterile and non sterile Tube sets and sterile Surgical Procedure bags and sterile Handpiece Sheaths.

AI/ML Overview

This document describes the Misonix SonicOne Plus Ultrasonic Wound Care System and Accessories, which is an ultrasonic surgical system used for wound debridement. The submission aims to demonstrate substantial equivalence to predicate devices, namely the SonicOne Ultrasonic Wound Care System (K112782) and the AUSS-7 Ultrasonic Surgical System (K070313).

Here's an analysis of the provided information:

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria for this device are based on compliance with a set of voluntary standards and successful completion of non-clinical tests. The "reported device performance" is essentially the statement that the device has "passed" these standards and tests. There are no specific quantitative performance metrics like sensitivity, specificity, or accuracy provided, as this is a medical device for physical intervention, not diagnostic imaging or AI.

Acceptance Criteria (Voluntary Standards & Non-Clinical Tests)Reported Device Performance
UL 60601-1 2nd Edition (Medical Electrical Equipment, Part 1: General Requirements for Safety)Passed
IEC 60601-1* 2nd Edition (Medical Electrical Equipment, Part 1: General Requirements for Safety)Passed
ISO 10993-1:2009 (Biological evaluation of medical devices —Part 1: Evaluation and testing)Passed
ISO 10993-7:2008 (Biological evaluation of medical devices Part 7: Ethylene oxide sterilization residuals)Passed
ISO 14971:2007 (Medical devices -- Application of risk management to medical devices)Passed
ISO 15223-1:2007/A1:2008 (Medical devices—Symbols to be used with medical device labels, labeling, and information to be supplied—Part 1: General requirements)Passed
ISO 11607:2006 (Packaging for Terminally Sterilized Medical Devices)Passed
ISO 11135:2007 (Sterilization of health care products -- Ethylene oxide -- Part 1: Requirements for development, validation and routine control of a sterilization process for medical devices)Passed
IEC 62304: 2006 (Medical Device Software-Software Life Cycle Processes)Passed
IEC 60601-1-4 (General Requirements for safety-Programmable electrical medical systems)Passed
FCC Part 18 (EMC Requirements)Passed
Output Frequency MeasurementsPerformed
Output Power Measurements (No Load to Maximum Load)Performed
Tip Displacement MeasurementsPerformed
Irrigation Flowrate MeasurementsPerformed
Life TestsPerformed
Input Power MeasurementsPerformed
EMI TestsPerformed
Dielectric Tests on Mains CircuitsPerformed
Patient Current Leakage and Patient Sink Current MeasurementsPerformed
Power Line Ground Leakage MeasurementsPerformed
Dielectric Tests on Patient CircuitsPerformed
Sterilization Validations (ANSI/AAMI/ISO 11135:1994 or latest and ISO 11135:2007)Validated
Reprocessing (cleaning/disinfecting/sterilization) instructions validationValidated
Software Validation (cleared under FDA 510k #K070313, meets FDA guideline "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices" and ISO 60601-1-4)Cleared and Meets Requirements

2. Sample Size Used for the Test Set and the Data Provenance

The document explicitly states: "As such, no additional clinical data was obtained in anticipation of this submission." This indicates that there was no dedicated test set involving human subjects or clinical data for this specific 510(k) submission. The safety and performance assessment relies on non-clinical tests, engineering validations, and substantial equivalence to previously cleared predicate devices.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and the Qualifications of Those Experts

Not applicable. There was no clinical test set requiring ground truth establishment by experts for this submission. The device's safety and effectiveness are established through engineering and biological testing against established standards.

4. Adjudication Method (e.g., 2+1, 3+1, none) for the Test Set

Not applicable. There was no clinical test set 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

Not applicable. This device is an ultrasonic surgical system, not an AI-powered diagnostic or assistive tool for human readers. Therefore, an MRMC comparative effectiveness study regarding "human readers improve with AI" is irrelevant.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

Not applicable. This is a physical medical device, not an algorithm.

7. The Type of Ground Truth Used (expert consensus, pathology, outcomes data, etc.)

The "ground truth" for this device's performance is established by engineering standards and biological safety standards (e.g., ISO, IEC, UL, FCC for electrical safety, biocompatibility, sterilization, and electromagnetic compatibility). For the software component, the ground truth is its compliance with FDA guidelines and ISO 60601-1-4, as validated by previous clearance (K070313).

8. The Sample Size for the Training Set

Not applicable. The device is not an AI algorithm that requires a training set in the typical sense. Its design and operational parameters are based on established engineering principles and its predicate devices.

9. How the Ground Truth for the Training Set Was Established

Not applicable. No training set for an AI algorithm was used.

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KI2-3980

Exhibit E 510(k) SUMMARY

Misonix SonicOne Plus Ultrasonic Wound Care System and Accessories

This summary of safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21CFR 807.92.

Submitter's Identification 1 .

Submitter's Name:MISONIX INCORPORATED
Address:1938 New Highway, Farmingdale, NY 11735
Telephone Number:516-694-9555
Contact Person:Ronald R. Manna
Date Prepared:December 20, 2012

2. Name of Device

Proprietary Name:Misonix SonicOne Plus Ultrasonic Wound Care Systemand Accessories
Common/Usual Name:Ultrasonic Surgical SystemUltrasonic Surgical Aspirator
Name:Low Energy Ultrasonic Wound Cleaner
C.F.R. Section21 CFR 878.4410
Product Codes:NRB, FQH

3. Predicate Device Information

Predicate Devices SonicOne Ultrasonic Wound Care System and Accessories K112782 Misonix Inc. Alliger Ultrasonic Surgical System AUSS-7 K070313 Microtek Medical Inc. Equipment Drapes K050322 Device Description The SonicOne Plus Ultrasonic Wound Care System and Accessories is comprised of a generator, which feeds a 22.5 kHz electrical signal to a piezoelectric crystals mounted in a hand-held handpiece; the crystals then vibrate at the same frequency. The titanium tip attached to the handpiece amplifies the vibration. An irrigation unit is provided to introduce irrigation solution to the operative site. Accessories include Probe tips, Wrenches, Sterile and non

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sterile Tube sets and sterile Surgical Procedure bags and sterile Handpiece Sheaths.

5. Intended Use:

The Misonix SonicOne Ultrasonic Would Care System and Accessories are indicated for use in the debridement of wounds, such as, but not limited to, burn wounds, diabetic ulcers. bedsores and vaginal ulcers. soft tissue debridement and cleansing of the surgical site in applications in which, in the physician's judgment would require the use of an ultrasonic aspirator with sharp debridement.

6. Comparison to Predicate Device

SonicOne Plus Ultrasonic Wound Care System and Accessories are similar in design, material and operating parameters to the Misonix Inc. AUSS-7 Ultrasonic Surgical Aspirator and the Misonix Inc. SonicOne Ultrasonic Wound Care System

7. Safety and Performance Data

The Misonix SonicOne Plus Ultrasonic Wound Care System and Accessories have been designed and tested to pass the following Voluntary Standards:

UL 60601-1 2nd EditionMedical Electrical Equipment, Part 1: General Requirements for Safety
IEC 60601-1* 2nd EditionMedical Electrical Equipment, Part 1: General Requirements for Safety
ISO 10993-1:2009Biological evaluation of medical devices —Part 1: Evaluation and testing
ISO 10993-7:2008Biological evaluation of medical devices Part 7: Ethylene oxide sterilization residuals
ISO 14971:2007Medical devices -- Application of risk management to medical devices
ISO 15223-1:2007/A1:2008Medical devices—Symbols to be used with medical device labels, labeling, and information to besupplied—Part 1: General requirements
ISO 11607:2006Packaging for Terminally Sterilized Medical Devices
ISO 11135:2007Sterilization of health care products -- Ethylene oxide -- Part 1: Requirements for development, validation and routine control of a sterilization process for medical devices
IEC 62304: 2006Medical Device Software-Software Life Cycle Processes
IEC 60601-1-4General Requirements for safety-Programmable electrical medical systems
FCC Part 18EMC Requirements
    1. This device contains software. Software has been cleared under Software Validation FDA 510k #K070313. The software and its documentation meets all of the requirements of the FDA guideline "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices" and ISO 60601-1-4.
    1. Sterilization Validations Items supplied sterile have been validated for sterility to ANSI/AAMI/ISO 11135:1994 or latest edition and ISO 11135:2007. For items to be reprocessed, cleaning/disinfecting/sterilization instructions are validated to insure appropriate level of cleaning/disinfection/sterilization when instructions are followed.

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10. Non-Clinical Tests Performed for Determination of Substantial Equivalence are as follows:

Output Frequency Measurements Output Power Measurements (No Load to Maximum Load) Tip Displacement Measurements Irrigation Flowrate Measurements Life Tests Input Power Measurements EMI Tests Dielectric Tests on Mains Circuits Patient Current Leakage and Patient Sink Current Measurements Power Line Ground Leakage Measurements Dielectric Tests on Patient Circuits

Discussions of Clinical Tests Performed | | .

The FDA has cleared all indications for use in the predicates. As such, no additional clinic data was obtained in anticipation of this submission.

l 2. Conclusions

Misonix Inc. can state that the SonicOne Plus Ultrasonic Wound Care System and Accessories is substantially equivalent in Mode of Operation, Hardware Design and Output Parameters to the Misonix Inc. AUSS-7 and the SonicOne Ultrasonic Wound Care System. Based upon the system and hardware validations described herein, the Misonix Inc. believes the SonicOne Plus Ultrasonic Wound Care System and Accessories poses no new issues of safety or efficacy when used for tissue ablation during wound debridement.

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle with its wings outstretched, symbolizing protection and care.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center- WO66-G609 Silver Spring, MD 209930002

Letter dated: March 5, 2013

Misonix, Incorporated % Mr. Ronald Manna Vice President, Regulatory Affairs 1938 New Highway Farmingdale, New York

Re: K123980

Trade/Device Name: SonicOne Plus Ultrasonic Wound Care System and Accessories Regulation Number: 21 CFR 878.4410 Regulation Name: Low energy ultrasound wound cleaner Regulatory Class: II Product Code: NRB, FQH Dated: February 11, 2013 Received: February 14, 2013

Dear Mr. Manna:

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

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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/Resourcesfor You/Industry/default.htm.

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

Enclosure

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K123980

Exhibit C INDICATIONS FOR USE STATEMENT

Device Name: SonicOne Plus Ultrasonic Wound Care System and Accessories

The Misonix SonicOne Ultrasonic Would Care System and Accessories are indicated for use in the debridement of wounds, such as, but not limited to, burn wounds, diabetic ulcers, bedsores and vaginal ulcers, soft tissue debridement and cleansing of the surgical site in applications in which, in the physician's judgment would require the use of an ultrasonic aspirator with sharp debridement.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Long H. Chen = -A

for MXM

(Division Sign-off) Division of Surgical Devices 510(k) Number K123980

§ 878.4410 Low energy ultrasound wound cleaner.

(a)
Identification. A low energy ultrasound wound cleaner is a device that uses ultrasound energy to vaporize a solution and generate a mist that is used for the cleaning and maintenance debridement of wounds. Low levels of ultrasound energy may be carried to the wound by the saline mist.(b)
Classification. Class II (special controls). The special control is FDA's guidance document entitled “Class II Special Controls Guidance Document: Low Energy Ultrasound Wound Cleaner.” See § 878.1(e) for the availability of this guidance document.