K Number
K131956
Device Name
QUICK RELAX PRO
Date Cleared
2014-04-24

(301 days)

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

To be used for temporary relief of pain associated with sore and aching muscles in the shoulder, waist, back, neck, upper extremities (arm), and lower extremities (leg) due to strain from exercise or normal household work activities.

Device Description

Hand held, 1.5 volt AA battery powered, single mode, single function device with ten "settings" that are controlled by means of rotating a marked disk that increases the microcurrent when rotated clockwise and decreases the microcurrent when rotated counterclockwise, directly through the device integrated electrode into the indicated region of the body. The purpose of the Quick Relax Pro is to provide a temporary relief of minor muscle pain within the indicated region of the body.

AI/ML Overview

The provided text describes a 510(k) summary for a medical device called "Quick Relax Pro," a transcutaneous electrical nerve stimulator (TENS) for pain relief.

However, the provided document does NOT contain information about acceptance criteria or a study proving the device meets specific performance criteria through clinical or analytical testing, especially not in the context of an AI/algorithm-based device as implied by the prompts' structured questions (e.g., ground truth, MRMC study, training sets).

This document focuses on:

  • Device Identification and Classification: Name, applicant, contact, classification, product code, CFR reference.
  • Predicate Device Comparison: Detailed comparison of the Quick Relax Pro to a legally marketed predicate device (HealthmateForever® Pro-8AB) in terms of intended use, technical characteristics (battery, isolation, output modes, waveform, software, functions), and specific parameters (voltage, current, pulse duration, frequency).
  • Non-Clinical Testing: Mentions biocompatibility testing (ISO 10993-5, -10, -12), product safety testing (IEC 60601-1), and electromagnetic compatibility testing (IEC 60601-1-2). It states that the "results... were satisfactory, and serve to demonstrate the safety and effectiveness."
  • Substantial Equivalence Argument: The core of the 510(k) submission, arguing that the Quick Relax Pro is substantially equivalent to the predicate device, emphasizing safety due to fewer features (no software, single mode).
  • FDA Communication: The letter from the FDA stating their "substantial equivalence" determination and regulatory responsibilities.

Therefore, I cannot provide the requested information about acceptance criteria and specific performance study details for an AI/algorithm-based device because the document describes a hardware medical device (TENS unit) and its regulatory submission, not an AI or software algorithm that would involve the kind of performance studies, ground truth establishment, or training/test sets typically associated with AI/ML medical devices.

The acceptance criteria mentioned in the document are implicitly met by:

  • Substantial Equivalence: The device is deemed safe and effective because its technological characteristics are substantially equivalent to a legally marketed predicate device.
  • Compliance with Standards: Satisfactory results from non-clinical testing (biocompatibility, product safety, EMC) against established international standards (ISO, IEC).

There is no mention of:

  • A table of acceptance criteria and reported device performance (in the context of AI/ML metrics like sensitivity, specificity, etc.)
  • Sample sizes for test sets or data provenance (as no clinical performance study for an algorithm is described).
  • Number of experts, their qualifications, or adjudication methods for ground truth.
  • MRMC comparative effectiveness studies.
  • Standalone algorithm performance.
  • Type of ground truth (pathology, outcomes data, etc.).
  • Training set size or ground truth establishment for a training set.

The document's structure is typical for a 510(k) premarket notification for a Class II medical device, focusing on comparison to a predicate and non-clinical safety testing, rather than an AI/ML clinical validation study.

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K131956

Section 005 – 510(k) Summary

APR 2 4 2014

.

Applicant or Sponsor Information

Name:Healthcare Innovations, LLC
Address:12889 Coco Plum Lane
Naples, FL 34119-8530
Contact:Dr. John Ricci
Phone:(239) 593 - 9570
Fax:(239) 593 - 9570
E-mail:jriccirx@earthlink.net
Establishment Registration:TBD
Date of Submission:23 June, 2013

Submission Correspondent (Preparer's) Information

Name:Shepard G. Bentley, RACPresident, Bentley Biomedical Consulting, LLCConsultant to Healthcare Innovations, LLC
Address:28241 Crown Valley ParkwaySuite 510(k)Laguna Niguel, CA 92677
Device Information
Device Common Name:Transcutaneous electrical nerve stimulator for pain reliefintended for over the counter use
Device Trade Name:Quick Relax Pro
Device Classification Name:Stimulator, nerve, transcutaneous, over-the -counter

(

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Device Class:Class II
Product Code:NUH
CFR Reference:882.5890
Predicate DeviceK121757HealthmateForever®

Design and Use of the Device

Hand held, 1.5 volt AA battery powered, single mode, single function device with ten "settings" that are controlled by means of rotating a marked disk that increases the microcurrent when rotated clockwise and decreases the microcurrent when rotated counterclockwise, directly through the device integrated electrode into the indicated region of the body. The purpose of the Quick Relax Pro is to provide a temporary relief of minor muscle pain within the indicated region of the body.

Technological Characteristics Comparison

Technical CharacteristicsQuick Relax ProHealthmateForever® Pro-8AB
Intended UseTo be used for temporaryrelief of pain associated withsore and aching muscles inthe shoulder, waist, back,neck, upper extremities (arm),and lower extremities (leg)due to strain from exercise ornormal household workactivitiesTo be used for temporaryrelief of pain associated withsore and aching muscles inthe shoulder, waist, back,neck, upper extremities (arm),and lower extremities (leg)due to strain from exercise ornormal household workactivities
Battery Powered1.5V DC3.7V DC
Method of Line CurrentIsolationType BFType BF
Number of Output Modes18
WaveformAsymetrical BiphasicAsymetrical Biphasic
SoftwareNoYes
FunctionsSingleMultiple

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ParameterSubject DevicePredicate Device
510(k) NumberK131956K121757
Device Name and ModelQuick Relax ProHealthmateForever
ManufacturerHealthcareInnovations, LLCHealthmateInternational, LLC
Power Source(s)Battery, singleAA dry cellBattery, single drycell
-Method of Line Current IsolationN/AN/A
-Patient Leakage CurrentN/AN/A
-Normal Condition (μC)N/AN/A
-Single Fault Condition (µC)N/AN/A
Average DC current through electrodes when device ison but no pulses are being applied (µC)N/A (pulsesalways appliedwhen on)N/A (pulses alwaysapplied when on)
Number of Output Modes12
Number of Output ChannelsSynchronous orAlternating?Method ofChannelIsolationN/AN/A
Regulated Current or RegulatedVoltage?N/AN/A
Software/Firmware/Microprocessor Control?NoYes
Automatic Overload Trip?NoNo
Automatic No-Load Trip?NoNo
Automatic Shut Off?NoNo
User Override Control?NoYes
Indicator Display:On/Off Status?Low Battery?Voltage/CurrentLevel?YesNoYesYesYesYes
Timer Range (minutes)N/AYes
Compliance with Voluntary Standards?YesYes
Compliance with 21 CFR 898?N/APresumed
Weight (lbs., oz.)4.5 oz3.9 oz
Dimensions (in) [W x H x D]8.75" x 2" x1.75"3.75" x 2" x .5"
Housing Materials and ConstructionFlame ret. ABS,stainless steelMetal, LCD
ParameterSubject DevicePredicate Device
Mode or Program NameOutputPro-8AB
Waveform (e.g., pulsed monophasic, biphasic)Pulsed biphasic (asymmetrical unbalanced)Pulsed biphasic (asymmetrical unbalanced)
Shape (e.g., rectified, spike, rectified sinusoidal)Rectified sinusoidal (with undershoot)Rectangular with taper
Maximum Output Voltage (volts) (+/-5%)58.4v @ 500Ω220v @ 2KΩ995v @ 10KΩapplies measure prior to EnCadis' clarification - revised calculation is approx 300v @ 10KΩ70v @ 500Ω90v @ 2KΩ100v @10KΩ
Maximum Output Current (mA) (+/- 5%)117 mA @ 500Ω110 mA @ 2KΩ100 mA @ 10KΩ140 mA @ 500Ω45 mA @ 2KΩ10 mA @ 10KΩ
Duration of primary (depolarizing) phase (µSec)N/Aunknown
Pulse Duration (µSec)11 µSec10 mSec
Frequency (Hz)30 Hz (max amplitude)100 Hz
For multiphasic waveforms only:Symmetrical phases?Phase DurationNoPositive Phase:11 µSecNegative Phase:2 µSec (@ min amplitude, 500Ω load)25 µSec (@ max amplitude, 10KΩ load)NoVarious, all are longer than Quick Relax Pro
Net Charge (microCoulombs (µC) per pulse)0.78 µC *Various, higher
Maximum Phase Charge (µC)0.82 µC *15.66 µC
Maximum Current Density (mA/cm2, r.m.s.)3.37 mA/cm2 r.m.s.7.2 mA/cm2 @500Ω
Parameter ---------------Subject DevicePredicate Device
Maximum Average Current (average absolute value)mA0.220 mANot measured
Maximum Average Power Density (W/cm2)803 µW/cm2Not measured
Burst Mode(a) Pulses perburstN/AVarious
(b) Bursts persecondN/AVarious
(c) BurstdurationN/AVarious
(d) Duty Cycle:Line b x Line cN/AVarious
ON Time (Sec)N/A1,200 default
OFF Time (Sec)N/AN/A
Additional FeaturesN/AUnknown

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:

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Summary of Technological Characteristics Comparison

The foregoing comparison of the technological characteristics of the subject and predicate devices confirms that the devices are substantially equivalent with respect to intended uses, method of powering, physical descriptions, method of isolation and waveforms.

The differences regarding battery power, material descriptions, number of output modes, presence of software and overall numbers of functions confer an added degree of safety to the subject device.

Therefore, the subject device is at least as safe if not safer than the predicate device, and substantially equivalent with regard to the relevant comparators of the devices.

Summary of Non-Clinical Testing

The Quick Relax Pro has undergone biocompatibility testing of its tissue-contacting electrode in compliance with ISO 10993-5, ISO 10993-10 and ISO 10993-12. In addition, the Quick Relax Pro has undergone Product Safety testing in compliance to IEC 60601-1 and Electromagnetic Compatibility testing in compliance to IEC 60601-1-2. The results of each of the foregoing sets of test requirements were satisfactory, and serve to demonstrate the safety and effectiveness of the Quick Relax Pro.

The product safety, electromagnetic compatibility and biocompatibility test results provide assurance that the subject device performs as well or better than the predicate device.

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The introduction of the Quick Relax Pro into interstate commerce does not raise any new issues of safety or effectiveness.

and the comments of the count

100 - 100 - 100 -

:

END OF 510(K) SUMMARY

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Image /page/6/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized symbol that resembles an abstract caduceus or a representation of human services.

Public Health Service

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

April 24, 2014

Healthcare Innovations, LLC c/o Shepard G. Bentley, RAC Bentley Biomedical Consulting, LLC 28241 Crown Valley Parkway, Suite 510(k) Laguna Niguel, CA 92677

Re: K131956

Trade/Device Name: Quick Relax Pro Regulation Number: 21 CFR 882.5890 Regulation Name: Transcutaneous electrical nerve stimulator for pain relief Regulatory Class: Class II Product Code: NUH Dated: March 4, 2014 Received: March 25, 2014

Dear Mr. Bentley:

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

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Page 2 - Mr. Shepard Bentley

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 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 contact the Division of Industry and Consumer Education 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. 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/McdicalDcvices/Safety/ReportalProblem/dcfault.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 Industry and Consumer Education 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,

Carlos L. Peña AS

Carlos L. Peña, Ph.D., M.S. Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K131956

Device Name

Quick Relax Pro

Indications for Use (Describe)

To be used for temporary relief of pain associated with sore and aching muscles in the shoulder, waist, back, neck, upper extremities (arm), and lower extremities (leg) due to strain from exercise or normal household work activities.

Type of Use (Select one or both, as applicable)

□ Prescription Use (Part 21 CFR 801 Subpart D)

[X] Over-The-Counter Use (21 CFR 801 Subpart C)

...

:

PLEASE DO NOT WRITE BELOW THIS LINE -- CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

.

Carlos Pena -S

Form Approved: OMB No. 0910-0120

Expiration Date: January 31, 2017

See PRA Statement on last page.

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§ 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).