K Number
K133254
Device Name
REVLITE Q-SWITCHED ND:YAG LASER SYSTEM
Manufacturer
Date Cleared
2014-03-05

(134 days)

Product Code
Regulation Number
878.4810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Incision, Excision, Ablation, Vaporization of Soft Tissue for General Dermatology, Dermatologic and General Surgical Procedures for Coagulation and Hemostasis. Specific Indications: 1064 nm wavelength - . Tattoo Removal (dark ink: blue and black) - Dermal Pigmented Lesions; including, but not limited to: Nevus of Ota, Lentigines, Nevi, . Melasma and Cafe-au-lait - Removal or lightening of hair with or without adjuvant preparation. . - . Skin Resurfacing for Acne Scars and Wrinkles - Benign cutaneous lesions; including, but not limited to: striae and scars (excludes the 650nm . wavelength) - Reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral . part of the scar (excludes the 650nm wavelength) 532 nm Wavelength (nominal delivered energy of 585 nm and 650 nm with the Optional Multilite Dyc Laser Handpiece) - Tattoo removal (light ink: red, sky blue, green) . - Vascular Iesions including but not limited to: port wine birthmarks, telangiectasias, spider . angioma, cherry angioma, spider nevi - Epidermal Pigmented lesions; including, but not limited to: cafe-au-lait birthmarks, solar . lentiginos, senile lentiginos, Becker's nevi, Freckles, Nevus spilus, seborrheic keratosis - Skin Resurfacing for Acne Scars and Wrinkles . - Benign cutaneous lesions; including, but not limited to: striae and scars, (excludes the 650nm . wavelength) - Reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral . part of the scar (excludes the 650nm wavelength)
Device Description
The RevLite Q-Switched Nd: YAG Laser System consist of an electrically powered Console, in which laser energy produced within the system is delivered to the tissues by means of an articulated arm, Handpiece Adaptor and specially designed handpieces. The user ectivates laser emission by means of a footswitch.
More Information

Not Found

No
The provided text describes a laser system for soft tissue procedures and does not mention any AI or ML components in its description, intended use, or performance studies.

Yes

Explanation: The device is described for procedures like 'Incision, Excision, Ablation, Vaporization of Soft Tissue' and treatments for 'Tattoo Removal', 'Dermal Pigmented Lesions', 'Skin Resurfacing for Acne Scars and Wrinkles', and 'Vascular lesions', all of which are medical treatments aimed at improving a patient's health or condition.

No

The provided text describes a laser system intended for the incision, excision, ablation, vaporization, and coagulation of soft tissue, as well as for treating various skin conditions like tattoo removal, pigmented lesions, and scars. These are all therapeutic or surgical procedures, not diagnostic ones. The device's function is to modify tissue, not to identify or characterize disease.

No

The device description explicitly states it is a "Laser System" consisting of a console, articulated arm, handpiece adaptor, and handpieces, which are all hardware components.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are devices intended for use in the examination of specimens derived from the human body (such as blood, urine, or tissue) to provide information for diagnostic, monitoring, or compatibility purposes.
  • Device Function: The description clearly states that this device is a laser system used for direct treatment of soft tissue through incision, excision, ablation, and vaporization. It also mentions applications like tattoo removal, treatment of pigmented and vascular lesions, skin resurfacing, and scar reduction. These are all therapeutic procedures performed directly on the patient's body.
  • Lack of Specimen Analysis: There is no mention of the device analyzing any specimens derived from the human body. Its function is to deliver energy to the tissue itself.

Therefore, the intended use and device description align with a therapeutic medical device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

Incision, Excision, Ablation, Vaporization of Soft Tissue for General Dermatology, Dermatologic and General Surgical Procedures for Coagulation and Hemostasis

Specific Indications:

1064 nm wavelength

  • . Tattoo Removal (dark ink: blue and black)
  • Dermal Pigmented Lesions; including, but not limited to: Nevus of Ota, Lentigines, Nevi, . Melasma and Cafe-au-lait
  • Removal or lightening of hair with or without adjuvant preparation. .
  • . Skin Resurfacing for Acne Scars and Wrinkles
  • Benign cutaneous lesions; including, but not limited to: striae and scars (excludes the 650nm . wavelength)
  • Reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral . part of the scar (excludes the 650nm wavelength)

532 nm Wavelength (nominal delivered energy of 585 nm and 650 nm with the Optional Multilite Dyc Laser Handpiece)

  • Tattoo removal (light ink: red, sky blue, green) .
  • Vascular Iesions including but not limited to: port wine birthmarks, telangiectasias, spider . angioma, cherry angioma, spider nevi
  • Epidermal Pigmented lesions; including, but not limited to: cafe-au-lait birthmarks, solar . lentiginos, senile lentiginos, Becker's nevi, Freckles, Nevus spilus, seborrheic keratosis
  • Skin Resurfacing for Acne Scars and Wrinkles .
  • Benign cutaneous lesions; including, but not limited to: striae and scars, (excludes the 650nm . wavelength)
  • Reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral . part of the scar (excludes the 650nm wavelength)

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

GEX

Device Description

The RevLite Q-Switched Nd: YAG Laser System consist of an electrically powered Console, in which laser energy produced within the system is delivered to the tissues by means of an articulated arm, Handpiece Adaptor and specially designed handpieces. The user ectivates laser emission by means of a footswitch.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

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)

Not Found

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.

K103118, K113588, K061436

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

§ 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 for RevLite Q-Switched Nd: YAG Laser System

A. Sponsor

Cynosure, Inc. 5 Carlisle Road Westford, MA 01886

B. Contact

C. Device Name

Trade Name:RevLite Q-Switched Nd: YAG Laser System
Common/usual Name:Medical Laser System
Classification Name:GEX-Powered laser surgical instrument, General & Plastic Surgery
21 CFR 878.4810, Class II

D. Predicate Device

Trade Name:RevLite Q-Switched Nd:YAG Laser System
Common/usual Name:Dermatology Laser System
Classification Name:GEX-Powered laser surgical instrument, General & Plastic Surgery
21 CFR 878.4810, Class II
Premarket Notification:HOYA PHOTONICS, Inc., K103118 (11/19/2010)
Trade Name:SPECTRA Q-Switched Nd:YAG
Common/usual Name:Laser System with Dye Handpieces
Classification Name:GEX-Powered laser surgical instrument, General & Plastic Surgery
21 CFR 878.4810, Class II
Premarket Notification:Lutronic Corporation, K113588 (2/2/2012)
Trade Name:Palomar Q-YAG 5TM Nd:YAG Laser System
Common/usual Name:Q: Switched Nd: YAG
Classification Name:GEX-Powered laser surgical instrument, General & Plastic Surgery
21 CFR 878.4810, Class II
Premarket Notification:Palomar Medical Technologies, Inc., K061436 (12/06/2006)

E. Device Description

The RevLite Q-Switched Nd: YAG Laser System consist of an electrically powered Console, in which laser energy produced within the system is delivered to the tissues by means of an articulated arm, Handpiece Adaptor and specially designed handpieces. The user ectivates laser emission by means of a footswitch.

F. Intended Use

1

Incision, Excision, Ablation, Vaporization of Soft Tissue for General Dermatology, Dermatologic and General Surgical Procedures for Coagulation and Hemostasis.

Specific Indications:

1064 nm wavelength

  • . Tattoo Removal (dark ink: blue and black)
  • Dermal Pigmented Lesions; including, but not limited to: Nevus of Ota, Lentigines, Nevi, . Melasma and Cafe-au-lait
  • Removal or lightening of hair with or without adjuvant preparation. .
  • . Skin Resurfacing for Acne Scars and Wrinkles
  • Benign cutaneous lesions; including, but not limited to: striae and scars (excludes the 650nm . wavelength)
  • Reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral . part of the scar (excludes the 650nm wavelength)

532 nm Wavelength (nominal delivered energy of 585 nm and 650 nm with the Optional Multilite Dyc Laser Handpiece)

  • Tattoo removal (light ink: red, sky blue, green) .
  • Vascular Iesions including but not limited to: port wine birthmarks, telangiectasias, spider . angioma, cherry angioma, spider nevi
  • Epidermal Pigmented lesions; including, but not limited to: cafe-au-lait birthmarks, solar . lentiginos, senile lentiginos, Becker's nevi, Freckles, Nevus spilus, seborrheic keratosis
  • Skin Resurfacing for Acne Scars and Wrinkles .
  • Benign cutaneous lesions; including, but not limited to: striae and scars, (excludes the 650nm . wavelength)
  • Reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral . part of the scar (excludes the 650nm wavelength)

The RevLite Q-Switched Nd: YAG Laser System (K103118) is currently indicated for the treatment of Dermal Pigmented lesions (1064 nm wavelength) and Epidermal Pigmentation lesions (532 nm wavelength). Both dermal and cpidermal pigmented lesions are types of benign pigmented lesions. Cynosure is seeking to clarify the indications for use statement for RevLite Q Switched laser to include examples of other pigmented lesions. There have been no changes to the device and the submission is only related to clarification of pigmented lesions.

G. Technological Characteristics

The laser systems have the same technological characteristics. All of the devices are Q-switched Nd: Y AG lasers operating at wavelengths of 1064 nm and 532 nm. Additionally, dye handpieces are available that convert the 532 nm wavelength beam into 585 nm or 650 nm wavelengths. The RevLite Q Switched Laser System has the exact same technological characteristics as the previously cleared RevLite Q Switched Laser System (K 103118). The clarified RevLite Indications for Use statement has the same example of benign cutaneous lesions, vascular lesions and epidermal pigmented treated as the RevLite, Spectra and Palomar predicates.

2

Proposed DevicePredicate DevicePredicate DevicePredicate Device
510(k)#K103118K113588K061436
ManufacturerCynosure (HOYA ConBio)Cynosure (HOYA ConBio)Lutronic CorporationPalomar Medical
Technologies, Inc.
Device NameRevLite Q-Switched
Nd: YAG Laser SystemRevLite Q-Switched
Nd: YAG Laser SystemSpectra Q-Switched Nd: YAG
Laser systemQ-YAG 5 Nd: YAG laser
system
Clearance Date11/19/20102/22/201212/6/2006
Classification/ Regulation21 CFR 878.4810 (GEX)21 CFR 878.4810 (GEX)21 CFR 878.4810 (GEX)21 CFR 878.4810 (GEX)
Laser MediumNd: YAGNd: YAGNd: YAGNd: YAG
Operating ParametersQ-SwitchedQ-SwitchedQ-SwitchedQ-Switched
Wavelength1064nm / 532 nm1064nm / 532 nm1064nm / 532 nm1064nm / 532 nm
Pulse Characteristics:
Maximum Pulse Duration7 - 20 ns7 - 20 ns5 - 10 ns3 ns
Energy Delivered1.6 J1.6 J1.2 J0.4 J
Fluence1 - 8 J/cm2 @ 3 - 8 mm spot
size1 - 8 J/cm2 @ 3 - 8 mm spot
size5 - 10 J/cm23.45 J/cm2 @ 4 mm spot size
Spot Sizes2-8.5mm range with 0.1mm
increments2-8.5mm range with 0.1mm
increments3,4,5,6,7,8 mm / 1,2,3,4,5,6,7
mm (option)2 mm, 4 mm, 6 mm
(optional)
Repetition RateSingle shot, 1,2,5, 10 HzSingle shot, 1,2,5, 10 HzMax. 10 Hz1-10 Hz
Physical Characteristics:
System Dimensions31.8" (H) x 12" (W) x 28.5"
(D)31.8" (H) x 12" (W) x 28.5"
(D)11.6" (W) x 25.8" (L) x
66.93" (H)18" (L) x 19" (H) x 17" (D)
System Weight131 lbs.131 lbs.194 lbs.88 lbs.
Electrical RequirementsAC 230 V, 50/60 HzAC 230 V, 50/60 HzAC 220-230V, 50/60 Hz100 - 240 V, 50/60 Hz
Maximum Power20W20W240MW4W

:

Indications for Use Statement

3

Proposed DevicePredicate DevicePredicate DevicePredicate Device
1064 nm wavelength1064 nm wavelength1064 nm Wavelength1064 nm Wavelength
Tattoo Removal (dark ink:
blue and black)Tattoo Removal (dark ink:
blue and black)Tattoo removal: dark ink
(black, blue and brown)Indicated for skin resurfacing
with or without adjuvant
Dermal Pigmented Lesions;Dermal Pigmented LesionsRemoval of Nevus of Otapreparation, dark ink tattoo
including, but not limited to:Nevus of OtaRemoval or lightening ofremoval (e.g., black ink),
Nevus of Ota, Lentigines,Removal or lightening of hairunwanted hair with orremoval of pigmented
Nevi, Melasma and Cafe-au-with or without adjuvantwithout adjuvant preparation.lesions, including, but not
laitpreparation.Treatment of Common Nevilimited to, lentigines, nevi,
Removal or lightening ofSkin Resurfacing for AcneSkin resurfacing proceduresmelasma, and cafe-au-lait,
hair with or without adjuvantScars and Wrinklesfor the treatment of acneand the removal or lightening
preparation.Benign cutaneous lesions,scars and wrinkleof hair.
Skin Resurfacing for Acnesuch as, but not limited to:Treatment of melasma
Scars and Wrinklesstriae and scars532 nm Wavelength
Benign cutaneous lesions;excludes the 650nm532nm Wavelength (nominalIndicated for the removal of
Intended Use / Indications for
Useincluding, but not limited to:wavelength)delivered energy of 585 nmred ink tattoos, treatment of
striae and scars (excludes theReduction of redand 650 nm with optionalvascular lesions, including
650nm wavelength)pigmentation in hypertrophicdye handpieces):facial and leg veins,
Reduction of redand keloid scars whereTattoo removal: light inktelangiectasias, angiomas,
pigmentation in hypertrophicvascularity is an integral part(red, tan, purple, orange, skyhemangiomas, portwine
and keloid scars whereof the scar (excludes theblue, green)stains, and most pigmented
vascularity is an integral part650nm wavelength)Removal of Epidermallesions (e.g., lentigines,
of the scar (excludes thePigmented Lesionsephelides). The 1064/532 nm
650nm wavelength)532 nm wavelength (nominalRemoval of Minor Vascularblended wavelength is
delivered energy of 585 nmLesions including but notindicated for tattoo removal.
532 nm wavelength (nominaland 650 nm with thelimited to telangiectasias
delivered energy of 585 nmOptional Multilite Dye LaserTreatment of Lentigines
and 650 nm with theHandpiece)Treatment of Cafe-Au-lait
Optional Multilite Dye LaserTattoo removal (light ink: red,Treatment of Seborrheic
Handpiece)sky blue, green)Keratoses
Tattoo removal (light ink:Vascular lesions including butTreatment of Post
red, sky blue, green)not limited to: port wineInflammatory Hyper
Vascular lesions includingbirthmarks, telangiectasias,Pigmentation
but not limited to: port winespider angioma, cherryTreatment of Becker's Nevi,

4

Indications for Use Statement

Proposed DevicePredicate DevicePredicate DevicePredicate Device
birthmarks, telangiectasias,
spider angioma, cherry
angioma, spider nevi
Epidermal Pigmented
lesions; including, but not
limited to: cafe-au-lait
birthmarks, solar lentiginos,
senile lentiginos, Becker's
nevi, Freckles, Nevus spilus,
seborrheic keratosis
Skin Resurfacing for Acne
Scars and Wrinkles
Benign cutaneous lesions;
including, but not limited to:
striae and scars (excludes the
650nm wavelength)
Reduction of red
pigmentation in hypertrophic
and keloid scars where
vascularity is an integral part
of the scar (excludes the
650nm wavelength)angioma, spider nevi
Epidermal Pigmented lesions
including but not limited to:
cafe-au-lait birthmarks, solar
lentiginos, senile lentiginos,
Becker's nevi, Freckles,
Nevus spilus
Skin Resurfacing for Acne
Scars and Wrinkles
Benign cutaneous lesions,
such as, but not limited to:
striae and scars (excludes the
650nm wavelength)
Reduction of red
pigmentation in hypertrophic
and keloid scars where
vascularity is an integral part
of the scar (excludes the
650nm wavelength)Freckles and Nevi Spilus

.

. . . . .

.

:

5

H. Substantial Equivalence

Utilizing FDA's Guidance for Industry and FDA Staff "Format for Traditional and Abbreviated $10(k)s", the proposed device, RevLite Q-Switched Nd:YAG Laser System is substantially equivalent to the predicate device in terms of intended use, technological characteristics, and performance characteristics. The RevLite Q-Switched Nd:YAG Laser System is as safe, as effective, and performs as well as the predicate devices.

6

DEPARTMENT OF HEALTH & HUMAN SERVICES

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" arranged around the perimeter. Inside the circle is a stylized representation of three overlapping human figures.

Public Health Service

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

March 5, 2014

Cynosure Incorporated Mrs. Huda Yusuf, MSc. Senior Regulatory Affairs Specialist 5 Carlisle Road Westford, Massachusetts 01888

Re: K133254

Trade/Device Name: RevLife O-Switched Nd:YAG 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: GEX Dated: December 4, 2013 Received: December 5, 2013

Dear Mrs. Yusuf:

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

7

Page 2 - Mr. Huda Yusuf, MSc.

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 contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/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/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,

Felipe Aguel

Binita S. Ashar, M.D., M.B.A., F.A.C.S. for Acting Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

8

Indications for Use Statement

510(k) numberK133254
Device NameRevLite Q-Switched Nd:YAG Laser System
Intended UseIncision, Excision, Ablation, Vaporization of Soft Tissue for General Dermatology,
Dermatologic and General Surgical Procedures for Coagulation and Hemostasis
Specific Indications1064 nm wavelength Tattoo Removal (dark ink: blue and black) Dermal Pigmented Lesions; including, but not limited to: Nevus of Ota, Lentigines,
Nevi, Melasma and Cafe-au-lait Removal or lightening of hair with or without adjuvant preparation. Skin Resurfacing for Acne Scars and Wrinkles Benign cutaneous lesions; including, but not limited to: striae and scars (excludes
the 650nm wavelength) Reduction of red pigmentation in hypertrophic and keloid scars where vascularity is
an integral part of the scar (excludes the 650nm wavelength) 532 nm Wavelength (nominal delivered energy of 585 nm and 650 nm with the Optional
Multilite Dye Laser Handpiece) Tattoo removal (light ink: red, sky blue, green) Vascular lesions including but not limited to: port wine birthmarks, telangiectasias,
spider angioma, cherry angioma, spider nevi Epidermal Pigmented lesions; including, but not limited to: cafe-au-lait birthmarks,
solar lentiginos, senile lentiginos, Becker's nevi, Freckles, Nevus spilus, seborrheic
keratosis Skin Resurfacing for Acne Scars and Wrinkles Benign cutaneous lesions; including, but not limited to: striae and scars, (excludes
the 650nm wavelength) Reduction of red pigmentation in hypertrophic and keloid scars where vascularity is
an integral part of the scar (excludes the 650nm wavelength)
Prescription Use
(Part 21 CFR 801 Subpart D)Over-The-Counter Use
AND/OR
(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)

Felipe Aguel Date: 2014.03.05
11:44:57 -05'00'

(Division Sign-Off) for BSA Division of Surgical Devices 510(k) Number K133254