K Number
K133297
Date Cleared
2014-06-10

(228 days)

Product Code
Regulation Number
878.4810
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The QuadroStarPROYELLOW (wavelength: 577nm) is intended for treatment of benign vascular and benign pigmented lesions.
The QuadroStarPROGREEN (wavelength: 532nm) is intended for vaporisation and photocoagulation of benign vascular and benign pigmented lesions in soft tissue.

Device Description

The QuadroStarPRO Laser system is a laser Class IV, solid state diode laser, which emits laser radiation with a wavelength of either 577 nm or 532 nm. It`s pulse duration can be varied from millisecond pulses up to continuous operation. The laser power up to 8 Watts is transmitted to the tissue through a transfer fiber and a handpiece, optionally a scanner can be operated.
The laser system consists of:
Laser system including control panel (user interface) Foot switch A transfer fiber with handpiece, optional different spacers.

AI/ML Overview

The provided document is a 510(k) Summary for the QuadroStarPRO laser system. It describes the device, its intended use, and compares it to predicate devices to establish substantial equivalence.

However, the document does not contain information about a study proving the device meets specific acceptance criteria in terms of performance in a clinical or diagnostic setting. Instead, it focuses on demonstrating compliance with recognized standards for medical device safety and functionality.

Here's a breakdown of the requested information based on the provided text, and where it's not available:

1. A table of acceptance criteria and the reported device performance

The document lists performance testing against several ISO and DIN EN standards:

  • ISO 14971:2009 (Risk management for medical devices)
  • DIN EN 60601-1:2006 (Medical electrical equipment - General requirements for basic safety and essential performance)
  • DIN EN 60601-1-2:2007 (Medical electrical equipment - General requirements for basic safety and essential performance - Collateral standard: Electromagnetic compatibility - Requirements and tests)
  • DIN EN 60601-1-6:2007 (Medical electrical equipment - General requirements for basic safety and essential performance - Collateral standard: Usability)
  • DIN EN 60601-2-22:1996 (Medical electrical equipment - Particular requirements for the safety of surgical, therapeutic and diagnostic laser equipment)
  • DIN EN 60825-1:2007 (Safety of laser products - Part 1: Equipment classification and requirements)
  • DIN EN 62304:2006 (Medical device software - Software life cycle processes)

The "reported device performance" in this context is simply the declaration that the device complies with these standards and the European Medical Device Directive 93/42/EEC + Amendment 2007/47/EC. Specific numerical acceptance criteria and detailed performance results from these tests are not provided in this summary. The 510(k) summary only states "The QuadroStarPRO laser system is tested according to following standards" and then concludes with "The QuadroStarPRO is substantially equivalent to the cited legally marked predicate devices. The minor differences between QuadroStarPRO and the predicate devices raise no new issues of safety and effectiveness, as these differences have no effect on the performance, function or intended use of these devices." This indicates that the device met the requirements of these standards.

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

This information is not provided in the document. The testing described is type testing against engineering and safety standards, not clinical performance testing with a "test set" of patient data.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

This information is not applicable/not provided. There is no "test set" or "ground truth" related to clinical or diagnostic performance discussed in this document.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

This information is not applicable/not provided. See point 3.

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

This information is not applicable/not provided. This document pertains to a medical laser device, not an AI-assisted diagnostic or imaging device. Therefore, an MRMC study or AI assistance is not relevant to the scope of this 510(k) summary.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

This information is not applicable/not provided. See point 5.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

This information is not applicable/not provided. There is no ground truth related to clinical performance mentioned. The "truth" in this context is compliance with engineering and safety standards.

8. The sample size for the training set

This information is not applicable/not provided. This device is a laser system, not an artificial intelligence or machine learning algorithm that requires a training set.

9. How the ground truth for the training set was established

This information is not applicable/not provided. See point 8.

In summary: The provided document is a 510(k) summary for a laser device seeking market clearance through substantial equivalence. It confirms compliance with various engineering and safety standards but does not detail clinical effectiveness studies, specific acceptance criteria for diagnostic/treatment performance, or "test sets" in the context of clinical data evaluation. The "study" referenced is the testing performed against the listed international and European standards, to which the device was found to comply, establishing its safety and effectiveness relative to predicate devices.

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JUN 1 0 2014

510(k) SUMMARY ASCLEPION LASER TECHNOLOGIES GmbH K133297 QuadroStarPRO

This 510(k) summary of safety and effectiveness for the Asclepion Laser Technologies GmbH QuadroStarPRO is submitted in accordance with the requirements of 21 CFR 907.92 and follows Office of Device Evaluation Guidance concerning the organization and content of a 510(k) summary.

Applicant:ASCLEPION LASER TECHNOLOGIES GmbHBruesseler Str. 1007747 Jena, Germany
Contact Person:Mrs. Antje KatzerProduct Management andInternational Regulatory Affairs
Phone:+49 3641 77 00 309
Fax:+49 3641 77 00 302
e-mail:antje.katzer@asclepion.com
Preparation Date:June 10, 2014
Device Name:QuadroStarPRO
Common Name:QuadroStarPRO
Classification Name:Laser surgical instrument for use in general and plasticsurgery79-GEX21 CFR 878.4810

Equivalent Devices:

K013940YellowStar Asclepion-Meditec AG(Assignor of Asclepion Laser Technologies GmbH)
K060457QuadroStar 532 Asclepion Laser Technologies GmbH

The QuadroStarPRO Laser system is a laser Class IV, Device Description: solid state diode laser, which emits laser radiation with a wavelength of either 577 nm or 532 nm. It`s pulse duration can be varied from millisecond pulses up to continuous operation. The laser power up to 8 Watts is transmitted to the tissue through a transfer fiber and a handpiece, optionally a scanner can be operated.

The laser system consists of:

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Laser system including control panel (user interface) Foot switch A transfer fiber with handpiece, optional different spacers. The QuadroStarPROYELLOW (wavelength: 577nm) is Intended Use: intended for treatment of benign vascular and benign pigmented lesions. The QuadroStarPROGREEN (wavelength: 532nm) is intended for vaporisation and photocoagulation of benign vascular and benign pigmented lesions in soft tissue.

Comparison to:

The QuadroStarPRO with 577 nm has identical indications for use as the K013940 YellowStar, the QuadroStarPRO with 532 nm has identical indications for use as the K060457 QuadroStar 532.

Therefore the QuadroStarPRO is found to be substantially equivalent to already marketed and predicate lasers. Both predicates were developed by Asclepion or it's assignor.

With regard to technology, the QuadroStarPRO is found to be substantially equivalent to K060457 QuadroStar 532, since the basic technology, design and safety features are very similar. With the availability of multi-color diodes it became practicable also to generate wavelengths such as 577 nm by means of modern diode

technology, whereas in former times these wavelengths could only be generated with the technology of Copper Bromide or Copper Vapor lasers.

The differences between QuadroStarPRO and the predicate devices raise no new issues of safety and effectiveness, as these differences have no effect on the performance, function or intended use of these devices.

DeviceQuadroStarPROK013940YellowStarK060457QuadroStar 532
Intended Use577 nm: intended fortreatment of benignvascular and benignpigmented lesions.532 nm: intended forvaporisation andphotocoagulation of benignvascular and benignpigmented lesions in softtissue.Intended for treatmentof vascular andpigmented lesions.Intended for vaporizationand photocoagulation ofvascular and pigmentedlesions in soft tissue.
Device TypeDiode pumped solid-statelaserCopper Bromide laserDiode pumped solid-statelaser
Wavelength532 nm or 577 nm(cannot be combined)511 nm and 578 nm(single or combined)532 nm
Principle ofoperationPulsed or cwOptical excitationPulsed or Quasi-continuousHigh voltageexcitationPulsed or cwOptical excitation
Maximum8 W (532 nm)5 W (511 nm)5 W

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Power5 W (577 nm)2 W (578 nm)7 W both/combined
Energy RangeUp to 1.9 JUp to 0.4 JUp to 12.4 J
DeviceK013940K060457
QuadroStarPROYellowStarQuadroStar 532
Pulse Duration1 ms - 95 s and cw10 - 950 ms and cw5 ms - 2.5 s and cw
Max.RepetitionRate20 Hz16 kHz Quasi-cw120 Hz
DeliveryTransfer fiberTransfer fiberTransfer fiber
Spotdiameters1 mm / optional :0.5/1.5/2.8 mmScanner : 1 mm0.2/0.4/0.6/1.0/1.5 mm0.5/1.0/1.5 mm
DeviceCoolingInternal air coolingInternal air coolingInternal air cooling
Power Supply100 - 240VAC, 50/60Hz230V 50/60Hz/10 A115/230V 50/60Hz

Performance Testing:

The QuadroStarPRO laser system is tested according to following standards:

ISO 14971:2009 DIN EN 60601-1:2006 DIN EN 60601-1-2:2007 DIN EN 60601-1-6:2007 DIN EN 60601-2-22:1996 DIN EN 60825-1:2007 DIN EN 62304:2006

The device also complies with European Medical Device Directive 93/42/EEC + Amendment 2007/47/EC.

Conclusion: The QuadroStarPRO is substantially equivalent to the cited legally marked predicate devices. The minor differences between QuadroStarPRO and the predicate devices raise no new issues of safety and effectiveness, as these differences have no effect on the performance, function or intended use of these devices.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

June 10, 2014

ASCLEPION LASER TECHNOLOGIES GmbH Ms. Antje Katzer Product Management and International Regulatory Affairs Bruesseler Str. 10 07747 Jena. Germany

Re: K133297 Trade/Device Name: QuadroStarPRO 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: May 7, 2014 Received: May 12, 2014

Dear Ms. Katzer:

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

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Page 2 - Ms. Antje Katzer

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.goy/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 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.

for

Sincerely yours,

David Krause -S

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

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICESFood and Drug Administration
Indications for Use
Form Approved:OMB No. 0910-0120
Expiration Date:January 31, 2017See PRA Statement below.
510(k) Number ( if known )K133297
Device NameQuadroStarPRO
Indications for Use (Describe)The QuadroStarPROYELLOW (wavelength: 577nm) is intended for treatment of benign vascular and benign pigmented lesions.
The QuadroStarPROGREEN (wavelength: 532nm) is intended for vaporisation and photocoagulation of benign vascular and benign pigmented lesions in soft tissue.
Federal law restricts this device to sale by or on the order of a physician!
Type of Use ( Select one or both, as applicable )
☑ Prescription Use (Part 21 CFR 801 Subpart D)☐ 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)
Neil R Ogden
2014.06.10 15:45:00 -04'00'For BSA
This section applies only to requirements of the Paperwork Reduction Act of 1995.
DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.
The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:
Department of Health and Human ServicesFood and Drug AdministrationOffice of Chief Information OfficerPaperwork Reduction Act (PRA) StaffPRAStaff@fda.hhs.gov
"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

FORM FDA 3881 (1/14)

Page 1 of 1

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PIC Publicition Scrines (1001) 40-476 EF

1

§ 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.