K Number
K140265
Device Name
ELECTRODE FOR URINARY INCONTINENCE
Date Cleared
2015-01-23

(354 days)

Product Code
Regulation Number
876.5320
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Urinary Incontinence Probe, model PR-51 Vaginal Probe are intended to provide electromyographic feedback from pelvic musculature or electrical stimulation for the purpose of rehabilitation of weak pelvic floor muscles and restoration of neuromuscular control during the treatment of urinary incontinence. The Urinary Incontinence Probe, model PR-51 Vaginal Probe & PR-52 Anal Probe are intended to provide electromyographic feedback from pelvic musculature or electrical stimulation to pelvic musculature for the purpose of rehabilitation of weak pelvic floor muscles and restoration of neuromuscular control during the treatment of urinary incontinence.
Device Description
The Urinary Incontinence Probe, model PR-51 Vaginal Probe & PR-52 Anal Probe are the light weight cylinder consisting of two independent conductive rings that are paired and isolated, physically and electrically. The cylinder is shaped with a handle for comfort positioning in vaginal/anal canal for incontinent treatment as above mentioned and easy for removing after treatment. It is watertight to allow for washing with soap and water between uses. The probe is designed for repeated intermittent use in home or clinic for up to one year by a single user. It does not require sterilization, but does required washing for reuse according to the validated cleaning method as recommended in user manual. To fit with different type of device connection, the lead wire of device was provided with three different type of wire connection terminals, 2mm pigtail, 3.5mm femelle and 2.35 mm femelle. Either of the PR-51 Vaginal Probe & PR-52 Anal Probe can be connected to any one of three connection terminals.
More Information

Not Found

No
The document describes a physical probe for electrical stimulation and EMG feedback, with no mention of AI or ML in the intended use, device description, or specific sections for AI/ML details.

Yes.
The device is intended for the "treatment of urinary incontinence" through "rehabilitation of weak pelvic floor muscles and restoration of neuromuscular control." The term 'rehabilitation' and 'treatment' clearly indicate a therapeutic purpose.

No

The device is intended to provide electromyographic feedback or electrical stimulation for rehabilitation purposes, not for diagnosing conditions.

No

The device description explicitly details a physical probe (cylinder with conductive rings, handle, lead wire) intended for insertion into the vaginal/anal canal, which is a hardware component.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health.
  • Device Function: The description clearly states the device is a probe intended for electromyographic feedback and electrical stimulation of pelvic muscles. It is inserted into the vaginal or anal canal.
  • Lack of Sample Analysis: The device does not analyze any biological samples taken from the body. It interacts directly with the body for therapeutic and feedback purposes.

Therefore, the function and intended use of this device fall outside the scope of In Vitro Diagnostics. It is a therapeutic and biofeedback device.

N/A

Intended Use / Indications for Use

The Urinary Incontinence Probe, model PR-51 Vaginal Probe & PR-52 Anal Probe are intended to provide electromyographic feedback from pelvic musculature or electrical stimulation to pelvic musculature for the purpose of rehabilitation of weak pelvic floor muscles and restoration of neuromuscular control during the treatment of urinary incontinence.

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

KPI, HIR

Device Description

The Urinary Incontinence Probe, model PR-51 Vaginal Probe & PR-52 Anal Probe are the light weight cylinder consisting of two independent conductive rings that are paired and isolated, physically and electrically. The cylinder is shaped with a handle for comfort positioning in vaginal/anal canal for incontinent treatment as above mentioned and easy for removing after treatment. It is watertight to allow for washing with soap and water between uses. The probe is designed for repeated intermittent use in home or clinic for up to one year by a single user. It does not require sterilization, but does required washing for reuse according to the validated cleaning method as recommended in user manual.

To fit with different type of device connection, the lead wire of device was provided with three different type of wire connection terminals, 2mm pigtail, 3.5mm femelle and 2.35 mm femelle. Either of the PR-51 Vaginal Probe & PR-52 Anal Probe can be connected to any one of three connection terminals.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

pelvic musculature

Indicated Patient Age Range

Not Found

Intended User / Care Setting

home or clinic

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 applicable.

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.

K122194

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

§ 876.5320 Nonimplanted electrical continence device.

(a)
Identification. A nonimplanted electrical continence device is a device that consists of a pair of electrodes on a plug or a pessary that are connected by an electrical cable to a battery-powered pulse source. The plug or pessary is inserted into the rectum or into the vagina and used to stimulate the muscles of the pelvic floor to maintain urinary or fecal continence. When necessary, the plug or pessary may be removed by the user. This device excludes an AC-powered nonimplanted electrical continence device and the powered vaginal muscle stimulator for therapeutic use (§ 884.5940).(b)
Classification. Class II (performance standards).

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three heads facing to the right. The eagle is surrounded by a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" written around it.

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

January 23, 2015

Guangzhou Finecure Medical Equipment Co., Ltd % Field Fu Consultant Shenzhen Joyantech Consulting Co., Ltd. 4th Floor, Jinhui Building, Nanhai Blvd, Nanshan District, Shenzhen, 518000 China

Re: K140265

Trade/Device Name: Electrode for Urinary Incontinence Regulation Number: 21 CFR 876.5320 Regulation Name: Non-Implanted electrical continence device Regulatory Class: II Product Code: KPI, HIR Dated: December 10, 2014 Received: December 14, 2014

Dear Field Fu,

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 mav 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

1

Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set 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" (21 CFR 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.

Benjamin R. Fisher -S

Benjamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K140265

Device Name Electrode for Urinary Incontinence

Indications for Use (Describe)

The Urinary Incontinence Probe, model PR-51 Vaginal Probe are intended to provide electromyographic feedback from pelvic musculature or electrical stimulation for the purpose of rehabilitation of weak pelvic floor muscles and restoration of neuromuscular control during the treatment of urinary incontinence.

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

X 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)

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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:

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Product: Electrode for Urinary Incontinence

SECTION 05 510(k) Summary

This summary of 510(K) safety and effectiveness information is submitted As Required by requirements of SMDA and 21 CFR §807.92.

1 Administrative Information

| Date of Summary

preparedJan, 19, 2014
Manufacturer
informationCompany title:
Guangzhou Finecure Medical Equipment Co.,
Ltd.
Company address:
F19, No.1 Kesheng Road, Baiyun Torch
Building, No.1633 Beitai Road, Baiyun District
Guangzhou, CHINA
Phone: +86(020) 2802 6079
Fax: +86(020) 2802 6059
Contact Person: Chiping Ma
E-mail: Finecure_export@163.com
Submission
CorrespondentShenzhen Joyantech Consulting Co., Ltd.
4th Floor, Jinhui Building, Nanhai BLVD,
Nanshan District, Shenzhen, Guangdong,
China.
Contact person: Mr. Field.Fu
Image: Joyantech logoE-Mail: cefda13485@163.com
QQ: 670312758
Website: www.cefda.com
Establishment registration
numberNo.

2 Device Information

Type of 510(k) submission:Traditional
Trade Name:Electrode for Urinary Incontinence
Model:PR-51, PR-52

5

Guangzhou Finecure Medical Equipment Co., LTD

SEC_005:001_510K Summary

Version:A/0

Product: Electrode for Urinary Incontinence

| Classification name: | Stimulator, electrical, non-implantable, for
incontinence;
Perineometer. |
|----------------------|--------------------------------------------------------------------------------|
| Review Panel: | Gastroenterology/Urology;
Obstetrics/Gynecology. |
| Product Code: | KPI; HIR |
| Device Class: | II |
| Regulation Number: | 876.5320;884.1425 |

3 Predicate Device Information

Sponsor:VERYWAY MEDICAL INSTRUMENT CO., LTD
Device:Everyway Incontinence Stimulation Electrode
Model: PR-02/02A, PR-03103A, PR-04104A, PR-10A,
PR-h1A, PR-14A for Life-Care VaginalProbe & PR-
06/06A, PR-1 2A, PR-1 3/13A for Life-Care Anal Probe.
510(K) Number:K122194

4 Device Description

The Urinary Incontinence Probe, model PR-51 Vaginal Probe & PR-52 Anal Probe are the light weight cylinder consisting of two independent conductive rings that are paired and isolated, physically and electrically. The cylinder is shaped with a handle for comfort positioning in vaginal/anal canal for incontinent treatment as above mentioned and easy for removing after treatment. It is watertight to allow for washing with soap and water between uses. The probe is designed for repeated intermittent use in home or clinic for up to one year by a single user. It does not require sterilization, but does required washing for reuse according to the validated cleaning method as recommended in user manual.

To fit with different type of device connection, the lead wire of device was provided with three different type of wire connection terminals, 2mm pigtail, 3.5mm femelle and 2.35 mm femelle. Either of the PR-51 Vaginal Probe & PR-52 Anal Probe can be connected to any one of three connection terminals.

5 Intended Use

The Urinary Incontinence Probe, model PR-51 Vaginal Probe & PR-52 Anal Probe are intended to provide electromyographic feedback from pelvic musculature or electrical stimulation to pelvic musculature for the purpose of rehabilitation of weak pelvic floor muscles and restoration of neuromuscular control during the treatment of urinary incontinence.

6

Version:A/0

Product: Electrode for Urinary Incontinence

6 Indication for Use

The Urinary Incontinence Probe. model PR-51 Vaginal Probe & PR-52 Anal Probe are intended to provide electromyographic feedback from pelvic musculature or electrical stimulation to pelvic musculature for the purpose of rehabilitation of weak pelvic floor muscles and restoration of neuromuscular control during the treatment of urinary incontinence.

7 Technological characteristics of the proposed device compared to the predicate device

The proposed device and the Predicate device have the same intended use, design principle, and similar material composition. The differences do not exert adverse effect on the proposed device. The proposed device is substantially equivalent to the predicate devices.

8 Brief discussion of the nonclinical tests

Electrode for Urinary Incontinence conforms to the following standards:

  • & ISO 10993-1:2009 Biological evaluation of medical devices Part 1: Evaluation and testing within a risk management process;
  • ISO 10993-5:2009 Biological evaluation of medical devices Part 5: Tests for � In Vitro cytotoxicity;
  • ISO 10993-10:2010 Biological evaluation of medical devices Part 10: Tests � for irritation and skin sensitization.

9 Brief discussion of clinical tests

Not applicable.

10 Other information (such as required by FDA guidance)

No other information.

11 Conclusions

The subject device---Electrode for Urinary Incontinence PR-51, PR-52 are substantially equivalent to Everyway Incontinence Stimulation Electrode whose 510(k) number is K122194.