K Number
K142866
Device Name
Myoscience iovera system
Manufacturer
Date Cleared
2015-01-21

(112 days)

Product Code
Regulation Number
882.4250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The myoscience ioveraº system is used to destroy tissue during surgical procedures by applying freezing cold. It can also be used to produce lesions in peripheral nervous tissue by the application of cold to the blocking of pain. The ioveraº system is not indicated for treatment of central nervous system tissue.
Device Description
The iovera° system is a portable cryogenic surgical device used to destroy tissue and/or produce lesions in nervous tissue through application of extreme cold to the selected site. The device is based on introduction of a Smart Tip internally cooled by the cryogenic fluid (nitrous oxide, N₂O) to a selected area. The Smart Tip is cooled by the Joule-Thomson Effect and/or Latent Heat of Vaporization. iovera° may be used in conjunction with a standard off-the-shelf nerve stimulator device in applications where precise nerve location is desired. The device is comprised of four main components: 1. A reusable Handpiece 2. A Charging Dock 3. An assortment of single-patient use Smart Tips 4. A Cartridge (Nitrous Oxide)
More Information

Not Found

No
The summary describes a cryogenic surgical device that uses physical principles (Joule-Thomson Effect, Latent Heat of Vaporization) for cooling. There is no mention of AI, ML, image processing, or data-driven algorithms for decision making or analysis. The software testing focuses on basic verification of parameters and is classified as "moderate" concern, which is typical for device control software, not AI/ML.

Yes
The device is described as destroying tissue and producing lesions in nervous tissue to block pain, which are therapeutic actions. It is used in surgical procedures.

No

The device is described as a "cryogenic surgical device used to destroy tissue and/or produce lesions," indicating a therapeutic rather than diagnostic function. It applies cold for tissue destruction and pain blocking, which are treatment actions.

No

The device description explicitly lists hardware components (Handpiece, Charging Dock, Smart Tips, Cartridge) and the performance studies include biocompatibility and bench testing related to these physical components. While software testing is mentioned, it is for software contained in the medical device, not the device itself being solely software.

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

Here's why:

  • Intended Use: The intended use clearly states the device is used to "destroy tissue during surgical procedures by applying freezing cold" and "produce lesions in peripheral nervous tissue by the application of cold to the blocking of pain." This describes a therapeutic or surgical intervention performed on the patient's body, not a test performed on a sample taken from the patient's body to diagnose a condition.
  • Device Description: The description details a system that applies cold directly to tissue and nervous tissue. This aligns with a surgical or therapeutic device, not a device used for in vitro testing.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue samples, etc.), detecting analytes, or providing diagnostic information based on laboratory testing.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information for the diagnosis, monitoring, or treatment of diseases or conditions. This device's function is to directly modify tissue or nerve function through the application of cold.

N/A

Intended Use / Indications for Use

The myoscience ioveraº system is used to destroy tissue during surgical procedures by applying freezing cold. It can also be used to produce lesions in peripheral nervous tissue by the application of cold to the blocking of pain. The ioveraº system is not indicated for treatment of central nervous tissue.

Product codes

GXH

Device Description

The iovera° system is a portable cryogenic surgical device used to destroy tissue and/or produce lesions in nervous tissue through application of extreme cold to the selected site. The device is based on introduction of a Smart Tip internally cooled by the cryogenic fluid (nitrous oxide, N₂O) to a selected area. The Smart Tip is cooled by the Joule-Thomson Effect and/or Latent Heat of Vaporization. iovera° may be used in conjunction with a standard off-the-shelf nerve stimulator device in applications where precise nerve location is desired.

Device Design
The device is comprised of four main components:

    1. A reusable Handpiece
    1. A Charging Dock
    1. An assortment of single-patient use Smart Tips
    1. A Cartridge (Nitrous Oxide)

The iovera° Handpiece is battery powered (single cell Lithium lon, 3.7 volts) and provides feedback to the user during device preparation and use. The Handpiece connects to both the Cartridge and to the Smart Tip. The user activates a treatment cycle through a control on the Handpiece, which starts and stops the treatment. The Handpiece also contains LEDs for providing feedback to the user when the device is ready to use. The Charging Dock stores the Handpiece between uses and provides power for charging the battery.

An assortment of Smart Tips is available for the iovera° system. All Smart Tip needles are made of stainless steel and have a closed-end that fully contains the cryogen so that it does not enter the target tissue. The Smart Tip is the only patient contacting component of the iovera° system. The user removes the Smart Tip from the sterile packaging and attaches it to the Handpiece.

The iovera system uses a commercially available nitrous oxide cylinder. The Cartridge is filled with pure N-O.

Device Functionality/Scientific Concepts
The device functionality is based on the user introducing the Smart Tip to the selected treatment area: unwanted tissue or the target nervous tissue. The user then initiates the flow of cryogen by pressing the on/off button. Liquid cryogen flows from the Handpiece into the closed-end Smart Tip. The Smart Tip is cooled by the Joule-Thomson Effect and/or Latent Heat of Vaporization; as the liquid cryogen expands into a gas, the temperature drops around the external surface of the Smart Tip causing the surrounding tissue to freeze. The treatment is completed after a pre-programmed amount of time the user can safely remove the Smart Tip.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Tissue, peripheral nervous tissue

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)

The following performance data were provided in support of the substantial equivalence determination.

Biocompatibility testing:
The biocompatibility evaluation for the Smart Tip needle was conducted in accordance with the FDA Blue Book Memorandum #G95-1 "Use of International Standard ISO-10993, 'Biological Evaluation of Medical Devices Part 1: Evaluation and Testing'"and International Standard ISO 10993-1 "Biological Evaluation of Medical Devices – Part 1: Evaluation and Testing Within a Risk Management Process," as recognized by FDA. The battery of testing included the following tests:

  • . Cytotoxicity
  • Sensitization (supplier testing)
  • . Intracutaneous reactivity (supplier testing)
    The stainless steel Smart Tip needle is considered tissue contacting for a duration of less than 24 hours.

Software testing:
Software verification testing was conducted and documentation was provided as recommended by FDA's Guidance document, "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices." The software for this device was considered as a "moderate" level of concern, since a failure or latent design flaw in the software could directly result in minor injury to the patient or operator.
Specifically, the following test was performed:

Test PerformedResult
Tip Descriptor verification to confirm treatment parametersPASS

Bench testing:
Bench testing was performed on the new Smart Tip to demonstrate that the product met the design requirements. A risk analysis was used to assess the impact of the modification, as well, and design verification testing was performed as a result of this risk analysis assessment. In all cases, the risk was mitigated to acceptable levels and the performance testing demonstrated that the device is in compliance with pertinent standards (i.e., ISO 11135-1). Needle integrity validation test was modified from the predicate to demonstrate safety and effectiveness due to the changes in needle design and longer length.
Specifically, the following tests were performed:

Test PerformedResult
Visual and dimensional inspection of Smart Tip needlePASS
Verification of temperature reproducibilityPASS
Validation of cryozone sizePASS
Validation of needle integrity in simulated use conditionsPASS
After flexing, needle shall return to straight condition Needle shall not leak after kink failurePASS
Sterility TestingPASS
Transit/Shelf Life TestingPASS

Preclinical Testing Submitted: No preclinical testing was deemed necessary for this modification.
Clinical Testing Submitted: No clinical testing was deemed necessary for this modification.

Conclusion:
The performance data demonstrate that the iovera° system is as safe, as effective, and performs comparably to the predicate device that is currently marketed for the same intended use.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K133453

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 882.4250 Cryogenic surgical device.

(a)
Identification. A cryogenic surgical device is a device used to destroy nervous tissue or produce lesions in nervous tissue by the application of extreme cold to the selected site.(b)
Classification. Class II (performance standards).

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Image /page/0/Picture/1 description: The image shows the seal of the Department of Health & Human Services - USA. The seal is circular, with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. In the center of the seal is a stylized image of three human profiles facing to the right, stacked on top of each other. The profiles are rendered in a dark color, contrasting with the white background of the seal.

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

January 21, 2015

Myoscience, Inc Tracey Henry VP RAQA, Operations 1600 Seaport Blvd, North Lobby, Suite 450 Redwood City, California 94063-2

Re: K142866 Trade/Device Name: Myoscience Iovera System Regulation Number: 21 CFR 882.4250 Regulation Name: Cryogenic Surgical Device Regulatory Class: Class II Product Code: GXH Dated: October 22, 2014 Received: October 23, 2014

Dear Ms. Henry,

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 devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in

1

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/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 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. Pena -$ D/△

Carlos L. Peña, PhD, MS Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K142866

Device Name Myoscience iovera system

Indications for Use (Describe)

The myoscience ioveraº system is used to destroy tissue during surgical procedures by applying freezing cold. It can also be used to produce lesions in peripheral nervous tissue by the application of cold to the blocking of pain. The ioveraº system is not indicated for treatment of central nervous system tissue.

Type of Use (Select one or both, as applicable)
× Prescription Use (Part 21 CFR 801 Subnart D)Over-The-Counter Use (21 CFR 801 Subpart C)

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510(k) Summary

Device Information:
-----------------------
CategoryComments
Sponsor / Submitter:Myoscience, Inc
1600 Seaport Blvd
North Lobby, Suite 450
Redwood City, CA 94063
Ph: (650) 474-2600
Fax: (650) 474-2700
Correspondent ContactTracey Henry
Information:Vice President RAQA, Operations
1600 Seaport Blvd
North Lobby, Suite 450
Redwood City, CA 94063
Ph: (650) 474-2600
Fax: (650) 474-2900
Device Common Name:Cryogenic surgical device
Device Classification & Code:Class II, GXH
Device Classification Name:Cryosurgical unit and accessories (21 CFR 882.4250)
Device Trade Name:Myoscience iovera® system

Predicate Device Information: a.

510(k) NumberProductSponsor
K133453ioveraMyoscience, Inc

This predicate has not been subject to a design-related recall.

b. Date Summary Prepared

September 30, 2014

c. Description of Device

The iovera° system is a portable cryogenic surgical device used to destroy tissue and/or produce lesions in nervous tissue through application of extreme cold to the selected site. The device is based on introduction of a Smart Tip internally cooled by the cryogenic fluid (nitrous oxide, N₂O) to a selected area. The Smart Tip is cooled by the Joule-Thomson Effect and/or Latent Heat of Vaporization. iovera° may be used in conjunction with a standard off-the-shelf nerve stimulator device in applications where precise nerve location is desired.

Device Design

The device is comprised of four main components:

    1. A reusable Handpiece
    1. A Charging Dock
    1. An assortment of single-patient use Smart Tips
    1. A Cartridge (Nitrous Oxide)

The iovera° Handpiece is battery powered (single cell Lithium lon, 3.7 volts) and provides feedback to the user during device preparation and use. The Handpiece connects to both the Cartridge and to the Smart Tip. The user activates a treatment cycle through a control on the Handpiece, which starts and stops the treatment. The Handpiece also contains LEDs for providing feedback to the user when the device is ready

CONFIDENTIAL

4

to use. The Charging Dock stores the Handpiece between uses and provides power for charging the battery.

An assortment of Smart Tips is available for the iovera° system. All Smart Tip needles are made of stainless steel and have a closed-end that fully contains the cryogen so that it does not enter the target tissue. The Smart Tip is the only patient contacting component of the iovera° system. The user removes the Smart Tip from the sterile packaging and attaches it to the Handpiece.

The iovera system uses a commercially available nitrous oxide cylinder. The Cartridge is filled with pure N-O.

Device Functionality/Scientific Concepts

The device functionality is based on the user introducing the Smart Tip to the selected treatment area: unwanted tissue or the target nervous tissue. The user then initiates the flow of cryogen by pressing the on/off button. Liquid cryogen flows from the Handpiece into the closed-end Smart Tip. The Smart Tip is cooled by the Joule-Thomson Effect and/or Latent Heat of Vaporization; as the liquid cryogen expands into a gas, the temperature drops around the external surface of the Smart Tip causing the surrounding tissue to freeze. The treatment is completed after a pre-programmed amount of time the user can safely remove the Smart Tip.

d. Indications for Use

The myoscience iovera® device is used to destroy tissue during surgical procedures by applying freezing cold. It can also be used to produce lesions in peripheral nervous tissue by the application of cold to the selected site for the blocking of pain. The iovera® device is not indicated for treatment of central nervous system tissue.

The Indications for Use statements for the subject and predicate devices are identical.

e. Comparison of Technological Characteristics with the Predicate Device

Following are the similarities/differences in technological characteristics between the subject and predicate devices. The differences in technological characteristics do not raise different questions of safety and effectiveness for the subject device as compared to the predicate device.

Technological Characteristics
Predicate Device (K133453)Subject Device
Cryogenic deviceSame
Nitrous oxide coolant, pressurized cylinderSame
Reusable handpiece, battery poweredSame
Single use tip for subdermal cooling, EO sterilizedSame
Charging dockSame
Sensors, monitor nitrous oxide deliver and rate of coolingSame
Smart Tip NeedleSmart Tip Needle
Length: 6 – 25mm (0.2 – 1.0in) Size: Ø.31 – .52mm (25 – 30 gauge) Patient contacting materials:
Closed sharp cutting tip Stainless Steel needleLength: 6 – 55mm (0.2 – 2.2in) Size: Ø.31 – .72mm (22 – 30 gauge) Patient contacting materials:
Closed sharp cutting and blunt tip Stainless Steel needle
Single Smart Tip configurations from 10 mm to 55 mm contain

5

| | electrochemically etched markings
on the needle surface |

--------------------------------------------------------------

f. Performance Data

The following performance data were provided in support of the substantial equivalence determination.

The biocompatibility evaluation for the Smart Tip needle was conducted in Biocompatibility testing: accordance with the FDA Blue Book Memorandum #G95-1 "Use of International Standard ISO-10993, 'Biological Evaluation of Medical Devices Part 1: Evaluation and Testing'"and International Standard ISO 10993-1 "Biological Evaluation of Medical Devices – Part 1: Evaluation and Testing Within a Risk Management Process," as recognized by FDA. The battery of testing included the following tests:

  • . Cytotoxicity
  • Sensitization (supplier testing)
  • . Intracutaneous reactivity (supplier testing)

The stainless steel Smart Tip needle is considered tissue contacting for a duration of less than 24 hours.

Software testing: Software verification testing was conducted and documentation was provided as recommended by FDA's Guidance document, "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices." The software for this device was considered as a "moderate" level of concern, since a failure or latent design flaw in the software could directly result in minor injury to the patient or operator. Specifically, the following test was performed:

Test PerformedResult
Tip Descriptor verification to confirm treatment parametersPASS

Bench testing: Bench testing was performed on the new Smart Tip to demonstrate that the product met the design requirements. A risk analysis was used to assess the impact of the modification, as well, and design verification testing was performed as a result of this risk analysis assessment. In all cases, the risk was mitigated to acceptable levels and the performance testing demonstrated that the device is in compliance with pertinent standards (i.e., ISO 11135-1). Needle integrity validation test was modified from the predicate to demonstrate safety and effectiveness due to the changes in needle design and longer length. Specifically, the following tests were performed:

Test PerformedResult
Visual and dimensional inspection of Smart Tip needlePASS
Verification of temperature reproducibilityPASS
Validation of cryozone sizePASS
Validation of needle integrity in simulated use conditionsPASS

CONFIDENTIAL

6

After flexing, needle shall return to straight condition Needle shall not leak after kink failure
Sterility TestingPASS
Transit/Shelf Life TestingPASS

Preclinical Testing Submitted: No preclinical testing was deemed necessary for this modification.

Clinical Testing Submitted: No clinical testing was deemed necessary for this modification.

g. Conclusion

The performance data demonstrate that the iovera° system is as safe, as effective, and performs comparably to the predicate device that is currently marketed for the same intended use.