K Number
K160309
Device Name
Neurosoft TMS
Manufacturer
Date Cleared
2016-12-22

(322 days)

Product Code
Regulation Number
882.5805
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Neurosoft TMS is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode.
Device Description
The Neurosoft TMS is a repetitive transcranial magnetic stimulation (rTMS) system. This computerized medical device produces non-invasive, repetitive pulsed magnetic fields of sufficient magnitude to induce neural action potentials in the prefrontal cortex for the treatment of Major Depressive Disorder.
More Information

Not Found

No
The summary describes a hardware-based rTMS system and does not mention any software features or algorithms that would suggest the use of AI or ML.

Yes
The device is indicated for the "treatment of Major Depressive Disorder," which signifies a therapeutic purpose.

No
The device description and intended use clearly state that the Neurosoft TMS is indicated for the treatment of Major Depressive Disorder. There is no mention of it being used for diagnosis, prognosis, or monitoring.

No

The device description explicitly states it is a "repetitive transcranial magnetic stimulation (rTMS) system" and a "computerized medical device" that "produces non-invasive, repetitive pulsed magnetic fields." This indicates the presence of hardware components beyond just software. The performance studies also mention testing of hardware aspects like electrical safety, electromagnetic compatibility, and magnetic field characteristics.

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

Here's why:

  • Intended Use: The intended use is for the treatment of Major Depressive Disorder by applying magnetic stimulation to the prefrontal cortex. IVDs are used to diagnose diseases or conditions by examining samples from the human body (like blood, urine, tissue).
  • Device Description: The device description clearly states it's a repetitive transcranial magnetic stimulation (rTMS) system that produces magnetic fields to induce neural action potentials. This is a therapeutic device, not a diagnostic one.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, performing tests on bodily fluids or tissues, or providing diagnostic information.

Therefore, the Neurosoft TMS is a therapeutic medical device, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Neurosoft TMS is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode.

Product codes

OBP

Device Description

The Neurosoft TMS is a repetitive transcranial magnetic stimulation (rTMS) system. This computerized medical device produces non-invasive, repetitive pulsed magnetic fields of sufficient magnitude to induce neural action potentials in the prefrontal cortex for the treatment of Major Depressive Disorder.
The Neurosoft TMS principle of operation is based on the discharge of high voltage capacitor (1.8 kV) through stimulation coil; the pulsed magnetic field generated by the discharge current (up to 10 kA) penetrates through neuromuscular tissues nearby to induce electrical currents in cortical neurons.
The Neurosoft TMS consists of the following main components:

  • . Main unit of the magnetic stimulator
  • Cooling unit ●
  • Extra power supply unit ●
  • Coils
    • Cooled figure-of-eight coil FEC-02-100-C O
    • O Cooled figure-of-eight coil AFEC-02-100-C
    • Figure-of-eight coil FEC-02-100 (optional) o
    • o Figure-of-eight coil AFEC-02-100 (optional)
  • . K8 coil holder
  • K3 flexible arm for coil positioning
  • Trolley with casters ●

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

prefrontal cortex, Frontal Cortex

Indicated Patient Age Range

adult patients

Intended User / Care Setting

Prescription Use (Part 21 CFR 801 Subpart D)

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)

Non-clinical performance data included electrical safety and electromagnetic compatibility testing compliant with AAMI/ANSI ES 60601-1:2005/(R)2012 and IEC 60601-1-2: 2007. Biocompatibility evaluation for coils met ISO 10993-1 (2009) standards. Software verification and validation testing demonstrated the software performs as intended. Risk assessment complied with ISO14971. Testing of magnetic field characteristics, magnetic field plots, and acoustic output measurements were conducted as per FDA's guidance document "Class II Special Controls Guidance Document: Repetitive Transcranial Magnetic Stimulation (rTMS) Systems" to demonstrate safety and performance.

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

Not Found

Predicate Device(s)

K150641, K143531

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 882.5805 Repetitive transcranial magnetic stimulation system.

(a)
Identification. A repetitive transcranial magnetic stimulation system is an external device that delivers transcranial repetitive pulsed magnetic fields of sufficient magnitude to induce neural action potentials in the prefrontal cortex to treat the symptoms of major depressive disorder without inducing seizure in patients who have failed at least one antidepressant medication and are currently not on any antidepressant therapy.(b)
Classification. Class II (special controls). The special control is FDA's “Class II Special Controls Guidance Document: Repetitive Transcranial Magnetic Stimulation System.” See § 882.1(e) for the availability of this guidance document.

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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 circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the top half of the circle. Inside the circle is a stylized image of three human profiles facing to the right, stacked on top of each other to create a sense of depth and unity.

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

December 22, 2016

TeleEMG, LLC % Barry Ashar President MakroMed, Inc. 88 Stiles Road Salem, New Hampshire 03079

Re: K160309

Trade/Device Name: Neurosoft TMS Regulation Number: 21 CFR 882.5805 Regulation Name: Repetitive Transcranial Magnetic Stimulation System Regulatory Class: Class II Product Code: OBP Dated: January 26, 2016 Received: February 4, 2016

Dear Barry Ashar:

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,

William J.

Heetderks -A

Digitally signed by William J. Heetderks -A
DN: c=US, o=U.S. Government, ou=HHS,
ou=NIH, ou=People,
0.9.2342.19200300.100.1.1=0010149848,
cn=William J. Heetderks -A
Date: 2016.12.22 14:55:04 -05'00'

for 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) K160309

Device Name Neurosoft TMS

Indications for Use (Describe)

The Neurosoft TMS is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode.

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)

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510(k) Summary for the TeleEMG, LLC Neurosoft TMS

(per 21 CFR 807.92 and http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/default.htm)

1. SUBMITTER/510(K) HOLDER

TeleEMG. LLC 27 Arlington Rd., Building 2, Unit 1 Woburn, MA 01801, USA

Contact Person: Barry V. Ashar, Makromed, Inc. Telephone: (603) 890-3311 Date Prepared: November 16, 2016

2. DEVICE NAME

Proprietary Name:Neurosoft TMS
Regulation Name:Repetitive transcranial magnetic stimulation system
Regulation Number:21 CFR §882.5805
Classification Name:Transcranial Magnetic Stimulator
Device Class:Class II
Product Code:OBP

(Note: During its development Neurosoft TMS was also known as Neuro-MS/D. As a result, many of its documents may be titled with Neuro-MS/D name. It is our intention to commercialize it as Neurosoft TMS. All product labeling now refer to this product as Neurosoft TMS. Some of the support documents included in this submission may still refer to Neuro-MS/D. The two names are fully interchangeable as they represent one and the same product)

3. PREDICATE DEVICES

  • Tonica Electronik A/S, MagVita TMS Therapy System, K150641
  • Magstim Company Limited, Rapid2 Therapy System, K143531

4. DEVICE DESCRIPTION

The Neurosoft TMS is a repetitive transcranial magnetic stimulation (rTMS) system. This computerized medical device produces non-invasive, repetitive pulsed magnetic fields of sufficient magnitude to induce neural action potentials in the prefrontal cortex for the treatment of Major Depressive Disorder.

4

The Neurosoft TMS principle of operation is based on the discharge of high voltage capacitor (1.8 kV) through stimulation coil; the pulsed magnetic field generated by the discharge current (up to 10 kA) penetrates through neuromuscular tissues nearby to induce electrical currents in cortical neurons.

The Neurosoft TMS consists of the following main components:

  • . Main unit of the magnetic stimulator
  • Cooling unit ●
  • Extra power supply unit ●
  • Coils
    • Cooled figure-of-eight coil FEC-02-100-C O
    • O Cooled figure-of-eight coil AFEC-02-100-C
    • Figure-of-eight coil FEC-02-100 (optional) o
    • o Figure-of-eight coil AFEC-02-100 (optional)
  • . K8 coil holder
  • K3 flexible arm for coil positioning
  • Trolley with casters ●

5. INTENDED USE

The Neurosoft TMS system is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode.

6. STANDARDS

The Neurosoft TMS system has been tested and complies with the following standards:

  • DIN EN ISO 13485: 2012 .
  • ISO 10993-1: 2009 .
  • ISO 14971: 2007 .
  • AAMI/ANSI ES 60601-1:2005/(R)2012 ●
  • IEC 60601-1-2: 2007 .

7. NON-CLINICAL PERFORMANCE DATA

Electrical safety and electromagnetic compatibility testing demonstrate that the Neurosoft TMS is compliant with AAMI/ANSI ES 60601-1:2005/(R)2012 and IEC 60601-1-2: 2007.

Only the coils in the delivery set of the Neurosoft TMS have direct contact with the patients. The biocompatibility evaluation demonstrates that the coils meet ISO 10993-1 (2009) standards.

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Software verification and validation testing is described section 16 "Software" following the corresponding FDA software guidelines. It demonstrates that the software performs as intended and in accordance with specifications. The potential risks of the Neurosoft TMS have been identified and evaluated in compliance with ISO14971, and the risks were determined to be acceptable, or have been addressed with risk control measures.

Additionally, the non-clinical testing with the Neurosoft TMS included testing of the magnetic field characteristics of the system, as required by FDA's guidance document "Class II Special Controls Guidance Document: Repetitive Transcranial Magnetic Stimulation (rTMS) Systems". The magnetic field plots and acoustic output measurements were conducted to demonstrate safety and performance.

8. SUBSTANTIAL EQUIVALENCE

The Neurosoft TMS and the predicate devices have identical intended use /indication for use (see table 5-1), and the technological characteristics are very similar such that they in our view can be considered equivalent.

The design of the Neurosoft TMS is similar to that of the MagVita TMS Therapy System and the Rapid2 Therapy System, as all systems are based on applying transcranial magnetic stimulation by means of repetitive pulse trains at a predetermined frequency. All systems use the same mechanism of action, i.e., an electromechanical instrument that produces and delivers brief duration, rapidly alternating (pulsed) magnetic fields to induce electrical currents in localized regions of the prefrontal cortex.

The basic software capabilities related to treatment administration in the Neurosoft TMS are the same as these in the predicate devices.

The Neurosoft TMS and the predicate devices have the same components consisting of TMS stimulator with software, electromagnetic coil and a flexible arm for positioning of the treatment coil. The basic operational procedures including system setup, patient preparations, motor threshold determination, coil positioning and treatment with predefined treatment stimulation parameters are essentially the same. A thorough comparison among the Neurosoft TMS and the predicate devices is shown in a tabular form (see table 5-1) below:

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CriteriaNeurosoft TMSMagVita TMS Therapy SystemRapid² Therapy System
Intended UseThe Neurosoft TMS is indicated
for the treatment of Major
Depressive Disorder in adult
patients who have failed to
receive satisfactory improvement
from prior antidepressant
medication in the current
episode.The MagVita TMS
Therapy System is
indicated for the treatment
of Major Depressive
Disorder in adult patients
who have failed to receive
satisfactory improvement
from prior antidepressant
medication in the current
episode.The Rapid² Therapy
System is indicated for
the treatment of Major
Depressive Disorder in
adult patients who have
failed to achieve
satisfactory improvement
from prior antidepressant
medication in the current
episode.
Recommended standard treatment
Magnetic Field
Intensity120% of the MT120% of the MT120% of the MT
Frequency10 Hz10 Hz10 Hz
Train duration4 sec4 sec4 sec
Inter-train interval26 sec26 sec26 sec
Number of trains757575
Magnetic Pulses
per Session300030003000
Treatment Session
Duration~ 37.0 min37.0 min37.5 min
Sessions/week555
Treatment
Schedule5 daily sessions for 6 weeks5 daily sessions for 6
weeks5 daily sessions for 6
weeks
Area of brain to be
stimulatedFrontal CortexFrontal CortexFrontal Cortex
Coils
Coils (including
optional
accessories)FEC-02-100-C, AFEC-02-100-C
FEC-02-100 (optional), AFEC-
02-100 (optional)C-B60
C-B65Magstim Double 70mm
Air Film Coil
ConfigurationFigure-of-eight coilFigure-of-eight coilFigure-of-eight coil
Core materialAir coreAir coreAir core
CoolingFEC-02-100-C & AFEC-02-100-
C: Liquid coolingC-B65: Liquid coolingForced Air
FEC-02-100 & AFEC-02-100
(optional accessories): NoneC-B60: None
Coil parametersFEC-02-100-C
Inner diameter - 47x50 mm1
Outer diameter - 97x100 mm1Coil Cool-B65
Inner diameter - 35 mm
Outer diameter - 75 mmArea = 33000 mm²
Average Inductance 12 μH
CriteriaNeurosoft TMSMagVita TMS Therapy SystemRapid2 Therapy System
Area = 184725 mm²
Average Inductance 10 μH
Flat spiral winding
N = 16 (4 turns/wing x 2 wings x 2 layers)
AFEC-02-100-C
Inner diameter - 36x51 mm1
Outer diameter - 84x106 mm1
Area = 184725 mm²
Average Inductance 10 μH
Flat spiral winding
N = 16 (4 turns/wing x 2 wings x 2 layers)Winding height - 12 mm
N = 2x (2 x 5)Flat spiral winding
N = 3x19 turns/wing x 2wings
FEC-02-100
Inner diameter - 47x50 mm1
Outer diameter - 97x100 mm1
Area = 91560 mm²
Average Inductance 10 μH
Flat spiral winding
N = 16 (4 turns/wing x 2 wings x 2 layers)
AFEC-02-100
Inner diameter - 36x51 mm1
Outer diameter - 84x106 mm1
Area = 87200 mm²
Average Inductance 10 μH
Flat spiral winding
N = 16 (4 turns/wing x 2 wings x 2 layers)Coil C-B60
Inner diameter - 35 mm
Outer diameter - 75 mm
Winding height - 12 mm
N = 2x (2 x 5)
Machine Output Parameters
Amplitude in
Standard Motor
Threshold (SMT)
unitsFEC-02-100-C 0 - 1.89
AFEC-02-100-C 0 - 2.38
FEC-02-100 0 - 1.92
AFEC-02-100 0 - 2.330 - 1.70.28 - 1.9
WaveformBiphasic sinusoidBiphasic sinusoidBiphasic sinusoid
Active pulse width
(μs)280290300
Max initial dB/dt
(kT/s) near the coil
surfaceFEC-02-100-C 25
AFEC-02-100-C 38
FEC-02-100 25
AFEC-02-100 32C-B65: 36
C-B60: 35N/A
The system will
automatically be
disabled when the
coil temperature
exceeds:41 °C (106 °F)41 °C (106 °F)40 °C (104 °F)
Frequency range0.1 - 30 (Stand-alone)0.1 - 30 or 0.1 - 100,0.1 - 30
CriteriaNeurosoft TMSMagVita TMS Therapy
SystemRapid2 Therapy System
(Hz)0.1 - 100 (with PC)depending on model
Pulse train
duration range (s)0.5 - 100Rep Rate: 0.1 ...100Hz
Pulses in Train: 1,2,3,4 ...
1000
Train duration = Pulses in
Train / Rep Rate1 - 20
Inter-train interval
range (s)0 - 3001 - 12010 - 60
Maximum trains
per session4800 = 2400 s [max session] /
(0.5 s [min train]+ 0 s [min
pause])500~140
Maximum number
of pulses per
session72,000(Stand-alone) = 2400 s
[max session] *30 Hz
240,000(with PC) = 2400 s [max
session] *100 Hz500,000 = 1,000 (pulses
max per train) x 500 (trains
max per session)65,000
Standards
Electrical
safetyComplies with AAMI/ANSI ES
60601-1:2005/(R)2012 and IEC
60601-1-2Complies with
IEC 60601-1, IEC 60601-
1-1 and IEC 60601-1-2.Complies with
EN 60601-1 and
EN 60601-1-2
ISO Standards
metCompany complies with DIN EN
ISO 13485: 2012
ISO 10993-1: 2009
ISO 14971: 2007Company complies with
ISO 13485:2012.Company complies with
ISO 13485: 2003
ISO 10993-1: 2009
ISO 14971

Table 5-1. Side-by-Side Comparison of the Proposed Device with Cited Predicate Devices

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8

1 see Fig. 1

Image /page/8/Figure/2 description: The image shows a diagram with several measurements labeled. The diagram appears to be a technical drawing of a mechanical component. The measurements are labeled as 'A', 'B', 'a', and 'b'.

Image /page/8/Figure/3 description: The image shows the text "Fig.1 Coil for magnetic stimulator". The text is in black font and is centered in the image. The text is likely a figure caption for a scientific paper or presentation.

9. CONCLUSION

The Neurosoft TMS and the predicate devices have identical intended use /indication for use, target population, treatment procedure, treatment position and all recommended standard

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treatment protocol parameters (intensity, frequency, number of pulses in a train, number of trains in a session, number of treatment sessions).

All coils compared in Table 5.1 share the same transducer design (figure-of-eight). The tested magnetic properties of the Neurosoft TMS and the predicate devices are substantial equivalent for the coils.

The reliability of the positioning method used by the Neurosoft TMS is based on the direct relationship of the underlying cortical brain anatomy to the patient's scalp, as is the method used in the predicate devices. The method for identifying the correct treatment position in the Neurosoft TMS is at least as effective as the method employed by the predicate devices.

The Neurosoft TMS does not introduce any new safety considerations in comparison to the predicate device. All other identified differences between the two systems are minor and without any known impact on safety or efficacy.

Based on the information and supporting documentation provided in the premarket notification, the Neurosoft TMS is substantially equivalent to the cited predicate devices. Testing demonstrates that the Neurosoft TMS fulfills prospectively defined design and performance specifications.