K Number
K161551
Device Name
TR-100
Date Cleared
2016-09-13

(102 days)

Product Code
Regulation Number
878.4400
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The TR-100 device is intended to provide heating for the purpose of elevating tissue temperature for selected medical conditions such as temporary relief of pain, muscle spasms, and increase in local circulation. The TR-100 massage device is intended to provide a temporary reduction in the appearance of cellulite.

Device Description

The TR-100 is a state-of-the-art radiofrequency device with integrated massager, that enables the application of therapy by a non-invasive, high-frequency field. The control unit of the system is fitted with a color touch screen, to facilitate use of the device. The on-screen information guides the operator through the entire therapy. For easier control, the handpiece is equipped with buttons, enabling operation of the device during therapy. The energy flow is indicated by the illuminated treatment tip. The TR-100 consists of the following main components: microprocessor-driven control unit, high-frequency electromagnetic energy generator, massage generator, user interface with 8.4" color touch screen, handpiece.

AI/ML Overview

The provided text describes the TR-100 device and its substantial equivalence to a predicate device (Exilis XP) for market clearance. The key study mentioned is a clinical performance testing to prove the device's ability to reach and maintain an effective treatment temperature.

Here's a breakdown of the requested information based on the document:

1. Table of Acceptance Criteria and Reported Device Performance

The document defines the "Effective Treatment Temperature" as 40 - 45 °C (104 - 113 °F) for both the TR-100 and the predicate device, Exilis XP. The clinical testing aims to prove that the TR-100 reaches this temperature and maintains it for the required time.

Acceptance CriteriaReported Device Performance
Effective Treatment Temperature is reached and maintained for the required timeThe clinical performance testing was conducted "to prove that the device reaches the effective treatment temperature and maintain it for required time." The effective treatment temperature is specified as 40 - 45 °C (104 - 113 °F). While the document states the aim of the test was to prove this, it does not explicitly provide the specific quantitative results (e.g., average temperature achieved, duration maintained) from this testing within the provided text. It merely states that the study was performed to demonstrate this capability.

2. Sample Size Used for the Test Set and Data Provenance

  • Sample Size for Test Set: The document does not specify the sample size used for the clinical performance testing.
  • Data Provenance: The document does not specify the country of origin of the data or whether the study was retrospective or prospective.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Their Qualifications

The document does not provide information on the number of experts used or their qualifications to establish ground truth for the clinical performance test. Given the nature of a thermal device where the "ground truth" is likely direct temperature measurement, it may not have relied on expert interpretation in the same way an image-based diagnostic device would.

4. Adjudication Method for the Test Set

The document does not specify any adjudication method.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

The document does not mention a multi-reader multi-case (MRMC) comparative effectiveness study. The clinical testing described is focused on the device's ability to achieve and maintain temperature, not on the improvement of human readers with AI assistance.

6. If a Standalone (Algorithm Only Without Human-in-the-Loop Performance) Was Done

This question is not applicable in the context of this device. The TR-100 is a physical device that delivers radiofrequency energy and massage, not an algorithm for image analysis or diagnosis. The "performance" being evaluated is its physical delivery of heat, not an algorithmic output.

7. The Type of Ground Truth Used

The ground truth implicitly used for the clinical performance testing would be direct temperature measurements of the tissue being treated. The acceptance criteria themselves define the target temperature range (40-45 °C).

8. The Sample Size for the Training Set

The document does not mention a training set. This is a physical therapy device with heating capabilities, not an AI/ML device that requires a training set in the typical sense. The "training" would be the engineering and developmental phases to tune the device's output to achieve the desired therapeutic temperature.

9. How the Ground Truth for the Training Set Was Established

Not applicable, as no training set (in the AI/ML sense) is mentioned or relevant for this type of device.

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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 seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of three human profiles facing right, stacked on top of each other.

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

September 13, 2016

BTL Industries, Inc. Mr. Jan Zarsky Director 47 Loring Drive Framingham, Massachusetts 01702

Re: K161551

Trade/Device Name: TR-100 Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical cutting and coagulation device and accessories Regulatory Class: Class II Product Code: PBX Dated: August 31, 2016 Received: September 1, 2016

Dear Mr. Zarsky:

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 Part 803); good manufacturing practice requirements as set forth

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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 Parts 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,

Christopher J. Ronk -S

Fox 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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Form Approved: OMB No. 0910-0120

Expiration Date: January 31, 2017

See PRA Statement below.

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) n/a K161551

Device Name

TR-100

Indications for Use (Describe)

The TR-100 device is intended to provide heating for the purpose of elevating tissue temperature for selected medical conditions such as temporary relief of pain, muscle spasms, and increase in local circulation. The TR-100 massage device is intended to provide a temporary reduction in the appearance of cellulite.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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:

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"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."

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Section 5 - 510(k) Summary

General Information

Sponsor:BTL Industries, Inc.47 Loring DriveFramingham, MA 01702Tel: +1-866-285-1656Fax: +1-888-499-2502
Applicant:BTL Industries, Inc.47 Loring DriveFramingham, MA 01702Tel: +1-866-285-1656Fax: +1-888-499-2502
Contact Person:Jan Zarsky
BTL Industries, Inc.
Executive VP
zarsky@btlnet.com
Summary Preparation
Date:09 May 2016

Device Names

Trade/Proprietary Name:TR-100
Primary Classification Name:Electrosurgical cutting and coagulation and accessories
Common Name:Combined high frequency and pulsed massager
Classification Regulation:878.4400
Product Code:PBX

Legally Marketed Predicate Devices

The TR-100 is substantially equivalent to the current product that is already cleared for USA distribution under the following 510(k) Premarket Notification number:

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Product Description

The TR-100 is a state-of-the-art radiofrequency device with integrated massager, that enables the application of therapy by a non-invasive, high-frequency field.

The control unit of the system is fitted with a color touch screen, to facilitate use of the device. The on-screen information guides the operator through the entire therapy. For easier control, the handpiece is equipped with buttons, enabling operation of the device during therapy. The energy flow is indicated by the illuminated treatment tip.

The TR-100 consists of the following main components:

  • . microprocessor-driven control unit
  • high-frequency electromagnetic energy generator
  • . massage generator
  • . user interface with 8.4" color touch screen
  • handpiece

Indications for Use

The TR-100 RF device is intended to provide heating for the purpose of elevating tissue temperature for selected medical conditions such as temporary relief of pain. muscle spasms, and increase in local circulation. The TR-100 massage device is intended to provide a temporary reduction in the appearance of cellulite.

Non-clinical Testing

The TR-100 device has been thoroughly evaluated for electrical safety. The TR-100 has been found to conform to applicable medical device safety standards. The device complies with the following standards:

  • ISO 14971 Medical devices – Application of risk management to medical devices
  • IEC 62304 Medical Device Software - Software Life Cycle Processes
  • IEC 60601-1 General requirements for safety
  • IEC 60601-1-2 Electromagnetic compatibility-Requirements and Tests
  • IEC 60601-2-2 Particular requirements for the basic safety and essential performance of high frequency surgery equipment and high frequency surgical accessories
  • ISO 10993-1 Evaluation and testing within a risk management process
  • ISO 10993-5 Biological Evaluation of Medical Devices-Tests for In Vitro toxicity

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  • ISO 10993-10 Biological Evaluation of Medical Devices—Test for Irritation and Skin Sensitization

Clinical testing

The substantial equivalence determination for the TR-100 is based on clinical performance testing. The aim of the performance test was to prove that the device reaches the effective treatment temperature and maintain it for required time.

Comparison with the Predicate Device

Device NameTR-100Exilis XP
ManufacturerBTL Industries, Inc.BTL Industries, Inc.
510(k) Numbern/aK143040
RegulationGeneral & Plastic Surgery21 CFR 878.4400Electrosurgical cutting and coagulationand accessoriesGeneral & Plastic Surgery21 CFR 878.4400Electrosurgical cutting and coagulation andaccessories
Product CodePBXPBX
Indications forUseThe TR-100 device is intended toprovide heating for the purpose ofelevating tissue temperature for selectedmedical conditions such as temporaryrelief of pain, muscle spasms, andincrease in local circulation. The TR-100massage device is intended to provide atemporary reduction in the appearanceof cellulite.The Exilis XP device is intended to provideheating for the purpose of elevating tissuetemperature for selected medical conditionssuch as temporary relief of pain, musclespasms, and increase in local circulation.The Exilis XP massage device is intended toprovide a temporary reduction in theappearance of cellulite.
DeviceTechnologiesApplication of the heat to the tissue viaRF energy. Massaging of body partswith massage tip.Application of the heat to the tissue via RFenergy. Massaging of body parts withmassage attachment.
ElectricalProtectionClass II, BFClass II, BF
Color TouchScreen8.4" (215mm) / 640x480 pixel8.4" (215mm) / 640x480 pixel
Device NameTR-100Exilis XP
ManufacturerBTL Industries, Inc.BTL Industries, Inc.
510(k) Numbern/aK143040
RF Tip Surface incontact with skin3.14 cm²1.13 - 2.54 cm²
Maximum OutputPower(Density)Up to 300 W(95.5 W/cm2)Up to 120 W(47.2 - 106.2 W/cm²)
EffectiveTreatmentTemperature40 - 45 °C (104 - 113 °F)40 - 45 °C (104 - 113 °F)
Skin TemperatureMonitoringBased on Patient's Feedback.Integrated IR thermometer.Based on Patient's Feedback.Separate IR thermometer.
Heating EnergyTypeRadiofrequencyRadiofrequency
Modes ofOperationMonopolarMonopolar
Output Frequency0.5 MHz ± 50 kHz3.25 MHz ± 50 kHz
WaveformSinusoidSinusoid
Massage TipMaterialMetalGrey Plastic material
MassageapplicationManual Circular,Automatic VerticalManual Circular
Material of theGenerator CaseAluminium, Plastic, Stainless SteelAluminium, Plastic, Stainless Steel
Handpiece HolderAvailabilityYESYES
Patch ElectrodeYESYES
Energy Source100 - 240 VAC, max 7A, 50-60 Hz110 - 240 V, max 4A, 50-60 Hz
Device NameTR-100Exilis XP
ManufacturerBTL Industries, Inc.BTL Industries, Inc.
510(k) Numbern/aK143040
Material of theGenerator CaseAluminum, Plastic, Stainless SteelAluminum, Plastic, Stainless Steel
RF EnergyEmission IndicatorYESYES
Dimensions(W x H x D)600 × 1000 × 600 mm(24" × 39" × 24")406 × 270 × 302 mm(15.98" × 10.63" × 11.87")
Weight50.7 lb (23 kg)16 lb (7.3 kg)

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Image /page/7/Picture/0 description: The image shows a logo with the letters B, T, and L. The letters are in blue and are inside of three diamond shapes. The diamond shapes are connected to each other. The logo is simple and modern.

Substantial Equivalence

Based upon the intended use and technical information provided in this pre-market notification, the TR-100 device has been shown to be substantially equivalent to currently marketed predicate device.

Conclusion

Based on the aforementioned information, the TR-100 is safe and effective and substantially equivalent to the identified predicate device.

§ 878.4400 Electrosurgical cutting and coagulation device and accessories.

(a)
Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.(b)
Classification. Class II.