K Number
K163067
Device Name
CyMedica e-vive™ System; CY-1000
Date Cleared
2016-12-01

(29 days)

Product Code
Regulation Number
890.5850
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The CyMedica e-vive System is a multifunctional electrotherapy device with two treatment modes that allow for neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS). Indications for Use: - As an NMES device, indications are for the following conditions: - Relaxation of muscle spasms - Retardation or prevention of disuse atrophy - Increasing local blood circulation - Re-educating muscles - Immediate post-surgical stimulation of calf muscles to prevent venous thrombosis - Maintaining or increasing range of motion As a TENS device, indications are for the following conditions: - Symptomatic relief and management of chronic intractable pain - Adjunctive treatment for post-surgical and post-trauma acute pain
Device Description
The CyMedica e-vive™ System is a multifunctional electrotherapy device with two stimulation channels and two treatment modes that allows for neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS). The principles of electrotherapy emulate the process observed during a voluntary muscle contraction. The e-vive™ system delivers stimulation based on the principles of NMES and TENS. NMES pulses stimulate motor points of target muscles, causing a muscle contraction. This can help re-educate and strengthen muscles following an injury or surgery. TENS blocks the pain signal sent from the affected area on nerve pathways. The e-vive device is equipped with a goniometer (Class I, 510(k) Exempt), which is intended to measure and record joint range of motion. e-vive™ electrical stimulation technology is based on the electrical stimulation technology developed for CyMedica QB1™ system. K150413. The e-vive™ electrotherapy programs are delivered to the patient directly by a User Interface controller integrated in a conductive garment. The stimulation programs are managed wirelessly using a mobile application developed for use on smart phones or tablets that interact with the User Interface controller. The e-vive™ system are prescription devices in the USA and are intended to be used following the directions of a healthcare provider. The device may be used in a healthcare facility setting or by a patient or lay operator in a home environment. In NMES mode, the e-vive™ system provides two therapeutic treatment programs: Post-Operative and Strength. Its simplified programming makes the device convenient for home use; after placing the electrodes and selecting the program as prescribed by a healthcare professional, the patient only needs to increase the intensity to a comfortable level to begin therapy. The evive™ NMES Post-Operative and Strength programs utilize an electrical stimulus that, when properly applied, activates specific muscles or muscle groups to help treat disuse muscle atrophy and to reeducate muscles. This is achieved via a closed loop feedback system that minimizes energy delivery to the targeted treatment areas. In NMES mode, the e-vive™ system consists of a knee conductive garment with an incorporated Controller, docking receptacle, range of motion sensor, three electrodes, a USB-A to micro-USB-B cable for Controller charging, an electrode gel tube, and e-vive mobile app available for download from the App Store onto a patient's mobile device. As a TENS device, the e-vive TENS treatment is a safe and effective method of providing a drug-free method of pain relief. Patients with recurring pain, can utilize the e-vive TENS treatment program for immediate and long-term pain relief. The e-vive™ TENS system consists of a conductive garment with an incorporated Controller. docking receptacle, two electrodes, a USB-A to micro-USB-B cable for Controller charging, an electrode gel tube, and e-vive mobile app available for download from the App Store onto a patient's mobile device. The e-vive electrogoniometer (battery powered goniometer) is capable of measuring and recording the joint range of motion by using two sensors to detect the knee range of motion. One sensor is located on the Controller board and the second sensor is located within the sensor pod, on a small electronic board. The sensor pod is contained within the conductive garment below the knee area opening. The sensor pod is connected wirelessly to the Controller using a BLE connection. The sensor data from the sensor pod and the Controller sensor is conveyed to the mobile device real time. The sensors can detect the knee extension/flexion angles, and associated range of motion angle through the use of the e-vive mobile app when initiated by the patient or healthcare provider. The e-vive™ System incorporates a Bluetooth Low Energy, BLE 4.1 connection module to enable wireless communication and can be paired with a Bluetooth enabled mobile device running the e-vive™ App, available from the App stores. The App implements a virtual control panel on the screen of the smart device where on-screen buttons are provided to the user. The Controller is connected to the conductive garment via a 16-pin interface. The Controller contains the primary safety controls for operation of the device and a push button is available for switching the unit on or off. The power button remains active and can be used in the event of loss of Bluetooth connection to power on/off the device or start/stop stimulation while performing stimulation sessions. The e-vive™ system contains light emitting diodes (LED) which indicate status relating to battery charge, stimulation and Bluetooth™ activity. Power is derived from a 3.7V Li-Po rechargeable battery pack and the unit can be recharged by using the supplied USB cable.
More Information

Not Found

No
The summary describes a standard electrotherapy device with a goniometer and mobile app control. There is no mention of AI or ML in the device description, intended use, or performance studies. The "closed loop feedback system" mentioned in the NMES mode description appears to be a basic control mechanism, not indicative of AI/ML.

Yes
The device is described as a "multifunctional electrotherapy device" with specific indications for use including "relaxation of muscle spasms," "retardation or prevention of disuse atrophy," "increasing local blood circulation," "re-educating muscles," "prevent venous thrombosis," "maintaining or increasing range of motion," and "symptomatic relief and management of chronic intractable pain." These are all therapeutic applications.

No

Explanation: The device is described as a "multifunctional electrotherapy device" used for therapy (NMES and TENS) to treat conditions like muscle spasms, disuse atrophy, pain relief, and to measure range of motion. It does not state that it is used to diagnose a medical condition or disease.

No

The device description explicitly lists multiple hardware components beyond just software, including a conductive garment with an integrated controller, electrodes, a goniometer, a charging cable, and a rechargeable battery pack. While it utilizes a mobile app for control, it is not solely software.

Based on the provided text, the CyMedica e-vive System is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Definition of IVD: In Vitro Diagnostic devices are used to examine specimens taken from the human body, such as blood, urine, or tissue, to provide information for diagnosis, monitoring, or screening.
  • CyMedica e-vive System Function: The description clearly states that the CyMedica e-vive System is an electrotherapy device that delivers electrical stimulation (NMES and TENS) to the body. It also includes a goniometer to measure joint range of motion.
  • Intended Use: The intended uses listed are for therapeutic purposes (muscle stimulation, pain relief, range of motion measurement) and do not involve the analysis of biological specimens.
  • Device Description: The components and operation described are consistent with an external electrotherapy device, not an IVD.

Therefore, the CyMedica e-vive System falls under the category of a therapeutic medical device, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The CyMedica e-vive System is a multifunctional electrotherapy device with two treatment modes that allow for neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS).

Indications for Use:

  • As an NMES device, indications are for the following conditions:
    • Relaxation of muscle spasms
    • Retardation or prevention of disuse atrophy
    • Increasing local blood circulation
    • Re-educating muscles
    • Immediate post-surgical stimulation of calf muscles to prevent venous thrombosis
    • Maintaining or increasing range of motion

As a TENS device, indications are for the following conditions:

  • Symptomatic relief and management of chronic intractable pain
  • Adjunctive treatment for post-surgical and post-trauma acute pain

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

IPF, GZJ, KQX

Device Description

The CyMedica e-vive™ System is a multifunctional electrotherapy device with two stimulation channels and two treatment modes that allows for neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS). The principles of electrotherapy emulate the process observed during a voluntary muscle contraction. The e-vive™ system delivers stimulation based on the principles of NMES and TENS. NMES pulses stimulate motor points of target muscles, causing a muscle contraction. This can help re-educate and strengthen muscles following an injury or surgery. TENS blocks the pain signal sent from the affected area on nerve pathways.

The e-vive device is equipped with a goniometer (Class I, 510(k) Exempt), which is intended to measure and record joint range of motion.

e-vive™ electrical stimulation technology is based on the electrical stimulation technology developed for CyMedica QB1™ system. K150413. The e-vive™ electrotherapy programs are delivered to the patient directly by a User Interface controller integrated in a conductive garment. The stimulation programs are managed wirelessly using a mobile application developed for use on smart phones or tablets that interact with the User Interface controller.

The e-vive™ system are prescription devices in the USA and are intended to be used following the directions of a healthcare provider. The device may be used in a healthcare facility setting or by a patient or lay operator in a home environment.

In NMES mode, the e-vive™ system provides two therapeutic treatment programs: Post-Operative and Strength. Its simplified programming makes the device convenient for home use; after placing the electrodes and selecting the program as prescribed by a healthcare professional, the patient only needs to increase the intensity to a comfortable level to begin therapy. The evive™ NMES Post-Operative and Strength programs utilize an electrical stimulus that, when properly applied, activates specific muscles or muscle groups to help treat disuse muscle atrophy and to reeducate muscles. This is achieved via a closed loop feedback system that minimizes energy delivery to the targeted treatment areas.

In NMES mode, the e-vive™ system consists of a knee conductive garment with an incorporated Controller, docking receptacle, range of motion sensor, three electrodes, a USB-A to micro-USB-B cable for Controller charging, an electrode gel tube, and e-vive mobile app available for download from the App Store onto a patient's mobile device.

As a TENS device, the e-vive TENS treatment is a safe and effective method of providing a drug-free method of pain relief. Patients with recurring pain, can utilize the e-vive TENS treatment program for immediate and long-term pain relief.

The e-vive™ TENS system consists of a conductive garment with an incorporated Controller. docking receptacle, two electrodes, a USB-A to micro-USB-B cable for Controller charging, an electrode gel tube, and e-vive mobile app available for download from the App Store onto a patient's mobile device.

The e-vive electrogoniometer (battery powered goniometer) is capable of measuring and recording the joint range of motion by using two sensors to detect the knee range of motion. One sensor is located on the Controller board and the second sensor is located within the sensor pod, on a small electronic board. The sensor pod is contained within the conductive garment below the knee area opening. The sensor pod is connected wirelessly to the Controller using a BLE connection. The sensor data from the sensor pod and the Controller sensor is conveyed to the mobile device real time. The sensors can detect the knee extension/flexion angles, and associated range of motion angle through the use of the e-vive mobile app when initiated by the patient or healthcare provider.

The e-vive™ System incorporates a Bluetooth Low Energy, BLE 4.1 connection module to enable wireless communication and can be paired with a Bluetooth enabled mobile device running the e-vive™ App, available from the App stores. The App implements a virtual control panel on the screen of the smart device where on-screen buttons are provided to the user.

The Controller is connected to the conductive garment via a 16-pin interface. The Controller contains the primary safety controls for operation of the device and a push button is available for switching the unit on or off. The power button remains active and can be used in the event of loss of Bluetooth connection to power on/off the device or start/stop stimulation while performing stimulation sessions. The e-vive™ system contains light emitting diodes (LED) which indicate status relating to battery charge, stimulation and Bluetooth™ activity. Power is derived from a 3.7V Li-Po rechargeable battery pack and the unit can be recharged by using the supplied USB cable.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

The e-vive™ system are prescription devices in the USA and are intended to be used following the directions of a healthcare provider. The device may be used in a healthcare facility setting or by a patient or lay operator in a home environment.

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 testing data was submitted to demonstrate substantial equivalence. These tests focused on safety aspects including electrical safety, electromagnetic compatibility, usability, biocompatibility, and risk management. Performance of the BLE module for wireless co-existence was also evaluated. The device complied with all specified standards and requirements.

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.

K150413

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

§ 890.5850 Powered muscle stimulator.

(a)
Identification. A powered muscle stimulator is an electrically powered device intended for medical purposes that repeatedly contracts muscles by passing electrical currents through electrodes contacting the affected body area.(b)
Classification. Class II (performance standards).

0

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

December 1, 2016

CyMedica Orthopedics, Inc. % Mark Job Regulatory Technology Services LLC 1394 25th Street NW Buffalo, Minnesota 55313

Re: K163067

Trade/Device Name: CyMedica e-vive™ System; CY-1000 Regulation Number: 21 CFR 890.5850 Regulation Name: Powered Muscle Stimulator Regulatory Class: Class II Product Code: IPF, GZJ, KQX Dated: October 31, 2016 Received: November 2, 2016

Dear Mark Job:

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 device

1

related 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 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,

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  • 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) K163067

Device Name

CyMedica e-vive System; CY-1000

Indications for Use (Describe)

The CyMedica e-vive System is a multifunctional electrotherapy device with two treatment modes that allow for neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS).

Indications for Use:

  • As an NMES device, indications are for the following conditions:
  • Relaxation of muscle spasms
  • Retardation or prevention of disuse atrophy
  • Increasing local blood circulation
  • Re-educating muscles
  • Immediate post-surgical stimulation of calf muscles to prevent venous thrombosis
  • Maintaining or increasing range of motion

As a TENS device, indications are for the following conditions:

  • Symptomatic relief and management of chronic intractable pain
  • Adjunctive treatment for post-surgical and post-trauma acute pain

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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3

K163067 510(k) Summary

CyMedica Orthopedics, Inc.

CyMedica e-vive™ System

1- SUBMITTER

| Manufacturer Name: | CyMedica Orthopedics, Inc.
19120 N. Pima Rd. Suite 135
Scottsdale, AZ 85255
Telephone (480) 664-1282
FAX (866) 296-2772 |
|------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Official Contact: | Kereshmeh Shahriari
19120 N. Pima Rd. Suite 135
Scottsdale, AZ 85255
kereshmeh@cymedicaortho.com
Telephone (480) 664-1282
FAX (866) 296-2772 |
| 510(k) Summary Preparation
Date | November 30, 2016 |
| 2- DEVICE | |
| Trade/Proprietary Name: | CyMedica e-vive™ System; CY-1000 |
| Common Name: | Muscle stimulator & Electrogoniometer |
| Classification Names: | Powered muscle stimulator (21 CFR 890.5850)
Transcutaneous Electrical Nerve Stimulator for Pain Relief (21
CFR 882.5890)
Goniometer, AC-powered (21 CFR 888.1500) |
| Product Codes: | Powered Muscle Stimulator or Neuromuscular Electrical
Stimulator (NMES); IPF
Transcutaneous Nerve Stimulator (TENS) for pain relief;
GZJ
Goniometer; KQX |
| Device Class: | Powered Muscle Stimulator & TENS: Class II
Goniometer: Class I, 510(k) Exempt |

4

CyMedica e-vive™ System K163067

NMES and TENS devices are reviewed by the Division of Neurological and Physical Medicine Devices (DNPMD).

3- PREDICATE DEVICE

Name & 510(k) Number:

K150413 QB1 NMES & TENS System CyMedica Orthopedics, Inc.

4- DEVICE DESCRIPTION

The CyMedica e-vive™ System is a multifunctional electrotherapy device with two stimulation channels and two treatment modes that allows for neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS). The principles of electrotherapy emulate the process observed during a voluntary muscle contraction. The e-vive™ system delivers stimulation based on the principles of NMES and TENS. NMES pulses stimulate motor points of target muscles, causing a muscle contraction. This can help re-educate and strengthen muscles following an injury or surgery. TENS blocks the pain signal sent from the affected area on nerve pathways.

The e-vive device is equipped with a goniometer (Class I, 510(k) Exempt), which is intended to measure and record joint range of motion.

e-vive™ electrical stimulation technology is based on the electrical stimulation technology developed for CyMedica QB1™ system. K150413. The e-vive™ electrotherapy programs are delivered to the patient directly by a User Interface controller integrated in a conductive garment. The stimulation programs are managed wirelessly using a mobile application developed for use on smart phones or tablets that interact with the User Interface controller.

The e-vive™ system are prescription devices in the USA and are intended to be used following the directions of a healthcare provider. The device may be used in a healthcare facility setting or by a patient or lay operator in a home environment.

In NMES mode, the e-vive™ system provides two therapeutic treatment programs: Post-Operative and Strength. Its simplified programming makes the device convenient for home use; after placing the electrodes and selecting the program as prescribed by a healthcare professional, the patient only needs to increase the intensity to a comfortable level to begin therapy. The evive™ NMES Post-Operative and Strength programs utilize an electrical stimulus that, when properly applied, activates specific muscles or muscle groups to help treat disuse muscle atrophy and to reeducate muscles. This is achieved via a closed loop feedback system that minimizes energy delivery to the targeted treatment areas.

In NMES mode, the e-vive™ system consists of a knee conductive garment with an incorporated Controller, docking receptacle, range of motion sensor, three electrodes, a USB-A to micro-USB-B cable for Controller charging, an electrode gel tube, and e-vive mobile app available for

5

download from the App Store onto a patient's mobile device.

As a TENS device, the e-vive TENS treatment is a safe and effective method of providing a drug-free method of pain relief. Patients with recurring pain, can utilize the e-vive TENS treatment program for immediate and long-term pain relief.

The e-vive™ TENS system consists of a conductive garment with an incorporated Controller. docking receptacle, two electrodes, a USB-A to micro-USB-B cable for Controller charging, an electrode gel tube, and e-vive mobile app available for download from the App Store onto a patient's mobile device.

The e-vive electrogoniometer (battery powered goniometer) is capable of measuring and recording the joint range of motion by using two sensors to detect the knee range of motion. One sensor is located on the Controller board and the second sensor is located within the sensor pod, on a small electronic board. The sensor pod is contained within the conductive garment below the knee area opening. The sensor pod is connected wirelessly to the Controller using a BLE connection. The sensor data from the sensor pod and the Controller sensor is conveyed to the mobile device real time. The sensors can detect the knee extension/flexion angles, and associated range of motion angle through the use of the e-vive mobile app when initiated by the patient or healthcare provider.

The e-vive™ System incorporates a Bluetooth Low Energy, BLE 4.1 connection module to enable wireless communication and can be paired with a Bluetooth enabled mobile device running the e-vive™ App, available from the App stores. The App implements a virtual control panel on the screen of the smart device where on-screen buttons are provided to the user.

The Controller is connected to the conductive garment via a 16-pin interface. The Controller contains the primary safety controls for operation of the device and a push button is available for switching the unit on or off. The power button remains active and can be used in the event of loss of Bluetooth connection to power on/off the device or start/stop stimulation while performing stimulation sessions. The e-vive™ system contains light emitting diodes (LED) which indicate status relating to battery charge, stimulation and Bluetooth™ activity. Power is derived from a 3.7V Li-Po rechargeable battery pack and the unit can be recharged by using the supplied USB cable.

5- INDICATIONS FOR USE

The e-vive™ System is a multifunctional electrotherapy device with two treatment modes that allow for neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS).

Indications for Use:

As an NMES device, indications are for the following conditions:

6

    1. Relaxation of muscle spasms
    1. Retardation or prevention of disuse atrophy
    1. Increasing local blood circulation
    1. Re-educating muscles
    1. Immediate post-surgical stimulation of calf muscles to prevent venous thrombosis
    1. Maintaining or increasing range of motion

As a TENS device, indications are for the following conditions:

    1. Symptomatic relief and management of chronic intractable pain
    1. Adjunctive treatment for post-surgical and post-trauma acute pain

The treatment programs for NMES Post-Op and NMES Strength are shown below.

| Treatment

ProgramPulse shapeDurationFrequencyPulse widthDuty cycleWork cycleRelaxation timeContraction timeRest timeIndications numbers
NMES Post-OpMonophasic20 min50 pps5 ms25%13 s10 s3 s
2 cycles3.4 s1, 2, 3, 4, 5, 6
NMES StrengthMonophasic20 min50 pps5 ms25%12 s10 s1 s
5 cycles1.4 s1, 2, 3, 4, 5, 6

The treatment program for TENS pain management is shown below .

| Treatment
Program | Pulse
shape | Duration | Frequency | Pulse
width | Duty
cycle | Work
cycle | Interphase
interval
time | Indications
numbers |
|-------------------------|--------------------------|----------|-----------|----------------|---------------|---------------|--------------------------------|------------------------|
| TENS Pain
Management | Biphasic,
symmetrical | 20 min | 100 pps | 1 ms | 20% | Continuous | 4 ms | 7, 8 |

6- COMPARISON OF TECHNOLOGICAL CHARACTERISTICS WITH THE PREDICATE DEVICE

CyMedica Orthopedics, Inc. demonstrated that, for the purposes of FDA's regulation of medical devices, the e-vive™ System is substantially equivalent to the predicate device, QB1 System, K150413. The data included in this submission demonstrates substantial equivalence to the predicate device listed above.

The intended use, design, materials and functional characteristics of the e-vive™ NMES and TENS System and the QB1 predicate device are substantially the same. The subject device and predicate device provide neuromuscular electrical stimulation therapy, are portable, hand-held, and for home healthcare environment use. Similar to the predicate device, the power in e-vive™ device is derived from a rechargeable battery that is pre-installed in the User Interface Controller. There are two channels of stimulation in both devices. In both devices, the user needs to select the desired treatment program and adjust the intensity. Both devices employ a ramp-up, work, and rest phases.

7

CyMedica e-vive™ System K163067

The data included in this submission demonstrates substantial equivalence to the predicate device listed above. The intended use, design, and functional characteristics of the e-vive electrogoniometer are within the limitations of exemption in 21 CFR 888.9, applicable to goniometers which are Class I, 510(k) exempt. The goniometer in the e-vive system measures and records joint range of motion similar to other goniometers under 21 CFR 888.1500. The goniometer is battery operated and uses accelerometers to measure the flexion and extension angles. An embedded software in the e-vive system calculates the range of motion using the measured flexion and extension angles data.

Parametere-viveQB1
510(k) NumberK163067K150413
Device Name and Modee-viveQB1
ManufacturerCyMedica OrthopedicsCyMedica Orthopedics
Power Source(s)†Single VD434053:
3.7V; 1000mAh;
Lithium ion polymer
batterySingle H605060: 3.7V;
2000mAh; Lithium ion
polymer battery
-Method of Line Current IsolationNo line connectionNo line connection
-Patient Leakage Current††------
-Normal Condition(µA)4.881.5
-Single Fault Condition (µA)8.002.6
Number of Output Modes †††33
Number of Output Channels ††††: Synchronous or Alternating? Method of Channel IsolationAlternating
TransistorAlternating
Transistor
Regulated Current or Regulated Voltage?Regulated PowerRegulated Power
Software/Firmware/Microprocessor Control?YesYes
Automatic Overload Trip?NoNo
Automatic No-Load Trip?NoNo
Automatic Shut Off?YesYes
User Override Control?Yes Stop ButtonsYes Stop Button
Indicator Display:
On/Off Status?
Low Battery?
Voltage/Current Level?Yes
Yes
NoYes
Yes
No
Timer Range (minutes)20-open20-open
Compliance with Voluntary Standards?Yes.
IEC 60601-2-10:2012 Part 2-10;

IEC 60601-1-11:2015 Part 1-11;

IEC 60601-1-6:2010;

ISO 10993-1:2009 Part 1 | Yes.
IEC 60601-2-10:2012 Part 2-10;

IEC 60601-1-11:2010 Part 1-11;

IEC 60601-1-6:2010;

ISO 10993-1:2009 Part 1 |
| | Compliance with 21 CFR 898? | Yes | Yes |
| | Weight (lbs., oz.) | 1.76 oz. (50g) | 8.6 oz (243.8g) |

Comparison of Technology to Predicate

8

Parametere-viveQB1
Dimensions (in.) [W x H x D]1.93" x 0.64" x 3.28"3.15" x 0.88" x 5.84"
Housing Materials and ConstructionMolded PC\ABSMolded PC\ABS
PlasticPlastic
Bayblend FR3010Bayblend FR3010
Parametere-vive NMES POST-OPe-vive NMES STRENGTHe-vive TENSQB1 NMES POST-OpQB1 NMES STRENGTHQB1 NMES STRENGTH
510(k) NumberK163067K163067K163067K150413K150413K150413
Mode or Program NameNMES POST-OPNMES STRENGTHTENSNMES POST-OPNMES STRENGTHTENS
Waveform (e.g., pulsed monophasic, biphasic)Pulsed MonophasicPulsed MonophasicSymmetric BiphasicPulsed MonophasicPulsed MonophasicSymmetric Biphasic
Shape (e.g., rectangular, spike, rectified sinusoidal)ComplexComplexComplexComplexComplexComplex
Maximum Output Voltage (volts, rms)8.5 @500Ω
15.5 @ 2 kΩ
20.2 @10 kΩ8.4 @500Ω
@ 2 kΩ
@10 kΩ10.4 @500Ω
17.1 @ 2 kΩ
20.9 @10 kΩ9.3 @500Ω
16.8 @ 2 kΩ
21.9 @10 kΩ9.3 @500Ω
16.6 @ 2 kΩ
21.8 @10 kΩ10.2 @500Ω
16.7 @ 2 kΩ
19.8 @10 kΩ
Maximum Output Current (mA, rms)17.1 @500Ω
7.7 @ 2 kΩ
2.0 @10 kΩ@500Ω
@ 2 kΩ
@10 kΩ20.9 @500Ω
8.5 @ 2 kΩ
2.1 @10 kΩ18.5 @500Ω
8.4 @ 2 kΩ
2.2 @10 kΩ18.6 @500Ω
8.3 @ 2 kΩ
2.2 @10 kΩ20.5 @500Ω
8.3 @ 2 kΩ
2.0 @10 kΩ
Duration of primary (depolarizing) phase (µsec)50005000N/A (Continuous)50005000N/A (Continuous)
Pulse Duration (µsec)500050001000500050001000
Parametere-vive NMES
POST-OPe-vive NMES
STRENGTHe-vive TENSQB1 NMES
POST-OpQB1 NMES
STRENGTHQB1 NMES
STRENGTH
Frequency (Hz) [or
Rate (pps)]50501005050100
For interferential
modes only: Beat
Frequency (Hz)N/AN/AN/AN/AN/AN/A
For
multiphasi
c
waveform
s only:Symmetrical
phases?N/AN/AYesN/AN/AYes
Phase
durationN/AN/A1 msN/AN/A1 ms
Net Charge
(microcoulombs
(µC) per pulse) (If
zero, state method
of achieving zero
net charge.)342 @500Ω336 @500Ω0 @500Ω
(Symmetric
Biphasic)371 @500Ω372 @500Ω0 @500Ω
(Symmetric
Biphasic)
Maximum Phase
Charge, (µC)342 @500Ω336 @500Ω417 @500Ω371 @500Ω372 @500Ω409 @500Ω
Maximum Current
Density (mA/cm², r.m.s.)0.66 @500Ω0.65 @500Ω0.81 @500Ω0.72 @500Ω0.72 @500Ω0.79 @500Ω
Maximum Average
Current (average
absolute value),
mA17.1 @500Ω16.8 @500Ω20.9 @500Ω18.5 @500Ω18.6 @500Ω20.5 @500Ω
Maximum Average
Power Density,
(W/cm²), (using
smallest electrode
conductive surface
area)0.005 @500Ω0.006 @500Ω0.009
@500Ω0.007
@500Ω0.007
@500Ω0.008
@500Ω
Parametere-vive NMES
POST-OPe-vive NMES
STRENGTHe-vive TENSQB1 NMES
POST-OpQB1 NMES
STRENGTHQB1 NMES
STRENGTH
Burst
Mode(a) Pulses
per burst1505015050
(b) Bursts
per second0.0870.230.0870.23
(c) Burst
duration
(seconds)3131N/A
(Continuous
Pulse)
(d) Duty
Cycle: Line
(b) x
Line (c)0.260.230.260.23
ON Time
(seconds)312276Continuous312276Continuous
OFF Time
(seconds)888924Continuous888924Continuous
Additional Features
(specify, if
applicable)N/AN/AN/AN/AN/AN/A

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e-vive™ System differs from the QB1 System device in the following area:

Difference AreaEquivalence Discussion
Technology; wireless and
mobile app controlled vs.
wired:
e-vive™ system is a
wireless and mobile app
controlled device while
QB1 system is a wired
device.The mobile app in e-vive system communicates the
User Interface Controller within the conductive
garment via Bluetooth Low Energy, BLE 4.1
connection. The QB1 User Interface is connected to
the treatment pod within the conductive garment using
a cable. As shown in Section 18, the system has been
fully tested per IEC 60601-1, 60601-1-2, 60601-1-6,
60601-1-11, 60601-2-10, and IEC 62366 and meets all
standard requirements and FDA guidance requirements.
It adequately controls the stimulator outputs to the
allowable ranges and within the tolerance limits
provided in the standards and guidance, evidenced in
IEC 60601-2-10. Accordingly, the e-vive wireless and
mobile app controlled system poses no new safety risks
and is substantially equivalent to the predicate.

Any differences in the technological characteristics between the subject and predicate device do not raise new issues of safety or effectiveness.

7- PERFORMANCE DATA

Non-clinical testing data submitted, referenced, or relied upon to demonstrate substantial equivalence.

To demonstrate the safety, the e-vive™ system was tested for electrical safety, electromagnetic compatibility, usability, biocompatibility, and risk management requirements.

To demonstrate the safety, the e-vive™ System was tested per the following standards:

  • AAMI/ANSI ES 60601-1:2005/(R)2012 And A1:2012 Medical electrical equipment -. Part 1: General requirements for basic safety and essential performance
  • . IEC 60601-1-2: 2014, 4th Edition. Medical electrical equipment- Part 1-2: General requirements for basic safety and essential performance- Collateral standard: Electromagnetic compatibility requirements
  • IEC 60601-2-10: 2012, 2nd Edition, Medical electrical equipment- Part 2-10: Particular . requirements for the basic safety and essential performance of nerve and muscle stimulator

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  • IEC 60601-1-11: 2015, 2nd Edition, Medical electrical equipment- Part 1-11: General . requirements for basic safety and essential performance- Collateral standard: Requirements for medical electrical equipment and medical electrical systems used in the home healthcare environment
  • . IEC 60601-1-6: 2010, 3rd Edition, Medical electrical equipment- Part 1-6: General requirements for basic safety and essential performance- Collateral standard: Usability including IEC 62366: Application of usability engineering to medical devices
  • IEC 62366: 2007, 1st Edition, Medical devices -- Application of usability engineering to medical devices
  • IEC 62304: 2006, 15T Edition, Medical device software Software life cycle processes ●
  • 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
  • . ISO 14971: 2007, Application of risk management to medical devices

In addition, the performance of e-vive™ BLE module for wireless co-existence was evaluated and certified by the supplier of the module in an environment with equipment operating in the ISM band i.e. Bluetooth and Wi-Fi devices, cellphones, cordless phones etc. The device met all specified requirements.

BLE module testing was conducted in accordance with the following standards:

  • FCC 47CFR PT 15-C, Issued:2007/10/01 Title 47 CFR Part 15 Subpart C: Intentional . Radiators [FCC §15.247]
  • FCC 47CFR PT 15 SPT B. Issued: 2013/01/28 Title 47 CFR Part 15 Subpart B: . Unintentional Radiators, FCC Part 15, Subpart B [FCC §15.107 & FCC §15.109]
  • . RSS 210, Issue:2010/12/01 Issue:8 Low Power License-Exempt Radio communication Devices (All Frequency Bands) - Category I Equipment
  • ICES 003 Issued: 2012/08/01Spectrum Management and Telecommunications . Interference-Causing Equipment Standard
  • . ETSI EN 300 328, Issued: 2012/06/08 V. 1.8.1 Electromagnetic Compatibility. & Radio Spectrum Matters; Wideband Trans. Systems; Data Trans. Equip. Operating in the 2.4

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GHz ISM Band & Using Wideband Modulation Techniques; Harmon. EN Covering Essen. Req. Under Art. 3.2-R&TTE Directive

  • ETSI EN 301 489-1, Issued: 2011/09/22 V1.9.2 Electromagnetic Compatibility & Radio . Spectrum Matters (ERM); Electromagnetic Compatibility (EMC) Radio Equipment & Services; Prt 1: Common Technical Requirements
  • ETSI EN 301 489-17, Issue:2009/05/12 Electromagnetic Compatibility And Radio . Spectrum Matters (Erm); Electromagnetic Compatibility (EMC) Standard For Radio Equipment; Part 17: Specific Conditions For Broadband Data Transmission Systems -V2.1.1

Battery testing was conducted in accordance with IEC 62133:2012 Secondary cells and batteries containing alkaline or other non-acid electrolytes - Safety requirements for portable sealed secondary cells and for batteries made from them, for use in portable applications.

To demonstrate the e-vive system effectiveness and performance substantial equivalency of the subject device, e-vive system and the predicate device OB1 System (K150413) were tested according to the following FDA guidance document:

  • . FDA Final Guidance Document for Powered Muscle Stimulator 510(k), June 9, 1999

Electrical Safety and Electromagnetic Compatibility (EMC)

Electrical safety and EMC testing were conducted on the e-vive system and complies with the IEC 60601-1, IEC 60601-2-10, and 60601-11 standards for safety and the IEC 60601-1-2 standard for EMC.

Software Verification & Validation Testing

The device's software has been validated in accordance with the requirements set forth in the FDA Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices (May 11, 2005) and IEC 62304: 2006, 180 Edition, Medical device software – Software life cycle processes. The software validation tests demonstrated that the software version meets its design requirements.

Human Factors and Usability

The human factors and usability study was conducted to validate the usability of the e-vive system in the home environment. The results of the study support the instructions for successfully using the device as intended. The results of human factors and usability study substantiates the acceptability of the risks identified during the risk assessment activities. The evive system complies with the IEC 60601-1-6: 2010 for usability and IEC 62366: Application of usability engineering to medical devices.

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8- CONCLUSION

Based on the performance testing and the supporting documentation, it can be concluded that the e-vive NMES and TENS system is safe, effective, and substantially equivalent to the predicate devices. The e-vive device output pulse parameters provide a safe and effective treatment for the NMES and TENS applications.

Based on the acceptable bench test results and e-vive compliance with the applicable standards, the e-vive NMES and TENS therapies are considered safe and as effective as the predicate device, QB1 System (K150413) for its intended uses and indications for use. The e-vive NMES and TENS pulse parameters and waveform are selected and designed so they would provide a safe and effective treatment for the indications for use.