(25 days)
The Mag Vita TMS Therapy System is indicated for the treatment of Major Depressive Disorder who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode.
The Mag Vita TMS Therapy System is a computerized, electromechanical medical device that produces and delivers non-invasive, magnetic fields to induce electrical currents directed at regions of the cerebral cortex. The MagVita TMS Therapy System is indicated for Treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode. Transcranial magnetic stimulation (TMS) is a non-invasive technique for stimulating brain and neural tissue. The principle of magnetic stimulation is implicit in Faraday's law. The pulses of current are generated with a circuit containing a capacitor connected to the stimulating coil. With the capacitor charged to a certain level, the conducting state will cause the discharging of the capacitor through the coil. A magnetic field is generated proportional to this current. The rapid change in the magnetic field induces a current in conducting materials e.g. the body tissue. If the current induced in the human body is of sufficient amplitude and duration, it will excite neurons. In the MagVita TMS therapy system TMS pulses are applied repetitively at a frequency of 10Hz. Such stimulation has been shown to be effective in modulating cortical excitability. The observed and documented increase in cortical excitability after high frequency (10Hz) repetitive transcranial magnetic stimulation has been shown to persist beyond the duration of the train of stimulation. Repetitive Magnetic stimulation with the MagVita TMS therapy system is applied to the human brain on the left dorsolateral prefrontal cortex (DLPFC). The MagVita TMS Therapy System consists of the following components: MagPro Stimulator , Trolley and Super Flexible Arm . Coil for MT determination . Marking apparatus for locating treatment area . Coil for Depression Treatment . Isolation Transformer
This document, K171967, is a 510(k) summary for a modification to the MagVita TMS Therapy System, not a study presenting new clinical efficacy data for the device itself.
Therefore, the document does not present acceptance criteria or a study proving the device meets those criteria in the way a clinical trial would for a new device's efficacy.
Instead, this submission is to demonstrate substantial equivalence of a modified device (one without a proprietary treatment chair and head support) to a previously cleared device. The "acceptance criteria" here are essentially the demonstration that the modified device's performance characteristics are largely unchanged and that it adheres to relevant safety standards.
Here's how to interpret the provided information in the context of your request:
1. A table of acceptance criteria and the reported device performance:
The document provides a comparison table (pages 5 & 6) between the modified MagVita TMS Therapy System and its predicate device (MagVita TMS Therapy System K150641/171481), as well as other predicate devices regarding the treatment chair. The "acceptance criteria" are implied to be the characteristics of the predicate device, and the "reported device performance" is how the modified device compares.
| Criteria | Acceptance Criteria (Predicate Device K150641/171481) | Reported Device Performance (Modified MagVita TMS Therapy System) | Conclusion |
|---|---|---|---|
| Performance (Waveforms) | Biphasic; Frequency: 0.1 - 30 pulses/second or 0.1 - 100 pulses (depending on model) | Biphasic; Frequency: 0.1 - 30 pulses/second or 0.1 - 100 pulses (depending on model) | Identical |
| Performance (Treatment Parameters) | Stimulation Intensity: 120% MT; Repetition rate: 10 Hz; Train duration: 4 sec; Inter-train interval: 11-26 sec; Pulses/session: 3000; Treatment duration: 19-37 min; Sessions/week: 5; Treatment schedule: 5 daily sessions for 6 weeks | Stimulation Intensity: 120% MT; Repetition rate: 10 Hz; Train duration: 4 sec; Inter-train interval: 11-26 sec; Pulses/session: 3000; Treatment duration: 19-37 min; Sessions/week: 5; Treatment schedule: 5 daily sessions for 6 weeks | Identical |
| Performance (Output Stimulation Parameters) | Amplitude in SMT units: 0 - 1.7; Pulse width: 290 µs, Biphasic sinusoid waveform; Frequency Range: 0.1-30 pps or 0.1-100 pps (depending on model) | Amplitude in SMT units: 0 - 1.7; Pulse width: 290 µs, Biphasic sinusoid waveform; Frequency Range: 0.1-30 pps or 0.1-100 pps (depending on model) | Identical |
| Coil Configuration/Cooling Design | Figure-of-eight coil, air core, liquid cooling. System components: Mobile console, software, coil positioning system, coil for MT and treatment, coil fixture, treatment chair, head support system. | Figure-of-eight coil, air core, liquid cooling. System components: Mobile console, software, coil positioning system, coil for MT and treatment, coil fixture. (Treatment chair and pillow removed). | Identical (except for removed chair/support). Justified by stating that the modified system is identical to other predicates (MagStim K143531, Neurosoft K160309) which also require the user to provide a treatment chair and ensure patient comfort/head fixation. |
| Standards Met | ISO 13485:2012 | ISO 13485:2012 | Identical |
| Electrical Safety | Complies with IEC60601-1, IEC60601-1-1 and IEC60601-1-2 | Complies with IEC60601-1, IEC60601-1-1 and IEC60601-1-2 | Identical |
2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective):
This document does not describe a clinical study with a test set of patient data. It describes a technical and regulatory comparison for a device modification. The "data" here refers to the device's technical specifications and compliance with standards.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:
Not applicable. This is not a study assessing clinical performance based on expert review of medical data. The ground truth for the device's technical specifications and safety compliance is established through engineering design, testing, and adherence to recognized standards.
4. Adjudication method (e.g. 2+1, 3+1, none) for the test set:
Not applicable, as there is no test set in the sense of patient data requiring adjudication.
5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:
Not applicable. This device is a Transcranial Magnetic Stimulator (TMS), not an AI-powered diagnostic imaging tool that would typically involve human readers.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:
Not applicable. The MagVita TMS Therapy System is a physical medical device for treatment, not a standalone algorithm.
7. The type of ground truth used (expert consensus, pathology, outcomes data, etc):
The "ground truth" for this 510(k) submission is the technical specifications, performance characteristics, and safety standards of the predicate device (MagVita TMS Therapy System K150641/171481) and recognized international standards (ISO, IEC). The aim is to demonstrate that the modified device is substantially equivalent to this established ground truth.
8. The sample size for the training set:
Not applicable. This document does not describe a machine learning algorithm requiring a training set.
9. How the ground truth for the training set was established:
Not applicable. There is no training set mentioned in this document.
In summary: The K171967 document is a premarket notification for a modification to an existing device. It demonstrates substantial equivalence by comparing the modified device's technical specifications and adherence to safety standards against its predicate, rather than presenting a clinical study with patient data and performance metrics like sensitivity/specificity.
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Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002 July 25, 2017
Tonica Elektronik A/S Lise Terkelsen QA/RA Manager Lucernemarken 15 Farum, Dk
Re: K171967
Trade/Device Name: MagVita TMS Therapy System Regulation Number: 21 CFR 882.5805 Regulation Name: Repetitive Transcranial Magnetic Stimulation System Regulatory Class: Class II Product Code: OBP Dated: June 26, 2017 Received: June 30, 2017
Dear Lise Terkelsen:
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
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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,
William J. Heetderks -S 2017.07.25 13:06:39 -04'00'
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
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Indications for Use
510(k) Number (if known) K171967
Device Name MagVita TMS Therapy System
Indications for Use (Describe)
The Mag Vita TMS Therapy System is indicated for the treatment of Major Depressive Disorder 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
Submitter's Information
| Name of 510(k) owner: | Tonica Elektronik A/SLucernemarken 15DK-3520 Farum, Denmark | ||
|---|---|---|---|
| Phone: | +45 4499 8444 | ||
| Fax: | +45 4499 1544 | ||
| Contact person: | Lise TerkelsenEmail: lise.terkelsen@tonica.dk | ||
| Preparation date: | June 26, 2017 | ||
| Trade name: | MagVita TMS Therapy System | ||
| Common name: | Transcranial Magnetic Stimulator | ||
| Classification name: | Repetitive Transcranial Magnetic Stimulator for treatment ofMajor Depressive Disorder21 CFR 882.5805, Product Code OBP | ||
| Classification: | Class II Medical Device | ||
| Predicate Devices: | MagVita TMS Therapy System, K150641 |
Device description:
The Mag Vita TMS Therapy System is a computerized, electromechanical medical device that produces and delivers non-invasive, magnetic fields to induce electrical currents directed at regions of the cerebral cortex. The MagVita TMS Therapy System is indicated for
Treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode.
Transcranial magnetic stimulation (TMS) is a non-invasive technique for stimulating brain and neural tissue. The principle of magnetic stimulation is implicit in Faraday's law. The pulses of current are generated with a circuit containing a capacitor connected to the stimulating coil. With the capacitor charged to a certain level, the conducting state will cause the discharging of the capacitor through the coil. A magnetic field is generated proportional to this current. The rapid change in the magnetic field induces a current in conducting materials e.g. the body tissue. If the current induced in the human body is of sufficient amplitude and duration, it will excite neurons.
In the MagVita TMS therapy system TMS pulses are applied repetitively at a frequency of 10Hz. Such stimulation has been shown to be effective in modulating cortical excitability. The observed and documented increase in cortical excitability after high frequency (10Hz)
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repetitive transcranial magnetic stimulation has been shown to persist beyond the duration of the train of stimulation. Repetitive Magnetic stimulation with the MagVita TMS therapy system is applied to the human brain on the left dorsolateral prefrontal cortex (DLPFC).
The MagVita TMS Therapy System consists of the following components:
- MagPro Stimulator , Trolley and Super Flexible Arm .
- MagPro family o
- Trolley with holding arrangements o
- Super Flexible Arm mounted on the trolley o
- Coil for MT determination .
- Coil C-B60 o
- Marking apparatus for locating treatment area .
- Marking plate for Coil C-B60 o
- Pen for marking, Cap, Ruler o
- . Coil for Depression Treatment
- Coil Cool-B65 with Coil Cooler unit o
- . Isolation Transformer
The difference between the cleared MagVita TMS Therapy System and the modified MagVita TMS Therapy System (this submission) is the reduction of the accompanying accessories; the Treatment Chair, Vaccum pillow and pump are removed. The patient is still expected to be seated in a comfortable treatment chair with his head on a neck rest, but the user will use his existing available chair. It is not mandatory that the treatment chair in the cleared K150641 is chosen.
Intended Use/Indication for Use:
Treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode.
Standards:
The MagVita TMS Therapy System has been tested and complies with the following standards
- ISO 13485:2012 •
- . IEC60601-1
- IEC60601-1-2 .
Non-Clinical performance data:
The non-clinical performance testing of the components of the MagVita TMS Therapy System has been tested as required and cleared by the FDA earlier on K091940 and K150641. These tests demonstrate that the MagVita TMS Therapy System is safe and effective for use in treatment of Major Depressive Disorder.
Substantial equivalence:
The MagVita TMS Therapy System is substantially equivalent to the predicate devices (our own MagVita TMS Therapy System before the modification, Magstim Rapid2 Therapy System and Neurosoft TMS). The MagVita TMS Therapy System and the predicate devices
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have identical intended use /indication for use, and the technological characteristics are very similar such that they in our view can be considered equivalent.
The MagVita TMS Therapy System and the predicate devices are all indicated for
Treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode.
Design of the Mag Vita TMS Therapy System is similar to the predicate device as all systems apply Transcranial Magnetic Stimulation as repetitive pulse trains at 10Hz delivered as brief rapidly alternating magnetic fields to induce electrical currents over the prefrontal cortex. Both the MagVita TMS Therapy System and the predicate devices have the same components consisting of TMS stimulator with software, electromagnetic coil and an articulated arm for positioning of the treatment coil. The operational procedures including system setup, patient preparations, motor threshold determination, coil positioning and treatment with predefined treatment stimulation parameters are essentially the same.
| Criteria | MagVita TMS Therapy System | MagVita TMS Therapy System K150641/171481 | Conclusion |
|---|---|---|---|
| Performance | Waveforms: Biphasic.Frequency: 0.1 -30 pulses persecond or 0.1 -100 pulses,depending on model | Waveforms: Biphasic.Frequency: 0.1 -30 pulses persecond or 0.1 -100 pulses,depending on model | Identical |
| Recommended standardtreatment:Stimulation Intensity: 120%MTRepetition rate:10 HzTrain duration: 4 secInter-train interval: 11-26 secPulses/session: 3000Treatment duration: 19-37 min.Sessions/week: 5Treatment schedule: 5 dailysessions for 6 weeks | Recommended standardtreatment:Stimulation Intensity: 120% MTRepetition rate: 10 HzTrain duration: 4 secInter-train interval: 11-26 secPulses/session: 3000Treatment duration: 19-37 min.Sessions/week: 5Treatment schedule: 5 dailysessions for 6 weeks | Identical | |
| Output Stimulation Parameters:Amplitude in Standard MotorThreshold (SMT) units :0 - 1.7Pulse width:290 µs, Biphasic sinusoidwaveform.Frequency Range:0.1-30 pps or 0.1-100 pps,depending on model | Output Stimulation Parameters:Amplitude in Standard MotorThreshold (SMT) units :0 – 1.7Pulse width:290 µs, Biphasic sinusoidwaveform.Frequency Range:0.1-30 pps or 0.1-100 pps,depending on model | Identical |
Characteristics of the Device as Compared to Predicate Device
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| Criteria | MagVita TMS TherapySystem | MagVita TMS Therapy SystemK150641/171481 | Conclusion |
|---|---|---|---|
| CoilConfigurationCoolingDesign | Figure-of-eight coilAir coreLiquid coolingThe system consists of:1. Mobile console2. System software with GUI3. Coil positioning system4. Coil for MT and coil fortreatment5. Coil Fixture | Figure-of-eight coilAir coreLiquid coolingThe system consists of:1. Mobile console2. System software with GUI3. Coil positioning system4. Coil for MT and coil fortreatment5. Coil Fixture6. Treatment chair7. Head support system | IdenticalTreatment chair and pillow arenot included in the modifiedsystem. The MagVita TMSTherapy System without atreatment chair and head supportis identical to other predicates onthe market; K143531 of companyMagStim and K160309 ofcompany Neurosoft. Both thsesTMS Therapy systems requirethat the user possesses atreatment chair of their own anddescribes in the user manual thatthe patient must be seatedcomfortable with the head fixedbefore the treatment is initiated |
| Standards met | Company complies with ISO13485:2012. | Company complies with ISO13485:2012 | Identical |
| Electricalsafety | Complies with IEC60601-1,IEC60601-1-1 and IEC60601-1-2 | Complies with IEC60601-1,IEC60601-1-1 and IEC60601-1-2 | Identical |
MagVita TMS Therapy System
Conclusion:
The SE comparison as documented in the Substantial Equivalence section, demonstrates and supports the substantial equivalency of the modified MagVita TMS Therapy System to our own not-modified MagVita TMS Therapy System as well as the Neurosoft TMS and the Magstim Rapid? Therapy System, the two latter regarding the conditions of the treatment chair and head support.
The indication for use, the target population, the dosage, the treatment procedure, the treatment position and all relevant protocol parameters (intensity, repetition rate, number of pulses in a train, numbers of trains, number of treatment sessions) are identical for the MagVita TMS Therapy System and the predicate device.
The transducer design (figure-of-eight) is equivalent and the realized magnetic properties of the MagVita TMS Therapy System and the predicate device are substantial equivalent for the treatment coils.
The positioning method used by the modified MagVita TMS Therapy System is identical to the cleared MagVIta TMS Therapy System.
The MagVita TMS Therapy System does not introduce any new safety considerations in comparison to the predicate devices.
§ 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.