K Number
K172358
Device Name
Instalief
Date Cleared
2018-01-10

(160 days)

Product Code
Regulation Number
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Instalief is a single use device for the treatment of hemorrhoids by applying it directly to the swollen hemorrhoidal tissues. By applying cold to the tissue, the inflammation is reduced. The device can be used for the treatment of external hemorrhoids and internal hemorrhoids. The device is for adults only.
Device Description
Instalief™ is a device designed for the treatment of internal and external hemorrhoids by the application of cold directly to the swollen hemorrhoidal tissue. The device consists of an outer bag which houses an endothermic salt, a smaller water-containing frangible bag, an insertion tip with an attached compliant balloon, as well as a separate component that aids in the usage of the device, known as the squeezer. To use the device, the user first bursts the frangible bag by pressing on it, initiating an endothermic process between the water and endothermic salt. The user then inserts the shaft of the device into the anal canal (for internal hemorrhoids) or applies to the outer tissues (for external hemorrhoids), and squeezes the bag with the aid of the squeezer. This action transfers the cold fluid generated into the balloon, which provides targeted cold therapy to the hemorrhoids. Instalief™ is meant to be used for 6 - 8 minutes.
More Information

No
The device description details a purely mechanical and chemical process for cold therapy. There is no mention of any computational or data-driven components that would indicate the use of AI or ML.

Yes
The device is described as "a single use device for the treatment of hemorrhoids by applying it directly to the swollen hemorrhoidal tissues." The description also details how it "provides targeted cold therapy to the hemorrhoids," indicating its therapeutic purpose.

No

The device description clearly states "Instalief™ is a device designed for the treatment of internal and external hemorrhoids". It applies cold therapy to reduce inflammation, which is a therapeutic action, not a diagnostic one.

No

The device description clearly outlines physical components including bags, salts, water, an insertion tip, a balloon, and a squeezer, indicating it is a hardware-based medical device.

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 hemorrhoids by applying cold therapy. This is a therapeutic intervention, not a diagnostic test performed in vitro (outside the body) on biological samples to diagnose a condition.
  • Device Description: The device description details a mechanism for generating and applying cold directly to tissue. It does not involve the analysis of biological samples like blood, urine, or tissue biopsies.
  • Lack of IVD Characteristics: There is no mention of reagents, calibrators, controls, or any other components typically associated with in vitro diagnostic tests. The performance studies focus on physical properties, cold duration, and biocompatibility, not diagnostic accuracy metrics like sensitivity, specificity, or AUC.

In summary, Instalief is a therapeutic device for treating a physical condition, not a diagnostic device for identifying a condition through laboratory analysis.

N/A

Intended Use / Indications for Use

Instalief is a single use device for the treatment of hemorrhoids by applying it directly to the sworthoidal tissues. By applying cold to the tissue, the inflammation is reduced. The device can be used for the treatment of external hemorrhoids and internal hemorrhoids. The device is for adults only.

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

LKX

Device Description

Instalief™ is a device designed for the treatment of internal and external hemorrhoids by the application of cold directly to the swollen hemorrhoidal tissue.

The device consists of an outer bag which houses an endothermic salt, a smaller water-containing frangible bag, an insertion tip with an attached compliant balloon, as well as a separate component that aids in the usage of the device, known as the squeezer.

To use the device, the user first bursts the frangible bag by pressing on it, initiating an endothermic process between the water and endothermic salt. The user then inserts the shaft of the device into the anal canal (for internal hemorrhoids) or applies to the outer tissues (for external hemorrhoids), and squeezes the bag with the aid of the squeezer. This action transfers the cold fluid generated into the balloon, which provides targeted cold therapy to the hemorrhoids. Instalief™ is meant to be used for 6 - 8 minutes.

In terms of physical characteristics, Instalief™ is anatomically designed by taking into account human anatomical characteristics. The introducer and balloon, which comes into contact with the user, is made from medical-grade material and conforms to the biocompatibility requirements of the device class. The introducer has filleted edges and a tapered shaft for smooth insertion into the anal. It is also designed with a functional length long enough to reach the internal hemorrhoids, as well as a flared base to physically prevent over-insertion. The balloon dimensions were chosen to allow for safe inflation without compromising the integrity of the material.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

anal canal

Indicated Patient Age Range

adults only

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Non-Clinical Testing:
Structural Integrity:

  • Inflated Static Load Pull Test - VV0001P: Passed
  • Balloon Burst Volume Test - VV0002P: Passed
  • Compression Test (Against Predicate) - VV0007P, VV0009P: Both Devices Passed
    Functional Performance:
  • Cold Duration Test (Against Predicate) - VV0003P, VV0008P: Cold duration similar to predicate
    Biocompatibility:
  • In-vitro cytotoxicity – Elution method: Non-cytotoxic
  • Skin sensitization test in guinea pigs (guinea pig maximization test): Non-sensitizing
  • Intracutaneous reactivity test in New Zealand white rabbits: Non-reactive

Clinical Testing:
Clinical testing is not applicable for establishing substantial equivalence of Instalief™.

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.

K981428

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.

K133393

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

N/A

0

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo features the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

January 10, 2018

Privi Medical Pte Ltd % Alan Donald, MS, MBA, RAC President Matrix Medical Consulting, Inc. 8880 Rio San Diego Drive, Suite 800 San Diego. CA 92108

K172358 Trade/Device Name: Instalief Regulatory Class: Unclassified Product Code: LKX Dated: December 16, 2017 Received: December 19, 2017

Dear Alan Donald:

Re:

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.

1

(Sections 531-542 of the Act); 21 CFR 1000-1050.

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 of medical device-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

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.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

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Benjamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K172358

Device Name Instalief

Indications for Use (Describe)

Instalief is a single use device for the treatment of hemorrhoids by applying it directly to the sworthoidal tissues. By applying cold to the tissue, the inflammation is reduced. The device can be used for the treatment of external hemorrhoids and internal hemorrhoids. The device is for adults only.

Type of Use (Select one or both, as applicable)
---------------------------------------------------

Prescription Use (Part 21 CFR 801 Subpart D)

|X | Over-The-Counter Use (21 CFR 801 Subpart C)

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3

Privi Medical Pte Ltd Instalief™ Traditional 510(k) Section 5 - Summary of Safety and Effectiveness

Section 5 - Summary of Safety and Effectiveness

1. Submitter's Information:

Company Name: Privi Medical Pte. Ltd. Company Address: 79 Ayer Rajah Crescent #05-03, Singapore 139955 Company Phone Number: (415) 906-5188 (USA) Contact: Mr. Prusothman M Sina Raja, CEO Establishment Registration Number: Not yet obtained.

Device Trade Name: Instalief™ Common Name: Hemorrhoid Cooling Device Classification Name: Device, Thermal, Hemorrhoids (LKX) Product Code: LKX

2. Authorized Contact Person:

Name: Prusothman M Sina Raja Email: prusothman@privimedical.com, prusothman@gmail.com Telephone: (65) 93393513 (Singapore) / (415) 906-5188 (USA)

3. Company Device Information:

Device Name: Instalief™ Classification: Unclassified (Pre-Amendment)

4. Predicate Device Information:

Device Name: ANUICE Cryotherapy Pain Relief Products, Inc. Classification: Unclassified (Pre-Amendment) 510(k): K981428 Product Code: LKX

5. Submission Information:

Date Summary Prepared: 11th July 2017 Prepared by: Prusothman M Sina Raja

4

6. Device Description

Instalief™ is a device designed for the treatment of internal and external hemorrhoids by the application of cold directly to the swollen hemorrhoidal tissue.

The device consists of an outer bag which houses an endothermic salt, a smaller water-containing frangible bag, an insertion tip with an attached compliant balloon, as well as a separate component that aids in the usage of the device, known as the squeezer.

To use the device, the user first bursts the frangible bag by pressing on it, initiating an endothermic process between the water and endothermic salt. The user then inserts the shaft of the device into the anal canal (for internal hemorrhoids) or applies to the outer tissues (for external hemorrhoids), and squeezes the bag with the aid of the squeezer. This action transfers the cold fluid generated into the balloon, which provides targeted cold therapy to the hemorrhoids. Instalief™ is meant to be used for 6 - 8 minutes.

In terms of physical characteristics, Instalief™ is anatomically designed by taking into account human anatomical characteristics. The introducer and balloon, which comes into contact with the user, is made from medical-grade material and conforms to the biocompatibility requirements of the device class. The introducer has filleted edges and a tapered shaft for smooth insertion into the anal. It is also designed with a functional length long enough to reach the internal hemorrhoids, as well as a flared base to physically prevent over-insertion. The balloon dimensions were chosen to allow for safe inflation without compromising the integrity of the material.

7. Indications for Use

Instalief™ is a single use device for the treatment of hemorrhoids by applying it directly to the swollen hemorrhoidal tissues. By applying cold to the tissue, the inflammation is reduced. The device can be used for the treatment of external hemorrhoids and internal hemorrhoids. The device is for adults only.

8. Substantial Equivalency

Instalief™ is substantially equivalent to Anuice and raises no new safety or effectiveness issues.

8.1. Non-Clinical Testing

The following tests were performed on Instalief™ and the predicate device (where applicable), for the comparison of functional performance and evaluation

5

of both structural integrity and biocompatibility.

Structural Integrity
Performance Documentation (Test
Protocols)Summary of Results
Inflated Static Load Pull Test
  • VV0001P | Passed |
    | Balloon Burst Volume Test
  • VV0002P | Passed |
    | Compression Test (Against Predicate)
  • VV0007P
  • VV0009P | Both Devices Passed |
    | Functional Performance | |
    | Performance Documentation (Test
    Protocols) | Summary of Results |
    | Cold Duration Test (Against Predicate)
  • VV0003P
  • VV0008P | Cold duration similar to predicate |
    | Biocompatibility | |
    | Test Information and Details | Summary of Results |
    | In-vitro cytotoxicity – Elution method | Non-cytotoxic |
    | Skin sensitization test in guinea pigs (guinea
    pig maximization test) | Non-sensitizing |
    | Intracutaneous reactivity test in New Zealand
    white rabbits | Non-reactive |

8.2. Clinical Testing

Clinical testing is not applicable for establishing substantial equivalence of Instalief™.

8.3. Comparison Table of New and Predicate Device

Features and SpecificationsInstaliefTMAnuiceNotes
1Mode of actionApplication of cold to hemorrhoidal tissueApplication of cold to hemorrhoidal tissueSame
2Max insertionUp to 25mm intoUp to 45mm intoSmaller initial insertion
depththe anal canal (for
internal
hemorrhoids)the anal canal (for
internal
hemorrhoids)depth for Instalief™
3Max working
depthUp to 55mm into
the anal canal (for
internal
hemorrhoids)Up to 45mm into
the anal canal (for
internal
hemorrhoids)Both depths are in similar
range. The slightly deeper
working depth ensures
better coverage of
hemorrhoidal region.
4Insertion depth
limiterFlared base
componentFlared base
componentSame. Both designed to
physically limit insertion
depth.
5Insertion OD7 mm (without
balloon inflation)
30 mm maximum
(with balloon
inflation)11mmA smaller insertion OD
allows for easier and more
comfortable insertion and
removal.
The balloon is expanded
after insertion into the anal
canal, and is deflated prior
to being withdrawn.
6Cold sourceChemical
(endothermic
process)Physical (phase
change)Similar. In Instalief™, the
cold source is generated
through an endothermic
reaction, while the predicate
device achieves this through
a physical change of state of
its contained substance.
Both devices function using
the principle of cold
therapy.
7Shaft materialSilicone Rubber
(introducer)Rigid plasticSoft flexible shaft reduces
the risk of tissue damage
caused by erroneous
insertion technique
8Cold therapy
deliveryDelivered via a
compliant balloonDelivered via a
hollow shaftThe balloon is a better cold
therapy delivery component
as it conforms to the shape
of the anal canal
9Removal
mechanismDeflate balloon
followed by
withdrawalWithdrawal of
deviceSimilar
10BasePVC BagHard plasticBag is designed to
withstand the require back
pressure during usage (see
VV0007P)
11Anatomically
designedYes. General design
characteristics:
  1. Tapered shaft
    extending into anal
    canal
  2. “Base” feature to
    prevent over-
    insertion of device
  3. Smooth rounded
    corners
  4. No sharp edges | Yes. General
    design
    characteristics:
  5. Tapered shaft
    extending into
    anal canal
  6. “Base” feature
    to prevent over-
    insertion of
    device
  7. Smooth
    rounded corners
  8. No sharp edges | Same. Similar design
    characteristics meant to
    facilitate insertion
    into/removal out of the anal
    canal. |

6

Privi Medical Pte Ltd

Instalief™

Traditional 510(k) Section 5 - Summary of Safety and Effectiveness

7

Privi Medical Pte Ltd Instalief™ Traditional 510(k)

Section 5 - Summary of Safety and Effectiveness

  • 8.4. Studies Cited for Substantial Equivalence Discussion
    • 8.4.1. Ratuapli, M. D. et al.(2013). Comparison of rectal balloon expulsion test in seated and left lateral positions. Neorugastroenterol Motil. 25(12). Doi:10.1111/nmo.12208
    • 8.4.2. Padda, B. S. et al. (2006). Effects of pelvic floor muscle contraction on anal canal pressure. Am J Physiol Gastrointest Liver Physiol. 292: G565-G571. Doi:10.1152/ajpgi.00250.2006
    • 8.4.3. Duthie, H. L., Bennett, R. C. (1963). The relation of sensation in the anal canal to the functional anal sphincter: a possible factor in anal continence. Gut,4, 179-182. Doi:10.1136/gut.4.2.179
  • 8.5. Referenced Devices
    • 8.5.1. GelPOINT Path Transanal Access Platform (K133393)

9. Conclusion

Based on the comparison of intended use, indications for use, non-clinical testing, literature, biocompatibility testing and technological characteristics, the Instalief™ is substantially equivalent to Anuice (K981428) and raises no new safety or effectiveness issues.