K Number
K180981
Device Name
Stimulator Kit, Trial Kit, Spare Lead Kit, Wearable Assembly Kit
Date Cleared
2018-09-19

(159 days)

Product Code
Regulation Number
882.5880
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Freedom Spinal Cord Stimulator (SCS) System is intended as the sole mitigating agent, or as an adjunct to other modes of therapy used in a multidisciplinary approach for chronic, intractable pain of the trunk and/or lower limbs, including unilateral or bilateral pain. The Freedom-8A Trial Lead Kit is only used in conjunction with the Freedom-8A Stimulator Receiver Kit, and the Freedom-4A Trial Lead Kit is used for either the Receiver Kit Freedom-4A Stimulator or the Receiver Kit Freedom-8A Stimulator. The trial devices are solely used for trial stimulation (no longer than 30 days) to determine efficacy before recommendation for a permanent (long term) device.
Device Description
The Stimwave Technologies Incorporated (Stimwave) Freedom Spinal Cord SCS System (System) is used for spinal column stimulation to provide therapeutic relief for chronic, intractable pain of the trunk and/or lower limbs including unilateral pain. The therapy utilizes pulsed electrical current to create an energy field that acts on nerves near the spinal column. The System is comprised of an implantable stimulator (Freedom-8A/4A Stimulator), receiver component (Receiver), and an externally worn transmitter (Wearable Antenna Assembly (WAA)) to power the device. The System is implanted only following a successful trial period with the Freedom-8A/4A Trial Lead.
More Information

No
The summary does not mention AI, ML, or any related technologies in the device description, intended use, or performance studies.

Yes

The device is explicitly stated to "provide therapeutic relief for chronic, intractable pain" by utilizing pulsed electrical current for spinal column stimulation.

No

Explanation: The device is a spinal cord stimulator intended for pain relief, not for diagnosing a condition or disease.

No

The device description explicitly states the system is comprised of implantable hardware components (stimulator, receiver) and externally worn hardware (wearable antenna assembly).

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

Here's why:

  • Intended Use: The intended use clearly states that the device is for the treatment of chronic, intractable pain by stimulating nerves near the spinal column. This is a therapeutic intervention, not a diagnostic test performed on samples from the human body.
  • Device Description: The description details an implantable stimulator, receiver, and external transmitter that deliver electrical current to the body. This is consistent with a therapeutic device, not a diagnostic one.
  • Lack of IVD Characteristics: The text does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in samples
    • Providing information for diagnosis, monitoring, or screening of diseases or conditions based on sample analysis.

The device is a therapeutic medical device used for pain management through electrical stimulation.

N/A

Intended Use / Indications for Use

The Freedom Spinal Cord Stimulator (SCS) System is intended as the sole mitigating agent, or as an adjunct to other modes of therapy used in a multidisciplinary approach for chronic, intractable pain of the trunk and/or lower limbs, including unilateral or bilateral pain. The Freedom-8A Trial Lead Kit is only used in conjunction with the Freedom-8A Stimulator Receiver Kit, and the Freedom-4A Trial Lead Kit is used for either the Receiver Kit Freedom-4A Stimulator or the Receiver Kit Freedom-8A Stimulator. The trial devices are solely used for trial stimulation (no longer than 30 days) to determine efficacy before recommendation for a permanent (long term) device.

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

GZB

Device Description

The Stimwave Technologies Incorporated (Stimwave) Freedom Spinal Cord SCS System (System) is used for spinal column stimulation to provide therapeutic relief for chronic, intractable pain of the trunk and/or lower limbs including unilateral pain. The therapy utilizes pulsed electrical current to create an energy field that acts on nerves near the spinal column. The System is comprised of an implantable stimulator (Freedom-8A/4A Stimulator), receiver component (Receiver), and an externally worn transmitter (Wearable Antenna Assembly (WAA)) to power the device. The System is implanted only following a successful trial period with the Freedom-8A/4A Trial Lead.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

epidural space, L5 to T5

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Intended Clinician: Orthopedic, Neurosurgeon, Anesthesiologist
Intended User: Layperson
Environmental Use: Hospital, Home

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)

The Freedom SCS System was tested to verify that the performance meets the system design requirements as well as all applicable voluntary standards. The Freedom SCS System complies with all design requirements and applicable voluntary standards.

AAMI ANSI ISO 14708-3:2008 - For protection from temperature change including shipping and storage temperature ranges, the Freedom-8A/4A Stimulator was functional, receiving a safe rating following post visual inspection and passed the change of temperature testing performed as specified by AAMI ANSI ISO 14708-3:2008. For atmospheric pressure change, the Freedom-8A/4A Stimulator were functional following post testing functionality inspection and passed atmospheric pressure change testing as specified by AAMI ANSI ISO 14708-3:2008. This testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the packaging and the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate. The Receiver/RF Stylet is a passive component that does not impact the outcome of the leveraged tests for safety and effectiveness. The Receiver/RF Stylet testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as Receiver/RF Stylet remains the same.

For testing external defibrillation exposure, the Freedom-8A/4A Stimulator and Receiver were verified as functional after exposure to external defibrillation. Thus, the Freedom SCS System complies with testing as specified by AAMI ANSI ISO 14708-3:2008. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate. The Receiver/RF Stylet testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as Receiver/RF Stylet remains the same.

Following the thermal shock testing, the Freedom-8A/4A Stimulator was found to have "no irreversible damage" and fully functional as specified by the manufacturer, and to have no physical anomalies present at the time of inspection. Thus, the Freedom-8A/4A Stimulator complies with the thermal shock design requirements and the applicable standard. This testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

For leakage current testing, the Freedom-8A/4A Stimulator was produced zero leakage current on all tested paths for all tested samples. Thus, the Freedom-8A/4A Stimulator complies with the leakage design requirements and the applicable standard. This testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate. The Receiver/RF Stylet is a passive component that does not impact the outcome of the leveraged tests for safety and effectiveness. The Receiver/RF Stylet testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as Receiver/RF Stylet remains the same.

For testing the insertion and withdrawal of the stylet within the Stimulator, the stylet was found to require less than 2.5N of insertion or withdrawal force for all tested stylets in all tested stimulator samples. For testing the insertion and withdrawal of the Receiver within the Stimulator, the Receiver/RF Stylet was found to require less than 2.2N of insertion or withdrawal force for all tested stylets in all tested stimulator samples. Visual inspection confirmed no damage was present in any stimulator samples. Thus, the Freedom-8A/4A Stimulator and Receiver/RF Stylet comply with design specifications for stylet insertion and withdrawal force. The Stimulator testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate. The Receiver/RF Stylet testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as Receiver/RF Stylet remains the same.

For mechanical testing, the Freedom-8A/4A Stimulator passed all criteria of the test, showing no visible damage to the stimulator body or functional damage to the components. Mechanical testing included tensile testing and torsion testing. Thus, the Freedom-8A/4A Stimulator complies with all stimulator mechanical design requirements. This testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate. The Receiver/RF Stylet is a passive component that does not impact the outcome of the leveraged tests for safety and effectiveness. The Receiver/RF Stylet testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as Receiver/RF Stylet remains the same.

For magnetic resonance imaging (MRI) radio frequency (RF) induced heating as related to specific absorbance rate (SAR), the Freedom-8A Stimulator produced a maximum temperature increase lower than the allowable limit for the 1.5T and 3T MRI procedure and thus passed the 1.5T and 3T testing. The Freedom-8A Stimulator produced a maximum temperature increase lower than the allowable limit for the 1.5T and 3T MRI procedure and thus passed both. The Stimulator testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

ASTM F2182-11a - In accordance with F2182-11a - American Society for Testing and Materials (ASTM) International Standard Test Method for Measurement of Radio Frequency Induced Heating Near Passive Implants During Magnetic Resonance Imaging, the Freedom-8A/4A Stimulator showed that its presence would not cause injury to the patient with the implant during an MRI procedure. The Freedom-8A Stimulator is a passive implant that is not powered while the external unit is not transmitting to it. The Stimulator testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

ASTM F2119-07 - In accordance with F2119-07 - American Society for Testing and Materials (ASTM) International Standard Test Method for Evaluation of MR Image Artifacts from Passive Implants, the Freedom-8A Stimulator showed that it does not produce image artifacts in 1.5T or 3T MRI procedures. The Stimulator testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

ASTM F2052-06 - In accordance with F2052-06 - The American Society for Testing and Materials (ASTM) International Designation Standard Test Method for Measurement of Magnetically Induced Displacement Force on Medical Devices in the Magnetic Resonance Environment, the Freedom-8A Stimulator showed that it does not harm the patient due to its displacement by forces induced by 1.5T or 3T MRI exposure. The Freedom-8A Stimulator passes the ASTM acceptance criteria for deflection angle in a 1.5T and 3T MRI system. The Freedom-8A Stimulator will not present an additional risk or hazard to a patient when used in their tested MR environment. The Stimulator testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

ASTM F2213-06 - In accordance with F2213-06 - American Society for Testing and Materials (ASTM) International Standard Test Method for Measurement of Magnetically Induced Torque on Passive Implants in the Magnetic Resonance Environment, the Freedom-8A/4A Stimulator must show that it does not harm the patient due to its torque by forces induced by MRI exposure. The Freedom-8A Stimulator will not present an additional risk or hazard to a patient in the 1.5T MRI or 3T environments or less with regard to torque.

The stimulation waveforms following post-exposure showed no component damage had occurred after MR exposure. During testing, no component damage was observed in any waveform. Based on these test results, the Freedom-8A Stimulator will be fully functional following standard 1.5T or 3T MR procedures and its performance or functionality is not affected by such exposures.

The Stimulator testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

IEC 60601-1 -The WAA was tested for compliance with IEC 60601-1. For testing the WAA for protection from temperature change, including shipping and storage temperature ranges, the WAA met the passing criteria of both of the visual and functional inspections following the testing. It showed no physical damage and was fully operational. Thus, the WAA of the Freedom SCS System satisfies the outlined protection from temperature change design requirements and the applicable standard, IEC 60601-1. For atmospheric pressure change testing, the WAA met the passing criteria of both of the visual and functional inspections following the testing. It showed no physical damage and was fully operational. Thus, the WAA of the Freedom SCS System satisfies the outlined atmospheric pressure change design requirements and the applicable standard, IEC 60601-1. For the push, drop, impact and mold stress relief testing of the WAA, it was determined through testing that the WAA is robust to withstand expected damage in accordance with general safety standards. The WAA met the passing criteria of both of the visual and functional inspections following the testing. It showed no physical damage and was fully operational. Thus, the WAA component of the Freedom-8A/4A SCS System satisfies the outlined push, drop, impact, and mold stress relief design requirements and the applicable standard, IEC 60601-1. For the identification, marking and documents of the WAA it was determined through an analysis of the labeling that the WAA complies with the requirements of the standard. All requirements and markings are clearly identified and viewable either from the external case of the product or from within the accompanying documents. For the means of protection, creepage distances, and air clearances of the WAA it was determined through an analysis of the design that the system satisfies the requirements of the applicable standard, IEC 60601-1. This testing presented for this submission is leveraged from K170141 and is directly applicable for demonstration of device safety and efficacy as the WAA remains the same. Performance testing for the additional Tx Antennas included in this submission demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

IEC 60529 - The WAA was tested for compliance with IEC 60529. For testing the ingress of water, the WAA met the passing criteria of both of the visual and functional inspections following the testing. It showed no physical damage and was fully operational. Thus, the WAA component of the Freedom SCS System satisfies the outlined Ingress of Water design requirements and the applicable standard IEC 60529. For particulate matter testing, the WAA met the passing criteria of both of the visual and functional inspections following the testing. It showed no physical damage and was fully operational. Thus, the WAA component of the Freedom SCS System satisfies the outlined Particulate Matter design requirements and the applicable standard, IEC 60529. This testing presented for this submission is leveraged from K170141 and is directly applicable for demonstration of device safety and efficacy as the WAA remains the same. Performance testing for the additional Tx Antennas included in this submission demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

IEC 60601-1-2 - The WAA was tested for compliance with IEC 60601-1-2. For testing the WAA for electromagnetic compatibility, the unit met all acceptance criteria for emissions, low-frequency magnetic fields, immunity, electrostatic discharge, radiated RF electromagnetic fields, electrical fast transients and magnetic fields. The WAA operated within all test limits and showed no physical damage and was fully operational. Thus, the WAA for the Freedom SCS System satisfies the IEC 60601-1-2 standard. This testing presented for this submission is leveraged from K170141 and is directly applicable for demonstration of device safety and efficacy as the WAA remains the same. Performance testing for the additional Tx Antennas included in this submission demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

The Freedom SCS System complies with the applicable standards for neurostimulators, electrical safety, electromagnetic interference and compatibility, packaging, and sterilization. The software of the Freedom SCS System passed all verification tests outlined and the design requirements for Software Verification have been met. The device passed all the testing in accordance with national and international standards.

There was no clinical testing required to support the medical device, as the indications for use are equivalent to the legally marketed predicate devices.

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.

K170141

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.

K172644, K141399

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

§ 882.5880 Implanted spinal cord stimulator for pain relief.

(a)
Identification. An implanted spinal cord stimulator for pain relief is a device that is used to stimulate electrically a patient's spinal cord to relieve severe intractable pain. The stimulator consists of an implanted receiver with electrodes that are placed on the patient's spinal cord and an external transmitter for transmitting the stimulating pulses across the patient's skin to the implanted receiver.(b)
Classification. Class II (performance standards).

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Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health and Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

September 19, 2018

Stimwave Technologies Incorporated Elizabeth Greene Vice President of Quality Assurance and Regulatory Affairs 1310 Park Central Boulevard South Pompano Beach, Florida 33064

Re: K180981

Trade/Device Name: Freedom Spinal Cord Stimulator (SCS) System Regulation Number: 21 CFR 882.5880 Regulation Name: Implanted Spinal Cord Stimulator For Pain Relief Regulatory Class: Class II Product Code: GZB Dated: August 16, 2018 Received: August 20, 2018

Dear Elizabeth Greene:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

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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 of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.html; good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 comprehensive regulatory information about mediation-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,

Pamela D. Scott -S

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) K180981

Device Name

Freedom Spinal Cord Stimulator (SCS) System

Indications for Use (Describe)

The Freedom Spinal Cord Stimulator (SCS) System is intended as the sole mitigating agent, or as an adjunct to other modes of therapy used in a multidisciplinary approach for chronic, intractable pain of the trunk and/or lower limbs, including unilateral or bilateral pain. The Freedom-8A Trial Lead Kit is only used in conjunction with the Freedom-8A Stimulator Receiver Kit, and the Freedom-4A Trial Lead Kit is used for either Kit Freedom-4A Stimulator or the Receiver Kit Freedom-8A Stimulator. The trial devices are solely used for trial stimulation (no longer than 30 days) to determine efficacy before recommendation for a permanent (long term) device.

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)

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Image /page/3/Picture/0 description: The image shows the logo for Stimwave Technologies. The word "stim" is in blue, and the word "wave" is in green. The word "TECHNOLOGIES" is in blue and is inside of a blue rounded rectangle. To the right of the word "wave" is a symbol that looks like a wave.

510(k) Summary

For Freedom Spinal Cord Stimulator (SCS) System

1. Submission Sponsor

Stimwave Technologies Incorporated 1310 Park Central Boulevard Pompano Beach Florida 33064 USA Phone: 800.965.5134 Fax: 800.965.5134 Contact: Elizabeth Greene, Chief Compliance Officer

2. Date Prepared

March 31, 2018

3. Device Identification

Trade/Proprietary Name:Freedom Spinal Cord Stimulator (SCS) System
Common/Usual Name:Spinal Cord Stimulator
Classification Name:Stimulator, Spinal-Cord, Implanted (Pain Relief)
Classification Regulation:882.5880
Product Code:GZB
Device Class:Class II
Classification Panel:Neurology

4. Legally Marketed Predicate Device(s)

Stimwave Freedom SCS System FR8A/FR4A, PDBT-915-2A (K170141)

5. Device Description

This submission is identical to K170141, but includes the following updates:

SectionChange Description
Section 11A. Inclusion of single pack accessories (sterile and non-sterile);
B. Updated Application Specific Integrated Circuit (ASIC) for Freedom-8A/4A
Stimulators (see Section 18 for design verification);
C. Wearable Antenna Assembly (WAA) manufacturing at Stimwave
Technologies Inc.;
D. Contract manufacturing and packaging for Freedom-8A/4A Stimulators at
Oscor, Inc.

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Image /page/4/Picture/0 description: The image contains the logo for Stimwave Technologies. The word "stim" is in blue, followed by the word "wave" in green. Below the words is the word "TECHNOLOGIES" in blue, inside of a blue rounded rectangle. To the right of the words is a blue graphic of concentric curved lines, resembling radio waves.

SectionChange Description
Section 13A. Revision of applicable Instructions for Use to replace the Suture Sleeve Cap
with the SandShark Injectable Anchor (SIA) System (K172644).
Section 14A. Increased sterilization capacity from 2 cases to one-half pallet.
Section 16A. Release of WaveCrest 2.4 version;
B. Inclusion of new patient programmer, WaveCrest Mobile (wcMobile);
C. Updated firmware version for WaveCrest 2.4 and wcMobile.
Section 18A. Inclusion of testing summaries in support of the modifications described in
this submission.

The Stimwave Technologies Incorporated (Stimwave) Freedom Spinal Cord SCS System (System) is used for spinal column stimulation to provide therapeutic relief for chronic, intractable pain of the trunk and/or lower limbs including unilateral pain. The therapy utilizes pulsed electrical current to create an energy field that acts on nerves near the spinal column. The System is comprised of an implantable stimulator (Freedom-8A/4A Stimulator), receiver component (Receiver), and an externally worn transmitter (Wearable Antenna Assembly (WAA)) to power the device. The System is implanted only following a successful trial period with the Freedom-8A/4A Trial Lead.

Freedom-8A and Freedom-4A Stimulator (Receiver Kit)

Freedom-8AA polyurethane (Pellethane 55D) casing with an embedded receiver, flexible
Stimulator,circuit board and electrodes (Platinum Iridium 90:10) that is placed in the
Freedom-4Apatient's epidural space. The Freedom-8A Stimulator has eight (8) electrodes,
Stimulatorand the Freedom-4A Stimulator has four (4) electrodes. Matches device
specifications of K170141.
ReceiverA copper and PEEK cable with dual couplers; placed within the center lumen
of the Freedom-8A or Freedom-4A Stimulator with the distal end combination
of Receiver and Stimulator being placed under the skin. Two (2) Receivers are
provided with each kit. Identical to K170141.
Stylet(s)A stainless steel wire with a polypropylene handle that is inserted into the open
central lumen of the stimulator to provide rigidity during implantation. Two
(2) stylets are provided in the Receiver Kit, one straight and one bent, each
with diameter of 0.30 mm. Identical to K170141.
NeedleA 13-gauge stainless steel needle that acts as a conduit for passage of the
Stimulator into the epidural space. Identical to K170141.
GuidewireA stainless steel, rigid, solid core guidewire used to create a hollow pathway in
the epidural space for the Stimulator to pass through easily. Identical to
K170141.

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Image /page/5/Picture/0 description: The image shows the logo for Stimwave Technologies. The word "stim" is in blue, and the word "wave" is in green. Below the word "wave" is the word "TECHNOLOGIES" in blue, inside of a blue oval. To the right of the word "wave" are three curved lines that are meant to represent radio waves.

Wearable Antenna Assembly (WAA Kit)

WAAThe WAA housing includes the following components:
A. Microwave Field Stimulator (MFS) – A printed circuit board (PCB) that
generates RF power with embedded waveform parameter settings and
switches for changing parameter settings as needed by the user. Identical to
K170141;
Switch Membrane - An elastomeric silicon rubber pad that corresponds to
B.
switches on the MFS that allows the user to turn the device on/off or
increase or decrease power amplitude as well as interpret device power
status (On, Off, Charging, Transmitting, and Bluetooth® Connection).
Identical to K170141;
Battery Assembly - A battery and wire assembly for charging and the
MFS for power delivery. Identical to K170141.
Transmitting (Tx) Antenna Assembly - An antenna and coaxial cable assembly
that is attached to the WAA that is used to transmit microwave energy to the
implanted Stimulator. Identical to K170141.
Charger Kit
Battery ChargerAn off-the-shelf battery charger that uses a power adapter and USB to micro-
USB cable to recharge the encased lithium ion battery of the WAA. Identical to
K170141.

Freedom-8A and Freedom-4A Spare Lead (Spare Lead Kit)

| Freedom-8A
Spare Lead,
Freedom-4A
Spare Lead | A polyurethane (Pellethane 55D) casing with an embedded receiver, flexible
circuit board and electrodes (Platinum Iridium 90:10) that is placed in the
patient's epidural space. The Freedom-8A Spare Lead has eight (8) electrodes,
and the Freedom-4A Spare Lead has four (4) electrodes. Matches device
specifications of K170141. |
|-------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| RF Stylet | A copper and PEEK cable with dual couplers; placed within the center lumen
of the Freedom-8A or Freedom-4A Spare Lead with the distal end combination
of RF Stylet and Spare Lead being placed under the skin. Two (2) RF Stylets
are provided with each kit. Identical to K170141. |
| Stylet(s) | A stainless steel wire with a polypropylene handle that is inserted into the open
central lumen of the stimulator to provide rigidity during implantation. Two
(2) stylets are provided in the Spare Lead Kit, one straight and one bent, each
with diameter of 0.30 mm. Identical to K170141. |
| Needle | A 13-gauge stainless steel needle that acts as a conduit for passage of the Spare
Lead into the epidural space. Identical to K170141. |
| Guidewire | A stainless steel, rigid, solid core guidewire used to create a hollow pathway in
the epidural space for the Spare Lead to pass through easily. Identical to
K170141. |

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Image /page/6/Picture/0 description: The image shows the logo for Stimwave Technologies. The logo features the word "stim" in bold, dark blue letters above the word "wave" in green. Below "wave" is the word "TECHNOLOGIES" in smaller, dark blue letters inside of a black rounded rectangle. To the right of the words is a symbol of three curved lines that resemble radio waves.

Freedom-8A and Freedom-4A Trial Lead (Trial Lead Kit)

| Freedom-8A
Trial Lead,
Freedom-4A
Trial Lead | A polyurethane (Pellethane 55D) casing with an embedded receiver, flexible
circuit board and electrodes (Platinum Iridium 90:10) that is placed
percutaneously in the patient's epidural space. The Freedom-8A Trial Lead has
eight (8) electrodes, and the Freedom-4A Trial Lead has four (4) electrodes.
Matches device specifications of K170141.. |
|-------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| RF Stylet | A copper and PEEK cable with dual couplers; placed within the center lumen
of the Freedom-8A or Freedom-4A Trial Lead with the distal end combination
of RF Stylet and Trial Lead being placed under the skin. Two (2) RF Stylets
are provided with each kit. Identical to K170141. |
| Stylet(s) | A stainless steel wire with a polypropylene handle that is inserted into the open
central lumen of the stimulator to provide rigidity during implantation. Two
(2) stylets are provided in the Trial Lead Kit, one straight and one bent with a
diameter of 0.30 mm. Identical to K170141. |
| Needle | A 13-gauge stainless steel needle that acts as a conduit for passage of the Trial
Lead into the epidural space. Identical to K170141. |
| Guidewire | A stainless steel, rigid, solid core guidewire used to create a hollow pathway in
the epidural space for the Trial Lead to pass through more easily. Identical to
K170141. |

Sterile Revision Kit

| Stylet(s) | A stainless steel wire with a polypropylene handle that is inserted into the open
central lumen of the stimulator to provide rigidity during implantation. Two
(2) stylets are provided in the Sterile Revision Kit, one straight and one bent
with a diameter of 0.30 mm. Identical to K170141. |
|-----------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Needle | A 13-gauge stainless steel needle that acts as a conduit for passage of the
Stimulator/Lead into the epidural space. Identical to K170141. |
| Guidewire | A stainless steel, rigid, solid core guidewire used to create a hollow pathway in
the epidural space for the Stimulator/Lead to pass through easily. Identical to
K170141. |

Sterile Single Pack Accessories

| RF Stylet | A copper and PEEK cable with dual couplers; placed within the center lumen
of the Freedom-8A or Freedom-4A Stimulator, Spare Lead, or Trial Lead with
the distal end combination of RF Stylet and Stimulator, Spare Lead, or Trial
Lead being placed under the skin. One (1) RF Stylet is provided in the single
pack. Identical to K170141. |
|---------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Needle (4.5") | A 13-gauge stainless steel needle that acts as a conduit for passage of the
Stimulator/Lead into the epidural space. Identical to K170141. |
| Needle (6") | A 13-gauge stainless steel needle that acts as a conduit for passage of the
Stimulator/Lead into the epidural space. Similar to K170141 no change in
materials or supplier. |
| Guidewires | A stainless steel, rigid, solid core guidewire used to create a hollow pathway in
the epidural space for the Stimulator/Lead to pass through easily. Three (3)
guidewires are provided, each with different diameters (1.05mm (MD0570),
1.30mm (MD0575), and 1.60mm (MD0580)), but all the same length (45cm).
Similar to K170141, no change in materials or supplier. |
| Introducer | A stainless steel stylet and polymer sheath that dilates the path over the
guidewire for advancing the Stimulator/ Lead into place. Identical to K171366. |

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Image /page/7/Picture/0 description: The image shows the logo for Stimwave Technologies. The word "stim" is in blue, and the word "wave" is in green. The word "TECHNOLOGIES" is in blue and is underlined. To the right of the word "wave" are three curved lines that are meant to represent a wave.

Non-Sterile Single Pack Accessories
Small SeaSilk
Antenna (12"
Cable Length)An antenna (conductive ink printed onto laminate) bonded to the outside of a
fabric shirt and coaxial cable assembly. Attaches to the WAA and used to
transmit microwave energy to the implanted Stimulator/Lead.
Small SeaSilk
Antenna (27"
Cable Length)An antenna (conductive ink printed onto laminate) bonded to the outside of a
fabric shirt and coaxial cable assembly. Attaches to the WAA and used to
transmit microwave energy to the implanted Stimulator/Lead.
Large SeaSilk
Antenna (30"
Cable Length)An antenna (conductive ink printed onto laminate) bonded to the outside of a
fabric shirt and coaxial cable assembly. Attaches to the WAA and used to
transmit microwave energy to the implanted Stimulator/Lead. Identical
performance to the Tx Antenna Assembly of K170141 and this submission.
Large SeaSilk
Antenna (28"
Cable Length)An antenna (conductive ink printed onto laminate) bonded to the outside of a
fabric shirt and coaxial cable assembly. Attaches to the WAA and used to
transmit microwave energy to the implanted Stimulator/Lead. Identical
performance to the Tx Antenna Assembly of K170141 and this submission.
Small Antenna
(12" Cable
Length)A flexible dipole antenna and coaxial cable assembly that is attached to the
WAA that is used to transmit microwave energy to the implanted Stimulator.
Small Antenna
(27" Cable
Length)A flexible dipole antenna and coaxial cable assembly that is attached to the
WAA that is used to transmit microwave energy to the implanted Stimulator.
Large Antenna
(30" Cable
Length)A flexible dipole array antenna and coaxial cable assembly that is attached to
the WAA that is used to transmit microwave energy to the implanted
Stimulator. Identical to K170141.

Non-Sterile Single Pack Accessories

6. Indication for Use Statement

The Freedom Spinal Cord Stimulator (SCS) System is intended as the sole mitigating agent, or as an adjunct to other modes of therapy used in a multidisciplinary approach for chronic, intractable pain of the trunk and/or lower limbs, including unilateral or bilateral pain. The Freedom-8A Trial Lead Kit is only used in conjunction with the Freedom-8A Stimulator Receiver Kit, and the Freedom-4A Trial Lead Kit is used for either the Receiver Kit Freedom-4A Stimulator or the Receiver Kit Freedom-8A Stimulator. The trial devices are solely used for trial stimulation (no longer than 30 days) to determine efficacy before recommendation for a permanent (long term) device.

7. Substantial Equivalence Discussion

The following table compares the Stimwave Freedom SCS System to the predicate device with respect to intended use, technological characteristics and principles of operation, providing more detailed information regarding the basis for the determination of substantial equivalence.

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Image /page/8/Picture/0 description: The image shows the logo for Stimwave Technologies. The word "stim" is in a bold, purple font, stacked on top of the word "wave" which is in a green, cursive font. To the right of the word "wave" are three curved lines that resemble radio waves. Underneath the words "stim" and "wave" is the word "TECHNOLOGIES" in a smaller, bold, black font, inside of a blue rounded rectangle.

Table 5A. Comparison of Characteristics

Table 5A. Comparison of Characteristics
ComparatorStimwave Freedom SCS System
(Predicate - K170141)Stimwave Freedom SCS System
(Subject device)
Product CodeGZBSame as K170141
Regulation No.882.5880Same as K170141
Regulation NameStimulator, Spinal-Cord, Implanted
(Pain Relief)Same as K170141
Intended UseStimulation of spinal cord for chronic, intractable pain of trunk and lower limbsSame as K170141
Mode of ActionRF wireless transmission of energy to produce stimulation at Stimulator electrodes. WAA sends a pulsed RF signal on a carrier frequency of 915MHz to the StimulatorSame as K170141
Implant SiteEpidural space, L5 to T5Same as K170141
Environmental UseHospital, HomeSame as K170141
Intended ClinicianOrthopedic, Neurosurgeon, AnesthesiologistSame as K170141
Intended UserLaypersonSame as K170141
Electrode MaterialPlatinum-iridium 90:10Same as K170141
Stimulator Body MaterialPolyurethane 2363-55DSame as K170141
Cable FeaturesMulti-lumen TubeSame as K170141
Stimulator Length45 centimetersSame as K170141
Diameter1.35 millimetersSame as K170141
Electrode Array Length24.0 millimeters
52.0 millimetersSame as K170141
No. of Electrodes4 or 8Same as K170141
Electrode Length3.0 millimetersSame as K170141
Electrode Spacing4.0 millimetersSame as K170141
Electrode Surface Area12.72 mm²Same as K170141
Method of IntroductionPercutaneous and Anchor IncisionSame as K170141
Tissue ContactYesSame as K170141
SterilizationEthylene Oxide (EO)Same as K170141
LabelingLabeled as Sterile, Single Use, Prescription DeviceSame as K170141
PackageBacker card and two sterile pouchesSame as K170141
Pulse Frequency5 to 1500 HertzSame as K170141
Pulse Width50 to 500 microsecondsSame as K170141
Current/Voltage RegulatedCurrentSame as K170141
Output Voltage (300 Ω)0 to 4.1 VSame as K170141
Output Voltage (500 Ω)0 to 6.4 VSame as K170141
Output Voltage (800 Ω)0 to 7.5 VSame as K170141
Output Current (300 Ω)0 to 13.5 mASame as K170141
Output Current (500 Ω)0 to 12.8 mASame as K170141
Output Current (800 Ω)0 to 9.4 mASame as K170141
WaveformCharge Balanced (delayed)
Biphasic asymmetricalSame as K170141
PolarityProgrammable
(Anode, Cathode, or Off)Same as K170141
Pulse ShapeDecaying ExponentialSame as K170141
Avg. Current Density (300 Ω)105.0 mA/cm²Same as K170141
Avg. Current Density (500 Ω)95.1 mA/cm²Same as K170141
Avg. Current Density (800 Ω)69.0 mA/cm²Same as K170141
Max. Phase Charge* (300 Ω)6.8 µC/pulseSame as K170141
Max. Phase Charge* (500 Ω)6.4 µC/pulseSame as K170141
ComparatorStimwave Freedom SCS System
(Predicate - K170141)Stimwave Freedom SCS System
(Subject device)
Max. Phase Charge* (800 Ω)4.7 µC/pulseSame as K170141
Max. Charge Density* (300 Ω)53.1 µC/cm²Same as K170141
Max. Charge Density* (500 Ω)50.3 µC/cm²Same as K170141
Max. Charge Density* (800 Ω)36.9 µC/cm²Same as K170141
Max. Current Density* (300 Ω)106.1 mA/cm²Same as K170141
Max. Current Density* (500 Ω)100.6 mA/cm²Same as K170141
Max. Current Density* (800 Ω)73.9 mA/cm²Same as K170141
Net Charge0 μCSame as K170141
Avg. Phase Power (300 Ω)0.053 W/phaseSame as K170141
Avg. Phase Power (500 Ω)0.073 W/phaseSame as K170141
Avg. Phase Power (800 Ω)0.062 W/phaseSame as K170141
Avg. Phase Power Density (300 Ω)0.42 W/cm²/phaseSame as K170141
Avg. Phase Power Density (500 Ω)0.58 W/cm²/phaseSame as K170141
Avg. Phase Power Density (800 Ω)0.48 W/cm²/phaseSame as K170141
Pulse Delivery ModeContinuousSame as K170141
ON/OFF TimesNo CyclingSame as K170141
Current Path OptionsBipolarSame as K170141
Power DeliveryEmbedded receiver and coupled
receiver in lumen of StimulatorSame as K170141
Transmit Frequency915 MHzSame as K170141
MaterialPlatinum-iridium 90:10,
Polyurethane 2363-55DSame as K170141
SterileYes - ethylene oxideSame as K170141
Contract SterilizerSteris Isomedix ServicesSame as K170141
Single-UseYesSame as K170141
Shelf Life2 yearSame as K170141
Complies with ISO 10993-1YesSame as K170141
Safety Testing PassedYesSame as K170141
MR ConditionalYesYes
AccessoriesReceiver/RF Stylet, Stylet(s), Guide-
wire, Needle, Suture Sleeve CapRF Stylet, Stylet(s), Guidewire,
Needle
Single Pack AccessoriesNoSterile: RF Stylet, Needle(s),
Guidewires, Introducer
Non-Sterile: SeaSilk Antenna(s),
Antenna Assembly
ChargerUSB ChargerSame as K170141
Wearable Antenna AssemblyAluminum transmitter & separate,
connected AntennaSame as K170141
Software Level of ConcernModerateSame as K170141
iPad ApplicationWaveCrest™Same as K170141
Patient Programmer ApplicationNoWaveCrest Mobile
KitsReceiver Kit, Spare Lead Kit, Trial
Lead Kit, Sterile Revision Kit, WAA
Kit, Charger KitSame as K170141, but includes
Single Pack Accessories

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Image /page/9/Picture/0 description: The image shows the logo for Stimwave Technologies. The word "stim" is in blue, and the word "wave" is in green. The word "TECHNOLOGIES" is in blue and is located in a blue rounded rectangle. There are three curved lines to the right of the word "wave".

(*) asterisk denotes that formulas were used for the calculations.

8. Biocompatibility Data

Materials of this submission are identical to K170141. The materials of the Freedom-8A/4A Stimulator in direct contact with tissue remain unchanged from the Freedom SCS System (K170141) and thus, the biocompatibility tests conducted on representative subassemblies of the Freedom SCS System (Freedom-4, K141399) directly apply to the

10

Image /page/10/Picture/0 description: The image shows the logo for Stimwave Technologies. The word "stim" is in blue, and the word "wave" is in green. Underneath the words is the word "TECHNOLOGIES" in blue. To the right of the words are three curved lines that resemble radio waves.

Stimwave Technologies Incorporated Traditional 510(k) Premarket Submission Freedom Spinal Cord Stimulator (SCS) System

Freedom SCS System (K170141, and this submission). The materials, construction and intended use of the Freedom SCS System is comparable to the predicate device, and have a long history of safety with respect to biocompatibility. The biological safety of the Freedom-8A/4A Stimulator (same as the Freedom-4 Stimulator) was evaluated in accordance to ISO 10993-1:2009 and guidance document Blue Book Memorandum G95-1 Use of International Standard ISO-10993, and Biological Evaluation of Medical Devices: Part 1: Evaluation and Testing. Under these, for the stated indications for use, the device was classified as a (C), implant device in contact with tissue/bone. The results for the biocompatible testing of the Freedom-8A/4A Stimulator (same as the Freedom-4 Stimulator) for cytotoxicity, sensitization, irritation or intracutaneous reactivity, acute systemic toxicity, genotoxicity, implantation (4, 8, and 13 weeks), and subchronic toxicity demonstrated no negative impacts from the materials that are used in the Freedom SCS System. The Freedom-8A/4A Stimulator materials in direct tissue contact include Pellethane 55D (Stimulator) and Pt-Ir (90:10) (Stimulator only), both having an extensive record (previously cleared and approved) of chronic and carcinogenetic safety. The Receiver/RF Stylet is never in direct or indirect contact with tissue. The WAA is intended to be on top of a thin shirt or article of clothing around the midsection of the patient. The User Manual provided to the patient describes that the WAA should always be worn on top of a layer of clothing. The WAA does not come into contact with the patient's skin. The categorization by nature of body contact of the WAA is thus "noncontacting device", and not included in the scope of ISO 10993-1:2009. The Freedom SCS System meets biological safety and compatibility requirements of ISO 10993-1:2009 and Blue Book Memorandum G95-1.

9. Non-Clinical Performance Data

The following modifications to the Freedom SCS System of K170141 were made in support of this submission:

  • A. Stimulator/Lead:
    • i. The ASIC component of the Freedom-8A/4A devices has been upgraded to a new design, but there are no changes to system performance or specification.
  • B. Software/Firmware:
    • Release of version 2.4 of the WaveCrest programming application; i.
    • Addition of patient programmer, wcMobile, for basic program selections; ii.
    • iii. New WAA Firmware version for enabling ASIC upgrade communication.
  • C. WAA Accessories:
    • Addition of various Antenna options (style and length) for patient i. usability.
  • D. Kitted Components:
    • i. Addition of single pack accessories for use by clinicians (sterile) and patients (non-sterile) as needed;
    • ii. Removal of the Suture Sleeve Cap from Receiver and Spare Lead Kits in favor of the SandShark Injectable Anchor (SIA) System (K172644).

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Image /page/11/Picture/0 description: The image shows the logo for Stimwave Technologies. The word "stim" is in blue, and the word "wave" is in green. Below the words is the word "TECHNOLOGIES" in blue. To the right of the words is a series of curved lines that resemble radio waves.

  • E. Sterilization:
    • Increased sterilization capacity from 2 cases to one-half pallet. i.
  • F. Manufacturing:
    • WAA manufacturing at Stimwave Technologies Inc.; i.
    • ii. Contract manufacturing and packaging for Freedom-8A/4A Stimulators at Oscor, Inc.

The Freedom SCS System was tested to verify that the performance meets the system design requirements as well as all applicable voluntary standards. The Freedom SCS System complies with all design requirements and applicable voluntary standards.

AAMI ANSI ISO 14708-3:2008 - For protection from temperature change including shipping and storage temperature ranges, the Freedom-8A/4A Stimulator was functional, receiving a safe rating following post visual inspection and passed the change of temperature testing performed as specified by AAMI ANSI ISO 14708-3:2008. For atmospheric pressure change, the Freedom-8A/4A Stimulator were functional following post testing functionality inspection and passed atmospheric pressure change testing as specified by AAMI ANSI ISO 14708-3:2008. This testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the packaging and the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate. The Receiver/RF Stylet is a passive component that does not impact the outcome of the leveraged tests for safety and effectiveness. The Receiver/RF Stylet testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as Receiver/RF Stylet remains the same.

For testing external defibrillation exposure, the Freedom-8A/4A Stimulator and Receiver were verified as functional after exposure to external defibrillation. Thus, the Freedom SCS System complies with testing as specified by AAMI ANSI ISO 14708-3:2008. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate. The Receiver/RF Stylet testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as Receiver/RF Stylet remains the same.

Following the thermal shock testing, the Freedom-8A/4A Stimulator was found to have "no irreversible damage" and fully functional as specified by the manufacturer, and to have no physical anomalies present at the time of inspection. Thus, the Freedom-8A/4A Stimulator complies with the thermal shock design requirements and the applicable standard. This testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy

12

Image /page/12/Picture/0 description: The image shows the logo for Stimwave Technologies. The word "stim" is in large, bold, blue letters on the top left. Below that, the word "wave" is in green letters. Below that, the word "TECHNOLOGIES" is in smaller, blue letters inside of a blue rounded rectangle. To the right of the words is a symbol of three curved lines that look like radio waves.

compared to the predicate. The Receiver/RF Stylet is a passive component that does not impact the outcome of the leveraged tests for safety and effectiveness.

For leakage current testing, the Freedom-8A/4A Stimulator was produced zero leakage current on all tested paths for all tested samples. Thus, the Freedom-8A/4A Stimulator complies with the leakage design requirements and the applicable standard. This testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate. The Receiver/RF Stylet is a passive component that does not impact the outcome of the leveraged tests for safety and effectiveness. The Receiver/RF Stylet testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as Receiver/RF Stylet remains the same.

For testing the insertion and withdrawal of the stylet within the Stimulator, the stylet was found to require less than 2.5N of insertion or withdrawal force for all tested stylets in all tested stimulator samples. For testing the insertion and withdrawal of the Receiver within the Stimulator, the Receiver/RF Stylet was found to require less than 2.2N of insertion or withdrawal force for all tested stylets in all tested stimulator samples. Visual inspection confirmed no damage was present in any stimulator samples. Thus, the Freedom-8A/4A Stimulator and Receiver/RF Stylet comply with design specifications for stylet insertion and withdrawal force. The Stimulator testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate. The Receiver/RF Stylet testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as Receiver/RF Stylet remains the same.

For mechanical testing, the Freedom-8A/4A Stimulator passed all criteria of the test, showing no visible damage to the stimulator body or functional damage to the components. Mechanical testing included tensile testing and torsion testing. Thus, the Freedom-8A/4A Stimulator complies with all stimulator mechanical design requirements. This testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate. The Receiver/RF Stylet is a passive component that does not impact the outcome of the leveraged tests for safety and effectiveness. The Receiver/RF Stylet testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as Receiver/RF

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Image /page/13/Picture/0 description: The image contains the logo for Stimwave Technologies. The word "stim" is in blue, and the word "wave" is in green. The word "TECHNOLOGIES" is in blue and is located inside of a black oval. To the right of the word "wave" are several curved lines that are meant to represent radio waves.

Stylet remains the same.

For magnetic resonance imaging (MRI) radio frequency (RF) induced heating as related to specific absorbance rate (SAR), the Freedom-8A Stimulator produced a maximum temperature increase lower than the allowable limit for the 1.5T and 3T MRI procedure and thus passed the 1.5T and 3T testing. The Freedom-8A Stimulator produced a maximum temperature increase lower than the allowable limit for the 1.5T and 3T MRI procedure and thus passed both. The Stimulator testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

ASTM F2182-11a - In accordance with F2182-11a - American Society for Testing and Materials (ASTM) International Standard Test Method for Measurement of Radio Frequency Induced Heating Near Passive Implants During Magnetic Resonance Imaging, the Freedom-8A/4A Stimulator showed that its presence would not cause injury to the patient with the implant during an MRI procedure. The Freedom-8A Stimulator is a passive implant that is not powered while the external unit is not transmitting to it. The Stimulator testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

ASTM F2119-07 - In accordance with F2119-07 - American Society for Testing and Materials (ASTM) International Standard Test Method for Evaluation of MR Image Artifacts from Passive Implants, the Freedom-8A Stimulator showed that it does not produce image artifacts in 1.5T or 3T MRI procedures. The Stimulator testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

ASTM F2052-06 - In accordance with F2052-06 - The American Society for Testing and Materials (ASTM) International Designation Standard Test Method for Measurement of Magnetically Induced Displacement Force on Medical Devices in the Magnetic Resonance Environment, the Freedom-8A Stimulator showed that it does not harm the patient due to its displacement by forces induced by 1.5T or 3T MRI exposure. The Freedom-8A Stimulator passes the ASTM acceptance criteria for deflection angle in a 1.5T and 3T MRI system. The Freedom-8A Stimulator will not present an additional risk or hazard to a patient when used in their tested MR environment. The Stimulator testing

14

Image /page/14/Picture/0 description: The image shows the logo for Stimwave Technologies. The word "stim" is in blue, and the word "wave" is in green. Below the words is the word "TECHNOLOGIES" in blue. To the right of the words is a blue graphic that looks like a series of curved lines, similar to radio waves.

Stimwave Technologies Incorporated Traditional 510(k) Premarket Submission Freedom Spinal Cord Stimulator (SCS) System

presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

ASTM F2213-06 - In accordance with F2213-06 - American Society for Testing and Materials (ASTM) International Standard Test Method for Measurement of Magnetically Induced Torque on Passive Implants in the Magnetic Resonance Environment, the Freedom-8A/4A Stimulator must show that it does not harm the patient due to its torque by forces induced by MRI exposure. The Freedom-8A Stimulator will not present an additional risk or hazard to a patient in the 1.5T MRI or 3T environments or less with regard to torque.

The stimulation waveforms following post-exposure showed no component damage had occurred after MR exposure. During testing, no component damage was observed in any waveform. Based on these test results, the Freedom-8A Stimulator will be fully functional following standard 1.5T or 3T MR procedures and its performance or functionality is not affected by such exposures.

The Stimulator testing presented for this submission is leveraged from K170141, and is directly applicable for demonstration of device safety and efficacy as the Freedom-8A/4A Stimulator remains unchanged by electrical component upgrades. The testing for the Freedom-8A/4A Stimulator with the upgraded ASIC demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

IEC 60601-1 -The WAA was tested for compliance with IEC 60601-1. For testing the WAA for protection from temperature change, including shipping and storage temperature ranges, the WAA met the passing criteria of both of the visual and functional inspections following the testing. It showed no physical damage and was fully operational. Thus, the WAA of the Freedom SCS System satisfies the outlined protection from temperature change design requirements and the applicable standard, IEC 60601-1. For atmospheric pressure change testing, the WAA met the passing criteria of both of the visual and functional inspections following the testing. It showed no physical damage and was fully operational. Thus, the WAA of the Freedom SCS System satisfies the outlined atmospheric pressure change design requirements and the applicable standard, IEC 60601-1. For the push, drop, impact and mold stress relief testing of the WAA, it was determined through testing that the WAA is robust to withstand expected damage in accordance with general safety standards. The WAA met the passing criteria of both of the visual and functional inspections following the testing. It showed no physical damage and was fully operational. Thus, the WAA component of the Freedom-8A/4A SCS System satisfies the outlined push, drop, impact, and mold stress relief design requirements and the applicable standard, IEC 60601-1. For the identification, marking and documents of the WAA it was determined through an analysis of the labeling that the

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Image /page/15/Picture/0 description: The image shows the logo for Stimwave Technologies. The word "stim" is in blue, and the word "wave" is in green. Below the words is the word "TECHNOLOGIES" in blue, inside of a blue oval. To the right of the words is a blue symbol that looks like a wave.

Stimwave Technologies Incorporated Traditional 510(k) Premarket Submission Freedom Spinal Cord Stimulator (SCS) System

WAA complies with the requirements of the standard. All requirements and markings are clearly identified and viewable either from the external case of the product or from within the accompanying documents. For the means of protection, creepage distances, and air clearances of the WAA it was determined through an analysis of the design that the system satisfies the requirements of the applicable standard, IEC 60601-1. This testing presented for this submission is leveraged from K170141 and is directly applicable for demonstration of device safety and efficacy as the WAA remains the same. Performance testing for the additional Tx Antennas included in this submission demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

IEC 60529 - The WAA was tested for compliance with IEC 60529. For testing the ingress of water, the WAA met the passing criteria of both of the visual and functional inspections following the testing. It showed no physical damage and was fully operational. Thus, the WAA component of the Freedom SCS System satisfies the outlined Ingress of Water design requirements and the applicable standard IEC 60529. For particulate matter testing, the WAA met the passing criteria of both of the visual and functional inspections following the testing. It showed no physical damage and was fully operational. Thus, the WAA component of the Freedom SCS System satisfies the outlined Particulate Matter design requirements and the applicable standard, IEC 60529. This testing presented for this submission is leveraged from K170141 and is directly applicable for demonstration of device safety and efficacy as the WAA remains the same. Performance testing for the additional Tx Antennas included in this submission demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

IEC 60601-1-2 - The WAA was tested for compliance with IEC 60601-1-2. For testing the WAA for electromagnetic compatibility, the unit met all acceptance criteria for emissions, low-frequency magnetic fields, immunity, electrostatic discharge, radiated RF electromagnetic fields, electrical fast transients and magnetic fields. The WAA operated within all test limits and showed no physical damage and was fully operational. Thus, the WAA for the Freedom SCS System satisfies the IEC 60601-1-2 standard. This testing presented for this submission is leveraged from K170141 and is directly applicable for demonstration of device safety and efficacy as the WAA remains the same. Performance testing for the additional Tx Antennas included in this submission demonstrates no change to device performance and specification, and thus, demonstrates continued safety and efficacy compared to the predicate.

The Freedom SCS System complies with the applicable standards for neurostimulators, electrical safety, electromagnetic interference and compatibility, packaging, and sterilization. The software of the Freedom SCS System passed all verification tests outlined and the design requirements for Software Verification have been met. The device passed all the testing in accordance with national and international standards.

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Image /page/16/Picture/0 description: The image shows the logo for Stimwave Technologies. The word "stim" is in blue, and the word "wave" is in green. Below the words is the word "TECHNOLOGIES" in blue. To the right of the words are three curved lines that resemble radio waves.

Following performance testing, it has been determined that the Freedom SCS System is substantially equivalent to legally marketed predicate devices for the therapy for chronic, intractable pain of the trunk and/or lower limbs, including unilateral pain.

Due to the similarities between the legally marketed predicate device (K170141), and the Freedom SCS System (this submission), Stimwave Technologies Incorporated has leveraged applicable performance testing in addition to completed a number of tests that demonstrates substantial equivalence to the legally marketed predicate devices. The Freedom SCS System meets all the requirements for overall design, sterilization, biocompatibility, and electrical safety confirms that the output meets the design inputs and specifications. The Freedom SCS System passed all testing stated above as shown by the acceptable results obtained.

10. Clinical Performance Data

There was no clinical testing required to support the medical device, as the indications for use are equivalent to the legally marketed predicate devices. These types of devices, including the legally marketed predicate devices, have been on the market for many years with a proven safety and efficacy for the use of the device. The non-clinical testing detailed in this submission supports the substantial equivalence of the device.

11. Statement of Substantial Equivalence

By definition, a device is substantially equivalent to legally marketed predicate devices when the device has the same intended use and the same technological characteristics as the previously cleared predicate device. The Freedom SCS System has the same intended use as the legally marketed predicates device and is implanted percutaneous into the epidural space ranging from T5 to L5. Performance tested verified that the Freedom SCS System complies with all applicable voluntary standards such as IEC 60601-1. AAMI ANSI ISO 14708-3, and IEC 60529. The Freedom SCS System also meets the design requirements where no applicable standard could be used. This included Receiver/RF Stylet performance testing, stimulator body durability testing, programmable parameters, as well as power and performance of the WAA. There were no recognized performance standards for this device. There was no clinical testing performed on this device since performance testing demonstrated similar performance as the legally marketed predicate device, and materials for the implanted stimulator are the same as the legally marketed predicate device.

It has been shown in this 510(k) submission that the difference between the Freedom SCS System and the legally marketed predicate devices do not raise any questions regarding its safety and effectiveness as compared to legally marketed predicate devices. Freedom SCS System, as designed and manufactured, is determined to be substantially equivalent to the referenced legally marketed predicate device.