K Number
K182682
Device Name
OrthoGold 100
Date Cleared
2018-12-21

(86 days)

Product Code
Regulation Number
890.5660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The OrthoGold 100 is intended for the activation of connective tissue.
Device Description
The OrthoGold 100™ is a pulsed acoustic wave device. It includes an electrically powered generator to generate transient compressed air that rapidly expands to create the acoustic waves, which in turn are propagated through a water-filled coupling membrane attached to the hand-held applicator. The hand-held applicator reflects the acoustic waves towards the treatment area through a silicone membrane and ultrasound transmission gel.
More Information

Not Found

No
The summary describes a pulsed acoustic wave device with a mechanical mechanism for generating waves and mentions standard software validation and safety testing, with no indication of AI/ML components.

Yes
The device is intended for "activation of connective tissue," which implies a therapeutic effect on the body.

No

The device is intended for the "activation of connective tissue" and uses acoustic waves for treatment, not for diagnosing conditions.

No

The device description explicitly details hardware components such as an electrically powered generator, a hand-held applicator, a water-filled coupling membrane, and a silicone membrane. While software is mentioned as being validated, the device is clearly a physical device with software control, not a software-only medical device.

Based on the provided information, the OrthoGold 100 is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use is "for the activation of connective tissue." This describes a therapeutic or physical treatment applied directly to the body, not a test performed on samples taken from the body (like blood, urine, or tissue).
  • Device Description: The device description details a system that generates and applies acoustic waves externally to the treatment area. This is consistent with a physical therapy or medical treatment device, not an IVD which analyzes biological samples.
  • Lack of IVD Characteristics: The document does not mention any aspects related to:
    • Analyzing biological samples.
    • Detecting or measuring substances in biological samples.
    • Providing information for diagnosis, monitoring, or screening based on sample analysis.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information about a person's health. The OrthoGold 100's function is to apply energy to the body for therapeutic purposes.

N/A

Intended Use / Indications for Use

The OrthoGold 100 is intended for the activation of connective tissue.

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

ISA

Device Description

The OrthoGold 100™ is a pulsed acoustic wave device. It includes an electrically powered generator to generate transient compressed air that rapidly expands to create the acoustic waves, which in turn are propagated through a water-filled coupling membrane attached to the hand-held applicator. The hand-held applicator reflects the acoustic waves towards the treatment area through a silicone membrane and ultrasound transmission gel.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

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)

Verification and validation testing was performed and demonstrated that the OrthoGold 100™ meets the design specifications and is safe and effective for its intended use. All tests required by the verification and validation plan were completed and passed. The OrthoGold 100™ software was validated and demonstrated to be of a Moderate level of concern; while hazard analysis / risk management was performed and demonstrated that all risks are mitigated to an acceptable level. The OrthoGold 100 was tested and demonstrated to conform to the general safety requirements of IEC 60601-1:2005; as well as the electromagnetic compatibility requirements of IEC 60601-1-2:2014 (4th Ed.) and 60601-2-36. In-vitro testing was performed to determine applicator displacement, force and penetration depth and was demonstrated to be equivalent to the AW module of the Dermablate predicate device. In addition, probe cover testing and transport verification and validation was also conducted. The performance testing demonstrated that the OrthoGold 100 is substantially equivalent to the predicate device.

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.

K081541

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 890.5660 Therapeutic massager.

(a)
Identification. A therapeutic massager is an electrically powered device intended for medical purposes, such as to relieve minor muscle aches and pains.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 890.9.

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December 21, 2018

Tissue Regeneration Technologies, LLC % Jennifer Daudelin, MSJ Regulatory Consultant III M Squared Associates, Inc. 575 Eighth Avenue, Suite 1212 New York, New York 10018

Re: K182682

Trade/Device Name: OrthoGold 100TM Regulation Number: 21 CFR 890.5660 Regulation Name: Therapeutic Massager Regulatory Class: Class I Product Code: ISA Dated: September 26, 2018 Received: September 26, 2018

Dear Jennifer Daudelin:

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.

1

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting 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,

Vivek J. Pinto -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

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Indications for Use

510(k) Number (if known) K182682

Device Name OrthoGold 100

Indications for Use (Describe) The OrthoGold 100 is intended for the activation of connective tissue.

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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3

510(k) Summary

Tissue Regeneration Technologies, LLC

OrthoGold 100™

The following information is provided as required by 21 CFR § 807.87 for the Tissue Regeneration Technologies, LLC 510(k) premarket notification. In response to the Safe Medical Devices Act of 1990, the following is a summary of the safety and effectiveness information upon which the substantial equivalence determination is based.

| Sponsor: | Tissue Regeneration Technologies, LLC
251 Heritage Walk
Woodstock, GA 30188 | | | |
|--------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------|---------|-------|
| Contact: | Jennifer A. Daudelin, M.S.J.
M Squared Associates, Inc.
575 Eighth Avenue, Suite 1212
New York, NY 10018
Ph: 703-562-9800 x251
Fax: 703-562-9797
Email: jdaudelin@msquaredassociates.com | | | |
| Date Prepared: | September 24, 2018 | | | |
| Proposed Class: | I | | | |
| Proprietary Name: | OrthoGold 100TM | | | |
| Common Name: | Therapeutic Massager | | | |
| Classification Name: | Massager, Therapeutic, Electric | | | |
| Regulation Number: | 21 CFR 890.5660 | | | |
| Product Codes: | ISA | | | |
| Predicate Device(s): | | | | |
| Manufacturer | Device Name | 510(k) Number | Procode | Class |
| Asclepion Laser
Technologies GmbH | Dermablate Effect | K081541 | ISA | I |

Indications for Use

The OrthoGold 100™ is intended for the activation of connective tissue.

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Device Description

The OrthoGold 100™ is a pulsed acoustic wave device. It includes an electrically powered generator to generate transient compressed air that rapidly expands to create the acoustic waves, which in turn are propagated through a water-filled coupling membrane attached to the hand-held applicator. The hand-held applicator reflects the acoustic waves towards the treatment area through a silicone membrane and ultrasound transmission gel.

Performance Data

Verification and validation testing was performed and demonstrated that the OrthoGold 100™ meets the design specifications and is safe and effective for its intended use. All tests required by the verification and validation plan were completed and passed. The OrthoGold 100™ software was validated and demonstrated to be of a Moderate level of concern; while hazard analysis / risk management was performed and demonstrated that all risks are mitigated to an acceptable level. The OrthoGold 100 was tested and demonstrated to conform to the general safety requirements of IEC 60601-1:2005; as well as the electromagnetic compatibility requirements of IEC 60601-1-2:2014 (4th Ed.) and 60601-2-36. In-vitro testing was performed to determine applicator displacement, force and penetration depth and was demonstrated to be equivalent to the AW module of the Dermablate predicate device. In addition, probe cover testing and transport verification and validation was also conducted. The performance testing demonstrated that the OrthoGold 100 is substantially equivalent to the predicate device.

Product CharacteristicSubject DevicePredicate DeviceComparison
OrthoGold 100TMDermablate Effect
510(k) NumberTo be assignedK081541NA
Indications for UseActivation of connective tissueActivation of connective tissueIdentical
Modes of ActionUnfocused pressure pulsesRadial (unfocused) pressure
waves, or extracorporeal pulse
activation respectivelySimilar
Mechanisms of ActionExtracorporeally induced
unfocused pressure pulsesPneumatically generated
vibrations + unfocused pressure
pulsesEquivalent
Maximum and Minimum
intensity settings1 to 16Specific Value Not AvailableSimilar
Subject DevicePredicate DeviceComparison
Product CharacteristicOrthoGold 100™Dermablate Effect
Number and size of
treatment applicator headsOP155
Size: 230 x ø 70 mmSpecific Value Not AvailableSimilar
Maximum and minimum
displacements of
applicator headsNot ApplicableSpecific Value Not AvailableNA
Type of application (e.g.,
continuous vibration at a
fixed frequency);Continuous at various frequenciesSpecific Value Not AvailableSimilar
Maximum and minimum
vibration frequencyFrequency of 1 - 8 Hz in steps of
0.5 HzSpecific Value Not AvailableSimilar
Driving PowerHigh voltage 2 - 7 kV
Capacitor: 0,2 uFSpecific Value Not AvailableSimilar
Power Supply115 VACSpecific Value Not AvailableSimilar
Maximum applicator
forceNot ApplicableSpecific Value Not AvailableNA
Maximum applicator
displacementNot ApplicableSpecific Value Not AvailableNA
Maximum penetration
depth25.4 mm at energy level 1630mm (3cm)Similar
Energy flow density
PIIT [mJ/mm2]0.00017 - 0.04403
at energy level 1 - 160.018-0.25Similar
Operating modeContinuousSpecific Value Not AvailableSimilar
Projectile mass (g)Not ApplicableSpecific Value Not AvailableNA
Pulse repeat rate (1/s)1 - 8 Hz1-11 HzSimilar
Number of pulses (min
and max)500 - 2000Specific Value Not AvailableSimilar
Maximum operating
temperatureRoom temperatureSpecific Value Not AvailableSimilar
Type of acoustic wave
generationElectro hydraulic, spark gap
under water caused by discharge
of high voltage condensersBallistic technology, pressurized
air pulses accelerate a projectile
within a guiding tubeSimilar
Peak compressional
acoustic pressure
pc [MPa]9.27
at energy level 1613.4Similar
Peak rarefactional
acoustic pressure
pcr[MPa]-1.52
at energy level 16Specific Value Not AvailableSimilar
Description of the spatial
distribution of the
acoustic pressure and
intensityUnfocused acoustic pressure field,
see pressure measurementsSpecific Value Not AvailableSimilar
Positive peak pressure
amplitude (MPa)
pc [MPa]0.43 - 9.27
at energy level 1 - 1613.4Similar
Subject DevicePredicate DeviceComparison
Product CharacteristicOrthoGold 100™Dermablate Effect
Negative peak pressure
amplitude (MPa)
$pcr[MPa]$-0.17 to -1.52
at energy level 1 - 16Specific Value Not AvailableSimilar
Derived focal acoustic
pulse energy (mJ)
$EbT [mJ]$0.022 - 2.278
at energy level 1 - 16Specific Value Not AvailableSimilar
Derived pulse intensity
integral, integrated over
total temporal integration
limits
$PIIT [mJ/mm2]$0.00017 - 0.04403
at energy level 1 - 16Specific Value Not AvailableSimilar
Rise time (ns)
(10% - 90%) tr [us]1.89 - 0.28
at energy level 1 - 16Specific Value Not AvailableSimilar
Compressional pulse
duration (us)
$tFWHMpc [uS]$1.23 - 0.77
at energy level 1 - 16Specific Value Not AvailableSimilar

The table below compares the OrthoGold 100 characteristics to the predicate device.

Tissue Regeneration Technologies, LLC OrthoGold100TM

510(k) Summary Page 2 of 4

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Tissue Regeneration Technologies, LLC OrthoGold100TM

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Technological Characteristics and Substantial Equivalence

The OrthoGold 100™ has the same indications for use and similar design features as compared with the predicate system. The bench testing demonstrates that the performance characteristics of the OrthoGold 100™ are equivalent to those of other legally marketed therapeutic massagers, and therefore supports a determination of Substantial Equivalence for the proposed indications for use. Any differences between the subject and predicate device would not render the device NSE, affect the safety or effectiveness, or raise different questions of safety and effectiveness.