K Number
K183153
Device Name
Microwave Ablation System
Date Cleared
2019-07-08

(236 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Microwave Ablation System is intended for coagulation (ablation) of soft tissue. It is not intended for use in cardiac procedures.
Device Description
The Microwave Ablation System M150E is microwave-based system intended to deliver energy through an antenna inserted into soft tissue for the purpose of coagulating (ablation) of a defined volume of that tissue. The Microwave Ablation System utilizes a 2450MHz generator to deliver power to single microwave ablation antenna or double microwave ablation antennas. The Microwave Ablation Generator provides for user setting of ablation time and ablation power. The proposed device consists of Microwave Ablation Generator, Microwave Ablation Electrode Kits, Temperature Probe and Foot Switch.
More Information

Not Found

No
The description focuses on the hardware components and basic user settings (time and power) for energy delivery, with no mention of AI/ML terms or functionalities like image analysis or automated parameter adjustments based on data.

Yes
Explanation: The device is intended for coagulation (ablation) of soft tissue, which is a therapeutic intervention to treat conditions affecting soft tissue.

No
Explanation: The device is described as an ablation system intended for coagulation of soft tissue, delivering energy to ablate tissue. It is not mentioned to be used for identifying or diagnosing a condition.

No

The device description explicitly lists hardware components such as a generator, electrode kits, temperature probe, and foot switch, indicating it is a hardware-based system with software control.

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

Here's why:

  • Intended Use: The intended use is "coagulation (ablation) of soft tissue." This is a therapeutic procedure performed on the patient's body, not a test performed on a sample taken from the patient's body.
  • Device Description: The description details a system that delivers energy into soft tissue for ablation. This is consistent with a therapeutic device, not a diagnostic one that analyzes samples.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue samples, etc.), detecting specific analytes, or providing diagnostic information based on laboratory testing.

IVD devices are designed to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device's function is to treat tissue directly.

N/A

Intended Use / Indications for Use

The Microwave Ablation System is intended for coagulation (ablation) of soft tissue. It is not intended for use in cardiac procedures.

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

NEY

Device Description

The Microwave Ablation System M150E is microwave-based system intended to deliver energy through an antenna inserted into soft tissue for the purpose of coagulating (ablatlng) a defined volume of that tissue. The Microwave Ablation System utilizes a 2450MHz generator to deliver power to single microwave ablation antenna or double microwave ablation antennas. The Microwave Ablation Generator provides for user setting of ablation time and ablation power.

The proposed device consists of Microwave Ablation Generator, Microwave Ablation Electrode Kits, Temperature Probe and Foot Switch. Wherein, The Microwave Ablation Electrode Kits consists of Microwave Ablation Antenna, water pipe and Coax cable, to be used for puncturing the patient's lesion position during operation and also for outputting microwave energy to ablate the tumor tissue through connection with Microwave Ablation Generator. The Temperature Probe is applied to monitor the temperature of the target location and to protect important organs and tissues in the periphery of the lesion from unexpected damage by microwave energy.

It supports both power and temperature modes.

Power mode
Under the power mode, at the beginning, the system output microwave power according manually setting. When the tissue temperature reaches the target temperature, the system adjusts the duty cycle in real time according to the specific algorithm and load power to keep the tissue temperature on the target temperature. Two microwave ablation antennas can be used for microwave ablation.

Temperature mode
Under the temperature mode, at the beginning, the system output microwave power according manually setting. When the tissue temperature reaches the target temperature, the system adjusts the output of microwave power in real time according to the specific algorithm to keep the tissue temperature on the target temperature. Two microwave ablation antennas can be used for microwave ablation.

The Microwave Ablation Generator is non-sterile, while Microwave Ablation Electrode Kits and Temperature Probe are sterile.

The device is software-driven and the software validation is provided in Section of Software.

Mentions image processing

During the surgery, the microwave ablation antenna is accurately placed in the tumor target area by imaging techniques (such as CT, US, etc.).

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

CT, US

Anatomical Site

soft tissue (Not for cardiac procedures), tumor target area

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Prescription Use

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

Not Found

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

Not Found

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

Non-Clinical Testing:

  • Electrical Safety Test According to IEC 60601-1
  • Electromagnetic Compatibility Test According to IEC 60601-1-2
  • Performance Test according to IEC 60601-2-6
  • System Performance Test
  • Thermal Effects test according to FDA Guidance Premarket Notification (510(K)) Submissions for Electrosurgical Devices for General Surgery
  • Temperature Monitoring test according to FDA Guidance Premarket Notification (510(K)) Submissions for Electrosurgical Devices for General Surgery
  • Shelf Life Test
  • Package Verification Test according to ISO 11607-1
  • Sterilization validation according to ISO 11135
  • Irritation, Sensitization, Cytotoxicity, Pyrogenicity, Acute Systemic Toxicity Test according to ISO 10993

Clinical Testing:
Clinical studies were not required to demonstrate the substantial equivalence of the microwave ablation system and the predicated 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.

K133821

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

§ 878.4400 Electrosurgical cutting and coagulation device and accessories.

(a)
Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.(b)
Classification. Class II.

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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 seal of the Department of Health & Human Services. To the right of that is the FDA logo, with the letters "FDA" in a blue square. Next to that is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

July 8, 2019

Surgnova Healthcare Technologies (Zhejiang) Co., Ltd. Guofang Ma Quality Director No.1 XinXing Yilu Road, Emerging Industrial Cluster Area Zonghan Subdistrict, Cixi City, Zhejiang, China 315300

Re: K183153

Trade/Device Name: Microwave Ablation System Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical Cutting and Coagulation Device and Accessories Regulatory Class: Class II Product Code: NEY Dated: November 2, 2018 Received: November 14, 2018

Dear Guofang Ma:

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 statutes and regulations administered by other Federal agencies. You must comply with all the Act's

1

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/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (OS) 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Long Chen, Ph.D. Assistant Director DHT4A: Division of General Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K183153

Device Name Microwave Ablation System

Indications for Use (Describe)

The Microwave Ablation System is intended for coagulation (ablation) of soft tissue. It is not intended for use in cardiac procedures.

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

X Prescription Use (Part 21 CFR 801 Subpart D)

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

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Section III 510(k) Summary

This summary of 510(k) is being submitted in accordance with the requirements of 21 CFR 807.92.

There is no prior submission for the device.

3.1 Submitter Information

  • 510(k) Submitter/Holder: Surgnova Healthcare Technologies (Zhejiang) Co., Ltd. No.1 Xinxing Yilu Road, Emerging Industrial Cluster Area, Zonghan Subdistrict, Cixi City, Zhejiang, China

. Contact

Guofang Ma Quality Director Telephone: +86-10-64116115 Fax: +86-10-64113261 Email: QARA@surgnova.com

● Date Prepared: August 02, 2018

3.2 Proposed Device Information

Device Common Name: Microwave ablation system and accessories Device Trade/Proprietary Name: Microwave Ablation System Model: M150E Classification Name: Electrosurgical cutting and coagulation device and accessories Regulation Number: 878.4400 Product Code: NEY Class: Il Panel: General & Plastic Surgery

3.3 Predicate Device

510(k) Number: K133821 Common Name: Microwave ablation system and accessories Device Trade/Proprietary Name: Emprint™ Ablation System Classification Name: Electrosurgical cutting and coagulation device and accessories Regulation Number: 878.4400 Product Code: NEY Class: II Panel: General & Plastic Surgery Manufacturer: Covidien LLC

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3.4 Device Description

The Microwave Ablation System M150E is microwave-based system intended to deliver energy through an antenna inserted into soft tissue for the purpose of coagulating (ablating) a defined volume of that tissue. The Microwave Ablation System utilizes a 2450MHz generator to deliver power to single microwave ablation antenna or double microwave ablation antennas. The Microwave Ablation Generator provides for user setting of ablation time and ablation power.

The proposed device consists of Microwave Ablation Generator, Microwave Ablation Electrode Kits, Temperature Probe and Foot Switch. Wherein, The Microwave Ablation Electrode Kits consists of Microwave Ablation Antenna, water pipe and Coax cable, to be used for puncturing the patient's lesion position during operation and also for outputting microwave energy to ablate the tumor tissue through connection with Microwave Ablation Generator. The Temperature Probe is applied to monitor the temperature of the target location and to protect important organs and tissues in the periphery of the lesion from unexpected damage by microwave energy.

It supports both power and temperature modes.

Power mode

Under the power mode, at the beginning, the system output microwave power according manually setting. When the tissue temperature reaches the target temperature, the system adjusts the duty cycle in real time according to the specific algorithm and load power to keep the tissue temperature on the target temperature. Two microwave ablation antennas can be used for microwave ablation.

Temperature mode

Under the temperature mode, at the beginning, the system output microwave power according manually setting. When the tissue temperature reaches the target temperature, the system adjusts the output of microwave power in real time according to the specific algorithm to keep the tissue temperature on the target temperature. Two microwave ablation antennas can be used for microwave ablation.

The Microwave Ablation Generator is non-sterile, while Microwave Ablation Electrode Kits and Temperature Probe are sterile.

The device is software-driven and the software validation is provided in Section of Software.

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3.5 Comparison list of the technological characteristics

Based on the comparison of the clinical and ablation antennas of the predicate device—Emprint™ ablation system, there are no significant differences between the material, the key technology, the design characteristics, the applicable population, the site of action, etc. Confirming that both devices are equivalent in terms of clinical performance and safety. The specific results are as follows:

| Comparison Elements | Predicate Device
(K133821) | Proposed Device | Comparison
(Equivalent,
Similar,
Different) | |
|---------------------|----------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------|
| Product Name | Emprint™ Ablation System | Microwave Ablation System | / | |
| Regulation No. | 21 CFR 878.4400 | 21 CFR 878.4400 | Equivalent | |
| Classification | II | II | Equivalent | |
| Classification Name | Electrosurgical cutting and coagulation device and accessories | Electrosurgical cutting and coagulation device and accessories | Equivalent | |
| Product Code | NEY | NEY | Equivalent | |
| Clinical | Indications for Use | The Emprint™ Ablation System is intended for use in percutaneous, laparoscopic, and intraoperative coagulation (ablation) of soft tissue, including partial or complete ablation of non-resectable liver tumors.

The Emprint™ Ablation System is not | The Microwave Ablation System is intended for the coagulation (ablation) of soft tissues.

The Microwave Ablation System is not intended for use in cardiac procedures. | Equivalent |

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intended for use in cardiac procedures.
Intended purposecoagulation and ablation of tissuecoagulation and ablation of tissueEquivalent
Comparison StatementThe proposed device has the same indications for use and classification as the predicate device.
TechnicalDesignSingle channelDouble channelsDifferent
cooling-water cycle, thermal ablation,
the probe of TEMP, foot switchcooling-water cycle, thermal ablation,
the probe of TEMP, foot switchEquivalent
Comparison
StatementCompared with the predicate device, the proposed device has double channel to output energy. The two
channel not only can output energy at the same time but also can work respectively.
Operating
temperature10°C-30°C5°C-40°CSimilar
Operating
humidity20%~80% non condensation20%~80% non condensationEquivalent
Comparison
StatementThe proposed device operating environment temperature is wider than that of the equivalent product. We
have confirmed through environmental tests that this temperature range does not affect the product's
safety and performance.
Output
Parameters2450MHz±50MHz,
0-100W2450MHz±10MHz,
0-100WEquivalent
Output Impedance50Ω nominal50Ω nominalEquivalent

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Premarket Notification 510(k) Submission—K183153
--------------------------------------------------------
Voltage Supply100-240VAC 50-60 Hz100-240VAC 50-60 HzEquivalent
Fuse Rating6.3 A, 250V6.3 A, 250VEquivalent
Physicochemical
PropertiesNot contain any medications, animal
tissues or blood components, especially
in contact with human tissue does not
contain the above substances.Not contain any medications, animal tissues
or blood components, especially in contact
with human tissue does not contain the
above substances.Equivalent
Working PrincipleDuring the surgery, the microwave
ablation antenna is accurately placed in
the tumor target area by imaging
techniques (such as CT, US, etc.). The
microwave energy generated by the
microwave generator transmits to the
microwave ablation antenna through the
coaxial cable, and then it is radiated out
through the microwave antenna and
absorbed by water molecules in the
tumor tissue. The microwave energy
transform into heat, and the
temperature rises rapidly result in tumor
tissue losing bioactivity.During the surgery, the microwave ablation
antenna is accurately placed in the tumor
target area by imaging techniques (such as
CT, US, etc.). The microwave energy
generated by the microwave generator
transmits to the microwave ablation
antenna through the coaxial cable, and then
it is radiated out through the microwave
antenna and absorbed by water molecules in
the tumor tissue. The microwave energy
transform into heat, and the temperature
rises rapidly result in tumor tissue losing
bioactivity.Equivalent
Comparison StatementThe proposed device and predicated device have the same working principle and similar technical
parameter.
Disposable
accessories-Antenna Length
(mm)CA15L1: 150SS-MWA-1526C: 150
SS-MWA-1531C: 150Different
Ablation
AntennasCA20L1: 200SS-MWA-2026C: 200
SS-MWA-2031C: 200
CA30L1: 300SS-MWA-2526C: 250
SS-MWA-2531C: 250
Comparison
StatementThe ablation antenna length of the proposed device is different from that of the predicate device, but
this difference is only reflected in the depth of the position of the tumor to be ablated and does not
affect the product's safety and performance.
Emission area
length (mm)CA15L1: 28SS-MWA-1526C: 26Different
CA20L1: 28SS-MWA-1531C: 31
SS-MWA-2026C: 26
CA30L1: 28SS-MWA-2031C: 31
SS-MWA-2526C: 26
SS-MWA-2531C: 31
Comparison
StatementThe range of microwave emission area of the proposed device is wider than that of the predicate device,
We have proved through performance tests that this difference does not affect the product's safety and
performance.
OD(mm)CA15L1: 2.40SS-MWA-1526C: 2.08Different
SS-MWA-1531C: 2.08
CA20L1: 2.40SS-MWA-2026C: 2.08
CA30L1: 2.40SS-MWA-2031C: 2.08
SS-MWA-2526C: 2.08
SS-MWA-2531C: 2.08
Comparison
StatementBased on not affecting the area of the ablation, the diameter of the microwave antenna is thinner, so
that the trauma caused by the puncture is smaller.
Comparison
StatementThe 304 stainless steel usually has excellent corrosion resistance, good weldability and formability, good
resistance to hydrogen embrittlement, in addition to high ductility and toughness. The material of the
proposed device has passed the Bicompatibility test according to ISO 10993-1.
Disposable /Single-
use DeviceThe antennas are disposable and are to
be used within a single patient
procedure only.The antennas are disposable and are to be
used within a single patient procedure only.Equivalent
SterilityThe accessories are sterilized with
EO(SAL: 10-6)The accessories are sterilized with EO(SAL:
10-6)Equivalent
BiocompatibilityPatient-contacting materials are
biocompatible.Patient-contacting materials are
biocompatible.Equivalent
Device
Temperature
MonitoringTemperature monitoring features used
to ensure system safetyTemperature monitoring features used to
ensure system safetyEquivalent
Device coolingPumped, normal saline is used to cool
the Emprint™ Antenna.Pumped, normal saline is used to cool the
antenna.Equivalent
Comparison StatementThe proposed device and predicated device have the similar disposable accessories-Ablation Antennas and
same sterilization method.

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3.6 Indications for use

The Microwave Ablation System is intended for the coagulation (ablation) of soft tissues. The MW Ablation System is not intended for use in cardiac procedures.

3.7 Testing

Non-Clinical Testing

The Microwave Ablation System and Accessories and the predicate device are substantially equivalent in design concepts, technologies and materials. The Microwave Ablation System and Accessories has been designed and will be manufactured in accordance with both mandatory and voluntary standards, including:

• IEC 60601-1: 2005/A1:2012 Medical Electrical Equipment-Part 1: General requirements for safety.

• IEC 60601-2-6:2012 Medical electrical equipment –Part 2-6: Particular requirements for the basic safety and essential performance of microwave therapy equipment.

• IEC 60601-1-2:2014 Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral Standard: Electromagnetic disturbances - Requirements and tests.

•ISO 11607-1:2016 Packaging for terminally sterilized medical devices - Part 1: Requirements for materials, sterile barrier systems and packaging systems.

• ISO 11135: 2014 Sterilization of health care products -- Ethylene oxide -- Requirements for the development, validation and routine control of a sterilization process for medical devices

The Software Validation is in compliance with FDA Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices.

The compatibility of the skin-contact component material in the finished product meets the requirement of Biocompatibility. The Biological Evaluation Tests are in compliance with the standards of ISO 10993, "Biological Evaluation of Medical Devices".

The shelf life of Microwave Ablation Electrode Kits and Temperature Probe is 2 years.

No.Test Name
1Electrical Safety Test According to IEC 60601-1
2Electromagnetic Compatibility Test According to IEC 60601-1-2

The list of non-clinical test performed on the proposed device.

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3Performance Test according to IEC 60601-2-6
4System Performance Test
5Thermal Effects test according to FDA Guidance Premarket Notification (510(K)) Submissions for Electrosurgical Devices for General Surgery
6Temperature Monitoring test according to FDA Guidance Premarket Notification (510(K)) Submissions for Electrosurgical Devices for General Surgery
7Shelf Life Test
8Package Verification Test according to ISO 11607-1
9Sterilization validation according to ISO 11135
10Irritation, Sensitization, Cytotoxicity, Pyrogenicity, Acute Systemic Toxicity Test according to ISO 10993

Clinical Testing

Clinical studies were not required to demonstrate the substantial equivalence of the microwave ablation system and the predicated device.

3.8 Determination of substantial equivalence

The proposed device is equivalent with respect to the basic system design and function to that of the predicate device. The proposed device isn't the implants and high-risk device. And it doesn't have new intended purposes, new medical, new target populations, and new users and so on. What's more, it can't use the medicinal substances or animal tissues. So differences between the predicate and proposed device do not raise new questions of safety or effectiveness.