K Number
K193464
Device Name
ND:YAG Laser
Date Cleared
2020-04-13

(119 days)

Product Code
Regulation Number
878.4810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The ND: YAG Laser is indicated for the treatment of: benign cutaneous lesions, such as Warts, Scars, Striae and Psoriasis; benign pigmented lesions, such as Lentigines, Nevus, and the removal of black or blue tattoos.
Device Description
The ND YAG Q-switch Laser Therapy Machine is laser system which delivers laser at a wavelength 1064nm or 532nm. The device is indicated for the treatment of: benign cutaneous lesions, such as Warts, Scars, Striae and Psoriasis; benign pigmented lesions, such as Lentigines, Nevus, and Birthmark; and the removal of black or blue tattoos. It is for prescription use only.
More Information

Not Found

No
The summary describes a laser therapy machine and its intended uses, with no mention of AI, ML, or related concepts in the device description, performance studies, or key metrics.

Yes
The device description and intended use clearly state that it is for the "treatment" of various medical conditions, indicating a therapeutic purpose.

No
The device description indicates it is used for "treatment" of various conditions and tattoo removal, not for diagnosing them.

No

The device description explicitly states it is a "laser system" and a "Laser Therapy Machine," indicating it is a hardware device that delivers laser energy. The performance studies also include testing related to electrical safety and laser safety standards, which are relevant to hardware.

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

Here's why:

  • IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • This device is a laser system used for the direct treatment of various skin conditions and tattoo removal. It interacts directly with the patient's body, not with a specimen taken from the body.

The description clearly indicates a therapeutic device used for external applications on the skin.

N/A

Intended Use / Indications for Use

The ND:YAG Laser is indicated for the treatment of: benign cutaneous lesions, such as Warts, Scars, Striae and Psoriasis; benign pigmented lesions, such as Lentigines, Nevus, and the removal of black or blue tattoos.

Product codes

GEX

Device Description

The ND YAG Q-switch Laser Therapy Machine is laser system which delivers laser at a wavelength 1064nm or 532nm.

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

Prescription Use, hospital

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

Non clinical tests were conducted to verify that the proposed device met all design specifications and was Substantially Equivalent (SE) to the predicate device. The following tests were conducted:

  • IEC 60601-1:2005/A1:2012 Medical Electrical Equipment - Part 1: General Requirements for Basic Safety and Essential Performance;
  • IEC 60601-2-22:2012, Medical Electrical Equipment - Part 2-22: Particular Requirements for Basic Safety and Essential Performance of Surgical, Cosmetic and Diagnostic Laser Equipment;
  • IEC 60825-1: 2014, Safety of laser products - Part 1: Equipment classification and requirements.
  • IEC 60601-1-2:2014, Medical electrical equipment- Part 1-2: General requirements for basic safety and essential performance- Collateral standard: Electromagnetic compatibility-Requirements and tests.
  • Software Validation & Verification Test
  • Bench Testing to verify the performance

No clinical study is included in this submission.

Key Metrics

Not Found

Predicate Device(s)

K161926

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4810 Laser surgical instrument for use in general and plastic surgery and in dermatology.

(a)
Identification. (1) A carbon dioxide laser for use in general surgery and in dermatology is a laser device intended to cut, destroy, or remove tissue by light energy emitted by carbon dioxide.(2) An argon laser for use in dermatology is a laser device intended to destroy or coagulate tissue by light energy emitted by argon.
(b)
Classification. (1) Class II.(2) Class I for special laser gas mixtures used as a lasing medium for this class of lasers. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 878.9.

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Image /page/0/Picture/0 description: The image contains 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.

April 13, 2020

Beijing Superlaser Technology Co., Ltd. % Ray Wang General Manager Beijing Believe-Med Technology Service Co. Ltd. Rm. 912, Building #15, XiYueHui, No. 5, YiHe North Rd., FangShan District Beijing, 102401 CN

Re: K193464

Trade/Device Name: ND:YAG Laser Regulation Number: 21 CFR 878.4810 Regulation Name: Laser Surgical Instrument For Use In General And Plastic Surgery And In Dermatology Regulatory Class: Class II Product Code: GEX Dated: March 13, 2020 Received: March 16, 2020

Dear Ray Wang:

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/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/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,

Colin Kejing Chen Acting 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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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K193464

Device Name ND:YAG Laser

Indications for Use (Describe)

The ND: YAG Laser is indicated for the treatment of: benign cutaneous lesions, such as Warts, Scars, Striae and Psoriasis; benign pigmented lesions, such as Lentigines, Nevus, and the removal of black or blue tattoos.

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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510(k) Summary

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

The assigned 510(k) Number: K193464

    1. Date of Preparation 04/10/2020
    1. Applicant Name: Beijing Superlaser Technology Co., Ltd. Address: No.2, Zhongfu Street, Economic and Technological Industrial zone, Xihongmen Tower, Daxing District, Beijing, China. Contact Person: Shi Shuang Position: Registration Specialist Telephone: 86-10-81284899 ext. 806 86-10-81284899 Fax: Email: 672257488@qq.com
    1. Submission Correspondent Mr. Ray Wang Beijing Believe-Med Technology Service Co., Ltd. Rm.912, Building #15, XiYueHui, No.5, YiHe North Rd., FangShan District, Beijing City, China, 102401 Tel: +86-18910677558 Fax: +86-10-56335780 Email: ray.wang@believe-med.com
    1. Identification of the Proposed Device
Trade Name:ND:YAG Laser
Common Name:Powered Laser Surgical Instrument
Model(s):SL-NY602
Classification Name:Powered Laser Surgical Instrument
Classification:II
Product Code:GEX
Regulation Number:21 CFR 878.4810
Review Panel:General& Plastic Surgery
  • Identification of Predicate Device న్.
510(k) Number:K161926
Product Name:ND YAG Q-switch Laser Therapy Machine
Manufacturer:Beijing ADSS Development Co., Ltd
    1. Device Description
      The ND YAG Q-switch Laser Therapy Machine is laser system which delivers laser at a wavelength 1064nm or 532nm.

The device is indicated for the treatment of: benign cutaneous lesions, such as Warts, Scars, Striae and Psoriasis; benign pigmented lesions, such as Lentigines, Nevus, and Birthmark; and the removal of black or blue tattoos. It is for prescription use only.

    1. Indications for Use
      The ND:YAG Laser is indicated for the treatment of: benign cutaneous lesions, such as Warts, Scars, Striae and Psoriasis; benign pigmented lesions, such as Lentigines, Nevus, and Birthmark; and the removal of black or blue tattoos.

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8. Substantially Equivalent (SE) Comparison

Tab 1 General Comparison

ITEMProposed DevicePredicate Device K161926Remark
Product CodeGEXGEXSE
Regulation No.21 CFR 878.481021 CFR 878.4810SE
Class22SE
Where usedhospitalhospitalSE
Intended UseThe ND:YAG Laser is indicated for the treatment of: benign cutaneous lesions, such as Warts, Scars, Striae and Psoriasis; benign pigmented lesions, such as Lentigines, Nevus, and Birthmark; and the removal of black or blue tattoos.The ND YAG Q-switch Laser Therapy Machine is indicated for the treatment of: Benign cutaneous lesions, such as Warts, Scars, Striae and Psoriasis; Benign pigmented lesions, such as Lentigines, Nevus, and Birthmark; and the removal of black or blue tattoos.SE

Tab 2 Technical Comparison

ITEMProposed DevicePredicate Device K161926Remark
Laser MediumNd:YAGNd:YAGSAME
wavelength1064 nm
532 nm1064 nm
532 nmSAME
Output energy100-1000mJ for 1064nm
50-500mJ for 532nm100-1000mJ for 1064nm
50-500mJ for 532nmSAME
Max. Energy
Density31.8J/cm2
15.9 J/cm231.8J/cm2
15.9 J/cm2SAME
Spot Size2-10mm2-10mmSAME
Pulse Width5ns-8ns5ns-8nsDIFFERENT
Frequency1-10 Hz1-10 HzSAME
DisinfectionThe outer surface of the system may be
wiped clean with a soft cotton cloth
swabbed in 70% alcohol and a non-
abrasive medical grade anti-bacterial
is recommended. Be careful not to spill
any liquids on the unit.Disinfect the handpiece before and
after every treatment by 75%
medicinal alcoholSIMILAR
Laser ClassClass 4Class 4SAME
Aiming BeamRed (650nm) laser, ≤5mWRed Laser, IEC 60601-2-22:2012, Medical Electrical Equipment - Part 2-22: Particular Requirements for Basic Safety and Essential Performance of Surgical, Cosmetic and Diagnostic Laser Equipment;
  • A IEC 60825-1: 2014, Safety of laser products - Part 1: Equipment classification and requirements.
  • IEC 60601-1-2:2014, Medical electrical equipment- Part 1-2: General requirements for basic safety and essential performance- Collateral standard: Electromagnetic compatibility-Requirements and tests.

  • ▲ Software Validation & Verification Test
  • ▲ Bench Testing to verify the performance

10. Clinical Testing

No clinical study is included in this submission.

11. Conclusion

Based on the comparison and analysis above, the proposed subject device is determined to be Substantially Equivalent (SE) to the predicate device.