K Number
K200751
Date Cleared
2020-05-21

(59 days)

Product Code
Regulation Number
878.4810
Panel
SU
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Photodynamic Therapy (PDT) Equipment use of the red, blue and infrared regions of the spectrum is intended to emit energy to treat dermatological conditions.

The blue light (415nm wavelength) is generally indicated to treat dermatological conditions and specifically indicated to treat moderate inflammatory acne vulgaris.

The red light (630mm wavelength) indicated to treatment of superficial, benign vascular, and pigmented lesions.

The infrared light (835nm wavelength) is generally use for the temporary relief of minor muscle and joint pain, arthritis and muscle spasm; relieving stiffness; promoting the relaxation of muscle tissue; and to temporarily increase local blood circulation where applied.

Device Description

The Photodynamic Therapy (PDT) Equipment HM-PDT 900 is a vertical device which uses specific wavelengths of light, produced by LEDs (Light emitting diodes), to manage aesthetic conditions. The device produces light in the red light region of the spectrum (630±15nm), in the blue light regions of the light spectrum (415±15nm) and infrared light region of light spectrum (835±15nm). Five sets of LEDs panels are available for the device.

AI/ML Overview

This document describes a 510(k) premarket notification for a Photodynamic Therapy (PDT) Equipment. It focuses on demonstrating substantial equivalence to a predicate device, rather than proving the device meets specific performance acceptance criteria through clinical studies. Therefore, much of the requested information regarding acceptance criteria, clinical study specifics, and expert involvement is not available in this document.

Here's a breakdown of the information that can be extracted and what is explicitly stated as not applicable or not provided:

1. Table of Acceptance Criteria and Reported Device Performance:

The document doesn't provide a typical "acceptance criteria" table with numerical performance goals and achieved results for clinical effectiveness. Instead, it focuses on demonstrating substantial equivalence to a predicate device based on technical specifications and safety standards.

The "performance comparison" in Table 7-2 highlights similarities and differences between the proposed device and the predicate. The "acceptance criteria" here is effectively "substantially equivalent to the predicate device."

Feature/ParameterAcceptance Criteria (Substantially Equivalent to Predicate K190938)Reported Device Performance (Proposed Device)Remark
Product CodeGEXGEXSAME
Regulation No.21 CFR 878.481021 CFR 878.4810SAME
ClassIIIISAME
Intended UseSame as PredicateThe Photodynamic Therapy (PDT) Equipment use of the red, blue and infrared regions of the spectrum is intended to emit energy to treat dermatological conditions.SAME
Blue Light (415nm) IndicationTreat dermatological conditions and specifically moderate inflammatory acne vulgaris.Treat dermatological conditions and specifically moderate inflammatory acne vulgaris.SAME
Red Light (630nm) IndicationTreatment of superficial, benign vascular, and pigmented lesions.Treatment of superficial, benign vascular, and pigmented lesions.SAME
Infrared Light (835nm) IndicationTemporary relief of minor muscle and joint pain, arthritis and muscle spasm; relieving stiffness; promoting the relaxation of muscle tissue; and to temporarily increase local blood circulation where applied.Temporary relief of minor muscle and joint pain, arthritis and muscle spasm; relieving stiffness; promoting the relaxation of muscle tissue; and to temporarily increase local blood circulation where applied.SAME
Wavelength (nm)Red light 630±15nm; Blue light 415±5nm; NIR light 835±10nmRed light 630nm±15nm; Blue light 415nm±15nm; Infrared light 835nm±15nmSAME (Note: Blue light wavelength tolerance slightly different for predicate, but declared "SAME")
Light frequency200Hz200HzSAME
LED power (per diode)3W3WSAME
Max Power Density (Red)115mW/cm2 (242J/cm2)115mW/cm2 (242J/cm2)SAME
Max Power Density (Blue)120mW/cm2 (180J/cm2)120mW/cm2 (180J/cm2)SAME
Max Power Density (IR)70mW/cm2 (147J/cm2)70mW/cm2 (147J/cm2)SAME
Treatment time20 minutes (recommended)20 minutes (recommended)SAME
Working distance10~15cm10~15cmSAME
Power supplyAC 100-240V 50/60Hz 10AAC 100-240V 50/60Hz 500VA (Note: 10A vs 500VA; implies similar power draw)SAME
Electrical SafetyComply with IEC 60601-1 and IEC 60601-1-2Comply with IEC 60601-1 and IEC 60601-1-2SAME
Radiation SafetyComply with IEC 60601-2-57Comply with IEC 60601-2-57SAME
Photobiological safetyComply with IEC 62471Comply with IEC 62471SAME
Panels Type3panel: 180EA LEDS; 4 Panel: 240 EALEDs. Panels may emit three lights (red, blue, infrared).5panel: 300 EALEDs. Panels may emit the three light (red, blue, infrared).Analysis (Differences in panel/LED count, but deemed not to affect output energy)
Treatment area756cm2 and 1008cm21410cm2Analysis (Difference, but deemed not to affect output energy)
Numbers of LEDs3 panels: 180EA; 4 panels: 240EA.5 panels: 300EA.Analysis (Difference, but deemed not to affect output energy)
Dimension500mm[H]× 500[W]× 1350[D]638mm×243mm×1560mm (Host); 494mm×346mm×69 (LEDs Panels)Analysis (Difference, but deemed not to affect output energy)

Analysis from document regarding "differences": "The proposed device has different panel number, diode number of each LED, LED number, and treatment area than predicate device, but the difference does not affect the output energy for treatment. Therefore, the slight difference is considered to have no effectiveness and safe."

2. Sample size used for the test set and the data provenance:

  • Sample Size: Not applicable. No clinical test set.
  • Data Provenance: Not applicable. The submission relies on non-clinical bench testing and adherence to international standards.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

  • Not applicable. No clinical test set or ground truth derived from expert consensus for clinical performance. The "ground truth" for non-clinical tests would be the established specifications and standards.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set:

  • Not applicable. No clinical test set.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:

  • Not applicable. This device is a light therapy equipment, not an AI diagnostic tool. No MRMC study was performed.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

  • Not applicable. This is not an algorithm-based device. The device's performance is measured by its output parameters (wavelength, power density, etc.) as confirmed by bench testing.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):

  • For the non-clinical tests (bench testing): The "ground truth" would be the engineering specifications and established performance limits defined by international standards (e.g., IEC 60601 series, IEC 62471).

8. The sample size for the training set:

  • Not applicable. No training set was used as this is not an AI/machine learning device.

9. How the ground truth for the training set was established:

  • Not applicable. No training set was used.

Summary from the document regarding studies:

  • Clinical Test Conclusion: "No clinical study is included in this submission." (Page 5)
  • Non-Clinical Test Conclusion: "Non clinical tests were conducted to verify that the proposed device met all design specifications as was Substantially Equivalent (SE) to the predicate device. The test results demonstrated that the proposed device complies with the following standards:
    • IEC 60601-1-2:2014 (EMC)
    • IEC 60601-1:2005/A1:2012 (Basic safety and essential performance)
    • IEC 60601-2-57:2011 (Non-laser light source equipment safety)
    • IEC 62471:2006 (Photobiological safety)
    • Software Verification and Validation Testing
    • Bench Testing (Energy density output accuracy, Wavelength accuracy)" (Page 5-6)

In essence, the acceptance criteria for this device's 510(k) clearance was its ability to demonstrate substantial equivalence to a previously cleared predicate device through non-clinical testing verifying its physical and electrical performance parameters, and by adhering to relevant safety and performance standards. No clinical efficacy or performance studies with human subjects were conducted or required for this submission.

§ 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.