K Number
K203066
Date Cleared
2020-12-22

(74 days)

Product Code
Regulation Number
882.4725
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The COOLIEF* Cooled Radiofrequency Kit Advanced is to be used in conjunction with the Radiofrequency (RF) Pain Management Generator (PMG-ADVANCED) or the COOLIEF* Radiofrequency Generator (CRG-Advanced) to create lesions in nervous tissue. The device includes a fluid delivery system for commonly used fluid agents limited to contrast medium, saline, and/or anesthetic solution delivery at the target site. This device is also indicated for creating radiofrequency lesions of the genicular nerves for the management of moderate to severe knee pain of more than 6 months with conservative therapy, including medication, in patients with radiologically-confirmed ostecarthritis (grade 2-4) and a positive response (≥50% reduction in pain) to a diagnostic genicular nerve block.

The COOLIEF® SINERGY* Cooled Radiofrequency Kit Advanced is to be used in conjunction with the Radiofrequency (RF) Pain Management Generator (PMG-ADV ANCED) or the COOLIEF* Radiofrequency Generator (CRG-ADVAN CED) to create RF lesions in nervous tissue. The device includes a fluid delivery system for commonly used fluid agents limited to contrast medium, saline, and/or anesthetic solution delivery at the target site.

Device Description

The COOLIEF* Cooled Radiofrequency Kit Advanced is a modification to the predicate COOLIEF* Cooled Radiofrequency Kit cleared under K163461. The subject device consists of the following:

  • COOLIEF* Cooled Radiofrequency Probe Advanced
  • COOLIEF* Cooled Radiofrequency Fluid Tubing Kit ●
  • COOLIEF* Cooled Radiofrequency Fluid Delivery Introducer ●

The modifications to the subject device are specific to the probe and fluid tubing kit.

The subject probe and fluid tubing kit are also included in the COOLIEFSINERGY Cooled Radiofrequency Kit Advanced.

The subject device has several configurations based on the anatomic region of use, length of the introducer and probe, and the length of the active electrode. The COOLIEF* Cooled Radiofrequency Kit Advanced is composed of fluid delivery introducers, probes, and fluid tubing kit. The kit is sterile, non-pyrogenic, and single-use. The COOLIEF* Cooled Radiofrequency Kit Advanced is to be used in conjunction with the Radiofrequency (RF) Pain Management Generator (PMG-ADVANCED) or the COOLIEF* Radiofrequency Generator (CRG-Advanced) to create lesions in nervous tissue.

The COOLIEF* SINERGY* Cooled Radiofrequency Kit Advanced is to be used in conjunction with the Radiofrequency (RF) Pain Management Generator (PMG-ADVANCED) or the COOLIEF* Radiofrequency Generator (CRG-ADVANCED) to create RF lesions in nervous tissue. This device includes the same components as the COOLIEF* Cooled RF Kit Advanced, but also includes an Epsilon The Epsilon Ruler is a circular stainless-steel ruler that may be used during the COOLIEF Ruler. SINERGY* procedure to assist the user in providing a 'template' around the foramen, which is specific to performing procedure around the sacroiliac (SI) nerve.

AI/ML Overview

This document is a 510(k) summary for the COOLIEF® Cooled Radiofrequency Kit Advanced, a medical device for creating lesions in nervous tissue. It details the device's characteristics, comparison to predicate devices, and non-clinical testing results.

Here's a breakdown of the requested information based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

Test Name / DescriptionAcceptance Criteria (Implied)Reported Device Performance
Sterilization and Shelf-Life (ANSI/AAMI/ISO 11135:2014)Compliance with standardPass
Bacterial Endotoxins Testing (ST72:2019)Compliance with standardPass
Human Factors (62366-1:2015)Compliance with standardPass
Biocompatibility (10993-5: 2009, 10993-10: 2010, 10993-11: 2006)Compliance with standardsPass
Electromagnetic Compatibility and Electrical Safety (60601-1:2005+AM1 (2012), 60601-1-6: 2010+A1:2013, 60601-1-9:2013, 60601-2-2:2017)Compliance with standardsPass
Performance Verification: Lesion Size TestingAs intendedPass
Performance Verification: Probe Thermocouple Accuracy TestingAs intendedPass ($\pm$ 3°C as per Table 3)
Performance Verification: Probe Fluid Delivery Port Injection Force TestingAs intendedPass
Performance Verification: Flow Rate TestingAs intendedPass
Performance Verification: High Pressure Leak TestingAs intendedPass
Performance Verification: Probe Mass TestingAs intendedPass
Performance Verification: Structural Strength TestingAs intendedPass
Performance Verification: Sterile Water and Saline Cooling Fluids TestingAs intendedPass
Performance Verification: Packaging Verification (ANSI/AAMI/ISO 11607-1:2019)Compliance with standardPass

2. Sample Size Used for the Test Set and Data Provenance

The document explicitly states that clinical data was not applicable for the subject device and therefore was not provided. All testing mentioned is "non-clinical testing" or "bench performance testing." The sample sizes for these non-clinical tests are not specified in the provided text, nor is the provenance of the data beyond being "bench performance testing."

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

This information is not applicable as there was no clinical study described that involved establishing a ground truth with experts. The stated tests are non-clinical, focusing on device performance and safety parameters.

4. Adjudication Method for the Test Set

This information is not applicable as there was no clinical study described. Adjudication methods are typically relevant for human-led assessments in clinical trials.

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

This information is not applicable. The device described is a radiofrequency kit, not an AI-powered diagnostic or assistive tool for human readers. There is no mention of AI or MRMC studies in the provided text.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

This information is not applicable. The device is hardware (a radiofrequency kit) and not an algorithm.

7. The Type of Ground Truth Used

This information is not applicable as no clinical studies with a ground truth were conducted or described. The "ground truth" for the non-clinical tests would be the established engineering and safety standards and specifications to which the device was tested.

8. The Sample Size for the Training Set

This information is not applicable. The device is a physical medical device, not a machine learning algorithm that requires a training set.

9. How the Ground Truth for the Training Set Was Established

This information is not applicable. As stated above, the device does not involve a training set or ground truth in the context of an algorithm.

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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 & 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 square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

December 22, 2020

Avanos Medical, Inc. % Rafael Aguila Responsible Third-Party Official Accelerated Device Approval Services 6800 S.W. 40th Street, Ste. 403 Ludlum, Florida 33155

Re: K203066

Trade/Device Name: COOLIEF Cooled Radiofrequency Kit Advanced Regulation Number: 21 CFR 882.4725 Regulation Name: Radiofrequency Lesion Probe Regulatory Class: Class II Product Code: GXI Dated: December 16, 2020 Received: December 17, 2020

Dear Rafael Aguila:

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

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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,

Adam D. Pierce, Ph.D. Assistant Director DHT5A: Division of Neurosurgical, Neurointerventional and Neurodiagnostic Devices OHT5: Office of Neurological and Physical Medicine 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) K203066

Device Name

COOLIEF* Cooled Radiofrequency Kit Advanced

Indications for Use (Describe)

The COOLIEF* Cooled Radiofrequency Kit Advanced is to be used in conjunction with the Radiofrequency (RF) Pain Management Generator (PMG-ADVANCED) or the COOLIEF* Radiofrequency Generator (CRG-Advanced) to create lesions in nervous tissue. The device includes a fluid delivery system for commonly used fluid agents limited to contrast medium, saline, and/or anesthetic solution delivery at the target site. This device is also indicated for creating radiofrequency lesions of the genicular nerves for the management of moderate to severe knee pain of more than 6 months with conservative therapy, including medication, in patients with radiologically-confirmed ostecarthritis (grade 2-4) and a positive response (≥50% reduction in pain) to a diagnostic genicular nerve block.

The COOLIEF® SINERGY* Cooled Radiofrequency Kit Advanced is to be used in conjunction with the Radiofrequency (RF) Pain Management Generator (PMG-ADV ANCED) or the COOLIEF* Radiofrequency Generator (CRG-ADVAN CED) to create RF lesions in nervous tissue. The device includes a fluid delivery system for commonly used fluid agents limited to contrast medium, saline, and/or anesthetic solution delivery at the target site.

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

Date: December 22, 2020

Submission Number: K203066

Manufacturer / Sponsor Name, Address, Telephone, Contact Information

510(k) Manufacturer / AddressAvanos Health, Inc.5405 Windward ParkwayAlpharetta, GA 30004
Contact PersonChristian SupinaAssociate Director, Regulatory AffairsPhone: (470) 462-8137

Classification, Common Name, Device Name

Trade NameCOOLIEF* Cooled Radiofrequency Kit Advanced;COOLIEF* SINERGY* Cooled Radiofrequency Kit Advanced
Common NameRadiofrequency Lesion Probe
Classification NameProbe, Radiofrequency lesion
Regulation Number21 CFR §882.4725
Product CodeGXI
Device ClassificationII
Review Panel(84) Neurology
Reason for Premarket NotificationModification to predicate device. The probe and fluid tubing kit are part of the COOLIEF* Cooled Radiofrequency Kit Advanced
Prior SubmissionThere are no previous submissions for this change.

Primary Predicate Device:

Trade NameCOOLIEF* Cooled Radiofrequency Probe
510(k) NumberK163461
ManufacturerHalyard Health, Inc. (currently Avanos Medical, Inc.)
Common NameRadiofrequency lesion probe
Classification NameProbe, Radiofrequency Lesion
Regulation Section21 CFR 882.4725
Device ClassificationII
Product CodeGXI
Review Panel(84) Neurology

Secondary Predicate Device:

Trade NameCOOLIEF* Cooled Radiofrequency Kit
510(k) NumberK163236
ManufacturerHalyard Health, Inc. (currently Avanos Medical, Inc.)
Common NameRadiofrequency lesion probe
Classification NameProbe, Radiofrequency Lesion
Regulation Section21 CFR 882.4725
Device ClassificationII
Product CodeGXI
Review Panel(84) Neurology

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Description of the Device:

The COOLIEF* Cooled Radiofrequency Kit Advanced is a modification to the predicate COOLIEF* Cooled Radiofrequency Kit cleared under K163461. The subject device consists of the following:

  • COOLIEF* Cooled Radiofrequency Probe Advanced
  • COOLIEF* Cooled Radiofrequency Fluid Tubing Kit ●
  • COOLIEF* Cooled Radiofrequency Fluid Delivery Introducer ●

The modifications to the subject device are specific to the probe and fluid tubing kit.

The subject probe and fluid tubing kit are also included in the COOLIEFSINERGY Cooled Radiofrequency Kit Advanced. The following shows the general naming convention used for the COOLIEF* Cooled RF Kits, and how this relates to specific product characteristics.

COOLIEF* Cooled Radiofrequency Probe Advanced

  • . CRPA-17-XXX: where 17 is the gauge size for mating to introducer, XXX is the length in mm (50, 75, 100, 150 mm)
  • CRPA designates "Cooled Radiofrequency Probe Advanced" .

COOLIEF* Cooled Radiofrequency Kit Advanced

  • CRKA-17-XXX-##; where 17 is the gauge size, XXX is the length in mm (50, 75, 100, or 150 . mm), and ## is the active tip length in mm (2, 4, or 5.5 mm)
  • CRKA designates "Cooled Radiofrequency Kit Advanced .

COOLIEF* Multi-Cooled Radiofrequency Kit Advanced

  • MCKAY-17-XXX-##; where Y indicates number of probes supplied with the kit (2 or 3), 17 is . the gauge size, XXX is the length in mm (50, 75, 100, 150), and ## is the active tip length in mm (2, 4, or 5.5 mm)
  • MCKA designates "Multi-Cooled Kit Advanced" .

COOLIEF* SINERGY* Cooled Radiofrequency Kit Advanced

  • SIKA-17-XXX-4; where 17 is the gauge size, XXX is the length in mm (75 or 150 mm) .
  • SIKA designates "SINERGY* Kit Advanced" .

The subject device has several configurations based on the anatomic region of use, length of the introducer and probe, and the length of the active electrode. The COOLIEF* Cooled Radiofrequency Kit Advanced is composed of fluid delivery introducers, probes, and fluid tubing kit. The kit is sterile, non-pyrogenic, and single-use. The COOLIEF* Cooled Radiofrequency Kit Advanced is to be used in conjunction with the Radiofrequency (RF) Pain Management Generator (PMG-ADVANCED) or the COOLIEF* Radiofrequency Generator (CRG-Advanced) to create lesions in nervous tissue. The system devices for the PMG and CRG systems are shown in Table 1

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COOLIEF*SystemReferenceDevice DescriptionPrinciple of OperationCondition ofUse510(k)Reference
Pain Management Generator System(compatible with subject COOLIEF*Cooled RF Kit Advanced)Pain ManagementGenerator (PMG)Source of RF energyClinical Use bytrainedphysicianK072478
Peristaltic Pump (PPU)Circulates cooling water orsaline to probe tip in aclosed-loopClinical Use bytrainedphysicianK031951
Fluid DeliveryIntroducerProvides a path for theprobe to the nervous tissueand includes a fluiddelivery systemClinical Use bytrainedphysicianK163236
Dispersive Electrode /Grounding PadCompletes electrical circuitClinical Use bytrainedphysicianK140658
Therapy / ConnectorCablesConnects probes togenerator (electrical)Clinical Use bytrainedphysicianK072478
COOLIEF* Radiofrequency GeneratorSystem (compatible with subjectCOOLIEF* Cooled RF Kit Advanced)COOLIEF*RadiofrequencyGenerator (CRG)Source of RF energyClinical Use bytrainedphysicianK192491
Quad Pump Unit (QPU)Circulates cooling water orsaline to probe tip in aclosed-loopClinical Use bytrainedphysicianK192491
Fluid DeliveryIntroducerProvides a path for theprobe to the nervous tissueand includes a fluiddelivery systemClinical Use bytrainedphysicianK163236
Dispersive Electrode /Grounding PadCompletes electrical circuitClinical Use bytrainedphysicianK140658
Therapy / ConnectorCablesConnects probes togenerator (electrical)Clinical Use bytrainedphysicianK192491

Table 1. COOLIEF* Generator System Devices (PMG and CRG)

The COOLIEF* SINERGY* Cooled Radiofrequency Kit Advanced is to be used in conjunction with the Radiofrequency (RF) Pain Management Generator (PMG-ADVANCED) or the COOLIEF* Radiofrequency Generator (CRG-ADVANCED) to create RF lesions in nervous tissue. This device includes the same components as the COOLIEF* Cooled RF Kit Advanced, but also includes an Epsilon The Epsilon Ruler is a circular stainless-steel ruler that may be used during the COOLIEF Ruler. SINERGY* procedure to assist the user in providing a 'template' around the foramen, which is specific to performing procedure around the sacroiliac (SI) nerve.

Indications for Use:

The COOLIEF* Cooled Radiofrequency Kit Advanced is to be used in conjunction with the (RF) Pain Management Generator (PMG-ADVANCED) or the COOLIEF* Radiofrequency Radiofrequency Generator (CRG-Advanced) to create lesions in nervous tissue. The device includes a fluid delivery system for commonly used fluid agents limited to contrast medium, saline, and/or anesthetic solution delivery at the target site. This device is also indicated for creating radiofrequency lesions of the genicular nerves for the management of moderate to severe knee pain of more than 6 months with conservative therapy, including medication, in patients with radiologically-confirmed osteoarthritis (grade 2-4) and a positive response (≥0% reduction in pain) to a diagnostic genicular nerve block.

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The COOLIEF* SINERGY* Cooled Radiofrequency Kit Advanced is to be used in conjunction with the Radiofrequency (RF) Pain Management Generator (PMG-ADVANCED) or COOLIEF* Radiofrequency Generator (CRG-ADVANCED) to create RF lesions in nervous the tissue. The device includes a fluid delivery system for commonly used fluid agents limited to contrast medium, saline, and/or anesthetic solution delivery at the target site.

Table 2. Indications for Use - Comparison of Subject Device. Primary and Secondary Predicate Devices
----------------------------------------------------------------------------------------------------------

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The COOLIEF* Cooled Radiofrequency Kit cleared under K163236 (Halyard Health, currently Avanos Medical) is included as a secondary predicate for this submission as it consists of the same COOLIEF* Cooled RF Kit devices as the predicate device (K163461), and includes the following indications for use for the COOLIEF* SINERGY* Cooled RF Kit:

The HALYARD* COOLIEF* SINERGY* Cooled Radiofrequency Kit, in combination with the HALYARD* Radiofrequency (RF) Generator (PMG-BASIC/PMG-ADVANCED) (formerly Baylis Pain Management Generator or KIMBERLY-CLARK® Pain Management Generator) is intended for the creation of Radio-Frequency (RF) heat lesions in nervous tissue for the relief of pain, and includes a fluid delivery system for commonly used fluid agents limited to contrast medium, saline, and/or anesthetic solution delivery at the target site.

The proposed indications for use for the subject COOLIEF* SINERGY* Cooled RF Kit Advanced are equivalent to the secondary predicate device (K163226). The proposed indications for use for the subject device include references for use with both the Pain Management Generator (PMG-ADVANCED) and the COOLIEF* Radiofrequency Generator (CRG-Advanced), as the COOLIEF* Cooled Radiofrequency Probe Advanced is compatible with both generator systems. The COOLIEF* Radiofrequency Generator system was recently cleared under K192491 (Avanos Medical, Inc.), and testing has been completed to demonstrate the safe and effective use with the subject COOLIEF* Cooled Radiofrequency Kit Advanced.

The intended use for the subject and predicate devices is the same, and therefore do not raise any issues related to safety or effectiveness.

Comparison of Technological Characteristics of the Predicate and Proposed Device:

The technological characteristics, indications for use, and construction material of the COOLIEF* Radiofrequency Kit Advanced (subject device) are substantially equivalent to the currently-marketed predicate device COOLIEF* Cooled Radiofrequency Probe, cleared under K163461. The same fundamental technology, assembly, labeling, packaging, and sterilization method is used.

The COOLIEF* Cooled RF Probe Advanced (CRPA probe) adds a new smaller, lighter handle compared to the COOLIEF* Cooled RF Probe (CRP probe) handle is lighter than the predicate device probe handle, which is used to direct the positioning of the procedure. In addition, the new handle incorporates a 90-degree design, which makes the probe less top-heavy by directing the cables and fluid tubing at a 90-degree angle from the probe shaft. These changes were made to the probe to improve the overall handling of the probe during the RF procedure.

The probe utilizes more flexible fluid tubing than the predicate device, allowing the user to more easily maneuver it during the COOLIEF* Radiofrequency procedure. The fluid tubing is thermally bonded to the jacket of the electrical cable to further improve probe handling and management during the procedure. The material of the probe fluid lines is the same as the predicate device (polyvinyl chloride). Reference Figure 1 for a picture and illustration of the CRPA probe.

The subject device fluid tubing kit includes a dual lumen IV spike for accessing standard IV bags to be used as the cooling fluid reservoir. The IV spike on the fluid tubing kit will allow the user to more easily access water or saline for use during the procedure set-up, instead of having the fill a burette with water (predicate).

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The IV spike on the subject device is the same material as the burette (polycarbonate). The fluid tubing kit also uses more flexible tubing than the predicate device for easier maneuverability during use and is the same material as the predicate tubing (PVC). This updated fluid tubing kit configuration continues to support closed-loop cooling fluid recirculation, same as the predicate device. The peristaltic tubing that is loaded into the perstaltic pump heads for fluid circulation is now tinted blue in color to help the user distinguish it from the other sections of the fluid tubing. There was no color for the predicate tubing. Reference Figure 2 for an illustration of the Fluid Tubing Kit (single and dual).

Tables 3 and 4 provide a comparison of similarities and differences between the subject and predicate These tables include probes and fluid tubing kits from both COOLIEF* Cooled RF Kits devices. and COOLIEF* SINERGY* kits.

Figure 1. Picture of COOLIEF* Cooled Radiofrequency Probe Advanced

Image /page/8/Picture/4 description: The image shows a medical device with a needle and tubing. The needle is attached to a clear plastic connector with a white cap. The tubing is clear with blue and black stripes and is coiled in the center of the image. There are two additional connectors in the center of the image, one gray and one clear.

Figure 2. Illustration of COOLIEF* Radiofrequency Tubing Kit

Image /page/8/Picture/6 description: The image shows two sets of medical tubing. Each set of tubing has a connector on one end and two connectors on the other end. The tubing is coiled in a circular shape.

CRA-TBK-1 (Single-Probe Configuration)

CRA-TBK-2 (Dual-Probe Configuration)

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Table 3. Similarities in Characteristics between Subject Device, Primary Predicate Device, and Secondary Predicate Device

CharacteristicsSubject DeviceCOOLIEF* CooledRadiofrequency KitAdvanced (K203066)Primary Predicate DeviceCOOLIEF* Cooled RFProbe(K163461)Secondary PredicateDeviceCOOLIEF* Cooled RFKit(K163236)
Operating PrincipleCooled RadiofrequencyAblationCooled RadiofrequencyAblationCooled RadiofrequencyAblation
Cooling MethodClosed-loop circulation ofcooling fluid to the tip ofthe active electrode usinga peristaltic pumpClosed-loop circulation ofcooling fluid to the tip of theactive electrode using aperistaltic pumpClosed-loop circulation ofcooling fluid to the tip ofthe active electrode usinga peristaltic pump
TemperatureMeasurement DeviceModified Type-TthermocoupleModified Type-TthermocoupleModified Type-Tthermocouple
TemperatureMeasurementLocationDistal tip of activeelectrodeDistal tip of active electrodeDistal tip of activeelectrode
TemperatureMeasurement Range38°C - 95°C38°C - 95°C38°C — 95°C
TemperatureAccuracy$\pm$ 3°C$\pm$ 3°C$\pm$ 3°C
Probe Shaft Length50mm, 75mm, 100mm,150mm50mm, 75mm, 100mm,150mm50mm, 75mm, 100mm,150mm
Active ElectrodeLength2mm, 4mm, 5.5mm2mm, 4mm, 5.5mm2mm, 4mm, 5.5mm
Single UseYesYesYes
SterilitySterilized by EthyleneOxide (SAL = 10-6)Sterilized by Ethylene Oxide(SAL = 10-6)Sterilized by EthyleneOxide (SAL = 10-6)
Fluid LinesMaterial: PVCDual LumenMaterial: PVCDual LumenMaterial: PVCDual Lumen
Luer Lock ConnectorFemale Luer LockConnector: transparentPolycarbonate (PC)Male Luer LockConnector: transparent PCFemale Luer Lock Connector:transparent Polycarbonate(PC)Male Luer Lock Connector:transparent PCFemale Luer LockConnector: transparentPolycarbonate (PC)Male Luer LockConnector: transparent PC
Luer CapsVented Female Luer Cap:white polypropyleneVented Male Luer Cap:white NylonVented Female Luer Cap:white polypropyleneVented Male Luer Cap: whiteNylonVented Female Luer Cap:white polypropyleneVented Male Luer Cap:white Nylon
CharacteristicSubject DeviceCOOLIEF* CooledRadiofrequency KitAdvanced (K203066)Primary Predicate DeviceCOOLIEF* Cooled RF Probe(K163461)Secondary PredicateDeviceCOOLIEF* Cooled RFKit(K163236)
Probe Handle ShapeL-shaped (90° betweenprobe shaft andcable/tubing)Cylindrical (probe shaft andcable/tubing in-line)Cylindrical (probe shaft andcable/tubing in-line)
Probe HandleMaterialMaterial: PolycarbonateColor: WhiteMaterial: AcetalColor: BlackMaterial: AcetalColor: Black
Tubing/CableManagementFluid tubing is thermallybonded to cableFluid tubing is not bonded cableFluid tubing is not bondedcable
Cable JacketJacket Material: MedicalGrade PVCJacket Material: SiliconeJacket Material: Silicone
Fluid Management KitOperationSpike on tubing kitconnected to standard IVbag (saline or sterilewater) prior to procedureBurette on tubing kit filled withsterile water prior to procedureBurette on tubing kit filledwith sterile water prior toprocedure
Peristaltic TubingMaterial: PolyvinylChloride (PVC)Color: Tinted BlueMaterial: Tygon E-LFLColor: TransparentMaterial: Tygon E-LFLColor: Transparent
Fluid Reservoir andConnection250 – 1000mL standardIV bags filled withsaline or sterile water(not provided with kit)IV spike (polycarbonate)bonded to fluid tubing70mL burettes filled with sterilewaterBurettes (polycarbonate)bonded to fluid tubing70mL burettes filled withsterile waterBurettes (polycarbonate)bonded to fluid tubing

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Table 4. Differences in Characteristics between Subject Device, Primary Predicate Device, and Secondary Predicate Device

Summary of Non-Clinical Testing (Performance Testing)

Performance Testing for the subject device was conducted in conjunction with both the Pain Management Generator (PMG) and COOLIEF* Radiofrequency Generator (CRG) Pain Management Systems. The bench performance testing demonstrates that the subject device performs as intended. As a result of the change to the probe and fluid tubing, no new risks were identified, and the device functions as intended. Table 5 provides a summary of non-clinical testing.

Table 5. Summary of Non-Clinical Testing (Performance Testing)

Test Name / DescriptionResult
Sterilization and Shelf-Life• ANSI/AAMI/ISO 11135:2014, Sterilization of health careproducts – Ethylene oxide – Part 1: Requirements fordevelopment, validation and routine control of a sterilizationprocess for medical devicesPass
Bacterial Endotoxins TestingPass
Test Name / DescriptionResult
• ST72:2019, Bacterial endotoxins – Test methods, routinemonitoring, and alternatives to batch testing
Human Factors• 62366-1:2015, Medical devices - Application of usabilityengineering to medical devicesPass
Biocompatibility• 10993-5: 2009, Biological evaluation of medical devices - Part5: Tests for in vitro cytotoxicity• 10993-10: 2010, Biological evaluation of medical devices - Part 10:Tests for irritation and skin sensitization• 10993-11: 2006, Tests for Acute Systemic Toxicity andMaterial-Mediated PyrogenicityPass
Electromagnetic Compatibility and Electrical Safety (for probe)• 60601-1:2005+AM1 (2012), Medical electrical equipment -Part 1: General requirements for basic safety and essentialperformance• 60601-1-6: 2010+A1:2013, Medical electrical equipment -Part 1-6: General requirements for basic safety and essentialperformance - Collateral standard: Usability• 60601-1-9:2013, Medical electrical equipment - Part 1-9:General requirements for basic safety and essentialperformance - Collateral Standard: Requirements forenvironmentally conscious design• 60601-2-2:2017, Medical electrical equipment - Part 2-2:Particular requirements for basic safety and essentialperformance of high frequency surgical equipment and highfrequency surgical accessoriesPass
Performance Verification• Lesion Size Testing• Probe Thermocouple Accuracy Testing• Probe Fluid Delivery Port Injection Force Testing• Flow Rate Testing• High Pressure Leak TestingPass
Test Name / DescriptionResult
Probe Mass Testing Structural Strength Testing Sterile Water and Saline Cooling Fluids Testing Packaging Verification (ANSI/AAMI/ISO 11607-1:2019, Packaging for terminally sterilized medical devices - Part 1: Requirements for materials, sterile barrier systems, and packaging systems)

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Clinical Performance Data:

Clinical data was not applicable for the subject device.

Conclusions

It has been established that the subject device is substantially equivalent to the predicate devices cleared under 510(k) K163461 and K163236 in terms of indications for use, technology, and performance specifications. The non-clinical testing performed on the subject device demonstrates that the design changes made to the probe and fluid tubing kit do not raise any new issues or questions on the safety or effectiveness of the device.

§ 882.4725 Radiofrequency lesion probe.

(a)
Identification. A radiofrequency lesion probe is a device connected to a radiofrequency (RF) lesion generator to deliver the RF energy to the site within the nervous system where a lesion is desired.(b)
Classification. Class II (performance standards).