K Number
K211652
Device Name
Renuvion Dermal Handpiece, Renuvion Dermal System
Date Cleared
2022-05-25

(362 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Renuvion® Dermal System is an electrosurgical device for dermatological procedures for the treatment of moderate to severe wrinkles and rhytides, limited to patients with Fitzpatrick skin types I, II or III. The treatment is achieved through controlled heating of the outer layers of the skin so that part or all of the epidermis becomes non-viable and there is controlled thermal modification to the underlying dermis. The Renuvion® Dermal Handpiece is only compatible with Apyx Medical Electrosurgical Generators.
Device Description
The Renuvion® Dermal Handpiece is a sterile single use electrosurgical (monopolar) device intended to be used in conjunction with a compatible Apyx Helium Plasma Generator (APYX-200P, APYX-RS3 - cleared under 510(k) K170188 & K192867) for the delivery of radiofrequency energy and/or helium plasma for the delivery of helium plasma for the noninvasive treatment of facial wrinkles and rhytides, in patients with Fitzpatrick skin types I, II or III. The Renuvion Dermal handpiece is part of the Renuvion System composed of the compatible Apyx generator, Foot switch, helium source, and patient grounding pad. The tip of the Renuvion® Dermal Handpiece is used to deliver thermal energy to tissue through a precise helium plasma beam. The device connects to the electrosurgical generator which is also connected to a helium gas tank and regulator. The device requires the use of a grounding pad plugged into the generator to complete the circuit. The device is offered only in one size, 44mm, catalog number APYX-044-DERM. The handpiece is activated by pressing the activation button on the handpiece or by pressing the purple foot pedal on the foot control accessory. The device is rated at 4.0kVpeak.
More Information

Not Found

No
The description focuses on electrosurgical and helium plasma technology for thermal treatment, with no mention of AI, ML, image processing, or data-driven decision making.

Yes
The device is described as an electrosurgical device for dermatological procedures for the treatment of moderate to severe wrinkles and rhytides, which constitutes a medical treatment.

No

The device is described as an electrosurgical device for dermatological procedures, specifically for the treatment of wrinkles and rhytides, through controlled heating of the skin. Its function is to deliver thermal energy to tissue for therapeutic effect, not to diagnose a condition.

No

The device description clearly states it is an electrosurgical handpiece, which is a hardware component, and part of a larger system including a generator, foot switch, helium source, and grounding pad.

Based on the provided information, the Renuvion® Dermal System is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use clearly states it's for "dermatological procedures for the treatment of moderate to severe wrinkles and rhytides." This is a therapeutic application performed directly on a patient's skin.
  • Device Description: The description details an electrosurgical device that delivers thermal energy to tissue through a helium plasma beam. This is a physical intervention on the body.
  • Lack of In Vitro Activity: There is no mention of the device being used to examine specimens (like blood, urine, tissue samples) outside of the body to provide information about a patient's health. IVDs are designed for testing samples in vitro (in glass).

Therefore, the Renuvion® Dermal System is a therapeutic medical device used for a dermatological procedure, not an IVD.

N/A

Intended Use / Indications for Use

The Renuvion® Dermal System is an electrosurgical device for dermatological procedures for the treatment of moderate to severe wrinkles and rhytides, limited to patients with Fitzpatrick skin types I, II or III. The treatment is achieved through controlled heating of the outer layers of the skin so that part or all of the epidermis becomes non-viable and there is controlled thermal modification to the underlying dermis.

The Renuvion® Dermal Handpiece is only compatible with Apyx Medical Electrosurgical Generators.

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

GEI

Device Description

The Renuvion® Dermal Handpiece is a sterile single use electrosurgical (monopolar) device intended to be used in conjunction with a compatible Apyx Helium Plasma Generator (APYX-200P, APYX-RS3 - cleared under 510(k) K170188 & K192867) for the delivery of radiofrequency energy and/or helium plasma for the delivery of helium plasma for the noninvasive treatment of facial wrinkles and rhytides, in patients with Fitzpatrick skin types I, II or III. The Renuvion® Dermal Handpiece is pictured below.

The major components of the Renuvion® Dermal Handpiece are pictured in Figure 1.

The Renuvion Dermal handpiece is part of the Renuvion System composed of the compatible Apyx generator, Foot switch, helium source, and patient grounding pad. The components of the system are pictured in Figure 2.

The handpiece is activated by pressing the activation button or by pressing the foot pedal on the footswitch accessory

The tip of the Renuvion® Dermal Handpiece is used to deliver thermal energy to tissue through a precise helium plasma beam. The device connects to the electrosurgical generator which is also connected to a helium gas tank and regulator. The device requires the use of a grounding pad plugged into the generator to complete the circuit. The device is offered only in one size, 44mm, catalog number APYX-044-DERM. The handpiece is activated by pressing the activation button on the handpiece or by pressing the purple foot pedal on the foot control accessory. The device is rated at 4.0kVpeak.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

outer layers of the skin (epidermis, dermis), facial wrinkles and rhytides.

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Doctor's Office, Surgery Center, or similar environment
Device to be used by trained medical staff only

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)

Two pre-clinical animal studies were conducted to establish the equivalence between the subject device and the predicate device, NeoGen® PSR System by Energist (formerly the Portrait PSR System by Rhytec). These pre-clinical studies were designed to provide a measurement (using histology under magnification) of the thermal damage zone (i.e., coagulation necrosis) on live porcine skin tissue at their minimum and maximum recommended power settings for dermatological wrinkle reduction procedures for moderate to severe wrinkles and rhytides.

These two (2) pre-clinical studies demonstrated that the depth of thermal effect for the Renuvion® Dermal System (subject Device) was less than or comparable to the depth of thermal effect for the predicate NeoGen PSR system in a porcine model.

The clinical performance of the subject device (Renuvion® Dermal Handpiece) is supported by the results of a Clinical IDE study performed (G170151) using the subject device. This clinical study was a prospective, multicenter, single arm clinical study evaluating the use of the Renuvion® Dermal System for dermatological wrinkle reduction conducted at 3 investigational centers in the United States as an evaluator-blinded prospective study of 55 study subjects who were seeking a procedure for the purpose of improving facial appearance by reducing facial wrinkles and rhytides. Each study subject received one single-pass fullface treatment with the Renuvion® Dermal System.

Primary Effectiveness Endpoint: The primary effectiveness endpoint was the proportion of subjects with at least one-point improvement from Baseline in Fitzpatrick Wrinkle and Elastosis Scale (FWS) at 90-days post-procedure as determined by 2 out of 3 blinded Independent Photographic Reviewers (IPR) assessment of photographs.
Result: Of 55 subjects treated. 92.7% (51/55) were scored to have at least a one-point improvement, 25.5% were scored to have at least a two- point improvement, and 5.5% were scored to have at least a three-point improvement on the Fitzpatrick Wrinkle and Elastosis Scale (FWS) at 90 days as determined by Independent Photographic Reviewers (IPRs).

Primary Safety Endpoint: The primary safety endpoint was the evaluation of adverse events up to the 3-month visit following the procedure.
Result: The study reported no serious adverse events (SAEs) related to the study device or procedure, and adverse events (AEs) were in line with the expectations of dermatological wrinkle reduction procedures involving the application of controlled heat to the epidermis to selectively render it non-viable with subsequent thermal modification of the underlying dermis to prompt a healing response. The most common events reported were, edema, erythema, and post-inflammatory hyperpigmentation.

The rate of AEs for the subject device is consistent with the expected range that has been observed for the predicate device, as reported in the literature. Based on the clinical performance as documented in the clinical study (G170151), the Renuvion® Dermal System was found to have a safety and effectiveness profile that is consistent with other legally marketed dermatological wrinkle reduction technologies such as the predicate device.

Conclusion: The clinical study demonstrated both safety and effectiveness, as endpoints related to effectiveness were met and there were no serious adverse events reported related to the study device or procedure. The risks and AE profile are comparable between the subject device and what is reported in published literature for the predicate device as long as the recommended treatment parameters are followed. The effectiveness outcomes are as good or better for the subject device as compared to the predicate device.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Primary Effectiveness Endpoint: The primary effectiveness endpoint was the proportion of subjects with at least one-point improvement from Baseline in Fitzpatrick Wrinkle and Elastosis Scale (FWS) at 90-days post-procedure as determined by 2 out of 3 blinded Independent Photographic Reviewers (IPR) assessment of photographs. Of 55 subjects treated. 92.7% (51/55) were scored to have at least a one-point improvement, 25.5% were scored to have at least a two- point improvement, and 5.5% were scored to have at least a three-point improvement on the Fitzpatrick Wrinkle and Elastosis Scale (FWS) at 90 days as determined by Independent Photographic Reviewers (IPRs).

Common Adverse Events and their rates:
Crusting: 1.8%
Edema: 34.5%
Erythema: 16.4%
Milia/Acne: 12.7%
Pruritus/Itching: 9.1%
Hypertrophic Scar: 3.6%
Post-inflammatory Hyperpigmentation: 14.5%
Telangiectasia: 0%
Discoloration/Hypopigmentation: 0%
Delayed Healing: 7.3%
Pain D0 Post-Op VAS Score (0=lowest, 10=highest): 4.3
Lid Retraction: 0%

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.

NeoGen PSR System, Energist Ltd (K132754)

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 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.

May 25, 2022

Apyx Medical Corporation (formerly Bovie Medical Corporation Priscilla Herpai Global Regulatory Director 5115 Ulmerton Road Clearwater, Florida 33760-4004

Re: K211652

Trade/Device Name: Renuvion Dermal Handpiece, Renuvion Dermal System Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical Cutting And Coagulation Device And Accessories Regulatory Class: Class II Product Code: GEI Dated: May 24, 2022 Received: May 25, 2022

Dear Priscilla Herpai:

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

1

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,

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

2

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: 06/30/2023 See PRA Statement below.

510(k) Number (if known) K211652

Device Name

Renuvion® Dermal Handpiece (APYX-044-DERM)

Indications for Use (Describe)

The Renuvion® Dermal System is an electrosurgical device for dermatological procedures for the treatment of moderate to severe wrinkles and rhytides, limited to patients with Fitzpatrick skin types I, II or III. The treatment is achieved through controlled heating of the outer layers of the skin so that part or all of the epidermis becomes non-viable and there is controlled thermal modification to the underlying dermis.

The Renuvion® Dermal Handpiece is only compatible with Apyx Medical Electrosurgical Generators.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

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Image /page/3/Picture/2 description: The image shows the Apyx Medical logo. The logo is orange and blue. The word "Apyx" is in orange, and the word "Medical" is in blue.

510(k) Summary

K211652

1.General Information
Submitted by:Apyx Medical Corporation
5115 Ulmerton Road
Clearwater, Florida 33760 -4004
United States of America
Establishment Registration #:3007593903
Submitter FAX Number:(727) 322-4465
Contact Person:Mrs. Priscilla Herpai, Global Regulatory Director
Phone: (727) 803-8512
Email: priscilla.herpai@apyxmedical.com
Date Prepared:May 27, 2021
Trade Names (Model Numbers):Renuvion® Dermal Handpiece
(APYX-044-DERM)
Common Name:Electrosurgical Handpiece
Classification:Class II per 21CFR 878.4400 - Electrosurgical
Cutting and Coagulation Device and Accessories
Product Code GEI
Predicate Devices:Predicate Device
NeoGen PSR System, Energist Ltd (K132754) -
(formerly Portrait PSR System, Rhytec Inc.)

2. Indications for Use

The Renuvion® Dermal System is an electrosurgical system for dermatological procedures for the treatment of moderate to severe wrinkles and rhytides, limited to patients with Fitzpatrick Skin Types I, II or III. The treatment is achieved through controlled heating of the outer layers of the skin so that part or all of the epidermis becomes non-viable and there is controlled thermal modification to the underlying dermis. The Renuvion® Dermal Handpiece is only compatible with Apyx Medical Electrosurgical Generators.

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Image /page/4/Picture/2 description: The image shows the logo for Aryx Medical. The logo is orange and blue. The word "Aryx" is in orange, and the word "Medical" is in blue.

K211652

3. Device Description

The Renuvion® Dermal Handpiece is a sterile single use electrosurgical (monopolar) device intended to be used in conjunction with a compatible Apyx Helium Plasma Generator (APYX-200P, APYX-RS3 - cleared under 510(k) K170188 & K192867) for the delivery of radiofrequency energy and/or helium plasma for the delivery of helium plasma for the noninvasive treatment of facial wrinkles and rhytides, in patients with Fitzpatrick skin types I, II or III. The Renuvion® Dermal Handpiece is pictured below.

The major components of the Renuvion® Dermal Handpiece are pictured in Figure 1.

Figure 1. Renuvion Dermal Handpiece

Image /page/4/Figure/9 description: The image shows the Renuvion Dermal Handpiece and its components. The handpiece has a tip, shaft, activation button, and handle. There are also standard and periorbital spacers, a plug connector, and a cable.

The Renuvion Dermal handpiece is part of the Renuvion System composed of the compatible Apyx generator, Foot switch, helium source, and patient grounding pad. The components of the system are pictured in Figure 2.

The handpiece is activated by pressing the activation button or by pressing the foot pedal on the footswitch accessory

The tip of the Renuvion® Dermal Handpiece is used to deliver thermal energy to tissue through a precise helium plasma beam. The device connects to the electrosurgical generator which is also connected to a helium gas tank and regulator. The device requires the use of a grounding pad plugged into the generator to complete the circuit. The device is offered only in one size, 44mm, catalog number APYX-044-DERM. The handpiece is activated by pressing the activation button on the handpiece or by pressing the purple foot pedal on the foot control accessory. The device is rated at 4.0kVpeak.

Figure 2. Renuvion Dermal System.

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Image /page/5/Picture/2 description: The image is a logo for Apyx Medical. The logo features the word "Apyx" in orange with a small, dark blue triangle in place of the "A". To the right of the word "Apyx" is the trademark symbol. Below the word "Apyx" is the word "MEDICAL" in dark blue. There is a thin, dark blue line below the word "MEDICAL".

510(k) Summary

K211652

Image /page/5/Figure/5 description: The image shows a medical device setup with several components labeled. A red helium tank is connected to a gas regulator via a blue tube. The gas regulator is connected to a generator, which also has a handpiece and cable attached. A foot switch and grounding pad are also part of the setup.

4. Performance Data

Performance testing was conducted in accordance with FDA's Guidance for Premarket Notification (510(k)) Submissions for Electrosurgical Devices for General Surgery originally issued on August 15, 2016 and updated on March 9, 2020

a. Bench Testing

Performance testing was conducted to verify that the Renuvion® Dermal Handpiece and associated accessory (Renuvion® Dermal Spacer) met performance specifications. All acceptance criteria were met, and the device met all its performance and product requirements. The testing performed is summarized in the following table:

TestObjectiveResult
Mechanical
Verification &
FunctionalityVerify Mechanical functionality of the Renuvion®
Dermal Handpiece and associated accessories,
Renuvion® Dermal Spacers.Mechanical
functionality
requirements met
System
Compatibility
TestingVerify the device, when connected to the
generators (with all the components and
accessories working together as a system), are
working as intended and are compatible with all
system components.System
compatibility
requirements met
Thermal Tissue
EffectCompare the tissue thermal effects of the subject
device (Renuvion® Dermal Handpiece) with the
reference device (Renuvion®/J-Plasma Precise
Open Handpiece) using 4 different tissue types.Thermal tissue
effect
requirements met

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Image /page/6/Picture/2 description: The image shows the logo for Apyx Medical. The logo features the word "Apyx" in orange, with a blue triangle in place of the letter "A". Below the word "Apyx" is the word "MEDICAL" in blue. The letters are sans-serif and the logo has a clean, modern look.

K211652

TestObjectiveResult
Inspectional
VerificationDocument parameters that can be verified
through inspection for the Renuvion® Dermal
Handpiece.Inspectional
requirements met
Packaging
ValidationEvaluate simulated (and/or real-time) aging and
associated package integrity and shelf-life claims.
Assess the potential for damage to the device
(e.g., drop tests of the instrument in its
packaging).Packaging
requirements met

b. Electrical Safety and Electromagnetic Compatibility (EMC)

Electrical safety and EMC testing was conducted on the system (subject device, Renuvion® Dermal Handpiece (HP), and the compatible Electrosurgical Generator, APYX-200P and APYX-RS3) to ensure compliance with the following recognized standards and all results were passing:

ANSI/AAMI/IEC ES60601-1:2005/(R)2012 and A1:2012, Medical electrical equipment -Part 1-2: General requirements for basic safety and essential performance

ANSI/AAMI/IEC 60601-2-2:2017 Medical electrical equipment - Part 2-2: Requirements for the basic safety and essential performance of high frequency surgical equipment and high frequency surqical accessories

IEC 60601-1-2 Edition 4.1 2020-09 Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral Standard: Electromagnetic disturbances - Requirements and Tests.

ANSI/AAMI/IEC 62366:2015 Medical devices - Part 1: Application of usability engineering to medical devices

c. Biocompatibility Testing

The biocompatibility evaluation for the Renuvion® Dermal Handpiece was conducted in accordance with the June 16, 2016, FDA Guidance, "Use of International Standard ISO 10993-1, Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process" and the AAMI/ANSI/ISO 10993-1:2018 and AAMI/ANSI/ISO 10993-1:2009 standards, "Biological Evaluation of Medical Devices - Part 1: Evaluation and Testing Within a Risk Management Process". The Renuvion® Dermal Handpiece (subject device) is considered a surface contacting device with contact to breached or compromised surfaces. Therefore, the following tests were conducted and passed in accordance with the respective ISO 10993 series recognized consensus standard:

  • Cytotoxicity ■
  • Systemic toxicity
    • Material Mediated Pyrogen/Pyrogenicity Sensitization ■
  • 트 Irritation

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Image /page/7/Picture/2 description: The image shows the logo for Apyx Medical. The logo is orange and blue, with the word "Apyx" in orange and a blue triangle in the letter "A". Below the word "Apyx" is the word "MEDICAL" in blue. The logo is simple and modern.

K211652

5. Pre-Clinical & Animal Studies

Two pre-clinical animal studies were conducted to establish the equivalence between the subject device and the predicate device, NeoGen® PSR System by Energist (formerly the Portrait PSR System by Rhytec). These pre-clinical studies were designed to provide a measurement (using histology under magnification) of the thermal damage zone (i.e., coagulation necrosis) on live porcine skin tissue at their minimum and maximum recommended power settings for dermatological wrinkle reduction procedures for moderate to severe wrinkles and rhytides.

These two (2) pre-clinical studies demonstrated that the depth of thermal effect for the Renuvion® Dermal System (subject Device) was less than or comparable to the depth of thermal effect for the predicate NeoGen PSR system in a porcine model. The results of these pre-clinical studies support the safety and substantial equivalence of the Renuvion® Dermal System for dermatological wrinkle reduction procedures in comparison to the predicate nitrogen plasma technology (NeoGen PSR System, K132754).

6. Human Clinical Trials

The clinical performance of the subject device (Renuvion® Dermal Handpiece) is supported by the results of a Clinical IDE study performed (G170151) using the subject device. This clinical study was a prospective, multicenter, single arm clinical study evaluating the use of the Renuvion® Dermal System for dermatological wrinkle reduction conducted at 3 investigational centers in the United States as an evaluator-blinded prospective study of 55 study subjects who were seeking a procedure for the purpose of improving facial appearance by reducing facial wrinkles and rhytides. Each study subject received one single-pass fullface treatment with the Renuvion® Dermal System.

Primary Effectiveness Endpoint: The primary effectiveness endpoint was the proportion of subjects with at least one-point improvement from Baseline in Fitzpatrick Wrinkle and Elastosis Scale (FWS) at 90-days post-procedure as determined by 2 out of 3 blinded Independent Photographic Reviewers (IPR) assessment of photographs.

Primary Safety Endpoint: The primary safety endpoint was the evaluation of adverse events up to the 3-month visit following the procedure.

a. Effectiveness Results

Of 55 subjects treated. 92.7% (51/55) were scored to have at least a one-point improvement, 25.5% were scored to have at least a two- point improvement, and 5.5% were scored to have at least a three-point improvement on the Fitzpatrick Wrinkle and Elastosis Scale (FWS) at 90 days as determined by Independent Photographic Reviewers (IPRs).

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Image /page/8/Picture/2 description: The image shows the logo for Apyx Medical. The logo has the word "Apyx" in orange with a blue triangle in place of the "A". Below the word "Apyx" is the word "MEDICAL" in blue. The TM symbol is in the upper right corner of the logo.

K211652

b. Safety Results

The study reported no serious adverse events (SAEs) related to the study device or procedure, and adverse events (AEs) were in line with the expectations of dermatological wrinkle reduction procedures involving the application of controlled heat to the epidermis to selectively render it non-viable with subsequent thermal modification of the underlying dermis to prompt a healing response. The most common events reported were, edema, erythema, and post-inflammatory hyperpigmentation.

The rate of AEs for the subject device is consistent with the expected range that has been observed for the predicate device, as reported in the literature. Based on the clinical performance as documented in the clinical study (G170151), the Renuvion® Dermal System was found to have a safety and effectiveness profile that is consistent with other legally marketed dermatological wrinkle reduction technologies such as the predicate device.

Table 2 is a direct comparison of adverse events for the Renuvion Dermal Handbiece (subject device) compared to the Rhytec/Energist (predicate device) established in literature.

| Adverse Event | Renuvion
Dermal System
(n=55) | Rhytec/Energist Predicate
(n=24)1 |
|----------------------------------------|-------------------------------------|--------------------------------------|
| Crusting | 1.8% | 100%1 |
| Edema | 34.5% | 100%1 |
| Erythema | 16.4% | 100%1 |
| Milia/Acne | 12.7% | Not Reported |
| Pruritus/Itching | 9.1% | Not Reported |
| Hypertrophic Scar | 3.6% | 4.2%1 |
| Post-inflammatory
Hyperpigmentation | 14.5% | "A number of patients" at D901 |
| Telangiectasia | 0% | Not Reported |

Table 2. Adverse Event Profile Comparison for Subject and Predicate Device

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Image /page/9/Picture/2 description: The image shows the logo for Aryx Medical. The logo features the word "Aryx" in orange, with a blue triangle replacing the "A". Below the word "Aryx" is the word "MEDICAL" in red. The logo is simple and modern, and the colors are bright and eye-catching.

K211652

| Discoloration/Hypopigmentation

n0%0%1
Delayed Healing7.3%Not Reported
Pain
D0 Post-Op VAS Score
(0=lowest, 10=highest)4.34.31
Lid Retraction0%Not Reported

Kilmer S, Semchyshyn N, Shah G, Fitzpatrick R. A pilot study on the use of a plasma skin regeneration device (Portrait PSR3) in full facial rejuvenation procedures. Lasers Med Sci. 2007 Jun;22(2):101-9 doi: 10.1007/s10103-006-0431-9. Epub 2007 Mar 7. PMID: 17342383.

c. Human Clinical Trial Outcome Summary

The clinical study demonstrated both safety and effectiveness, as endpoints related to effectiveness were met and there were no serious adverse events reported related to the study device or procedure. The risks and AE profile are comparable between the subject device and what is reported in published literature for the predicate device as long as the recommended treatment parameters are followed. The effectiveness outcomes are as good or better for the subject device as compared to the predicate device.

  • ❖ The totality of the data shows benefit to all subjects via the reduction of facial wrinkles and rhytides in subjects with Fitzpatrick Skin Type I, II, and III. The primary effectiveness endpoint for this study was achieved at 92.7%.
    • The primary safety endpoint identified the type and frequency of adverse events, and no new or different risks or adverse events were identified. There were no serious adverse events reported as related to the study device or the study procedure. The adverse events were comparable to those reported for the predicate device and fully ablative dermatological wrinkle reduction procedures in general using other FDA-cleared energybased modalities as long as the recommended treatment parameters are followed.
    • These data support the proposed Indications for Use of the product and substantial equivalence to the predicate device (Energist NeoGen Nitrogen Plasma K132754) for a 510(k) submission.

Based on the totality of data (safety variables and success criteria), there is sufficient assurance that safety and effectiveness has been demonstrated and clinically meaningful benefits have been observed in a majority of subjects. The safety and effectiveness conclusions drawn from the clinical studies demonstrate that there is statistically significant data to support the safety, effectiveness, and performance of the Renuvion® Dermal System for the treatment of moderate to severe facial wrinkles and rhytides in patients with Fitzpatrick Skin Types I, II or III and the benefits of Renuvion outweigh the risks. The subject device clinical study results, when compared to the predicate device safety and effectiveness data as stated in literature also supports substantial equivalence of the Renuvion Dermal Handpiece.

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7. Substantial Equivalence

The predicate device was selected because the subject device's intended use is a subset of the intended use for the primary predicate device (electrosurgical device for dermatologic treatment of wrinkles and rhytides - the treatment is achieved through controlled heating of the outer layers of the skin so that part or all the epidermis becomes non-viable and there is controlled thermal modification to the underlying dermis). The reference device was selected due to having the same principle of operation, mechanism of action, sterilization methods and technology used for device performance as the subject device, other than the few design modifications described in the submission. A summary of the subject device and predicate device comparison is provided below.

Subject DevicePredicate Device
Feature/
CharacteristicRenuvion® Dermal HandpieceNeoGen PSR System,
K132754
Indications for
UseThe Renuvion® Dermal system is an
electrosurgical device for
dermatological procedures for the
treatment of moderate to severe
wrinkles and rhytides, limited to
patients with Fitzpatrick skin types I,
II or III. The treatment is achieved
through controlled heating of the
outer layers of the skin so that part or
all the epidermis becomes non-viable
and there is controlled thermal
modification to the underlying dermis.
The Renuvion® Dermal Handpiece is
only compatible with Apyx Medical
Electrosurgical GeneratorsThe NeoGen PSR system is an
electrosurgical device for the
treatment of dermatologic
conditions including acne scars,
actinic keratosis, superficial skin
lesions and the treatment of
wrinkles and rhytides. The
treatment is achieved through
controlled heating of the outer
layers of the skin so that part or
all the epidermis becomes non-
viable and there is controlled
thermal modification to the
underlying dermis.
SoftwareRenuvion® Dermal handpiece does
not contain software; Renuvion
generator contains firmwareNeoGen PSR handpiece does
not contain software; NeoGen
generator contains software
SterilitySingle Use disposable Sterile (EO)
HandpieceHandpiece clean but non-sterile
Use
EnvironmentDoctor's Office, Surgery Center, or
similar environmentDoctor's Office/ Clinics or
hospitals
Clinical
ApplicationDermatologic on intact & broken skin;
Dermal procedures (facial)Dermatologic on intact & broken
skin; Dermal procedures (facial &
non-facial)
Prescription or
OTCPrescription Use OnlyPrescription Use Only
Energy SourceElectrosurgical generatorElectrosurgical generator
Energy TypeInert Gas Plasma (helium)Inert Gas Plasma (nitrogen)
WaveformRadiofrequency waveformRadiofrequency waveform

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Image /page/11/Picture/2 description: The image shows the logo for Apyx Medical. The logo is orange and blue. The word "MEDICAL" is written in blue below the logo.

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Subject DevicePredicate Device
Feature/
CharacteristicRenuvion® Dermal HandpieceNeoGen PSR System,
K132754
Device
ActivationFoot Pedal Activation or
button hand activationFoot Pedal Activation
User InterfaceGenerator buttons and displaysGenerator buttons and displays
Limitations on
device useDevice to be used by trained medical
staff only, in a Doctor's Office,
Surgery Center or similar
environmentDevice to be used by trained
medical staff only, in a Doctor's
Office, Surgery Center or similar
environment
Mode of ActionThe treatment is achieved through
controlled heating of the outer layers
of the skin so that part or all the
epidermis becomes non-viable and
there is controlled thermal
modification to the underlying dermisThe treatment is achieved
through controlled heating of the
outer layers of the skin so that
part or all of the epidermis
becomes non-viable and there is
controlled thermal modification to
the underlying dermis
Power
delivered to
patient3.2 - 8.55 W1 – 10 W
Procedures &
Anatomical
siteDermatological proceduresDermatological procedures
Plasma
SettingsControls on the generator allows the
user to vary the power delivered to
the patientControls on the generator allows
the user to vary the power
delivered to the patient
CompatibilityCompatible only with specific
generatorCompatible only with specific
generator
ConnectorCompatible only with specific
generatorCompatible only with specific
generator

8. Conclusion

Clinical testing of the Renuvion® Dermal System (subject device) demonstrated that the device performed as intended with a favorable safety profile. The primary effectiveness endpoint FWS improvement score, investigator FWS score, and patient assessment of results yielded comparable or more improved outcomes than the predicate device. The safety profile of the subject device is comparable to the predicate device; no new or different risks were identified, and adverse event rates were comparable to the predicate device rates when used following recommended treatment settings. The Renuvion® Dermal Handpiece safety and performance has been further confirmed by the results of the performance bench and animal testing. Technologically, there are no differences between the subject and predicate device that would raise new or different questions regarding safety or effectiveness; the maximum depths of thermal effect measured for the Renuvion® Dermal Handpiece are less than or statistically equivalent to the predicate device as measured by histopathology. In conclusion,

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the totality of the data (clinical, pre-clinical animal data, performance bench testing, and benefit-risk assessment) demonstrate that the Renuvion® Dermal Handpiece is substantially equivalent to the predicate device (NeoGen PSR System, Energist Ltd.- K132754) for the requested indication for use.