K Number
K212733
Device Name
Diode laser therapy device
Date Cleared
2023-06-06

(645 days)

Product Code
Regulation Number
878.4810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Diode laser therapy device is intended for delivery of laser light to soft tissue in the contact mode during surgical procedures. The device's 980mm laser is generally indicated for use in incision, vaporization, ablation, hemostasis or coagulation of soft tissue in ear, nose and throat and oral surgery (otolaryngology), dental procedures, gastroenterology, general surgery, dermatology, plastic surgery, podiatry, urology, gynecology. The device is further indicated for laser assisted lipolysis. The device's intended for delivery of laser light to soft tissue in non-contact mode during general surgery procedures, indicated for the treatment of reflux of the saphenous veins associated with varicose veins and varicosities.
Device Description
The diode laser generates a 980nm wavelength laser to act on a target tissue to achieve resection, hemostasis, ablation, and coaqulation of the target tissue. The diode laser generates a 1470 nm wavelength laser that acts on the water molecules of the target tissue to achieve the function of treatment of reflux of the saphenous veins associated with varicose veins and varicosities. The Diode laser therapy device has following characteristics: - Dual wavelengths A - A Temperature monitoring system
More Information

Not Found

No
The summary describes a laser therapy device with dual wavelengths and a temperature monitoring system. There is no mention of AI, ML, image processing, or any data-driven algorithms for diagnosis, treatment planning, or control beyond basic temperature monitoring. The performance studies are non-clinical comparisons to predicate devices, not evaluations of AI/ML performance metrics.

Yes.
The device is used to perform surgical procedures, including incision, vaporization, ablation, hemostasis, coagulation of soft tissue, and treatment of saphenous vein reflux, which are all therapeutic interventions aimed at treating medical conditions.

No

This device is a therapeutic laser used for surgical procedures like incision, vaporization, ablation, and coagulation of tissue, as well as laser-assisted lipolysis and treatment of varicose veins. Its intended use is to deliver laser light to act on target tissues, which is a treatment function, not a diagnostic one.

No

The device description explicitly details hardware components, including a diode laser generator with specific wavelengths and a temperature monitoring system, indicating it is a physical device, not software-only.

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

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • Device Function: The description clearly states the device is a laser therapy device intended for surgical procedures and treatment of veins. It delivers laser light directly to soft tissue or veins within the body.
  • Lack of Specimen Analysis: There is no mention of the device analyzing any biological specimens taken from the body. Its action is directly on the patient's tissues.

Therefore, this device falls under the category of a therapeutic or surgical device, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Diode laser therapy device is intended for delivery of laser light to soft tissue in the contact mode during surgical procedures. The device's 980mm laser is generally indicated for use in incision, vaporization, ablation, hemostasis or coagulation of soft tissue in ear, nose and throat and oral surgery (otolaryngology), dental procedures, gastroenterology, general surgery, dermatology, plastic surgery, podiatry, urology, gynecology. The device is further indicated for laser assisted lipolysis. The device's intended for delivery of laser light to soft tissue in non-contact mode during general surgery procedures, indicated for the treatment of reflux of the saphenous veins associated with varicose veins and varicosities.

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

GEX

Device Description

The diode laser generates a 980nm wavelength laser to act on a target tissue to achieve resection, hemostasis, ablation, and coaqulation of the target tissue. The diode laser generates a 1470 nm wavelength laser that acts on the water molecules of the target tissue to achieve the function of treatment of reflux of the saphenous veins associated with varicose veins and varicosities. The Diode laser therapy device has following characteristics:

  • Dual wavelengths A
  • A Temperature monitoring system

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

ear, nose and throat and oral surgery (otolaryngology), dental procedures, gastroenterology, general surgery, dermatology, plastic surgery, podiatry, urology, gynecology, saphenous veins

Indicated Patient Age Range

Adult

Intended User / Care Setting

Not Found

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)

No clinical study implemented for the Diode laser therapy device.
The conclusion drawn from the nonclinical tests demonstrates that the subject device in 510(K) submission, the Diode laser therapy device is as safe, as effective, and performs as well as or better than the legally marketed predicate device cleared under K081015, K073063.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K081015, K073063

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

§ 878.4810 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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June 6, 2023

Beijing Star New Tech Co., Ltd. % Boyle Wang General Manager Shanghai Truthful Information Technology Co., Ltd. Room608,No.738,Shangcheng Rd.,Pudong Shanghai, Shanghai 200120 China

Re: K212733

Trade/Device Name: Diode laser therapy device 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: April 28, 2023 Received: May 1, 2023

Dear Boyle 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.

1

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 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.

Jianting Wang -S

Jianting Wang 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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Indications for Use

510(k) Number (if known) K212733

Device Name Diode laser therapy device

Indications for Use (Describe)

The Diode laser therapy device is intended for delivery of laser light to soft tissue in the contact mode during surgical procedures. The device's 980mm laser is generally indicated for use in incision, vaporization, ablation, hemostasis or coagulation of soft tissue in ear, nose and throat and oral surgery (otolaryngology), dental procedures, gastroenterology, general surgery, dermatology, plastic surgery, podiatry, urology, gynecology. The device is further indicated for laser assisted lipolysis. The device's intended for delivery of laser light to soft tissue in non-contact mode during general surgery procedures, indicated for the treatment of reflux of the saphenous veins associated with varicose veins and varicosities.

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

Deposition Use (Part 21 CFR 601.21 and D)
The Concordance (21 CFR

| > Prescription Use (Part 21 CFR 801 Subpart D)

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

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510(k) Summary

510(k) number: K212733

This summary of 510(k) safety and effectiveness information is being submitted in accordance with requirements of SMDA 1990 and 21 CFR 807.92.

1.0 Submitter's information

Name: Beijing Star New Tech Co., Ltd. Address: Room 618, Block C, Jinri Science Park, No. 26 Jinyuan Road, Daxing District, Beijing, China Phone Number: 86-10-61271282 Fax number: 86-10-61271282 Contact: Liang Zhongdong Date of Preparation: Jun.02, 2023

Prior submissions

This is the first submission, there is no prior submission.

Designated Submission Correspondent

Mr. Boyle Wang Shanghai Truthful Information Technology Co., Ltd. Room 608, No. 738 Shangcheng Rd., Pudong Shanghai, 200120 China Tel: +86-21-50313932 Email: Info@truthful.com.cn

2.0 Device information

Trade name:Diode laser therapy device
Common name:Powered Laser Surgical Instrument
Regulation name:Laser surgical instrument for use in general and plastic surgery
and in dermatology
Model(s):ST-AR.

3.0 Classification

Production code: GEX Regulation number: 21 CFR 878.4810 Classification: Class II Panel: General & Plastic Surgery

4.0 Predicate device information

4

510(k) Number: K081015 Product Name: Ceralas Diode 980nm Laser System Manufacturer: Biolitec, Inc.

510(k) Number: K073063 Product Name: 15W Ceralas Diode 1470nm Laser System Manufacturer: Biolitec, Inc.

5.0 Indication for Use Statement

The Diode laser therapy device is intended for delivery of laser light to soft tissue in the contact and non contact mode during surgical procedures. The device's 980nm laser is generally indicated for use in incision, excision, vaporization, ablation, hemostasis or coagulation of soft tissue in ear, nose and throat and oral surgery (otolaryngology), dental procedures, gastroenterology, general surgery, dermatology, plastic surgery, podiatry, urology, gynecology. The device is further indicated for laser assisted lipolysis. The device's 1470nm laser is intended for delivery of laser light to soft tissue in non-contact mode during general surgery procedures, indicated for the treatment of reflux of the saphenous veins associated with varicose veins and varicosities.

6.0 Device description

The diode laser generates a 980nm wavelength laser to act on a target tissue to achieve resection, hemostasis, ablation, and coaqulation of the target tissue. The diode laser generates a 1470 nm wavelength laser that acts on the water molecules of the target tissue to achieve the function of treatment of reflux of the saphenous veins associated with varicose veins and varicosities. The Diode laser therapy device has following characteristics:

  • Dual wavelengths A
  • A Temperature monitoring system

7.0 Non-Clinical Test Conclusion

ltemTechnical specification
Wavelength980nm±5nm, 1470nm±5nm
Max Power16W/980nm±20%, 4.5W/1470nm±20%, 0.5mw/650nm
Security LevelClass IV type B
Laser Output ModeContinuous, Pulse, Single.
Pulse Width0.05ms-1s (stepping 0.05, 0.1ms)
CoolingAir Cooling
Size38×46.5×22.5cm
Net Weight8KG
FuseØ5×25, 2A
Laser Output Power16W/980nm±10%, 4.5W/1470nm±10%

Table 1 - Product Technical Specification

5

0.05mw/650nm
Fiber DiameterΦ400
Aiming beam650 nm, red 0.5 mW, user controlled intensity
Treatment modeContinuous, Pulse, Single.

Table 2 - Biocompatibility testing for components contacting patients

ItemProposed DeviceResult
CytotoxicityUnder the conditions of the study, the device is noncytotoxic.Pass
IrritationUnder the conditions of the study, the device is nonirritating.Pass
SensitizationUnder the conditions of the study, the device is nonsensitizingPass
Aucte systemic toxicity,Under the conditions of the study, the device does show aucte systemic toxicityPass
Pyrogen testUnder the conditions of the study, the device does show pyrogenPass
In vitro hemolytic testUnder the conditions of the study, the device does show In vitro hemolytic riskPass

8.0 _Clinical Test Conclusion

No clinical study implemented for the Diode laser therapy device.

9.0 Technological Characteristic Comparison Table

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ItemProposed devicePredicated deviceRemark
Product CodeGEXGEXGEXIdentical
Regulation No.21 CFR 878.481021 CFR 878.481021 CFR 878.4810Identical
ClassIIIIIIIdentical
Product nameDiode laser therapy deviceCeralas Diode 980nm Laser System15W Ceralas Diode 1470nm
Laser System-
510(k) No.K212733K081015K073063-
ModelsST-ARD15D1470-
Intended useThe Diode laser therapy device is
intended for delivery of laser light to soft
tissue in the contact and non contact
mode during surgical procedures. The
device's 980nm laser is generally
indicated for use in incision, excision,
vaporization, ablation, hemostasis or
coagulation of soft tissue in ear, nose and
throat and oral surgery (otolaryngology),
dental procedures, gastroenterology,
general surgery, dermatology, plastic
surgery, podiatry, urology, gynecology.
The device is further indicated for laser
assisted lipolysis.The Ceralas D 980 is intended for
delivery of laser light to soft tissue in the
contact or noncontact mode during
surgical procedures, including via
endoscopes, introducers, or catheters.
The Ceralas D 980 is generally indicated
for incision, excision, vaporization,
ablation, hemostasis, or coagulation of
soft tissue in ear, nose and throat and
oral surgery (otolaryngology), dental
procedures, arthroscopy,
gastroenterology, general surgery,
dermatology, plastic surgery,
podiatry, urology, gynecology,
neurosurgery (peripheral nervous
system), pulmonary surgery, and
cardiothoracic surgery. and* Gap 1

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| | | ophthalmology. This Ceralas D 980 is
specifically indicated for laser assisted
lipolysis. | | |
|-----------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------|
| | The device's 1470nm laser is intended
for delivery of laser light to soft tissue in
non-contact mode during general surgery
procedures, indicated for the treatment of
reflux of the saphenous veins associated
with varicose veins and varicosities. | | The Ceralas D1470 is a diode
laser that is intended for delivery
of laser light to soft tissue in
non-contact mode during
general surgery procedures.
The device is indicated for the
treatment of reflux of the
saphenous veins associated
with varicose veins and
varicosities. | Same |
| Patient
Population | Adult | Adult | Adult | Same |

  • Gap analysis:

Gap 1: The proposed device does not use with the endoscope, the indication of Arthroscopy, Cardiothoracic Surgery, Neurosurgery, treatment of reflux of the saphenous veins and varicosities, which the predicate device applies does not apply to the proposed device, less indication will not bring additional risks to the proposed device.

Gap 2: The proposed device defines specific contraindication which does not bring additional clinical risk for the product use.

Table 4- Performance Comparison

ItemProposed DevicePredicate DeviceRemark
Diode laser therapy device
K212733Ceralas Diode 980nm Laser System
K08101515W Ceralas Diode 1470nm Laser System
K073063

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Wavelength980nm±5nm,1470nm±10nm980 nm1470 nmSame
Output Power max.16W/980nm±20%,
4.5W/1470nm±20%15 Watt15 Watt* Gap 2
Aiming beam650 nm, red 0.5 mW, user
controlled intensity635 nm, red 4 mW, user controlled
intensity635 nm, red 4 mW, user controlled
intensity* Gap 3
Treatment modeContinuous or PulsedContinuous or PulsedContinuous or PulsedSame
Power supplyAC110V±11V, 60HZ110/220 V110/220 V* Gap 4
Interval980nm 1% ~ 100%,
1470nm 2% ~100%,
continuously adjustable
energy980nm 1% ~ 100%, continuously
adjustable energy1470nm 2% ~100%, continuously
adjustable energySame
Cooling systemAir cooledAir cooledAir cooledSame
Fiber (applied part)Sterile, for single useSingle use or repeated useSingle use or repeated use* Gap 5
  • Gap analysis:

Gap 2, the 980nm max power of the proposed device is close to the predicate device, which does not create additional risk to the product use. For 1470m max power of the proposed device is different to the predicate device, we collect clinical survey data, and clinical literature which can support the efficacy of the 4.5W is effective to realize its intended performance, the lower 4.5W can risks compared to predicate device.

Gap 3, the aiming beam of the two device are close, which difference does not create additional risks to the product clinical use.

Gap 4, the power supply range of the proposed device is included in the predicate device.

Gap 5, the fiber (applied part) of the proposed device is for single use, sterile, which will not create addtional risks compared to the equivalence device.

Table 5- Safety Comparison

ItemProposed DevicePredicate DeviceRemark
-------------------------------------------------

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Diode laser therapy deviceCeralas Diode 980nm Laser15W Ceralas Diode 1470nm
SystemLaser System
K212733K081015K073063
Materials
contacting userFiberFiberFiberSame
Biocompatibility of
materials
contacting userCytotoxicity, Comply with ISO
10993-5;
Irritation, Sensitization, comply
with ISO 10993-10;
Aucte systemic toxicity,
Pyrogen test comply with ISO
10993-11;
In vitro hemolytic test comply
with ISO 10993-4.Cytotoxicity, Comply with ISO
10993-5;
Irritation, Sensitization, comply
with ISO 10993-10Cytotoxicity, Comply with ISO
10993-5;
Irritation, Sensitization, comply
with ISO 10993-10Gap 6
Electric safetyComply with IEC
60601-1:2005+A1:2012, IEC
60825-1:2014,
IEC 60601-2-22:2007+A1:2012Comply with IEC 60601-1, IEC
60825-1, IEC 60601-2-22Comply with IEC 60601-1, IEC
60825-1, IEC 60601-2-22Same
EMCComply with IEC
60601-1-2:2014Comply with IEC 60601-1-2Comply with IEC 60601-1-2Same
  • Gap analysis:

Gap 6: the proposed device implement more biccompatibility study for the device, which does not create additional risks for product use

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10.0 Conclusion

The conclusion drawn from the nonclinical tests demonstrates that the subject device in 510(K) submission, the Diode laser therapy device is as safe, as effective, and performs as well as or better than the legally marketed predicate device cleared under K081015, K073063.