K Number
K212871
Device Name
Aliya(TM) System, Aliya(TM) Generator, Aliya(TM) Needle, Aliya(TM) Electrode
Date Cleared
2022-06-17

(281 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Aliya System is indicated for the surgical ablation of soft tissue.
Device Description
The Aliva System is designed to ablate soft tissue through the delivery of pulsed electric fields (PEF) energy to target tissue. The high frequency, short duration energy delivered to the target tissue to induce programmed cell death (apoptosis) while maintaining the cellular matrix. The Aliya System consists of an Aliya Generator, an Aliya Ablation Device and a cardiac monitor. Generator: The Aliya Generator is a transportable non-sterile electrical device compatible for use in the operating room environment. It consists of hardware, software, a display touch screen user interface, a power supply cord and a foot switch. It features controls to initiate and stop treatment as well as indicators to monitor the treatment and provide alerts to the user. The Aliya Generator creates high frequency short duration energy, which is delivered to the target tissue via the Aliya Ablation Device. The Generator interfaces with the commercially available Ivy Biomedical Model 7600 cardiac monitor (Cardiac Monitor), which is provided with the Aliya System and is used in accordance with its cleared indications. The Cardiac Monitor uses a 4-lead configuration, which detects the R-wave of the electrocardiogram (ECG) signal and sends a trigger signal to the Generator for precise synchronization of energy output to the patient. This ensures reliable energy delivery synchronization with the patient's cardiac cycle thereby reducing risk of cardiac rhythm disturbances. The Generator software includes an algorithm that interprets trigger signals from the Cardiac Monitor. The algorithm will only allow the initiation and delivery of energy output when the patient's heart rate is within acceptable limits. Aliya Ablation Device: The Aliya Ablation Device is a monopolar electrosurgical instrument comprising the Aliya Needle and the Aliya Electrode. Both the needle and electrode are designed for sterile, single use. The Aliya Needle consists of a 19 gauge, 20cm needle with a 1 cm exposed tip and a nested stylet (which is removed once the Aliya Electrode is in position). The Aliya Electrode consists of a 21 cm probe that connects with the needle, a 3-meter cable, and a plug that connects with the Aliya Generator. When connected to the Aliya Generator, the Aliya Ablation Device delivers PEF energy to the target zone at the distal 1 cm of the needle.
More Information

Not Found

No
The description mentions an "algorithm" for interpreting trigger signals and ensuring heart rate is within limits, but this is a rule-based algorithm, not indicative of AI/ML. There are no mentions of AI, ML, deep learning, training data, or performance metrics typically associated with AI/ML devices.

Yes
The device is indicated for the surgical ablation of soft tissue to induce programmed cell death (apoptosis), which is a therapeutic intervention.

No

The device is an ablation system designed for the surgical ablation of soft tissue using pulsed electric fields. It is a treatment device, not a diagnostic one.

No

The device description explicitly states that the Aliya System consists of a Generator (hardware and software), an Ablation Device (hardware), and a cardiac monitor (hardware). It is not solely software.

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

Here's why:

  • Intended Use: The intended use is "surgical ablation of soft tissue." This is a therapeutic procedure performed directly on the patient's body.
  • Device Description: The device delivers pulsed electric fields (PEF) energy to target tissue to induce cell death. This is a physical intervention, not a test performed on samples outside the body.
  • Mechanism of Action: The system directly interacts with the patient's tissue to achieve a therapeutic effect (ablation).
  • Lack of In Vitro Testing: The description of performance studies includes animal studies and ex-vivo tissue ablation performance testing, but these are not the same as in vitro diagnostic testing which involves analyzing samples (like blood, urine, tissue biopsies) to diagnose or monitor a condition.

In vitro diagnostic devices are used to examine specimens derived from the human body to provide information for the diagnosis, prevention, monitoring, treatment, or alleviation of disease or injury. The Aliya System does not perform this function. It is a surgical device used for treatment.

N/A

Intended Use / Indications for Use

The Aliya System is indicated for the surgical ablation of soft tissue.

Product codes

OAB

Device Description

The Aliva System is designed to ablate soft tissue through the delivery of pulsed electric fields (PEF) energy to target tissue. The high frequency, short duration energy delivered to the target tissue to induce programmed cell death (apoptosis) while maintaining the cellular matrix.

The Aliya System consists of an Aliya Generator, an Aliya Ablation Device and a cardiac monitor.

Generator: The Aliya Generator is a transportable non-sterile electrical device compatible for use in the operating room environment. It consists of hardware, software, a display touch screen user interface, a power supply cord and a foot switch. It features controls to initiate and stop treatment as well as indicators to monitor the treatment and provide alerts to the user.

The Aliya Generator creates high frequency short duration energy, which is delivered to the target tissue via the Aliya Ablation Device. The Generator interfaces with the commercially available Ivy Biomedical Model 7600 cardiac monitor (Cardiac Monitor), which is provided with the Aliya System and is used in accordance with its cleared indications. The Cardiac Monitor uses a 4-lead configuration, which detects the R-wave of the electrocardiogram (ECG) signal and sends a trigger signal to the Generator for precise synchronization of energy output to the patient. This ensures reliable energy delivery synchronization with the patient's cardiac cycle thereby reducing risk of cardiac rhythm disturbances.

The Generator software includes an algorithm that interprets trigger signals from the Cardiac Monitor. The algorithm will only allow the initiation and delivery of energy output when the patient's heart rate is within acceptable limits.

Aliya Ablation Device: The Aliya Ablation Device is a monopolar electrosurgical instrument comprising the Aliya Needle and the Aliya Electrode. Both the needle and electrode are designed for sterile, single use. The Aliya Needle consists of a 19 gauge, 20cm needle with a 1 cm exposed tip and a nested stylet (which is removed once the Aliya Electrode is in position). The Aliya Electrode consists of a 21 cm probe that connects with the needle, a 3-meter cable, and a plug that connects with the Aliya Generator. When connected to the Aliya Generator, the Aliya Ablation Device delivers PEF energy to the target zone at the distal 1 cm of the needle.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Computed Tomography (CT) and/or ultrasound

Anatomical Site

soft tissue, liver, kidney, skeletal muscle

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Operating room environment; Prescription Use

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)

To address the recommendations contained in the FDA Guidance document "Premarket Notification (510(k)) Submissions for Electrosurgical Devices for General Surgery", an animal study was conducted in accordance with 21 CFR Part 58, Good Laboratory Practice. The purpose of the testing was to evaluate safety and performance of the Aliya System under clinically relevant operating conditions. The study was completed using three different study physicians and six healthy porcine in accordance with the operating instructions in the User Manual and IFU. Treatment was applied to the liver, kidney, and skeletal muscle in all animals. To visualize the treatment sites, all animals underwent a baseline and post procedure CB-CT (Cone Beam Computer Tomography) scanning procedure. Animals were survived up to 28 days depending on their treatment group assignment.

In addition. Galvanize performed ex-vivo tissue ablation performance testing following the FDA guidance document Premarket Notification (510(k)) Submissions for Electrosurgical Devices for General Surgery, dated August 15, 2016. The performance comparison testing and evaluation between the bipolar monophasic NanoKnife system predicate device and the monopolar biphasic Aliya System subject device was conducted using liver, kidney, and muscle tissue.

Results of the successful testing of the Aliya System demonstrate that the technological differences in the Aliya System compared to the predicate device do not raise any new questions of safety or effectiveness and therefore support substantial equivalence to the predicate NanoKnife System.

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

Not Found

Predicate Device(s)

NanoKnife™ System (K183385)

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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.

0

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

June 17, 2022

Galvanize Therapeutics, Inc. % Lisa Pritchard VP of Regulatory, Quality, Clinical & Engineering DuVal & Assoicates, P.A. 1820 Medical Arts Building 825 Nicollet Mall Minneapolis, Minnesota 55402

Re: K212871

Trade/Device Name: Aliya(TM) System, Aliya(TM) Generator, Aliya(TM) Needle, Aliya(TM) Electrode Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical Cutting and Coagulation Device and Accessories Regulatory Class: Class II Product Code: OAB Dated: September 6, 2021 Received: September 9, 2021

Dear Lisa Pritchard:

We have reviewed vour 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

1

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 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 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

510(k) Number (if known) K212871

Device Name Aliya(TM) System

Indications for Use (Describe)The Aliya System is indicated for the surgical ablation of soft tissue.
---------------------------------------------------------------------------------------------------------
Type of Use (Select one or both, as applicable)
-------------------------------------------------

X Prescription Use (Part 21 CFR 801 Subpart D)

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

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Image /page/3/Picture/0 description: The image is a logo for Galvanize Therapeutics. The logo features the word "GALVANIZE" in a bold, sans-serif font, with a stylized "G" symbol to the left. Below "GALVANIZE" is the word "THERAPEUTICS" in a smaller, sans-serif font. The colors used in the logo are shades of blue and purple.

510(k) Summary - K212871

The following information is provided in accordance with 21 CFR 807.92 for the Premarket 510(k) Summary.

Date Summary Prepared: June 15, 2022

Submitter Information

Company:Galvanize Therapeutics, Inc.
1531 Industrial Road
San Carlos, CA 94070
Ph:650-268-4252
Fax:NA

Contact: Deborah Sheffield Sr. Vice President, Regulatory & Quality Affairs Deb@GalvanizeTherapeutics.com Ph: 650-268-4252

Name of the Device

Trade Name:Aliya™ System
Common Name:Low energy soft tissue ablation device
Classification Name:Low Energy Direct Current Thermal Ablation System
Review Panel:General & Plastic Surgery (SU)
Regulation:878.4400
Class:Class II
Product Code:OAB
Predicate Device:NanoKnife™ System (K183385)
AngioDynamics, Inc.

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K212871

Image /page/4/Picture/1 description: The image shows the logo for Galvanize Therapeutics. The logo features the word "GALVANIZE" in a bold, sans-serif font, with the letters in a dark teal color. Below "GALVANIZE" is the word "THERAPEUTICS" in a smaller, sans-serif font, with the letters in a lighter purple color. A horizontal line in dark teal is below the word "THERAPEUTICS".

Equivalence Claimed to Predicate Device

The predicate device is classified as follows:

Regulation Number21 CFR 878.4400
Regulation NameElectrosurgical cutting and coagulation device and accessories
Product CodeOAB
Regulatory ClassII

Predicate Trade Name, 510(k) Number and Manufacturer:

Trade NameNanoKnife System
510(k) NumberK183385
ManufacturerAngioDynamics, Inc.

Based on the information and rationale presented and supported by the collective content of this 510(k), the Aliya System is equivalent to the legally marketed predicate, the NanoKnife System.

Intended Use/Indications for Use

The Aliya System has the same intended use as the predicate in that it was designed for the ablation of soft tissue.

The Aliya System has the same Indication for Use statement as the predicate with one exception. The omitted words reflect a minor design difference in the number of outputs between the two systems that has no impact on the intended use.

Subject Indications for Use

The Aliya System is indicated for the surgical ablation of soft tissue.

Device Description

The Aliva System is designed to ablate soft tissue through the delivery of pulsed electric fields (PEF) energy to target tissue. The high frequency, short duration energy delivered to the target tissue to induce programmed cell death (apoptosis) while maintaining the cellular matrix.

The Aliya System consists of an Aliya Generator, an Aliya Ablation Device and a cardiac monitor.

Generator: The Aliya Generator is a transportable non-sterile electrical device compatible for use in the operating room environment. It consists of hardware, software, a display touch screen user interface, a power supply cord and a foot switch. It features controls to initiate and stop treatment as well as indicators to monitor the treatment and provide alerts to the user.

The Aliya Generator creates high frequency short duration energy, which is delivered to the target tissue via the Aliya Ablation Device. The Generator interfaces with the commercially available Ivy Biomedical Model 7600 cardiac monitor (Cardiac Monitor), which is provided with

5

Image /page/5/Picture/1 description: The image is a logo for Galvanize Therapeutics. The logo features a stylized letter "G" on the left, followed by the word "GALVANIZE" in a bold, sans-serif font. Below "GALVANIZE" is the word "THERAPEUTICS" in a smaller, lighter font. The colors of the logo transition from a darker blue at the top to a lighter purple at the bottom.

the Aliya System and is used in accordance with its cleared indications. The Cardiac Monitor uses a 4-lead configuration, which detects the R-wave of the electrocardiogram (ECG) signal and sends a trigger signal to the Generator for precise synchronization of energy output to the patient. This ensures reliable energy delivery synchronization with the patient's cardiac cycle thereby reducing risk of cardiac rhythm disturbances.

The Generator software includes an algorithm that interprets trigger signals from the Cardiac Monitor. The algorithm will only allow the initiation and delivery of energy output when the patient's heart rate is within acceptable limits.

Aliya Ablation Device: The Aliya Ablation Device is a monopolar electrosurgical instrument comprising the Aliya Needle and the Aliya Electrode. Both the needle and electrode are designed for sterile, single use. The Aliya Needle consists of a 19 gauge, 20cm needle with a 1 cm exposed tip and a nested stylet (which is removed once the Aliya Electrode is in position). The Aliya Electrode consists of a 21 cm probe that connects with the needle, a 3-meter cable, and a plug that connects with the Aliya Generator. When connected to the Aliya Generator, the Aliya Ablation Device delivers PEF energy to the target zone at the distal 1 cm of the needle.

Comparison of Subject and Predicate Device Characteristics

The principle of operation (i.e., delivery of pulsed electric fields (PEF) energy to surgically ablate soft tissue via programmed cell death) of the subject device is identical to the predicate device. Some subject device waveform characteristics (e.g., frequency, number of activations, monopolar biphasic, etc.) vary from the predicate devices utilize a cardiac monitor to synchronize ablation timing with the patient's heart rate. The predicate device requires two to six sterile 19-Gauge electrodes (probes) positioned in a parallel array with equal depth placement while the subject device utilizes one sterile 19-Gauge electrode (needle) which can be repositioned as needed to obtain the desired treatment effect. Both devices utilize Computed Tomography (CT) and/or ultrasound for visualization during placement. The dimensions, needle tip geometry and the markings of the predicate and subject device (electrodes) are very similar. While both devices (generators) are transportable, the predicate device is larger in size compared to the subject device.

Performance Testing

The following testing was conducted to confirm that the Aliya System meets specifications and that it performs equivalent to the predicate NanoKnife System. Performance testing was completed in accordance with applicable standards.

Verification ActivityResult
System Electromechanical Safety TestingPass

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Image /page/6/Picture/1 description: The image is the logo for Galvanize Therapeutics. The logo has the word "GALVANIZE" in a dark teal color, with the first letter "G" stylized with a lightning bolt design. Below "GALVANIZE" is the word "THERAPEUTICS" in a lighter purple color, and there is a purple line underneath the word.

Verification ActivityResult
System Electromagnetic Compatibility TestingPass
System Ablation Tissue Effects – Ex Vivo TestingPass
Aliya Ablation Device – Electrical TestPass
Aliya Ablation Device – Mechanical TestPass
Aliya Ablation Device – Dimensional InspectionPass
Aliya Ablation Device – Packaging and Transit TestPass
Aliya Ablation Device – Shelf LifePass
Aliya Ablation Device – BiocompatibilityPass
Aliya Ablation Device – SterilizationPass
Aliya Generator – System and Software VerificationPass
Aliya Generator – Hardware VerificationPass
Aliya Generator – Packaging and Transit VerificationPass

Device safety and performance were evaluated against the following published consensus standards as necessary per the subject device intended use and technological characteristics.

Standard IDTitle
ISO 14971:2019Medical devices - Application of risk management to medical
devices
ISO 24971:2020Medical devices. Guidance on the application of ISO 14971
ASTM F 88/F88-15Standard Test Method for Seal Strength of Flexible Barrier
Materials
ASTM F 1980-16Standard Guide for Accelerated Aging of Sterile Barrier Systems
for Medical Devices
ISO/IEC 17025:2017General requirements for the competence of testing and calibration
laboratories
ISTA 3A:2018Packaged Products for Parcel Delivery System Shipment 70kg
(150lbs) or Less
ISO 10993-1:2018Biological evaluation of medical devices -Part 1: Evaluation and
testing within a risk management process
Standard IDTitle
ANSI/AMI/ISO 10993-5:2009
(R)2014Biological Evaluation of Medical Devices - Part 5: Tests for in
vitro cytotoxicity
ISO 10993-10 Third edition 2010-
08-01Biological Evaluation of Medical Devices - Part 10: Tests for
Irritation and Skin Sensitization
ISO 10993-11 Third edition 2017-
09Biological Evaluation of Medical Devices - Part 11: Tests for
Systemic Toxicity.
IEC 60601-1:2005 /A1:2012
Edition 3.1Medical electrical equipment – Part 1: General Requirements for
Basic Safety and Essential Performance
AAMI/ANSI ES60601-
1:2005/(R)2012 & A1:2012,
C1:2009/(R) 2012 &
A2:2010/(R)2012 (Consolidated
Text), Edition 3.1Medical Electrical Equipment - Part 1: General Requirements for
Basic Safety and Essential Performance
AAMI/ANSI/IEC 60601-1-2:2014Medical electrical equipment - Part 1-2: General requirements for
basic safety and essential performance - Collateral Standard:
Electromagnetic disturbances - Requirements and test
IEC 60601-2-2: 2017 Edition 6.0Medical electrical equipment - Part 2-2: Particular requirements for
the safety of high frequency surgical equipment
IEC60601-2-27: 2011 Edition 3.0Medical electrical equipment - Part 2-27: Particular requirements
for the basic safety and essential performance of
electrocardiographic monitoring equipment
IEC 61000-4-2 2008Electromagnetic compatibility (EMC) - Part 4-2: Testing and
measuring techniques - Electrostatic discharge immunity test
IEC 61000-4-3: 2006, A1: 2007,
A2: 2010Electromagnetic compatibility (EMC) - Part 4-3: Testing and
measurement techniques -Radiated, radio-frequency,
electromagnetic field immunity test
IEC 61000-4-4: 2012Electromagnetic compatibility (EMC) - Part 4-4: Testing and
measurement techniques - Electrical fast transient/burst immunity
test.
IEC 61000-4-5: 2005Electromagnetic compatibility (EMC) - Part 4-5: Testing and
measurement techniques - Surge immunity test
IEC 61000-4-6: 2013Electromagnetic compatibility (EMC) - Part 4- 6: Testing and
measurement techniques - Immunity to conducted disturbances,
induced by radio-frequency fields
Standard IDTitle
IEC 61000-4-8: 2009Electromagnetic compatibility (EMC) - Part 4-8: Testing and
measurement techniques - Power frequency magnetic field
immunity test
IEC 61000-4-11: 2004Electromagnetic compatibility (EMC) - Part 4-11: Testing and
measurement techniques - Voltage dips, short interruptions and
voltage variations immunity tests
CISPR 11: 2009, A1:2010Industrial, scientific and medical equipment - Radio-frequency
disturbance characteristics - Limits and methods of measurement
IEC 61000-3-2: 2014Electromagnetic compatibility (EMC) - Part 3-2: Limits - Limits
for harmonic current emissions (equipment input current