K Number
K212897
Date Cleared
2021-11-04

(55 days)

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

The IPL Hair Removal Device (Model: AI01) is intended for the removal of unwanted body hair.

Device Description

IPL Hair Removal Device, model: Al01 is a device for the permanent reduction of hair growth based on Intense Pulsed Light (IPL). It works below the skin's surface and does not involve any cutting or pulling, reducing hair growth with minimal pain. The device is only powered by the external power adapter and its IPL emission activation is by finger switch. The device contains a Xenon Arc Flashlamp and a skin sensor to detect appropriate skin contact. If the device is not properly applied to the treatment area (in full contact with the skin), the device cannot emit the treatment light pulses. The device incorporates Intense Pulse Light (IPL) technology. The purpose of the light is to heat the root where the hair grows. Device includes a main unit, an adaptor, and accessories, accessories include goggle.

AI/ML Overview

The provided text is a 510(k) summary for the IPL Hair Removal Device, model: AI01. It describes acceptance criteria for safety and effectiveness based on non-clinical testing and comparison to a predicate device, as well as the study that demonstrates the device meets these criteria. No clinical study was performed.

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

1. A table of acceptance criteria and the reported device performance

Since this is a 510(k) submission and not a clinical study report, the acceptance criteria are primarily related to meeting recognized consensus standards for safety and biocompatibility, and demonstrating substantial equivalence to a predicate device. The "reported device performance" refers to the successful completion of these tests and alignment with the predicate.

Acceptance Criteria CategorySpecific Criteria/StandardReported Device Performance
Safety - ElectricalANSI AAMI ES60601-1Complied
Safety - Electromagnetic CompatibilityIEC 60601-1-2Complied
Safety - Home Healthcare EnvironmentIEC 60601-1-11Complied
Safety - Performance of Non-Laser Light SourceISO 60601-2-57: 2011Complied
Safety - PhotobiologicalIEC 62471: 2006Complied
Biocompatibility - CytotoxicityISO 10993-5:2009Meets requirement ("positive results" for validation implies successful testing if "positive" refers to the test for meeting the standard)
Biocompatibility - Irritation & SensitizationISO 10993-10:2010Meets requirement ("positive results" for validation implies successful testing if "positive" refers to the test for meeting the standard)
Software Verification & ValidationIEC 62304:2006+A1:2015 and FDA Guidance for SoftwarePerformed in accordance with guidance
Substantial Equivalence - Indications for UseSame as predicate (unwanted body hair removal)Same (with a note on OTC vs. Prescription, deemed not to raise new safety questions)
Substantial Equivalence - TechnologyIntense Pulse Light (IPL)Same
Substantial Equivalence - Technical SpecificationsWavelength, Spot Size, Max. Fluence, Pulse Duration, Output energy, Pulsing ControlSame as predicate

2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)
The document states: "There was no clinical testing performed." Therefore, there is no sample size for a clinical test set, nor is there data provenance from human subjects. The testing was non-clinical (device bench testing, biocompatibility, and software validation). The country of origin for the device manufacturer is China.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)
Not applicable, as no clinical testing was performed for hair removal effectiveness. The "ground truth" for the non-clinical tests is based on adherence to recognized international standards and comparison to the predicate device's established safety and performance characteristics.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set
Not applicable, as no clinical testing with human subjects or expert adjudication of results was performed.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance
Not applicable. This device is an IPL hair removal device, not an AI-assisted diagnostic or imaging device that would involve human readers or MRMC studies.

6. If a standalone (i.e. algorithm only without human-in-the loop performance) was done
Not applicable. The device is a physical IPL hair removal device, not a standalone algorithm.

7. The type of ground truth used (expert concensus, pathology, outcomes data, etc)
The "ground truth" for this 510(k) submission is primarily:

  • Adherence to Recognized Standards: The device's components and overall system passed various safety, biocompatibility, and software validation tests according to established international standards (e.g., IEC 60601 series, ISO 10993 series, IEC 62304).
  • Substantial Equivalence to Predicate Device: The device's technical characteristics, operating principle, and indications for use are demonstrated to be substantially equivalent to a legally marketed predicate device (K183217). The "ground truth" here is the established safety and effectiveness profile of the predicate.

8. The sample size for the training set
Not applicable. No machine learning or AI algorithm requiring a training set for clinical performance was described in the context of hair removal effectiveness. The software referred to in the document is for device control and functionality, not for performing a diagnostic or predictive task.

9. How the ground truth for the training set was established
Not applicable, as there was no training set mentioned in the context of clinical performance.

{0}------------------------------------------------

Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food & 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.

November 4, 2021

Shenzhen Century Dongyuan Technology Co Ltd. % You Yijie Manager Qimmiq Medical Consulting Service Co., Ltd. Rm.1711, Building K. No.101 Science Ave International Creative Valley Guangzhou, Guangdong 510663 China

Re: K212897

Trade/Device Name: IPL Hair Removal Device, model: AI01 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: ONF Dated: August 27, 2021 Received: September 10, 2021

Dear You Yijie:

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 and Part 809); 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,

Purva Pandya 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) K212897

Device Name IPL Hair Removal Device, model: AI01

Indications for Use (Describe)

The IPL Hair Removal Device (Model: AI01) is intended for the removal of unwanted body hair.

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."

{3}------------------------------------------------

Section 5: 510(k) Summary

1. Submitter's Information

Establishment Registration Information

Name: Shenzhen Century Dongyuan Technology Co Ltd. Address: Floor 2, Building B1, Gonghe Fourth Industrial Zone, Shajing Street, Bao'an District, Shenzhen City, Guangdong Province China Contact Person of applicant Name: Zhang Benrong Address: Floor 2, Building B1, Gonghe Fourth Industrial Zone, Shajing Street, Bao'an District, Shenzhen City, Guangdong Province China TEL: +86 18565833539 Email: aijofi01@163.com

Contact Person of the Submission:

Name: Yijie You Address: RM.1711, Building K, NO.101 Science Ave International Creative Valley Development Zone, Guangzhou China Floor 2, Building B1, Gonghe Fourth Industrial Zone, Shajing Street, Bao'an District, Shenzhen City, Guangdong Province China TEL: +86 020-8224 5821 FAX: +86 020-8224 5821 Email: Jet.you@qimmiq-med.com

Date prepared: Oct. 20, 2021

2. Device Information

Trade Name:IPL Hair Removal Device, model: AI01
Classification name:Laser Surgical Instrument For Use In General And Plastic
Surgery And In Dermatology
Common or Usual Name:Powered Light Based Non-Laser Surgical Instrument With
Thermal Effect
Review panel:General & Plastic Surgery
Product code:ONF
Regulation Class:II
Regulation Number:878.4810

{4}------------------------------------------------

3. Predicate Device Information

510(k) submitter/holder:Touchbeauty Beauty & Health (Shenzhen) Co., Ltd.
510(K) Number:K183217
Trade Name:IPL Hair Removal Device
Model:TB-1755
Classification name:Laser Surgical Instrument For Use In General And
Plastic Surgery And In Dermatology
Review panel:General & Plastic Surgery
Product code:OHT, ONF
Regulation Class:II
Regulation Number:878.4810

4. Device description

IPL Hair Removal Device, model: Al01 is a device for the permanent reduction of hair growth based on Intense Pulsed Light (IPL). It works below the skin's surface

and does not involve any cutting or pulling, reducing hair growth with minimal pain. The device is only powered by the external power adapter and its IPL emission activation is by finger switch. The device contains a Xenon Arc Flashlamp and a skin sensor to detect appropriate skin contact. If the device is not properly applied to the treatment area (in full contact with the skin), the device cannot emit the treatment light pulses. The device incorporates Intense Pulse Light (IPL) technology. The purpose of the light is to heat the root where the hair grows.

Device includes a main unit, an adaptor, and accessories, accessories include goggle.

Principle of operation:

The device works by use of thermal energy of Intense Pulse Light (IPL) to kill hair follicles for hair removal. The device generally targets skin (including dermis, epidermis), underlying soft tissue and hair follicles.

5. Indications for Use

The IPL Hair Removal Device (Model: Al01) is intended for the removal of unwanted body hair.

6. Summary of technological characteristics of device

compared to the predicate devices (K183217)

{5}------------------------------------------------

K212897

SEComparisonsSubject device(IPL Hair Removal Device,model: AI01)Predicate device(IPL Hair Removal Device, Model:TB-1755)Discussion ofdifference
510K Number/K183217/
Classification21CFR 878.481021CFR 878.4810Same
Product CodeONFOHT, ONFSame
FDA ClassIIIISame
Indications for UseThe IPL Hair Removal Device (Model:AI01) is intended for the removal ofunwanted body hair.The IPL Hair Removal Device (Model:TB-1755) is an Over the Counterdevice intended for the removal ofunwanted body hair.Same(Discussion isindicated inD1)
ModelAI01TB-1755/
Environment of UseHome useHome useSame
DesignHand-holdHand-holdSame
Patient PopulationAdultAdultSame
Material of PatientcontactcomponentsPCABSDifferent(Discussion isindicated inD2)
BiocompabilitytestingMeets ISO 10993- 5ISO 10993-10Meets ISO 10993- 5ISO 10993-10Same
Single Patient,multi-useYesYesSame
Patient InterfaceButtonsButtonsSame
TechnologyIntense Pulse Light (IPL)Intense Pulse Light (IPL)Same
Dimensions1402035618272.469.2mmDifferent(Discussion isindicated inD3)
Power sourcean external power supplyan external power supplySame
Light sourceXenon Arc FlashlampXenon Arc FlashlampSame
Wavelength510nm~1100nm510nm~1100nmSame
Spot Size3.1 cm²3.1 cm²Same
Max. Fluence(J/cm²)3.8-5.2 J/cm²3.8-5.2 J/cm²Same
Pulse duration3 milliseconds3 millisecondsSame
Output energy12-16 J12-16 JSame
PulsingControlFinger switchFinger switchSame
OutputChannelOne channelOne channelSame
DeliveryDirect Illumination to TissueDirect Illumination to TissueSame
SoftwareYesYesSame
Control
Electricalsafety, EMC,BiologicalEvaluationIEC 60601-1IEC 60601-1Same
IEC 60601-1-2IEC 60601-1-2
IEC 60601-1-11IEC 60601-1-11
IEC 60601-2-57IEC 60601-2-57
IEC 62471IEC 62471
ISO 10993-5ISO 10993-5
ISO 10993-10ISO 10993-10

{6}------------------------------------------------

K212897

The discussion of differences exist between the subject and predicate devices is listed in following:

  • D1: The subject device has same indication with equivalent device regarding remove unwanted hair, the difference is that the equivalent device is for OTC use and the subject device is for Prescription Use, this difference does not raise new questions of safety.
  • D2: The subject device has been validated for cytotoxicity per ISO 10993- 5 and Irritation as well as Sensitization per ISO 10993-10 with positive results, therefore, the material difference of subject device with Predicate device TB-1755 (K183217) do not raise new questions of safety and effectiveness.
  • D3: The difference of dimensions will not affect the safety and effectiveness.

7. Discussion of Non-Clinical Tests Performed for Safety and

effectiveness are as follows

The recognized consensus standards for safety of medical electrical equipment: ANSI AAMI ES60601-1, IEC 60601-1-11 for safety, IEC 60601-1-2 for electromagnetic compatibility, IEC 60601-2-57:2011 for performance and IEC 62304 for software verification, and ISO 10993-5:2009 for Cytotoxicity endpoints, ISO 10993-10:2010 for Sensitization and Irritation endpoints are complied. See below table for details:

StandardsStandards Name
ANSI AAMI ES60601-1:2005/(R)2012 andA1:2012Medical Electrical Equipment - Part 1: General RequirementsFor Basic Safety And Essential Performance
IEC 60601-1-2: 2014Medical Electrical Equipment -- Part 1-2: General RequirementsFor Basic Safety And Essential Performance -- CollateralStandard: Electromagnetic Disturbances -- Requirements AndTests
IEC 60601-1-11: 2015Medical Electrical Equipment - Part 1-2: General RequirementsFor Basic Safety And Essential Performance - Collateral

{7}------------------------------------------------

Standard: Electromagnetic Disturbances - Requirements AndTests
ISO 60601-2-57: 2011Particular requirements for the basic safety and essentialperformance of non-laser light source equipment intended fortherapeutic, diagnostic, monitoring and cosmetic/aesthetic use
IEC 62471: 2006Photobiological safety of lamps and lamp systems
ISO 10993-5:2009Biological evaluation of medical devices - Part 5: Tests for invitro cytotoxicity
ISO 10993-10:2010Biological evaluation of medical devices - Part 10: Tests forirritation and skin sensitization
IEC 62304:2006+A1:2015Medical device software - Software life cycle processes

Software verification and validation was performed for the subject device in accordance with Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices - Guidance for Industry and FDA Staff, May 2005.

8. Discussion of Clinical Accuracy Testing Performed

There was no clinical testing performed.

9. Conclusions

Based on performance testing, comparison and analysis, the subject device IPL Hair Removal Device, model Al01 is as safe, as effective, and performs as well as the legally marketed predicate device.

§ 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.