K Number
K221597
Device Name
CO2 Laser System
Date Cleared
2022-09-15

(105 days)

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

The CO2 Laser System is used for body soft tissue ablation, vaporization and coagulation in dermatology, plastic surgery and general surgery.

Device Description

CO2 Laser System is a carbon dioxide surgical laser device intended for prescription use and is comprised mainly of three components: console, articulated arm and footswitch. CO2 Laser System contains a radio-frequency excited CO2 laser tube which generates laser sources at nominal wavelength of 10,600 nm. As CO2 laser radiation is invisible; therefore, a low-power, visible aiming laser source (650 mm) is required to position the treatment laser beam. The output of laser beam is delivered through articulated arm to a fractional handpiece or normal handpiece. The control panel is in the form of an LCD touch screen in front of device and displays for operating and monitoring the laser. The physician activates laser emission by means of a footswitch. The fractional handpiece is suited mainly for general surgical application.

AI/ML Overview

This document is a 510(k) premarket notification for a CO2 Laser System. It focuses on demonstrating substantial equivalence to a predicate device rather than presenting a study proving a device meets specific acceptance criteria based on clinical performance metrics. Therefore, many of the requested categories (e.g., sample size for test set, number of experts for ground truth, MRMC study, standalone performance, training set details) are not applicable or cannot be extracted from this type of regulatory submission.

The "performance data" section primarily discusses non-clinical testing related to electrical safety, electromagnetic compatibility, laser safety standards, and software verification and validation. It does not provide clinical performance data or acceptance criteria in terms of accuracy, sensitivity, specificity, or similar metrics typically associated with AI/diagnostic device studies.

Here's a breakdown based on the available information:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance Criteria CategorySpecific Acceptance CriteriaReported Device Performance
Electrical SafetyCompliance with IEC 60601-1 (general), IEC 60601-1-2 (EMC), IEC 60601-2-22 (surgical lasers)"The test results demonstrated that the proposed device complies with the following standards: IEC 60601-1, IEC 60601-1-2, IEC 60825-1, IEC 60601-2-22."
Laser SafetyCompliance with IEC 60825-1 (equipment classification and requirements)"The test results demonstrated that the proposed device complies with the following standards: IEC 60825-1."
SoftwareVerification and validation testing conducted as recommended by FDA guidance for "moderate" level of concern software."Software verification and validation testing were conducted, and documentation was provided as recommended by FDA's Guidance... The software for this device was considered as a 'moderate' level of concern since a failure of the software could result in minor injury to a patient or to a user of the device."
Energy Output(Implicitly) Verification of laser energy output"The CO2 Laser System has been determined through engineering testing to verify laser energy output..."
Intended UseSame intended use as predicate device"The CO2 Laser System has the same intended use..."
Technological CharacteristicsSimilar technological characteristics to predicate device"similar indications for use, the same technological characteristics, the same energy used, and the same operating principles as its predicates."

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

Not applicable. This submission describes non-clinical engineering and software testing of a physical laser device, not a study involving human subjects or data sets for performance evaluation of an AI or diagnostic algorithm.

3. Number of Experts Used to Establish Ground Truth and Qualifications

Not applicable. No ground truth based on expert review of clinical data is mentioned. The "ground truth" here is compliance with engineering and safety standards.

4. Adjudication Method for the Test Set

Not applicable. There is no adjudicated test set in the context of clinical or AI performance. The device's compliance is based on direct measurement and verification against established standards.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done

No. This document does not describe any MRMC comparative effectiveness study, as it's for a surgical laser device and not an AI or diagnostic tool where reader performance is typically evaluated.

6. If a Standalone Performance Study was done

Yes, in a sense, a standalone engineering performance assessment was done. The device's electrical safety, laser safety, electromagnetic compatibility, and software were independently tested against specified standards. However, this is not a "standalone (i.e., algorithm only without human-in-the-loop performance)" in the context of AI or diagnostic algorithms.

7. The Type of Ground Truth Used

The "ground truth" in this context is adherence to established international and national engineering standards for medical electrical equipment, laser safety, and electromagnetic compatibility. For software, the ground truth is adherence to FDA's guidance for software verification and validation. There is no clinical "ground truth" (e.g., pathology, outcomes data) mentioned in this regulatory submission.

8. The Sample Size for the Training Set

Not applicable. This device is not an AI/ML algorithm that requires a training set of data.

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

Not applicable.

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September 15, 2022

Smedtrum Medical Technology Co., Ltd. Crimson Wu Senior Regulatory Engineer 1F., No. 8, Ln. 97, Wugong Rd., New Taipei City, Xinzhuang Dist. 248016 Taiwan

Re: K221597

Trade/Device Name: CO2 Laser System 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: August 3. 2022 Received: August 3, 2022

Dear Crimson Wu:

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.

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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 mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely.

Jianting Wang Acting Assistant Director DHT4A: Division of General Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K221597

Device Name CO2 Laser System

Indications for Use (Describe)

The CO2 Laser System is used for body soft tissue ablation, vaporization and coagulation in dermatology, plastic surgery and general surgery.

Type of Use (Select one or both, as applicable)
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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 contains a logo for Smedtrum Medical Technology Co., Ltd. The logo features a stylized blue and teal geometric shape resembling a stylized letter "S" on the left. To the right of the shape is the company name, with "Smedtrum" in a larger, light blue font and "MEDICAL TECHNOLOGY CO., LTD." in a smaller, gray font below it. Above the company name is the Chinese translation of the company name in gray.

Smedtrum Medical Technology Co., Ltd. 1F., No. 8, Ln. 97, Wugong Rd., Xinzhuang Dist., New Taipei City 248016 , Taiwan TEL:+886 (02) 2298 9578 FAX:+886 (02) 2298 9426

Section 5 : 510(k) Summary CO2 Laser System (K221597)

I. SUBMITTER

Smedtrum Medical Technology Co., Ltd. 1F., No. 8, Ln. 97, Wugong Rd., Xinzhuang Dist., New Taipei City 248016, Taiwan (R.O.C.) Contact Person Crimson Wu Position: Senior Regulatory Engineer Tel: +886-2-2298-9578, Ext. 301 Fax: +886-2-2298-9426 E-mail: crimsonwu@smedtrum.com Date of preparation: May 31th, 2022

II. DEVICE

Trade Name:CO2 Laser System
Common or Usual Name:Surgical Laser Device
Classification Name:GEX-Powered Laser Surgical Instrument
21 C.F.R. § 878.4810, Device Class II

III. PREDICATE DEVICE

Trade Name:CO2 Laser Therapy System
Common or Usual Name:Surgical Laser Device
Classification Name:GEX-Powered Laser Surgical Instrument
21 C.F.R. § 878.4810, Device Class II
Premarket Notification:K201109Sep 15th, 2020

IV. DEVICE DESCRIPTION

CO2 Laser System is a carbon dioxide surgical laser device intended for prescription use and is comprised mainly of three components: console, articulated arm and footswitch.CO2 Laser System contains a radio-frequency excited CO2 laser tube which generates laser sources at nominal wavelength of 10,600 nm. As CO2 laser radiation is invisible; therefore, a low-power, visible aiming laser source (650 mm) is required to position the treatment laser beam. The output of laser beam is delivered through articulated arm to a fractional handpiece or normal handpiece. The control panel is in the form of an LCD touch screen in front of device and displays for operating and monitoring the laser. The physician activates laser emission by means of a footswitch. The fractional handpiece is suited mainly for general surgical application.

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Image /page/4/Picture/0 description: The image contains a logo for a medical technology company. On the left side of the logo is a blue and gray geometric shape. To the right of the shape is the company name, "Smedtrum MEDICAL TECHNOLOGY CO.,LTD."

When the laser contacts human tissue, the laser energy is absorbed by water in the target tissue, resulting in a very rapid, highly localized temperature increase to the tissue. The instantaneous temperature-increase heats up the water and causes evaporation of the affected tissue. Some heat is absorbed by tissue adjacent to the treatment area, causing tissue coagulation which induces hemostasis as well as thermal stimulation of deep skin layers, that inducing fibroblast stimulation and neocollagenesis.

The CO2 Laser System is capable of producing continuous-wave, pulsed laser or fractional laser radiation. The physician can optimize the parameter for different applications by adjusting the energy of laser pulse and output pattern.

INDICATIONS FOR USE V.

The CO2 Laser System is used for body soft tissue ablation, vaporization, excision and coagulation in dermatology, plastic surgery and general surgery.

COMPARISON OF TECHNOLOGICAL CHARATERISTICS WITH THE VI.

FeatureProposed devicePredicate device(K201109)
Device NameCO2 Laser SystemCO2 Laser Therapy System
Product CodeGEXGEX
Regulation No.21 CFR 878.481021 CFR 878.4810
Device ClassClass IIClass II
Indication forUseThe CO2 Laser System is usedfor body soft tissue ablation,vaporization, excision andcoagulation in dermatology,plastic surgery and generalsurgery.The CO2 Laser TherapySystem is used for body softtissue vaporization andcoagulation in dermatology andplastic surgery, general surgery,gynecology.
Laser TypeRF Sealed-off CO2RF Sealed-off CO2
LaserClassificationClass 4Class 4
CO2 LaserWavelength10600 nm10600 nm
Aiming BeamWavelength<2 mw /650 nm/Semiconductor Laser LD< 2 mw /650 nm/Semiconductor Laser LD
Max. AimingBeam PowerWatts2 mW2 mW
Laser DeliverySystemArticulated arm withcounterweightArticulated arm withcounterweight
Beam DeliveryHandpiece2 Normal Handpieces or 1Fractional Handpiece2 Normal Handpieces or 1Fractional Handpiece
Laser firingControlsLCD color TouchscreenFootswitchLCD color TouchscreenFootswitch

PREDICATE DEVICE

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Image /page/5/Picture/0 description: The image contains a logo for Smedtrum Medical Technology Co., LTD. The logo features a stylized teal and gray geometric shape on the left. To the right of the shape is the company name in both Chinese and English. The word "Smedtrum" is in a larger, light gray font.

Smedtrum Medical Technology Co., Ltd. 1F., No. 8, Ln. 97, Wugong Rd., Xinzhuang Dist., New Taipei City 248016 , Taiwan TEL:+886 (02) 2298 9578 FAX:+886 (02) 2298 9426

FeatureProposed devicePredicate device(K201109)
Max. OutputPower Watts35 WHS-411: 35 W
HS-411A: 55 W
Scan Area Size2x2 mm~20x20 mm2x2 mm~20x20 mm
PulseCWNACWNA
Single1~375 msSingle10~500ms
DurationPulsePulse width:5375 msDelay time:1500 msPulseOn time: 5~500 msOff time:1-500 ms
S-PulsePulse width:14 msDelay time:1100 msS. PulseOn time: 1~4 msOff time:1-100 ms
U-pulsePulse width:0.1-0.9 msDelay time:1-100 msU pulseOn time:0.1-0.9 msOff time:1-100 ms
FractionalPulse Energy1-300 mJ/dot1-300 mJ/dot
Spot Size120 μm( fractional )150 µm( fractional )
Spot Density(DPA)/ cm²25, 36, 49, 64, 81, 100, 121,144, 169, 196, 225, 256, 289,324, 361, 400, 441, 484, 529,784, 1024, 1521, 2025, 2500,3025 dots.25, 36, 49, 64, 81, 100, 121,144, 169, 196, 225, 256, 289,324, 361, 400, 441, 484, 529,784, 1024, 1521, 2025, 2500,3025 dots.
OperationalModeFractional mode, and normalmode (CW, Single, Pulse, S.pulse, U. pulse)Fractional mode, and normalmode (CW, Single, Pulse, S.pulse, U. pulse)
CoolingSystemForced-air coolingForced-air cooling
Power Input100-240VAC, 50/60 Hz100-240VAC, 50/60 Hz
Dimension188 cm x 61 cm x 53.4 cm(H x W x D)113 cm x 45 cm x 50 cm(H x W x D)
Weight50 Kg55 Kg
SoftwareYes. Verification and validationtesting of the software areperformedYes

VII. PERFORMANCE DATA

The CO2 Laser System has been determined through engineering testing to verify laser energy output and electrical safety.

Electrical safety and electromagnetic compatibility

The test results demonstrated that the proposed device complies with the following standards:

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Image /page/6/Picture/0 description: The image contains the logo for Smedtrum Medical Technology Co., LTD. The logo features a geometric design on the left, consisting of overlapping triangles in shades of blue and gray. To the right of the geometric design is the company name, with "Smedtrum" in a larger, bolder font and "MEDICAL TECHNOLOGY CO.,LTD." in a smaller font below it. Above the company name, in a smaller font, is the company name in Chinese.

IEC 60601-1: 2005+corr.1:2006+Corr.2.2007+A1:2012 Medical electrical equipment - Part 1: General requirements for basic safety and essential performance

IEC 60601-1-2:2014 Medical electrical equipment -Part 1-2: General requirements for basic safety and essential performance-Collateral Standard: Electromagnetic disturbances - Requirements and tests

IEC 60825-1:2014 Safety of Laser products-Part 1: Equipment classification and requirements

IEC 60601-2-22:2007(third edition)+A1:2012 for use in conjunction with IEC 60601-1:2005 (third edition)+A1:2012 Medical electrical equipment - Part 2-22: Particular requirements for the safety and essential performance of surgical, cosmetic, therapeutic and diagnostic laser equipment

Software Verification and Validation Testing

Software verification and validation testing were conducted, and documentation was provided as recommended by FDA's Guidance for Industry and FDA Staff, "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices." The software for this device was considered as a "moderate" level of concern since a failure of the software could result in minor injury to a patient or to a user of the device.

Sterilization and Shelf-Life

The proposed device is not provided sterile and does not need to be sterilized. The handpiece and the body are cleaned with a soft cloth moistened with isopropyl alcohol or ethanol of 70% strength or higher. The proposed device is reusable and does not have a restricted shelf-life.

VIII. CONCLUSION

The CO2 Laser System has the same intended use, similar indications for use, the same technological characteristics, the same energy used, and the same operating principles as its predicates. The non-clinical data and performance testing reports in this submission demonstrate that CO2 Laser System meets the expected performance requirements. Any difference between the subject and predicate device do not raise new issues of safety or effectiveness. Based on above analysis, the CO2 Laser System is substantial equivalent to the cited 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.