K Number
K233364
Device Name
Axon Therapy
Date Cleared
2024-01-10

(100 days)

Product Code
Regulation Number
882.5890
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Axon Therapy is intended to stimulate peripheral nerves for relief of chronic intractable pain, post-surgical pain and/or for relief of chronic painful diabetic peripheral neuropathy in the lower extremities. The Axon Therapy is for use on patients 18 and older.
Device Description
The Axon Therapy is a magnetic stimulator system that provides brief and focused magnetic pulses in order to non-invasively stimulate peripheral nerves and provide chronic nerve pain relief. The subject device is intended to be used in clinics such as pain management clinics and physical therapy clinics. The device consists of Magnetic Stimulation Coil, Liquid Cool Unit, and a Cart. The Axon Therapy includes a thermal shutdown feature which is activated once the inside temperature of the stimulation coil either: (A) reaches 45°C or (B) exceeds 41°C for a total of nine minutes during a 20-minute session.
More Information

Not Found

No
The summary does not mention AI, ML, or related concepts in the device description, intended use, or performance studies. The device appears to be a magnetic stimulator with a thermal shutdown feature.

Yes
The device is intended to stimulate peripheral nerves for relief of chronic intractable pain, post-surgical pain, and/or chronic painful diabetic peripheral neuropathy, as well as being demonstrated to be effective and safe in clinical studies for pain reduction and improved quality of life.

No

The device description and intended use state that the Axon Therapy is a magnetic stimulator system intended to stimulate peripheral nerves for pain relief. It describes a treatment modality, not a device used to diagnose a medical condition.

No

The device description explicitly states it consists of physical components: a Magnetic Stimulation Coil, Liquid Cool Unit, and a Cart. This indicates it is a hardware-based medical device, not software-only.

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

Here's why:

  • Intended Use: The intended use is to "stimulate peripheral nerves for relief of chronic intractable pain, post-surgical pain and/or for relief of chronic painful diabetic peripheral neuropathy in the lower extremities." This describes a therapeutic intervention applied directly to the patient's body.
  • Device Description: The device is a "magnetic stimulator system" that provides "magnetic pulses" to "non-invasively stimulate peripheral nerves." This is a physical treatment method.
  • Lack of In Vitro Activity: IVD devices are used to examine specimens (like blood, urine, tissue) outside of the body to provide information for diagnosis, monitoring, or screening. The Axon Therapy does not involve the analysis of any biological specimens.

The Axon Therapy is a therapeutic device that uses magnetic stimulation to treat pain.

N/A

Intended Use / Indications for Use

The Axon Therapy is intended to stimulate peripheral nerves for relief of chronic intractable pain, post-surgical pain and/or for relief of chronic painful diabetic peripheral neuropathy in the lower extremities. The Axon Therapy is for use on patients 18 and older.

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

QPL, IPF

Device Description

The Axon Therapy is a magnetic stimulator system that provides brief and focused magnetic pulses in order to non-invasively stimulate peripheral nerves and provide chronic nerve pain relief. The subject device is intended to be used in clinics such as pain management clinics and physical therapy clinics. The device consists of Magnetic Stimulation Coil, Liquid Cool Unit, and a Cart. The Axon Therapy includes a thermal shutdown feature which is activated once the inside temperature of the stimulation coil either: (A) reaches 45°C or (B) exceeds 41°C for a total of nine minutes during a 20-minute session.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Any area, such as Hand, Arm, Chest, Waist, Buttock, Thigh, Calf, Back and low back etc.

Indicated Patient Age Range

18 and older.

Intended User / Care Setting

clinics such as pain management clinics and physical therapy clinics.

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)

Clinical Testing: One additional study for patients with diabetic peripheral neuropathy (PDN) for the subject device. The primary efficacy objective of this trial was to compare the proportion of responders in the Axon Therapy plus CMM group, (responder is defined as a subject who experiences 50% or greater reduction from baseline in neuropathic pain intensity as measured by an in-clinic visual analog score (VAS) for the primary area of pain at Day 30, with no increase over baseline pain medications within four weeks of the Day 30 visit), to the Sham plus CMM group. The results of the study demonstrate effectiveness of this non-invasive Treatment at statistically significant levels. The % reduction in VAS pain scores showed a -57.6% reduction for Treatment vs -12.5% for Sham at a p value of

§ 882.5890 Transcutaneous electrical nerve stimulator for pain relief.

(a)
Identification. A transcutaneous electrical nerve stimulator for pain relief is a device used to apply an electrical current to electrodes on a patient's skin to treat pain.(b)
Classification. Class II (performance standards).

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.

January 10, 2024

NeuraLace Medical Inc. % Allison Komivama, PhD, RAC VP, MedTech Innovation ROM+ 2251 San Diego Ave, Suite B-257 San Diego, California 92110

Re: K233364

Trade/Device Name: Axon Therapy Regulation Number: 21 CFR 882.5890 Regulation Name: Transcutaneous Electrical Nerve Stimulator For Pain Relief Regulatory Class: Class II Product Code: QPL, IPF Dated: September 29, 2023 Received: October 2, 2023

Dear Dr. Komiyama:

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 (the 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 available 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

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device" (https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (OS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30, Design controls; 21 CFR 820.90, Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review, the QS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 Part 803) for devices or postmarketing safety reporting (21 CFR Part 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 Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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,

Lauren E. Woodard -S

for Amber Ballard, Ph.D. Assistant Director DHT5B: Division of Neuromodulation

2

and Rehabilitation Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

3

Indications for Use

510(k) Number (if known) K233364

Device Name Axon Therapy

Indications for Use (Describe)

The Axon Therapy is intended to stimulate peripheral nerves for relief of chronic intractable pain, post-surgical pain and/or for relief of chronic painful diabetic peripheral neuropathy in the lower extremities. The Axon Therapy is for use on patients 18 and older.

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."

4

510(k) SUMMARY K233364

DATE PREPARED

January 10, 2024

MANUFACTURER AND 510(k) OWNER

NeuraLace Medical, Inc. 16990 Goldentop Road, San Diego, CA 92127 Telephone: +1 (858) 229-9218 Official Contact: Joe Milkovits, CTO Email: joe@neuralacemedical.com

REPRESENTATIVE/CONSULTANT

Allison C. Komiyama, Ph.D., RAC, VP, MedTech Innovation Charles Neitzel, Principal Consultant RQM+ Telephone: +1 (412) 816-8253 Email: akomiyama@rqmplus.com

DEVICE INFORMATION

Proprietary Name/Trade Name:Axon Therapy
Common Name:Electromagnetic stimulator, pain relief
Regulation Number:21 CFR 882.5890
Regulation Name:Transcutaneous Electrical Nerve Stimulator for Pain Relief
Class:Class II
Product Code:QPL
IPF
Review Panel:Neurology
Physical Medicine

PREDICATE DEVICE IDENTIFICATION

The Axon Therapy is substantially equivalent to the following predicates:

510(k) NumberPredicate Device Name / ManufacturerPrimary Predicate
K210021Axon Therapy / NeuraLace

The predicate device has not been subject to a design related recall.

5

DEVICE DESCRIPTION

The Axon Therapy is a magnetic stimulator system that provides brief and focused magnetic pulses in order to non-invasively stimulate peripheral nerves and provide chronic nerve pain relief. The subject device is intended to be used in clinics such as pain management clinics and physical therapy clinics. The device consists of Magnetic Stimulation Coil, Liquid Cool Unit, and a Cart. The Axon Therapy includes a thermal shutdown feature which is activated once the inside temperature of the stimulation coil either: (A) reaches 45°C or (B) exceeds 41°C for a total of nine minutes during a 20-minute session.

INDICATIONS FOR USE

The Axon Therapy is intended to stimulate peripheral nerves for relief of chronic intractable pain, post-traumatic pain, post-surgical pain and/or for relief of chronic painful diabetic peripheral neuropathy in the lower extremities. The Axon Therapy is for use on patients 18 and older.

COMPARISON OF TECHNOLOGICAL CHARACTERISTICS

NeuraLace believes that the Axon Therapy is substantially equivalent to the predicate device based on the information summarized here:

The subject device has an identical design and dimensions, and uses identical materials as the device cleared in K210021. The subject device has the same intended use and identical technological characteristics to the device cleared in K210021. The device has identical instrumentation to the device cleared in K210021.

Comparison TopicSubject DevicePredicate DeviceStatement of Equivalence
Company Name
/ Device NameNeuraLace Medical Inc.
Axon TherapyNeuraLace Medical Inc.
Axon TherapyN/A
Indications for UseThe Axon Therapy is intended
to stimulate peripheral
nerves for relief of chronic
intractable pain, post-
traumatic pain, post-surgical
pain and/or for relief of
chronic painful diabetic
peripheral neuropathy in the
lower extremities. The Axon
Therapy is for use on patients
18 and older.The Axon Therapy is intended
to stimulate peripheral nerves
for relief of chronic
intractable, post-traumatic
and post-surgical pain for
patients 18 and older.Substantially equivalent
to the predicate device.
Clinical testing
demonstrates that there
is no impact on safety and
effectiveness for
expanded indication.
Product Codes / Regulation
NumbersQPL / 21 CFR 882.5890
IPF / 21 CFR 890.5850QPL / 21 CFR 882.5890
IPF / 21 CFR 890.5850Identical to predicate
device with no impact on
safety and effectiveness.
Technological Characteristics
Power SourcePower Supply: 110V to 240V
ac, 50/60Hz
Power consumption: 800VA
maximum, 115W idlePower Supply: 110V to 240V
ac, 50/60Hz
Power consumption: 800VA
maximum, 115W idleIdentical to predicate
device with no impact on
safety and effectiveness.
Comparison TopicSubject DevicePredicate DeviceStatement of Equivalence
Company Name
/ Device NameNeuraLace Medical Inc.
Axon TherapyNeuraLace Medical Inc.
Axon TherapyN/A
User InterfaceLED displayLED displayIdentical to predicate device with no impact on safety and effectiveness.
WaveformBiphasic waveBiphasic waveIdentical to predicate device with no impact on safety and effectiveness.
Software / Firmware /
Microprocessor Control?YesYesIdentical to predicate device with no impact on safety and effectiveness.
Indication FunctionsOn/off status
Ready statusOn/off status
Ready statusIdentical to predicate device with no impact on safety and effectiveness.
Time Range800 seconds (400 pulses at 0.5 Hertz)800 seconds (400 pulses at 0.5 Hertz)Identical to predicate device with no impact on safety and effectiveness.
Housing Materials ConstructionStimulator: AL sheet EN AW 5754 H111
Coil: ABSStimulator: AL sheet EN AW 5754 H111
Coil: ABSIdentical to predicate device with no impact on safety and effectiveness.
Applied Part(s)Coil 60BF-NLCoil 60BF-NLIdentical to predicate device with no impact on safety and effectiveness.
Applied Part Area16 cm²16 cm²Identical to predicate device with no impact on safety and effectiveness.
Treatment AreaAny area, such as Hand, Arm, Chest, Waist, Buttock, Thigh, Calf, Back and low back etc.Any area, such as Hand, Arm, Chest, Waist, Buttock, Thigh, Calf, Back and low back etc.Identical to predicate device with no impact on safety and effectiveness.
WeightStimulator: 17 kg
Coil: 3.2 kg
Full system (with cart): 54 kgStimulator: 17 kg
Coil: 3.2 kg
Full system (with cart): 54 kgIdentical to predicate device with no impact on safety and effectiveness.
Unit Dimensions485 x 380 x 165 mm485 x 380 x 165 mmIdentical to predicate device with no impact on safety and effectiveness.
Pulse Frequency0-2 Hz0-2 HzIdentical to predicate device with no impact on safety and effectiveness.
Pulse Amplitude0 to 100%
A maximum of 80% intensity is recommended to reduce the risk of coil overheating0 to 100%
A maximum of 80% intensity is recommended to reduce the risk of coil overheatingIdentical to predicate device with no impact on safety and effectiveness.
On-Cycle Duty Period2-800 seconds2-800 secondsIdentical to predicate device with no impact on safety and effectiveness.
Maximum Repetition Rate2 pulses per second (pps)2 pulses per second (pps)Identical to predicate device with no impact on safety and effectiveness.
Pulse ModeStandardStandardIdentical to predicate device with no impact on safety and effectiveness.
Comparison TopicSubject DevicePredicate DeviceStatement of Equivalence
Company Name
/ Device NameNeuraLace Medical Inc.
Axon TherapyNeuraLace Medical Inc.
Axon TherapyN/A
Pulse WidthBiphasic (290 µsec)Biphasic (290 µsec)Identical to predicate device with no impact on safety and effectiveness.
Maximum Output Power100% at 2 pps100% at 2 ppsIdentical to predicate device with no impact on safety and effectiveness.
Testing
Non-Clinical TestingElectrical safety per IEC 60601-1
EMC testing per IEC 60601-1-2
Software testing per IEC 62304
Usability testing per IEC 62366-1Electrical safety per IEC 60601-1
EMC testing per IEC 60601-1-2
Software testing per IEC 62304
Usability testing per IEC 62366-1Identical to predicate device, no new elements proposed for subject device requiring new non-clinical testing. No impact to safety and effectiveness.
Clinical TestingThree previous studies that evaluated the effectiveness and safety of the subject device.

One additional study for patients with diabetic peripheral neuropathy (PDN) for the subject device. | Three studies that evaluated the effectiveness and safety of the subject device. | Substantially equivalent to the predicate device. Performance and clinical testing demonstrate that there are no new questions of safety and effectiveness. |

6

7

SUMMARY OF NON-CLINICAL TESTING

The Axon Therapy subject device had no design changes from the predicate device cleared in K210021 that required additional non-clinical testing for this submission to demonstrate safety and effectiveness:

Software Verification: The subject device did not undergo any new software verification testing due to substantial equivalence of the predicate device and no new questions of safety and effectiveness.

Electromagnetic Compatibility and Electrical Safety: The subject device did not undergo any new electromagnetic compatibility and electrical safety testing due to substantial equivalence of the predicate device and no new questions of safety and effectiveness.

8

Usability: The subject device did not undergo any new usability testing due to substantial equivalence of the predicate device and no new questions of safety and effectiveness.

Performance Testing: The subject device did not undergo any new performance testing due to substantial equivalence of the predicate device and no new questions of safety and effectiveness.

SUMMARY OF CLINICAL TESTING

The goal of the Axon Therapy PDN clinical study was to expand the indications to include painful diabetic peripheral neuropathy. Axon Therapy was demonstrated to be effective and safe in the original clinical studies for chronic intractable post-traumatic and post-surgical pain. The primary efficacy objective of this trial was to compare the proportion of responders in the Axon Therapy plus CMM group, (responder is defined as a subject who experiences 50% or greater reduction from baseline in neuropathic pain intensity as measured by an in-clinic visual analog score (VAS) for the primary area of pain at Day 30, with no increase over baseline pain medications within four weeks of the Day 30 visit), to the Sham plus CMM group.

The results of the study demonstrate effectiveness of this non-invasive Treatment at statistically significant levels. The % reduction in VAS pain scores showed a -57.6% reduction for Treatment vs -12.5% for Sham at a p value of