K Number
K233470
Device Name
DEKA LILY
Manufacturer
Date Cleared
2023-12-19

(55 days)

Product Code
Regulation Number
890.5850
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The LILY device is indicated for muscle conditioning to stimulate healty muscles. The device is not intended to be used in conjunction with therapy or treatment of medical disease or medical conditions of any kind. The device is intended to be operated by a trained professional who is present to monitor treatment.
Device Description
The DEKA LILY device consists of a main unit that generates electrical pulses and delivers rectangular biphasic waveforms via electrodes incorporated in an EMS applicator connected to the main unit. The delivery of the electrical energy is controlled by a footswitch. The DEKA LIL Y is provided with an applicator to perform EMS (Electrical Muscle Stimulation). The applicator is provided with two different tips: Large and Medium, used to treat areas having different sizes, which include 3 stainless-steel equidistant electrodes. The Applicator is directly applied on the area to be treated and moved by the operator across the skin. The overall weight is approximately 62 kg and the sizes 47cm x 56cm x 106cm (L x W x H). Electrical requirements: 115V, 50/60Hz, 2300VA.
More Information

Not Found

No
The description focuses on standard electrical muscle stimulation technology and does not mention any AI or ML components.

No.
The device's intended use explicitly states: "The device is not intended to be used in conjunction with therapy or treatment of medical disease or medical conditions of any kind."

No

Explanation: The "Intended Use / Indications for Use" states that the device is "indicated for muscle conditioning to stimulate healthy muscles" and "is not intended to be used in conjunction with therapy or treatment of medical disease or medical conditions of any kind." This indicates it's for muscle stimulation, not for diagnosing medical conditions.

No

The device description explicitly details hardware components including a main unit, electrodes, an EMS applicator, a footswitch, and physical dimensions and weight, indicating it is not software-only.

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

Here's why:

  • Intended Use: The intended use is "muscle conditioning to stimulate healthy muscles." This is a physical function, not a diagnostic test performed on samples taken from the human body.
  • Device Description: The device uses electrical pulses delivered via electrodes applied to the skin. This is a form of physical stimulation, not a method for analyzing biological samples.
  • Lack of IVD Characteristics: There is no mention of analyzing blood, urine, tissue, or any other biological sample. There is no mention of detecting diseases, conditions, or physiological states through the analysis of these samples.

IVD devices are specifically designed to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. The LILY device's function falls outside of this definition.

N/A

Intended Use / Indications for Use

The LILY device is indicated for muscle conditioning to stimulate healthy muscles.

The device is not intended to be used in conjunction with therapy or treatment of medical disease or medical conditions of any kind.

The device is intended to be operated by a trained professional who is present to monitor treatment.

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

NGX

Device Description

The DEKA LILY device consists of a main unit that generates electrical pulses and delivers rectangular biphasic waveforms via electrodes incorporated in an EMS applicator connected to the main unit.

The delivery of the electrical energy is controlled by a footswitch.

The DEKA LILY is provided with an applicator to perform EMS (Electrical Muscle Stimulation).

The applicator is provided with two different tips: Large and Medium, used to treat areas having different sizes, which include 3 stainless-steel equidistant electrodes.

The Applicator is directly applied on the area to be treated and moved by the operator across the skin.

The overall weight is approximately 62 kg and the sizes 47cm x 56cm x 106cm (L x W x H).

Electrical requirements: 115V, 50/60Hz, 2300VA.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

trained professional who is present to monitor treatment.

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 Performance Data:

None

Non-Clinical Performance Data:

Electrical safety and electromagnetic compatibility (EMC)
Electrical safety and EMC testing were conducted on the DEKA LIL Y device, according to the following standards:

ANSI AAMI ES60601-1Medical electrical equipment - Part 1: General requirements for basic safety and essential performance.

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

Software Validation and Verification Testing
Software verification and validation testing were conducted and documented as recommended by FDA's Guidance for Industry and FDA Staff, "Content of Premarket Submissions for Device Software Functions".

Biocompatibility evaluation
Biocompatibility evaluation was performed according to the FDA Guidance "Use of International Standard ISO 10993-1, "Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process".

Additional non-clinical testing conducted
Additional tests were conducted on the DEKA LILY device, according to the following standards:

IEC 60601-2-10 - Medical electrical equipment - Part 2-10: Particular requirements for basic safety and essential performance of nerve and muscle stimulators.

Conclusion:

Based on the comparison of indications for use and the technological characteristics, DEKA LIL Y is deemed to be substantially equivalent to the predicate device for the proposed indications for use.

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.

K200545

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

§ 890.5850 Powered muscle stimulator.

(a)
Identification. A powered muscle stimulator is an electrically powered device intended for medical purposes that repeatedly contracts muscles by passing electrical currents through electrodes contacting the affected body area.(b)
Classification. Class II (performance standards).

0

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December 19, 2023

El.En. S.p.A. Paolo Peruzzi Regulatory Affairs Manager Via Baldanzese 17 Calenzano, Fl 50141 Italy

Re: K233470

Trade/Device Name: DEKA LIL Y Regulation Number: 21 CFR 890.5850 Regulation Name: Powered Muscle Stimulator Regulatory Class: Class II Product Code: NGX Dated: October 25, 2023 Received: October 25, 2023

Dear Paolo Peruzzi:

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.

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"

1

(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 (QS) 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 OS 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 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.

Heather L. Dean -S

Heather Dean, PhD Assistant Director DHT5B: Division of Neuromodulation and Rehabilitation Devices OHT5: Office of Neurological and Physical Medicine Devices

2

Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

3

Indications for Use

510(k) Number (if known) K233470

Device Name DEKA LILY

Indications for Use (Describe)

The LILY device is indicated for muscle conditioning to stimulate healty muscles.

The device is not intended to be used in conjunction with therapy or treatment of medical disease or medical conditions of any kind.

The device is intended to be operated by a trained professional who is present to monitor treatment.

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)

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510(k) Summary

LILY

Submitter:

El.En. S.p.A.

Via Baldanzese, 17

50041 Calenzano (FI), Italy

Contact:

Paolo Peruzzi Regulatory Affairs Manager & Official Correspondent Phone: +39.055.8826807 E-mail: p.peruzzi@elen.it

Date Summary Prepared:

December 19, 2023

Device Trade Name:

DEKA LILY

Manufacturer:

DEKA M.E.L.A. srl

Via Baldanzese, 17

50041 Calenzano (FI), Italy

Common Name:

Electro Muscle Stimulator

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Regulation Number:

21 CFR 890.5850

Regulation Name:

Powered Muscle Stimulator

Regulatory Class:

Class II

Product Code:

NGX

Predicate Devices:

Legend Pro DMA (K200545)

Device Description:

The DEKA LILY device consists of a main unit that generates electrical pulses and delivers rectangular biphasic waveforms via electrodes incorporated in an EMS applicator connected to the main unit.

The delivery of the electrical energy is controlled by a footswitch.

The DEKA LIL Y is provided with an applicator to perform EMS (Electrical Muscle Stimulation).

The applicator is provided with two different tips: Large and Medium, used to treat areas having different sizes, which include 3 stainless-steel equidistant electrodes.

The Applicator is directly applied on the area to be treated and moved by the operator across the skin.

The overall weight is approximately 62 kg and the sizes 47cm x 56cm x 106cm (L x W x H).

Electrical requirements: 115V, 50/60Hz, 2300VA.

6

Intended Use:

The LILY device is indicated for muscle conditioning to stimulate healthy muscles.

The device is not intended to be used in conjunction with therapy or treatment of medical conditions of any kind.

The device is intended to be operated by a trained professional who is present to monitor treatment.

Comparison with the Predicate Device:

Device Trade NamePredicate Device
Subject DeviceK200545Comment
LILYLegend Pro DMA
Product CodeNGXNGX
Type of UsePrescription Use (Part 21 CFR 801 Subpart D)Prescription Use (Part 21 CFR 801 Subpart D)Identical
Mechanism of ActionMuscle contraction by electrical pulsingMuscle contraction by electrical pulsingIdentical
Indications for useThe LILY device is indicated for muscle
conditioning to stimulate healthy muscles.
The device is not intended to be used in
conjunction with therapy or treatment of medical
disease or medical conditions of any kind.
The device is intended to be operated by a
trained professional who is present to monitor
treatment.Legend Pro DMA is intended for muscle
conditioning to stimulate healthy muscles.
Legend Pro DMA is not intended to be used in
conjunction with therapy or treatment of medical
diseases or medical conditions.
Legend Pro DMA is intended to be operated by a
trained professional who is present to monitor
treatment.Identical
Predicate Device
Device Trade NameSubject DeviceK200545Comment
LILYLegend Pro DMA
Mode of OperationApplication of transcutaneous electrical muscle
stimulation (EMS) through skin contact
electrodesApplication of transcutaneous electrical muscle
stimulation (EMS) through skin contact
electrodesIdentical
Mode of applicationMetal (Stainless steel) electrodes in the System
Applicator emit electric energy to the skin while
the system applicator is rolled across the
treatment areaMetal (Stainless steel) electrodes in the System
Applicator emit electric energy to the skin while
the system applicator is rolled across the
treatment areaIdentical
Basic Unit Characteristics
Dimensions47cm x 56cm x 106cm45 x 110 x 45 cmDifferences do not
affect safety and
effectiveness of
the device, as the
subject is
compliant with
requirements of
IEC 60601-1 and
IEC 60601-2-10
Standards
Weight:~ 62 Kg~30 Kg;Differences do not
affect safety and
effectiveness of
the device, as the
subject is
compliant with
requirements of
Device Trade NameSubject DevicePredicate DeviceComment
LILYK200545
Legend Pro DMAIEC 60601-1 and
IEC 60601-2-10
Standards
Power Source(s)115V, 50/60Hz110-240 V, 50-60 HzDifferences do not
affect safety and
effectiveness of
the device, as the
subject is
compliant with
requirements of
IEC 60601-1 and
IEC 60601-2-10
Standards
Method of line current isolationMedical Power Supply, Transformer in output
stageMedical Power Supply, Transformer in output
stageIdentical
Patient Leakage Current - Normal
Condition (μΑ)0.1 μA1.5 μΑDifferent.
Value reported for
the subject device
is in compliance
with the limit of
100uA set out in
FDA's "Guidance
Document for
Powered Muscle
Stimulator 510(k)"
and with IEC
60601-1 and IEC
Device Trade NameSubject Device
LILYPredicate Device
K200545
Legend Pro DMAComment
60601-2-10
Standards
Patient Leakage Current - Single
Fault Condition (μΑ)2 μΑ40 μΑDifferent
Value reported for
the subject device
is in compliance
with the limit of
500uA set out in
FDA's "Guidance
Document for
Powered Muscle
Stimulator 510(k)"
and with IEC
60601-1 and IEC
60601-2-10
Standards
Number of output modes11Identical
Number of Output channels11Identical
Synchronous or alternatingSingle output channelSingle output channelIdentical
Method of Channel IsolationSingle output channelSingle output channelIdentical
Device Trade NameSubject Device
LILYPredicate Device
K200545
Legend Pro DMAComment
Regulated Current or Regulated
Voltage (output signals only)VoltageVoltageIdentical
Software/Firmware/Microprocessor
ControlYesYesIdentical
Automatic Overload TripNoNoIdentical
Automatic No-Load TripNoNoIdentical
Automatic Shut OffYes, On/off switchYes, On/off switchIdentical
Patient Override ControlNoYesDifferences do not
affect safety and
effectiveness of
the device, as the
subject is
compliant with
requirements of
IEC 60601-1 and
IEC 60601-2-10
Standards
Indicator DisplayYesYesIdentical
On/Off StatusYesYesIdentical
Device Trade NameSubject Device
LILYPredicate Device
K200545
Legend Pro DMAComment
Low BatteryN/AN/AIdentical
Voltage/Current levelVoltageVoltageIdentical
Timer Range (minutes)1-30 minutes1-99 minDifferences do not
affect safety and
effectiveness of
the device, as the
subject is
compliant with
requirements of
IEC 60601-1 and
IEC 60601-2-10
Standards
Compliance with 21 CFR 898YesYesIdentical
Housing MaterialMetal, PlasticsMetal, PlasticsIdentical
Output Specifications
WaveformBiphasicBiphasicIdentical
ShapeRectangularRectangularIdentical
Device Trade NameSubject Device
LILYPredicate Device
K200545
Legend Pro DMAComment
Maximum output voltage
(± 10%)60V @500Ω
3.95VRMS@500Ω
200V @2kΩ
12.3VRMS @2kΩ
360V@10kΩ
17.6VRMS@10kΩ60V @500Ω
3.95VRMS @500Ω
200V @2kΩ
12.3VRMS @2kΩ
360V@10kΩ
17.6VRMS@10kΩIdentical
Maximum output
current (± 10%)120mA@500 Ω
100mA@2 kΩ
36mA@10 kΩ120mA@500 Ω
100mA@2 kΩ
36mA@10 kΩIdentical
Pulse Width (μs)25 to 400 μs20 to 400 μsAlmost identical.
Differences do not
affect safety and
efficacy of the
device
Frequency (Hz)0.78, 1.56, 3.13, 6.25, 12.5 Hz0.78, 1.56, 3.13, 6.25, 12.5 HzIdentical
Net Charge @ 500 ohms
(µC/pulse)]0μC @ 500Ω
biphasic waveform
Zero net charge is achieved by using0μC @ 500Ω
biphasic waveform
Zero net charge is achieved by usingIdentical
Device Trade NameSubject DevicePredicate Device
K200545Comment
LILYLegend Pro DMA
symmetrical biphasic waveformssymmetrical biphasic waveforms
Maximum Phase Charge (µC)24 µC @ 500Ω @12.5 Hz24 µC @ 500Ω @12.5 HzIdentical
Maximum Current Density
(mA/cm2)1.mA/cm² @ 500Ω1.1 mA/cm² @ 500ΩIdentical
Maximum Power Density
(mW/cm2)0.0044mW/cm² @500Ω0.0044mW/cm² @500ΩIdentical
Burst Mode (i.e., pulse trains)
a. Pulses per burstN/A no burst modeN/A no burst modeIdentical
b. Bursts per second
c. Burst duration (seconds)
d. Duty Cycle [Line (b) x Line (c)]
ON time30 minutesNot Publicly availableN/A
OFF time5 minutesNot Publicly available sN/A

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12

13

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Clinical Performance Data:

None

Non-Clinical Performance Data:

Electrical safety and electromagnetic compatibility (EMC)

Electrical safety and EMC testing were conducted on the DEKA LIL Y device, according to the following standards:

ANSI AAMI ES60601-1Medical electrical equipment - Part 1: General requirements for basic safety and essential performance.

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

Software Validation and Verification Testing

Software verification and validation testing were conducted and documented as recommended by FDA's Guidance for Industry and FDA Staff, "Content of Premarket Submissions for Device Software Functions".

Biocompatibility evaluation

Biocompatibility evaluation was performed according to the FDA Guidance "Use of International Standard ISO 10993-1, "Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process".

Additional non-clinical testing conducted

Additional tests were conducted on the DEKA LILY device, according to the following standards:

IEC 60601-2-10 - Medical electrical equipment - Part 2-10: Particular requirements for basic safety and essential performance of nerve and muscle stimulators.

Conclusion:

Based on the comparison of indications for use and the technological characteristics, DEKA LIL Y is deemed to be substantially equivalent to the predicate device for the proposed indications for use.

Additional Information:

None