K Number
K240632
Manufacturer
Date Cleared
2024-11-22

(261 days)

Product Code
Regulation Number
882.5810
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The NeuStim NN-01 is an electrical stimulation device indicated for the following uses:

Functional Electrical Stimulation (FES):

Improvement of hand function and active range of motion in patients with hemiplegia due to stroke or upper limb paralysis due to C5 spinal cord injury.

NeuroMuscular Electrical Stimulation (NMES):

  • · Maintaining or increasing hand range of motion;
  • · Prevention or retardation of disuse atrophy;
  • · Increasing local blood circulation;
  • · Relaxation of muscle spasms; and
  • · Muscle re-education.

The NeuStim NN-01 is intended for use on the right arm/right hand only.

Device Description

The NeuStim Model NN-01 (herein Device) consists of a voltage-controlled generating source that connects to disposable electrodes that are worn by the patient on the anterior and posterior forearm and around the thumb, these are named the Flexor, Extensor and Thumb Disposable Electrodes respectively. The disposable electrodes consist of multiple contacts that can stimulate the muscles in different areas of the forearm and thumb with 10kHz voltage pulses generated by the NeuStim voltage-controlled stimulator.

The Device is classified as a Functional Stimulation (FES) and NeuroMuscular Electrical Stimulation (NMES) device. The Device uses galvanic electrical energy to evoke muscle contractions.

The Device has 181 addressable electrode contacts enabling fine spatial resolution of stimulation to the patient. The Device allows manual electrode scanning to facilitate rapid mapping of effective stimulation points, which can be stored for use in future sessions. This rapid scanning capability is enabled through the use of solid-state relay technology embedded in the flexible patches that mate directly with the disposable electrodes. The motion of the user's (i.e. licensed healthcare professional) finger on the screen of the NeuStim" Tablet electronically steers the stimulation point through the use of a solid-state relay matrix in each patch and thumb dongle, while lighting LED indicators on the back of the patch/dongle under control. This allows immediate, dynamic visual indication of the stimulation location which facilitates rapid mapping (i.e. user can quickly find and return to useful stimulation points). When the user observes desired muscle activations and associated wrist, hand, or finger movements, the related stimulation locations can be stored as a pattern. Up to three of these stored patterns can then be combined into a compound move where the stimulator will continuously time multiplex between them to allow for compound motion. Finally, up to three compound moves or patterns can be combined into a sequence where each of the selected compound moves or patterns are applied for a user configurable number of seconds.

The Device uses a stimulation pulse repetition rate of 50 Hz. The stimulation pulse is comprised of a multiphasic (5 cycle) waveform with a total duration of 0.5 ms. The stimulation output (peak) voltage is less than 65V (500 Ohm load) and less than 120V (10,000 Ohm load). The stimulation output power will not exceed 0.25 W/cm^2 (averaged over one second) into a 500 Ohm Load.

AI/ML Overview

Here's an analysis of the provided text regarding the acceptance criteria and study information for the Neuvotion NeuStim (NN-01) device:

1. Table of Acceptance Criteria and Reported Device Performance

The provided FDA 510(k) summary does not explicitly detail a table of acceptance criteria with specific quantitative thresholds. Instead, it references compliance with various national and international standards. The "Results" column consistently states "Passed" for each test, indicating that the device met the requirements of these standards.

PurposeTestingReported Device Performance (Results)
Verify compliance with ANSI/AAMI ES60601-1 and IEC 60601-1 requirements for basic safety and essential performanceBattery powered device, Type BF Applied PartsPassed
Verify compliance with IEC 60601-1-2 requirements for basic safety and essential performance Electromagnetic DisturbancesBattery powered device; radiated emissions, radiated field immunity, proximity filed immunity, magnetic field immunity, electrostatic discharge immunityPassed
Verify compliance with IEC 60601-2-10 requirements for the safety and essential performance of nerve and muscle stimulatorsBattery powered muscle stimulator, Type BF Applied Parts, normal and single-fault, energy and power limitsPassed
Verify compliance with ISO 10993-1 Biologic Evaluation of Medical DevicesPart 5: Tests for in vitro cytotoxicity; Part 10: Tests for irritation and skin sensitizationPassed
Verify compliance with IEC 62133-2 Secondary cells and batteries containing alkaline or other non-acid electrolytes - Safety requirements for portable sealed secondary cells, and for batteries made from them, for use in portable applications - Part 2: Lithium systemsBattery individual cells and packs certified via third party testingPassed
Verify software meets requirementsSoftware Verification and ValidationPassed
Verify user needs are metSystem Design ValidationPassed
Verify device meets requirementsDesign VerificationPassed
Verify device meets IEEE/ANSI C63.27 Coexistence TestingTier 2Passed
Verify device meets labeled Shelf-Life.Shelf-Life Validation StudyPassed
Verify device meets Adhesive Performance CriteriaAdhesive Performance Validation StudyPassed
Verify device meets Current Distribution (Dispersion) and Electrode Impedance CriteriaPower and Current Density Validation StudyPassed

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

The provided text does not include information about the sample size used for a test set, nor does it specify the data provenance (e.g., country of origin, retrospective or prospective). The studies listed are primarily non-clinical, focusing on device safety, performance, and compliance with standards. There is a "Summary of Clinical Testing: Not Applicable" statement, which further confirms the absence of a test set derived from human subjects.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Their Qualifications

Since "clinical testing is not applicable" and no human test set is described, there is no information provided regarding experts used to establish ground truth or their qualifications. The ground truth for the non-clinical tests is established by meeting the requirements of the specific engineering and safety standards referenced.

4. Adjudication Method for the Test Set

As there is no described test set involving human subjects and clinical outcomes, an adjudication method is not applicable and not mentioned.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No MRMC comparative effectiveness study is mentioned. The submission explicitly states "Summary of Clinical Testing: Not Applicable," indicating that no clinical studies (which would include MRMC studies) were performed for this 510(k). The comparison provided is between the subject device's technical specifications and the predicate device's general characteristics, not a clinical effectiveness study.

6. Standalone (Algorithm Only Without Human-in-the-Loop) Performance

The Neuvotion NeuStim (NN-01) is an external functional neuromuscular stimulator, a physical device that delivers electrical stimulation. It leverages software/firmware control for its operation but is not an AI algorithm that makes diagnostic or treatment decisions in a standalone manner without human interaction. Therefore, the concept of "standalone (algorithm only without human-in-the-loop performance)" as typically applied to AI/ML devices is not directly applicable here. The software verification and validation are part of the overall device performance, which is intrinsically human-controlled (by a licensed healthcare professional).

7. Type of Ground Truth Used

The ground truth used for the reported studies is primarily compliance with established regulatory standards and engineering specifications. For example:

  • Safety and Essential Performance: Defined by standards like ANSI/AAMI ES60601-1, IEC 60601-1, IEC 60601-1-2, IEC 60601-2-10.
  • Biocompatibility: Defined by ISO 10993-1 (specifically Parts 5 and 10).
  • Battery Safety: Defined by IEC 62133-2.
  • Software Requirements: Defined by the software verification and validation process against predefined requirements.
  • User Needs, Device Requirements, Coexistence, Shelf-Life, Adhesive Performance, Current Distribution/Electrode Impedance: These are validated against internal design specifications, user requirements, and relevant standards (e.g., IEEE/ANSI C63.27 for coexistence).

8. Sample Size for the Training Set

There is no mention of a training set sample size. Training sets are typically associated with machine learning or AI models. The NeuStim NN-01, while having software, is not described as an AI/ML device that requires a data training set in the context of this 510(k) submission. Its functionality relies on pre-programmed parameters and user-defined stimulation patterns.

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

Since there is no training set mentioned, there is no information on how its ground truth was established.

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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.

November 22, 2024

Neuvotion Inc. Chad Bouton President and CEO 165 Club Rd Stamford, Connecticut 06905

Re: K240632

Trade/Device Name: Neuvotion NeuStim (NN-01) Regulation Number: 21 CFR 882.5810 Regulation Name: External Functional Neuromuscular Stimulator Regulatory Class: Class II Product Code: GZI, IPF Dated: October 31, 2024 Received: November 1, 2024

Dear Chad Bouton:

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"

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(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.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rue"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-devices/device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

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).

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Sincerely,

Amber T. Ballard -S

Amber Ballard, PhD Assistant Director DHT5B: Division of Neuromodulation and Physical Medicine Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K240632

Device Name Neuvotion NeuStim NN-01

Indications for Use (Describe)

The NeuStim NN-01 is an electrical stimulation device indicated for the following uses:

Functional Electrical Stimulation (FES):

Improvement of hand function and active range of motion in patients with hemiplegia due to stroke or upper limb paralysis due to C5 spinal cord injury.

NeuroMuscular Electrical Stimulation (NMES):

  • · Maintaining or increasing hand range of motion;
  • · Prevention or retardation of disuse atrophy;
  • · Increasing local blood circulation;
  • · Relaxation of muscle spasms; and
  • · Muscle re-education.

The NeuStim NN-01 is intended for use on the right arm/right hand only.

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

Contact Details 21 CFR 807.92(a)(1):

Neuvotion Inc. 165 Club Rd. Stamford, CT 06905

Mr. Chad Bouton Email: boutonce@neuvotion-inc.com Tel: 614.561.1140

Date Prepared: November 22, 2024

Device Name 21 CFR 807.92(a)(2):

Device Trade Name: Neuvotion NeuStim NN-01 Common Name: External functional neuromuscular stimulator Classification Name: Stimulator, Neuromuscular, External Functional Regulation Number: 882.5810 Product Codes: GZI, IPF

Legally Marketed Predicate Devices 21 CFR 807.92(a)(3):

K123636, Bioness NESS H200 Wireless Hand Rehabilitation System Product Codes GZI, IPF

Device Description Summary 21 CFR 807.92(a)(4):

The NeuStim Model NN-01 (herein Device) consists of a voltage-controlled generating source that connects to disposable electrodes that are worn by the patient on the anterior and posterior forearm and around the thumb, these are named the Flexor, Extensor and Thumb Disposable Electrodes respectively. The disposable electrodes consist of multiple contacts that can stimulate the muscles in different areas of the forearm and thumb with 10kHz voltage pulses generated by the NeuStim voltage-controlled stimulator.

The Device is classified as a Functional Stimulation (FES) and NeuroMuscular Electrical Stimulation (NMES) device. The Device uses galvanic electrical energy to evoke muscle contractions.

The Device has 181 addressable electrode contacts enabling fine spatial resolution of stimulation to the patient. The Device allows manual electrode scanning to facilitate rapid mapping of effective stimulation points, which can be stored for use in future sessions. This rapid scanning capability is enabled through the use of solid-state relay technology embedded in the flexible patches that mate directly with the disposable electrodes. The motion of the user's (i.e. licensed healthcare professional) finger on the screen of the NeuStim" Tablet electronically steers the stimulation point through the use of a solid-state relay matrix in each patch and thumb dongle, while lighting LED indicators on the back of the patch/dongle under control. This allows immediate, dynamic visual indication of the stimulation location which facilitates rapid mapping (i.e. user can quickly find and return to useful stimulation points). When the user observes desired muscle activations and associated wrist, hand, or finger movements, the related stimulation locations can be stored as a pattern. Up to three of these stored patterns can then be combined into a compound move where the stimulator will continuously time multiplex between them to allow for

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compound motion. Finally, up to three compound moves or patterns can be combined into a sequence where each of the selected compound moves or patterns are applied for a user configurable number of seconds.

The Device uses a stimulation pulse repetition rate of 50 Hz. The stimulation pulse is comprised of a multiphasic (5 cycle) waveform with a total duration of 0.5 ms. The stimulation output (peak) voltage is less than 65V (500 Ohm load) and less than 120V (10,000 Ohm load). The stimulation output power will not exceed 0.25 W/cm^2 (averaged over one second) into a 500 Ohm Load.

Indications for Use 21 CFR 807.92(a)(5):

The NeuStim NN-01 is an electrical stimulation device indicated for the following uses:

Functional Electrical Stimulator (FES):

Improvement of hand function and active range of motion in patients with hemiplegia due to stroke or upper limb paralysis due to C5 spinal cord injury.

NeuroMuscular Electrical Stimulation (NMES):

  • -Maintenance and/or increase of hand range of motion;
  • -Prevention or retardation of disuse atrophy;
  • -Increasing local blood circulation;
  • -Relaxation of muscle spasms; and
  • -Muscle re-education

The NeuStim NN-01 is intended for use on the right arm/right hand only.

Device/CharacteristicNESS H200 Wireless (K123636)Predicate DeviceNeuStim Model NN-01 (K240632)Subject DeviceComparisonResults
Indications for Use 21CFR807.92(a)(5)
1. Indications forUseFunctional Electrical Stimulation (FES):- Improvement of hand function and active range of motion in patients with hemiplegia due to stroke or upper limb paralysis due to C5 spinal cord injury.NeuroMuscular Electrical Stimulation (NMES):- Maintenance and/or increase of hand range of motion- Prevention and/or retardation of disuse atrophy- Increase in local blood circulationFunctional Electrical Stimulation (FES):- Improvement of hand function and active range of motion in patients with hemiplegia due to stroke or upper limb paralysis due to C5 spinal cord injury.NeuroMuscular Electrical Stimulation (NMES):- Maintenance and/or increase of hand range of motion- Prevention or retardation of disuse atrophy- Increasing local blood circulation- Relaxation of muscle spasms- Muscle re-educationEquivalentSubject Device is identical with a subset of Predicate Device, i.e. right arm/right hand

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Device/CharacteristicNESS H200 Wireless (K123636)Predicate DeviceNeuStim Model NN-01 (K240632)Subject DeviceComparisonResults
- Re-education of musclesThe NeuStim NN-01 is intended for use on the right arm/right hand only.
2. Intended UseEnvironmentUsed both for therapy session in a professional healthcare facility and for patient to take homeUsed for therapy session only in a professional healthcare facility by a licensed practitionerEquivalentSubject Device is identical with a subset of Predicate Device
3. Prescription orOTC?PrescriptionPrescriptionIdentical
4. TargetPopulationPatients with hemiplegia due to stroke or upper limb paralysis due to C5 spinal cord injuryPatients with hemiplegia due to stroke or upper limb paralysis due to C5 spinal cord injuryIdentical
5. Anatomical SiteNot publicly availableThe NeuStim NN-01 stimulates the following muscles:- Extensor Digitorum, Extensor Pollicis Brevis and Longus- Thenar Muscle Group- Flexor Digitorum Superficialis, Flexor Pollicis LongusIdentical
Device/CharacteristicNESS H200 Wireless (K123636)Predicate DeviceNeuStim Model NN-01 (K240632)Subject DeviceComparisonResults
Basic Unit Characteristics Summary (Guidance Document for Powered Muscle Stimulators, Attachment II, Section 2)
1.510(k) NumberK123636K240632N/A
2.Device Name,ModelNESS H200 WirelessNeuStim NN-01N/A
3.ManufacturerBionessNeuvotion Inc.N/A
4.Power Source(s)Rechargeable batteryInternally powered (secondaryLithium Ion battery)Identical
-Method of LineCurrent IsolationNot publicly availableWireless (inductive) chargingEquivalent
-Method of LineCurrent IsolationNot publicly availablen/an/a
-Patient LeakageCurrent NormalConditionNot publicly availableMeets 60601-1 Clause 8.7 limitsIdentical
-Patient LeakageCurrent SingleFault ConditionNot publicly availableMeets 60601-1 Clause 8.7 limitsIdentical
5.Number ofOutput ModesNot publicly availableOne (1)Identical
6.Number ofOutput ChannelsNot publicly availableTwo (2)Different
-Synchronous orAlternating?Not publicly availableSynchronousIndeterminate
-Method ofChannelIsolationNot publicly availableTransformerIndeterminate
7.RegulatedCurrent orRegulatedVoltage?Not publicly availableRegulated VoltageDifferentSubject Devicesafe by designsince currentlimitinghardwarecircuitryemployed
8.Software/Firmware/MicroprocessorControl?Not publicly availableYesIdentical
9.AutomaticOverload Trip?Not publicly availableYesIdentical
10.Automatic No-Load Trip?Not publicly availableNoDifferent
Device/CharacteristicNESS H200 Wireless (K123636)Predicate DeviceNeuStim Model NN-01 (K240632)Subject DeviceComparisonResults
11. Automatic ShutOff?Not publicly availableNoSubject Devicesafe by designsince voltagemode is usedand current-limitinghardwarecircuitryemployedDifferent
12. Patient OverrideControl?Not publicly availableYesSubject Devicesafe since usedunder clinicalstaff directsupervisionIdentical
13. Indicator Display– On/Off Status?Not publicly availableYesIdentical
– Low Battery?Not publicly availableYesIdentical
– Voltage/CurrentLevelNot publicly availableYesIdentical
14. Timer Range(minutes)Not publicly availablen/aDifferent
15. Compliance withVoluntaryStandardsYesIEC 60601-1, IEC 60601-1-2YesIEC 60601-1, IEC 60601-1-2, IEC60601-2-10, ES60601-1, ISO 10993-5, ISO 10993-10, IEC 62133-2, IEEEANSI C63.27-2017. AAMI TIR69:2017Subject Devicesafe since usedunder clinicalstaff directsupervisionEquivalentSubject deviceconforms toadditional safetyand performancestandards
16. Compliance with21 CFR 898Not publicly availableYesIdentical
17. WeightNot publicly available55gN/A
18. Dimensions (in.)[W x H x D]Not publicly availableLength: 2.34inWidth: 1.87inDepth: .91inN/A
19. HousingMaterials andConstructionNot publicly availablePolymer Housing,Silicone Rubber,Volero StrapsIdentical
Device/CharacteristicNESS H200 Wireless (K123636)Predicate DeviceNeuStim Model NN-01 (K240632)Subject DeviceComparisonResults
Subject Devicesafe per ISO10993 testingand per FDABiocompatibilityGuidanceAttachment G,Section B
Output Specifications (Guidance Document for Powered Muscle Stimulators, Attachment II, Section 3)
Waveform (e.g.,pulsed monophasic,biphasic)Not publicly availableMultiphasic
Shape (e.g.,rectangular, spike,rectified sinusoidal)Not publicly availableSinusoidalDifferentSubject Deviceuses voltagemode, but safeby design sincecharge-balancedand maximumpower densitylevel is belowlimit of0.25W/cm² toprevent excesstissue heating
Maximum OutputVoltage (volts) (+/-%) at 500 Ohms,2k Ohms and 10kOhmsNot publicly available55.9 @ 500Ω87.4V @ 2000Ω105.5V @ 10000ΩDifferentSubject Deviceuses voltagemode, but safeby design. Themaximum voltageand currentvalues are
Device/CharacteristicNESS H200 Wireless (K123636)Predicate DeviceNeuStim Model NN-01 (K240632)Subject DeviceComparison Results
Maximum OutputCurrent (specifyunits) (+/- __%) at500 ohms, 2k Ohmsand 10k OhmsNot publicly available111.9 mA @ 500Ω43.7 mA @ 2000Ω10.6 mA @ 10000Ωinstantaneous maximum valuefor a high- frequency (veryshort phase duration)stimulation waveform. Sincethe phase duration issignificantly lower (0.05ms vs.the predicate durations of 0.1,0.2, 0.3 ms). Therefore theresulting maximum phasecharge is substantiallyequivalent to the Predicate Device.DifferentSubject Device uses voltagemode, but safe by design. Themaximum voltage and currentvalues are instantaneousmaximum values for a high-frequency (very short phaseduration) stimulationwaveform. Since the phaseduration is significantlylower (0.05ms vs. the predicatedurations of 0.1, 0.2, 0.3 ms).Therefore the resultingmaximum phase charge is
Device/CharacteristicNESS H200 Wireless (K123636)Predicate DeviceNeuStim Model NN-01 (K240632)Subject DeviceComparisonResults
Pulse width (specifyunits)Not publicly available0.5 millisecondsequivalent to thePredicate Device.
FrequencyNot publicly available50 HzEquivalent
Symmetricalphases? (yes/no)Not publicly availableYesIdentical
Phase Duration(include units),(state range, ifapplicable), (bothphases, ifasymmetrical)Not publicly available0.05 millisecondsEquivalentThe shorterphase duration ofthe SubjectDevice results indecreasedapparent tissueimpedancethereby allowingincreased currentdelivery for agiven voltagelevel resulting ineffective musclecontractions.
Net Charge (uC perpulse) (If zero, statemethod of achievingzero net charge)Not publicly available0, Balanced WaveformIdentical
Maximum PhaseCharge (mC)Not publicly available0.00408 mCEquivalent
Maximum CurrentDensity (RMS)(mA/cm²)Not publicly available1.78 mA/cm²(500 Ohm Load)DifferentSubject Devicesafe by design asmaximumcurrent densitylevel is belowlimit of 2mA/cm² per IEC60601-2-10 toprevent excesstissue heating
Maximum PowerDensity, (W/cm²),(using smallestelectrodeconductivesurface area)Not publicly available0.0563 W/cm²(500 Ohm Load)DifferentSubject Devicesafe by design asmaximum power
Device/CharacteristicNESS H200 Wireless (K123636)Predicate DeviceNeuStim Model NN-01 (K240632)Subject DeviceComparisonResults
below limit of0.25W/cm² toprevent excesstissue heating
Burst Mode (i.e.Pulse trains):– Pulses per burst– Bursts persecond– Burst duration(seconds)– Duty Cycle: Line(b) x Line (c)Not publicly availableN/AN/A
ON Time (seconds)Not publicly availableVariableIdentical
OFF Time (seconds)Not publicly availableVariableIdentical
Additional Features(if applicable)– Intelli-Connect Earpiece TriggerDevicen/aN/A
Description of Accessories (Guidance Document for Powered Muscle Stimulators, Attachment II, Section 4)Section 4 applies to only to the Subject Device.
Description of Software/Firmware/Microprocessor Control (Guidance Document for Powered Muscle Stimulators,Attachment II, Section 5)
1. Determinationof the level ofconcernNot publicly availableBasic Documentation LevelSubject devicecomplies withcurrentregulations andFDA Guidance
2. Description of alldevice functionscontrolled bythe softwareNot publicly availableStart / Stop StimulationStimulation AmplitudeStimulation LocationStimulation PatternLED IndicatorsPairing with Control DeviceMonitor and Display Battery LevelsEntering Sleep ModeEquivalent

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Non-Clinical and/or Clinical Tests Summary & Conclusions 21 CFR 807.92(b):

PurposeTestingResults
Verify compliance withANSI/AAMI ES60601-1 and IEC60601-1 requirements forbasic safety and essentialperformanceBattery powered device, TypeBF Applied PartsPassed
Verify compliance with IEC60601-1-2 requirements forbasic safety and essentialperformance ElectromagneticDisturbancesBattery powered device;radiated emissions, radiatedfield immunity, proximity filedimmunity, magnetic fieldimmunity, electrostaticdischarge immunityPassed
Verify compliance with IEC60601-2-10 requirements forthe safety and essentialperformance of nerve andmuscle stimulatorsBattery powered musclestimulator, Type BF AppliedParts, normal and single-fault,energy and power limitsPassed
Verify compliance with ISO10993-1 Biologic Evaluation ofMedical DevicesPart 5: Tests for in vitrocytotoxicity;Part 10: Tests for irritation andskin sensitizationPassed
Verify compliance with IEC62133-2 Secondary cellsand batteries containingalkaline or other non-acidelectrolytes - Safetyrequirements for portablesealed secondary cells, andfor batteries made fromthem, for use in portableapplications - Part 2:Lithium systemsBattery individual cells andpacks certified via third partytestingPassed
Verify software meetsrequirementsSoftware Verification andValidationPassed
Verify user needs are metSystem Design ValidationPassed
Verify device meetsrequirementsDesign VerificationPassed
Verify device meetsIEEE/ANSI C63.27Coexistence TestingTier 2Passed
Verify device meets labeledShelf-Life.Shelf-Life Validation StudyPassed
Verify device meetsAdhesive PerformanceCriteriaAdhesive PerformanceValidation StudyPassed
Verify device meets CurrentDistribution (Dispersion)and Electrode ImpedanceCriteriaPower and Current DensityValidation StudyPassed

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Summary of Clinical Testing:

Not Applicable

Conclusion: The NeuStim NN-01 Device has the same intended use, does not raise any different questions of safety and effectiveness, and the provided performance data demonstrate substantial equivalence to the cleared Bioness Ness H200 System (K123636).

§ 882.5810 External functional neuromuscular stimulator.

(a)
Identification. An external functional neuromuscular stimulator is an electrical stimulator that uses external electrodes for stimulating muscles in the leg and ankle of partially paralyzed patients (e.g., after stroke) to provide flexion of the foot and thus improve the patient's gait.(b)
Classification. Class II (performance standards).