K Number
K242204
Device Name
Disposable Neutral Electrodes (GP201B-A, GP202B-A, GP202B-P, GP202B-I, GP202M-A, GP202M-P, GP202M-I, GP202B-AC, GP202B-PC, GP202B-IC, GP202M-AC, GP202M-PC, GP202M-IC, GP203M-A, GP203B-A, GP203M-AC, GP203B-AC, GP203M-P, GP203B-P, GP203M-PC, GP203B-PC, GP203M-I, GP203B-I, GP203M-IC, GP203B-IC)
Date Cleared
2024-09-25

(61 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Disposable neutral electrodes are indicated for use to adhere to the patient over the entire pad surface to complete an electrical circuit during electrosurgery between the electrosurgical generator, the active electrode and the patient. Solid Electrosurgical pads are for use with generators that do not have a Contact Quality Monitoring System (CQMS). Split Electrosurgical pads are for use with generators that have a CQMS (i.e. REM,ARM,NESSY etc.).
Device Description
Disposable neutral electrodes are part of a family of patient return electrodes. They are non-sterile, single-use devices used in electrosurgery to complete the electrical circuit with the generator. Providing a low-impedance path back to the generator through the return electrodes helps to prevent unintended HF burns. The solid electrosurgical pads are designed to be compatible with generators without Contact Quality Monitoring System (CQMS), and the split electrosurgical pads are designed to be compatible with the Contact Quality Monitoring System (CQMS) of compatible generators. The models share the same design elements (functional design, technology design, packaging, etc.) but have different sizes and shapes. The models are designed for adults, children, and neonates, separate catalog numbers are assigned for the intended patients, and pre-attached cord. Disposable neutral electrodes consist of foam backing, cable connection area, conductive aluminum foil, conductive adhesive gel layer and release liner. The pads are applied on a release liner. The surface of the conductive aluminum foil is fully covered with a soft, conformable conductive adhesive gel. The electrode backing is made of foam material. The electrodes are supplied with or without cable. For the non-corded pads, a reusable cable is not available as an accessory.
More Information

Not Found

No
The device description and performance studies focus on the physical and electrical properties of the neutral electrode, with no mention of AI or ML technologies. The device's function is to complete an electrical circuit, which is a standard electrosurgical principle.

No.
The device is an accessory used to complete an electrical circuit during electrosurgery, which is a therapeutic procedure, but the device itself does not provide therapy. It is a return electrode designed to prevent burns during the electrosurgical procedure.

No

Explanation: The device, a disposable neutral electrode, is used to complete an electrical circuit during electrosurgery. Its function is to provide a low-impedance path back to the generator to prevent burns, not to diagnose a condition or disease.

No

The device description clearly outlines physical components like foam backing, aluminum foil, conductive adhesive gel, and a release liner. It also mentions cables and compatibility with electrosurgical generators, indicating a hardware-based device.

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

Here's why:

  • Intended Use: The intended use clearly states that the device is used to complete an electrical circuit during electrosurgery. This is a therapeutic/surgical function, not a diagnostic one.
  • Device Description: The description details the physical components and how they function in an electrical circuit for electrosurgery. There is no mention of analyzing biological samples or providing diagnostic information.
  • Performance Studies: The performance studies focus on electrical safety, thermal performance, adhesion, and biocompatibility – all relevant to a surgical accessory, not an IVD.
  • Lack of IVD Characteristics: There is no mention of analyzing biological specimens (blood, urine, tissue, etc.), detecting analytes, or providing information for diagnosis, monitoring, or screening.

IVD devices are specifically designed to perform tests on samples taken from the human body to provide information for diagnostic purposes. This device's function is entirely within the realm of surgical intervention.

N/A

Intended Use / Indications for Use

Disposable neutral electrodes are indicated for use to adhere to the patient over the entire pad surface to complete an electrical circuit during electrosurgery between the electrosurgical generator, the active electrode and the patient.

Solid Electrosurgical pads are for use with generators that do not have a Contact Quality Monitoring System (CQMS). Split Electrosurgical pads are for use with generators that have a CQMS (i.e. REM,ARM,NESSY etc.).

Product codes

GEI

Device Description

Disposable neutral electrodes are part of a family of patient return electrodes. They are non-sterile, single-use devices used in electrosurgery to complete the electrical circuit with the generator. Providing a low-impedance path back to the generator through the return electrodes helps to prevent unintended HF burns. The solid electrosurgical pads are designed to be compatible with generators without Contact Quality Monitoring System (CQMS), and the split electrosurgical pads are designed to be compatible with the Contact Quality Monitoring System (CQMS) of compatible generators. The models share the same design elements (functional design, technology design, packaging, etc.) but have different sizes and shapes. The models are designed for adults, children, and neonates, separate catalog numbers are assigned for the intended patients, and pre-attached cord.

Disposable neutral electrodes consist of foam backing, cable connection area, conductive aluminum foil, conductive adhesive gel layer and release liner. The pads are applied on a release liner. The surface of the conductive aluminum foil is fully covered with a soft, conformable conductive adhesive gel.
The electrode backing is made of foam material. The electrodes are supplied with or without cable. For the non-corded pads, a reusable cable is not available as an accessory.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Select a well convex area (muscle) next to the area to be operated but at least 20 cm far from it, possibly on the forearm, on the thigh or on a whip.

Indicated Patient Age Range

Neonates, Children, Adults

Intended User / Care Setting

Not Found

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)

As part of demonstrating safety and effectiveness of Nissha Medical Technologies Neutral Electrodes and in showing substantial equivalence to the predicate devices, Nissha Medical Technologies completed several non-clinical performance tests. The Nissha Medical Technologies Neutral Electrodes meet all the requirements for overall design, biocompatibility and electrical safety with results confirming that the design output meets the design inputs and specifications for the devices. The Nissha Medical Technologies Neutral Electrodes passed all the testing in accordance with internal requirements, and international standards shown below to support substantial equivalence of the predicate devices:
. The device passed performance testing conducted according to standard IEC 60601-2-2:2017 "Medical electrical equipment - Part 2-2: Particular requirements for the basic safety and essential performance of high frequency surgical equipment and high frequency surgical accessories" and IEC 60601-1, relevant requirements. The testing conducted Thermal performance, Contact impedance, Adhesion, Shelf-life, Cord attachment, Cord connector and Cord insulation.
. Biocompatibility testing per ISO 10993-1 confirmed that the finished devices are biocompatible, and do not induce new risks. Testing per ISO 10993-5 Cytotoxicity was showing a slight reactivity, and ISO 10993-10 (Skin Irritation and Sensitization) was showing no adverse results.
Shelf Life Testing - According to accelerated aging of the Nissha Medical Technologies Neutral Electrodes and subsequent electrical safety testing, as it is required in subclause 201.15.101.8 of the standard IEC 60601-2-2, it has been demonstrated that the Nissha Medical Technologies Neutral Electrodes can be labeled with a shelf-life of 24 months.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K203494

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4400 Electrosurgical cutting and coagulation device and accessories.

(a)
Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.(b)
Classification. Class II.

0

Image /page/0/Picture/0 description: The image shows the logo for the U.S. Food & Drug Administration (FDA). The logo consists of two parts: a symbol on the left and the FDA name on the right. The symbol is a stylized representation of a human figure, while the FDA name is written in blue and includes the words "U.S. Food & Drug Administration".

September 25, 2024

Dongguan Quanding Medical Supplies Co., Ltd. % Jett Li Regulation Manager Guangzhou KEADA Biological Tech Co., Ltd. 6F, No.1 TianTai road Science City, LuoGang District GuangZhou, Guangdong 510000 China

Re: K242204

Trade/Device Name: Disposable Neutral Electrodes (GP201B-A, GP202B-A, GP202B-P, GP202B-I, GP202M-A, GP202M-P, GP202M-I, GP202B-AC, GP202B-PC, GP202B-IC, GP202M-AC, GP202M-PC, GP202M-IC, GP203M-A, GP203B-A, GP203M-AC, GP203B-AC, GP203M-P, GP203B-P, GP203M-PC, GP203B-PC, GP203M-I, GP203B-I, GP203M-IC, GP203B-IC) Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical Cutting And Coagulation Device And Accessories Regulatory Class: Class II Product Code: GEI

Dated: January 23, 2024 Received: July 26, 2024

Dear Jett Li:

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

1

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" (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 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.

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 Rule"). 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 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

2

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,

Digitally signed by Long H. Chen
Long H. Chen -S-s
Date: 2024.09.25 09:02:55 -04'00'

Long Chen, Ph.D. Assistant Director DHT4A: Division of General Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

3

Indications for Use

Submission Number (if known)

K242204

Device Name

Disposable Neutral Electrodes (GP201B-A, GP202B-A, GP202B-P, GP202B-I, GP202M-A, GP202M-P, GP202M-I, GP202B-AC, GP202B-PC, GP202B-IC, GP202M-AC, GP202M-PC, GP202M-IC, GP203M-A, GP203B-A, GP203M-AC, GP203B-AC, GP203M-P, GP203B-P, GP203M-PC, GP203B-PC, GP203M-I, GP203B-I, GP203M-IC, GP203B-IC)

Indications for Use (Describe)

Disposable neutral electrodes are indicated for use to adhere to the patient over the entire pad surface to complete an electrical circuit during electrosurgery between the electrosurgical generator, the active electrode and the patient.

Solid Electrosurgical pads are for use with generators that do not have a Contact Quality Monitoring System (CQMS). Split Electrosurgical pads are for use with generators that have a CQMS (i.e. REM,ARM,NESSY etc.).

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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4

510(K) Summary

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of 21 CFR 807.92.

1 510 (k) submitter

1.1 Sponsor

Company Name: Dongguan Quanding Medical Supplies Co., Ltd.

Address: No.3 Yongfa East Road, Dongshan, Qishi Town, Dongguan City, Guangdong, China

Phone: +86- 189 2372 2306

Email: 2851139778@qq.com

Contact Person (including title): Grace Zhao (General Manager)

1.2 Application Correspondent

Guangzhou KEADA Biological Tech Co., Ltd. Address: 6F, No.1 TianTai road, Science City, LuoGang District, GuangZhou City, China Contact Person: Mr. Jett Li Title: Regulation Manager Tel: +86-13512755282 Email: jianda-lee@foxmail.com

2 Date Prepared

2024-01-23

3 Subject Device Information

  • Trade Name: Disposable Neutral Electrodes
  • Common Name: Disposable Neutral Electrodes
  • Classification Name: Electrosurgical cutting and coagulation device and accessories

5

  • Review Panel: General & Plastic Surgery
  • Product Code: GEI
  • Regulation Number: 21 CFR 878.4400
  • Regulation Class: 2

4 Predicate device Information

Legally marketed device K203494 Trade Name: Nissha Medical Technologies Neutral Electrodes Classification Name: Electrosurgical cutting and coagulation device and accessories Review Panel: General & Plastic Surgery Product Code: GEI Regulation Number: 21 CFR 878.4400 Regulation Class: 2

5 Device Description

Disposable neutral electrodes are part of a family of patient return electrodes. They are non-sterile, single-use devices used in electrosurgery to complete the electrical circuit with the generator. Providing a low-impedance path back to the generator through the return electrodes helps to prevent unintended HF burns. The solid electrosurgical pads are designed to be compatible with generators without Contact Quality Monitoring System (CQMS), and the split electrosurgical pads are designed to be compatible with the Contact Quality Monitoring System (CQMS) of compatible generators. The models share the same design elements (functional design, technology design, packaging, etc.) but have different sizes and shapes. The models are designed for adults, children, and neonates, separate catalog numbers are assigned for the intended patients, and pre-attached cord.

Disposable neutral electrodes consist of foam backing, cable connection area, conductive aluminum foil, conductive adhesive gel layer and release liner. The pads are applied on a release liner. The surface of the conductive aluminum foil is fully covered with a soft, conformable conductive adhesive gel.

6

The electrode backing is made of foam material. The electrodes are supplied with or without cable. For the non-corded pads, a reusable cable is not available as an accessory.

6 Indications for Use

Disposable neutral electrodes are indicated for use to adhere to the patient over the entire pad surface to complete an electrical circuit during electrosurgery between the electrosurgical generator, the active electrode and the patient.

Solid Electrosurgical pads are for use with generators that do not have a Contact Quality Monitoring System (CQMS). Split Electrosurgical pads are for use with generators that have a CQMS (i.e. REM,ARM,NESSY etc.).

| IEC60601-1 | Medical 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 |
| IEC 60601-2-2: 2017 | Medical electrical equipment- Part 2-2: Particular
requirements for the basic safety and essential performance
of high frequency surgical equipment and high frequency
surgical accessories. |
| ISO 10993-5:2009 | biological evaluation of medical devices -- part 5: tests for in
vitro cytotoxicity. |
| ISO 10993-10:2010 | biological evaluation of medical devices - part 10: tests for
skin sensitization. |
| ISO 10993-23: 2021 | biological evaluation of medical devices - part 10: tests for
irritation |

7 Complied Standards

7

8 Performance Testing

As part of demonstrating safety and effectiveness of Nissha Medical Technologies Neutral Electrodes and in showing substantial equivalence to the predicate devices, Nissha Medical Technologies completed several non-clinical performance tests. The Nissha Medical Technologies Neutral Electrodes meet all the requirements for overall design, biocompatibility and electrical safety with results confirming that the design output meets the design inputs and specifications for the devices. The Nissha Medical Technologies Neutral Electrodes passed all the testing in accordance with internal requirements, and international standards shown below to support substantial equivalence of the predicate devices:

. The device passed performance testing conducted according to standard IEC 60601-2-2:2017 "Medical electrical equipment - Part 2-2: Particular requirements for the basic safety and essential performance of high frequency surgical equipment and high frequency surgical accessories" and IEC 60601-1, relevant requirements. The testing conducted Thermal performance, Contact impedance, Adhesion, Shelf-life, Cord attachment, Cord connector and Cord insulation.

. Biocompatibility testing per ISO 10993-1 confirmed that the finished devices are biocompatible, and do not induce new risks. Testing per ISO 10993-5 Cytotoxicity was showing a slight reactivity, and ISO 10993-10 (Skin Irritation and Sensitization) was showing no adverse results.

Shelf Life Testing - According to accelerated aging of the Nissha Medical Technologies Neutral Electrodes and subsequent electrical safety testing, as it is required in subclause 201.15.101.8 of the standard IEC 60601-2-2, it has been demonstrated that the Nissha Medical Technologies Neutral Electrodes can be labeled with a shelf-life of 24 months.

9 Biocompatibility

Biocompatibility testing per ISO 10993-1 confirmed that the finished devices are biocompatible, and do not induce new risks. Testing per ISO 10993-5 Cytotoxicity was showing a slight reactivity, and ISO 10993-10 (Skin Irritation and Sensitization) was showing no adverse results.

10 Clinical Performance

No human clinical testing is required to support the medical device as the intended use is equivalent

8

to the predicate devices. The non-clinical testing detailed in this submission supports the substantial equivalence of the device.

11 Comparison with Predicate Device

DescriptionSubject DevicePredicate DeviceDevice Comparison
ManufacturerDongguan Quanding
Medical Supplies Co., Ltd.Nissha Medical
Technologies Ltd.-
510(k) Number-K203494-
Product CodeGEIGEISame
Regulation
Number21 CFR 878.440021 CFR 878.4400Same
Regulation
NameElectrosurgical cutting and
coagulation device and
accessoriesElectrosurgical cutting and
coagulation device and
accessoriesSame
Indications for
UseDisposable neutral electrodes
are indicated for use to
adhere to the patient over the
entire pad surface to
complete an electrical circuit
during electrosurgery
between the electrosurgical
generator, the active
electrode and the patient.
Solid Electrosurgical pads
are for use with generators
that do not have a Contact
Quality Monitoring System
(CQMS). Split
Electrosurgical pads are for
use with generators that have
a CQMS (i.e.
REM,ARM,NESSY etc.).Nissha Medical
Technologies Neutral
Electrodes -
SWAROPLATE:
Neutral electrodes are an
accessory for monopolar
HF-surgery and represent
the large area and low
impedance contact with the
patient's skin required for
returning the electric current
to the HF-generator. Neutral
electrodes are self-adhesive,
ready-to-use disposable
products.
The SWAROPLATE neutral
electrodes of Nissha
Medical Technologies are
not intended for use in High
Current Mode. These are
applications with high
current and / or long
activation periods where
heating factors of more than
30 A2s in a 60 s period
occur.Words is
different, but the
Indications for
Use is identical
DescriptionSubject DevicePredicate DeviceDevice
Comparison
Nissha Medical
Technologies Neutral
Electrodes – Boston
Scientific:
Neutral electrodes are an
accessory for monopolar
HF-surgery and represent
the large area and low
impedance contact with the
patient's skin required for
returning the electric current
to the HF-generator. Neutral
electrodes are self-adhesive,
ready-to-use disposable
products.
The Boston Scientific
Neutral Electrodes REF
DGP-PMC2-5, REF DGP-
PMC2-25, REF DGP-PM2-
5, and REF DGP-PM2-25
are intended to be used in
combination with the
devices "Boston Scientific
G4™ and 1A/1B
Radiofrequency
Generators".
Prescription or
OTCPrescriptionPrescriptionSame
Mechanism of
ActionDisposable neutral electrodes
are indicated for use to
adhere to the patient over the
entire pad surface to
complete an electrical circuit
during electrosurgery
between the electrosurgical
generator, the active
electrode and the patient.Neutral electrodes serve to
return the current from the
patient to the electrosurgical
unit (ESU) during HF
surgery in monopolar
application.Words is
different, but the
Mechanism of
Action is identical
Technology
OverviewMulti-layer device consisting
of:Multi-layer device
consisting of:Similar
DescriptionSubject DevicePredicate DeviceDevice
Comparison
Conductive aluminum foil
Backing material
Conductive adhesive gel
layer
Release linerBacking material
Conductive layer
Conductive adhesive
hydrogel
Cover material
PopulationNeonates, Children, AdultsNeonates, Children, AdultsSame
Anatomical
LocationSelect a well convex area
(muscle) next to the area to
be operated but at least 20
cm far from it, possibly on
the forearm, on the thigh or
on a whip.Muscular or well
vascularized convex skin
site, as close as possible to
the operating fieldSimilar
Weight range
according to
IEC 60601-2-2>15kg: Adults
Between 5 and 15kg:
Children
15kg (33lbs) Adults

5kg (11lbs) Children and
Adults
Between 5 and 15kg (11 to
33lbs) Children
15kg Adults: 130-173 cm²
Between 5 and 15kg
Children: 65-94cm²