K Number
K994109
Device Name
DETRUSAN 500
Date Cleared
2000-08-03

(241 days)

Product Code
Regulation Number
876.5320
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Detrusan 500 Incontinence Treatment System is indicated for acute, ongoing or chronic treatment of Urge. Stress, or Mixed Urinary Incontinence. The System is indicated to improve urethral sphincter closure, strengthen of the pelvic floor and inhibition of the detruser muscle through reflexive mechanisms.
Device Description
Detrusan 500 incontinence Therapy system comes with the external electric stimulator unit and vaginal and anal electrodes (Probes made by "Laborie Medical Technologies") Vaginal Probes K 990041 Anal Probes K 993721 Approved by FDA. Detrusan 500 is a Main net powered electrical stimulator, which provides output stimulus to the probes. The Device can be adjusted to deliver AC voltages in the range up to 30 Volts. The current is depended on the resistor of the patient as standard measuring level at 500 Ohm- 60 mA limited by hardware and software up to 80 mA. Frequencies are adjustable 1 to 100 Hz The pulse width is adjustable 10 to 400 us. 12 preprogrammed follow-ups and frequencies as well as pulse width adjustments are available by calling program number. The Device is constant Voltage stabilized.
More Information

K930530/C, K9039647

No
The device description details a standard electrical stimulator with adjustable parameters and preprogrammed settings. There is no mention of AI, ML, or any learning or adaptive capabilities based on patient data.

Yes
The device is used for the treatment of urinary incontinence to improve urethral sphincter closure, strengthen the pelvic floor, and inhibit the detrusor muscle, indicating a therapeutic purpose.

No

The device is described as a treatment system for urinary incontinence, not as a diagnostic tool. Its function is to provide electrical stimulation for therapeutic purposes, such as strengthening muscles and inhibiting detrusor muscle activity.

No

The device description explicitly states it comes with an external electric stimulator unit and vaginal and anal electrodes (probes), which are hardware components. It also describes the device as a "Main net powered electrical stimulator."

Based on the provided information, the Detrusan 500 Incontinence Treatment System is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • IVD devices are used to examine specimens taken from the human body. This typically involves analyzing blood, urine, tissue, or other bodily fluids outside of the body to diagnose diseases or conditions.
  • The Detrusan 500 system is an electrical stimulator used on the body. It applies electrical stimulation to the urethral sphincter, pelvic floor, and detrusor muscle through vaginal and anal electrodes. This is a therapeutic treatment applied directly to the patient, not an analysis of a specimen.

The description clearly indicates a device for treatment of incontinence through electrical stimulation, not for diagnosis through laboratory analysis of samples.

N/A

Intended Use / Indications for Use

The Detrusan 500 Incontinence Treatment System is indicated for acute, ongoing or chronic treatment of Urge, Stress, or Mixed Urinary Incontinence. The System is indicated to improve urethral sphincter closure, strengthen of the pelvic floor and inhibition of the detruser muscle through reflexive mechanisms.

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

78 KPI

Device Description

Detrusan 500 incontinence Therapy system comes with the external electric stimulator unit and vaginal and anal electrodes (Probes made by "Laborie Medical Technologies") Vaginal Probes K 990041 Anal Probes K 993721 Approved by FDA.
Detrusan 500 is a Main net powered electrical stimulator, which provides output stimulus to the probes. The Device can be adjusted to deliver AC voltages in the range up to 30 Volts. The current is depended on the resistor of the patient as standard measuring level at 500 Ohm- 60 mA limited by hardware and software up to 80 mA. Frequencies are adjustable 1 to 100 Hz The pulse width is adjustable 10 to 400 us. 12 preprogrammed follow-ups and frequencies as well as pulse width adjustments are available by calling program number. The Device is constant Voltage stabilized.

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

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)

Not Found

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.

K994109

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.

K930530/C, K9039647

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

§ 876.5320 Nonimplanted electrical continence device.

(a)
Identification. A nonimplanted electrical continence device is a device that consists of a pair of electrodes on a plug or a pessary that are connected by an electrical cable to a battery-powered pulse source. The plug or pessary is inserted into the rectum or into the vagina and used to stimulate the muscles of the pelvic floor to maintain urinary or fecal continence. When necessary, the plug or pessary may be removed by the user. This device excludes an AC-powered nonimplanted electrical continence device and the powered vaginal muscle stimulator for therapeutic use (§ 884.5940).(b)
Classification. Class II (performance standards).

0

AUG 3 2000

K994109 PG. 1 of 4

DETRUSAN 500

Version July 2000

Incontinence Therapy System

Safety and Effectiveness Summary

  1. Submitters Name:

Innovamed-USA, Inc. 1140 Lee Blvd. Suite 101 Lehigh Acres FL 33936

Establishment Registration No: Owner Operator ID:

106 43 903 96 47

2. Name of Device:

Detrusan 500 Device Class ll

3. Name of Predicate Devices:

Detrusan 500 Incontinence Therapy System. K 994109

4. Description of the Device:

l List of Components

Detrusan 500 incontinence Therapy system comes with the external electric stimulator unit and vaginal and anal electrodes (Probes made by "Laborie Medical Technologies") Vaginal Probes K 990041 Anal Probes K 993721 Approved by FDA.

Page 1

1

Electric Characterization:

Detrusan 500 is a Main net powered electrical stimulator, which provides output stimulus to the probes. The Device can be adjusted to deliver AC voltages in the range up to 30 Volts. The current is depended on the resistor of the patient as standard measuring level at 500 Ohm- 60 mA limited by hardware and software up to 80 mA. Frequencies are adjustable 1 to 100 Hz

The pulse width is adjustable 10 to 400 us. 12 preprogrammed follow-ups and frequencies as well as pulse width adjustments are available by calling program number. The Device is constant Voltage stabilized.

Intended Use:

The Detrusan 500 Incontinence Treatment System is indicated for acute, ongoing or chronic treatment of Urge. Stress, or Mixed Urinary Incontinence. The System is indicated to improve urethral sphincter closure, strengthen of the pelvic floor and inhibition of the detruser muscle through reflexive mechanisms.

5. Statement of Indented Use

The Detrusan 500 Incontinence Treatment System is indicated for acute, ongoing or chronic treatment of Urge, Stress, or Mixed Urinary Incontinence. The System is indicated to improve urethral sphincter closure, strengthen of the pelvic floor and inhibition of the detruser muscle through reflexive mechanisms.

6. Statement of technology Characteristics:

A list of comparison shows the difference of the Detrusan 500 and a legally premarket device (K930530/C), - see next Page.

Page 2

2

PG. 3 OF 4

DETRUSAN 500

Version July 2000

Comparison of the Technological Characteristics of the PRS 9300(K930530C) and the Predicate Device Detrusan 500 (K9039647)

יין

| Stimulation
Characteristics | Proposed device
PRS 9300 (K930530/C) | Predicate device
Detrusan 500 (K994109) |
|--------------------------------|------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------|
| Intended Use | Treatment of Incontinence | Treatment of Incontinence |
| Control | Laptop Computer | Preprogrammed CPU |
| Output (nominal) | 0 to 30 VDC ?! | 0 to 30 VAC |
| Waveform: | Square, Symmetrical,
Balanced, Biphasic; | Square Symmetrical,
Balanced, Biphasic; |
| Charge Pulse at 500 Ω | 60 µC/phase;
net charge/pulse=0 | 64 µC/phase;
net charge/pulse=0 |
| Frequency | 12.5,20,50,100 Hz | 1 - 100 Hz |
| Peak Pulse Intensity | 30 VDC ?! | 30 VAC |
| Pulse with | 0.3, 1 ms | 0.01 - 0.4 ms |
| Ramps | 20%, 40%, 60%, 80%, 100%
of "On" time (no down ramp) | 1/12th of the intensity (V) |
| Duty Cycle | On (sec): 1-80 in 1sec increm.
Off (sec): 0-80 in 1 sec increm. | On (sec): 1-60 in1sec.increm
Off (sec:0-60 in 1 sec.increm |
| Session Duration (min) | 0-30
1 minute increments | 0-30
1 minute increments |
| Programmable Features | Not by Patient
By Physician: Pulse width,
Frequency, Duty Cycle,
Session length | Not by Patient!
By Physician: Pulse width,
Frequency, Duty Cycle,
Session length, Programs |

Page3

3

| Current Density
Condition: Full output
Settings, 100 Hz, pulse
Width at 500 Ω (nominal) | Probe9595 - 0.003 $A /cm^2$
Probe9596 - 0.018 $A /cm^2$ | Probe 185_5053
0.00403 $A / cm^2$
Probe 185_5056
0.01640 $A / cm^2$ |
|--------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------|
| Power Density
Condition: Full output
Settings, 100 Hz, pulse | Probe9595 - 0.047 $W/cm^2$
Probe9596 - 0.239 $W/cm^2$ | Probe 185_5053
0.12 $W / cm^2$
Probe 185_5056
0.12 $W/cm^2$ |
| EMR | Engineering models of
PRS9300 have been tested
and shown to comply with
EN 5501 and IEC 801-3
emissions and immunity,
respectively | engineering models of
Detrusan have been
tested as shown by the
EMR Report included
first 510K proposal.
(K994109) |

Measurement conditions: of Detrusan: Range 1: Output Power = 30.V Range2: Full Output Settings 100Hz, = max. Pulse with 400 µs = max at 500KΩ

4

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle-like symbol with three curved lines representing its wings or body. The symbol is enclosed within a circle, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged around the upper portion of the circle.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

3 2000 AUG

Mr. Ernest H. Czadilek President InnovaMed-USA, Inc. 1140 Lee Blvd., Suite 101-103 P.O. Box 1361 Lehigh Acres, FL 33936

Re: K994109 Detrusan 500 Incontinence Therapy System Dated: May 27, 2000 Received: May 31, 2000 Requlatory Class: Il 21 CFR §876.5320/Procode: 78 KPI

Dear Mr. Czadilek:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate idevices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act). You may, therefore, market the device, subject to the general controls provisions of the Act. 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.

If your device is classified (see above) into either class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalion assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket not fied any obligation you might have under sections 531 through 542 of the Act for devices under Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4591. Additionally, for question and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-5597 or at its internet address "http://www.fda.gov/odrh/dsmaldsmamain.html".

Sincerely yours,

Daniel G. Schultz, M.D.

Captain, USPHS Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure(s)

5

510(k) Number (if known): K 99 41 09

Device Name: DETRUSAN 500 Version May 27, 2000

Indications for Use:

The Detrusan 500 Incontinence Treatment System is indicated for acute, ongoing or chronic treatment of Urge, Stress, or Mixed Urinary Incontinence. The System is indicated to improve urethral sphincter closure, strengthen of the pelvic floor and inhibition of the detruser muscle through reflexive mechanisms.

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

(Division Sign-Off) Division of Reproductive, Abdominal, ENT, and Radiological Device 510(k) Number ..

Prescription Use (Per 21 CFR 801.109)

OR

Over-The Counter Use

(Optional Format 1 -2 - 96