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510(k) Data Aggregation

    K Number
    K240512
    Manufacturer
    Date Cleared
    2024-11-04

    (256 days)

    Product Code
    Regulation Number
    886.5200
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Novoxel Ltd.

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Tixel i is indicated for the application of localized heat and pressure therapy in adult patients with evaporative dry eye disease due to meibomian gland dysfunction (MGD).

    Device Description

    The Tixel i is intended to deliver heat and pressure to the eyelids of patients with evaporative dry eye disease (DED) due to meibomian gland dysfunction (MGD). The Tixel i is comprised of a Console, which is connected via an umbilical tube to an applicator, referred to as "Handpiece."

    The Handpiece includes a therapeutic element, the "Tip," fixated on its distal end. A clear polycarbonate illuminated Distance Gauge, mounted on the distal end of the Handpiece, covers the Tip and allows proper and safe positioning of the Handpiece on the skin prior to performing a treatment pulse. The Distance Gauge is removed only when the Tip is being cleaned.

    The Tip is comprised of a gold-plated copper base and a thin-walled titanium alloy cover. The active surface of the Tip consists of an array of 24 (6×4) square-based pyramids, evenly spaced. The pyramids have a blunt apex to allow effective heat transfer and prevent any risk of mechanical puncturing of the skin. The backplane of the Tip attaches to a ceramic heater that maintains a constant temperature during operation.

    During a Tixel i procedure, an Aestek plastic ocular shield (Oculo-Plastik, Inc.) is to be inserted under the eyelids on the ocular surface to protect the eye during the procedure.

    AI/ML Overview

    The FDA 510(k) summary for the Novoxel Tixel i device does not describe an AI/ML-driven device, but rather a medical device for treating dry eye disease. Therefore, many of the typical acceptance criteria and study details relevant to AI/ML devices (e.g., number of experts, adjudication methods, MRMC studies, training/test set ground truth establishment, standalone performance) are not applicable here.

    However, based on the provided text, I can infer the "acceptance criteria" through the study's primary and secondary endpoints for clinical performance and the non-clinical testing performed to ensure safety and functionality.

    Here's an attempt to structure the information based on your request, adapting it to the nature of the device described:


    Acceptance Criteria and Device Performance for Novoxel Tixel i (TXLI0001)

    The Tixel i device is an eyelid thermal pulsation system indicated for the application of localized heat and pressure therapy in adult patients with evaporative dry eye disease due to meibomian gland dysfunction (MGD). Its acceptance criteria are primarily defined by its non-inferiority to a legally marketed predicate device (LipiFlow) in terms of clinical effectiveness and an acceptable safety profile.

    1. Table of Acceptance Criteria and Reported Device Performance

    Criteria CategoryAcceptance Criteria (Success Metric)Reported Device Performance
    Clinical Effectiveness
    Primary Endpoint:Non-inferiority to LipiFlow for change from baseline to 4 weeks in Tear Break-Up Time (TBUT). (Upper bound of one-sided 95% CI for difference in mean improvement
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    K Number
    K223033
    Device Name
    Tixel® 2 System
    Manufacturer
    Date Cleared
    2023-06-21

    (265 days)

    Product Code
    Regulation Number
    878.4400
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Novoxel Ltd.

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Tixel® 2 System is intended for dermatological procedures requiring ablation and resurfacing of the skin, and for treatment of periorbital wrinkles.

    Device Description

    The Tixel® 2 System is a thermo-mechanical fractional skin treatment device that is designed to perform ablative fractional skin treatment is achieved by transfer of energy in the form of heat to the skin to create coagulation sites. The treatment is applied through an operating Tip that consists of 81 (standard Tip) or 24 (small Tip) biocompatible titanium, square pyramidal shapes assembled over a gold-plated copper base that are heated by an underlying flat ceramic heating element. The desired skin treatment is achieved by defining the speed and distance at which the Tip contacts and pushes the skin, and the number of pulses performed. Based on the treatment parameters selected, the pyramids contact the skin surface in 81 (or 24 for the small Tip) discrete, non-overlapping areas and by the transfer of heat, a matrix of coagulation sites and thermal necrosis is generated.

    Tixel 2 transfers heat to the tissue by direct conduction to target tissue in a localized manner via the discrete non-overlapping pyramids. The complete Tixel 2 System contains two Handpieces, which are attached to the Tixel 2 Console by an umbilical tube. The Console's touch screen is used to control the system parameters.

    AI/ML Overview

    The provided text describes the Tixel® 2 System, a thermo-mechanical fractional skin treatment device. However, it does not contain information about acceptance criteria or a study proving the device meets those criteria in the context of an AI/ML-based diagnostic or prognostic device. The document is an FDA 510(k) summary for a medical device that performs ablation and resurfacing of the skin, and treats periorbital wrinkles.

    Therefore, I cannot provide a table of acceptance criteria and reported device performance or answer questions regarding sample size for test/training sets, expert involvement, adjudication methods, MRMC studies, or standalone performance, as this information is not present in the given text.

    The information provided pertains to the Tixel® 2 System as a physical medical device, not an AI/ML algorithm requiring such validation.

    Here's what the document does provide regarding its performance and safety validation:

    The "Performance Data" section lists various engineering and biological tests performed to establish equivalence with its predicate device (Novoxel Tixel® System K202988):

    • Disinfection validation: per ISO 20857
    • Use-life validation testing
    • Software and cybersecurity validation: per FDA guidance
    • Electrical safety: per IEC 60601-1 and 60601-1-6
    • EMC: per IEC 60601-1-2
    • Comparative animal tissue histology studies: (In-Vivo and Ex-Vivo)

    The "Clinical Data" section describes a prospective, blinded (pre- and post-treatment), single-arm clinical study evaluating the safety and efficacy of the Tixel® 2 in the treatment of periorbital wrinkles:

    • Sample size: 51 patients (48 completed the study).
    • Data provenance: Two clinics (US, Israel).
    • Ground Truth: Clinical assessment metrics:
      • FWCS score: Performed by blinded raters for baseline and 3-month follow-up visits, demonstrating improvement > 1 grade.
      • GAIS assessment: Performed at follow-up compared to baseline. Mean score at Visit 5 was 3.54±0.68, and 3.52±0.58 at Visit 6 (3-month FU). Most subjects achieved the highest improvement grade (grade 4, 75-100%).
      • Raters: At least 2 out of 3 raters were in agreement for grading 83.3% of subjects as responders. (Specificity of "raters'" qualifications is not provided beyond "blinded raters").
      • Safety Outcomes: No SAEs or significant related AEs. Two AEs (Erythema, back pain) were reported in two subjects (3.92%). Mean procedure-associated VAS pain scores were low.

    This information is relevant to the device's clinical performance, but not in the context of an AI/ML model's performance on a specific decision threshold or diagnostic accuracy.

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    K Number
    K202988
    Device Name
    Tixel System
    Manufacturer
    Date Cleared
    2021-02-25

    (148 days)

    Product Code
    Regulation Number
    878.4400
    Reference & Predicate Devices
    Why did this record match?
    Applicant Name (Manufacturer) :

    Novoxel Ltd.

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Tixel® System is intended for dermatological procedures requiring ablation and resurfacing of the skin.

    Device Description

    The Tixel is a thermo-mechanical fractional skin treatment device that is designed to perform ablative fractional skin treatment is achieved by transfer of energy in the form of heat to the skin to create coagulation sites.

    The treatment is applied through an operating Tip that consists of 81 (standard tip) or 24 (small tip) biocompatible titanium square pyramidal shape assembled over gold plated copper base that are heated by an underlying flat ceramic heating element. The desired skin treatment is achieved by defining the speed and distance at which the Tip contacts and pushes the skin and the amount of pulses performed. Based on the treatment parameters selected the pyramids contact the skin surface in 81 (or 24 for small tip) discrete, non-overlapping areas and by the transfer of heat, a matrix of coagulation sites and thermal necrosis is generated.

    Tixel transfers heat to the tissue by direct conduction to target tissue in a localized manner via the discrete non-overlapping pyramids. The Tixel Tip contacts the skin for a very short period. defined by pulse duration that varies between 5 and 16ms.

    The Tip is mounted directly above the heating element in the Handpiece. The Tip and the heating element are mounted on a titanium alloy assembly. The Tip assembly structure is rigidly connected to the motor shaft (also known as forcer) by a polymer component. The polymeric components provide both thermal and electrical insulation between the heating element and the motor shaft. The Handpiece is attached to the Tixel Console by an umbilical tube. The console touch screen is used to control the system parameters.

    AI/ML Overview

    The provided text is a 510(k) summary for the Novoxel Tixel® System, which is a medical device. This document describes the device, its intended use, and its comparison to a predicate device to establish substantial equivalence for FDA clearance.

    However, the information provided does not contain acceptance criteria and a study that proves the device meets those criteria in the way you've outlined for AI-driven diagnostic or assistive technologies.

    Here's why and what information is available:

    • Type of Device: The Tixel System is a thermo-mechanical fractional skin treatment device, which is an electrosurgical cutting and coagulation device and accessories. This is a physical treatment device, not an AI or diagnostic software. Therefore, the "acceptance criteria" and "study" format you've requested (e.g., performance metrics like sensitivity/specificity, human reader improvement with AI, ground truth establishment by experts, sample size for test/training sets) are not directly applicable to this type of device.

    • Focus of the Document: The 510(k) summary aims to demonstrate substantial equivalence to a predicate device. This means showing that the new device is as safe and effective as a legally marketed device, not necessarily proving performance against specific, quantifiable diagnostic metrics for AI.

    Therefore, I cannot populate the table and sections as requested for an AI/diagnostic device.

    However, I can extract the relevant "performance data" that the 510(k) uses to demonstrate safety and effectiveness for this physical medical device:


    1. Acceptance Criteria and Reported Device Performance (Non-AI/Diagnostic)

    Feature/TestAcceptance Criteria (Implied by Regulatory Standards & Predicate Comparison)Reported Device Performance
    Intended UseSame as predicateThe Tixel® System is intended for dermatological procedures requiring ablation and resurfacing of the skin, which is the same intended use as the predicate device (Venus Viva SR Device).
    Technological CharacteristicsSafe and effective operation; no new safety/effectiveness issues compared to predicate or reference.Both Tixel and predicate transfer energy via a handpiece to a console. Tips are comparable in physical design (array of pins/pyramids). Patient-contacting materials are biocompatible. Both deliver localized, fractional thermal effects. While Tixel uses heat conduction and predicate uses fractional radiofrequency, this difference "does not result in different types of safety or effectiveness questions." Uses metallic elements for thermal energy, similar to CONMED Altrus.
    BiocompatibilityPass cytotoxicity, sensitization, irritation for surface contact (≤ 24 hours).All tests showed passing results. Surface chemical analysis showed no diffusion of underlying materials.
    Cleaning/DisinfectionEffective cleaning; high-level disinfection for tip.Cleaning validation passed. Tip undergoes high-level disinfection via dry heat (ISO 20857), achieving complete kill of 10^6 Bacillus atrophaeus spores.
    Shelf Life/Tip DurabilityFunctionality maintained over specified operating cycles.Tixel designed for 100,000 pulses per tip. Shelf-life testing showed no deterioration of handpieces after 250,000 cycles.
    Electrical Safety & EMCCompliance with IEC 60601-1 and IEC 60601-1-2.Conducted by an independent test laboratory; results implicitly acceptable for clearance.
    Software VerificationAcceptable for software release.Testing results were found acceptable for software release.
    Bench TestingPerforms according to specifications and functions as intended.Bench testing demonstrated that Tixel performs according to specifications and functions as intended.
    Animal Study (Performance Comparison)Similar treatment effect (lesion depth, width, inflammation, healing) to predicate device.In a porcine model, Tixel-treated and predicate (Venus Viva)-treated animals showed similar immediate skin changes. Histopathology demonstrated similar lesion depths for Tixel and Venus Viva at medium and high settings, creating a focus of ablation over a wedge-shaped dermal area of collagen coagulation. Increased energy levels led to proportionately greater thermal lesions. "Tixel displays a similar treatment effect compared to the predicate."

    Regarding the specific questions you asked for AI/diagnostic devices:

    1. Sample size used for the test set and data provenance:

      • Animal Study: Five female domestic pigs were used. This is an animal model study, not human clinical data. The provenance is not specified beyond "porcine model."
      • Other tests (Biocompatibility, Cleaning, Electrical Safety, Software, Bench): These typically involve laboratory samples, components, or software code, not patient-derived "test sets."
    2. Number of experts used to establish the ground truth for the test set and qualifications: Not applicable in the context of this device. The histopathology from the animal study would have been evaluated by veterinary pathologists, but the number and specific qualifications are not detailed.

    3. Adjudication method (e.g. 2+1, 3+1, none) for the test set: Not applicable.

    4. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance: Not applicable, as this is not an AI diagnostic or assistive device.

    5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not applicable.

    6. The type of ground truth used:

      • For the animal study: Histopathology (depth and width of lesions, inflammatory reaction, healing process) from harvested tissue samples.
      • For other tests: Engineering specifications, regulatory standards, and objective measurements (e.g., electrical parameters, bacterial count for disinfection).
    7. The sample size for the training set: Not applicable, as this is a physical device, not an AI model requiring a training set.

    8. How the ground truth for the training set was established: Not applicable.


    In summary, the document addresses regulatory requirements for a physical medical device (Tixel® System) by demonstrating substantial equivalence to a predicate device, focusing on safety and effectiveness through engineering tests, biocompatibility, cleaning validation, and an animal study. It does not contain the type of performance evaluation metrics or study designs typically associated with AI or diagnostic software.

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