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510(k) Data Aggregation

    K Number
    K100378
    Date Cleared
    2010-04-28

    (71 days)

    Product Code
    Regulation Number
    878.4630
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    1 SERIES MODEL 1 SERIES T2, 1 SERIES X2, 1 SERIES T4, 1 SERIES X4

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

    The 1 Series Unit is a therapeutic product designed for individuals who require ultraviolet radiation for diagnosed skin disorders. The 1-Series, equipped with PL-L36W /03 blue lamps, is indicated for the treatment of mild to moderate acne vulgaris

    Device Description

    The 1 Series Unit is a partial-body phototherapy panel ultraviolet light source controlled by an integrated digital timer or a microprocessor controller. The operator interface consists of two main components: a LCD, and a Membrane with 4 buttons. When the operator sets the treatment time or the desired dose using the operator interface located on the control panel, the treatment begins by illuminating the lamps which emit ultraviolet light or blue light. The spectral output peaks at wavelengths of 305nm,311nm,350nm,365nm, or 420nm depending on lamp. The 1 Series Unit is a therapeutic product designed for individuals who require ultraviolet radiation for diagnosed skin disorders or blue light radiation for acne vulgaris.

    AI/ML Overview

    This 510(k) summary for the Daavlin 1 Series Phototherapy Unit is a substantial equivalence submission, not a study demonstrating the device meets performance criteria in the way a clinical trial would for an AI algorithm. Instead, it argues that the new device is safe and effective because it is essentially the same as already legally marketed devices.

    Therefore, many of your requested items (e.g., sample sizes, ground truth establishment, expert qualifications, MRMC studies) are not applicable (N/A) to this type of regulatory submission and device.

    Here's a breakdown of the available information:

    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance Criteria (Implied)Reported Device Performance
    Safety and EffectivenessSubstantially Equivalent to Predicate Devices
    - Intended UseSame or similar
    - Design ConfigurationSame
    - Energy SourcesIdentical (UV or blue light lamps)
    - MaterialsIdentical composition
    - General/Specific Indications for UseSame or similar
    - Spectral OutputSame or similar
    - Mode of OperationSame or similar
    - LabelingSame or similar
    - Treatment AreaSame or similar
    - General Operating PrinciplesSame or similar
    Performance DataUV or blue light lamps and cabinet construction are similar to predicate devices.

    2. Sample size used for the test set and the data provenance

    • N/A. This device approval is based on substantial equivalence to existing devices, not a test set and performance metrics derived from data.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

    • N/A. Ground truth establishment for a test set is not relevant for this type of device submission.

    4. Adjudication method for the test set

    • N/A. Not applicable.

    5. 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

    • N/A. This is a phototherapy unit, not an AI-powered diagnostic or assistive tool.

    6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

    • N/A. This is not an algorithm; it's a physical medical device.

    7. The type of ground truth used

    • N/A. Not applicable. The "ground truth" for this submission is that the predicate devices are already legally marketed and presumed safe and effective.

    8. The sample size for the training set

    • N/A. This is not an AI/ML device that requires a training set.

    9. How the ground truth for the training set was established

    • N/A. Not applicable.
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