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510(k) Data Aggregation

    K Number
    K161925
    Date Cleared
    2016-10-05

    (84 days)

    Product Code
    Regulation Number
    878.4810
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The CO2 Laser Therapy Machine is used for human tissue vaporization in dermatology and plastic surgery, general surgery, gynecology, podiatry, dental and otorhinolaryngology.

    The CO2 Laser Therapy Machine is used for human tissue vaporization, coagulation in dermatology and plastic surgery, general surgery, gynecology, podiatry, dental and otorhinolaryngology.

    Device Description

    The CO2 Laser Therapy Machine is a carbon dioxide laser used in medical and aesthetic industry for treatment of such skin conditions as fine and coarse wrinkles, scars of various origin, uneven pigmentation and dilated pores. Due to the CO2 laser's high absorption of water, its high-energy beam of laser light interacts with the skin's surface causing the upper layer to peel off and use photothermolysis to stimulate deep cell regeneration and then achieve the target of skin improvement.

    The proposed device is mainly used for human tissue vaporization, carbonization, coagulation and exposure to achieve the purpose of treatment.

    The CO2 Laser Therapy Machine includes three models in this submission, FG 900, FG 900-B and FG 900-C, all three models have same principle, software, operation etc., only differences are appearance.

    The proposed device includes the following components: Surgery tip, Surgery tip Arm, Touchscreen, Emergency Switch, Key Switch, Goggles for Patient, Goggles for Doctor, Foot Switch.

    AI/ML Overview

    The provided document is a 510(k) Summary for a CO2 Laser Therapy Machine. It describes the device, its intended use, and a comparison to a predicate device to demonstrate substantial equivalence.

    Here's an analysis of the acceptance criteria and study information based on the provided text:

    1. A table of acceptance criteria and the reported device performance

    The document presents a comparison of the proposed device against a predicate device across various parameters. It doesn't explicitly state "acceptance criteria" for each parameter with numeric thresholds, but rather lists characteristics that are considered "Substantially Equivalent (SE)" if they match or are comparable to the predicate. The performance is reported as the proposed device's specifications.

    ParameterAcceptance Criteria (Implied by Predicate)Reported Device PerformanceRemark (as per document)
    Product CodeGEXGEXSE
    Regulation No.21 CFR 878.481021 CFR 878.4810SE
    Class22SE
    Where usedHospitalHospitalSE
    Intended UseHuman tissue vaporization, coagulation in dermatology and plastic surgery, general surgery, gynecology, podiatry, dental and otorhinolaryngology.Human tissue vaporization, coagulation in dermatology and plastic surgery, general surgery, gynecology, podiatry, dental and otorhinolaryngology.SE
    Maximum PowerCFL-10: 12W (±20%), UFL-60: 30W (±20%)30WSE
    Work ModeScanner (half, fast and random), Surgery (CW, repeat and pulse)Surgery (Single Pulse, Continuous, Muti-Pulse)SE
    Wavelength10.6 um10.6 umSE
    Mode StructureTEM00TEM00SE
    Beam Delivery7 knucklearmkey joints light arm7 knucklearmkey joints light armSE
    Light ArmCFL-10: 0.97m, UFL-60: 1.17m1.32mAnalysis
    Aiming Beam650nm red diode laser (<1mW)650nm red diode laser (0.5 mW)SE
    Spot Size0.5mm (±10%)0.5 mmSE
    Pulse SettingSingle Pulse (10-1000ms), Time On (10-1000ms), Time Off (10-1000ms)Single Pulse (Pulse 1-999ms), Muti-Pulse (Repeat Time On 1-999 ms, Time Off 1-999 ms)SE
    Continuous PowerCW CFL-10: 0.1-12W, UFL-60: 0.1-30W0-30WSE
    Power CalibrationPeriod of 1 yearPeriod of 1 yearSE
    Control SystemTouch screen, footswitchTouch screen, footswitchSE
    Laser OperationFootswitchFootswitchSE
    Laser Medium/EnergyCO2CO2SE
    Cooling SystemAir coolingAir coolingSE
    Clean Method70% medical alcohol70% medical alcoholSE
    Patient ContactedSkinSkinSE
    DimensionsVaried by predicate models (e.g., CFL-10: 210 x 600 x 330 mm)Varied by proposed models (FG 900: 5646112 cm, FG 900-B: 605432cm, FG 900-C: 4642125cm)SE
    WeightVaried by predicate models (e.g., CFL-10: 20kg)Varied by proposed models (FG 900: 49 kg, FG 900-B: 28kg, FG 900-C: 43kg)SE
    Power InputCFL-10: 120 V AC/60Hz, UFL-60: 120 VAC/60HzAC 110V/50Hz-60HzSE
    Electrical SafetyComply with IEC 60601-1, IEC 60601-2-22Comply with IEC 60601-1, IEC 60601-2-22SE
    EMCComply with IEC 60601-1-2Comply with IEC 60601-1-2SE
    Laser SafetyComply with IEC 60601-2-22, IEC 60825Comply with IEC 60601-2-22, IEC 60825SE

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

    The document states: "No clinical study is included in this submission." The evaluation is based on non-clinical tests and comparisons to a predicate device. Therefore, there is no "test set" in the sense of patient data, and no data provenance information for such a set.

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

    Not applicable, as no clinical study or test set with patient data was used to establish ground truth.

    4. Adjudication method for the test set

    Not applicable, as no clinical study or test set with patient data was used.

    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

    Not applicable. The device is a CO2 Laser Therapy Machine, not an AI-assisted diagnostic device.

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

    Not applicable. The device is a medical instrument, not an algorithm. Performance was evaluated through non-clinical testing of the physical device. The device itself is "standalone" in that it performs its intended function without requiring human intervention in that specific function, but it is operated by a human.

    7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

    For the non-clinical tests, the "ground truth" was established by compliance with international standards (e.g., IEC 60601-1, IEC 60601-2-22, IEC 60825-1, ISO 10993-5, ISO 10993-10) and verification of design specifications such as Spot Size Accuracy and Energy Output Accuracy, and Software Validation & Verification. These standards and specifications serve as the "ground truth" for the device's technical and safety performance.

    8. The sample size for the training set

    Not applicable, as this is a physical medical device, not a machine learning algorithm.

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

    Not applicable, as this is a physical medical device, not a machine learning algorithm.

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