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510(k) Data Aggregation

    K Number
    K143207
    Manufacturer
    Date Cleared
    2015-03-23

    (136 days)

    Product Code
    Regulation Number
    890.5850
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    Revitive IX (OTC)

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

    The Revitive IX (OTC) is intended to be used for electrical stimulation of the muscles of the lower leg for the purposes of supporting muscle function, and improving blood circulation. In addition Revitive IX (OTC) is intended to be used for electrical stimulation of sore and aching muscles to relieve pain. The device is intended for home use for 30 minutes per treatment with a maximum of 3 hours treatment time per day as required.

    Revitive IX (OTC) is indicated for:

    • To temporarily increase local blood circulation in healthy leg muscles
    • To stimulate healthy muscles in order to improve and facilitate muscle performance. ●
    • For temporary relief of pain associated with sore and aching muscles in the shoulder, waist, back, upper extremities (arms) and lower extremities (legs) due to strain from exercise or normal household duties.
    Device Description

    The Revitive IX (OTC) consists of foot pads and/or electrode pads that deliver electrical stimulation to the lower limb muscles, electrode pads may also deliver electrical stimulation to muscles in the shoulder, waist, back and arms; an optional feature that allows for ankle movement during stimulation; a remote control; dust protectors for the electrode pads; and a user interface. Replacement electrode pads are available separately under 510(k) K132588.

    Revitive IX (OTC) is a neuromuscular electrical stimulation (NMES) device that applies electrical impulses that are of sufficient intensity to produce an artificial contraction of the muscle tissue. The device delivers electrical stimulation to the lower limb muscles through foot pads and/or through electrode pads which may be positioned on the lower limb, waist, back or arms. The foot pads are made of conductive black nitrile butyl rubber (NBR) containing carbon, while the electrode pads are made from conductive carbon film coated with an adhesive hydrogel on a cloth backing. It has an optional IsoRocker™ feature that allows ankle movement during stimulation. When enabled, the lsoRocker™ allows Revitive IX (OTC) to tilt back and forth as the muscles contract and relax. The main body of the device is constructed from ABS plastic.

    The Revitive IX (OTC) is intended for multiple uses in the home environment and is not provided sterile. The software included in the device controls the pulses generated by the device to stimulate the muscle. The software allows the device to generate various different shapes of pulses with different repetition rates, duration and magnitude. The Revitive IX (OTC) utilizes standard household AC/DC power supply with a 5V DC power adaptor.

    AI/ML Overview

    The provided text describes the Revitive IX (OTC) device and its substantial equivalence to predicate devices, focusing on safety and performance, but it does not contain information about acceptance criteria or a study proving that an AI device meets acceptance criteria.

    The document is a 510(k) summary for an Over-The-Counter (OTC) powered muscle stimulator (Revitive IX), and typically these submissions demonstrate substantial equivalence to legally marketed predicate devices rather than proving performance against specific acceptance criteria for an AI algorithm.

    However, I can extract the information that is present concerning performance testing and usability studies:


    1. Table of Acceptance Criteria and Reported Device Performance

    As stated, the document does not explicitly list "acceptance criteria" in the typical sense of a target performance metric for an AI system (e.g., sensitivity, specificity, AUC). Instead, it refers to compliance with safety and biocompatibility standards and successful usability testing.

    Acceptance Criteria CategoryReported Device Performance/Compliance
    BiocompatibilityISO 10993-5 (in vitro cytotoxicity): Complied and functioned as intended, results as expected.
    ISO 10993-10 (irritation and skin sensitization): Complied and functioned as intended, results as expected.
    Safety & Essential Performance (General)BS EN 60601-1 (Medical electrical equipment): Complied and functioned as intended, results as expected.
    Electromagnetic Compatibility (EMC)BS EN 60601-1-2 (Medical electrical equipment - EMC): Complied and functioned as intended, results as expected.
    Safety (Nerve and Muscle Stimulators Specific)EN 60601-2-10 (Nerve and muscle stimulators safety): Complied and functioned as intended, results as expected.
    Safety (Home Healthcare Environment)BS EN 60601-1-11 (Home healthcare environment requirements): Complied and functioned as intended, results as expected.
    Usability/Human Factors (for OTC use)Usability study: Established that the Revitive IX (OTC) device, as labeled, is safe and effective in the hands of the intended population and suitable for Over-The-Counter use.
    Substantial Equivalence (Overall Safety & Effectiveness)Performance data (including the above) demonstrates the Revitive IX (OTC) is as safe and effective as the predicate devices.

    The following information is NOT present in the provided text, as it pertains to AI/algorithm performance studies which are not described for this device.

    1. Sample size used for the test set and the data provenance (e.g., country of origin of the data, retrospective or prospective): Not applicable (N/A) as no AI performance study is described.
    2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g., radiologist with 10 years of experience): N/A.
    3. Adjudication method (e.g., 2+1, 3+1, none) for the test set: N/A.
    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: N/A.
    5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: N/A.
    6. The type of ground truth used (expert consensus, pathology, outcomes data, etc.): N/A.
    7. The sample size for the training set: N/A.
    8. How the ground truth for the training set was established: N/A.

    Summary of what is available from the document:

    The document describes performance data primarily related to meeting established medical device safety, EMC, and biocompatibility standards (e.g., ISO and EN standards). A usability study was also conducted to demonstrate safe and effective operation by intended users in a home environment for OTC use, following FDA human factors draft guidance. The device is a "Powered Muscle Stimulator" and the "software included in the device controls the pulses generated by the device to stimulate the muscle." However, this software is for device function control, not for an AI-driven diagnostic or treatment recommendation system that would typically have the AI-specific performance metrics requested. The submission is a 510(k) for substantial equivalence, implying that its safety and effectiveness are established by comparison to existing legally marketed predicate devices, supported by compliance with relevant standards and usability testing.

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