THERMACOOL TC SYSTEM

K030142 · Thermage, Inc. · GEI · Feb 3, 2003 · General, Plastic Surgery

Device Facts

• Record ID: K030142
• Device Name: THERMACOOL TC SYSTEM
• Applicant: Thermage, Inc.
• Product Code: GEI · General, Plastic Surgery
• Decision Date: Feb 3, 2003
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 878.4400
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The ThermaCool TC System is indicated for use in - Non-invasive treatment of periorbital rhytids and wrinkles . - Dermatologic and general surgical procedures for electrocoagulation and . hemostasis.

Device Story

The ThermaCool TC System is an electrosurgical device used for tissue coagulation and hemostasis, as well as non-invasive treatment of periorbital rhytids and wrinkles. The system utilizes high-frequency electrical current to achieve its clinical effects. This specific submission covers a modification to the system's accessory, specifically a reformulated coupling fluid. The device is intended for use by healthcare professionals in clinical settings. The system operates by delivering RF energy to target tissues; the coupling fluid facilitates the interface between the device and the skin. The device is substantially equivalent to previous iterations of the ThermaCool TC System, with the modification limited to the accessory component.

Clinical Evidence

No clinical data provided. The submission relies on the substantial equivalence of the modified accessory to the predicate devices.

Technological Characteristics

Electrosurgical cutting and coagulation device. Utilizes high-frequency electrical current. Accessory includes a reformulated coupling fluid. Manufacturing follows in-house Standard Operating Procedures and QSR-based vendor qualification. No FDA-mandated performance standards apply.

Indications for Use

Indicated for non-invasive treatment of periorbital rhytids and wrinkles, and for dermatologic and general surgical procedures requiring electrocoagulation and hemostasis.

Regulatory Classification

Identification

An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.

Predicate Devices

• ThermaCool TC System (K013639)
• ThermaCool TC System (K021402)

Submission Summary (Full Text)

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030142

## 510(k) Premarket Notification

Summary of Safety and Effectiveness Information

### ThermaCool TC SYSTEM JANUARY 14, 2003

ThermaCool TC System Device Name:

Common Name(s): RF Unit, coagulator

Classification Name: Electrosurgical cutting and coagulation device and accessories

#### Establishment Name & Registration Number:

Name: Thermage Number: 2954746

#### Classification:

Title 21, Code of Federal Regulations,

\$ 878.4400 Electrosurgical cutting and coagulation device and accessories. (a) Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current. (b) Classification. Class II.

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ProCode: 79GEI

#### Equivalent Device(s):

The modified ThermaCool TC System accessory claims substantial equivalence to the ThermaCool TC System K013639 and K021402.

#### Description of the Device:

The device as described in the above referenced Premarket Notifications has been modified to include a reformulated Coupling Fluid.

#### Applicant / Sponsor Name / Address:

Thermage 4058 Point Eden Way Hayward, CA 94545-3721 510.782.2286 telephone [phone] fax

#### Contact Person:

Pamela M. Buckman, R.N., M.S. Thermage 4058 Point Eden Way Hayward, CA 94545-3721 510.782.2286 telephone [phone] fax

#### Submission Correspondent:

Pamela M. Buckman, R.N., M.S. Thermage 4058 Point Eden Way Hayward, CA 94545-3721 510.782.2286 telephone [phone] fax

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K030142 2/2

#### Manufacturing Facility:

At the present time, this ThermaCool TC System accessory is contract manufactured according to Thermage specifications.

#### Performance Standards:

: 上一篇:

There are no applicable FDA mandated performance standards for electrosurgical cutting and coagulation device and accessories. However, voluntary standards such as in-house Standard Operating Procedures and QSR based vendor qualification procedures are in place and utilized in the production of the device.

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Image /page/2/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized image of an eagle's head with three profiles within the head. The text "DEPARTMENT FOR HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the eagle's head.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

# FEB 0 3 2003

Thermage, Inc. Pamela M. Buckman, R.N., M.S. 4058 Point Eden Way Hayward, California 94545-3721

Re: K030142

Trade/Device Name: ThermaCool TC System Regulation Number: 878:4400 Regulation Name: Electrosurgical cutting and coagulation device and accessories Regulatory Class: Class II Product Code: GEI Dated: January 14, 2003 Received: January 15, 2003

Dear Ms. Buckman:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices 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) that do not require approval of a premarket approval application (PMA), 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. Iisting of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), 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 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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Page 2 -- Ms. Pamela M. Buckman

This letter will allow you to begin marketing your device as described in your Section 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), please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address

http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Miriam C. Provost

for Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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510(k) NUMBER: Ko 3014L

DEVICE NAME: ThermaCool TC System

INDICATIONS FOR USE:

.

The ThermaCool TC System is indicated for use in

- Non-invasive treatment of periorbital rhytids and wrinkles .
- Dermatologic and general surgical procedures for electrocoagulation and . hemostasis.

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NECESSARY Concurrence of CDRH, Office of Device Evaluation (ODE)

**Prescription Use**
(Per 21 CFR 801.109) /

OR

Over-The-Counter Use ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------(Optional format 1-2-96)

ThermaCool510.doc

. vision Sign-Off) Division of General, Restorative and Neurological Devices

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MONITOR K030142