ML830 LASER SYSTEM

K041364 · Microlight Corporation of America · ILY · Dec 13, 2004 · Physical Medicine

Device Facts

• Record ID: K041364
• Device Name: ML830 LASER SYSTEM
• Applicant: Microlight Corporation of America
• Product Code: ILY · Physical Medicine
• Decision Date: Dec 13, 2004
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 890.5500
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

MicroLight Corporation of America's “ML830®d” is an infrared lamp that is indicated for use to emit energy in the infrared spectrum to provide topical heating for the purpose of elevating tissue temperature: for the temporary relief of minor muscle and joint pain, arthritis and muscle spasm; relieving stiffness; promoting relaxation of muscle tissue; and to temporarily increase local blood circulation where applied.

Device Story

ML830®d is a hand-held, non-invasive infrared lamp; weight approximately 0.5 pounds; surface area 34 square centimeters. Device utilizes 12 light-emitting diodes (660 nm) and 12 infrared diodes (880 nm) with total power output of approximately 500 milliwatts. Device provides topical heating to elevate tissue temperature. Used for temporary relief of minor muscle/joint pain, arthritis, muscle spasm, stiffness, and to promote muscle relaxation and increase local blood circulation. Operated by clinician or patient for home use. Output is thermal energy delivered to the skin surface; healthcare provider uses device to provide therapeutic heat; patient benefits from symptomatic relief of pain and stiffness.

Clinical Evidence

No clinical data provided; substantial equivalence is based on identical technological characteristics to the predicate device.

Technological Characteristics

Hand-held infrared lamp; 12 light-emitting diodes (660 nm) and 12 infrared diodes (880 nm); total power output ~500 mW; surface area 34 sq cm; non-invasive; electrical energy source.

Indications for Use

Indicated for patients requiring topical heating for temporary relief of minor muscle and joint pain, arthritis, muscle spasm, stiffness, muscle relaxation, and temporary increase of local blood circulation.

Regulatory Classification

Identification

An infrared lamp is a device intended for medical purposes that emits energy at infrared frequencies (approximately 700 nanometers to 50,000 nanometers) to provide topical heating.

Special Controls

*Classification.* Class II (special controls). The device, when it is an infrared therapeutic heating lamp, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 890.9.

Predicate Devices

• Dio LFT 3000 (K022888)

Submission Summary (Full Text)

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041364 1/2

# 510(k) PREMARKET NOTIFICATION SUMMARY (per 21 CFR 807.92)

### ML830®d - PRELIMINARY STATEMENT

# The ML830®d

Applicant seeks market clearance for a device that is already cleared by another applicant, Light Force Therapy, Inc. under K022888. However, Applicant seeks the right to market that same device without making reference to the original applicant or its labeling.

#### I. Applicant:

DEC 1 3 2004

MicroLight Corporation of America 2935 Highland Lakes Drive Missouri City, Texas 77459

| Contact Person: | Fred A. Simpson, Esq.<br>c/o Jackson Walker L.L.P.<br>713-752-4248 telephone<br>713-752-4221 facsimile<br>e-mail [e-mail] |
|-----------------|----------------------------------------------------------------------------------------------------------------------------------|
|-----------------|----------------------------------------------------------------------------------------------------------------------------------|

September 22, 2004 Date Prepared:

#### II. Device Name

| Proprietary Name: | ML830®d |
|----------------------|--------------------------------|
| Common / Usual Name: | Infrared Lamp |
| Classification Name: | Infrared Lamp (21 CFR 890.550) |
| Product Code: | NHN |

#### III. Predicate Device

The ML830 d is substantially equivalent to the Dio LFT 3000 cleared by the Agency under K022888. The manufacturer of the Dio LFT 3000 has agreed to supply MicroLight Corporation of America with the Dio LFT 3000 units which MicroLight will specifically label with the designation “ML830®d” and publish and distribute with independent sales literature and instructions for use.

#### IV. Intended Use of the Device

The MicroLight ML830 d contains infrared lamps that are indicated for use to emit energy in the infrared spectrum to provide topical heating for the purpose of elevating tissue temperature: for the temporary relief of minor muscle and joint

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pain, arthritis and muscle spasm; relieving stiffness; promoting relaxtion of pain, artifitis and inuscle spassily increase local blood circulation where applied.

### Description of the Device V.

The ML830®d is an innovative, safe, easy to use, hand-held, non-invasive device The ML830 u is an innovative, sare, easy es approximately % pound and has a designed for in-nonic use. "The device worgine upper of these (34 square centimeters).

The ML830®d contains 12 light emitting diodes and 12 infrared diodes with The NILGSV a commits TF ingile change
wavelengths of 660 nanometers, and 880 nanometers, respectively, with total or waverongais of approximately 500 milliwatts.

### Summary of the technical characteristics of the ML830®d to the referenced VI. predicate devices.

The ML830®d is identical to the Dio LFT 3000 marketed by Light Force Therapy, Inc. Therefore, the ML830®d has identical technological characteristics Therapy, Inc. Therefore, the ML830®d has features... ...regarding safety as the predicate device. The only difference is that the ML830®d will be marketed under MicroLight's brand name.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Image /page/2/Picture/2 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of an eagle or bird-like figure with three curved lines representing its body and wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the bird-like figure.

DEC 1 3 2004

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MicroLight Corporation of America c/o Mr. Fred A. Simpson, Esq. Jackson Walker L.L.P. 1401 McKinney Street, Suite 1900 Houston, Texas 77010

Re: K041364

Trade/Device Name: ML830®d Regulation Number: 21 CFR 890.5500 Regulation Name: Infrared lamp Regulatory Class: II Product Code: ILY Dated: September 22, 2004 Received: September 23, 2004

Dear Mr. Simpson:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your becamed the device is substantially equivalent (for the indications ferenced about and in sure) to legally marketed predicate devices marketed in interstate for use stated in the encreations) (3 tegain) and entirent date of the Medical Device Amendments, or to conmision to Frid 11125 20, 2017, 11:11
devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, de nees that have been require approval of a premarket approval application (PMA). and Costhele Fee (. 10) may the device, subject to the general controls provisions of the Act. The r ou may, cherefore, mains of the Act include requirements for annual registration, listing of genoral ocharitis proficturing 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 If your device is exastinon (tional controls. Existing major regulations affecting your device can may or babyes to and was a made as a legulations, 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 r lease of action that i Dry over device complies with other requirements of the Act that I Dr has Interves and regulations administered by other Federal agencies. You must of any I cacial stututes and regaranents, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set Orth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic forul in and quinn control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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Page 2 - Mr. Fred A. Simpson, Esq.

This letter will allow you to begin marketing your device as described in your Section 510(k) I mis letter will and w yourse organ finding of substantial equivalence of your device to a legally premailed predicated on "The 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 if you desire specific advisional [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small other genoral 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

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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### APPENDIX B

## STATEMENT OF INDICATIONS FOR USE

K041364 510(k) Number:

ML830®d Device Name:

- Indications for Use: MicroLight Corporation of America's “ML830®d” is an infrared lamp that is indicated for use to emit energy in the infrared spectrum to provide topical heating for the purpose of elevating tissue temperature: for the temporary relief of minor muscle and joint pain, arthritis and muscle spasm; relieving stiffness; promoting relaxation of muscle tissue; and to temporarily increase local blood circulation where applied.
(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

YES OR Prescription Use: (Per 21 CFR 801.109)

Over the Counter Use: (Optional Format 1-2-96)

Muriam C. Provost

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

(Division Sign-Off)

510(k) Number K041364

510(k) Number K041364

ML830 d 510(k) Premarket Notification, September 22, 2004