The HORIZON™ TMS Therapy System is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from prior antidepressant medication in the current episode.
Device Story
The HORIZON TMS Therapy System is a computerized, electromechanical device for non-invasive cortical stimulation. It delivers brief, rapidly alternating (pulsed) magnetic fields to induce electrical currents in the prefrontal cortex. The system comprises a stimulator, user interface, power supply, stimulating coils (MT Remote, AFC, E-z Cool), and coil holding mechanisms. Used in clinical settings (physicians' offices, clinics, hospitals) under physician supervision. The operator uses a touchscreen interface to control the mainframe, which charges a high-voltage capacitor to discharge pulses through the coil. The system allows for adjustable inter-train intervals (11-26 seconds), reducing treatment time to a minimum of 18.8 minutes. The device assists in treating Major Depressive Disorder by stimulating cortical neurons, potentially benefiting patients who have not responded to medication.
Clinical Evidence
Bench testing only. Compliance with IEC 60601-1 (electrical/mechanical safety) and EN 60601-1-2 (EMC) demonstrated. Biocompatibility of coils verified per ISO 10993-1. Magnetic field characteristics were tested and found equivalent to the primary predicate. Software verification and validation confirmed performance per specifications. Risk management conducted per ISO 14971.
Technological Characteristics
Electromechanical system; air-core stimulating coils; high-voltage discharge capacitor; touchscreen LCD interface. Connectivity: standalone. Standards: IEC 60601-1 (safety), EN 60601-1-2 (EMC), ISO 10993-1 (biocompatibility), ISO 14971 (risk). Software level of concern: moderate.
Indications for Use
Indicated for treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from prior antidepressant medication in the current episode.
Regulatory Classification
Identification
A repetitive transcranial magnetic stimulation system is an external device that delivers transcranial repetitive pulsed magnetic fields of sufficient magnitude to induce neural action potentials in the prefrontal cortex to treat the symptoms of major depressive disorder without inducing seizure in patients who have failed at least one antidepressant medication and are currently not on any antidepressant therapy.
Special Controls
*Classification.* Class II (special controls). The special control is FDA's “Class II Special Controls Guidance Document: Repetitive Transcranial Magnetic Stimulation System.” See § 882.1(e) for the availability of this guidance document.
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August 3, 2018
Magstim Company Ltd. Tom Campbell Regulatory Affairs Manager Spring Gardens Whitland, Camarthenshire Wales, UK SA34 0HR
Re: K180907
Trade/Device Name: HORIZON TMS Therapy System Regulation Number: 21 CFR 882.5805 Regulation Name: Repetitive Transcranial Magnetic Stimulation System Regulatory Class: Class II Product Code: OBP Dated: July 2, 2018 Received: July 5, 2018
Dear Tom Campbell:
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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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
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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); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.html; good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803). please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm.
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Sincerelv.
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for Carlos L. Peña, PhD, MS Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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# Indications for Use
510(k) Number (if known) K180907
Device Name HORIZON™ TMS Therapy System
#### Indications for Use (Describe)
The HORIZON™ TMS Therapy System is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from prior antidepressant medication in the current episode.
| Type of Use (Select one or both, as applicable) |
|-------------------------------------------------|
|-------------------------------------------------|
| <div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <input checked="true" type="checkbox"/> </div></td><td><div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div></td></tr></table> </div></td></tr></table> </div></td></tr></table> </div></td><td><div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <input type="checkbox"/> </div></td><td><div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div></td></tr></table> </div></td></tr></table> </div></td></tr></table> </div></td></tr></table> </div> | <div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <input checked="true" type="checkbox"/> </div></td><td><div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div></td></tr></table> </div></td></tr></table> </div></td></tr></table> </div> | <div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <input checked="true" type="checkbox"/> </div></td><td><div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div></td></tr></table> </div></td></tr></table> </div> | <div> <table border="0"><tr><td><div> <input checked="true" type="checkbox"/> </div></td><td><div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div></td></tr></table> </div> | <div> <input checked="true" type="checkbox"/> </div> | <div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div> | <div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <input type="checkbox"/> </div></td><td><div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div></td></tr></table> </div></td></tr></table> </div></td></tr></table> </div> | <div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <input type="checkbox"/> </div></td><td><div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div></td></tr></table> </div></td></tr></table> </div> | <div> <table border="0"><tr><td><div> <input type="checkbox"/> </div></td><td><div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div></td></tr></table> </div> | <div> <input type="checkbox"/> </div> | <div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div> |
|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------|---------------------------------------------------------|
| <div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <input checked="true" type="checkbox"/> </div></td><td><div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div></td></tr></table> </div></td></tr></table> </div></td></tr></table> </div> | <div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <input checked="true" type="checkbox"/> </div></td><td><div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div></td></tr></table> </div></td></tr></table> </div> | <div> <table border="0"><tr><td><div> <input checked="true" type="checkbox"/> </div></td><td><div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div></td></tr></table> </div> | <div> <input checked="true" type="checkbox"/> </div> | <div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div> | <div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <input type="checkbox"/> </div></td><td><div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div></td></tr></table> </div></td></tr></table> </div></td></tr></table> </div> | <div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <input type="checkbox"/> </div></td><td><div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div></td></tr></table> </div></td></tr></table> </div> | <div> <table border="0"><tr><td><div> <input type="checkbox"/> </div></td><td><div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div></td></tr></table> </div> | <div> <input type="checkbox"/> </div> | <div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div> | |
| <div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <input checked="true" type="checkbox"/> </div></td><td><div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div></td></tr></table> </div></td></tr></table> </div> | <div> <table border="0"><tr><td><div> <input checked="true" type="checkbox"/> </div></td><td><div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div></td></tr></table> </div> | <div> <input checked="true" type="checkbox"/> </div> | <div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div> | | | | | | | |
| <div> <table border="0"><tr><td><div> <input checked="true" type="checkbox"/> </div></td><td><div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div></td></tr></table> </div> | <div> <input checked="true" type="checkbox"/> </div> | <div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div> | | | | | | | | |
| <div> <input checked="true" type="checkbox"/> </div> | <div> <span>Residential Use (Part 21 CFR 601 Subpart D)</span> </div> | | | | | | | | | |
| <div> <table border="0"><tr><td><div> <table border="0"><tr><td><div> <input type="checkbox"/> </div></td><td><div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div></td></tr></table> </div></td></tr></table> </div> | <div> <table border="0"><tr><td><div> <input type="checkbox"/> </div></td><td><div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div></td></tr></table> </div> | <div> <input type="checkbox"/> </div> | <div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div> | | | | | | | |
| <div> <table border="0"><tr><td><div> <input type="checkbox"/> </div></td><td><div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div></td></tr></table> </div> | <div> <input type="checkbox"/> </div> | <div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div> | | | | | | | | |
| <div> <input type="checkbox"/> </div> | <div> <span>OTC Cosmetic Use (21 CFR 331)</span> </div> | | | | | | | | | |
> Prescription Use (Part 21 CFR 801 Subpart D)
| | Over-The-Counter Use (21 CFR 801 Subpart C)
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## 510(k) SUMMARY Magstim's HORIZON®TMS Therapy System
#### Submitter's Name, Address, Telephone Number, Contact Person and Date Prepared
Magstim Company Limited Spring Gardens, Whitland, Carmarthenshire SA34 0HR, United Kingdom
Phone: +44 (0) 1994 240798 Facsimile: +44 (0) 1994 240061
Contact Person: Tom Campbell
Date Prepared: July 30, 2018
#### Name of Device
HORIZON® TMS Therapy System
#### Common or Usual Name/
Repetitive Transcranial Magnetic Stimulation (rTMS) System
#### Classification
Repetitive Transcranial Magnetic Stimulation (rTMS) System
21 C.F.R. § 882.5805, Class II, product code OBP
### Predicate Devices
HORIZON® Therapy System, The Magstim Company Limited. (K171051) (Primary Predicate) NeuroStar TMS Therapy System, Neuronetics, Inc. (K160703) (Secondary Predicate) Neurosoft TMS, TeleEMG, LLC. (K173441) (Secondary Predicate)
### Device Description
The HORIZON® TMS Therapy System is a computerized, electromechanical medical device that produces and delivers non-invasive, magnetic stimulation using brief duration rapidly alternating, or pulsed, magnetic fields to induce electrical currents directed at spatially discrete regions of the cerebral cortex. This method of cortical stimulation by application of brief magnetic pulses to the head is known as Transcranial Magnetic Stimulation.
The HORIZON® TMS Therapy System is a non-invasive tool for the stimulation of cortical neurons for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from antidepressant medication in the current episode. The HORIZON® TMS Therapy System is used for patient treatment by prescription only under the supervision of a licensed physician. It can be used in both inpatient settings, including physicians' offices, clinics, and hospitals.
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The HORIZON® TMS Therapy System is an integrated system consisting of a combination of hardware, software, and accessories. Its technological characteristics are described in further detail below.
## Intended Use / Indications for Use
The HORIZON® TMS Therapy System is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from prior antidepressant medication in the current episode.
## Technological Characteristics
The HORIZON® TMS Therapy System is comprised of the following components:
- 1. HORIZON® Stimulator
- a. HORIZON® User Interface:
- b. HORIZON® Mainframe;
- c. HORIZON® Power Supply:
- d. Accessory Cables;
- e. Accessory Footswitch.
- 2. Coil for MT Determination
- a. HORIZON® MT Remote Coil.
- 3. Coil(s) for Treatment
- a. HORIZON® AFC;
- b. HORIZON® E-z Cool Coil.
- 4. Accessory Cart(s) and Coil Holding Mechanism(s)
- a. Magstim® Trolley;
- b. Magstim® Coil Stand(s):
- c. HORIZON® E-z Cart;
- d. HORIZON® E-z Arm.
- 5. Accessory Marking Apparatus
- a. TMS Patient Caps.
The operator controls the HORIZON® TMS Therapy System via the HORIZON® User Interface, using a graphic LCD panel with touchscreen technology. The operator instructions, given through the HORIZON® User Interface, direct the HORIZON® Mainframe in charging and discharging the device's high voltage discharge capacitor. The discharge is delivered to the patient via the stimulating coil. Motor threshold level can be determined using the HORIZON® MT Remote Coil. Treatment is delivered to the treatment area via either the HORIZON® AFC or the HORIZON® E-z Cool Coil, which is positioned above the treatment area. Positioning, and fixation, of the coil over the treatment area is accomplished using the Coil Holding Mechanism(s). The HORIZON® Power Supply provides power to charge the high voltage capacitor in the HORIZON® Mainframe.
Software documentation for a "moderate" level of concern has been provided.
### Non-Clinical Testing
Electrical safety and electromagnetic compatibility ("EMC") testing was conducted on the system to demonstrate that the device is compliant with IEC 60601-1 (Ed. 3.1.) and EN 60601-1-2 (2007). Environmental testing also demonstrated compliance with IEC 60601-1.
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EN 60601-1-2 (2007) is not an FDA recognized standard and hence a justification of its equivalence to the appropriate FDA recognized standard for its acceptance has been provided.
The biocompatibility evaluation demonstrated that the stimulation coils meet ISO 10993-1 (2009) standards. In addition, acoustic output measurements have been conducted during IEC 60601-1 (Ed. 3.1) testing to demonstrate safety and performance.
The software verification and validation testing further demonstrated that the software performs as intended and in accordance with specifications. The potential risks of HORIZON® TMS Therapy System have been identified and evaluated in compliance with ISO14971, and the risks were determined to be acceptable, or have been addressed with risk control measures.
As required by FDA's Guidance Document titled "Class II Special Controls Guidance Document: Repetitive Transcranial Magnetic Stimulation (rTMS) Systems", non-clinical testing of the HORIZON® TMS Therapy System included testing of the magnetic field characteristics of the system. The results of this testing demonstrate that the magnetic field characteristics of the HORIZON® TMS Therapy System is substantially equivalent to the primary predicate device, the HORIZON® Therapy System (K171051).
#### Substantial Equivalence
The HORIZON® TMS Therapy System is substantially equivalent to the primary predicate device, the HORIZON® Therapy System (K171051).
The HORIZON® TMS Therapy System and the primary predicate device (K171051) have identical intended use and indications for use, equivalent principles of operation, as well as the same key technological characteristics.
The technological difference between the HORIZON® TMS Therapy System and the HORIZON® Therapy System (K171051), includes the addition of the HORIZON® E-z Cool Coil, HORIZON® E-z Cart and HORIZON® E-z Arm. These changes raise no new issues of safety or effectiveness. Performance data demonstrates that the HORIZON® TMS Therapy System is as safe and effective as the primary predicate device.
The design of the HORIZON® TMS Therapy System is substantially equivalent to the design of the primary predicate device (K171051), as both systems are based on applying transcranial magnetic stimulation by means of repetitive pulse trains at a predetermined frequency. Both systems use the same mechanism of action, i.e., an electromechanical instrument that produces and delivers brief duration, rapidly alternating (pulsed) magnetic fields to induce electrical currents in localized regions of the prefrontal cortex.
The principles of operation of the HORIZON® TMS Therapy System is equivalent to the HORIZON® Therapy System (K171051). The modification to the device allows a range of inter-train intervals from 11 to 26 seconds, rather than the fixed 26 second duration, which allows a reduction in treatment time from 37.5 minutes to a minimum of 18.8 minutes. The change to this output stimulation parameter is identical to the secondary predicate device, the NeuroStar TMS Therapy System (K160703).
Transcranial magnetic stimulation is enabled in the HORIZON® TMS Therapy System and in the HORIZON® Therapy System (K171051), as both have the same key system
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components, consisting of electromagnetic coils, a coil holding mechanism, a TMS stimulator and software. The operation procedure is the same in both the HORIZON® TMS Therapy System and the HORIZON® Therapy System (K171051), consisting of system setup, patient preparation, determination of patients' motor threshold, coil position, and administration of treatment at pre-defined treatment stimulation parameters.
The basic software capabilities related to treatment administration are the same as the primary predicate, the HORIZON® Therapy System (K171051). A notable difference is that the arbitrary upper limit imposed by software for the maximum number of pulses per session (cumulative exposure) has been increased from 6000 to 60,000 in the HORIZON® TMS Therapy System. This is supported by TeleEMG, LLC's Neurosoft TMS (K173441) that is capable of delivering a maximum of 72,000.
The HORIZON® TMS Therapy System meets the same electrical and mechanical safety standards (IEC 60601-1) and the same EMC standards (EN 60601-1-2).
The similarities and minor differences between the HORIZON® TMS Therapy System, the HORIZON® Therapy System (Primary Predicate), the NeuroStar TMS Therapy System (Secondary Predicate) and the Neurosoft TMS (Secondary Predicate) are described in Table 1.
#### Conclusions
In summary, the intended use and indications for use for the HORIZON® TMS Therapy System and primary predicate device, The HORIZON® Therapy System (K171051) are identical.
Furthermore, the key technological characteristics and principles of operation, including basic design, mechanism of action, specifications and treatment procedure are substantially equivalent.
Non-clinical test data demonstrates that the HORIZON® TMS Therapy System is as safe and effective as the HORIZON® Therapy System (K171051).
Thus, the HORIZON® TMS Therapy System is considered substantially equivalent to the primary predicate device, the HORIZON® Therapy System (K171051).
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## Table 1: Substantial Equivalence Summary
| Criteria | HORIZON® TMS Therapy System<br>(Subject of this submission) | HORIZON® Therapy<br>System<br>(K171051)<br>(Primary Predicate) | NeuroStar TMS<br>Therapy System<br>(K160703)<br>(Secondary<br>Predicate) | Neurosoft TMS<br>(K173441)<br>(Secondary Predicate) | Sessions/week | 5 | | 5 | | 5 | 5 | |
|--------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------|-------------------------------------|---------------------------|----------------------------------------|----------------------------|----------------------------------------|----------------------------------------|-----------------------------------------------------------------------------------------------------------------|
| Manufacturer | Magstim Company Limited | Magstim Company Limited | Neuronetics Inc. | TeleEMG, LLC | Treatment Schedule | 5 daily sessions for 6 weeks | | 5 daily sessions for 6 weeks | | 5 daily sessions for 6<br>weeks | 5 daily sessions for 6<br>weeks | |
| Device Name | HORIZON® Therapy System | HORIZON® Therapy System | NeuroStar TMS<br>Therapy System | Neurosoft TMS | Area of brain to be<br>stimulated | Left Dorsolateral Prefrontal Cortex | | Left Dorsolateral Prefrontal<br>Cortex | | Left Dorsolateral<br>Prefrontal Cortex | Left Dorsolateral<br>Prefrontal Cortex | |
| Clearance date | | 09/13/2017 | 06/10/2016 | 12/13/2017 | | HORIZON®<br>MT Remote<br>Coil | HORIZON®<br>E-z Cool Coil | HORIZON®<br>AFC | HORIZON®<br>MT Remote Coil | HORIZON®<br>AFC | NeuroStar Stimulating<br>Coil | FEC-02-100-C, AFEC-<br>02-100-C<br>FEC-02-100 (optional),<br>AFEC-02-100 (optional) |
| 510(k) number | | K171051 | K160703 | K173441 | Waveform | Biphasic | Biphasic | Biphasic | Biphasic | Biphasic | Biphasic | Biphasic |
| Device code | OBP | OBP | OBP | OBP | Core Material | Air | Air | Air | Air | Air | Ferromagnetic core | Air |
| Intended Use/<br>Indications for Use | The HORIZON® TMS Therapy System is indicated for the<br>treatment of Major Depressive Disorder in adult<br>patients who have failed to achieve satisfactory<br>improvement from prior antidepressant medication in<br>the current episode. | The HORIZON® Therapy System is<br>indicated for the treatment of Major<br>Depressive Disorder in adult<br>patients who have failed to achieve<br>satisfactory improvement from prior<br>antidepressant medication in the<br>current episode. | The NeuroStar TMS<br>Therapy System is indicated<br>for the treatment of Major<br>Depressive Disorder in<br>adult patients who have<br>failed to achieve<br>satisfactory improvement<br>from prior antidepressant<br>medication in the current<br>episode. | The Neurosoft TMS is indicated<br>for the treatment of Major<br>Depressive Disorder in adult<br>patients who have failed to<br>achieve satisfactory<br>improvement from prior<br>antidepressant medication in<br>the current episode. | Pulse Width | 330μs | 340μs | 300μs | 330μs | 300μs | 185μs | 280μs |
| Magnetic Field<br>Intensity | 120% of the MT | 120% of the MT | 120% of the MT | 120% of the MT | Amplitude in SMT units<br>(Standard Motor Threshold) | 0.28 - 1.9 | | 0.28 - 1.9 | | 0.22 - 1.6 | | FEC-02-100-C 0-1.89<br>AFEC-02-100-C 0-2.38<br>FEC-02-100 0-1.92<br>AFEC-02-100 0-2.33 |
| Stimulus Frequency | 10 Hz | 10 Hz | 10 Hz | 10 Hz | Frequency range (Hz)<br>at 100% | | 1 - 20 | | 1 - 20 | | 0.1-30 | 0.1-30 (stand-alone)<br>0.1-100 (with PC) |
| Stimulus Train duration | 4 sec | 4 sec | 4 sec | 4 sec | Pulse train duration<br>range (sec) | | 0.1 - 600 | | 0.1 - 600 | | 1-20 | 0.5 - 100 |
| Inter-train interval | 11-26 sec | 26 sec | 11-26 sec | 11-26 sec | Inter-train interval range<br>(sec) | | 1 - 540 | | 1 - 540 | | 10-60 | 0 - 300 |
| Number of trains | 75 | 75 | 75 | 75 | Maximum # of pulses<br>per session<br>(cumulative exposure) | | 60000 | | 6000 | | 5000 | 72000 (Stand-alone) =<br>2400 s [max session]<br>*30Hz<br>240000 (with PC) =<br>2400 s [max session] *<br>100Hz |
| Magnetic Pulses per<br>Session | 3000 | 3000 | 3000 | 3000 | Maximum output<br>amplitude (V/m) at a<br>depth of 2cm below the<br>coil surface | | 150 V/m | | 150 V/m | | 135V/m nominal | Not disclosed by<br>Manufacturer |
| Treatment Session<br>Duration | 18.8 min-37.5 min | 37.5 min | 18.8 min – 37.5 min | 18.8 min-37.5 min | | | | | | | | |
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1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.