DEKA Motus AY

K181486 · El.En Electronic Engineering Spa · GEX · Aug 30, 2018 · General, Plastic Surgery

Device Facts

• Record ID: K181486
• Device Name: DEKA Motus AY
• Applicant: El.En Electronic Engineering Spa
• Product Code: GEX · General, Plastic Surgery
• Decision Date: Aug 30, 2018
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 878.4810
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

Alexandrite 755nm laser source: Temporary hair reduction. Stable long-term or permanent hair reduction through selective targeting of melanin in hair follicles. Permanent hair reduction is defined as the long-term, stable reduction in the number of hairs regrowing when measured at 6,9, and 12 months after the completion of a treatment regime, on all skin types (Fitzpatrick I - VI) including tanned skin. Treatment of benign pigmented lesions. Treatment of wrinkles. Photocoagulation of benign dermatological vascular lesions (such as port-wine stains, hemangiomas, telangiectasias). Nd:YAG 1064nm laser source: Removal of unwanted hair, for stable long term or permanent hair reduction and for treatment of PFB . The lasers are indicated on all Skin Types Fitzpatrick I-VI including tanned skin. Photocoagulation and hemostasis of benign pigmented and benign vascular lesions, such as but not limited to port wine stains, hemangioma, warts, teleangiectasia, rosacea, venus lake, leg veins and spider veins. Coagulation and hemostasis of soft tissue. Benign pigmented lesions such as, but not limited to, lentigos (sun spots), solar lentigos (sun spots), cafe au lait macules, seborrheic keratosis, nevi, cloasma, verrucae, skin tags, keratosis and plaques. The laser is indicated for benign pigmented lesion size, for patients with lesions that would potentially benefit from aggressive treatment, and for patients with lesions that have not responded to other laser treatments. The laser is also indicated for the reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral part of the scar. Treatment of wrinkles.

Device Story

Medical laser system utilizing dual sources: 755nm Alexandrite and 1064nm Nd:YAG. Laser output delivered via lens-coupled, user-replaceable optical fiber; interchangeable handpieces feature electronic spot recognition. Operated by physician/clinician in clinical setting via footswitch or fingerswitch. Integrated and external skin cooling system (15°C) protects epidermis during treatment. Device targets melanin in hair follicles or vascular/pigmented lesions to achieve photocoagulation, hemostasis, or hair reduction. Output parameters (fluence, pulse duration, repetition rate) adjusted by clinician based on lesion type and patient skin characteristics. Clinical benefit includes stable long-term hair reduction and resolution of dermatological lesions.

Clinical Evidence

No clinical data provided. Substantial equivalence established via non-clinical bench testing and standards conformance.

Technological Characteristics

Dual-source laser (755nm Alexandrite, 1064nm Nd:YAG). Pulse duration 0.2-50ms; repetition rate up to 10Hz. Integrated/external skin cooling (15°C). Handpieces feature electronic spot recognition. Conforms to AAMI/ANSI ES60601-1, IEC 60601-1-2, IEC 60601-2-22, and IEC 60825-1.

Indications for Use

Indicated for patients of all skin types (Fitzpatrick I-VI), including tanned skin, requiring hair reduction, treatment of benign pigmented/vascular lesions, wrinkle treatment, soft tissue coagulation/hemostasis, and scar pigmentation reduction.

Regulatory Classification

Identification

(1) A carbon dioxide laser for use in general surgery and in dermatology is a laser device intended to cut, destroy, or remove tissue by light energy emitted by carbon dioxide.(2) An argon laser for use in dermatology is a laser device intended to destroy or coagulate tissue by light energy emitted by argon.

Predicate Devices

• Synchro Repla:Y family of laser systems (K150516)
• DEKA Motus AX (K162886)

Submission Summary (Full Text)

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

August 30, 2018

Elen Electronic Engineering Spa Paolo Peruzzi Regulatory Affairs Manager Via Baldanzese, 17 Calenzano, 50041 IT FI

Re: K181486

Trade/Device Name: DEKA MOTUS AY Regulation Number: 21 CFR 878.4810 Regulation Name: Laser Surgical Instrument For Use In General And Plastic Surgery And In Dermatology Regulatory Class: Class II Product Code: GEX Dated: May 31, 2018 Received: June 6, 2018

Dear Paolo Peruzzi:

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/cfpmr/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 statutes and regulations administered by other Federal agencies. You must comply with all the Act's

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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 (OS) 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 entiled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely.

# Jennifer R. Stevenson -S3

For Binita S. Ashar, M.D., M.B.A., F.A.C.S. Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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# Indications for Use

510(k) Number (if known) K181486

Device Name DEKA MOTUS AY

| Indications for Use (Describe) | |
|---------------------------------|--|
| Alexandrite 755nm laser source: | |

Alexandrite 755nm laser source:

Temporary hair reduction.

Stable long-term or permanent hair reduction through selective targeting of melanin in hair follicles. Permanent hair reduction is defined as the long-term, stable reduction in the number of hairs regrowing when measured at 6.9, and 12 months after the completion of a treatment regime, on all skin types (Fitzpatrick I - VI) including tanned skin. Treatment of benign pigmented lesions.

Treatment of wrinkles.

Photocoagulation of benign dermatological vascular lesions (such as port-wine stains, hemangiomas, telangiectasias).

#### Nd:YAG 1064nm laser source:

Removal of unwanted hair, for stable long term or permanent hair reduction and for treatment of PFB . The lasers are indicated on all Skin Types Fitzpatrick I-VI including tanned skin.

Photocoagulation and hemostasis of benign pigmented and benign vascular lesions, such as but not limited to port wine stains, hemangioma, warts, teleangiectasia, rosacea, venus lake, leg veins and spider veins.

Coagulation and hemostasis of soft tissue.

Benign pigmented lesions such as, but not limited to, lentigos (sun spots), solar lentigos (sun spots), cafe au lait macules, seborrheic keratosis, nevi, cloasma, verrucae, skin tags, keratosis and plaques.

The laser is indicated for benign pigmented lesion size, for patients with lesions that would potentially benefit from aggressive treatment, and for patients with lesions that have not responded to other laser treatments.

The laser is also indicated for the reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral part of the scar.

Treatment of wrinkles.

Type of Use (Select one or both, as applicable)

| <div> <span style="font-size: 10pt;">☑ Prescription Use (Part 21 CFR 801 Subpart D)</span> </div> |
|---------------------------------------------------------------------------------------------------|
| <div> <span style="font-size: 10pt;">☐ Over-The-Counter Use (21 CFR 801 Subpart C)</span> </div> |

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# 510(K) Summary

## DEKA Motus AY

#### Submitter:

El.En. S.p.A. Via Baldanzese, 17 50041 Calenzano (FI), Italy

## Contact:

Paolo Peruzzi Regulatory Affairs Manager & Official Correspondent Phone: [phone] E-mail: [e-mail]

## Date Summary Prepared:

August 28, 2018

Device Trade Name:

DEKA MOTUS AY

Common Name:

Medical Laser system

#### Classification Name:

Laser Surgical Instrument for use in General and Plastic Surgery and in Dermatology (GEX)

#### Classification Number:

21 CFR 878.4810

#### Predicate Devices:

Primary predicate: Synchro Repla: Y family of laser systems (K150516). Reference predicate: DEKA Motus AX (K162886)

#### Device Description:

The DEKA MOTUS A Y is a medical device equipped with two laser sources: 755nm and 1064mm. The laser sources deliver the laser output through a lens coupled user replaceable optical fiber with a wide range of interchangeable, quick release laser handpieces with electronic spot recognition. Handpiece activation is either by footswitch or fingerswitch.

#### Intended Use:

Alexandrite 755nm laser source:

Temporary hair reduction.

Stable long-term or permanent hair reduction through selective targeting of melanin in hair follicles. Permanent hair reduction is defined as the long-term, stable reduction in the number of hairs

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regrowing when measured at 6,9, and 12 months after the completion of a treatment regime, on all skin types (Fitzpatrick I - VI) including tanned skin.

Treatment of benign pigmented lesions.

Treatment of wrinkles.

Photocoagulation of benign dermatological vascular lesions (such as port-wine stains, hemangiomas, telangiectasias).

#### Nd:YAG 1064nm laser source:

Removal of unwanted hair, for stable long term or permanent hair reduction and for treatment of PFB . The lasers are indicated on all Skin Types Fitzpatrick I-VI including tanned skin. Photocoagulation and hemostasis of benign pigmented and benign vascular lesions, such as but not limited to port wine stains, hemangioma, warts, teleangiectasia, rosacea, venus lake, leg veins and spider veins.

Coagulation and hemostasis of soft tissue.

Benign pigmented lesions such as, but not limited to, lentigos, (age spots), solar lentigos (sun spots), cafe au lait macules, seborrheic keratosis, nevi, cloasma, verrucae, skin tags, keratosis and plaques.

The laser is indicated for benign pigmented lesions to reduce lesion size, for patients with lesions that would potentially benefit from aggressive treatment, and for patients with lesions that have not responded to other laser treatments.

The laser is also indicated for the reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral part of the scar.

Treatment of wrinkles.

#### Substantial equivalence discussion:

The DEKA MOTUS AY is substantially equivalent to the DEKA Synchro Repla:Y family of laser systems (K150516).

755 nm laser:

| Device Trade Name | Proposed 510(k) Device<br>DEKA MOTUS AY | Predicate Device<br>K162886<br>DEKA Motus AX | Predicate Device<br>K150516<br>DEKA Synchro Repla: Y<br>family of laser systems |
|-----------------------------------------------|---------------------------------------------|----------------------------------------------|---------------------------------------------------------------------------------|
| Laser Type | Alexandrite | Alexandrite | Alexandrite |
| Wavelength (nm) | 755 nm | 755 nm | 755 nm |
| MAX Fluence (J/cm2) | 2-200 J/cm² | 2-600 J/cm² | 2-600 J/cm² |
| Handpiece Spot Sizes<br>(diameter millimeter) | 2.5, 5, 7, 10, 12, 14, 15, 16,<br>18, 20 mm | 2.5, 5, 7, 10, 12, 14, 15, 16,<br>18, 20 mm | 2.5, 5, 7, 10, 12, 14, 15, 16,<br>18, 20, 22, 24 mm |
| Pulse Duration<br>(milliseconds) | 2 to 50 ms | 2 to 50 ms | 0.2 to 50 ms |
| Pulse Repetition Rate<br>(Hz) | up to 10 Hz | up to 10 Hz | up to 10 Hz |

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| Device Trade Name | Proposed 510(k) Device<br>DEKA MOTUS AY | Predicate Device<br>K162886<br>DEKA Motus AX | Predicate Device<br>K150516<br>DEKA Synchro Repla: Y<br>family of laser systems |
|-----------------------------|-----------------------------------------------|-----------------------------------------------|---------------------------------------------------------------------------------|
| Skin Cooling System | Yes<br>(handpiece integrated and<br>external) | Yes<br>(handpiece integrated and<br>external) | Yes<br>(handpiece integrated and<br>external) |
| Skin Cooling<br>temperature | 15°C | 15°C | 4-20°C |

1064 nm laser:

| Device Trade Name | Proposed 510(k) Device<br>DEKA MOTUS AY | Predicate Device<br>K150516<br>DEKA Synchro Repla:Y family of laser<br>systems |
|-----------------------------------------------|--------------------------------------------|--------------------------------------------------------------------------------|
| Laser Type | Nd: YAG | Nd:YAG |
| Wavelength (nm) | 1064 nm | 1064 nm |
| MAX Fluence (J/cm2) | 2-600 J/cm² | 2-600 J/cm² |
| Handpiece Spot Sizes<br>(diameter millimeter) | 2.5, 5, 7, 10, 12, 14, 15, 16, 18, 20 , mm | 2.5, 5, 7, 10, 12, 14, 15, 16, 18, 20, 22, 24<br>mm |
| Pulse Duration<br>(milliseconds) | 0.2 to 50 ms | 0.2 to 50 ms |
| Pulse Repetition Rate<br>(Hz) | up to 10 Hz | up to 10 Hz |
| Skin Cooling System | Yes<br>(handpiece integrated and external) | Yes<br>(handpiece integrated and external) |
| Skin Cooling<br>temperature | 15°C | 4-20°C |

The DEKA MOTUS AY has the same indications for use as the above mentioned predicate devices, with same principle of operation and essentially the same performances.

#### Clinical Performance Data:

None

#### Non-Clinical Performance Data:

The DEKA MOTUS AY was tested for standards conformance with the following standards:

AAMI/ANSI ES60601-1- Medical electrical equipment – Part 1: General requirements for basic safety and essential performance.

IEC 60601-1-2 - Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral Standard: Electromagnetic disturbances - Requirements and tests.

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IEC 60601-2-22 Medical electrical equipment - Part 2-22: Particular requirements for basic safety and essential performance of surgical, cosmetic, therapeutic and diagnostic laser equipment.

IEC 60825-1- Safety of laser products – Part 1: Equipment classification and requirements.

# Conclusion:

Based on the outcome of non-clinical performance data performed, we can conclude that the DEKA Motus AY laser system is substantially equivalent to the predicate devices .

#### Additional Information:

None