K220122 · Rf Innovations, Inc. · GXD · Mar 15, 2023 · Neurology
Device Facts
Record ID
K220122
Device Name
APEX 6
Applicant
Rf Innovations, Inc.
Product Code
GXD · Neurology
Decision Date
Mar 15, 2023
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 882.4400
Device Class
Class 2
Attributes
Therapeutic
Indications for Use
Intended for use for lesioning of neural tissue and for pain management. It is indicated for use in the peripheral nervous system. The APEX 6 is to be used with LCCS electrodes and cannulae and Conmed Thermogard Dispersive Electrodes.
Device Story
Desktop RF lesioning generator; 6-channel; provides continuous or pulsed RF output at 460 kHz; supports monopolar or dual (bipolar) electrode modes. Used for neural tissue lesioning and pain management. Features touch screen monitor, microprocessor, self-diagnostics, calibration checks, and recordkeeping. Physician-operated in clinical settings. Inputs include electrode impedance/temperature data; device transforms inputs via microprocessor control to deliver RF energy to neural tissue. Output is controlled RF energy for lesioning; sensory/motor stimulation functions assist in electrode placement. Benefits include precise neural tissue lesioning for pain management.
Clinical Evidence
Bench testing only. No clinical data required. Bench testing included electrical safety (ANSI/AAMI 60601-1, 60601-2-2), EMC (IEC 60601-1-2), lesion size comparison, and treatment time efficiency compared to the predicate device.
Technological Characteristics
Desktop RF generator; 6 channels; 460 kHz RF output; 50W max power (100 ohm load). Touchscreen interface; microprocessor-controlled. Compliant with ANSI/AAMI 60601-1, 60601-2-2, and IEC 60601-1-2. Sterilization not applicable (generator unit).
Indications for Use
Indicated for lesioning of neural tissue and pain management in the peripheral nervous system. Used with LCCS electrodes/cannulae and Conmed Thermogard Dispersive Electrodes.
Regulatory Classification
Identification
A radiofrequency lesion generator is a device used to produce lesions in the nervous system or other tissue by the direct application of radiofrequency currents to selected sites.
Predicate Devices
NeuroTherm NT 2000 RF Lesioning Generator (K111576)
Thermogard & Thermogard Plus ABC dispersive electrodes (K140658)
Submission Summary (Full Text)
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March 15, 2023
RF Innovations, Inc % Daniel Kamm Principal Engineer Kamm & Associates 8870 Ravello Ct Naples, Florida 34114
Re: K220122
Trade/Device Name: Apex 6 Regulation Number: 21 CFR 882.4400 Regulation Name: Radiofrequency Lesion Generator Regulatory Class: Class II Product Code: GXD Dated: April 27, 2022 Received: April 28, 2022
Dear Daniel Kamm:
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 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/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); 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 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.
For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
Digitally signed am D. bv Adam D. Pierce -S Pierce -Spate: 2023.03.15 13:24:54 -04'00'
Adam D. Pierce, Ph.D. Assistant Director DHT5A: Division of Neurosurgical, Neurointerventional and Neurodiagnostic Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health
Enclosure
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# Indications for Use
510(k) Number (if known) K220122
Device Name APEX 6
Indications for Use (Describe)
Intended for use for lesioning of neural tissue and for pain management. It is indicated for use in the peripheral nervous system. The APEX 6 is to be used with LCCS electrodes and cannulae and Conmed Thermogard Dispersive Electrodes.
Type of Use (Select one or both, as applicable)
X Prescription Use (Part 21 CFR 801 Subpart D)
Over-The-Counter Use (21 CFR 801 Subpart C)
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### 510(k) Summary K220122
## Date Prepared: March 10, 2023
| SUBMITTED BY: | RF Innovations, Inc<br>Middleton, MA 01940 |
|--------------------------------------|----------------------------------------------------------------|
| CONTACT: | William Rittman, Director.<br>RF Innovations, Inc |
| | Middleton, MA 01949 |
| | 781-640-1212 |
| DEVICE NAME: | APEX 6 Lesioning Generator |
| Regulation Number: | 21 CFR 882.4400 |
| Regulation Name: | Radiofrequency Lesion Generator |
| Regulatory Class: | II |
| Product Code: | GXD |
| PREDICATE DEVICE: | K111576 |
| DEVICE NAME: | NeuroTherm NT 2000 RF Lesioning Generator |
| Regulation Number: | 21 CFR 882.4400 |
| Regulation Name: | Radiofrequency Lesion Generator |
| Regulatory Class: | II |
| Product Code: | GXD |
| Reference Devices: | Compatible electrodes: |
| 510(k) number: | K191293 |
| Trade/Device Name: | LCCS RF Cannula |
| Regulation Number: | 21 CFR 882.4725 |
| Regulation Name: | Radiofrequency Lesion Probe |
| Regulatory Class: | Class II |
| Product Code: | GXI |
| 510(k) number: | K152642 |
| Trade/Device Name: | LCCS Radiofrequency (RF) Electrode |
| Regulation Number: | 21 CFR 882.4725 |
| Regulation Name: | Radiofrequency Lesion Probe |
| Regulatory Class: | Class II |
| Product Code: | GXI |
| Compatible Dispersive Grounding Pad: | |
| 510(k) number: | K140658 |
| 510(k) number: | K140658 |
| Trade/Device Name: | Thermogard & Thermogard Plus ABC dispersive electrodes |
| Regulation Number: | 21CFR878.4400 |
| Regulation Name: | Electrosurgical cutting and coagulation device and accessories |
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| Regulatory Class: | Class I |
|-------------------|---------|
| Product Code: | GEI |
### DEVICE DESCRIPTION:
The RF Innovations APEX 6 is a desktop RF lesioning generator which is used for the lesioning of neural tissue. The APEX 6 is a multi-lesioning, 6 channel portable generator that can provide continuous or pulsed RF output at 460 kHz, and monopolar or dual electrode modes. The device includes sensory and motor stimulation functions to fine tune electrode placement for procedures. Based on performance testing the device is designed to connect to LCCS FDA cleared lesioning probes which are inserted into patients for lesioning of neural tissue during medical procedures. Device features include a touch screen monitor incorporating microprocessor and graphics display for user interface as well as self-diagnostics, calibration checks, and recordkeeping functions.
INDICATIONS FOR USE: Intended for use for lesioning of neural tissue and for pain management. It is indicated for use in the peripheral nervous system. The APEX 6 is to be used with LCCS electrodes and cannulae and Conmed Thermogard Dispersive Electrodes.
| | NeuroTherm<br>NT 2000<br>Generator K111576 | RF Innovations<br>APEX 6<br>Generator K220122 | Discussion |
|---------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------|
| Indication<br>for Use | The NT 2000 is intended for use for<br>lesioning of neural tissue. The NT<br>2000 is indicated for use in the<br>peripheral nervous system. The NT<br>2000 is to be used only, with FDA<br>cleared NeuroTherm RF probes and<br>Smith & Nephew SPINECATH and<br>ACUTHERM catheters, catheters. | Intended for use for lesioning of neural<br>tissue and for pain management. It is<br>indicated for use in the peripheral<br>nervous system. The APEX 6 is to be<br>used with LCCS electrodes and<br>cannulae and Conmed Thermogard<br>Dispersive Electrodes. | SIMILAR |
| Appearance | Image: NeuroTherm NT 2000 Generator | Image: RF Innovations APEX 6 Generator | SIMILAR |
| Touchscreen<br>dimensions | 12" diagonal LCD | 15" diagonal LCD | SIMILAR |
| Number of<br>Channels | 4 | 6 | Same max<br>power<br>delivered |
| RF Output<br>Frequency | 460 kHz | 460 kHz | SAME |
| Maximum<br>output<br>power (100<br>ohm load) | 50 watts | 50 watts | SAME |
| Energy<br>delivery<br>during multi<br>channel RF<br>treatment | Independent sequential energy delivery | Independent sequential energy delivery | SAME |
| Power<br>delivery<br>modes | Continuous and pulsed | Continuous and pulsed | SAME |
| Power<br>supply | AC Line | AC Line | SAME |
| Auto<br>shutdown<br>for power<br>exceeding<br>safe levels | Yes | Yes | SAME |
| Electrical<br>safety/EMC | IEC 60601 compliant | Tested to ANSI/AAMI 60601-1:2005 +<br>C1:2009 + A2:2010 + A1:2012, CAN/CSA-<br>C22.2 & 60601-1:2014 AND ANSI/AAMI<br>60601-2-2:2017, CAN/CSA-C22.2 No.<br>60601-2-2:2019. AND IEC 60601-1-2:2014/<br>EN 60601-1-2:2015 | Equivalent |
| RF energy delivery modes: | | | |
| Continuous<br>thermal | YES | YES | SAME |
| Stimulation-<br>sensory and<br>motor | YES | YES | SAME |
| Pulsed RF | YES | YES | SAME |
| RF energy delivery channel types | | | |
| Monopolar | YES | YES | SAME |
| Bipolar* | Yes<br>aka "dual" | Yes<br>aka "dual" | SAME |
SUBSTANTIAL EQUIVALENCE COMPARISON AND DISCUSSION
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* current between two monopolar electrodes
Any differences between the APEX 6 and the predicate 4-channel devices do not raise new issues of safety or effectiveness. The APEX 6 uses the same amount of energy output across 6 channels and delivers this energy sequentially as opposed to continuously. Therefore, the APEX 6 is substantially equivalent to the predicate device based upon the Indication for Use, technology, functional modes, hardware and software components, and performance.
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### PERFORMANCE TESTING
Bench - Bench testing supports that the APEX 6 performs as expected. Safety was tested in accordance with Standard for Medical electrical equipment - Part 1: General requirements for basic safety and essential performance ANSI/AAMI 60601-1:2005 + Cl:2009 + A2:2010 + Al:2012, CAN/CSA-C22.2 No. 60601-1:2014 and the Standard for Medical Electrical Equipment - Part 2-2: Particular requirements for the basic safety and essential performance of high frequency surgical equipment and high frequency surgical accessories ANSI/AAMI 60601-2-2:2017, CAN/CSA-C22.2 No. 60601-2-2:2019. EMC was tested in accordance with IEC 60601-1-2:2014/ EN 60601-1-2:2015/IEC 60601-2-2.
| Test | Test Method Summary | Results |
|---------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Lesion size | Purpose was to document the maximum<br>linear dimensions in all three planes as<br>well as the volume for the affected tissue<br>region and compare them to the<br>predicate device for minimal, typical, and<br>maximum energy delivery | Analysis: All affected area differences were less<br>than 1 mm. Minor errors can introduced by:<br>• Measuring small diameters with fuzzy borders<br>can increase the measurement error.<br>• For volume, a 10% error in the linear<br>dimensions will result in a 33% error in volume.<br>Therefore this study confirms that the Apex 6<br>and the predicate device are substantially<br>equivalent in regards to affected tissue size. |
| Comparison<br>of treatment<br>times<br>between<br>NeuroTherm<br>NT 2000<br>and Apex 6 | The purpose of this protocol is to<br>measure and compare the time to ramp<br>up to set temperature of the Apex 6 and<br>the predicate device under worse case<br>conditions to evaluate the efficiency of<br>energy delivery and measure treatment<br>times. | Results demonstrated that the APEX 6 was<br>substantially equivalent in terms of treatment<br>times compared to the predicate device. |
| Design<br>Validation<br>Review | A documented review of device<br>acceptance criteria was performed to<br>confirm compliance with the following<br>plans:<br>• Requirement Specification<br>• Requirements, Design and Verification<br>Traceability Matrix<br>• Embedded Software Requirement<br>Specification<br>• GUI Software Requirement<br>Specification<br>• Embedded Software Validation Plan<br>• GUI Software Validation Plan<br>• Instructions for Use | The finished unit design review verified that all<br>documented device requirements were met. |
| Every unit<br>functional<br>test | Every unit manufactured is subjected to a<br>full functional test regimen and the results<br>are recorded in the Device History<br>Record:<br>Voltage checks<br>Program and Impedance Testing<br>Software testing<br>Main GUI | Each unit must pass all tests prior to shipment. |
| Test | Test Method Summary | Results |
| | Final testing: Impedance/Temperature<br>measurement<br>Electrical safety testing | |
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Software - Software testing supports that the APEX 6 performs as expected. Validation was performed to the FDA Moderate Level of Concern per the FDA software guidance for the Content of Premarket Submissions for Software Contained in Medical Devices
CLINICAL TESTING Not required.
### CONCLUSION
The APEX 6 is similar to or the same as the predicate device as follows:
- . Technology
- Intended use/Indication for Use
- Technical specifications, or ranges of technical specifications
- . Functional modes compared to 4-channel devices
The fundamental technological characteristics of the APEX 6 are substantially equivalent to the predicate device based upon the Indication for Use, technology, functional modes, hardware components, and performance. Therefore, the APEX 6 is substantially equivalent to the predicate device.
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
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.