UV Radiation Treatment System

K191571 · Xuzhou Yongkang Electronic Science Technology Co., Ltd. · FTC · Feb 6, 2020 · General, Plastic Surgery

Device Facts

• Record ID: K191571
• Device Name: UV Radiation Treatment System
• Applicant: Xuzhou Yongkang Electronic Science Technology Co., Ltd.
• Product Code: FTC · General, Plastic Surgery
• Decision Date: Feb 6, 2020
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 878.4630
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The UV Radiation Treatment System models YK-6000A, YK-6000A-T, YK-6000B, andYK-6000B-T, are intended for use under the direction of a physician, for the treatment of vitiligo, psoriasis, and eczema. The devices are intended for treatment of these conditions on Fitzpatrick Skin Types (I-VI).

Device Story

Portable UV radiation treatment system; consists of UV tubes, irradiator, and control circuit. Models YK-6000A/A-T emit UVA; models YK-6000B/B-T emit UVB. Used in hospitals, clinics, and professional medical environments; operated by healthcare professionals. Device provides partial skin treatment; internal glisten board enhances radiant efficiency. Physician directs treatment; patient receives targeted UV exposure for diagnosed skin disorders. Benefits include therapeutic management of vitiligo, psoriasis, and eczema.

Clinical Evidence

No clinical data.

Technological Characteristics

Materials: ABS shell. Energy: AC outlet powered. Light source: Philips UV lamps. Wavelengths: UVA (320-400 nm) or UVB (300-320 nm). Form factor: Portable. Standards: IEC 60601-1 (safety), IEC 60601-2-57 (non-laser light source), IEC 60601-1-2 (EMC), IEC 62471 (photobiological safety), ISO 10993-5/10/11 (biocompatibility).

Indications for Use

Indicated for treatment of vitiligo, psoriasis, and eczema in patients of all Fitzpatrick Skin Types (I-VI) under physician direction.

Regulatory Classification

Identification

An ultraviolet lamp for dermatologic disorders is a device (including a fixture) intended to provide ultraviolet radiation of the body to photoactivate a drug in the treatment of a dermatologic disorder if the labeling of the drug intended for use with the device bears adequate directions for the device's use with that drug.

Predicate Devices

• UV Phototherapy Device (K181805)

Submission Summary (Full Text)

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Image /page/0/Picture/0 description: The image shows 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.

Xuzhou Yongkang Electronic Science Technology Co., Ltd % Boyle Wang Official Correspondent Shanghai Truthful Information Technology Co., Ltd. RM. 608, No. 738, Shangcheng Rd., Pudong Shanghai, 200120 Cn

#### Re: K191571

Trade/Device Name: UV Radiation Treatment System Regulation Number: 21 CFR 878.4630 Regulation Name: Ultraviolet Lamp For Dermatologic Disorders Regulatory Class: Class II Product Code: FTC Dated: June 14, 2019 Received: June 14, 2019

#### Dear Boyle Wang:

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 requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part

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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 (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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

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/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 ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely,

Jessica Mavadia-Shukla Acting Assistant Director DHT4A: Division of General Surgery Devices OHT4: Office of Surgical and Infection Control 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) K191571

Device Name UV Radiation Treatment System

Indications for Use (Describe)

The UV Radiation Treatment System models YK-6000A-T, YK-6000B, andYK-6000B-T, are intended for use under the direction of a physician, for the treatment of vitilizo, psoriasis, and eczema. The devices are intended for treatment of these conditions on Fitzpatrick Skin Types (I-VI).

| Type of Use (Select one or both, as applicable) | |
|-------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------|
| <label><input checked="" type="checkbox"/> Prescription Use (Part 21 CFR 801 Subpart D)</label> | <label><input type="checkbox"/> Over-The-Counter Use (21 CFR 801 Subpart C)</label> |

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# Tab #06 510(k) Summary

This summary of 510(k) safety and effectiveness information is being submitted in accordance with requirements of 21 CFR 807.92.

#### 1.0 Submitter's information

Name: Xuzhou Yongkang Electronic Science Technology Co., Ltd Address: 4F Building C8, 40 Jingshan Road, Economic and Technological Development Zone, Xuzhou, Jiangsu,221000,China Tel: [phone]-601 Fax: [phone]-606 Contact: Kai Li Date of Preparation: Feb.5,2020

#### Designated Submission Correspondent

Mr. Boyle Wang Shanghai Truthful Information Technology Co., Ltd. Address: Room 608, No. 738 Shangcheng Rd., Pudong Shanghai, 200120 China Tel: [phone] Email: [e-mail]

#### 2.0 Device information

Trade name: UV Radiation Treatment System Common name: Ultraviolet Lamp for Dermatologic Disorders Classification name: Light, Ultraviolet, Dermatological Model(s): YK-6000A,YK-6000A-T,YK-6000B,YK-6000B-T

#### 3.0 Classification

Production code: FTC Regulation number: 21 CFR 878.4630 Classification: Class II Review Panel: General& Plastic Surgery

#### 4.0 Predicate device information

Manufacturer: Xuzhou Kernel Medical Equipment Co., LTD. UV Phototherapy Device: 510(k) number: K181805

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### 5.0 Indication for Use Statement

The UV Radiation Treatment System models YK-6000A, YK-6000A-T, YK-6000B, andYK-6000B-T, are intended for use under the direction of a physician, for the treatment of vitiligo, psoriasis, and eczema. The devices are intended for treatment of these conditions on Fitzpatrick Skin Types (I-VI).

### 6.0 Device Description

The proposed device, UV Radiation Treatment System is a portable medical device that consists of tubes, irradiator, control circuit. It is a therapeutic product under the direction of a physician for individuals who require ultraviolet radiation for diagnosed skin disorders. It is for the partial treatment. It has four models: YK-6000A,YK-6000A-T,YK-6000B,YK-6000B-T,in which the model YK-6000A and YK-6000A-T emit UVA light and the model YK-6000B and YK-6000B-T emit UVB light.

This product has the features are as follows:

A. Use Philips special UV lamp as light source, with high stability and long service life:

B. Small bulk, lightweight, operation simply, patients can take with themselves;

C. There is glisten board inner radiation unit, which can raise radiant efficiency.

The UV Radiation Treatment System only can be used in Hospital, Clinic, Medical Center, Private Medical Practice, or Other Professional Medical Environments under direction of physician.

#### 7.0 Non-Clinical Test Conclusion

Non clinical tests were conducted by lab bench testing to verify that the proposed device met all design specifications as was Substantially Equivalent (SE) to the predicate device. The test results demonstrated that the proposed device complies with the following standards:

IEC 60601-1:2012, Medical electrical equipment-Part 1: General requirements for basic safety, and essential performance.

IEC 60601-2-57: 2011 Medical electrical equipment Part2-57: Particular requirements for the basic safety and essential performance of non-laser light source equipment intended for therapeutic, diagnostic, monitoring and cosmetic/ aesthetic use.

IEC 60601-1-2:2014, Medical electrical equipment -Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic compatibility - Requirements and tests.

IEC 62471:2006, Photobiological safety of lamps and lamp systems

ISO 10993-5:2009 Biological evaluation of medical devices- Part 5: Test for in

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vitro cytotoxicity

ISO 10993-10:2010 Biological evaluation of medical devices- Part 10: Test for irritation and delayed-type hypersensitivity

ISO 10993-11:2017 Biological evaluation of medical devices- Part 11: Test for systemic toxicity

# 8.0 Clinical Test Conclusion

No clinical study is included in this submission.

# 9.0 Substantial Equivalence Comparison

| Item | Proposed device | Predicated device<br>K181805 | Remark |
|--------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------|
| Product Code | FTC | FTC | SE |
| Regulation No. | 21 CFR 878.4630 | 21 CFR 878.4630 | SE |
| Class | II | II | SE |
| Intended Use | The UV Radiation<br>Treatment System<br>models YK-6000A,<br>YK-6000A-T, YK-6000B,<br>andYK-6000B-T, are<br>intended for use under<br>the direction of a<br>physician, for the<br>treatment of vitiligo,<br>psoriasis, and eczema.<br>The devices are intended<br>for treatment of these<br>conditions on Fitzpatrick<br>Skin Types (I-VI). | The UV Phototherapy<br>is intended for use, by<br>or under the direction<br>of a physician for the<br>treatment of psoriasis,<br>vitiligo, and atopic<br>dermatitis (eczema). It<br>is intended for use on<br>all skin types (I-VI). It<br>can be used in<br>hospitals, clinics and<br>households. | SE |
| Prescriptive | Yes | Yes | SE |
| Mode of operation | Portable | Handheld | Analysis |
| Shell material | ABS | ABS | SE |
| Treatment Area | Partial treatment<br>excluding eyes | Partial treatment<br>excluding eyes | SE |
| Treatment Time | 5~20 min | 0~30min | Analysis |
| UV spectral output | UVA or UVB | UVA or UVB | SE |
| Lamp configuration | 1<br>9W UV tube | 1 or 2<br>9W UV tube | Analysis |
| Power Source | AC outlet | AC outlet or DC jack | Analysis |
| Wavelength range<br>(nm) | UVA:320~400<br>UVB: 300~320 | UVA: 350~400<br>UVB: 310~315 | Analysis |

#### Table1- Technological Characteristic Comparison

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| IPX – Rating / water<br>resistance | IPX0 | IP22 | Analysis |
|------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------|
| Application<br>Environment | Hospital, Clinic, Medical<br>Center, Private Medical<br>Practice, or Other<br>Professional Medical<br>Environments under<br>direction of physician | Hospital, Clinic,<br>Medical Center,<br>Private Medical<br>Practice, or Other<br>Professional Medical<br>Environments,<br>Household use under<br>direction of physician. | Analysis |
| Electrical<br>Safety/Performance | Comply with IEC60601-1<br>and IEC 60601-2-57 | Comply with<br>IEC60601-1 and IEC<br>60601-2-57 | SE |
| Home Use | Not applied | Comply with IEC<br>60601-1-11 | Analysis |
| Sterile | N/A | N/A | SE |
| Single Use | No | No | SE |
| EMC | Comply with IEC<br>60601-1-2 | Comply with IEC<br>60601-1-2 | SE |
| Biocompatibility | Cytotoxicity (ISO<br>10993-5:2009) | Under the conditions of<br>the study, Comply with<br>the requirements | SE |
| | Sensitization (ISO<br>10993-10:2010) | | |
| | Irritation (ISO<br>10993-10:2010) | | |
| | Pyrogen(ISO<br>10993-11:2017) | | |
| | Acute Systemic<br>Toxicity(ISO<br>10993-11:2017) | | |
| Label and Labeling | Conforms to FDA<br>Regulatory<br>Requirements | Conforms to FDA<br>Regulatory<br>Requirements | SE |

Analysis:

The predicate device has the models which can support household use. The proposed device is not recommended household use, it just can be used in the professional medical environments under the guidance of doctors. In addition, the proposed device is substantially equivalent to the predicate device. The differences between both devices are insignificant in terms of safety and effectiveness. Based on the nonclinical and clinical tests performed, the subject device is as safe, as effective, and performs as well as the legally marketed predicate device.

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#### 10.0 Conclusion

The conclusions drawn from the comparison and analysis above demonstrate that the proposed device is as safe, as effective, and performs as well as the legally marketed predicated device and raises no new questions of safety or effectiveness. The differences between both devices are insignificant in terms of safety and effectiveness.