PHOTEX30 DIODE LASER SERIES: 980, 810, 940

K092197 · Biotex, Inc. · GEX · Oct 6, 2009 · General, Plastic Surgery

Device Facts

• Record ID: K092197
• Device Name: PHOTEX30 DIODE LASER SERIES: 980, 810, 940
• Applicant: Biotex, Inc.
• Product Code: GEX · General, Plastic Surgery
• Decision Date: Oct 6, 2009
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 878.4810
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The PhoTex30 Diode Laser Series is indicated for use in surgical applications requiring the ablation, vaporization, excision, incision, and coagulation of soft tissue in areas of surgery including: gastroenterology, general surgery, plastic surgery, genitourinary (urology), gynecology (GYN), neurosurgery, otolaryngology (ENT) head and neck, orthopedics, ophthalmology, pulmonology, and thoracic surgery.

Device Story

PhoTex30 Diode Laser Series (980nm, 810nm, 940nm) provides surgical energy for soft tissue management; operates in continuous-wave, pulsed, or external modulation modes. Device utilizes compatible fiber optic delivery accessory (numerical aperture ≥ 0.37) to deliver laser radiation to target tissue. Used by clinicians in surgical settings for ablation, vaporization, excision, incision, and coagulation. Output allows precise tissue interaction; benefits patient through controlled surgical intervention. Device performance and safety verified via engineering studies and compliance with FDA standards 21CFR1040.10 and 21CFR1040.11.

Clinical Evidence

Bench testing only. Engineering studies demonstrated substantial equivalence to predicate devices and compliance with 21CFR1040.10 and 21CFR1040.11. No clinical data presented.

Technological Characteristics

Diode laser system; wavelengths 980nm, 810nm, 940nm. Modes: continuous-wave, pulsed, external modulation. Compatible with fiber optic delivery accessories (numerical aperture ≥ 0.37). Complies with 21CFR1040.10 and 21CFR1040.11 laser safety standards.

Indications for Use

Indicated for soft tissue ablation, vaporization, excision, incision, and coagulation in patients requiring surgery in gastroenterology, general, plastic, genitourinary (urology), gynecology, neurosurgery, otolaryngology (ENT) head and neck, orthopedics, ophthalmology, pulmonology, and thoracic specialties.

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

• PhoTex15 Diode Laser Series: 980, 810, 940 (K060304)
• SLT Thermalite Diode Laser Series: 980, 810, 940 (K952661)

Submission Summary (Full Text)

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K092197

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CT - 6 2009

### 510(k) Summary

In accordance with the Safe Medical Devices Act of 1990 and in compliance with 21CFR 807, the In accordance with the Oale Medion Donoof of in the substantial equivalence determination is based.

### Contact Information

| Submitter: | BioTex, Inc.<br>8058 El Rio St. .<br>Houston, TX 77054 |
|-----------------|--------------------------------------------------------|
| Phone: | 713.741.0111 |
| Contact Person: | Ashok Gowda |
| Date Prepared: | 6/18/2009 |

### Device Names

| Trade/Proprietary Name: | PhoTex30 Diode Laser Series: 980, 810, 940 |
|-------------------------|--------------------------------------------|
| Common Name: | Diode Laser Series |
| Classification Name: | Powered surgical laser instrument |
| Product Code: | GEX |
| Reg.Class: | II |
| Reg. Number: | 878.4810 |

### Predicate Device

PhoTex15 Diode Laser Series: 980, 810, 940 (K060304) SLT Thermalite Diode Laser Series: 980, 810, 940 (K952661)

### Description of Device

The PhoTexാ Diode Laser Series are diode lasers emitting radiation in either a continuous-wave The ProTexsi Diode Laser Senes are dious facile that manye at one of the following (CVV), pulsed or external modulation modes in the initalians and series provides a means.
wavelengths: 980nm, 810nm, and 940nm. The PhoTexy Diode Laser Series dollygry wavelengths. 960mm, and vaporization of tissue using a compatible fiber optic delivery for cutting, coagulation, and vaporization of tiber optic delivery accessory terminated with a numerical accessory. The laser is compatible with uny hist "bptro" and one of larger with a numerical aperture of at least .37.

### Indications for Use

The PhoTex30 Diode Laser Series is indicated for use in surgications requiring The PhoTex.50 Diode Easer Ochoo is inalisation of soft tissue in areas of
the ablation, vaporization, excision, incision, and coagulation of soft tissue in areas of the ablation, vaponzution, oxolon, meneral surgery, plastic surgery, genitourinary
surgery including: gastroenterology, general surgery, plastic surgery, genitourings surgery including. gastroomorology, genery, otolaryngology (ENT) head and neck, (urchogy), g) . synoothalmology, pulmonology, and thoracic surgery.

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# Comparison to Predicate Device

Comparison to Predicate Device
The PhoTexy Diode Laser Series has been shown to be substantially equivalent to the predicate The PhoTex.g Diode Laser Series nas been shown to be subscaninder stars. Based on the devices, the PhoTex., Diode Laser Series and SET Theimalic Liber States that no
technological features, device performance, and indications for use, BioTex, Inc. belices that technological features, device performance, and the productions of the producate devices.
significant differences exist between the PhoTexa Diode Laser Series and the significant differences exist between the Prior example the spectively and the listed by the Differences were determined to be minor and are each within the operall safety and effectiveness of the device.

## Non-clinical Performance Tests:

Engineering studies have demonstrated the substantial equivalence of the PhoTexa Diode Laser Series Engineering studies have demonstrated (ne subscribe bir The mail of The mail on the mainten of the maint Series to the PhoText Diode Laser Seles (Kooooors and in compliano with FDA standards
(K952661). The Studies concluded that the lasers are in compliance with FDA standards (K952661). The studies concluded that the lasers finctioned as intonded and 21CFR1040.10 and 21CFR1040.11. In an Tirances, the facebook and and and and and and and one with the labeled
performed in a manner similar to the predicate device when used i directions for use and specified indications.

### Conclusion

BioTex has demonstrated the PhoTexto Diode Laser Series is substantially equivalent to the BloTex fras demonstrated the The PhoToxy Disable and indications for use.

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Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized graphic of an eagle or bird-like figure with three wing-like extensions.

Food and Drug Administration 10903 New Hampshire Avenue Document Mail Center - WO66-G609 Silver Spring, MD 20993-0002

BioTex, Inc. % Ashok Gowda, Ph.D. President 8058 El Rio Street Houston, Texas 77054

## OCT - 6 2009

Re: K092197

Trade/Device Name: PhoTex30 Diode Laser Series, Model 980nm, 810nm, 940nm 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: July 16, 2009 Received: July 21, 2009

Dear Dr. Gowda:

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. 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.

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 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set

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Page 2 - Ashok Gowda, Ph.D.

forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 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/cdrl/mdr/ for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html,

Sincerely yours,

Mark N. Melkerson

Director

Division of Surgical, Orthopedic and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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K092197

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## Indications for Use

510(k) Number (if known):

Device Name:

PhoTex30 Diode Laser Series, Model 980nm, 810nm, 940nm

Indications for Use:

The PhoTex30 Diode Laser Series is indicated for use in surgical applications requiring the ablation, vaporization, excision, incision, and coagulation of soft tissue in areas of surgery including: gastroenterology, general surgery, plastic surgery, genitourinary (urology), gynecology (GYN), neurosurgery, otolaryngology (ENT) head and neck. orthopedics, ophthalmology, pulmonology, and thoracic surgery.

Prescription Use × (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (21 CFR 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

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(Division Sign-Off) Division of Surgical, Orthopedic, and Restorative Devices

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510(k) Number K092197