Delta III Lithotripter

FDA 510(k) K201074 · Dornier Medtech America, Inc.

Substantially Equivalent

510(k) numberK201074

Submission

Device name
Delta III Lithotripter
Applicant
Dornier Medtech America, Inc.
Kennesaw, GA, US
Received
April 22, 2020
Decision date
September 3, 2020
Decision
Substantially Equivalent (SESE)
Type
Traditional 510(k)
Summary
510(k) summary available from FDA

Official FDA 510(k) record

Device classification

Product code
LNS – Lithotriptor, Extracorporeal Shock-Wave, Urological
Device class
Class II (moderate risk)
Regulation
21 CFR 876.5990
Specialty
Gastroenterology, Urology

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K261086Break WaveLNS · Special Sonomotion, Inc.04/29/2026SE
K252913Break WaveLNS · Traditional Sonomotion, Inc.01/12/2026SE
K242922Extracorporeal Shock Wave Lithotripter (U200)LNS · Traditional Shenzhen Wikkon Precision Technologies Co., Ltd.06/18/2025SE
K221903Delta III ProLNS · Traditional Dornier Medtech America, Inc.02/22/2023SE
K213772LM-9300 Plus LithotripterLNS · Traditional Lite-Med, Inc.01/19/2023SE
K201001Modulith SLX-F2LNS · Traditional Karl Storz Endoscopy America03/30/2021SE
K172084Delta III LithotripterLNS · Special Dornier Medtech America, Inc.08/08/2017SE
K170122Delta III LithotripterLNS · Traditional Dornier Medtech America06/28/2017SE
K151298Gemini XXP-HPLNS · Traditional Dornier Medtech America07/30/2015SE
K142561LM-9300 ELMA LithotripterLNS · Abbreviated Lite-Med, Inc.03/20/2015SE

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K221903Delta III ProLNS · Traditional 02/22/2023SE
K213252Dornier ThulioGEX · Traditional 07/27/2022SE
K220871NautilusJAA · Special 04/18/2022SE
K210394Electrosurgical accessoryFAS · Traditional 05/19/2021SE
K201815Dornier MAGELLAN Ureteral Access SheathFED · Traditional 11/20/2020SE
K190612EQUINOX Balloon Dilatation CatheterEZN · Traditional 12/06/2019SE
K190312Dornier Ureteral StentFAD · Traditional 11/15/2019SE
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Questions and answers

When was Delta III Lithotripter cleared by the FDA?

Delta III Lithotripter (K201074) received a 510(k) decision of Substantially Equivalent on September 3, 2020, 134 days after the submission was received.

What is the product code of K201074?

The FDA product code is LNS – Lithotriptor, Extracorporeal Shock-Wave, Urological, a Class II (moderate risk) device regulated under 21 CFR 876.5990.