K Number
K021379

Validate with FDA (Live)

Manufacturer
Date Cleared
2002-05-31

(30 days)

Product Code
Regulation Number
888.3070
Age Range
All
Reference & Predicate Devices
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticPediatricDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

When used as a nonpedicle posterior system, the SCS system is indicated for patients with: degenerative disk disease defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies, spondylolisthesis, fracture, spinal stenosis, deformities (i.e., scoliosis, kyphosis, lordosis), tumors, failed previous fusion (pseudarthrosis).

When used as an anterolateral/anterior system the SCS system is indicated for patients with: degenerative disk disease defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies, spondylolisthesis, fracture, spinal stenosis, deformities (i.e., scoliosis, kyphosis, lordosis), tumors, failed previous fusion (pseudarthrosis)

When used as a posterior pedicle system, the SCS system is indicated for use in skeletally mature patients L3 and below who are: having severe spondylolisthesis (Grades 3 and 4) at the L5-S1 joint, receiving fusions using autogenous bone graft only, having the device fixed or attached to the lumbar and sacral spine, having the device removed after the development of a solid fusion mass. Screw fixation is limited to L3 and below.

Posterior pedicle systems are intended to provide immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar, and sacral spine: degenerative spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor, failed previous fusion (pseudarthrosis).

Device Description

The SCS Claris Spinal Lengthened Lateral Connectors are available in one size only and are used to connect the rods and screws of the SCS Claris Spinal System.

AI/ML Overview

This is a 510(k) premarket notification for a medical device called the SCS Claris Lengthened Lateral Connector (AL06), which is part of the SCS Claris Spinal System. This document is a summary of the device's characteristics and its substantial equivalence to a previously cleared device. It does not contain information about a study proving the device meets acceptance criteria through performance metrics.

Here's why and what information is available:

  • 510(k) Premarket Notification: This regulatory pathway is primarily about demonstrating "substantial equivalence" to a legally marketed predicate device, not necessarily proving efficacy or specific performance against a set of acceptance criteria through a clinical study or detailed performance testing. The focus is on showing that the new device is as safe and effective as a predicate device.
  • Substantial Equivalence: The document explicitly states: "Documentation was provided which demonstrated the SCS Claris Lengthened Lateral Connector (AL06) to be substantially equivalent to the previously cleared SCS Extremity Connector (AL02). The substantial equivalence is based upon equivalence in indications/intended use, manufacturing methods, interconnection (attachment) mechanism, basic design and materials."

Therefore, the provided text does not contain the detailed study information you requested regarding acceptance criteria and device performance metrics. It focuses on the comparison to a predicate device.

To answer your specific points:

  1. A table of acceptance criteria and the reported device performance: This information is not present. The submission relies on substantial equivalence to a predicate device, implying that the predicate's established safety and performance are sufficient.
  2. Sample size used for the test set and the data provenance: Not applicable, as performance testing of this nature is not described in the summary.
  3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable.
  4. Adjudication method for the test set: Not applicable.
  5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance: Not applicable. This device is a spinal implant component, not an AI-powered diagnostic tool.
  6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not applicable.
  7. The type of ground truth used: Not applicable.
  8. The sample size for the training set: Not applicable.
  9. How the ground truth for the training set was established: Not applicable.

In summary, the provided 510(k) document is not a performance study report but a regulatory submission based on substantial equivalence. It outlines the device, its intended use, materials, and claims substantial equivalence to another device based on design, materials, manufacturing, and intended use.

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510(k) SUMMARY of Safety and Effectiveness

Sponsor:OrthoTec, LLC9595 Wilshire Blvd. Suite 502Beverly Hills, CA 90212Phone: (310) 557-2000 & (310) 273-1500Fax: (310) 843-9500
ContactPerson:Patrick Bertranou, MD
ProprietaryTrade Name:SCS Claris Lengthened Lateral Connector (AL06)
DeviceDescription:The SCS Claris Spinal Lengthened Lateral Connectors are available in one sizeonly and are used to connect the rods and screws of the SCS Claris SpinalSystem.
Intended Use:When used as a nonpedicle posterior system, the SCS system is indicated forpatients with: degenerative disk disease defined as back pain of discogenicorigin with degeneration of the disc confirmed by history and radiographicstudies, spondylolisthesis, fracture, spinal stenosis, deformities (i.e., scoliosis,kyphosis, lordosis), tumors, failed previous fusion (pseudarthrosis).When used as an anterolateral/anterior system the SCS system is indicatedfor patients with: degenerative disk disease defined as back pain of discogenicorigin with degeneration of the disc confirmed by history and radiographicstudies, spondylolisthesis, fracture, spinal stenosis, deformities (i.e., scoliosis,kyphosis, lordosis), tumors, failed previous fusion (pseudarthrosis)When used as a posterior pedicle system, the SCS system is indicated for usein skeletally mature patients L3 and below who are: having severespondylolisthesis (Grades 3 and 4) at the L5-S1 joint, receiving fusions usingautogenous bone graft only, having the device fixed or attached to the lumbarand sacral spine, having the device removed after the development of a solidfusion mass. Screw fixation is limited to L3 and below.Posterior pedicle systems are intended to provide immobilization andstabilization of spinal segments in skeletally mature patients as an adjunctto fusion in the treatment of the following acute and chronic instabilities ordeformities of the thoracic, lumbar, and sacral spine: degenerativespondylolisthesis with objective evidence of neurologic impairment, fracture,dislocation, scoliosis, kyphosis, spinal tumor, failed previous fusion(pseudarthrosis).
Materials:The SCS Claris Spinal System Lengthened Lateral Connector (AL06) ismanufactured from stainless steel (ASTM F136 / ISO 5832-1) and titanium alloy(ASTM F138 / ISO 5832-3).
SubstantialEquivalence:Documentation was provided which demonstrated the SCS Claris LengthenedLateral Connector (AL06) to be substantially equivalent to the previouslycleared SCS Extremity Connector (AL02). The substantial equivalence is basedupon equivalence in indications/intended use, manufacturing methods,interconnection (attachment) mechanism, basic design and materials.

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAY 3 1 2002

OrthoTec. LLC c/o Ms. Karen Warden, MEBE 8202 Sherman Road Cleveland, Ohio 44026-2141

Re: K021379

Trade Name: SCS Claris Spinal System Lengthened Lateral Connector (AL06) Regulatory Number: 21 CFR 888.3070, 21 CFR 888.3050 and 21 CFR 888.3060 Regulatory Name: Pedicle screw spinal system, Spinal interlaminal fixation orthosis and Spinal intervertebral body fixation orthosis

Regulatory Class: II Product Code: MNI, MNH, KWP, KWQ Dated: April 26, 2002 Received: May 1, 2002

Dear Ms. Warden:

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 such 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); good manufacturing practice requirements as set 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.

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Page 2 - Patrick Bertranou, M.D.

This letter will allow you to begin marketing your device as described in your Section 510(k) - rms reter with and it your finding of substantial equivalence of your device to a legally promation in a classification for your device and thus, permits your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of additionally 21 - 11 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 -Compliance at (201) 57 - 1 - 1 - 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). regulation entral information on your responsibilities under the Act may be obtained from the O insi gonetar in in an and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Mark N Milham

Celia Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use Statement

510(k) Number (if known): K (02 | 379

Device Name: SCS Claris Spinal System

Indications for Use:

When used as a nonpedicle posterior system, the SCS system is indicated for patients with:

degenerative disk disease defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies spondylolisthesis fracture spinal stenosis deformities (i.e., scoliosis, kyphosis, fordosis) tumors failed previous fusion (pseudarthrosis)

When used as an anterolateral/anterior system the SCS system is indicated for patients with:

degenerative disk disease defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies spondylolisthesis fracture spinal stenosis deformities (i.e., scoliosis, kyphosis, lordosis) tumors failed previous fusion (pseudarthrosis)

When used as a posterior pedicle system, the SCS system is indicated for use in skeletally mature patients who are:

having severe spondylolisthesis (Grades 3 and 4) at the L5-S1 joint receiving fusions using autogenous bone graft only having the device fixed or attached to the lumbar and sacral spine having the device removed after the development of a solid fusion mass. screw fixation is limited to L3 and below.

Posterior pedicle systems are intended to provide immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar, and sacral spine:

degenerative spondylolisthesis with objective evidence of neurologic impairment fracture dislocation scoliosis kyphosis spinal tumor failed previous fusion (pseudarthrosis)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

OR
Over-the-Counter Use
Mark N Mellem
Division Sign-Off

ision of General. Restorative

510(k) Number

K021379

Confidential: OrthoTec - SCS Claris Lengthened Lateral Connector (AL06) Modification

Page 22

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