K Number
K140879
Date Cleared
2014-07-21

(105 days)

Product Code
Regulation Number
888.3040
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The BIOSURE HEALICOL PK Interference Screw is indicated for the reattachment of ligament, tendon, soft tissue, or bone-tendon-bone for the following indications: Knee (ACL repairs, PCL repairs, Extra-capsular repairs, Medial collateral ligament, Lateral ligament, Posterior oblique ligament, Patellar realignment and tendon repairs, Vastus medialis obliquus advancement, Iliotibial band tenodesis), Shoulder (Acromioclavicular separation repairs, Biceps tenodesis), Foot and Ankle (Medial or lateral instability repairs/reconstructions, Achilles tendon repairs/reconstructions, Metatarsal ligament/tendon repairs/reconstructions, Flexor hullucis longus (FHL), Tendon transfers), Elbow, Wrist, and Hand (Bicens tendon reattachment, Ulnar or radial collateral ligament reconstructions, Lateral epicondylitis repair, Scapholunate ligament reconstruction, Tendon transfers, Carpomedicarpal joint arthroplasty)

Device Description

Smith & Nephew BIOSURE HEALICOIL PK interference screw is a non-absorbable, sterile, single-use, interference screw composed of Polyetheretherketone (PEEK). It has a fenestrated open design which allows for bone ingrowth. It is provided in size ranging from 6mm to 10 mm diameter. BIOSURE HEALICOIL interference screw minimizes the volume of material implanted into the body while providing equal fixation strength of a standard interference screw. The central channel of the screw can be packed with autologous bone.

AI/ML Overview

The provided document describes the Smith & Nephew BIOSURE HEALICOIL PK Interference Screw, a non-absorbable, sterile, single-use interference screw made of PEEK. The document focuses on establishing substantial equivalence to legally marketed predicate devices rather than providing acceptance criteria for a novel device or AI algorithm. Therefore, many of the requested points related to AI performance, ground truth establishment, expert review, and sample sizes for training/test sets are not applicable.

Here's an analysis based on the information available in the document:

1. Table of Acceptance Criteria and Reported Device Performance:

The document primarily focuses on establishing "substantial equivalence" to predicate devices, meaning it does not define specific acceptance criteria in the traditional sense of a performance metric to be met by a new device against a predefined threshold. Instead, it aims to demonstrate that its performance is comparable to already cleared devices.

Acceptance Criterion (Implicit)Reported Device Performance (Summary)
Mechanical Strength (Pull-out and Insertion)"Mechanical testing data for pull out and insertion testing demonstrates the BIOSURE HEALICOIL PK interference screw is substantially equivalent to the currently marketed predicate devices."
Bone Ingrowth (Qualitative)"µCT demonstrated at twelve weeks that there was bone between the fenestrations and within the central cannulations. Histology and analysis demonstrated that new bone formed within the BIOSURE HEALICOIL PK interference screw and control in the fenestration between the threads into the central channel in all specimens." (Note: This was an animal study, and the document explicitly states: "Animal data is not necessarily indicative of human clinical outcomes. These results have not been demonstrated in humans having variety of bone quality based on specific disease states such as osteoporosis.")

2. Sample Size Used for the Test Set and Data Provenance:

The document refers to mechanical testing and an animal study.

  • Mechanical Testing: The document does not specify the sample size for the mechanical testing (pull-out and insertion).
  • Animal Study: The animal study used a sample size of n=11 for the BIOSURE HEALICOIL PK interference screw and n=11 for the control group. The provenance of this data (e.g., specific animal model, institution) is not detailed, but it is explicitly an animal study and not human data. It is a prospective study by nature of being conducted to evaluate the device.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications:

Not applicable. This device is a physical medical implant, not an AI or diagnostic device that requires expert interpretation for establishing ground truth on a test set. The evaluation relies on mechanical and histological analysis.

4. Adjudication Method for the Test Set:

Not applicable. There is no "test set" in the context of interpretation or diagnosis that would require an adjudication method like 2+1 or 3+1. The evaluation methods were mechanical testing and histological analysis.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:

Not applicable. This is not a diagnostic device involving human readers or AI assistance.

6. Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study:

Not applicable. This is not an AI algorithm.

7. Type of Ground Truth Used:

  • Mechanical Testing: The ground truth for mechanical performance (pull-out and insertion strength) would have been established by direct measurements using calibrated testing equipment, following established engineering standards.
  • Animal Study (Bone Ingrowth): The ground truth for bone ingrowth was established through:
    • Micro computed tomography (µCT): Provides detailed 3D imaging of bone structure.
    • Histology: Microscopic examination of tissue samples to assess new bone formation.

8. Sample Size for the Training Set:

Not applicable. This is not a machine learning device that requires a training set. The device design and materials are based on established engineering principles and prior knowledge.

9. How the Ground Truth for the Training Set Was Established:

Not applicable. There is no training set.

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JUL 2 1 2014

510(k) Summary

Date Prepared: May 23'd, 2014

SUBMITTERINFORMATIONCONTACT INFORMATION
Smith & Nephew, Inc.Vivek Mukhatyar
150 Minuteman RoadRegulatory Affairs Specialist II
Andover, MA 01810' Phone: (978)749-1043
Fax: (978)749-1443
DEVICE NAME (UNMODIFIED)
Trade or proprietary nameBIOSURE HEALICOIL PK Interference Screw
Common or usual nameSoft Tissue Fixation Device
Classification name21 CFR §888.3040 - Smooth or threaded metallic bone fixationfastener
Device ClassClass II
Product CodeMBI

LEGALUY MARKETED PREDICATE DEVICE

The Smith & Nephew BIOSURE HEALICOIL PK interference screw is substantially equivalent in intended use and Fundamental Scientific Technology to the following legally marketed devices in commercial distribution:

K083635Smith & Nephew BIOSURE PK(Cleared on January 30, 2009)
K083226

K042552 Biomet Bio-Core (Cleared on December 14, 2004)

DEVICE DESCRIPTION

Smith & Nephew BIOSURE HEALICOIL PK interference screw is a non-absorbable, sterile, single-use, interference screw composed of Polyetheretherketone (PEEK). It has a fenestrated open design which allows for bone ingrowth. It is provided in size ranging from 6mm to 10 mm diameter. BIOSURE HEALICOIL interference screw minimizes the volume of material implanted into the body while providing equal fixation strength of a standard interference screw. The central channel of the screw can be packed with autologous bone.

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INTEXPED Clase

The BIOSURE HEALICOL PK Interference Screw is indicated for the reattachment of ligament, tendon, soft tissue, or bone-tendon-bone for the following indications:

Knee

ACL repairs PCL repairs Extra-capsular repairs Medial collateral ligament Lateral collateral ligament Posterior oblique ligament Patellar realignment and tendon repairs Vastus medialis obliquus advancement Iliotibial band tenodesis

Shoulder

Acromioclavicular separation repairs Biceps tenodesis

Foot and Ankle

Medial or lateral instability repairs/reconstructions Achilles tendon repairs/reconstructions Metatarsal ligament/tendon repairs/reconstructions Flexor hullucis longus (FHL) Tendon transfers

Elbow, Wrist, and Hand

Biceps tendon reattachment Ulnar or radial collateral ligament reconstructions Lateral epicondylitis repair Scapholunate ligament reconstruction Tendon transfers Carpomedicarpal ioint arthroplasty

TECHNOID ACA CHARACTERESTICS *

Smith & Nephew BIOSURE HEALICOIL interference screw is substantially equivalent in intended use and fundamental scientific technology to the legally marketed predicate devices (Smith and Nephew BIOSURE PK - K083226 & K083635 and BIOMET Bio-Core K042552) and raises no new issues of safety and efficacy. Smith & Nephew BlOSURE HEALICOIL interference screw and the predicate Smith & Nephew BIOSURE PK Interference screws (K083226 & K083635) are manufactured from the same PEEK material. Smith & Nephew BIOSURE HEALICOIL interference screw and the predicate Biomet Bio-core (K042552) have a similar open lattice construction to allow for bone ingrowth through the fenestrations to the central channel of the screws or to be packed with autologous bone.

SUMMARK OF PERFORMANCE DATA

Mechanical testing data for pull out and insertion testing demonstrates the BIOSURE HEALICOIL PK interference screw is substantially equivalent to the currently marketed predicate devices.

The animal study evaluated bone ingrowth into the BIOSURE HEALICOIL PK interference screw (n=11) and control (n=11) via micro computed tomography (µCT) and histology. µCT demonstrated at twelve weeks that there was bone between the fenestrations and within the central cannulations. Histology andwsis

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demonstrated that new bone formed within the BIOSURE HEALICOIL PK interference screw and control in the fenestration between the threads into the central channel in all specimens.

Note: Animal data is not necessarily indicative of human clinical outcomes. These results have not been demonstrated in humans having variety of bone quality based on specific disease states such as osteoporosis.

SUBSTANTIAL EQUIVALENCE INFORMATION
and the control control control control control controller and the controlled to the contribution of the contribution of the contribution of the contribution of the contribut

The substantial equivalence of the BIOSURE HEALICOIL PK interference screw is based on similarities in indications for use, design features, operational principles, material composition, and performance to the predicate devices listed above. Based on the similarities to the BIOSURE HEALICOIL PK interference screw is substantially equivalent to its predicates.

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Image /page/3/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the top half of the circle. Inside the circle is a stylized image of an eagle with its wings spread, with three lines representing the feathers.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

July 21, 2014

Smith & Nephew, Incorporated Vivek Mukhatyar, Ph.D. Regulatory Affairs Specialist II 150 Minuteman Road Andover, Massachusetts 01810

Re: K140879

Trade/Device Name: BIOSURE HEALICOIL PK Interference Screw Regulation Number: 21 CFR 888.3040 Regulation Name: Smooth or threaded metallic bone fixation fastener Regulatory Class: Class II Product Code: MBI Dated: May 23, 2014 Received: May 28, 2014

Dear Dr. Mukhatyar:

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. 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 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 - Vivek Mukhatyar, 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 contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. 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

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm 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 Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Ronald P. Jean -S for

Mark N. Melkerson Director Division of Orthopedic Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known)

140879

Device Name The BIOSURE HEALICOIL PK Interference Screw

Indications for Use (Describe)

The BIOSURE HEALICOL PK Interference Screw is indicated for the reattachment of ligament, tendon, soft tissue, or bone-tendon-bone for the following indications:

Knee

ACL repairs, PCL repairs, Extra-capsular repairs, Medial collateral ligament, Lateral ligament, Posterior oblique ligament, Patellar realignment and tendon repairs, Vastus medialis obliquus advancement, Iliotibial band tenodesis

Shoulder

Acromioclavicular separation repairs, Biceps tenodesis

Foot and Ankle

Medial or lateral instability repairs/reconstructions, Achilles tendon repairs/reconstructions, Metatarsal ligament/tendon repairs/reconstructions, Flexor hullucis longus (FHL), Tendon transfers

Elbow, Wrist, and Hand

Bicens tendon reattachment, Ulnar or radial collateral ligament reconstructions, Lateral epicondylitis repair, Scapholunate ligament reconstruction, Tendon transfers, Carpomedicarpal joint arthroplasty

Type of Use (Select one or both, as applicable)

2 Prescription Use (Part 21 CFR 801 Subpart D)

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

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

Casey L. Hanley; Ph.D.

Division of Orthopedic Devices

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§ 888.3040 Smooth or threaded metallic bone fixation fastener.

(a)
Identification. A smooth or threaded metallic bone fixation fastener is a device intended to be implanted that consists of a stiff wire segment or rod made of alloys, such as cobalt-chromium-molybdenum and stainless steel, and that may be smooth on the outside, fully or partially threaded, straight or U-shaped; and may be either blunt pointed, sharp pointed, or have a formed, slotted head on the end. It may be used for fixation of bone fractures, for bone reconstructions, as a guide pin for insertion of other implants, or it may be implanted through the skin so that a pulling force (traction) may be applied to the skeletal system.(b)
Classification. Class II.