K Number
K142052
Manufacturer
Date Cleared
2014-12-05

(130 days)

Product Code
Regulation Number
888.3030
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Galaxy UNYCO Diaphyseal Tibia Kit is intended to be used to provide treatment for bone stabilization in trauma, specifically lower limb fractures that require temporary fixation prior to definitive fixation.

The Galaxy UNYCO Diaphyseal Tibia Kit is indicated to be used for temporary stabilization of tibial fractures in trauma procedures (damage control orthopaedics prior to definitive treatment). The product is indicated for non-weight- bearing use. The indications for use include:

• Tibial fractures extending from about 8cm below the knee to about 7 cm above the ankle joint, including comminuted open or closed tibial fractures and polytrauma.

• Temporary stabilisation of the tibia after debridement for osteomyelitis or an infected non-union pending second stage treatment.

Device Description

The Orthofix Galaxy UNYCO Diaphyseal Tibia Kit consists of a series of UNYCO Screws, UNYCO Cancellous Screws, Large Multiscrew Clamp for UNYCO Screws, Rods Ø12mm L 350mm and specific application tools. External fixation systems are modular, therefore different frame configurations are possible. The Orthofix components in the Galaxy UNYCO Diaphyseal Tibia Kit are not intended to replace normal healthy bone or to withstand the stresses of weight bearing. The System is intended to be used to provide treatment for bone stabilization in trauma, specifically lower limb fractures that require temporary fixation prior to definitive fixation. The System may be used in conjunction with the Orthofix Galaxy Fixation system for crossing the knee and the ankle during temporary fixation.

AI/ML Overview

The provided text is a 510(k) Premarket Notification for a medical device called the "Orthofix Galaxy UNYCO Diaphyseal Tibia Kit". This type of submission is for demonstrating substantial equivalence to a predicate device, not for proving a device meets specific acceptance criteria in the context of an AI/software device performance study.

Therefore, many of the requested items (e.g., acceptance criteria table, sample size for test set, number of experts, adjudication method, MRMC study, standalone performance, training set details) are not applicable to this type of regulatory document.

However, I can extract the information that is relevant to the device's performance demonstration.

Here's a summary of what can be inferred from the document:

1. A table of acceptance criteria and the reported device performance:

Acceptance CriteriaReported Device Performance
Mechanical StrengthThe device passed testing in accordance with ASTM F 1541-02.
Mechanical strength shown to be at least equivalent to the predicate devices.
MRI CompatibilityThe device passed testing per ASTM F2182.
Risk ManagementPotential hazards were evaluated and controlled through a Risk Management Plan.
General PerformanceAll testing met or exceeded the requirements as established by the test protocols and applicable standards. The components are capable of withstanding expected loads without failure.

2. Sample sized used for the test set and the data provenance:

  • Sample Size: Not specified for the mechanical or MRI compatibility testing. The document states "components" were tested, implying physical samples of the device.
  • Data Provenance: The tests conducted are laboratory-based mechanical and MRI compatibility tests on the device itself, rather than patient data.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

  • Not applicable. This is a physical device performance study, not a study evaluating human expert interpretation against a ground truth.

4. Adjudication method (e.g., 2+1, 3+1, none) 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 is a physical device, not an AI or software device.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

  • Not applicable. This is a physical device.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc):

  • For mechanical testing, the "ground truth" or reference was the performance requirements outlined in ASTM F 1541-02 and the performance of the predicate devices.
  • For MRI compatibility, the "ground truth" or reference was the performance requirements outlined in ASTM F2182.

8. The sample size for the training set:

  • Not applicable. This is a physical device.

9. How the ground truth for the training set was established:

  • Not applicable. This is a physical device.

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Image /page/0/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 image of three human profiles facing to the right, stacked on top of each other.

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

December 5, 2014

Orthofix Srl % Ms. Cheryl Wagoner Principal Consultant Wagoner Consulting LLC P.O. Box 15729 Wilmington, North Carolina 28408

Re: K142052

Trade/Device Name: Orthofix Galaxy UNYCO Diaphyseal Tibia Kit Regulation Number: 21 CFR 888.3030 Regulation Name: Single/multiple component metallic bone fixation appliances and accessories Regulatory Class: Class II Product Code: KTT Dated: November 3, 2014 Received: November 4, 2014

Dear Ms. Wagoner:

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

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(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 forth in the quality systems (OS) 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/Resourcesfor You/Industry/default.htm. 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/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 vours.

Lori A. Wiggins -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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Indications for Use

510(k) Number (if known) K142052

Device Name Galaxy UNYCO Diaphyseal Tibia Kit

Indications for Use (Describe)

The Galaxy UNYCO Diaphyseal Tibia Kit is intended to be used to provide treatment for bone stabilization in trauma, specifically lower limb fractures that require temporary fixation prior to definitive fixation.

The Galaxy UNYCO Diaphyseal Tibia Kit is indicated to be used for temporary stabilization of tibial fractures in trauma procedures (damage control orthopaedics prior to definitive treatment). The product is indicated for non-weight- bearing use. The indications for use include:

• Tibial fractures extending from about 8cm below the knee to about 7 cm above the ankle joint, including comminuted open or closed tibial fractures and polytrauma.

· Temporary stabilisation of the tibia after debridement for osteomyelitis or an infected non-union pending second stage treatment.

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)

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

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Traditional 510(k) Premarket Notification Orthofix Galaxy ÚNYCO Diaphyseal Tibia Kit

Image /page/3/Picture/2 description: The image shows the logo for Orthofix, a medical device company. The logo consists of a stylized blue symbol above the word "ORTHOFIX" in bold, black letters. Below the logo is the text "510(k) Summary" in a smaller, black font. The image is likely from a document related to the company's products or regulatory submissions.

(as required by 21 CFR 807.92)

SubmitterOrthofix Srl
Via delle Nazioni, 9 37012 Bussolengo (VR) - Italy
Telephone+ 39 045 6719.000
Fax+ 39 045 6719.380
Contact PersonGianluca RicadonaQuality & Regulatory Affairs Manager
AddressVia delle Nazioni, 937012 Bussolengo (VR) - Italy
Telephone+ 39 045 6719.000
Fax+ 39 045 6719.380
emailgianlucaricadona@orthofix.com
Date PreparedNovember 28th, 2014
Trade NameOrthofix Galaxy UNYCO Diaphyseal Tibia Kit
Common NameExternal Fixation Device and Accessories
Panel CodeOrthopaedics/87
Classification NameSingle/multiple component metallic bone fixation appliances and accessories.
ClassClass II
Regulation Number21 CFR 888.3030
Product CodeKTT
Device Name510(k) NumberManufacturer
Synthes Large External Fixation, MR ConditionalK082650Synthes
Orthofix Galaxy FixationK113770Orthofix Srl
Hoffmann 3 External Fixation SystemK122284Stryker
DescriptionThe Orthofix Galaxy UNYCO Diaphyseal Tibia Kit consists of a series ofUNYCO Screws, UNYCO Cancellous Screws, Large Multiscrew Clamp forUNYCO Screws, Rods Ø12mm L 350mm and specific application tools.External fixation systems are modular, therefore different frameconfigurations are possible. The Orthofix components in the GalaxyUNYCO Diaphyseal Tibia Kit are not intended to replace normal healthybone or to withstand the stresses of weight bearing. The System isintended to be used to provide treatment for bone stabilization in trauma,specifically lower limb fractures that require temporary fixation prior todefinitive fixation. The System may be used in conjunction with theOrthofix Galaxy Fixation system for crossing the knee and the ankleduring temporary fixation.
Indications andThe Galaxy UNYCO Diaphyseal Tibia Kit is intended to be used to provide
Indications andIntended UseThe Galaxy UNYCO Diaphyseal Tibia Kit is intended to be used to providetreatment for bone stabilization in trauma, specifically lower limb fracturesthat require temporary fixation prior to definitive fixation.
The Galaxy UNYCO Diaphyseal Tibia Kit is indicated to be used for

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Traditional 510(k) Premarket Notification

Orthofix Galaxy UNYCO Diaphyseal Tibia Kit

temporary stabilization of tibial fractures in trauma procedures (damagecontrol orthopaedics prior to definitive treatment). The product is indicatedfor non-weight- bearing use. The indications for use include:
• Tibial fractures extending from about 8cm below the knee to about 7 cmabove the ankle joint, including comminuted open or closed tibial fracturesand polytrauma.
• Temporary stabilisation of the tibia after debridement for osteomyelitis oran infected non union pending second stage treatment.
TechnologicalCharacteristicsand SubstantialEquivalenceDocumentation was provided to demonstrate that the Orthofix GalaxyUNYCO Diaphyseal Tibia Kit is substantially equivalent to the legallymarketed Predicates. The devices and accessories included in theOrthofix Galaxy UNYCO Diaphyseal Tibia Kit and the predicate devicesare all external fracture fixation systems as defined in 21 CFR 888.3030.The Galaxy UNYCO Diaphyseal Tibia Kit is substantially equivalent to thepredicate devices in intended use, site of application, patient population,conditions-of-use, mechanical performances, basic design, operatingprinciples, and materials. The Galaxy UNYCO Diaphyseal Tibia Kit iscomparable to its predicate in size and materials. Testing in accordancewith ASTM F 1541-02 shows the mechanical strength of the subjectdevice to be at least equivalent to the predicate devices.
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Performance DataThe potential hazards have been evaluated and controlled through a RiskManagement Plan.All testing met or exceeded the requirements as established by the testprotocols and applicable standards. A review of the mechanical dataindicates that the components of the Subject device are capable ofwithstanding expected loads without failure. The Subject device wastherefore found to be substantially equivalent to the Predicates. Clinicaldata was not needed to support the safety and effectiveness of theSubject Device.The following mechanical testing was performed:• ASTM F 1541 “Standard Specification and Test Methods for ExternalSkeletal Fixation Devices”MRI compatibility testing was also conducted per:• ASTM F2182 “Standard test method for measurement of radiofrequency induced heating near passive implants during magneticresonance imaging”
ConclusionBased on design, materials, intended use, technological characteristics,
ConclusionBased on design, materials, intended use, technological characteristics,and comparison to predicate devices, the Subject Orthofix GalaxyUNYCO Diaphyseal Tibia Kit has been shown to be substantiallyequivalent to legally marketed predicate devices.
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§ 888.3030 Single/multiple component metallic bone fixation appliances and accessories.

(a)
Identification. Single/multiple component metallic bone fixation appliances and accessories are devices intended to be implanted consisting of one or more metallic components and their metallic fasteners. The devices contain a plate, a nail/plate combination, or a blade/plate combination that are made of alloys, such as cobalt-chromium-molybdenum, stainless steel, and titanium, that are intended to be held in position with fasteners, such as screws and nails, or bolts, nuts, and washers. These devices are used for fixation of fractures of the proximal or distal end of long bones, such as intracapsular, intertrochanteric, intercervical, supracondylar, or condylar fractures of the femur; for fusion of a joint; or for surgical procedures that involve cutting a bone. The devices may be implanted or attached through the skin so that a pulling force (traction) may be applied to the skeletal system.(b)
Classification. Class II.