K Number
K012738
Device Name
SYMPHONY GRAFT DELIVERY SYSTEM (GDS)
Manufacturer
Date Cleared
2001-11-14

(90 days)

Product Code
Regulation Number
878.4820
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Symphony Graft Delivery System is indicated for the delivery of allograft, autograft, or synthetic bone graft materials to an orthopedic surgical site. In addition, it is designed to facilitate pre-mixing of bone graft materials with I.V. fluids, blood, plasma, platelet rich plasma, bone marrow or other specific blood component(s) as deemed necessary by the clinical use requirements.
Device Description
The Symphony Graft Delivery System Syringe is designed specifically to collect, mix and deliver bone graft materials to a surgical site. The Graft Chamber component of the Symphony GDS can be provided either empty or pre-filled with human allograft
More Information

No
The summary describes a mechanical device for delivering bone graft material and does not mention any AI/ML components or functions.

No.
The device facilitates the delivery and mixing of bone graft materials, which are used in orthopedic surgical procedures; it does not directly treat a disease or condition itself.

No
Explanation: The device is used for the delivery and mixing of bone graft materials, not for diagnosing medical conditions.

No

The device description explicitly mentions physical components like a "Syringe" and "Graft Chamber," indicating it is a hardware device for delivering bone graft materials.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is for the delivery of bone graft materials to an orthopedic surgical site. While it facilitates mixing with biological fluids, its primary function is mechanical delivery within the body during surgery, not for testing or analyzing samples in vitro (outside the body).
  • Device Description: The description focuses on collecting, mixing, and delivering bone graft materials. It doesn't mention any components or functions related to analyzing biological samples for diagnostic purposes.
  • Lack of IVD Indicators: There is no mention of analyzing biological samples, detecting analytes, or providing diagnostic information. The focus is entirely on the handling and delivery of bone graft material.

IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. This device's function is entirely different.

N/A

Intended Use / Indications for Use

The Symphony Graft Delivery System is indicated for the delivery of allograft, autograft, or synthetic bone graft materials to an orthopedic surgical site. In addition, it is designed to facilitate pre-mixing of bone graft materials with I.V. fluids, blood, plasma, platelet rich plasma, bone marrow or other specific blood component(s) as deemed necessary by the clinical use requirements.

Product codes

GEY

Device Description

The Symphony Graft Delivery System Syringe is designed specifically to collect, mix and deliver bone graft materials to a surgical site. The Graft Chamber component of the Symphony GDS can be provided either empty or pre-filled with human allograft

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

orthopedic surgical site

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

The resins, from which the components of the Symphony Graft Delivery System are manufactured, meet the requirements set forth in the Tripartite Biocompatibility Guidance for Medical Devices. This Guidance includes testing requirements for Pharmacopeia XXII, Class VI as well as the FDA modified ISO 10993-1 tests for biocompatibility for human body fluid contact of 30 days or less.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

Symphony Graft Delivery System (K003286, K010320)

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4820 Surgical instrument motors and accessories/attachments.

(a)
Identification. Surgical instrument motors and accessories are AC-powered, battery-powered, or air-powered devices intended for use during surgical procedures to provide power to operate various accessories or attachments to cut hard tissue or bone and soft tissue. Accessories or attachments may include a bur, chisel (osteotome), dermabrasion brush, dermatome, drill bit, hammerhead, pin driver, and saw blade.(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 878.9.

0

VIII. 510(k) SummaryK012738
SUBMITTER:DePuy AcroMed, Inc.
325 Paramount Drive
Raynham, MA 02780NOV 1 4 2001
CONTACT PERSON:Karen F. Jurczak
DATE PREPARED:August 15, 2001
CLASSIFICATION NAME:Piston Syringe
PROPRIETARY NAME:Symphony Graft Delivery System
PREDICATE DEVICES:Symphony Graft Delivery System (K003286, K010320)
INTENDED USE:The Symphony Graft Delivery System is indicated for the
delivery of allograft, autograft, or synthetic bone graft
materials to an orthopedic surgical site. In addition, it is
designed to facilitate pre-mixing of bone graft materials
with I.V. fluids, blood, plasma, platelet rich plasma, bone
marrow or other specific blood component(s) as deemed
necessary by the clinical use requirements.
MATERIALS:Medical grade polycarbonate resin
Medical grade High Density Polyethylene
PERFORMANCE DATA:The resins, from which the components of the Symphony
Graft Delivery System are manufactured, meet the
requirements set forth in the Tripartite Biocompatibility
Guidance for Medical Devices. This Guidance includes
testing requirements for Pharmacopeia XXII, Class VI as
well as the FDA modified ISO 10993-1 tests for
biocompatibility for human body fluid contact of 30 days or
less.
DESIGN:The Symphony Graft Delivery System Syringe is designed
specifically to collect, mix and deliver bone graft materials
to a surgical site. The Graft Chamber component of the
Symphony GDS can be provided either empty or pre-filled
with human allograft

... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

!

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Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular emblem with the department's name encircling an abstract symbol. The symbol resembles a stylized caduceus, featuring a staff with a serpent entwined around it, representing health and medicine. The logo is rendered in black and white.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV 1 4 2001

Ms. Karen F. Jurczak Regulatory Affairs Associate DePuy AcroMed, Inc. 325 Paramount Drive Raynham, Massachusetts 02767

Re: K012738

Trade/Device Name: Symphony Graft Delivery System (GDS) Regulation Number: 878.4820 Regulation Name: Surgical instrument motors and accessories/attachments Regulatory Class: I Product Code: GEY Dated: August 15, 2001 Received: August 16, 2001

Dear Ms. Jurczak:

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.

2

Page 2 - Ms. Karen F. Jurczak

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for 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 Compliance at (301) 594-4659. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International 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,

Sincerely yours,

lo Mark n Mellum

Celia M. 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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IV. Indications for Use

510(k) Number (if known):K012738
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NOV 1 4 2001
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Device Name: Symphony Graft Delivery System

The Symphony Graft Delivery System is indicated for the delivery of allograft, or synthetic bone graft materials to an orthopedic surgical site. In addition, it is designed to facilitate pre-mixing of bone graft materials with I.V. fluids, blood, plasma, platelet rich plasma, bone marrow or other specific blood component(s) as deemed necessary by the clinical use requirements.

(Please do not write below this line - continue on another page if needed)

Concurrence of CDRH, Office of Device Evaluation (ODE)

| Prescription Use: Use:

(Per 21 CFR 801.109)OR Over-The-Counter
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for (Division Sign-Off)
Division of General, Restorative
and Neurological Devices

510(k) Number: K012738