K Number
K012830
Manufacturer
Date Cleared
2001-11-20

(89 days)

Product Code
Regulation Number
882.5970
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Lerman & Son Cranial Orthosis Helmet is intended to be used by or under the direction of a physician for treatment of abnormal head shape in infants from 3-18 months of age (positional/ deformational plagiocephaly).

Device Description

The Lerman & Son Cranial Orthosis Helmet is a custom made orthosis used to treat children between the ages of three and eighteen months for abnormal head shapes. Through the concavity formed during the design of this helmet, the skull is encouraged to grow in a more normal manner.

AI/ML Overview

This is a premarket notification (510(k)) for a cranial orthosis helmet, not a study evaluating a device's performance against acceptance criteria using advanced AI or imaging technology. Therefore, the requested information elements related to AI, statistical studies, expert ground truth, and training/test sets are not applicable to this document.

The document establishes substantial equivalence to a predicate device, Orthomerica STARband (K001167), primarily by comparing design, materials, intended use, and other key specifications.

Here's a breakdown of the relevant information from the provided document:

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

The document does not present "acceptance criteria" in the typical sense of numerical thresholds for performance metrics. Instead, it demonstrates "substantial equivalence" to a predicate device. The "reported device performance" is essentially that it matches the predicate device in key characteristics.

Feature / Criteria (as compared to predicate)Predicate Device (Orthomerica STARband K001167)Lerman & Son Cranial Orthosis Helmet (This submission)
Indications for UseTreatment of abnormal infant head shape (positional/deformational plagiocephaly)Treatment of abnormal infant head shape (positional/deformational plagiocephaly)
MaterialsCopolymer plastic/Closed Cell Polyethylene Foam/Velcro strapCopolymer plastic/Closed Cell Polyethylene Foam/Velcro strap
Clinical PopulationInfants age 3-18 monthsInfants age 3-18 months
Daily Wear Time23 hrs./day23 hrs./day
Avg. Time to Effectiveness (patients age 3-7 mos.)2 - 4 months2 - 4 months
Contraindications for UseCraniosynostosis/ HydrocephalusCraniosynostosis/ Hydrocephalus
Method of ManufactureCustom from moldCustom from mold by Certified Orthotist

2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

Not applicable. This is a 510(k) submission focusing on substantial equivalence, not a clinical trial with a "test set" to evaluate performance. There is no mention of a specific test set or data provenance in this document beyond the predicate device's existing clearance.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

Not applicable. No "ground truth" was established for a test set in the context of this 510(k) submission. Substantial equivalence relies on comparing the device to an already legally marketed predicate, not on new clinical data requiring expert review for ground truth.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

Not applicable. There was no "test set" or adjudication method described in this 510(k) submission.

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 physical cranial orthosis helmet and does not involve AI or human readers for diagnostic interpretation. Therefore, an MRMC study is irrelevant.

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

Not applicable. This device is a physical medical device, not a software algorithm.

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

Not applicable. The concept of "ground truth" as used in testing AI or diagnostic devices is not relevant here. The "truth" for this submission is based on the established safety and effectiveness of the predicate device (Orthomerica STARband K001167).

8. The sample size for the training set

Not applicable. This is a physical device, and the submission does not involve machine learning or a "training set."

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

Not applicable. As there is no training set mentioned, there is no ground truth established for it.

{0}------------------------------------------------

K012830 PG1 of 3

NOV 2 0 2001

510(k) Summary Lerman & Son Cranial Orthosis Helmet Lerman & Son

510(k) Summary

The following safety and effectiveness summary has been prepared pursuant to requirement for 510(k) summaries specified in 21CFR¶807.92(a).

807.92(a)(1)

Submitter Information

Lerman & Son 8710 Wilshire Blvd. Beverly Hills, California 90211 Phone: (310) 659-2290 Facsimile: (310) 659-1601

Contact Persons: Max Lerman, President

Date: August 20, 2001

807.92(a)(2)

Trade Name:

Lerman & Son Cranial Orthosis Helmet

Common Name: Cranial Helmet

Classification Name(s): Orthosis, Cranial

Classification Number: MVA

807.92(a)(3)

Predicate Device(s)

Orthomerica

STARband

K001167

Additional substantial equivalence information is provided in the following Substantial Equivalence Comparison Table.

{1}------------------------------------------------

510(k) Summary Lerman & Son Cranial Orthosis Helmet Lerman & Son

807.92(a)(5)

Intended Use(s)

The Lerman & Son Cranial Orthosis Helmet is intended to be used by or under the direction of a physician for treatment of abnormal head shape in infants from 3-18 months of age (positional/ deformational plagiocephaly).

Device Description

The Lerman & Son Cranial Orthosis Helmet is a custom made orthosis used to treat children between the ages of three and eighteen months for abnormal head shapes. Through the concavity formed during the design of this helmet, the skull is encouraged to grow in a more normal manner.

The Lerman & Son Cranial Orthosis Helmet is intended for use by or under the direction of a physician for treatment of abnormal infant head shape (positional/ deformational plagiocephaly).

The Lerman & Son Helmet is substantially equivalent to Orthomerica's STARband helmet cleared by FDA via K001167. A Substantial Equivalency table has been included within this submission.

Materials:Helmet-Copolymer plastic; Padding-Closed cell foam polypropylene
Straps:Velcro
Final shape:Dependant upon infant head shape
Size:Side to side - 4"-5-1/2"Front to back - 6"-7-1/2"
Weight:8 - 12 ounces

{2}------------------------------------------------

)(012830 P&G of 3

510(k) Summary

Lerman & Son Cranial Orthosis Helmet
Lerman & Son

Substantial Equivalence Comparison Table
Orthomerica STARband K001167Lerman & Son Cranial Orthosis Helmet This submission
Indications for UseTreatment of abnormal infant head shape (positional/deformational plagiocephaly)Treatment of abnormal infant head shape (positional/deformational plagiocephaly)
MaterialsCopolymer plastic/Closed CellPolyethylene Foam/Velcro strapCopolymer plastic/Closed CellPolyethylene Foam/Velcro strap
Clinical PopulationInfants age 3-18 monthsInfants age 3-18 months
Daily Wear Time23 hrs./day23 hrs./day
Avg. Time to Effectiveness (patients age 3-7 mos.)2 - 4 months2 - 4 months
Contraindications for UseCraniosynostosis/ HydrocephalusCraniosynostosis/ Hydrocephalus
Method of ManufactureCustom from moldCustom from mold by Certified Orthotist

4-1 P ..... . Comparison Tahle Cubet

{3}------------------------------------------------

Image /page/3/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 an abstract symbol resembling an eagle or bird with three stylized wing-like shapes.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV 2 0 2001

Mr. Max Lerman President Lerman & Son 8710 Wilshire Boulevard Beverly Hills, California 90211

Re: K012830

Trade/Device Name: Lerman & Son Cranial Orthosis Helmet Regulation Number: 882.5970 Regulation Name: Cranial Orthosis Regulatory Class: II Product Code: MVA Dated: August 20, 2001 Received: August 23, 2001

Dear Mr. Lerman:

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.

{4}------------------------------------------------

Page 2 - Mr. Max Lerman

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,

Mark A. Millener

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

{5}------------------------------------------------

Indications for Use Statement

Applicant: Lerman & Son

NOV 2 0 2001 510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Device Name: Lerman & Son Cranial Orthosis Helmet

Indications For Use:

The Lerman & Son Cranial Orthosis Helmet is intended to be used by or under the direction of a 11te Lennan & Soll Cramar Of abnormal head shape in infants from 3-18 months of age (positional/ deformational plagiocephaly).

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

OR Over The Counter_ Prescription Use

(Per 21 CFR, 801.109)

(Optional Format 1-2-99)
Mark N Millerson
0 K017830

General, Restorative and Neurological Devices

510(k) Number K012830

§ 882.5970 Cranial orthosis.

(a)
Identification. A cranial orthosis is a device that is intended for medical purposes to apply pressure to prominent regions of an infant's cranium in order to improve cranial symmetry and/or shape in infants from 3 to 18 months of age, with moderate to severe nonsynostotic positional plagiocephaly, including infants with plagiocephalic-, brachycephalic-, and scaphocephalic-shaped heads.(b)
Classification. Class II (special controls) (prescription use in accordance with § 801.109 of this chapter, biocompatibility testing, and labeling (contraindications, warnings, precautions, adverse events, instructions for physicians and parents)).