K Number
K041584
Device Name
KYPHX HV-R BONE CEMENT, MODEL C01A
Manufacturer
Date Cleared
2004-07-07

(23 days)

Product Code
Regulation Number
888.3027
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
KyphX® HV-R™ bone cement is indicated for the treatment of pathological fractures of the vertebral body due to osteoporosis, cancer, or benign lesions using a balloon kyphoplasty procedure. Cancer includes multiple myeloma and metastatic lesions, including those arising from breast or lung cancer, or lymphoma. Benign lesions include hemagioma and giant cell tumor.
Device Description
Like the predicate devices, KyphX® HV-RTM Bone Cement is provided as a two-component system. The powder component consists of a PMMA copolymer (polymethyl methacrylate/methyl-methacrylate-styrene-copolymer) with barium sulfate as a radiopacifier and benzoyl peroxide as an initiator. The liquid component consists of methylmethacrylate monomer, with the addition of hydroquinone as a stabilizer and N.N-dimethyl-p-toluidine as a promoter. The powder and liquid components are mixed prior to use.
More Information

Not Found

No
The device description and performance studies focus on the material properties and mechanical performance of bone cement, with no mention of AI or ML technologies.

Yes
The device is a bone cement used for the treatment of pathological fractures of the vertebral body, indicating a therapeutic purpose.

No
The device, KyphX® HV-R™ bone cement, is indicated for the treatment of pathological fractures of the vertebral body and is described as a two-component system to be mixed and used. It is a surgical implant used for treatment, not for diagnosing conditions.

No

The device description clearly states it is a two-component bone cement system consisting of powder and liquid components, which are physical materials, not software.

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

Here's why:

  • Intended Use: The intended use describes the treatment of pathological fractures of the vertebral body using a balloon kyphoplasty procedure. This is a surgical procedure performed directly on the patient's body.
  • Device Description: The device is a bone cement, a material implanted into the body.
  • Lack of Diagnostic Activity: There is no mention of the device being used to examine specimens derived from the human body to provide information for diagnostic purposes. IVDs are typically used to test blood, urine, tissue samples, etc.

The device is a therapeutic device used in a surgical procedure, not a diagnostic device used for in vitro testing.

N/A

Intended Use / Indications for Use

KyphX® HV-R™ bone cement is indicated for the treatment of pathological fractures of the vertebral body due to osteoporosis, cancer, or benign lesions using a balloon kyphoplasty procedure. Cancer includes multiple myeloma and metastatic lesions, including those arising from breast or lung cancer, or lymphoma. Benign lesions include hemagioma and giant cell tumor.

Product codes

NDN

Device Description

Like the predicate devices, KyphX® HV-RTM Bone Cement is provided as a two-component system. The powder component consists of a PMMA copolymer (polymethyl methacrylate/methyl-methacrylate-styrene-copolymer) with barium sulfate as a radiopacifier and benzoyl peroxide as an The liquid component consists initiator. of methylmethacrylate monomer, with the addition of hydroquinone as a stabilizer and N.N-dimethyl-p-toluidine as a promoter. The powder and liquid components are mixed prior to use.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

vertebral body

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)

Mechanical Tests:
KyphX® HV-R™ Bone Cement was tested in direct comparison to the Surgical Simplex® P predicate device and verified substantially equivalent, as defined by ISO 5833:2002, "Implants for Surgery - Acrylic resin cements."

Biocompatibility:
KyphX® HV-RTM Bone Cement meet the requirements for "Implant, Tissue/Dentin/Bone, Permanent Contact" described in the FDA Blue Book Memorandum #G95-1. KyphX® HV-RTM Bone Cement was tested in direct comparison to the Surgical Simplex® P predicate device and verified substantially equivalent, as defined by ISO-10993, "Biological Evaluation of Medical Devices Part 1: Evaluation and Testing."

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

Not Found

Predicate Device(s)

K033801, K002652, K032945

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 888.3027 Polymethylmethacrylate (PMMA) bone cement.

(a)
Identification. Polymethylmethacrylate (PMMA) bone cement is a device intended to be implanted that is made from methylmethacrylate, polymethylmethacrylate, esters of methacrylic acid, or copolymers containing polymethylmethacrylate and polystyrene. The device is intended for use in arthroplastic procedures of the hip, knee, and other joints for the fixation of polymer or metallic prosthetic implants to living bone.(b)
Classification. Class II (special controls). The special control for this device is the FDA guidance document entitled “Class II Special Controls Guidance Document: Polymethylmethacrylate (PMMA) Bone Cement.”

0

Kyphon Inc Page 1 of 3, Amended Tab 5 KyphX® HV-RTM Bone Cement Premarket Notification [510(k)] Submission

JUL = 7 2004

K041584

Tab 5

Premarket Notification [510(k)] Summary

Trade Name:KyphX® HV-R™ Bone Cement
Common Name:Bone Cement
Classification /Name:Class II
Bone Cement: 21 CFR, part 888.3027
Device Code:NDN
Manufacturer's Name:
Address:Kyphon Inc.
1221 Crossman Avenue
Sunnyvale, CA 94089
Corresponding Official:
Title:
Address:
Telephone:Cindy Domecus
Vice President, Clinical Research and Regulatory Affairs
1221 Crossman Avenue
Sunnyvale, CA 94089
408-222-6740
Predicate Device(s):K033801: KyphX® HV-R™, Model C01A

K002652: Stryker Howmedica Surgical Simplex®
Radiopaque pre-packed in ACM and MixEvac II.

K032945: Stryker Spineplex™ Radiopaque Bone Cement |
| Intended Use: | KyphX® HV-R™ bone cement is indicated for the
treatment of pathological fractures of the vertebral body
due to osteoporosis, cancer, or benign lesions using a
balloon kyphoplasty procedure. Cancer includes multiple
myeloma and metastatic lesions, including those arising
from breast or lung cancer, or lymphoma. Benign lesion- |

Any statement regarding "substantial equivalence" made in this submission only relates to whether the intended to be interested in this submission may be lawfully market approval or reclassification, and is not intended o be interpreted as an admission of evidence in any patent proceeding, and is not infingement therein therefore should not be consider and of the scope of any patent or patent or patent or patent or patent opplication, or to whether the product addressed in this submission, or its use, may be considered indistinct, from a patentability perspective, from any of the other devices referenced in this filing.

include hemagioma and giant cell tumor.

1

Like the predicate devices, KyphX® HV-RTM Bone Cement Device Description: is provided as a two-component system. The powder component consists of a PMMA copolymer (polymethyl methacrylate/methyl-methacrylate-styrene-copolymer) with barium sulfate as a radiopacifier and benzoyl peroxide as an The liquid component consists initiator. of methylmethacrylate monomer, with the addition of hydroquinone as a stabilizer and N.N-dimethyl-p-toluidine as a promoter. The powder and liquid components are mixed prior to use.

Table 5-1 compares the chemical composition of KyphX® HV-RTM Bone Cement to the Surgical Simplex® P predicate device.

Table 5-1: Chemical Composition of KyphX® HV-R and Surgical Simplex®P
Chemical CompositionKyphX® HV-RTMSurgical Simplex® P
Powder20 g. packet of sterile powder20 g (half-dose) packet of sterile powder
Polymethyl methacrylate / methyl methacrylate-styrene copolymer68.0% w/w88.5% w/w
Barium sulfate30.0% w/w10.0% w/w
Benzoyl peroxide2.0% w/w1.5% w/w
Liquid10 ml vial of sterile liquid10 ml (half-dose) vial of sterile liquid
Methyl methacrylate (monomer)99.1% v/v97.4% v/v
N, N-dimethyl-p-toluidine0.90% v/v2.6% v/v
Hydroquinone75 ppm75 ± 15 ppm

Mechanical Tests:

KyphX® HV-R™ Bone Cement was tested in direct comparison to the Surgical Simplex® P predicate device and verified substantially equivalent, as defined by ISO 5833:2002, "Implants for Surgery - Acrylic resin cements."

Any statement regarding "substantial equivalence" made in this submission only relates to whether the product addressed in this submission may be lawfully market approval or reclassification, and is not intended to be interpreted as an admission or any other type of evidence in any patent proceeding, including patent infringement fitigation or proceeding before any Patent office. The present submission and statements therein the product not be construed as affecting or help to the scope of any patent or patent or patent or patent or patent or patent or patent or patent opplication, or to whether the product addressed in this submission, or its use, any parent application, of the laboration, from a a atentability perspective, from any of the other devices referenced in this filing.

2

  • Clinical information demonstrates that the intended use of Clinical Discussion: KyphX® HV-RTM Bone Cement is substantially equivalent to the Surgical Simplex® P indication for the fixation of pathological fractures, to the KyphX® HV-R™ predicate indication for the treatment of pathological fractures of the vertebral body due to osteoporosis using a kyphoplasty procedure, and to the Spineplex™ bone cement for use in benign and metastatic lesions.
    The materials used in KyphX® HV-R™ Bone Cement meet Biocompatibility: the requirements for "Implant, Tissue/Dentin/Bone, Permanent Contact" described in the FDA Blue Book Memorandum #G95-1. KyphX® HV-RTM Bone Cement was tested in direct comparison to the Surgical Simplex® P predicate device and verified substantially equivalent, as defined by ISO-10993, "Biological Evaluation of Medical Devices Part 1: Evaluation and Testing."

The KyphX® HV-RTM Bone Cement is sterile and non-Sterilization: pyrogenic. The solid components and pouch are sterilized with gamma radiation to a Sterility Assurance Level (SAL) of 10°. The liquid components are sterilized with filtration methods to an SAL of 10-5. The outer packaging containing the liquid component is sterilized with ethylene oxide gas. The bone cement is intended for single use only.

Substantial Equivalence: The information submitted in this pre-market notification supports a determination that KyphX® HV-RTM Bone Cement is substantially equivalent in technological characteristics and intended use to the predicates. The products have the same fundamental scientific technology their chemical composition, material properties, in performance characteristics, and biocompatibility, and also have the same intended use.

Any statement regarding "substantial equivalence" made in this submission only relates to whether the intended to be interest without may be lawfully marketed without premarket approval or reclassification, and is not intended to be interpreted as an admission or any other type of evidence in any petent proceeding, including paract infringement litigation or proceeding before any Patent Office. The present submission and statements therein therefore should not be construed as affecting or relating to the "stennssion and "statinlerity whether the product addressed in this submission, or its use, may be considered indistinct, from a patentablity perspective, from any of the other devices referenced in this filing.

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 a stylized symbol that resembles a caduceus, with three abstract human figures or forms intertwined. The symbol is rendered in black and is the focal point of the logo.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUL - 7 2004

Cindy Domecus Vice President, Clinical Research and Regulatory Affairs Kyphon Inc. 1221 Crossman Avenue Sunnyvale, California 94089

Re: K041584

Trade/Device Name: KyphX® HV-R™ Bone Cement, Model C01A Regulation Number: 21 CFR 888.3027 Regulation Name: Polymethylmethacrylate (PMMA) bone cement Regulatory Class: II Product Codes: NDN Dated: June 11, 2004 Received: June 14, 2004

Dear Ms. Domecus:

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 -- Ms. Cindy Domecus

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), please contact the Office of Compliance at (301) 594-4659. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act 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,

Miriam C. Provost

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

Enclosure

5

Indications for Use

510(k) Number (if known): K041584

Device Name: KyphX® HV-RTM Bone Cement

Indications for Use:

KyphX HV-R bone cement is indicated for the treatment of pathological fractures of the vertebral body due to osteoporosis, cancer, or benign lesions using a balloon kyphoplasty procedure. Cancer includes multiple myeloma and metastatic lesions, including those atising from breast or lung cancer, or lymphoma. Benign lesions include hemagioma and giant cell tumor.

Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Page 1 of 1

Miriam C. Provost

(Division Sign-Off) Division of General, Restorative, and Neurological Devices

510(k) Number_Ko41584