K Number
K042078
Device Name
ENDOTINE FOREHEAD TRIPLE DEVICE
Date Cleared
2004-08-27

(25 days)

Product Code
Regulation Number
888.3040
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The ENDOTINE Forehead™ Triple is intended for use in subperiosteal browplasty surgery. The ENDOTINE Forehead™ Triple Device is specifically indicated for use to fixate the subcutaneous tissues to the cranial bone in browplasty.
Device Description
The ENDOTINE Forehead™ Triple Device consists of a bioabsorbable implant, an insertion tool, and stainless steel drill bit. The device implant is a soft tissue fixation platform that is anchored in the cranial bone. The insertion tool and the drill bit are sterilized together with the implant device in a plastic tray.
More Information

Not Found

No
The summary describes a mechanical implant and associated tools for surgical fixation, with no mention of software, algorithms, or any characteristics indicative of AI/ML.

No
The device is used for fixation of soft tissues to cranial bone in a surgical procedure (browplasty), which is a reconstructive or aesthetic procedure rather than one focused on treating or curing a disease or medical condition.

No
The device is described as an implant used for fixation in surgery, not for diagnosing a condition or disease.

No

The device description explicitly states it consists of a bioabsorbable implant, an insertion tool, and a stainless steel drill bit, which are all hardware components.

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

Here's why:

  • Intended Use: The intended use is for "subperiosteal browplasty surgery" and "to fixate the subcutaneous tissues to the cranial bone in browplasty." This describes a surgical procedure performed directly on a patient's body.
  • Device Description: The device is an "implant" and "soft tissue fixation platform" anchored in bone. This is a physical device used within the body.
  • Lack of IVD Characteristics: IVD devices are used to examine specimens (like blood, urine, or tissue) outside of the body to provide information about a person's health. The description of the ENDOTINE Forehead™ Triple does not involve any such testing of specimens.

Therefore, the ENDOTINE Forehead™ Triple is a surgical implant, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The ENDOTINE Forehead™ Triple is intended for use in subperiosteal browplasty surgery. The ENDOTINE Forehead™ Triple Device is specifically indicated for use to fixate the subcutaneous tissues to the cranial bone in browplasty.

Product codes

HWC

Device Description

The ENDOTINE Forehead™ Triple Device consists of a bioabsorbable implant, an insertion tool, and stainless steel drill bit. The device implant is a soft tissue fixation platform that is anchored in the cranial bone. The insertion tool and the drill bit are sterilized together with the implant device in a plastic tray.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

cranial bone

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

K014153, K023922

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

0

Ko42078 P/2

AUG 2 7 2004

10.0 510(k) SUMMARY

Coapt Systems is providing a summary of the safety and effectiveness information available for the ENDOTINE Forehead™ Triple Device. This 510(k) summary of safety and effectiveness information is submitted in accordance with the requirements of 21 CFR §807.92 and pursuant to Section 12, Part (a)(i)(3A) of the Safe Medical Devices Act of 1990.

SPONSOR/APPLICANT NAME AND ADDRESS

Coapt Systems, Inc. 1820 Embarcadero Road Palo Alto, CA Telephone: (650) 461-7600 Facsimile: (650) 213-9336

CONTACT INFORMATION

Lori DonDiego Director, Regulatory Affairs Coapt Systems, Inc. 1820 Embarcadero Road Palo Alto, CA Telephone: (650) 461-7647 Facsimile: (650) 213-9336 Email: Idondiego@@coaptsystems.com

DATE OF PREPARATION OF 510(K) SUMMARY

July 30, 2004

DEVICE TRADE OR PROPRIETARY NAME

ENDOTINE Forehead™ Triple Device

DEVICE COMMON OR CLASSIFICATION NAME

Classification Name: Smooth or threaded metallic bone fixation fastener Regulation Number: 888.3040 Class: II HWC Product Code:

1

IDENTIFICATION OF THE LEGALLY MARKETED DEVICES TO EQUIVALENCE IS BEING CLAIMED

| Name of Predicate Device | Name of Manufacturer | 510(k) or PMA
Number |
|------------------------------|----------------------|-------------------------|
| ENDOTINE Forehead™
Device | Coapt Systems, Inc | K014153 and K023922 |

DEVICE DESCRIPTION

The ENDOTINE Forehead™ Triple Device consists of a bioabsorbable implant, an insertion tool, and stainless steel drill bit. The device implant is a soft tissue fixation platform that is anchored in the cranial bone. The insertion tool and the drill bit are sterilized together with the implant device in a plastic tray.

INTENDED USE STATEMENT

The ENDOTINE Forehead™ Triple is intended for use in subperiosteal browplasty surgery. The ENDOTINE Forehead Triple Device is specifically indicated for use to fixate the subcutaneous tissues to the cranial bone in browplasty.

SUBSTANTIAL EQUIVALENCE

In review of the device description, predicate comparison and design control activities incorporated in this submission, no different issues of safety or effectiveness have been raised for the modified Forehead device. The modified device meets all internal functional performance requirements previously established for the predicate device.

Based on the design, materials, fundamental technology, intended use, and performance evaluations, Coapt Systems believes the proposed ENDOTINE Forehead™ Triple Device is substantially equivalent to the unmodified predicate device currently marketed under the Federal Food, Drug and Cosmetic Act. Therefore, safety and effectiveness are reasonably assured, justifying 510(k) clearance for commercial sale.

2

Image /page/2/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized image of three human profiles facing right, stacked on top of each other. The profiles are simple and abstract, with flowing lines suggesting hair or movement. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the image.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG 2 7 2004

Ms. Lori DonDiego Director, Regulatory Affairs Coapt Systems, Inc. 1820 Embarcadero Road Palo Alto, California 94303

Re: K042078

Trade/Device Name: ENDOTINE Forehead™ Triple Device Regulation Number: 21 CFR 888.3040 Regulation Name: Smooth or threaded metallic bone fixation fastener Regulatory Class: II Product Code: HWC Dated: July 30, 2004 Received: August 2, 2004

Dear Ms. DonDiego:

We have reviewed your Section 510(k) premarket notification of intent to market the device we have reviewed your betermined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for abo surveior to May 28, 1976, the enactment date of the Medical Device Amendments, or to eoniner of prox 8 120 2011 11 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 r ou may, merelevy mans 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 if your device to such additional controls. Existing major regulations affecting your device can may be subject to back academal 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 r loast be device that I Dr mination that your device complies with other requirements of the Act that + 27 Maxal statutes and regulations administered by other Federal agencies. You must or any I cueral battler and strengents, 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.

3

This letter will allow you to begin marketing your device as described in your Section 510(k) I mis letter wating of substantial equivalence of your device of your device to a legally promative notificated on " *************************************************************************************************************************************************** to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please If you desire 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 other general informational 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,

Muriam C. Provost

+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

4

Coapt Systems, Inc.

042078

STATEMENT OF INDICATIONS FOR USE

510(k) Number (if known):


Not yet assigned

Device Name:

ENDOTINE Forehead™ Triple Device

Indications For Use:

The ENDOTINE Forehead™ Triple is intended for use in subperiosteal browplasty surgery. The ENDOTINE Forehead™ Triple Device is specifically indicated for use to fixate the subcutaneous tissues to the cranial bone in browplasty.

Prescription Use

AND/OR

Over-The-Counter Use

(Part 21 CFR 801 Subpart D)

(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)

Miriam C. Provost

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

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510(k) Number_________________________________________________________________________________________________________________________________________________________________