K Number
K091679
Device Name
LEFORTE SYSTEM BONE PLATE
Date Cleared
2009-10-02

(115 days)

Product Code
Regulation Number
872.4760
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
This device is intended for use in selective trauma of the mid-face and craniofacial skeleton; craniofacial surgery; reconstructive procedures; and selective orthognathic surgery of the maxilla and chin.
Device Description
LeForte Neuro System Bone Plate is made of unalloyed titanium (ASTM F67) and is manufactured and intended for use in selective trauma of the mid-face and craniofacial skeleton; craniofacial surgery; reconstructive procedures; and selective orthognathic surgery of the maxilla and chin. Jeil Medical Corporation utilizes the state of the art technology and apply the essential requirement of MDD(93/42/EEC) and ISO 14630:1997 from the device design to manufacturing and QC.
More Information

NOT APPLICABLE

No
The description focuses on the material and intended use of a bone plate, with no mention of AI or ML capabilities.

No
This device is a bone plate used for structural support in reconstructive and surgical procedures, not for therapy of a condition. Its function is mechanical, not therapeutic.

No
The device is a bone plate used for surgical repair and reconstruction, not for diagnosis. Its intended use describes therapeutic applications (trauma, surgery, reconstructive procedures) rather than identifying or characterizing a medical condition.

No

The device description explicitly states it is a "Bone Plate" made of "unalloyed titanium," which is a physical hardware component.

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

Here's why:

  • Intended Use: The intended use clearly states the device is for surgical procedures involving the mid-face, craniofacial skeleton, maxilla, and chin. This involves direct intervention on the patient's body.
  • Device Description: The device is described as a bone plate made of unalloyed titanium, designed for surgical implantation.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens derived from the human body (like blood, urine, tissue, etc.) to provide information about a physiological state, health, disease, or congenital abnormality.

IVD devices are used in vitro (outside the body) to analyze samples. This device is used in vivo (inside the body) during surgery.

N/A

Intended Use / Indications for Use

"This device is intended for use in selective trauma of the mid-face and craniofacial skeleton; craniofacial surgery; reconstructive procedures; and selective orthognathic surgery of the maxilla and chin."

Product codes

JEY

Device Description

"LeForte Neuro System Bone Plate is made of unalloyed titanium (ASTM F67) and is manufactured and intended for use in selective trauma of the mid-face and craniofacial skeleton; craniofacial surgery; reconstructive procedures; and selective orthognathic surgery of the maxilla and chin. Jeil Medical Corporation utilizes the state of the art technology and apply the essential requirement of MDD(93/42/EEC) and ISO 14630:1997 from the device design to manufacturing and QC."

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Mid-face and craniofacial skeleton; maxilla and chin

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)

Not Found

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

Not Found

Predicate Device(s)

K042365

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.4760 Bone plate.

(a)
Identification. A bone plate is a metal device intended to stabilize fractured bone structures in the oral cavity. The bone segments are attached to the plate with screws to prevent movement of the segments.(b)
Classification. Class II.

0

K091679

Image /page/0/Picture/1 description: The image shows the logo for "Jell Medical Corporation". The logo has a stylized graphic on the left, followed by the company name in a bold, sans-serif font. The text is black, and the background is white.

OCT - 2 2009

1 5

Exhibit 5 510(k) Summary of Safety and Effectiveness

Model: LeForte Neuro System Bone Plate

l.

Submitter and US Official Correspondent
Submitter:Jeil Medical Corporation
Address:#702, Kolon Science Valley 2nd
811, Guro-dong, Guro-gu
Seoul, 152-050, Korea
Official Correspondent:Shin Kuk Yoo, Consultant
Telephone No.:714-313-7442
Fax No.:801-303-7455
Email:skyone@LSKBioPartners.com
    1. Establishment Registration Number 3004049923

3. Device Information

Proprietary/Trade Name:LeForte Neuro System Bone Plate
Common/Usual Name:Bone Plate
Classification Name:Plate, Bone
Classification Product Code:JEY
Device Class:Class II per regulation 21 CFR 872.4760

4. New or Modification

The application is intended for premarket notification of new medical device, LeForte Neuro System Bone Plate, for US market.

ડ. Equivalent Legally Marketed Deyice

    1. Plate, Bone (Model: Synthes (USA) Neuro Plate and Screw System) manufactured by Synthes (USA) - K042365, Decision Date: 11/18/2004, JEY (Class II per regulation 21CRF 872.4760)

1

Ko91679

Image /page/1/Picture/1 description: The image shows the numbers 2 and 3, with a symbol in between them. The symbol looks like a cursive letter 'g' that is slightly tilted to the right. There is a horizontal line below the numbers and symbol.

Description of the Device

LeForte Neuro System Bone Plate is made of unalloyed titanium (ASTM F67) and is manufactured and intended for use in selective trauma of the mid-face and craniofacial skeleton; craniofacial surgery; reconstructive procedures; and selective orthognathic surgery of the maxilla and chin. Jeil Medical Corporation utilizes the state of the art technology and apply the essential requirement of MDD(93/42/EEC) and ISO 14630:1997 from the device design to manufacturing and QC.

7. Indications for Use (Intended Use)

This device is intended for use in selective trauma of the mid-face and craniofacial skeleton; craniofacial surgery; reconstructive procedures; and selective orthognathic surgery of the maxilla and chin.

8. Potential Adverse Affects and Complications (Common to all devices of this type)

  • l) Poor bone formulation, Osteoporosis, Osteolysis, Osteomyelitis, inhibited revascularization, or infection can cause loosening, bending, cracking or fracture of the device or premature loss of fixation with the bone, leading to nonunion.
  • Nonunion or delayed union which may lead to breakage of the implant. 2)
    1. Migration, bending, fracture or loosening of the implant.
    1. Metal sensitivity, or allergic reaction to foreign body
    1. Decrease in bone density due to stress shielding
    1. Pain, discomfort, or abnormal sensation due to the presence of the device
    1. Increased fibrous tissue response around the facture site and/or the implant
    1. Necrosis of bone
    1. Inadequate healing

Apart from these adverse effects there are always possible complications of any surgical procedure such as but not limited to, infection, nerve damage and pain which may not be related to the implant.

2

K09 1679

Safety and Effectiveness, comparison to Predicate device
Device NameLeForte Neuro System Bone PlateSynthes(USA) Neuro Plate & Screw System
ApplicantJeil Medical CorporationSynthes(USA)
510(k)
NumberNewK042365
ClassificationPlate, Bone
(Class II, 21 CFR 872. 4760)Bone Plate
(Class II, 21 CFR 872. 4760)
Burr hole cover
(Class II, 21 CFR 882. 5250)
Intraosseous fixation screw or wire
(Class II, 21 CFR 872. 4880)
MaterialTitaniumTitanium
Titanium Alloy
Intended UseThis device is intended for use in selective
trauma of the mid-face and craniofacial
skeleton; craniofacial surgery;
reconstructive procedures; and selective
orthognathic surgery of the maxilla and
chin.This device is intended for use in selective
trauma of the mid-face and craniofacial
Skeleton; craniofacial surgery;
reconstructive procedures; and selective
orthognathic surgery of the maxilla and
chin.
Single useSingle UseSingle Use
SterileNon-sterileNon-sterile

10. Conclusion

In all respects, the LeForte Neuro System Bone Plates are the equivalent of currently marketed devices. They are made of the same materials and have similar dimensions and characteristics. Potential adverse effects are identical to those of the predicate device.

32

3

Image /page/3/Picture/1 description: The image shows the logo for the Department of Health & Human Services USA. The logo features a stylized eagle with three lines forming its body and wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" is arranged in a circular fashion around the eagle.

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

Jeil Medical Corporation C/O Mr. Shin Kuk Yoo Manager LSK BioPartners, Incoporated 215 South State Street, Suite 100B Salt Lake City, Utah 84111

OCT - 2 2009

Re: K091679

Trade/Device Name: LeForte Neuro System Bone Plate (Various Models) Regulation Number: 21 CFR 872.4760 Regulation Name: Bone Plate Regulatory Class: II Product Code: JEY Dated: September 8, 2009 Received: September 10, 2009

Dear Mr. Yoo:

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 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.

4

Page 2- Mr. Yoo

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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.

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

http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. 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/cdrh/mdr/ 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 Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

for

Susan Runner, D.D.S., M.A. Acting Division Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

K091679

Exhibit 4 Indications for Use

510(k) number (if known): _

Device Name: LeForte Neuro System Bone Plate (Various Models)

AND/OR

Indications for Use:

This device is intended for use in selective trauma of the mid-face and craniofacial skeleton; craniofacial surgery; reconstructive procedures; and selective orthognathic surgery of the maxilla and chin.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ > (Part 21 CFR 801 Subpart D) Over-The-Counter Use (Part 21 CFR 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Kein Mulvey Son M SR

(Division Sign-Off) Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number: