K Number
K091722
Device Name
COAXIAL APPLICATOR SYSTEM
Manufacturer
Date Cleared
2010-03-12

(274 days)

Product Code
Regulation Number
880.5860
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The CoAxial Applicator System is designed to facilitate pre-mixinq of allograft, autograft, or synthetic bone graft materials for application to an orthopedic surgical site, with autologous blood, plasma, platelet-rich plasma, or other specific blood component(s) as deemed necessary by the clinical use requirements. In addition, the CoAxial Applicator System is intended for the application of autologous blood, plasma, platelet-rich plasma, or other specific blood component(s), as deemed necessary by the surgeon's determination of the clinical use requirements to facilitate the preparation of soft tissue autograft or allograft material prior to the application of the graft material to a repair site.
Device Description
The CoAxial™ Applicator System consists of the CoAxial™ Spray Kit and CoAxial™ Applicator Tips. Within the CoAxial™ Spray Kit is a sterile, single-use, syringe type device (CoAxial™ Applicator), connector and Spray Tip. The CoAxial™ Applicator is comprised of two separate chambers to facilitate pre-mixing of bone graft materials with blood or blood products. The CoAxial™ Applicator is a dual-syringe system, similar to all three predicate devices. It is comprised of an inner, smaller syringe and an outer, larger syringe, instead of two separate syringes. While the design differs from the predicates, it is designed to function in the same manner. Two fluids can be held by separate syringes and all applicators allow for dispensing the two liquids simultaneously. The dimensions of the two chambers that comprise the CoAxial™ Applicator are 12 ml (outer) and 1.2 ml (inner), which are similar to the 10 ml and 1 ml volumes held by the two syringes in both the Harvest SmartJet™ Bone Grafting Liquid Applicator predicates. The 10:1 ratio of dispelled fluids is the same for the SmartJet™ systems. The FibriJet® Applicator has a ratio of 1:1.
More Information

Not Found

No
The device description and performance studies focus on mechanical aspects of fluid mixing and application, with no mention of AI or ML.

No.
The device is designed to facilitate the pre-mixing and application of bone graft materials and blood components to an orthopedic surgical site, but it does not inherently provide therapy. Its function is to prepare and deliver materials that facilitate a therapeutic process (grafting), rather than being therapeutic itself.

No

Explanation: The device is designed to facilitate the pre-mixing and application of bone graft materials and blood components to an orthopedic surgical site, which is a therapeutic function, not a diagnostic one. It does not identify or analyze a condition or disease.

No

The device description clearly outlines physical components like syringes, applicators, and tips, indicating it is a hardware-based medical device. There is no mention of software as a component or the primary function.

Based on the provided text, the CoAxial Applicator System is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use clearly describes the device as being used to facilitate the application and pre-mixing of bone graft materials and blood components to an orthopedic surgical site or prior to application to a repair site. This is a direct application to the body or preparation for application to the body.
  • Device Description: The description details a mechanical system (syringes, chambers, tips) for holding and dispensing materials. It does not describe any components or processes for analyzing biological samples in vitro (outside the body).
  • Lack of IVD Characteristics: There is no mention of the device being used to diagnose, monitor, or screen for diseases or conditions by examining samples like blood, urine, or tissue in vitro.

The device is designed for the delivery and preparation of materials for surgical procedures, which falls under the category of surgical or procedural devices, not IVDs.

N/A

Intended Use / Indications for Use

The CoAxial Applicator System is designed to facilitate pre-mixinQ of allograft, autograft, or synthetic bone graft materials for application to an orthopedic surgical site, with autologous blood, plasma, platelet-rich plasma, or other specific blood component(s) as deemed necessary by the clinical use requirements.

In addition, the CoAxial Applicator System is intended for the application of autologous blood, plasma, platelet-rich plasma, or other specific blood component(s), as deemed necessary by the surgeon's determination of the clinical use requirements to facilitate the preparation of soft tissue autograft or allograft material prior to the application of the graft material to a repair site.

Product codes (comma separated list FDA assigned to the subject device)

FMF

Device Description

The CoAxial™ Applicator System consists of the CoAxial™ Spray Kit and CoAxial™ Applicator Tips. Within the CoAxial™ Spray Kit is a sterile, single-use, syringe type device (CoAxial™ Applicator), connector and Spray Tip. The CoAxial™ Applicator is comprised of two separate chambers to facilitate pre-mixing of bone graft materials with blood or blood products.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

orthopedic surgical site, repair site

Indicated Patient Age Range

Not Found

Intended User / Care Setting

surgeon

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)

Torque testing (separation force, unscrewing torque, ease of assembly, resistance of overriding, stress cracking) and volume accuracy testing was performed on the CoAxial™ Applicator. Results either met the acceptance criteria set forth within the applicable standard, or if there were no set acceptance criteria, the results were acceptable per the test protocol.

Assembly time and mixing thoroughness were evaluated against the FibriJet® Applicator, manufactured by Micromedics. The CoAxial™ Applicator System demonstrated ease of use advantage over the FibriJet® Applicator, with a three-fold decrease in assembly time using an assembly test subject who was unfamiliar with either device assembly. The results of the mixing analysis were comparable for the two devices.

The CoAxial™ Applicator System is intended to be used for the application of liquids in a 10:1 ratio, and the instructions for use clearly define how to achieve this application. Bone graft handling testing was performed to compare the effect that an 11:1, 10:1, and 9:1 ratio of PRP/PP to autologous serum has on bone graft cohesive strength. No statistically significant differences between the groups were observed.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K011032, K020252, K883338

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 880.5860 Piston syringe.

(a)
Identification. A piston syringe is a device intended for medical purposes that consists of a calibrated hollow barrel and a movable plunger. At one end of the barrel there is a male connector (nozzle) for fitting the female connector (hub) of a hypodermic single lumen needle. The device is used to inject fluids into, or withdraw fluids from, the body.(b)
Classification. Class II (performance standards).

0

K0917222

MAR ] 2 2010

510(k) Summary

Applicant/Sponsor: Biomet Biologics, LLC 56 East Bell Drive P.O. Box 587 Warsaw, IN 46581 Phone: 800-348-9500 www.biomet.com

Contact Person: Lonnie Witham Summary Preparation Date: March 11, 2010

Device Trade Name: CoAxial™ Applicator System Common Name: Piston Syringe

Classification Name: Piston Syringe FMF (21 CFR 880.5860)

510(k) NumberPredicate DeviceManufacturer
K011032SmartJet™ Bone Grafting Liquid ApplicatorHarvest Technologies Corp.
Plymouth, MA 02360
K020252SmartJet™ Liquid Grafting ApplicatorHarvest Technologies Corp.
Plymouth, MA 02360
K883338Surgical Sealant Applicator (FibriJet®)Micromedics, Inc.
St. Paul, MN 55107

Legally Marketed Predicate Devices To Which Substantial Equivalence Is Claimed:

Device Description:

The CoAxial™ Applicator System consists of the CoAxial™ Spray Kit and CoAxial™ Applicator Tips. Within the CoAxial™ Spray Kit is a sterile, single-use, syringe type device (CoAxial™ Applicator), connector and Spray Tip. The CoAxial™ Applicator is comprised of two separate chambers to facilitate pre-mixing of bone graft materials with blood or blood products.

Statement of Intended Use:

The CoAxial™ Applicator System is designed to facilitate pre-mixing of allograft, or synthetic bone graft materials for application to an orthopedic surgical site, with autologous blood, plasma, platelet-rich plasma, or other specific blood component(s) as deemed necessary by the clinical use requirements

In addition, the CoAxial™ Applicator System is intended for the application of autologous blood, plasma, platelet-rich plasma, or other specific blood component(s), as deemed necessary by the surgeon's determination of the clinical use requirements to facilitate the preparation of

1

soft tissue autograft or allograft material prior to the application of the graft material to a repair site.

Summary of Technological Characteristics:

The CoAxial™ Applicator is a dual-syringe system, similar to all three predicate devices. It is comprised of an inner, smaller syringe and an outer, larger syringe, instead of two separate syringes. While the design differs from the predicates, it is designed to function in the same manner. Two fluids can be held by separate syringes and all applicators allow for dispensing the two liquids simultaneously.

The dimensions of the two chambers that comprise the CoAxial™ Applicator are 12 ml (outer) and 1.2 ml (inner), which are similar to the 10 ml and 1 ml volumes held by the two syringes in both the Harvest SmartJet™ Bone Grafting Liquid Applicator predicates. The 10:1 ratio of dispelled fluids is the same for the SmartJet™ systems. The FibriJet® Applicator has a ratio of 】1:1.

Summary of Performance Data:

Torque testing (separation force, unscrewing torque, ease of assembly, resistance of overriding, stress cracking) and volume accuracy testing was performed on the CoAxial™ Applicator. Results either met the acceptance criteria set forth within the applicable standard, or if there were no set acceptance criteria, the results were acceptable per the test protocol.

Assembly time and mixing thoroughness were evaluated against the FibriJet® Applicator, manufactured by Micromedics. The CoAxial™ Applicator System demonstrated ease of use advantage over the FibriJet® Applicator, with a three-fold decrease in assembly time using an assembly test subject who was unfamiliar with either device assembly. The results of the mixing analysis were comparable for the two devices.

The CoAxial™ Applicator System is intended to be used for the application of liquids in a 10:1 ratio, and the instructions for use clearly define how to achieve this application. Bone graft handling testing was performed to compare the effect that an 11:1, 10:1, and 9:1 ratio of PRP/PP to autologous serum has on bone graft cohesive strength. No statistically significant differences between the groups were observed.

Non-Clinical Testing:

Non-clinical laboratory testing was performed to determine substantial equivalence. Testing indicated that the Fat Concentration System is substantially equivalent to currently marketed predicate devices. The results indicated that the device was functional within its intended use.

Clinical Testing:

None provided as a basis for substantial equivalence.

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Adverse Events:

A search of FDA's MAUDE database for the period of Jan. 1, 2008 thru Jan. 31, 2010 revealed that no adverse events were reported under K011032, K020252, and K883338.

Substantial Equivalence:

The CoAxial™ Applicator System is shown to be substantially equivalent to the previously cleared devices, the Harvest SmartJet™ Bone Grafting Liquid Applicator- K011032, SmartJer™ Liquid Grafting Applicator - K020252, and the Micromedics FibriJet® Applicator - K883338. The design, sizes, and materials are similar to the aforementioned predicates and there are no new performance characteristics that introduce new safety and/or effectiveness issues.

All trademarks are property of Biomet, Inc.

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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" arranged around the perimeter. Inside the circle is an abstract symbol resembling an eagle or bird in flight, composed of three curved lines.

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

Mr. Lonnie Witham Regulatory Affairs Consultant Biomet, Biologics, LLC 56 East Bell Drive P.O. Box 587 Warsaw, Indiana 46581-0587

MAR 1 2 2010

Re: K091722

Trade/Device Name: CoAxial Applicator System Regulation Number: 21CFR 880.5860 Regulation Name: Piston Syringe Regulatory Class: II Product Code: FMF Dated: March 3, 2010 Received: March 4, 2010

Dear Mr. Witham:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

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.

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Page 2 Mr. Witham

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/MedicalDevices/Safety/ReportaProblem/default.htm 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 (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely vours,

for

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

Enclosure

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Indications for Use

510(k) Number (if known): NA _________________________________________________________________________________________________________________________________________________

Device Name: CoAxial Applicator System

Indications for Use:

The CoAxial Applicator System is designed to facilitate pre-mixinq of allograft, autograft, or synthetic bone graft materials for application to an orthopedic surgical site, with autologous blood, plasma, platelet-rich plasma, or other specific blood component(s) as deemed necessary by the clinical use requirements.

In addition, the CoAxial Applicator System is intended for the application of autologous blood, plasma, platelet-rich plasma, or other specific blood component(s), as deemed necessary by the surgeon's determination of the clinical use requirements to facilitate the preparation of soft tissue autograft or allograft material prior to the application of the graft material to a repair site.

Prescription Use YES (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use NO (21 CFR 807 Subpart C)

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

Concurrence of CBER, Office of Blood Research and Review

Division Sign-Off) vision of Anesthesiology, General Hospital ection Control, Dental Devices

10(k) Number:

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