K Number
K100240
Device Name
ORTHOPEDIATRICS PEDILOC TIBIA PLATE SYSTEM
Date Cleared
2010-05-17

(110 days)

Product Code
Regulation Number
888.3030
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
OrthoPediatrics PediLoc™ Tibia Plates are indicated for fractures, osteotornies, and non-unions of the pediatric and small stature adult tibia.
Device Description
The OrthoPediatrics PediLoc™ Tibial Plates are machined metallic plates that offer screw to plate locking designed for various fracture modes of the distal end of the tibia and other small bones.
More Information

Not Found

No
The summary describes a mechanical implant (metallic plates) and mentions engineering strength calculations, with no indication of software, image processing, or AI/ML terms.

Yes
The device, OrthoPediatrics PediLoc™ Tibia Plates, is indicated for medical conditions such as fractures, osteotomies, and non-unions of the pediatric and small stature adult tibia, which is a therapeutic purpose.

No
The device description indicates it is a machined metallic plate designed for fixing fractures and osteotomies, not for diagnosing conditions.

No

The device description explicitly states it is "machined metallic plates," indicating it is a hardware device, not software only.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body (like blood, urine, tissue) to provide information about a person's health.
  • Device Description: The OrthoPediatrics PediLoc™ Tibia Plates are described as "machined metallic plates" designed for surgical implantation to treat fractures and other bone issues.
  • Intended Use: The intended use is for "fractures, osteotornies, and non-unions of the pediatric and small stature adult tibia." This is a surgical intervention, not a diagnostic test performed on a specimen.

The information provided clearly indicates this is a surgical implant device, not a diagnostic device.

N/A

Intended Use / Indications for Use

OrthoPediatrics PediLoc™ Tibial Plates are indicated for fractures, osteotomies, and non-unions of the pediatric and small stature adult tibia.

Product codes

HRS, HWC

Device Description

The OrthoPediatrics PediLoc™ Tibial Plates are machined metallic plates that offer screw to plate locking designed for various fracture modes of the distal end of the tibia and other small bones.

  • Intended use: OrthoPediatrics PediLoc™ Tibial Plates are indicated for . fractures, osteotomies, and non-unions of the pediatric and small stature adult tibia.
  • Materials: The devices are manufactured from 316L stainless steel which . meets the ASTM-F138 standard.
  • Function: The system functions to provide immediate stability and . temporary fixation during the natural healing process.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

distal end of the tibia, pediatric and small stature adult tibia

Indicated Patient Age Range

pediatric and small stature adult

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

Engineering (strength) calculations were included demonstrating these devices are as strong as the devices cleared through K080522.

Key Metrics

Not Found

Predicate Device(s)

K080522, K083286, K090666

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 888.3030 Single/multiple component metallic bone fixation appliances and accessories.

(a)
Identification. Single/multiple component metallic bone fixation appliances and accessories are devices intended to be implanted consisting of one or more metallic components and their metallic fasteners. The devices contain a plate, a nail/plate combination, or a blade/plate combination that are made of alloys, such as cobalt-chromium-molybdenum, stainless steel, and titanium, that are intended to be held in position with fasteners, such as screws and nails, or bolts, nuts, and washers. These devices are used for fixation of fractures of the proximal or distal end of long bones, such as intracapsular, intertrochanteric, intercervical, supracondylar, or condylar fractures of the femur; for fusion of a joint; or for surgical procedures that involve cutting a bone. The devices may be implanted or attached through the skin so that a pulling force (traction) may be applied to the skeletal system.(b)
Classification. Class II.

0

MAY 1 7 2010

SUMMARY OF SAFETY AND EFFECTIVENESS

| NAME OF FIRM: | OrthoPediatrics, Corp.
210 N. Buffalo Street
Warsaw, Indiana 46580
Establishment Registration No.: 9102640 |
|-----------------|-----------------------------------------------------------------------------------------------------------------------------------|
| 510(K) CONTACT: | Gary Barnett
VP-Regulatory & Medical Affairs
Tel: (574) 268-6379
Fax: (574) 269-3692 |
| TRADE NAME: | OrthoPediatrics PediLoc™ Tibial Plate
System |
| COMMON NAME: | Bone Plates and Bone Screws |
| CLASSIFICATION: | 21 CFR 888.3030: Single/Multiple components
metallic bone fixation appliances and accessories
Class II per 21 CFR §888.3030 |
| PRODUCT CODE: | HRS HWC |

SUBSTANTIALLY EQUIVALENT DEVICES:

K080522, LCP Distal Tibia T-Plates, Synthes K083286, PediLoc Locking Plate System, OrthoPediatrics K090666, PediPlate System, OrthoPediatrics

DEVICE DESCRIPTION:

The OrthoPediatrics PediLoc™ Tibial Plates are machined metallic plates that offer screw to plate locking designed for various fracture modes of the distal end of the tibia and other small bones.

  • Intended use: OrthoPediatrics PediLoc™ Tibial Plates are indicated for . fractures, osteotomies, and non-unions of the pediatric and small stature adult tibia.
  • Materials: The devices are manufactured from 316L stainless steel which . meets the ASTM-F138 standard.
  • Function: The system functions to provide immediate stability and . temporary fixation during the natural healing process.

1

  • Technological Characteristics: Components comprising OrthoPediatrics . PediLocTM Tibial Plate (and screws) System are similar to the predicate devices listed above in that they share indications for use, are made from similar materials, and incorporate similar technological characteristics.
  • Performance Characteristics: Engineering (strength) calculations were . included demonstrating these devices are as strong as the devices cleared through K080522.

BASIS FOR SUBSTANTIAL EQUIVALENCE:

OrthoPediatrics believes that this system is substantially equivalent to the legally marketed predicate devices based on similarities in design, materials, and indications.

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized image of an eagle with three lines representing its body and wings. The eagle is facing to the right. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle.

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

MAY 1 7 2010

OrthoPediatrics Corp. % Gary D. Barnett 210 N. Buffalo Street Warsaw, Indiana 46580

Re: K100240

Trade/Device Name: OrthoPediatrics PediLoc Tibia Plate System Regulation Number: 888.3030 Regulation Name: Single/multiple component metallic bone fixation appliances and accessories Regulatory Class: Class II Product Code: HRS, HWC Dated: May 4, 2010 Received: May 11, 2010

Dear Mr. Barnett:

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.

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

3

Page 2 - Mr. Gary D. Barnett

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/ReportalProblem/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.

Sincerelv vours.

Sarbanu Prehm

Mark N. Melkerson Director Division of Surgical, Orthopedic and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

Indications for Use Statement

510(k) Number (if known): K \cO2YO (pg // >

Device Name: OrthoPediatrics PediLoc™ Tibial Plate System

OrthoPediatrics PediLoc™ Tibia Plates are indicated for fractures, osteotornies, and non-unions of the pediatric and small stature adult tibia.

AND/OR Over-The-Counter Use __
(21 CFR 801 Subpart C) Prescription Use X (Part 21 CFR 801 Subpart D)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Souther for mxn
(Division Sign-Off)

Division of Surgical, OHhopedic, and Restorative Devices

510(k) Number K100240

Page 1 of 1