K Number
K102701
Manufacturer
Date Cleared
2010-10-20

(30 days)

Product Code
Regulation Number
888.3070
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The VIPER System is intended to provide immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine.

The VIPER System is intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudarthrosis; and failed previous fusion in skeletally mature patients.

When used in a percutaneous approach with MIS Instrumentation, the VIPER Systems are intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudoarthrosis; and failed previous fusion in skeletally mature patients.

Device Description

The VIPER® Systems consist of rods and cannulated screws used in a percutaneous approach and are available in various geometries and sizes. The proposed Viper® 4.35mm diameter cannulated screws maintain the identical cannulation through the center of the screw shank as the previously cleared Viper® pedicle screws. The screw shank component of the proposed screws will have the same dual lead thread form, tapered distal tip, and same flutes as the previously cleared Viper® screws and are available in polyaxial or uniplanar configurations.

AI/ML Overview

This is a 510(k) summary for a medical device, the Viper™ Spinal System, which falls under the category of spinal implants. The document focuses on demonstrating substantial equivalence to predicate devices rather than providing a detailed study on a device's performance against set acceptance criteria in the context of AI or diagnostic accuracy.

Therefore, many of the requested categories regarding acceptance criteria and study details (especially those related to AI, human readers, ground truth establishment, sample sizes for training/test sets, and expert qualifications) are not applicable to this type of regulatory submission. This document describes a traditional medical device (spinal system components), not an AI/ML-driven diagnostic or assistive device.

Here's an analysis of the provided text, addressing the closest relevant information and explicitly stating when a category is not applicable:

1. A table of acceptance criteria and the reported device performance

Acceptance Criteria (Implied)Reported Device Performance
Material Specifications: Manufactured from implant grade stainless steel (ASTM F 138) and titanium alloy (ASTM F 136).Material Conformance: "Manufactured from ASTM F 138 implant grade stainless steel and ASTM F 136 implant grade titanium alloy."
Mechanical Performance: Meet static and fatigue requirements relevant to spinal fixation systems (e.g., per ASTM F 1717).Mechanical Performance: "Performance data per ASTM F 1717 were submitted to characterize the subject VIPER System components... This testing was compromised of static and fatigue testing on the proposed device. Specifically, static and dynamic compression testing as well as static torsion and cantilever beam testing were performed."
Design Equivalence: Maintain identical design principles (cannulation, thread form, tip, flutes) to previously cleared Viper® pedicle screws.Design Equivalence: "The proposed Viper® 4.35mm diameter cannulated screws maintain the identical cannulation through the center of the screw shank as the previously cleared Viper® pedicle screws. The screw shank component of the proposed screws will have the same dual lead thread form, tapered distal tip, and same flutes as the previously cleared Viper® screws." "The design, materials, and technology remain identical to the predicate system."
Intended Use Equivalence: Similar indications for use as predicate devices.Intended Use Equivalence: The stated "Intended Use" (Section F) is consistent with the predicate devices and the device seeks to demonstrate substantial equivalence based on this.
Safety and Effectiveness: Demonstrate device is as safe, as effective, and performs as well as the predicate device.Conclusion: "Both the Performance Testing and Substantial Equivalence Justification demonstrate that the device is as safe, as effective, and performs as well as the predicate device."

2. Sample sizes used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

  • This information is not provided in the summary. For mechanical testing, "sample size" typically refers to the number of test articles (screws, rods) subjected to various loads. The document states "Performance data per ASTM F 1717 were submitted," which is a standard for spinal implant testing, but it does not specify the number of samples tested or the exact conditions of data provenance beyond being submitted for regulatory review. This is not a clinical study involving patient data.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

  • This is not applicable. This submission is for a physical medical device (spinal implant), not a diagnostic device requiring expert interpretation or ground truth establishment based on clinical data. The "ground truth" for this device's performance is derived from standardized mechanical testing.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

  • This is not applicable. Adjudication methods are typically used in clinical studies, especially for evaluating diagnostic outputs. This submission is for a physical medical device.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

  • This is not applicable. This is not an AI-driven device, and therefore, no MRMC study or assessment of human reader improvement with AI assistance would be conducted or relevant for this submission.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

  • This is not applicable. This is not an algorithm or software device.

7. The type of ground truth used (expert concensus, pathology, outcomes data, etc)

  • For this type of device, the "ground truth" for performance is established through objective, standardized mechanical testing (e.g., tensile strength, fatigue life, torsional resistance) as defined by standards like ASTM F 1717. This is not clinical ground truth derived from patient observations or expert consensus.

8. The sample size for the training set

  • This is not applicable. This is not an AI/ML device that requires a training set.

9. How the ground truth for the training set was established

  • This is not applicable. As it's not an AI/ML device, there is no training set or associated ground truth to establish in that context.

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510(K) SUMMARY
A.Submitter InformationOCT 20 2010
DePuy Spine, Inc.
325 Paramount Drive
Raynham, MA 02767
Contact Person:Kevin G. Stevens
Regulatory Affairs Project Manager
Voice:(508) 977-6445
Fax:(508) 828-3797
E-Mail:ksteven1@its.jnj.com
B.Date Prepared9/17/2010
C.Device Name
Trade/Proprietary Name:Viper Spine System
Common/Usual Name:Spinal System
Classification Name:Spinal interlaminar fixation orthosis
per 21 CFR §888.3050
Spinal intervertebral body fixation orthosis
per 21 CFR §888.3060
Pedicle screw spinal fixation
per 21 CFR §888.3070

D. Predicate Device Name

Trade name: DePuy Spine VIPER® Spine System (K090648) DePuy Spine EXPEDIUM® System (K041119, K033901, K090230, K071495) DePuy Spine Moss Miami® System (K011182, K953915)

E. Device Description

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The VIPER® Systems consist of rods and cannulated screws used in a percutaneous approach and are available in various geometries and sizes. The proposed Viper® 4.35mm diameter cannulated screws maintain the identical cannulation through the center of the screw shank as the previously cleared Viper® pedicle screws. The screw shank component of the proposed screws will have the same dual lead thread form, tapered distal tip, and same flutes as the previously cleared Viper® screws and are available in polyaxial or uniplanar configurations.

F. Intended Use

The VIPER® System is intended to provide immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine.

The VIPER® System is intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudarthrosis; and failed previous fusion in skeletally mature patients.

When used in a percutaneous approach with MIS Instrumentation, the VIPER® Systems are intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudoarthrosis; and failed previous fusion in skeletally mature patients.

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F. Summary of Similarities and Differences in Technological Characteristics, Performance and Intended Use

The proposed modifications to the DePuy Viper® Spinal System are identical to the predicate device with one minor difference. The only change is the inclusion of polyaxial and uniplanar pedicle screws of differing diameters that were not originally cleared in the predicate 510k. The design, materials, and technology remain identical to the predicate system.

ઉ. Materials

Manufactured from ASTM F 138 implant grade stainless steel and ASTM F 136 implant grade titanium alloy.

Performance Data H.

Performance data per ASTM F 1717 were submitted to characterize the subject VIPER System components addressed in this notification. This testing was compromised of static and fatigue testing on the proposed device. Specifically, static and dynamic compression testing as well as static torsion and cantilever beam testing were performed.

l. Conclusion

Both the Performance Testing and Substantial Equivalence Justification demonstrate that the device is as safe, as effective, and performs as well as the predicate device

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

OCT 2 0 2010

DePuy Spine, Inc. % Mr. Kevin G. Stevens Regulatory Affairs Project Manager 325 Paramount Drive Raynham, Massachusetts 02767

Re: K102701

Trade/Device Name: Viper™ Spinal System Regulation Number: 21 CFR 888.3070 Regulation Name: Pedicle screw spinal system Regulatory Class: III Product Code: NKB, MNH, MNI, KWQ, KWP Dated: September 17, 2010 Received: September 20, 2010

Dear Mr. Stevens:

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. Isting 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

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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 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 tolloffred number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours.

Barbara Buehr

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

Enclosure

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INDICATIONS FOR USE STATEMENT

510(k) Number (if known): K10270 1

Device Name: Viper™ Spinal System

OCT 2 0 2010

Indications For Use:

The VIPER System is intended to provide immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine.

The VIPER System is intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudarthrosis; and failed previous fusion in skeletally mature patients.

When used in a percutaneous approach with MIS Instrumentation, the VIPER Systems are intended for noncervical pedicle fixation and nonpedicle fixation for the following indications: degenerative disc disease (defined as back pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies); spondylolisthesis; trauma (i.e., fracture or dislocation); spinal stenosis; curvatures (i.e., scoliosis, kyphosis, and/or lordosis); tumor; pseudoarthrosis; and failed previous fusion in skeletally mature patients.

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)

__ is a signature.

(Division Sign-Off Division of Surgical, Orthopedic. and Restorative Devices

510(k) Number K102901

§ 888.3070 Thoracolumbosacral pedicle screw system.

(a)
Identification. (1) Rigid pedicle screw systems are comprised of multiple components, made from a variety of materials that allow the surgeon to build an implant system to fit the patient's anatomical and physiological requirements. Such a spinal implant assembly consists of a combination of screws, longitudinal members (e.g., plates, rods including dual diameter rods, plate/rod combinations), transverse or cross connectors, and interconnection mechanisms (e.g., rod-to-rod connectors, offset connectors).(2) Semi-rigid systems are defined as systems that contain one or more of the following features (including but not limited to): Non-uniform longitudinal elements, or features that allow more motion or flexibility compared to rigid systems.
(b)
Classification. (1) Class II (special controls), when intended to provide immobilization and stabilization of spinal segments in skeletally mature patients as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar, and sacral spine: severe spondylolisthesis (grades 3 and 4) of the L5-S1 vertebra; degenerative spondylolisthesis with objective evidence of neurologic impairment; fracture; dislocation; scoliosis; kyphosis; spinal tumor; and failed previous fusion (pseudarthrosis). These pedicle screw spinal systems must comply with the following special controls:(i) Compliance with material standards;
(ii) Compliance with mechanical testing standards;
(iii) Compliance with biocompatibility standards; and
(iv) Labeling that contains these two statements in addition to other appropriate labeling information:
“Warning: The safety and effectiveness of pedicle screw spinal systems have been established only for spinal conditions with significant mechanical instability or deformity requiring fusion with instrumentation. These conditions are significant mechanical instability or deformity of the thoracic, lumbar, and sacral spine secondary to severe spondylolisthesis (grades 3 and 4) of the L5-S1 vertebra, degenerative spondylolisthesis with objective evidence of neurologic impairment, fracture, dislocation, scoliosis, kyphosis, spinal tumor, and failed previous fusion (pseudarthrosis). The safety and effectiveness of these devices for any other conditions are unknown.”
“Precaution: The implantation of pedicle screw spinal systems should be performed only by experienced spinal surgeons with specific training in the use of this pedicle screw spinal system because this is a technically demanding procedure presenting a risk of serious injury to the patient.”
(2) Class II (special controls), when a rigid pedicle screw system is intended to provide immobilization and stabilization of spinal segments in the thoracic, lumbar, and sacral spine as an adjunct to fusion in the treatment of degenerative disc disease and spondylolisthesis other than either severe spondylolisthesis (grades 3 and 4) at L5-S1 or degenerative spondylolisthesis with objective evidence of neurologic impairment. These pedicle screw systems must comply with the following special controls:
(i) The design characteristics of the device, including engineering schematics, must ensure that the geometry and material composition are consistent with the intended use.
(ii) Non-clinical performance testing must demonstrate the mechanical function and durability of the implant.
(iii) Device components must be demonstrated to be biocompatible.
(iv) Validation testing must demonstrate the cleanliness and sterility of, or the ability to clean and sterilize, the device components and device-specific instruments.
(v) Labeling must include the following:
(A) A clear description of the technological features of the device including identification of device materials and the principles of device operation;
(B) Intended use and indications for use, including levels of fixation;
(C) Identification of magnetic resonance (MR) compatibility status;
(D) Cleaning and sterilization instructions for devices and instruments that are provided non-sterile to the end user; and
(E) Detailed instructions of each surgical step, including device removal.
(3) Class II (special controls), when a semi-rigid system is intended to provide immobilization and stabilization of spinal segments in the thoracic, lumbar, and sacral spine as an adjunct to fusion for any indication. In addition to complying with the special controls in paragraphs (b)(2)(i) through (v) of this section, these pedicle screw systems must comply with the following special controls:
(i) Demonstration that clinical performance characteristics of the device support the intended use of the product, including assessment of fusion compared to a clinically acceptable fusion rate.
(ii) Semi-rigid systems marketed prior to the effective date of this reclassification must submit an amendment to their previously cleared premarket notification (510(k)) demonstrating compliance with the special controls in paragraphs (b)(2)(i) through (v) and paragraph (b)(3)(i) of this section.