K Number
K113167
Device Name
MTF NEW BONE VOILD FILLER
Date Cleared
2012-01-24

(89 days)

Product Code
Regulation Number
888.3045
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The MTF New Bone Void Filler is intended for use as a Demineralized Bone Matrix for voids or gaps that are not intrinsic to the stability of the bony structure. The MTF New Bone Void Filler is indicated for treatment of surgically created osseous defects or osseous defects created from traumatic injury. It can be used in the pelvis and extremities. The MTF New Bone Void Filler can be used as an extender in the pelvis and extremities with autograft or allograft. The MTF New Bone Void Filler can be used with bone marrow aspirate, blood or saline. The MTF New Bone Void Filler is for single patient use only.
Device Description
The MTF New Bone Void Filler is processed human bone that has been demineralized and combined with gelatin and sodium hyaluronate, which are naturally derived materials that are biocompatible and biodegradable. The sodium hyaluronate used in the manufacturing of the MTF New Bone Void Filler is not of animal origin. The MTF New Bone Void Filler comes in the form of a mixture of demineralized bone with gelatin and sodium hyaluronate, and a spatula that is necessary to mix the components. A hydrating agent can be used with the MTF New Bone Void Filler. Upon addition of a hydrating agent, the MTF New Bone Void Filler will achieve a flowable consistency. The resultant putty can then be manipulated by a surgeon into various shapes for ease and flexibility of use during surgical application.
More Information

Not Found

No
The device description and intended use focus on the material composition and physical properties of a bone void filler. There is no mention of software, algorithms, or any capabilities that would suggest the use of AI or ML. The "Mentions AI, DNN, or ML" field is explicitly marked as "Not Found".

Yes
The device is intended for the treatment of surgically created or traumatically induced osseous defects, indicating a direct therapeutic purpose.

No

The device is described as a bone void filler used for surgically created or traumatic osseous defects, functioning as a demineralized bone matrix to fill gaps in bony structures. This is a therapeutic purpose, not diagnostic.

No

The device is a physical bone void filler made of processed human bone, gelatin, and sodium hyaluronate, and includes a spatula. It is not software.

Based on the provided text, the MTF New Bone Void Filler is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use clearly states it's for filling bone voids or gaps in the body (pelvis and extremities) during surgery. This is an in vivo application (within a living organism).
  • Device Description: The description details a material implanted into the body to aid in bone repair.
  • Lack of IVD Characteristics: There is no mention of the device being used to test samples (blood, urine, tissue, etc.) outside of the body to provide diagnostic information about a patient's health.

IVD devices are used to perform tests on samples taken from the human body to diagnose diseases or other conditions. The MTF New Bone Void Filler is a therapeutic device used directly in the body during surgery.

N/A

Intended Use / Indications for Use

The MTF New Bone Void Filler is intended for use as a Demineralized Bone Matrix for voids or gaps that are not intrinsic to the stability of the bony structure. The MTF New Bone Void Filler is indicated for treatment of surgically created osseous defects or osseous defects created from traumatic injury. It can be used in the pelvis and extremities. The MTF New Bone Void Filler can be used as an extender in the pelvis and extremities with autograft or allograft. The MTF New Bone Void Filler can be used with bone marrow aspirate, blood or saline.

The MTF New Bone Void Filler is for single patient use only.

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

MBP, MQV

Device Description

The MTF New Bone Void Filler is processed human bone that has been demineralized and combined with gelatin and sodium hyaluronate, which are naturally derived materials that are biocompatible and biodegradable. The sodium hyaluronate used in the manufacturing of the MTF New Bone Void Filler is not of animal origin. The MTF New Bone Void Filler comes in the form of a mixture of demineralized bone with gelatin and sodium hyaluronate, and a spatula that is necessary to mix the components. A hydrating agent can be used with the MTF New Bone Void Filler. Upon addition of a hydrating agent, the MTF New Bone Void Filler will achieve a flowable consistency. The resultant putty can then be manipulated by a surgeon into various shapes for ease and flexibility of use during surgical application.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

pelvis and extremities

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)

The MTF New Bone Void Filler has been demonstrated to be substantially equivalent to its predicate devices in the animal study provided within this submission.

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.

K040262, K103784, K103795, K042829, K062205

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

§ 888.3045 Resorbable calcium salt bone void filler device.

(a)
Identification. A resorbable calcium salt bone void filler device is a resorbable implant intended to fill bony voids or gaps of the extremities, spine, and pelvis that are caused by trauma or surgery and are not intrinsic to the stability of the bony structure.(b)
Classification. Class II (special controls). The special control for this device is the FDA guidance document entitled “Class II Special Controls Guidance: Resorbable Calcium Salt Bone Void Filler Device; Guidance for Industry and FDA.” See § 888.1(e) of this chapter for the availability of this guidance.

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JAN 2 4 2012

MTF New Bone Void Filler 510(k) Premarket Notification

KII367

PAGE 1 OF 3

VII. 510(k) SUMMARY OF SAFETY & EFFECTIVENESS (Per 21 CFR 807.92)

General Company Information

Name: Musculoskeletal Transplant Foundation Contact: Nancy Joy Senior Regulatory Affairs Submission Specialist

Address:

125 May Street Edison, NJ 08837 USA

Telephone: Fax:

(732) 661-2381 (732) 661-2189

Date Prepared

October 19, 2011

General Device Information

Product Name:

The MTF New Bone Void Filler

Classification:

Bone Void Filler Containing Human Bone 21 CFR §888.3045 - Product code: MBP, MOV Class II

· Predicate Devices

DBX® Demineralized Bone Matrix Musculoskeletal Transplant Foundation 510(k) K040262, K103784, K103795

DBX Strip® Musculoskeletal Transplant Foundation 510(k) K042829, K062205

Osteoinductive Potential

The MTF New Bone Void Filler is osteoconductive and has been shown to have osteoinductive potential in an athymic mouse model. Every lot of final product is tested to ensure the osteoinductive potential of the final product. Standard testing performed in an athymic mouse model must prove positive for lot release. It is unknown how the osteoinductive potential, measured in the athymic mouse model, will correlate with clinical performance in human subjects.

1

Description

The MTF New Bone Void Filler is processed human bone that has been demineralized and combined with gelatin and sodium hyaluronate, which are naturally derived materials that are biocompatible and biodegradable. The sodium hyaluronate used in the manufacturing of the MTF New Bone Void Filler is not of animal origin. The MTF New Bone Void Filler comes in the form of a mixture of demineralized bone with gelatin and sodium hyaluronate, and a spatula that is necessary to mix the components. A hydrating agent can be used with the MTF New Bone Void Filler. Upon addition of a hydrating agent, the MTF New Bone Void Filler will achieve a flowable consistency. The resultant putty can then be manipulated by a surgeon into various shapes for ease and flexibility of use during surgical application.

Intended Use (Indications)

The MTF New Bone Void Filler is intended for use as a Demineralized Bone Matrix for voids or gaps that are not intrinsic to the stability of the bony structure. The MTF New Bone Void Filler is indicated for treatment of surgically created osseous defects or osseous defects created from traumatic injury. It can be used in the pelvis and extremities. The MTF New Bone Void Filler can be used as an extender in the pelvis and extremities with autograft or allograft. The MTF New Bone Void Filler can be used with bone marrow aspirate, blood or saline.

The MTF New Bone Void Filler is for single patient use only.

Viral Clearance and Inactivation

A panel of model potential human viruses representing various virus types, sizes, shapes and genomes were evaluated. The viral inactivation testing demonstrated suitable viral inactivation potential of the processing method for a wide spectrum of potential human viruses. The MTF New Bone Void Filler process further reduces the risk of viral contamination beyond donor testing and screening procedures.

Substantial Equivalence

This submission supports the position that the MTF New Bone Void Filler is substantially equivalent to a number of previously cleared devices, including:

DBX® Demineralized Bone Matrix - Musculoskeletal Transplant Foundation [K040262, K103784, K103795] DBX Strip® - Musculoskeletal Transplant Foundation [K042829, K062205]

When comparing the MTF New Bone Void Filler to its predicate devices, there are no new types of safety and effectiveness questions. The MTF New Bone Void Filler has been demonstrated to be substantially equivalent to its predicate devices in the animal study provided within this submission.

2

K113167 PAGE 3 OF 3 MTF New Bone Void Filler 510(k) Premarket Notification

Safety and Effectiveness Information

The MTF New Bone Void Filler is single-donor processed. The MTF New Bone Void Filler is aseptically processed and passes USP Sterility Tests. The donor suitability criteria used to screen this donor are in compliance with the FDA regulations published in 21 CFR Part 1271 Human Cells, Tissues, and Cellular and Tissue Based Products.

Conclusion

Musculoskeletal Transplant Foundation believes that the information provided in this 510(k) submission establishes that similar legally marketed devices have been used for the same clinical applications as the MTF New Bone Void Filler. The materials from which the MTF New Bone Void Filler is fabricated have an established history of use. and the device has been tested in accordance with applicable FDA guidelines.

3

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus, a symbol often associated with medicine and healthcare. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the caduceus.

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

Ms. Nancy Joy Musculoskeletal Transplant Foundation 125 May Street Edison, New Jersey 08837

JAN 2 4 2012

Re: K113167

Trade/Device Name: MTF New Bone Void Filler (BVF) Regulation Number: 21 CFR 888.3045 Regulation Name: Resorbable calcium salt bone void filler device Regulatory Class: Class II Product Code: MQV, MBP Dated: October 25, 2011 Received: October 27, 2011

Dear Ms. Joy:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave roviewed your co determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for ass surfall 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 r ou may) ateresy majors 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.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean 1 tease be day isou may 1 Dr wintian that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must or any I oderal states and securements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical Or ice rated adverse events) (21 CFR 803); good manufacturing practice requirements as set

4

Page 2 - Ms. Nancy Joy

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 yours,

Mark N. Melkerson

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

Enclosure

5

V. INDICATIONS FOR USE

510(k) Number (if known): not known

Device Name: MTF New Bone Void Filler

Indications for Use:

The MTF New Bone Void Filler is intended for use as a Demineralized Bone Matrix for voids or gaps that are not intrinsic to the stability of the bony structure. The MTF New Bone Void Filler is indicated for treatment of surgically created osseous defects or osseous defects created from traumatic injury. It can be used in the pelvis and extremities. The MTF New Bone Void Filler can be used as an extender in the pelvis and extremities with autograft or allograft. The MTF New Bone Void Filler can be used with bone marrow aspirate, blood or saline.

The MTF New Bone Void Filler is for single patient use only.

OR Prescription Use X (Per 21 CFR 801 Subpart D)

Over-The-Counter Use (Per 21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)


(Division Sign-Off)

Division of Surgical, Orthopedic, and Restorative Devices

510(k) Number K113167