K Number
K121826
Device Name
INTEGRA PROXIMAL HUMERAL PLATE SYSTEM
Date Cleared
2013-02-13

(237 days)

Product Code
Regulation Number
888.3030
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Integra Proximal Humeral Fracture Plate System is designed for fractures and fracture dislocations, osteotomies and non-unions of the proximal humerus. Indications include: - Dislocated two-, three-, and four-fragment fractures of the proximal humerus, including fractures . involving osteopenic bone - Pseudoarthroses in the proximal humerus . - Osteotomies in the proximal humerus .
Device Description
The Integra Proximal Humeral Fracture Plate System is composed of left and right humeral reconstruction plate implants in two options, GT Plate and LP Plate. The GT plate is designed to cover the greater tuberosity and is available in four-hole , seven-hole, and ten-hole lengths or sizes. The LP plate is designed to sit lower on the greater tuberosity and is available in three-hole, six-hole, and nine-hole lengths or sizes. The system features 3.5mm locking, non-locking and lag screws, in addition to, 2.7mm locking screws. The Integra Proximal Humeral Fracture Plate System is a single component made from stainless steel (SS 316L). The non-locking, locking and lag screws are made from stainless steel (SS 316L).
More Information

Not Found

No
The device description and performance studies focus on the mechanical properties and design of a bone plate system, with no mention of software, algorithms, or data processing that would indicate AI/ML.

No.
The device is an orthopedic implant (plate and screws) used to stabilize fractures and treat other bone conditions in the proximal humerus, which serves a restorative rather than therapeutic function.

No
The device is a fracture plate system designed to treat fractures and reattach bones, not to diagnose medical conditions.

No

The device description clearly states it is a "Proximal Humeral Fracture Plate System" composed of physical implants (plates and screws) made from stainless steel. This is a hardware device, not software.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, or tissue) to provide information about a person's health.
  • Device Description: The Integra Proximal Humeral Fracture Plate System is a surgical implant made of stainless steel, designed to fix fractures in the proximal humerus (the upper part of the arm bone).
  • Intended Use: Its intended use is to mechanically stabilize bone fractures and related conditions. It does not involve testing biological samples.

The description clearly indicates a surgical implant used for structural support, not for diagnostic testing.

N/A

Intended Use / Indications for Use

The Integra Proximal Humeral Fracture Plate System is designed for fractures and fracture dislocations, osteotomies and non-unions of the proximal humerus. Indications include:

  • Dislocated two-, three-, and four-fragment fractures of the proximal humerus, including fractures involving osteopenic bone
  • Pseudoarthroses in the proximal humerus
  • Osteotomies in the proximal humerus

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

HRS

Device Description

The Integra Proximal Humeral Fracture Plate System is composed of left and right humeral reconstruction plate implants in two options, GT Plate and LP Plate. The GT plate is designed to cover the greater tuberosity and is available in four-hole, seven-hole, and ten-hole lengths or sizes. The LP plate is designed to sit lower on the greater tuberosity and is available in three-hole, six-hole, and nine-hole lengths or sizes. The system features 3.5mm locking, non-locking and lag screws, in addition to, 2.7mm locking screws.
The Integra Proximal Humeral Fracture Plate System is a single component made from stainless steel (SS 316L). The non-locking, locking and lag screws are made from stainless steel (SS 316L).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

proximal humerus

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 subject system was determined to be equivalent to the predicate devices by comparing the section moduli of the original design (K110700), the subject devices, and the predicate devices (Synthes LCP, K011815). Because the designs included in this 510(k) do not represent a worst case plate, additional testing was not required.

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.

K011815, K010700

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

§ 888.3030 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

FEB 1 3 2013

SUMMARY OF SAFETY AND EFFECTIVENESS
SPONSORAscension Orthopedics, Inc.
A wholly owned division of Integra LifeSciences, Inc.
8700 Cameron Road
Austin, TX 78754-3832
510(k) CONTACT:Susan Walton
susan.walton@integralife.com
Phone: (512) 836-5001 x1591
FAX (512) 836-6933
DATE PREPARED:February 12, 2013
TRADE NAME:Integra Proximal Humeral Fracture Plate System
COMMON NAME:Plate, Fixation, Bone
CLASSIFICATION:21 CFR 888.3030 - Single/Multiple component metallic bone fixation
appliances and accessories
PRODUCT CODE:HRS
PANEL:Orthopedic
PREDICATE DEVICE:K011815 - Synthes LCP Proximal Humerus Plate
K010700 - ATLAS Humeral Plate System
DEVICE DESCRIPTION:The Integra Proximal Humeral Fracture Plate System is composed of
left and right humeral reconstruction plate implants in two options,
GT Plate and LP Plate. The GT plate is designed to cover the greater
tuberosity and is available in four-hole , seven-hole, and ten-hole
lengths or sizes. The LP plate is designed to sit lower on the greater
tuberosity and is available in three-hole, six-hole, and nine-hole
lengths or sizes. The system features 3.5mm locking, non-locking and
lag screws, in addition to, 2.7mm locking screws.
The Integra Proximal Humeral Fracture Plate System is a single
component made from stainless steel (SS 316L). The non-locking,
locking and lag screws are made from stainless steel (SS 316L).
INTENDED USE:The Integra Proximal Humeral Fracture Plate system is designed for
fractures and fracture dislocations, osteotomies and non-unions of
the proximal humerus. Indications include:
● Dislocated two-, three-, and four-fragment fractures of the
proximal humerus, including fractures involving osteopenic
bone
● Pseudoarthroses in the proximal humerus
● Osteotomies in the proximal humerus
SUMMARY OF
TECHNOLOGICAL
CHARACTERISTICSThe technological characteristics for the Integra Proximal Humeral
Fracture Plate System were compared to the predicate devices. The
characteristics were defined to be device material, dimensional
characteristics such as plate length, number and
location of holes as well as screw sizes and packaging/sterilization
methods. These characteristics were determined to be the same or
similar between the subject and predicate devices.
NONCLINICAL TESTINGThe subject system was determined to be equivalent to the predicate
devices by comparing the section moduli of the original design (K110700),
the subject devices, and the predicate devices (Synthes LCP, K011815).
Because the designs included in this 510(k) do not represent a worst case
plate, additional testing was not required.
CLINICAL PERFORMANCE
DATA:Clinical performance data were not necessary to support substantial
equivalence.
BASIS OF SUBSTANTIAL
EQUIVALENCE:Ascension Orthopedics believes that this system is substantially
equivalent to the legally marketed predicate devices based on similarities
in design, materials and indications.

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K121826

and the control control control of the control of

:

2

Image /page/2/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular, with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" arranged around the top half of the circle. Inside the circle is a stylized symbol that resembles a caduceus, a traditional symbol of medicine, but with a more abstract and modern design.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Letter dated: February 13, 2013

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

Ascension Orthopedics, Incorporated % Ms. Susan Walton Director 8700 Cameron Road Austin, Texas 78754

Re: K121826

Trade/Device Name: Integra Proximal Humeral Fracture Plate System Regulation Number: 21 CFR 888.3030 Regulation Name: Smooth or threaded metallic bone fixation fastener. Regulatory Class: Class II Product Code: HRS Dated: January 31, 2013 Received: February 6, 2013

Dear Ms. Walton:

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 device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set

3

Page 2 – Ms. Susan Walton

forth in the quality systems (OS) 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/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Mark Niji Kerson

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

Enclosure

4

Indications for Use

Indications for Use Statement

K121826 510(K) Number:

Integra Proximal Humeral Fracture Plate System Device Name:

Indications for Use:

The Integra Proximal Humeral Fracture Plate System is designed for fractures and fracture dislocations, osteotomies and non-unions of the proximal humerus. Indications include:

  • Dislocated two-, three-, and four-fragment fractures of the proximal humerus, including fractures . involving osteopenic bone
  • Pseudoarthroses in the proximal humerus .
  • Osteotomies in the proximal humerus .

Prescription Use (Part 21 CFR 801 Subpart D)

AND/OR

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


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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Michael C. Owens

Division of Orthopedic Devices