K Number
K133223
Device Name
XENMATRIX AB SURGICAL GRAFT
Manufacturer
Date Cleared
2014-09-19

(333 days)

Product Code
Regulation Number
878.3300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Intended for implantation to reinforce soft tissue where weakness exists and for surgical repair of damaged or ruptured soft tissue, including: abdominal plastic and reconstructive surgery; muscle flap reinforcement; hernia repair including abdominal, inguinal, femoral, diaphragmatic, scrotal, umbilical, and incisional hernias. The Rifampin and Minocycline coating has been shown in preclinical in vitro and in vivo testing to reduce or inhibit microbial colonization on the device. The claim of bacterial colonization of the device has not been established with human clinical data, nor has a clinical impact associated with this claim been demonstrated.
Device Description
The XenMatrix™ AB Surgical Graft is an acellular, sterile, non-pyrogenic porcine dermal matrix for use in the reconstruction of soft tissue deficiencies. The graft is packed dry and must be hydrated in sterile saline prior to use. The thickness of the device is 1.5 to 2.3mm. The XenMatrix™ AB Surgical Graft surfaces are coated with an antimicrobial coating, which is comprised of a bioresorbable L-tyrosine succinate polymer and antimicrobial agents Rifampin and Minocycline at 180 µg/cm each. The coating is shaded orange in color due to the color of the antimicrobial agents. The bioresorbable L - Tyrosine succinate polymer is essentially absorbed in 12 months based on in vitro studies. The antimicrobial coating present on this device is intended to protect the graft from bacterial colonization.
More Information

Not Found

No
The summary describes a surgical graft with an antimicrobial coating and does not mention any AI or ML components.

No.
The device is described as a surgical graft intended for implantation to reinforce and repair soft tissue. While it aids in the body's repair process, its primary function is structural reinforcement and not directly treating a disease or therapeutic condition. The antimicrobial coating is to protect the device itself from colonization, not to therapeutically treat the patient.

No
The device is described as a surgical graft intended for implantation to reinforce and repair soft tissue, not to diagnose medical conditions.

No

The device is a physical surgical graft made from porcine dermal matrix with an antimicrobial coating. It is intended for implantation and tissue reinforcement, not a software application.

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

Here's why:

  • Intended Use: The intended use clearly states it's for implantation to reinforce and repair soft tissue. This is a surgical device used in vivo (within the body).
  • Device Description: The description details a surgical graft made from porcine dermal matrix, designed for implantation.
  • Lack of IVD Characteristics: There is no mention of the device being used to test samples in vitro (outside the body) to diagnose a condition, monitor treatment, or screen for diseases. IVDs typically involve analyzing biological samples like blood, urine, or tissue.

The device is a surgical implant with an antimicrobial coating, intended for direct use in surgical procedures on patients.

N/A

Intended Use / Indications for Use

Intended for implantation to reinforce soft tissue where weakness exists and for surgical repair of damaged or ruptured soft tissue, including: abdominal plastic and reconstructive surgery; muscle flap reinforcement; hernia repair including abdominal, inguinal, femoral, diaphragmatic, scrotal, umbilical, and incisional hernias. The Rifampin and Minocycline coating has been shown in preclinical in vitro and in vivo testing to reduce or inhibit microbial colonization on the device. The claim of bacterial colonization of the device has not been established with human clinical data, nor has a clinical impact associated with this claim been demonstrated.

Product codes

PIJ, FTM, OXH

Device Description

The XenMatrix™ AB Surgical Graft is an acellular, sterile, non-pyrogenic porcine dermal matrix for use in the reconstruction of soft tissue deficiencies. The graft is packed dry and must be hydrated in sterile saline prior to use. The thickness of the device is 1.5 to 2.3mm.

Product sizes when hydrated are:

  • 6x6cm
  • 6 x 10 cm ●
  • 6 x 16 cm
  • 8 x 8 cm ●
  • 10 x 10 cm
  • 10 x 15 cm ●
  • 15 x 20 cm ●
  • . 19 x 28 cm
  • 19 x 35 cm ●
  • 10 x 20 cm ●
  • 20 x 20 cm
  • 20 x 25 cm
  • 10 x 28 cm .
  • 15 x 25 cm

The XenMatrix™ AB Surgical Graft surfaces are coated with an antimicrobial coating, which is comprised of a bioresorbable L-tyrosine succinate polymer and antimicrobial agents Rifampin and Minocycline at 180 µg/cm each. The coating is shaded orange in color due to the color of the antimicrobial agents. The bioresorbable L - Tyrosine succinate polymer is essentially absorbed in 12 months based on in vitro studies.

The antimicrobial coating present on this device is intended to protect the graft from bacterial colonization. In preclinical studies the coating has been shown to reduce or inhibit microbial colonization of the device (please see performance data, section 5., below). The claim of reduction of bacterial colonization of the device has not been established with human clinical data, nor has a clinical impact associated with this claim been demonstrated.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

soft tissue, abdominal, inguinal, femoral, diaphragmatic, scrotal, umbilical, and incisional hernias

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 XenMatrix™ AB surgical mesh was evaluated in the following assessments:

  1. Biocompatibility testing: Biocompatibility testing in accordance to the current ISO 10993 series was conducted on the finished device and the results indicate that the device is biocompatible per these standards.
  2. Bench testing: Bench testing in accordance with the FDA Guidance for the Preperation of a Premarket Notification Application for a Surgical Mesh was conducted comparing the XenMatrix™ AB device with the cited predicates. The testing included:
    a. Physical Characteristics:
    i. Device Thickness
    ii. Device (Flexural) Stiffness
    b. Functional Characteristics:
    i. Burst Strength
    ii. Suture Pullout Strength
    iii. Tear Resistance
    Results demonstrate that the physical and functional characteristics of XenMatrix™ AB Surgical Mesh are substantially equivalent to the predicate comparator devices.
  3. In vivo strength determinations: The device was implanted in a 28 day, porcine evaluation and tested for strength characteristics in comparison to the cited predicate device at Time zero (To) and Day 28 (D28). This study assessed the following characteristics of the implanted mesh:
    a. Mechanical Testing
    i. Tensile Testing
    ii. Tissue in-growth Testing
    iii. Device Burst Testing
    b. Percent Area Contracture
    c. Peritoneal Tissue Attachments
    d. Histology
    Results demonstrate that the in vivo performance of XenMatrix™ AB Surgical Mesh is substantially equivalent to the predicate device.
  4. Drug Content and Impurities of the Antimicrobial Agents Rifampin and Minocycline: Analytical and in vitro testing was also performed on the device and included speed to kill, kinetic drug release (KDR), drug content and impurity, and polymer degradation testing. The test results demonstrated substantial equivalence to the predicate comparator surgical mesh with respect to these parameters.
  5. Animal Testing: An in vivo porcine implantation study was performed to investigate the device's mechanical strength and the host inflammatory response to the device over a 28 day duration. At 28 days, the XenMatrix™ AB surgical mesh had greater tissueingrowth/T-Peel Force values than the surgical mesh predicate. The mechanical strength values (i.e., Ultimate Load/Burst Force, Peak Tensile Strength) of the graft alone were lower than the surgical mesh predicate.
    In addition, two in vivo dorsum-implanted rabbit infection model studies were performed. Devices were inoculated with bacteria at implantation, and at 7 days, post-implantation, bacterial colonization quantifications were conducted. At that time point the antimicrobial coating on the XenMatrix™ AB was observed to prevent bacterial colonization of the device in comparison to the surgical mesh predicate device. The relevance of these studies to human clinical performance outcomes has not been demonstrated. The correlation of these studies has not been demonstrated to be predictive of positive human clinical outcomes.
  6. Human clinical data: None. The claim of reduction of colonization has not been established with human clinical data, nor has a clinical impact associated with this claim been demonstrated.

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

Not Found

Predicate Device(s)

K081272, K073391, K113229

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.3300 Surgical mesh.

(a)
Identification. Surgical mesh is a metallic or polymeric screen intended to be implanted to reinforce soft tissue or bone where weakness exists. Examples of surgical mesh are metallic and polymeric mesh for hernia repair, and acetabular and cement restrictor mesh used during orthopedic surgery.(b)
Classification. Class II.

0

Image /page/0/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 words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is an abstract image of a stylized eagle or bird with three human profiles incorporated into its design.

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

September 19, 2014

Davol Incorporated Mr. Tony John, MS Regulatory Affairs Specialist 100 Crossings Boulevard Warwick, Rhode Island 02886

Re: K133223

Trade/Device Name: XenMatrix™ AB Surgical Graft Regulation Number: 21 CFR 878.3300 Regulation Name: Surgical mesh Regulatory Class: Class II Product Code: PIJ, FTM, OXH Dated: August 6, 2014 Received: August 7, 2014

Dear Mr. John:

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

1

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 contact the Division of Industry and Consumer Education 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. 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 Industry and Consumer Education 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,

David Krause -S

  • Binita S. Ashar, M.D., M.B.A., F.A.C.S. for Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health
    Enclosure

2

INDICATION FOR USE STATEMENT

510(k) Number (if known): K133223

Device Name: XenMatrix™ AB Surgical Graft

Intended for implantation to reinforce soft tissue where weakness exists and for surgical repair of damaged or ruptured soft tissue, including: abdominal plastic and reconstructive surgery; muscle flap reinforcement; hernia repair including abdominal, inguinal, femoral, diaphragmatic, scrotal, umbilical, and incisional hernias. The Rifampin and Minocycline coating has been shown in preclinical in vitro and in vivo testing to reduce or inhibit microbial colonization on the device. The claim of bacterial colonization of the device has not been established with human clinical data, nor has a clinical impact associated with this claim been demonstrated.

Prescription Use X (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 IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

3

Davol Inc. Subsidiary of C.R. Bard, Inc. 100 Crossings Blvd. Warwick, RI 02886 (401) 463-7000

Image /page/3/Picture/1 description: The image contains the logo for BARD Davol Inc. The logo is green and features the word "BARD" in a stylized font, with "Davol INC." written below it in a smaller font. To the right of the logo is a vertical line, followed by the words "TECHNOLOGY", "TECHNIQUE", "TRAINING", and "TRUST" stacked vertically in a smaller font.

510(K) SUMMARY OF SAFETY AND EFFECTIVENESS

This 510(k) Summary is provided per the requirements of section 807.92(c).

Submitter Information:

Company Name:Davol Inc., Subsidiary of C. R. Bard, Inc.
Company Address:100 Crossings Boulevard
Warwick, RI 02886
Telephone:(401) 825-8692
Fax:(401) 825-8765
Submitter's Name:Tony John, MS
Regulatory Affairs Specialist
Date Summary Prepared:August 25, 2014

Device Identification:

Trade Name:XenMatrix™ AB Surgical Graft
Common/Usual Name:Surgical Mesh
Classification Name:Mesh, Surgical
Antimicrobial Agent
Device Class:Class II
Regulation Number:21 CFR § 878.3300
Product Code:FTM

Predicate Device Names:

  • Porcine Dermal Matrix Surgical Mesh, K081272 (Brennen Medical, LLC), ● FDA cleared on 31 July, 2008 - Currently marketed by Davol as XenMatrix™ Surgical Graft
  • SURGISIS® Biodesign Tissue Graft, K073391 (Cook Biotech Incorporated), . FDA cleared on 21 March, 2008
  • Ventrio™ Light Hernia Patch with TRM Antimicrobial Coating, K113229 . (Davol, Inc.), FDA cleared on 20 July, 2012

Device Description:

The XenMatrix™ AB Surgical Graft is an acellular, sterile, non-pyrogenic porcine dermal matrix for use in the reconstruction of soft tissue deficiencies. The graft is packed dry and must be hydrated in sterile saline prior to use. The thickness of the device is 1.5 to 2.3mm.

PREMARKET NOTIFICATION FOR XENMATRIX™ AB SURGICAL GRAFT

SECTION 7

4

Product sizes when hydrated are:

  • . 6x6cm
  • 6 x 10 cm ●
  • 6 x 16 cm
  • 8 x 8 cm ●
  • 10 x 10 cm
  • 10 x 15 cm ●
  • 15 x 20 cm ●
  • . 19 x 28 cm
  • 19 x 35 cm ●
  • 10 x 20 cm ●
  • 20 x 20 cm
  • 20 x 25 cm
  • 10 x 28 cm .
  • 15 x 25 cm

The XenMatrix™ AB Surgical Graft surfaces are coated with an antimicrobial coating, which is comprised of a bioresorbable L-tyrosine succinate polymer and antimicrobial agents Rifampin and Minocycline at 180 µg/cm each. The coating is shaded orange in color due to the color of the antimicrobial agents. The bioresorbable L - Tyrosine succinate polymer is essentially absorbed in 12 months based on in vitro studies.

The antimicrobial coating present on this device is intended to protect the graft from bacterial colonization. In preclinical studies the coating has been shown to reduce or inhibit microbial colonization of the device (please see performance data, section 5., below). The claim of reduction of bacterial colonization of the device has not been established with human clinical data, nor has a clinical impact associated with this claim been demonstrated.

Intended Use:

The XenMatrix™ AB Surgical Graft is intended for implantation to reinforce soft tissue where weakness exists and for surgical repair of damaged or ruptured soft tissue, including: abdominal plastic and reconstructive surgery; muscle flap reinforcement; hernia repair including abdominal, inguinal, femoral, diaphragmatic, scrotal, umbilical, and incisional hernias. The Rifampin and Minocycline coating has been shown in preclinical in vitro and in vivo testing to reduce or inhibit microbial colonization on the device. The claim of reduction of bacterial colonization of the device has not been established with human clinical data, nor has a clinical impact associated with this claim been demonstrated.

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

The XenMatrix™ AB Surgical Graft is similar in intended use and in technological characteristics and performance when compared to the cited predicate devices. XenMatrix™ AB and the cited predicates are intended for use in the reconstruction and repair of soft tissue deficiencies where weakness exists such as hernia repair. In addition, these devices are similar in technological characteristics with regard to sterilization, packaging and labeling.

The XenMatrix™ AB Surgical Graft and the predicate Porcine Dermal Matrix Surgical Mesh (K081272, marketed by Davol as XenMatrix™) are based on the same mesh matrix. The XenMatrix™ AB device contains a higher concentration, 180 µg/cm² (each drug) of the same antibacterial drug coating as the Ventrio Light Hernia Patch with TRM

PREMARKET NOTIFICATION FOR XENMATRIX™ AB SURGICAL GRAFT SECTION 7

5

Antimicrobial Coating (K113229). The Ventrio Light Hernia Patch device is a nonresorbable, synthetic surgical mesh containing 115 ug/cm- per Rifampin and Minocycline (each drug). Preparation, i.e., hydration, rinsing, of the XenMatrix™ AB device prior to use elutes Rifampin and Minocycline to equivalent concentrations as the comparator predicate surgical mesh. The instructions for use cite the specific hydration steps, i.e., submersion of the device in room temperature sterile water for at least 5 minutes but not exceeding 40 minutes, prior to surgical implantation.

The device differs from the SURGISIS Biodesign Tissue Graft (K073391) and Ventrio Light Hernia Patch with TRM Antimicrobial Coating (K113229) in material substrate.

Both XenMatrix™ AB and SURGISIS are based on porcine derived material. SURGISIS does not have any antimicrobial coating.

Where technological differences exist between the device and the predicate devices, performance testing indicates that the devices are substantially equivalent.

Performance Data:

The XenMatrix™ AB surgical mesh was evaluated in the following assessments:

    1. Biocompatibility testing
      Biocompatibility testing in accordance to the current ISO 10993 series was conducted on the finished device and the results indicate that the device is biocompatible per these standards.
    1. Bench testing
      Bench testing in accordance with the FDA Guidance for the Preperation of a Premarket Notification Application for a Surgical Mesh was conducted comparing the XenMatrix™ AB device with the cited predicates. The testing included the following:
  • a. Physical Characteristics:

    • i. Device Thickness
    • ii. Device (Flexural) Stiffness
  • b. Functional Characteristics:

    • i. Burst Strength
    • ii. Suture Pullout Strength
    • iii. Tear Resistance

Results demonstrate that the physical and functional characteristics of XenMatrix™ AB Surgical Mesh are substantially equivalent to the predicate comparator devices.

3. In vivo strength determinations

The device was implanted in a 28 day, porcine evaluation and tested for strength characteristics in comparison to the cited predicate device at Time zero (To) and Day 28 (D28). This study assessed the following characteristics of the implanted mesh:

PREMARKET NOTIFICATION FOR XENMATRIX™ AB SURGICAL GRAFT SECTION 7

6

  • a. Mechanical Testing
    • i. Tensile Testing
    • ii. Tissue in-growth Testing
    • iii. Device Burst Testing
  • b. Percent Area Contracture
  • c. Peritoneal Tissue Attachments
  • d. Histology

Results demonstrate that the in vivo performance of XenMatrix™ AB Surgical Mesh is substantially equivalent to the predicate device.

4. Drug Content and Impurities of the Antimicrobial Agents Rifampin and Minocycline

Analytical and in vitro testing was also performed on the device and included speed to kill, kinetic drug release (KDR), drug content and impurity, and polymer degradation testing. The test results demonstrated substantial equivalence to the predicate comparator surgical mesh with respect to these parameters.

    1. Animal Testing
      An in vivo porcine implantation study was performed to investigate the device's mechanical strength and the host inflammatory response to the device over a 28 day duration. At 28 days, the XenMatrix™ AB surgical mesh had greater tissueingrowth/T-Peel Force values than the surgical mesh predicate. .The mechanical strength values (i.e., Ultimate Load/Burst Force, Peak Tensile Strength) of the graft alone were lower than the surgical mesh predicate .

In addition, two in vivo dorsum-implanted rabbit infection model studies were performed. Devices were inoculated with bacteria at implantation, and at 7 days, post-implantation, bacterial colonization quantifications were conducted. At that time point the antimicrobial coating on the XenMatrix™ AB was observed to prevent bacterial colonization of the device in comparison to the surgical mesh predicate device.

The relevance of these studies to human clinical performance outcomes has not been demonstrated.

The correlation of these studies has not been demonstrated to be predictive of positive human clinical outcomes.

    1. Human clinical data None.
      The claim of reduction of colonization has not been established with human clinical data, nor has a clinical impact associated with this claim been demonstrated.

PREMARKET NOTIFICATION FOR XENMATRIX™ AB SURGICAL GRAFT SECTION 7

7

Conclusion:

Results of the testing performed in support of this submission demonstrate that the XenMatrix™ AB Surgical Graft is substantially equivalent to currently marketed predicate devices. The claim of reduction of bacterial colonization of the device has not been established with human clinical data, nor has a clinical impact associated with this claim been demonstrated.