K Number
K133529
Device Name
CAMBER SPINE COVERIS CERVICAL CAGE
Manufacturer
Date Cleared
2014-03-20

(125 days)

Product Code
Regulation Number
888.3080
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
When used as a cervical intervertebral fusion device, the Coveris Cage is indicated for use at one level in the cervical spine, from C3-C7, in skeletally mature patients who have had six weeks of non-operative treatment for the treatment of degenerative disc disease (DDD) with up to Grade 1 spondylolisthesis. DDD is defined as neck pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies. The device is intended for use with autogenous bone graft and with supplemental fixation systems (such as anterior cervical plating systems, or posterior systems) cleared for use in the cervical spine.
Device Description
The Camber Spine Coveris Cage series of intervertebral body fusion devices are used to maintain disc space distraction in skeletally mature adults requiring intervertebral body fusion. They are designed to be used in conjunction with supplemental spinal fixation instrumentation. The series is comprised of cages of various fixed heights and shapes for placement in the cervical spine. Each cage has a hollow center to allow placement of graft material inside of the cage. Ridges on the superior and inferior surfaces of the device help to grip the endplates and prevent expulsion. The Coveris Cage of intervertebral body fusion devices are made from the PEEK radiolucent material with embedded tantalum x-ray markers as specified in ASTM F2026 and ASTM F560, respectively.
More Information

K 073440, K120345, K073351

No
The summary describes a physical implantable device (intervertebral fusion cage) and its mechanical properties and materials. There is no mention of software, algorithms, image processing, or any terms related to AI/ML.

Yes
The device is indicated for use in the treatment of degenerative disc disease, which is a medical condition, making it a therapeutic device.

No

Explanation: The device, the Coveris Cage, is an intervertebral body fusion device designed to maintain disc space distraction and facilitate fusion, primarily for treatment of degenerative disc disease. Its purpose is therapeutic (fusion), not diagnostic (identifying or characterizing disease).

No

The device description clearly states it is a physical implantable device made of PEEK material with tantalum markers, intended for surgical use in the cervical spine.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections.
  • Device Description: The description clearly states that the Coveris Cage is an implantable medical device used for intervertebral body fusion in the cervical spine. It is a physical structure made of PEEK material designed to maintain disc space and facilitate bone fusion.
  • Intended Use: The intended use is for the surgical treatment of degenerative disc disease by fusing vertebrae, not for analyzing biological samples.

The device is a surgical implant, not a diagnostic test performed outside the body.

N/A

Intended Use / Indications for Use

When used as a cervical intervertebral fusion device, the Coveris Cage is indicated for use at one level in the cervical spine, from C3-C7, in skeletally mature patients who have had six weeks of non-operative treatment for the treatment of degenerative disc disease (DDD) with up to Grade 1 spondylolisthesis. DDD is defined as neck pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies. The device is intended for use with autogenous bone graft and with supplemental fixation systems (such as anterior cervical plating systems, or posterior systems) cleared for use in the cervical spine.

Product codes

ODP

Device Description

The Camber Spine Coveris Cage series of intervertebral body fusion devices are used to maintain disc space distraction in skeletally mature adults requiring intervertebral body fusion. They are designed to be used in conjunction with supplemental spinal fixation instrumentation. The series is comprised of cages of various fixed heights and shapes for placement in the cervical spine. Each cage has a hollow center to allow placement of graft material inside of the cage. Ridges on the superior and inferior surfaces of the device help to grip the endplates and prevent expulsion.
The Coveris Cage of intervertebral body fusion devices are made from the PEEK radiolucent material with embedded tantalum x-ray markers as specified in ASTM F2026 and ASTM F560, respectively.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

cervical spine, from C3-C7

Indicated Patient Age Range

skeletally mature patients

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

No clinical tests were performed.
The following tests were performed to demonstrate that the Camber Spine Coveris Cage is substantially equivalent to other predicate devices: Static and Dynamic Compression Test per ASTM F2077, Static and Dynamic Compression Shear ASTM F2077, Static and Dynamic Torsional ASTM F2077, Subsidence Test per ASTM F2267, Wear Debris ASTM F2077 and ASTM F1877, Static Expulsion Test. The results of these studies showed that the Coveris Cage met the acceptance criteria.

Key Metrics

Not Found

Predicate Device(s)

K 073440, K120345, K073351

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 888.3080 Intervertebral body fusion device.

(a)
Identification. An intervertebral body fusion device is an implanted single or multiple component spinal device made from a variety of materials, including titanium and polymers. The device is inserted into the intervertebral body space of the cervical or lumbosacral spine, and is intended for intervertebral body fusion.(b)
Classification. (1) Class II (special controls) for intervertebral body fusion devices that contain bone grafting material. The special control is the FDA guidance document entitled “Class II Special Controls Guidance Document: Intervertebral Body Fusion Device.” See § 888.1(e) for the availability of this guidance document.(2) Class III (premarket approval) for intervertebral body fusion devices that include any therapeutic biologic (e.g., bone morphogenic protein). Intervertebral body fusion devices that contain any therapeutic biologic require premarket approval.
(c)
Date premarket approval application (PMA) or notice of product development protocol (PDP) is required. Devices described in paragraph (b)(2) of this section shall have an approved PMA or a declared completed PDP in effect before being placed in commercial distribution.

0

MAR 2 0 2014

K133529

Page 1 of 3

Traditional 510(k) Summary

as required by section 807.92(c).

Camber Spine Technologies Coveris Cage K 133529

RevisedMarch 20, 2014
Submitter:Camber Spine Technologies
90 S. Newtown Street Rd., Suite #10
Newtown Square, PA 19073
Contact PersonDan Pontecorvo
President
Phone: 484-420-4219
Fax: (484) 318-8031
Email: delvalsyn@comcast.net
Trade NameCamber Spine Coveris Cage
Common NameIntervertebral Body Fusion Device
Device ClassClass II
Classification Name
and NumberIntervertebral fusion device with bone graft, cervical
21 CFR 888.3080
Classification Panel:Orthopedic
Product CodeODP
Reason for 510kNew Device
Predicate DevicesCorelink Foundation Cage (K 073440), Nexxt Honour Spacer
(K120345) & Spinal Elements Crystal (K073351)
Device DescriptionThe Camber Spine Coveris Cage series of intervertebral body fusion
devices are used to maintain disc space distraction in skeletally
mature adults requiring intervertebral body fusion. They are
designed to be used in conjunction with supplemental spinal fixation
instrumentation.
The series is comprised of cages of various fixed heights and shapes
for placement in the cervical spine. Each cage has a hollow center to
allow placement of graft material inside of the cage. Ridges on the
superior and inferior surfaces of the device help to grip the endplates
and prevent expulsion.
The Coveris Cage of intervertebral body fusion devices are made
from the PEEK radiolucent material with embedded tantalum x-ray
markers as specified in ASTM F2026 and ASTM F560, respectively.
ImplantsThe Implant will be shipped non-sterile and will be autoclaveable,
validation testing of the process was conducted (using the half-cycle
method) to a Sterility Assurance Level (SAL) of 10-6 per ISO 17665.

l

1

| Intended Use | When used as a cervical intervertebral fusion device, the Coveris
Cage is indicated for use at one level in the cervical spine, from C3-
C7, in skeletally mature patients who have had six weeks of non-
operative treatment for the treatment of degenerative disc disease
(DDD) with up to Grade 1 spondylolisthesis. DDD is defined as neck
pain of discogenic origin with degeneration of the disc confirmed by
history and radiographic studies. The device is intended for use with
autogenous bone graft and with supplemental fixation systems (such
as anterior cervical plating systems, or posterior systems) cleared for
use in the cervical spine. |

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

| Materials: | The implant is manufactured from ASTM2026 Solvay Zeniva
ZA-500 implant grade Polyetheretherketone (PEEK) |

-------------------------------------------------------------------------------------------------------------------------

2

K133529

T

T

| Statement of
Technological
Comparison | Camber Spine Coveris Cage and its predicate devices have the same
indications for use, similar design, and test results. Both devices are
manufactured using materials with a long history of use in orthopaedic
implants. |

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

| Nonclinical Test
Summary | The following tests were performed to demonstrate that the Camber Spine Coveris
Cage is substantially equivalent to other predicate devices.
Static and Dynamic Compression Test per ASTM F2077 Static and Dynamic Compression Shear ASTM F2077 Static and Dynamic Torsional ASTM F2077 Subsidence Test per ASTM F2267 Wear Debris ASTM F2077 and ASTM F1877 Static Expulsion Test The results of these studies showed that the Coveris Cage met the acceptance criteria. |
|-----------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Clinical Test
Summary | No clinical tests were performed. |

Conclusion
The Camber Spine Coveris Cage is substantially equivalent to its predicate devices. This conclusion is based upon the fact the Coveris Cage and its predicate devices have the same indications for use, have a similar design and technical characteristics, similar test results, and any differences do not raise question of safety and effectiveness.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized depiction of an eagle or bird-like figure with outstretched wings. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the bird-like figure. The logo is black and white.

Public Health Service

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

March 20, 2014

Camber Spine Technologies Mr. Daniel Pontecorvo President & CEO 90 South Newtown Street Road, Suite 10 Newtown Square, Pennsylvania 19073

Re: K133529

Trade/Device Name: Coveris Cage Regulation Number: 21 CFR 888.3080 Regulation Name: Intervertebral Body Fusion Device Regulatory Class: Class II Product Code: ODP Dated: February 10, 2014 Received: February 18, 2014

Dear Mr. Pontecorvo:

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

4

Page 2 - Mr. Daniel Pontecorvo

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 Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.lda.gov/MedicalDevices/ResourcesforYou/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/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/ResourcesforYou/Industry/default.htm.

Sincerely yours.

Lori A. Wiqqins

for

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

Enclosure

5

Indications for Use

510(k) Number: K133529

Device Name: Coveris Cage

Indications for Use:

When used as a cervical intervertebral fusion device, the Coveris devices are indicated for use at one level in the cervical spine, from C3-C7, in skeletally mature patients who have had six weeks of non-operative treatment for the treatment of degenerative disc disease (DDD) with up to Grade 1 spondylolisthesis. DDD is defined as neck pain of discogenic origin with degeneration of the disc confirmed by history and radiographic studies. The device is intended for use with autogenous bone graft and with supplemental fixation (such as anterior cervical plating systems, or posterior systems) systems cleared for use in the cervical spine.

AND/OR Over-the-counter _____________________________________________________________________________________________________________________________________________________________ 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) Anton E. Dmitriev, PhD

Division of Orthopedic Devices