K Number
K143338
Device Name
Argulated Locking Plates
Manufacturer
Date Cleared
2015-04-01

(132 days)

Product Code
Regulation Number
872.4760
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The OSTEOMED ICON Modular Locking Fixation System is indicated for fracture fixation in maxillofacial trauma reconstruction, mandibular reconstruction and orthognathic reconstruction. The OSTEOMED ICON Modular Locking Fixation System implants and drills are intended for single use onlv.
Device Description
The OSTEOMED ICON Modular Locking Fixation System is comprised of plates, screws and instrumentation utilized in the fixation of maxillofacial and mandibular fractures. The screw and plate interface allows up to 20 degrees of angulation within screw placement. The plating system allows for the use of locking standard screws, locking Auto-Drive™ screws, standard non-locking screws, safety screws and Auto-Drive™ screws, as needed. The system features three modular blocks. - . The 1.6mm Midface System consists of 1.6mm locking standard screws with lengths ranging from 3mm to 14mm, 1.6mm locking Auto-Drive™ screws with lengths ranging from 4mm to 8mm and 1.9mm safety screws with lengths ranging from 3mm to 1.6mm midface plates range in thicknesses of 0.6mm to 0.8mm. - . The 2.0mm Midface/Mandible System consists of 2.0mm locking standard screws with lengths 4mm to 18mm, 2.0mm locking Auto-Drive™ screws with lengths of 4mm to 8mm, and 2.3mm safety screws with lengths ranging from 4mm to 24mm. The midface plates range in thicknesses of 0.6mm to 0.8mm and the mandible plates range in thicknesses of 1.0mm to 1.5mm. - The 2.8mm Mandible System consists of 2.0mm locking standard screws with lengths 6mm to 22mm, 2.4mm locking Auto-Drive™ screws with lengths of 6mm to 8mm, and 2.7mm safety screws with lengths ranging from 6mm to 22mm. The fracture plates range in thicknesses of 1.0mm to 1.5mm and the reconstruction plates range in thicknesses of 2.0mm to 2.8mm. The instruments include drill bits, plate bending pliers, plate holding forceps, plate cutters, drill guides, cannulae, taps, countersinks, and screwdrivers to facilitate the placement of screws and modification of plates.
More Information

Not Found

No
The device description focuses on mechanical components (plates, screws, instruments) and their physical properties, with no mention of software, algorithms, or data processing that would indicate AI/ML.

Yes
The device is described as a "Modular Locking Fixation System" intended for "fracture fixation in maxillofacial trauma reconstruction, mandibular reconstruction and orthognathic reconstruction," which are all forms of therapy.

No

Explanation: The device is a fixation system comprised of plates, screws, and instrumentation used for fracture fixation in maxillofacial and mandibular trauma, reconstruction, and orthognathic reconstruction. It is a treatment device, not a diagnostic one.

No

The device description explicitly lists physical components such as plates, screws, and instrumentation (drill bits, pliers, etc.), indicating it is a hardware-based medical device.

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

Here's why:

  • Intended Use: The intended use clearly states "fracture fixation in maxillofacial trauma reconstruction, mandibular reconstruction and orthognathic reconstruction." This describes a surgical procedure involving the physical repair of bone fractures.
  • Device Description: The device is comprised of "plates, screws and instrumentation utilized in the fixation of maxillofacial and mandibular fractures." These are physical implants and tools used in surgery.
  • Lack of IVD Characteristics: An IVD device is used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. The description of the OSTEOMED ICON Modular Locking Fixation System does not involve any such examination of biological specimens.

Therefore, the OSTEOMED ICON Modular Locking Fixation System is a surgical implant and instrumentation system, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The OSTEOMED ICON Modular Locking Fixation System is indicated for fracture fixation in maxillofacial trauma reconstruction, mandibular reconstruction and orthognathic reconstruction.

The OSTEOMED ICON Angulated Locking Plate System implants and drills are intended for single use only.

Product codes

JEY

Device Description

The OSTEOMED ICON Modular Locking Fixation System is comprised of plates, screws and instrumentation utilized in the fixation of maxillofacial and mandibular fractures. The screw and plate interface allows up to 20 degrees of angulation within screw placement. The plating system allows for the use of locking standard screws, locking Auto-Drive™ screws, standard non-locking screws, safety screws and Auto-Drive™ screws, as needed.

The system features three modular blocks.

  • . The 1.6mm Midface System consists of 1.6mm locking standard screws with lengths ranging from 3mm to 14mm, 1.6mm locking Auto-Drive™ screws with lengths ranging from 4mm to 8mm and 1.9mm safety screws with lengths ranging from 3mm to 1.6mm midface plates range in thicknesses of 0.6mm to 0.8mm.
  • . The 2.0mm Midface/Mandible System consists of 2.0mm locking standard screws with lengths 4mm to 18mm, 2.0mm locking Auto-Drive™ screws with lengths of 4mm to 8mm, and 2.3mm safety screws with lengths ranging from 4mm to 24mm. The midface plates range in thicknesses of 0.6mm to 0.8mm and the mandible plates range in thicknesses of 1.0mm to 1.5mm.
  • The 2.8mm Mandible System consists of 2.0mm locking standard screws with lengths 6mm to 22mm, 2.4mm locking Auto-Drive™ screws with lengths of 6mm to 8mm, and 2.7mm safety screws with lengths ranging from 6mm to 22mm. The fracture plates range in thicknesses of 1.0mm to 1.5mm and the reconstruction plates range in thicknesses of 2.0mm to 2.8mm.

The instruments include drill bits, plate bending pliers, plate holding forceps, plate cutters, drill guides, cannulae, taps, countersinks, and screwdrivers to facilitate the placement of screws and modification of plates.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

maxillofacial, mandibular

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

The OsteoMed ICON Modular Locking Fixation System 2.8mm plates were compared to the OsteoMed 2.5mm Modular Locking Fixation System plates, K080694. The ICON Modular Locking Fixation System plates underwent verification evaluation to ensure that the design features met the required mechanical strength criteria for their intended use of the OsteoMed ICON Modular Locking Fixation System plates is the same as the OsteoMed Modular Locking Fixation System plates.

Key Metrics

Not Found

Predicate Device(s)

OsteoMed Modular Locking Fixation System, K080694

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.4760 Bone plate.

(a)
Identification. A bone plate is a metal device intended to stabilize fractured bone structures in the oral cavity. The bone segments are attached to the plate with screws to prevent movement of the segments.(b)
Classification. Class II.

0

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

April 1, 2015

OsteoMed L.P. Ms. Anita Zacherl Senior Regulatory Specialist 3885 Arapaho Road Addison, TX 75001

Re: K143338

Trade/Device Name: OsteoMed ICON Modular Locking Fixation System Regulation Number: 21 CFR 872.4760 Regulation Name: Bone Plate Regulatory Class: II Product Code: JEY Dated: February 27, 2015 Received: March 2, 2015

Dear Ms. Zacherl:

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.

1

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 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 vours.

Tina
Kiang -S

for Erin I. Keith, M.S. Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Image /page/2/Picture/0 description: The image shows the logo for Osteomed. The logo is in blue and green, with the word "OSTEOMED" in large, bold letters. The logo has a swoosh design above and below the text. The swoosh above the text is blue, and the swoosh below the text is green.

Indications for Use

K143338 510(k) Number (if known): _

Device Name: OsteoMed ICON Modular Locking Fixation System

Indications for Use:

The OSTEOMED ICON Modular Locking Fixation System is indicated for fracture fixation in maxillofacial trauma reconstruction, mandibular reconstruction and orthognathic reconstruction.

The OSTEOMED ICON Angulated Locking Plate System implants and drills are intended for single use only.

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 OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

OsteoMed 3885 Arapaho Road Addison, Texas 75001 (972) 677-4600 FAX: (972) 677-4601

3

Image /page/3/Picture/0 description: The image shows the logo for OsteoMed. The logo is in blue and gray, with the word "OSTEOMED" in large, bold, blue letters. The logo has a blue swoosh above the word and a gray swoosh below the word. There is a registered trademark symbol in the upper right corner of the logo.

Special 510(k) Summary

Name of Submitter: OsteoMed
3885 Arapaho Road
Addison, Texas 75001
Phone: (972) 677-4600
Fax: (972) 677-4601
Contact Person:Anita Zacherl
Date Prepared:March 30, 2015
Device Proprietary Name:OsteoMed ICON Modular Locking Fixation System
Device Common Name:ICON Locking Fixation System
Classification Name:21 CFR 872.4760, Plate, Bone
Product Code:JEY
Predicate Devices:OsteoMed Modular Locking Fixation System,
K080694
Classification Name:Plate, bone (21CFR 872.4760,
Product Code JEY)
Device Class: II

Summary:

Device Description:

The OSTEOMED ICON Modular Locking Fixation System is comprised of plates, screws and instrumentation utilized in the fixation of maxillofacial and mandibular fractures. The screw and plate interface allows up to 20 degrees of angulation within screw placement. The plating system allows for the use of locking standard screws, locking Auto-Drive™ screws, standard non-locking screws, safety screws and Auto-Drive™ screws, as needed.

OsteoMed 3885 Arapaho Road Addison, Texas 75001 (972) 677-4600 FAX: (972) 677-4601

4

The system features three modular blocks.

  • . The 1.6mm Midface System consists of 1.6mm locking standard screws with lengths ranging from 3mm to 14mm, 1.6mm locking Auto-Drive™ screws with lengths ranging from 4mm to 8mm and 1.9mm safety screws with lengths ranging from 3mm to 1.6mm midface plates range in thicknesses of 0.6mm to 0.8mm.
  • . The 2.0mm Midface/Mandible System consists of 2.0mm locking standard screws with lengths 4mm to 18mm, 2.0mm locking Auto-Drive™ screws with lengths of 4mm to 8mm, and 2.3mm safety screws with lengths ranging from 4mm to 24mm. The midface plates range in thicknesses of 0.6mm to 0.8mm and the mandible plates range in thicknesses of 1.0mm to 1.5mm.
  • The 2.8mm Mandible System consists of 2.0mm locking standard screws with lengths 6mm to 22mm, 2.4mm locking Auto-Drive™ screws with lengths of 6mm to 8mm, and 2.7mm safety screws with lengths ranging from 6mm to 22mm. The fracture plates range in thicknesses of 1.0mm to 1.5mm and the reconstruction plates range in thicknesses of 2.0mm to 2.8mm.

The instruments include drill bits, plate bending pliers, plate holding forceps, plate cutters, drill guides, cannulae, taps, countersinks, and screwdrivers to facilitate the placement of screws and modification of plates.

Indications for Use:

The OSTEOMED ICON Modular Locking Fixation System is indicated for fracture fixation in maxillofacial trauma reconstruction, mandibular reconstruction and orthognathic reconstruction.

The OSTEOMED ICON Modular Locking Fixation System implants and drills are intended for single use onlv.

Technological Characteristics:

The OsteoMed ICON Modular Locking Fixation System is recommended for fixation of maxillofacial and mandibular fractures.

The ICON Modular Locking Fixation System screws are made from Titanium Alloy (ASTM F-136). The plates are made from Titanium Alloy (ASTM F-136) or commercially pure Titanium (ASTM F-67). The instrumentation is made from various grades of stainless steel, anodized aluminum, and/or medical grade plastic, the same materials used in the manufacture of the predicate devices. These materials are biocompatible.

Performance/Clinical Data:

The OsteoMed ICON Modular Locking Fixation System 2.8mm plates were compared to the OsteoMed 2.5mm Modular Locking Fixation System plates, K080694. The ICON Modular Locking Fixation

OsteoMed 3885 Arapaho Road Addison, Texas 75001 (973) 677-4600 FAX: (972) 677-4601

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Image /page/5/Picture/0 description: The image shows the logo for OsteoMed. The logo is in blue and gray, with the word "OSTEOMED" in large, bold letters. The logo is surrounded by a blue and gray oval shape. The logo is simple and modern, and it is likely used to represent the company's brand.

System plates underwent verification evaluation to ensure that the design features met the required mechanical strength criteria for their intended use of the OsteoMed ICON Modular Locking Fixation System plates is the same as the OsteoMed Modular Locking Fixation System plates.

Performance equivalence was shown through the verification comparison to the predicate devices.

Clinical Testing is not required to support substantial equivalence.

Substantial Equivalence:

A design, dimensional, and performance comparison was performed to establish substantial equivalence to the legally marketed predicate devices listed in this summary. The basis of substantial equivalence for this device is based on similarities in intended use, material, function, performance, design, technology and operational principles to the OsteoMed Modular Locking Fixation System (K080694).

Comparison Table Modular Locking Fixation Mandible Module
System / DeviceOSTEOMED ICON ModularOSTEOMED Modular Locking
NameLocking Fixation MandibleFixation System Mandible
Module Reconstruction PlatesModule Reconstruction Plates
510K NumberPendingK080694
ClassificationClass IIClass II
21 CFR 872.476021 CFR 872.4760
JEYJEY
Indication forThe OsteoMed ICON ModularThe OsteoMed Modular Locking
UseLocking Fixation System is indicatedFixation System is indicated for
for fracture fixation in maxillofacialfracture fixation in cranio-
trauma reconstruction, mandibularmaxillofacial trauma reconstruction,
reconstruction and orthognathicmandibular reconstruction and
reconstruction.orthognathic reconstruction.
The implants and drills are intendedThe implants and drills are intended
for single use only.for single use only.
PlatesVarious shapesVarious shapes
Recon Plate2.8mm2.5mm
Thickness
Material (ReconASTM F-67ASTM F-67
Plates)
The 2.4mm• 2.4mm locking standard screws• 2.4mm locking standard screws
Mandiblewith lengths 6mm to 22mmwith lengths 6mm to 22mm
Module· 2.4mm locking Auto-Drive™· 2.4mm locking Auto-Drive™
Screw Sizes andscrews with lengths of 6mm to 8mmscrews with lengths of 6mm to 8mm
Lengths
InstrumentsThe instruments include drill bits,The instruments include drill bits,
plate bending pliers, plate holdingplate bending pliers, plate holding
forceps, plate cutters, drill guides,forceps, plate cutters, drill guides,
cannulae, taps, countersinks, andcannulae, taps, countersinks, and

6

Comparison Table Modular Locking Fixation Mandible Module
System / Device
NameOSTEOMED ICON Modular
Locking Fixation Mandible
Module Reconstruction PlatesOSTEOMED Modular Locking
Fixation System Mandible
Module Reconstruction Plates
screwdrivers to facilitate the
placement of screws and modification
of plates.screwdrivers to facilitate the
placement of screws and
modification of plates.
TechnologyLocking Plates and Screws to fixate
boneLocking Plates and Screws to fixate
bone
Principles of
OperationAngulated Locking for Rigid FixationAngulated Locking for Rigid Fixation
FeaturesVarious Plates and ScrewsVarious Plates and Screws
Plates
(shape)Variety of shapes and sizes (e.g.,
straight, angled right, angled left,
contoured with various size holes).
Plates can be modified/contoured and
cut to lengthVariety of shapes and sizes (e.g.,
straight, angled right, angled left,
contoured with various size holes).
Plates can be modified/contoured and
cut to length
Plate holesAngled Locking/LockingAngled Locking/Locking

The basis of substantial equivalence of the OsteoMed ICON Modular Locking Fixation System to the OsteoMed Modular Locking Fixation System, K080694, is based on the similarities in design, technology, material, function, sterilization, and intended use. OsteoMed believes that the nonclinical tests demonstrate that the device is substantially equivalent to the predicate devices.

OsteoMed 3885 Arapaho Road Addison, Texas 75001 (974) 677-4600 FAX: (972) 677-4601