K Number
K153519

Validate with FDA (Live)

Device Name
DReal
Date Cleared
2016-03-16

(99 days)

Product Code
Regulation Number
882.4310
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Carevature DReal™ is intended to be used with high-speed compatible electric and pneumatic motors. When used with these motors, it is intended to cut bone by drilling, reaming, decorticating, shaping, dissecting, shaving and smoothing for neurosurgical and spinal applications. Specific applications include laminectomy/laminotomy and craniotomy/craniectomy/ skull base cuts < 1 cm3.

Device Description

The DReal™ is a handheld bone-removal device based on a rotating cutter, with a protective shield (hood) partially covering the cutter; following its indications for use, it is designed to cut bone < 1 cm3.

The DReal™ comprises a handpiece with a plastic grip ("handle") and a central shaft that curves at its distal end ("tip"). The curved tip is equipped with an active, drill-like cutter that is protected by an extension of the central shaft as a protective shield. The DReal™ has two models, with different angles of curvature at the distal end: Short 45° and Long 75°.

Located in the proximal end of the handle, is the motor adaptor (the motor is not part of the supplied product).

The DReal™ principles of operation are the same as any other bone cutting tool, as well as the predicate device; it uses electrical or pneumatic power to rotate a cutting element that is approximated to the bone requiring cutting.

The DReal™ has an irrigation port on its handle that connects to irrigation source. Irrigation should be running at all times while the DReal™ is active. In case of irrigation malfunction, irrigation can be added externally as with any high-speed, rotating power device, including the predicate.

The DReal™ can be powered by an electric or pneumatic motors using a 'micro' adaptor as per ISO 3964; however, it can rotate only clockwise (right-hand, or Forward).

AI/ML Overview

The device in question is the DReal™, a handheld bone-removal device. The provided document is a 510(k) Pre-market Notification for the DReal™, demonstrating its substantial equivalence to a predicate device.

Here's an analysis of the acceptance criteria and the study proving the device meets them:

1. Table of Acceptance Criteria and Reported Device Performance

The FDA 510(k) summary indicates that for each performance test, the device "passed the test" and "The acceptance criteria were met." However, specific quantitative acceptance criteria values are generally not detailed in this type of summary. The table below lists the performance tests and the reported results:

TestAcceptance Criteria (General)Reported Device Performance
Biocompatibility Testing
GLP Cytotoxicity per ISO 10993-5Non-cytotoxic (less than grade 2 reactivity)Non-cytotoxic
ISO- intracutaneous in Rabbits (irritation) per ISO 10993-10Not irritant (difference between test article extract and control is low)Not irritant
Sensitization per ISO 10993-10Not considered a sensitizer (no evidence of delayed dermal contact)Not considered a sensitizer
Systemic toxicity per ISO 10993-11Nontoxic (no mortality or evidence of systemic toxicity)Nontoxic
Systemic toxicity USP pyrogen Study per ISO 10993-11Nonpyrogenic (total rise of rabbit temperatures within USP limits)Nonpyrogenic
LAL test per NAMSA LAL SOPAcceptable (less than 0.06 EU/ml)Acceptable
Sterilization, Packaging, and Shelf Life Testing
Sterilization validation (ISO 11137-1)Compliance with ISO 11137-1Successfully completed
Shelf life and packaging testing (including integrity, simulated use)Support for labeled shelf life and packaging integritySuccessfully completed
Performance Testing
Simulated use testing (material removal, durability, integrity on hard tissue)Efficacy, durability, and integrity for bone removal in clinical settingsPassed the test
Temperature Testing (tissue necrosis)Compliance with safety requirements regarding tissue necrosisPassed the test
Slippage testing (motor compatibility)Compatibility with specified motorsPassed the test
Simulated distribution testing/transportation validation (Chatter testing)Compatibility with ASTM D4169-09 and ASTM D4332-13Passed the test
Fatigue test (durability on hard tissue)Durability and integrity for intended usePassed the test
Motor compatibilityCompatibility with specified motorsPassed the test
Excessive VibrationCompatibility with specified motor without malfunctionPassed the test
Animal Feasibility Test (safety and performance in spine)Safety and performance for intended use in the spinePassed the test
Cadaver Feasibility Test (performance in spine)Performance for intended use in the spine (gross bone volume reduction)Passed the test

2. Sample Size Used for the Test Set and Data Provenance

  • Biocompatibility Testing: The sample sizes are specific to the biological tests performed (e.g., rabbits for irritation, guinea pigs for sensitization, mice for systemic toxicity). Specific numerical sample sizes beyond the general animal models are not explicitly stated in this summary.
  • Sterilization, Packaging, and Shelf Life Testing: Sample sizes are not specified, but the tests were performed on device samples.
  • Performance Testing:
    • Animal Feasibility Test: One live adult (7 months) pig.
    • Cadaver Feasibility Test: One skeletally mature human cadaver.
    • For other performance tests (simulated use, temperature, slippage, chatter, fatigue, motor compatibility, excessive vibration), the sample size of devices tested is not specified in this summary.
  • Data Provenance: Not explicitly stated, but given the manufacturer is Carevature Medical Ltd. in Israel, it is likely that the testing (especially feasibility tests) was conducted there or arranged through a contract research organization. The studies are assumed to be prospective as part of the premarket notification process for the device.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

This type of information (number and qualifications of experts for ground truth) is not typically required or provided in a 510(k) summary for mechanical surgical devices. The "ground truth" for these tests primarily relies on objective measurements against established engineering and biological standards (e.g., ISO, ASTM, USP standards) and direct observation by qualified technicians and researchers conducting the tests.

4. Adjudication Method for the Test Set

Adjudication methods like 2+1 or 3+1 are typically used in clinical studies where expert consensus is needed to establish a "ground truth" for diagnostic or AI-based devices. For this mechanical surgical device, the "adjudication" is inherent in passing or failing objective engineering and biocompatibility tests against predefined standards. There is no mention of a separate expert adjudication process for these tests.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was Done

No, an MRMC comparative effectiveness study was not done. These studies are relevant for diagnostic devices where human readers interpret images, and the AI's assistance to human readers is evaluated. The DReal™ is a surgical tool, not a diagnostic imaging AI.

6. If a Standalone Performance (i.e., algorithm only without human-in-the-loop performance) was Done

This question is not applicable. The DReal™ is a mechanical surgical device operated by a surgeon, not an algorithm. Its performance is evaluated through its physical properties, safety, and functionality, not as a standalone algorithm.

7. The Type of Ground Truth Used

The ground truth for this device is based on several objective measures and established standards:

  • Biocompatibility: In vitro and in vivo testing against ISO and USP standards.
  • Sterilization, Packaging, and Shelf Life: Validation against ISO standards.
  • Performance Testing (Simulated Use, Temperature, Fatigue, etc.): Objective measurements of mechanical properties, material removal efficacy, temperature generation, durability, and compatibility against predefined engineering specifications and regulatory standards (e.g., ASTM).
  • Feasibility Tests (Animal and Cadaver): Direct observation of safety, performance, and gross bone volume reduction in a controlled environment.

8. The Sample Size for the Training Set

This question is not applicable. The DReal™ is a mechanical device, not an AI or machine learning algorithm that requires a training set. Its design and manufacturing are based on engineering principles and materials science.

9. How the Ground Truth for the Training Set was Established

This question is not applicable as there is no training set for this mechanical surgical device.

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Image /page/0/Picture/1 description: The image is a seal for the Department of Health & Human Services - USA. The seal is circular with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the edge. In the center of the seal is an abstract image of a bird.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - W 066-G609 Silver Spring, MD 20993-0002

March 24, 2016

Carevature Medical, Ltd. Ms. Orly Maor Company Consultant 42nd Tvuot Haarets Street Tel Aviv, Israel 6954648

Re: K153519

Trade/Device Name: DReal™ Regulation Number: 21 CFR 882.4310 Regulation Name: Powered Simple Cranial Drills, Burrs, Trephines, and Their Accessories Regulatory Class: Class II Product Code: HBE Dated: February 9, 2016 Received: February 11, 2016

Dear Ms. Orly Maor:

This letter corrects our substantially equivalent letter of March 16, 2016.

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 devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in

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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 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/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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,

Carlos L. Pena -S/Δ

Carlos L. Peña, PhD, MS Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K153519

Device Name DReal™M

Indications for Use (Describe)

The Carevature DReal™ is intended to be used with high-speed compatible electric and pneumatic motors. When used with these motors, it is intended to cut bone by drilling, reaming, decorticating, shaping, dissecting, shaving and smoothing for neurosurgical and spinal applications. Specific applications include laminectomy/laminotomy and craniotomy/craniectomy/ skull base cuts < 1 cm3.

Type of Use (Select one or both, as applicable)

☑ Prescription Use (Part 21 CFR 801 Subpart D)
☐ Over-The-Counter Use (21 CFR 801 Subpart C)

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Traditional Premarket Notification Submission – 510(k) Summary DReal™ 510(k) Number K153519

I. SUBMITTER

Carevature Medical Ltd. 42 Tvuot Haarets St. Tel Aviv, Israel 6954648 Tel: +972-8-6757073 Fax: +972-8-6757073

Contact Person

Orly Maor Company consultant ra@carevature.com Tel: +972-9-7453607 Fax: +972-8-6757073 42nd Tvuot Haarets St. Tel Aviv, Israel 6954648

Date Prepared: February 26, 2016

II. DEVICE

Name of Device: DReal™ Common or Usual Name: DReal™ Classification Name: drills, burrs, trephines & accessories (simple, powered) CFR: 21 CFR §882.4310 Regulatory Class: II Product Code: HBE

III. PREDICATE DEVICE

The predicate device is the Stryker Corporation Stryker MIS Attachments and Cutting Accessories cleared under K143540 (product code HBE, Regulation No. 21 CFR $882.4310).

IV. DEVICE DESCRIPTION

The DReal™ is a handheld bone-removal device based on a rotating cutter, with a protective shield (hood) partially covering the cutter; following its indications for use, it is designed to cut bone < 1 cm3.

The DReal™ comprises a handpiece with a plastic grip ("handle") and a central shaft that curves at its distal end ("tip"). The curved tip is equipped with an active, drill-like

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Image /page/4/Picture/0 description: The image shows the logo for "carevature MEDICAL". The word "carevature" is in a sans-serif font, with the "c" in a darker shade of blue than the rest of the word. Below "carevature" is the word "MEDICAL" in a smaller, sans-serif font. There are two curved lines above and below the word "carevature", both in shades of blue.

cutter that is protected by an extension of the central shaft as a protective shield. The DReal™ has two models, with different angles of curvature at the distal end: Short 45° and Long 75°.

Located in the proximal end of the handle, is the motor adaptor (the motor is not part of the supplied product).

The DReal™ principles of operation are the same as any other bone cutting tool, as well as the predicate device; it uses electrical or pneumatic power to rotate a cutting element that is approximated to the bone requiring cutting.

The DReal™ has an irrigation port on its handle that connects to irrigation source. Irrigation should be running at all times while the DReal™ is active. In case of irrigation malfunction, irrigation can be added externally as with any high-speed, rotating power device, including the predicate.

The DReal™ can be powered by an electric or pneumatic motors using a 'micro' adaptor as per ISO 3964; however, it can rotate only clockwise (right-hand, or Forward).

The following motor system (Class II, Product Code HBE) was validated for use with the DRealTM.

  • Stryker Consolidated Operating Room Equipment (CORE) -K112593

V. INDICATIONS FOR USE

The Carevature DReal™ is intended to be used with high-speed compatible electric and pneumatic motors. When used with these motors, it is intended to cut bone by drilling, reaming, decorticating, shaping, dissecting, shaving and smoothing for neurosurgical and applications. Specific applications include laminectomy/laminotomy and craniotomy/craniectomy/ skull base cuts < 1cm .

VI. COMPARISON OF TECHNOLOGICAL CHARACTERISTICS WITH THE PREDICATE DEVICE

A substantial equivalence table, which summarizes the similarities and differences between the DReal™ and the predicate device, is provided below.

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Image /page/5/Picture/0 description: The image shows the logo for "carevature MEDICAL". The word "carevature" is in a sans-serif font, with the word "MEDICAL" in a smaller font size below it. There are two curved lines above and below the text, creating a circular shape around the logo. The logo is in a light blue color.

Carevature Medical DReal™Stryker MIS Attachmentsand Cutting AccessoriesSEJUSTIFICATION
510(k) NumberK153519K143540
ManufacturerCarevature Medical Ltd.Stryker Corporation
Product CodeHBEHBE, ERLSame
CFR§882.4310§882.4310, §874.4240Same
Intended UseThe Carevature DReal™ isintended to be used with high-speed compatible electric andpneumatic motorsThe MIS Attachments andCutting Accessories areintended to be used with theStrykerConsolidated Operating RoomEquipment (CORE Consoleand electric and pneumaticmotorsSame-Substantiallyequivalent
When used with these motors,it is intended to cut bone bydrilling, reaming, decorticating,shaping, dissecting, shavingand smoothing forneurosurgical and spinalapplications.When used with these motors,the MIS Attachments andCutting Accessories areintended to cut bone in thefollowing manner: drilling,reaming, decorticating,shaping, dissecting, shaving,and smoothing for thefollowing medical applications:Neuro; Spine; Ear, Nose, andThroat(ENT)/Otorhinolaryngology;and Endoscopic applications.DifferentThe DReal™ haslimitedindications thanthe Stryker MISattachments. Thespecificindications are asubset of alreadyclearedindications forthe predicatedevice.
Specific applications includelaminectomy/laminotomy andcraniotomy/craniectomy/ skullbase cuts < 1cm3.Specific applications includeCraniotomy/Craniectomy,Laminotomy/Laminectomy,Minimally Invasive Surgery(MIS) Spine, ExpandedEndonasal Approach(EEA)/Anterior Skull Base/Endoscopic/Transnasal/Transphenoidal, and Orthopedic Spine.These devices are also usable inthe preparation for theplacement of screws, metal,wires, pins, and other fixationdevices.
Carevature Medical DReal™Stryker MIS Attachmentsand Cutting AccessoriesSEJUSTIFICATION
PatientPopulationGeneralPrescription medical deviceGeneralPrescription medical deviceSame
Function• The subject CarevatureDReal™ models act as aninterface between the high speedmotors and the cuttingaccessories• Carevature DReal™ modelsare intended as a location for theuser to hold and grip the devicesystem• The predicate Stryker MISAttachments act as an interfacebetween the high speed motorsand the cutting accessories• The predicate MISattachments are intended as alocation for the user to holdand grip the device system.MIS Attachments and CuttingAccessories are intended to cutbone and used in the preparationfor the placement of screws,metal, wires, pins, and otherfixation devicesSame
ContraindicationsNone knownNone knownSame
Type of operationOpen surgical proceduresOpen surgical proceduresSame
Conditions forUseDReal™– Single UseAttachments – ReusableCutting accessories – Single useSameCarevatureDReal™ devicesare unifiedattachments andcuttingaccessoriestherefore, a singleuse
SterilizationDReal™– supplied sterile,gamma irradiatedAttachments– sterilized by theuserCutting accessories – suppliedsterile, gamma irradiatedSimilarCarevatureDReal™ devicesare unifiedattachments andcuttingaccessoriestherefore,sterilized by themanufacturer
Carevature Medical DReal™Stryker MIS Attachmentsand Cutting AccessoriesSEJUSTIFICATION
Main MaterialsCommonly used medical grademetals and plastics:The handle is made ofSteralloy, a USP-6 plasticmaterial The central shaft is madeof medical grade stainlesssteel The cutter is made ofmedical grade stainlesssteelCommonly used medical grademetals and plasticsSameBoth the subjectand the predicateare comprised ofsimilar materials.DifferentThe DReal™ hasno color strip;instead, thevarious modelsare designated onthe single-useouter and inner-packaging.
PackagingConfigurationCarevature DReal™ products -double sterile sealed pouchesand corresponding cardboardbox.Attachments - Retention insert ina rigid cartonMIS Cutting Accessories –sealed chevron style pouchsterile barrier systemSimilarCarevatureDReal™ modelsare unifiedattachments andcutting accessoriestherefore, packedin sterile sealedway
Available StyleCurved, Angled (45° and 75°),partially-hooded burrStraight, Curved, AngledSimilarThe curve andangle of the tipare intended toimprove its accessand visibilityDifferent• The DReal™possesses asharperangulation nearthe distal end• The DReal™possesses apartially-hoodedburr to provideprotection forsurroundingtissue
Carevature Medical DRealTMStryker MIS Attachmentsand Cutting AccessoriesSEJUSTIFICATION
Driving motorThe Carevature DRealTMmodels were validated to beused with the StrykerConsolidated Operating RoomEquipment (CORE Consoleand electric motors)The MIS Attachments andCutting Accessories areintended to be used with theStryker Consolidated OperatingRoom Equipment (COREConsole and electric orpneumatic motors)Same
Head StyleOfferingMatch HeadRound, Diamond, Match HeadSimilar
Diameter/HeadSize2.5 mm1.5 mm - 5.0 mmSimilar
LengthShaft length 11cmTwo lengths 13 and 16 cmSimilar
Motor powersupplyElectric and PneumaticElectric and PneumaticSame
Speed10,000-40,000 rpm5,000-75,000 rpmSimilar
PneumaticPressureRecommendation120 psi (pounds per square inch)120 psi (pounds per square inch)Same
Source ofActivationFootswitchHandswitch and FootswitchSimilar
Performance1. Shelf life testing2. Temperature Testing3. Slippage testing4. Simulated distribution testingtransportation validation(Chatter testing)5. Simulated use testing6. Fatigue test7. Motor compatibility8. Excessive vibrations1. Shelf life testing2. Temperature Testing3. Slippage testing4. Chatter testing5. Whip testingSameWhip test wasdeemedunnecessary dueto the productdesign. Whippingeffect isinherently limitedto an acceptablevalue.

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Image /page/6/Picture/0 description: The image contains the logo for "carevature MEDICAL". The word "carevature" is in a larger, bold font, and the word "MEDICAL" is in a smaller font below it. There are two curved lines above and below the text, creating a circular effect.

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Image /page/7/Picture/0 description: The image shows the logo for Carevature Medical. The logo consists of the word "carevature" in a sans-serif font, with the word "MEDICAL" in a smaller font below it. There are two curved lines above and below the word "carevature", which are blue.

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Image /page/8/Picture/0 description: The image shows the logo for "carevature MEDICAL". The word "carevature" is in a sans-serif font, with the word "MEDICAL" in a smaller font below it. There are two curved lines above and below the word "carevature", which are blue in color. The logo is simple and modern.

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Image /page/9/Picture/0 description: The image shows the logo for "carevature MEDICAL". The word "carevature" is in a sans-serif font, with the word "MEDICAL" in smaller letters below it. There are two curved lines above and below the word "carevature", which are blue in color. The logo is simple and modern.

VII. PERFORMANCE DATA

The following performance data was provided in support of the substantial equivalence determination:

Biocompatibility testing

An evaluation of biocompatibility was performed in compliance with ISO 10993-1. The biocompatibility tests are listed in the table below:

TestResultsConclusions
GLP Cytotoxicity perISO 10993-5Less than grade 2 (mild reactivity)Non-cytotoxic
ISO- intracutaneous inRabbits (irritation) perISO 10993-10The difference between each test articleextract overall mean score andcorresponding control was 0.0 and 0.1for test articles extractNot irritant
Sensitization per ISO10993-10The test article showed no evidence ofcausing delayed dermal contact in theguinea pigNot considered asensitizer
Systemic toxicity perISO 10993-11No mortality or evidence of systemictoxicity from the extracts injected intomiceNontoxic
Systemic toxicity USPpyrogen Study per ISO10993-11The total rise of rabbit temperatureswas within acceptable USP limitsNonpyrogenic
LAL test per NAMSALAL SOPLess than 0.06 EU/mlAcceptable

All tests were successfully completed.

Sterilization, Packaging and Shelf Life Testing

Sterilization validation testing was performed to demonstrate compliance with ISO 11137-1. In addition, shelf life and packaging testing were performed to support the labeled shelf life. All tests, including packaging integrity and simulated use (performance), were performed after simulated distribution testing (transportation validation) and successfully completed.

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Image /page/10/Picture/0 description: The image shows the logo for "carevature MEDICAL". The word "carevature" is in a sans-serif font, with the word "MEDICAL" in smaller letters below it. There are two curved lines above and below the text, creating a circular shape around the logo. The colors are shades of blue.

Performance Testing

Performance testing included the following:

TestTest Method SummaryResults
Simulated use testingTo demonstrate the performance of the DRealTM for its intended use: activation of the DRealTM ona hard-tissue model to show efficacy (materialremoval), durability and integrity for the removalof material needed with the device' indications inclinical settings.The devicepassed the test.The acceptancecriteria were met.
Temperature TestingTo demonstrate the compliance of the DRealTM tosafety requirements derived from tissue necrosisThe devicepassed the test.The acceptancecriteria were met.
Slippage testingTo demonstrate the compatibility of the DRealTMto the specified motorsThe devicepassed the test.The acceptancecriteria were met.
Simulateddistribution testingtransportationvalidation (Chattertesting)To demonstrate the compatibility of the DRealTMto ASTM D4169-09 and ASTM D4332-13The devicepassed the test.The acceptancecriteria were met.
Fatigue testTo demonstrate the durability of the DRealTM forits intended use.Method: Activation of the DRealTM on a hard-tissue (bone) to show durability and integrityneeded with the device' indications in clinicalsettings.The devicepassed the test.The acceptancecriteria were met.
Motor compatibilityTo demonstrate the compatibility of the DRealTMto the specified motorsThe devicepassed the test.The acceptancecriteria were met.The motors thatare approvedappears on thedevice IFU
Excessive VibrationTo demonstrate the compatibility of the DRealTMto the specified motor without malfunctionThe devicepassed the test.The acceptancecriteria were met.
Animal FeasibilityTestTo investigate the safety and performance of theDRealTM for its intended use in the spine. Onelive adult (7 months) pig was used. Intra-operative performance, gross bone volumereduction, and histopathological sections wereThe devicepassed the test.The acceptancecriteria were met.
TestTest Method SummaryResults
Cadaver FeasibilityTestTo investigate the performance of the DReal™ for its intended use in the spine. One skeletallymature human cadaver was used. Gross bonevolume reduction was observed.The devicepassed the test.The acceptancecriteria were met.

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Image /page/11/Picture/0 description: The image shows the logo for "carevature MEDICAL". The word "carevature" is in a sans-serif font, with the "c" in a darker shade of gray than the rest of the word. Below "carevature" is the word "MEDICAL" in a smaller, sans-serif font. Above and below the words is a curved line that is blue on the ends and fades to white in the middle.

Conclusions:

The tests met the predefined acceptance criteria and passed.

VIII. CONCLUSIONS

The DReal™ was determined to be substantially equivalent to the predicate device.

§ 882.4310 Powered simple cranial drills, burrs, trephines, and their accessories.

(a)
Identification. Powered simple cranial drills, burrs, trephines, and their accessories are bone cutting and drilling instruments used on a patient's skull. The instruments are used with a power source but do not have a clutch mechanism to disengage the tip after penetrating the skull.(b)
Classification. Class II (performance standards).