K Number
K163593
Device Name
Additive Orthopaedics Bunion System
Date Cleared
2017-06-20

(181 days)

Product Code
Regulation Number
888.3030
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Additive Orthopaedics Bunion System is indication and fusion of fractures, ostotomies and arthrodesis of small bones such as the foot and ankle. The Additive Orthopaedics Bunion System is indicated for alignment, stabilization and fusion of fractures, osteotomies and arthrodesis of small bones such as the foot and ankle.
Device Description
The Additive Orthopaedics Bunion System consists of a plate and screws (both locking and nonlocking) with surgical site preparation and insertion instruments. The devices is intended to be used for fixation following an osteotomy in bunion correction procedures. The plates are additively manufactured from medical grade titanium alloy (Ti-6AL-4V Eli). The screws are manufactured from medical grade titanium alloy. (Ti-6AL-4V). The implants are provided sterile and intended for single use only. The bunion plate comes in 1 individual size and the screws come in 4 lengths.
More Information

No
The device description and performance studies focus on the mechanical properties and surgical application of a plate and screw system, with no mention of AI or ML.

Yes.
The device is used for fracture fusion, osteotomies, and arthrodesis of small bones, which are therapeutic interventions.

No
This device is a surgical system for the fixation and fusion of bones, not for diagnosing conditions.

No

The device description explicitly states that the system consists of a plate and screws, which are physical hardware components.

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

Here's why:

  • Intended Use: The intended use clearly states the device is for "alignment, stabilization and fusion of fractures, osteotomies and arthrodesis of small bones such as the foot and ankle." This describes a surgical implant used in vivo (within the body) for structural support and bone healing.
  • Device Description: The description details a "plate and screws" made of titanium alloy, intended for "fixation following an osteotomy in bunion correction procedures." This further confirms its use as a surgical implant.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens derived from the human body (like blood, tissue, or urine) to provide information for diagnosis, monitoring, or treatment.

IVD devices are used in vitro (outside the body) to analyze biological samples. This device is a surgical implant used in vivo.

N/A

Intended Use / Indications for Use

The Additive Orthopaedics Bunion System is indication and fusion of fractures, ostotomies and arthrodesis of small bones such as the foot and ankle.

The Additive Orthopaedics Bunion System is indicated for alignment, stabilization and fusion of fractures, osteotomies and arthrodesis of small bones such as the foot and ankle.

Product codes

HRS, HWC

Device Description

The Additive Orthopaedics Bunion System consists of a plate and screws (both locking and nonlocking) with surgical site preparation and insertion instruments. The devices is intended to be used for fixation following an osteotomy in bunion correction procedures. The plates are additively manufactured from medical grade titanium alloy (Ti-6AL-4V Eli). The screws are manufactured from medical grade titanium alloy. (Ti-6AL-4V). The implants are provided sterile and intended for single use only. The bunion plate comes in 1 individual size and the screws come in 4 lengths.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

foot and ankle

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

Mechanical testing including 4 point bending (static and dynamic) per ASTM F382 for the predicate and subject device. Also included were static driving torque and removal torque, and static axial pullout per F543 for the subject device. In addition to the mechanical testing of the screws, an engineering analysis was performed for the subject device to show substantial equivalency with respect to insertion/removal torque, torsional strength, pull-out strength and bending strength. The results of these verification activities demonstrate that the Additive Orthopaedics Bunion System is substantially equivalent to the predicate device identified.

Key Metrics

Not Found

Predicate Device(s)

K131061, K120157, K131445, K141784

Reference Device(s)

K153207, K160264

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 888.3030 Single/multiple component metallic bone fixation appliances and accessories.

(a)
Identification. Single/multiple component metallic bone fixation appliances and accessories are devices intended to be implanted consisting of one or more metallic components and their metallic fasteners. The devices contain a plate, a nail/plate combination, or a blade/plate combination that are made of alloys, such as cobalt-chromium-molybdenum, stainless steel, and titanium, that are intended to be held in position with fasteners, such as screws and nails, or bolts, nuts, and washers. These devices are used for fixation of fractures of the proximal or distal end of long bones, such as intracapsular, intertrochanteric, intercervical, supracondylar, or condylar fractures of the femur; for fusion of a joint; or for surgical procedures that involve cutting a bone. The devices may be implanted or attached through the skin so that a pulling force (traction) may be applied to the skeletal system.(b)
Classification. Class II.

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Image /page/0/Picture/2 description: The image shows the logo for the Department of Health & Human Services - USA. The logo consists of a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" written around it. Inside the circle is an abstract symbol that resembles a stylized human figure or a caduceus, which is a symbol often associated with healthcare.

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

June 20, 2017

Additive Orthopaedics, LLC Greg Kowalczyk President 83 Amelia Circle Little Silver, New Jersey 07739

Re: K163593

Trade/Device Name: Additive Orthopaedics Locking Lattice Plate Regulation Number: 21 CFR 888.3030 Regulation Name: Single/Multiple Component Metallic Bone Fixation Appliances And Accessories Regulatory Class: Class II Product Code: HRS, HWC Dated: May 25, 2017 Received: May 25, 2017

Dear Mr. Kowalczyk:

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

1

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 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/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.

Vincent J. Devlin -S

for

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

Enclosure

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Indications for Use

510(k) Number (if known) K163593

Device Name Additive Orthopaedics Bunion System

Indications for Use (Describe)

The Additive Orthopaedics Bunion System is indication and fusion of fractures, ostotomies and arthrodesis of small bones such as the foot and ankle.

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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K163593

510K Summary (Per 21 CFR 807.92)

| General Company Information: | Additive Orthopaedics, LLC.
Gregory Kowalczyk
President
83 Amelia Circle
Little Silver, NJ 07739
Phone: (732) 882-6633
greg@additiveorthopaedics.com |
|------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Date Prepared: | February 9, 2017 |

General Device Information:

Proprietary Name:Additive Orthopaedics Bunion System
System Classification:Common Name: Bunion System
Regulation Name: Single/multiple component metallic
bone fixation appliances and accessories;
Product Code: HRS- Class II
Classification Name and Reference: 21 CFR 888.3030
Regulation Name: Smooth or Threaded metallic bone fixation fastener and accessories;
Product Code: HWC- Class II
Classification Name and Reference: 21 CFR 888.3040

Predicate Devices:

CompanyProduct Name510K Number
Primary: Nextremity Solutions, Inc.Restore Fixation SystemK131061
Additional: OrthoHelix Surgical Designs, Inc.Mini MaxLock Extreme Plating SystemK120157
Additional: OsteomedExtremiLock SystemK131445
Additional: OrthoSolutions, Inc.Ultos Foot Plating systemK141784
Reference: Additive Orthopaedics, LLCHammertoe Correction SystemK153207
Reference: Additive Orthopaedics, LLCBone Wedge SystemK160264

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Description

The Additive Orthopaedics Bunion System consists of a plate and screws (both locking and nonlocking) with surgical site preparation and insertion instruments. The devices is intended to be used for fixation following an osteotomy in bunion correction procedures. The plates are additively manufactured from medical grade titanium alloy (Ti-6AL-4V Eli). The screws are manufactured from medical grade titanium alloy. (Ti-6AL-4V). The implants are provided sterile and intended for single use only. The bunion plate comes in 1 individual size and the screws come in 4 lengths.

Indications for Use

The Additive Orthopaedics Bunion System is indicated for alignment, stabilization and fusion of fractures, osteotomies and arthrodesis of small bones such as the foot and ankle.

(a) (6) Technological Characteristics Comparison

The Additive Orthopaedics Bunion System and the legally marketed predicated devices have similar indications, dimensions, geometry, materials and manufacturing process. The Additive Orthopaedics Bunion System is technologically substantially equivalent to the predicate devices.

(b) (1) Substantial Equivalence- Non-Clinical Evidence

Mechanical testing including 4 point bending (static and dynamic) per ASTM F382 for the predicate and subject device. Also included were static driving torque and removal torque, and static axial pullout per F543 for the subject device. In addition to the mechanical testing of the screws, an engineering analysis was performed for the subject device to show substantial equivalency with respect to insertion/removal torque, torsional strength, pull-out strength and bending strength. The results of these verification activities demonstrate that the Additive Orthopaedics Bunion System is substantially equivalent to the predicate device identified.

(b) (3) Substantial Equivalence - Conclusions

The Additive Orthopaedics Bunion System possesses the same technologic characteristics of the predicate devices. These characteristics include the intended use, basic design, material, manufacturing process, size and fundamental technology. The design characteristics of the subject system do not raise any different questions of safety and effectiveness. From the evidence submitted in this 510(k), the subject devices can be expected to perform at least as well as the predicate device.