K Number
K170889
Device Name
HV Screw System
Date Cleared
2017-04-26

(33 days)

Product Code
Regulation Number
888.3040
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The HV Screw is indicated for fixation of bone fractures or for bone reconstruction. Examples include: - · Mono or Bi-Cortical osteotomies in the foot or hand - · Distal or Proximal metatarsal or metacarpal osteotomies - · Fusion of the first metatarsophalangeal joint and interphalangeal joint - · Fixation of osteotomies for Hallux Valgus treatment (such as Scarf, Chevron, etc.) - Akin type osteotomy - · Arthrodesis base first metatarsal cuneiform joint to reposition and stabilize metatarsus varus primus - · Talar/navicular arthrodesis
Device Description
The HV Screws are cannulated screws offered in 3.0mm diameter, various lengths, and have self-tapping features on both distal and proximal threads. All screws are manufactured from titanium alloy.
More Information

K082320- Wright TM Compression Screw

No
The summary describes a mechanical bone screw and does not mention any software, algorithms, or data processing that would indicate the use of AI or ML.

No
The device is described as a screw for fixation of bone fractures or for bone reconstruction, which is a structural or mechanical function, not a therapeutic (treatment of disease/disorder) one in the common medical device sense (e.g., drug delivery, stimulation, active treatment).

No

The device is a cannulated screw for bone fixation and reconstruction, which is a therapeutic rather than a diagnostic function.

No

The device description clearly states it is a physical screw manufactured from titanium alloy, which is a hardware component.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly states the device is for "fixation of bone fractures or for bone reconstruction." This is a surgical procedure performed directly on the patient's body.
  • Device Description: The description details a physical implantable device (screws) made of titanium alloy.
  • Lack of IVD Characteristics: An IVD is a medical device used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health. This device does not interact with biological samples in this way.

The information provided describes a surgical implant, not a diagnostic test performed in vitro.

N/A

Intended Use / Indications for Use

The HV Screw is indicated for fixation of bone fractures or for bone reconstruction. Examples include:

  • · Mono or Bi-Cortical osteotomies in the foot or hand
  • · Distal or Proximal metatarsal or metacarpal osteotomies
  • · Fusion of the first metatarsophalangeal joint and interphalangeal joint
  • · Fixation of osteotomies for Hallux Valgus treatment (such as Scarf, Chevron, etc.)
  • Akin type osteotomy
  • · Arthrodesis base first metatarsal cuneiform joint to reposition and stabilize metatarsus varus primus
  • · Talar/navicular arthrodesis

Product codes

HWC

Device Description

The HV Screws are cannulated screws offered in 3.0mm diameter, various lengths, and have self-tapping features on both distal and proximal threads. All screws are manufactured from titanium alloy.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Foot or hand

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

Non-Clinical Evidence:
Validation and/or Verification Method: Torsional Testing (Insertion Torque, Removal Torque, Ultimate Torque), Engineering Analysis (Axial Pullout Force, Bending Strength, Torsional Strength), Bacterial Endotoxins Testing.
Acceptance Value/Criteria: Ultimate Torque must exceed insertion torque and removal torque by a safety factor; Comparable to the predicate device design;

§ 888.3040 Smooth or threaded metallic bone fixation fastener.

(a)
Identification. A smooth or threaded metallic bone fixation fastener is a device intended to be implanted that consists of a stiff wire segment or rod made of alloys, such as cobalt-chromium-molybdenum and stainless steel, and that may be smooth on the outside, fully or partially threaded, straight or U-shaped; and may be either blunt pointed, sharp pointed, or have a formed, slotted head on the end. It may be used for fixation of bone fractures, for bone reconstructions, as a guide pin for insertion of other implants, or it may be implanted through the skin so that a pulling force (traction) may be applied to the skeletal system.(b)
Classification. Class II.

0

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

April 26, 2017

Wright Medical Technology, Inc. Ms. Tara Conrad Regulatory Affairs Specialist II 1023 Cherry Road Memphis. Tennessee 38117

Re: K170889

Trade/Device Name: HV Screw System Regulation Number: 21 CFR 888.3040 Regulation Name: Smooth Or Threaded Metallic Bone Fixation Fastener Regulatory Class: Class II Product Code: HWC Dated: March 15, 2017 Received: March 24, 2017

Dear Ms. Conrad:

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-

Image /page/0/Picture/11 description: The image is a circular seal for the U.S. Department of Health & Human Services. The seal features the department's name in a circular arrangement around the edge. In the center of the seal is a stylized image of three faces in profile, stacked on top of each other, creating a sense of depth and unity.

1

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/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,

Mark N. Melkerson -S

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

Enclosure

2

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement on last page.

510(k) Number (if known)

K170889

Device Name HV Screw System

Indications for Use (Describe)

The HV Screw is indicated for fixation of bone fractures or for bone reconstruction. Examples include:

  • · Mono or Bi-Cortical osteotomies in the foot or hand
  • · Distal or Proximal metatarsal or metacarpal osteotomies
  • · Fusion of the first metatarsophalangeal joint and interphalangeal joint
  • · Fixation of osteotomies for Hallux Valgus treatment (such as Scarf, Chevron, etc.)
  • Akin type osteotomy
  • · Arthrodesis base first metatarsal cuneiform joint to reposition and stabilize metatarsus varus primus
  • · Talar/navicular arthrodesis
Type of Use (Select one or both, as applicable)
---------------------------------------------------

X Prescription Use (Part 21 CFR 801 Subpart D)

_ Over-The-Counter Use (21 CFR 801 Subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

3

K170889 Page 1 of 2

Headquarters Wright Medical Technology, Inc.

mohis TN 38117

901 867 997
wmt.com

Image /page/3/Picture/4 description: The image contains the logo for Wright. The logo consists of two overlapping trapezoids, one red and one orange, on the left side of the word "WRIGHT" in red, all caps. Below the word "WRIGHT" is the phrase "FOCUSED EXCELLENCE" in a smaller, gray font.

510(K) SUMMARY OF SAFETY AND EFFECTIVENESS

In accordance with the Food and Drug Administration Rule to implement provisions of the Safe Medical Devices Act of 1990 and in conformance with 21 CFR 807.92, this information serves as a Summary of Safety and Effectiveness for the USe of the HV Screw System.

| 1. | Submitted By: | Wright Medical Technology, Inc.
1023 Cherry Road
Memphis, TN 38117 | |
|----|-------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------|--|
| | 510(k) Number: | K170889 | |
| | Date: | April 25, 2017 | |
| | Contact Person: | Tara Conrad
Regulatory Affairs Specialist II
Office
(901) 867-4367
(901) 867-4190
Fax | |
| 2. | Proprietary Name:
Common Name:
Classification Name and Reference: | HV Screw System
Cannulated Bone Screw
21 CFR 888.3040- Class II- Smooth or threaded | |
| | Device Product Code, Device Panel: | metallic bone fixation fastener
HWC - Orthopedic | |
| 3. | Predicate Device: | K082320- Wright TM Compression Screw | |
| 4. | Device Description | | |

The HV Screws are cannulated screws offered in 3.0mm diameter, various lengths, and have self-tapping features on both distal and proximal threads. All screws are manufactured from titanium alloy.

ഹ Intended Use and Indications for Use

The HV Screw is indicated for fixation of bone fractures or for bone reconstruction. Examples include:

  • · Mono or Bi-Cortical osteotomies in the foot or hand
  • · Distal or Proximal metatarsal or metacarpal osteotomies
  • Fusion of the first metatarsophalangeal joint and interphalangeal joint
  • · Fixation of osteotomies for Hallux Valgus treatment (such as Scarf, Chevron, etc.)
  • · Akin type osteotomy

4

  • Arthrodesis base first metatarsal cuneiform joint to reposition and stabilize
  • metatarsus varus primus
  • Talar/navicular arthrodesis

6. Technological Characteristics Comparison

The HV Screw System utilizes similar instrumentation, is made from identical materials, and has identical sterilization methods when compared to the legally marketed predicate device.

7. Substantial Equivalence- Non-Clinical Evidence

Validation and/orAcceptance Value/CriteriaResults
Verification Method
Torsional Testing
Insertion Torque
Removal Torque
Ultimate Torque
Ultimate Torque must
exceed insertion torque and
removal torque by a safety
factorAcceptable
Engineering Analysis
Axial Pullout Force
Bending Strength

Torsional Strength | Comparable to the predicate
device design | Acceptable | |
| Bacterial Endotoxins
Testing |