K Number
K182711
Device Name
Customized Craniofacial Implant (CCI), Customized Skull Implant (CSI)
Date Cleared
2019-05-21

(236 days)

Product Code
Regulation Number
882.5320
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Customized Craniofacial Implant (CCI) and Customized Skull Implant (CSI) is intended to fill a bony void or defect area in a patient's specific cranial and craniofacial skeleton (orbital rim, zygoma, & adjacent bone).
Device Description
Customized Craniofacial Implant (CCI) and Customized Skull Implant (CSI) is an individually sized and shaped implantable prosthetic plates intended to fill a bony void or defect area in a specific patient's cranial and craniofacial skeleton (orbital rim, zygoma, & adjacent bone), ranging from 2 mm to 10 mm thick (typically 4mm thick based on the patient CT Scan imaging data) x 25mm to 250 mm wide x 25 mm to 250 mm long. A Customized Skull Implant (CSI) is intended to fill a bony void or defect area in a specific patient's skull whereas a Customized Craniofacial Implants (CCI) is intended to fill a bony void or defect area in a specific patient's facial region of the skull, excluding the Maxilla (upper jaw area surrounding the teeth only) and Mandible, which are both considered load bearing areas of the facial region of the skull. The size, asymmetrical shape, thickness, contour, and edge profile are design elements of the non-load bearing patient-specific Base Implant that are used to support the base implant in the bony void or defect area while providing for a "Precise Fit". The single patient use base implant is (1) fabricated from a billet block of natural implant grade Polyether ether ketone (PEEK) Thermoplastic Polymer using the patient's CT Scan imaging data, (2) provided clean but non-sterile for steam sterilization prior to implantation at a hospital or surgical site with neurosurgery capabilities, and (3) attached to the native bone using commercially available cranioplasty hardware and fasteners. The additional features listed below are additional design elements that may be added to the Base Implant and Base Implant with Perfusion Holes, as requested by the Physician. The Base Implant, as defined above (as previously cleared on K103582 and K121755).
More Information

No
The description focuses on the fabrication process based on CT scan data and material properties, with no mention of AI or ML for design, analysis, or any other function.

Yes.
The device is intended to fill bony voids or defects, which is a therapeutic intervention to restore anatomical structure and function.

No

Explanation: The device is an implantable prosthetic intended to fill a bony void or defect, which is a therapeutic function, not a diagnostic one. It does not provide information about a patient's medical condition.

No

The device description clearly states that the device is an "individually sized and shaped implantable prosthetic plates" fabricated from PEEK, which is a physical material. The summary also details performance testing related to the physical properties and sterilization of this implant.

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

Here's why:

  • Intended Use: The intended use is to "fill a bony void or defect area in a patient's specific cranial and craniofacial skeleton." This is a surgical implant designed for structural repair.
  • Device Description: The description details a physical implantable prosthetic made of PEEK, designed to be surgically placed.
  • Lack of Diagnostic Function: IVD devices are used to examine specimens (like blood, urine, or tissue) from the human body to provide information for diagnosis, monitoring, or screening. This device does not perform any such diagnostic function. It is a therapeutic device.
  • Performance Studies: The performance studies focus on biocompatibility, mechanical strength, sterilization, and cleaning – all relevant to an implantable device, not an IVD.

Therefore, the Customized Craniofacial Implant (CCI) and Customized Skull Implant (CSI) are not In Vitro Diagnostic devices. They are surgical implants.

N/A

Intended Use / Indications for Use

The Customized Craniofacial Implant (CCI) and Customized Skull Implant (CSI) is intended to fill a bony void or defect area in a patient's specific cranial and craniofacial skeleton (orbital rim, zygoma, & adjacent bone).

Product codes

GWO

Device Description

Customized Craniofacial Implant (CCI) and Customized Skull Implant (CSI) is an individually sized and shaped implantable prosthetic plates intended to fill a bony void or defect area in a specific patient's cranial and craniofacial skeleton (orbital rim, zygoma, & adjacent bone), ranging from 2 mm to 10 mm thick (typically 4mm thick based on the patient CT Scan imaging data) x 25mm to 250 mm wide x 25 mm to 250 mm long. A Customized Skull Implant (CSI) is intended to fill a bony void or defect area in a specific patient's skull whereas a Customized Craniofacial Implants (CCI) is intended to fill a bony void or defect area in a specific patient's facial region of the skull, excluding the Maxilla (upper jaw area surrounding the teeth only) and Mandible, which are both considered load bearing areas of the facial region of the skull. The size, asymmetrical shape, thickness, contour, and edge profile are design elements of the non-load bearing patient-specific Base Implant that are used to support the base implant in the bony void or defect area while providing for a "Precise Fit". The single patient use base implant is (1) fabricated from a billet block of natural implant grade Polyether ether ketone (PEEK) Thermoplastic Polymer using the patient's CT Scan imaging data, (2) provided clean but non-sterile for steam sterilization prior to implantation at a hospital or surgical site with neurosurgery capabilities, and (3) attached to the native bone using commercially available cranioplasty hardware and fasteners. The additional features listed below are additional design elements that may be added to the Base Implant and Base Implant with Perfusion Holes, as requested by the Physician. The Base Implant, as defined above (as previously cleared on K103582 and K121755).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

CT Scan imaging data

Anatomical Site

Cranial and craniofacial skeleton (orbital rim, zygoma, & adjacent bone)

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Hospital or surgical site with neurosurgery capabilities (inferred from "steam sterilization prior to implantation at a hospital or surgical site with neurosurgery capabilities")

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

Bench Performance Testing:

  • Material Specifications and Certification of Analysis/Certification of Compliance for Invibio PEEK Optima LT-1® and Evonik Vestakeep i4® (ASTM F2026-16 Standard Specification for Polyether ether ketone (PEEK) Polymers for Surgical Implant Applications). PEEK Certification reviewed against approved specifications.
  • Cleaning Validation testing in accordance with ANSI/AAMI ST72:2011, USP , USP , EP 2.6.14, and JP 4.01.
  • Steam Sterilization Validation testing in accordance with ANSI/AAMI/ISO 17665-1:2006 and ANSI/AAMI/ISO 14937:2009.
  • Mechanical Testing Validation: A Mechanical Testing Validation Protocol was developed by KGI as there is no industry accepted standard for non-load bearing implantable prosthetic plates.
  • Ship Testing Validation testing in accordance with FedEx Packaging Testing Under 150Lb (Same as ITSA-2A-2011 Packaged-Products 150 lb (68 kg) or Less).
    MR Safety: The Kelyniam Global Inc. implants are electrically nonconductive or a nonmagnetic item and poses no known hazards in all MR environments. The KGI Customized Craniofacial (CCI) and Customized Skull (CSI) Implants are MR Safe.

Biocompatibility Testing:

  • Biocompatibility was leveraged from previously cleared devices. A risk assessment was conducted to evaluate the impact of design changes on the biocompatibility of subject device.
    Results: The results demonstrate that the subject device meets biological safety requirements per ISO 10993-1 for permanently implanted devices that have tissue/bone and cerebrospinal fluid contact.

Clinical Testing:

  • Clinical Testing was determined not applicable for Kelyniam Global Inc. Customized Craniofacial Implant (CCI) and Customized Skull Implant (CSI).

Key Results: All samples passed the acceptance criteria in biocompatibility, steam sterilization, cleaning, mechanical, and ship testing. The device is safe and effective and substantially equivalent to the predicate devices.

Key Metrics

Not Found

Predicate Device(s)

K121153 Stryker PEEK Customized Cranial Implant Kit, K053199 Synthes Patient Specific Cranial/Craniofacial Implant (PSCI), K103582 Kelyniam Global Inc. (KGI) Customized Skull Implant (CSI), K121755 Kelyniam Global Inc. (KGI) Customized Craniofacial Implant (CCI)

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 882.5320 Preformed alterable cranioplasty plate.

(a)
Identification. A preformed alterable cranioplasty plate is a device that is implanted into a patient to repair a skull defect. It is constructed of a material, e.g., tantalum, that can be altered or reshaped at the time of surgery without changing the chemical behavior of the material.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo is in blue and includes the letters "FDA" in a square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION".

May 21, 2019

Kelyniam Global Inc. Eric Boyea Quality Director 97 River Road. Suite A Canton, Connecticut 06019

Re: K182711

Trade/Device Name: Customized Craniofacial Implant (CCI), Customized Skull Implant (CSI) Regulation Number: 21 CFR 882.5320 Regulation Name: Preformed Alterable Cranioplasty Plate Regulatory Class: Class II Product Code: GWO Dated: April 15, 2019 Received: April 16, 2019

Dear Eric Boyea:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

1

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 of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.html; good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Matthew Krueger, M.S.E. Assistant Director THT5A1: Neurosurgical Devices DHT5A: Division of Neurosurgical, Neurointerventional and Neurodiagnostic Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K182711

Device Name Customized Craniofacial Implant (CCI) Customized Skull Implant (CSI)

Indications for Use (Describe)

The Customized Craniofacial Implant (CCI) and Customized Skull Implant (CSI) is intended to fill a bony void or defect area in a patient's specific cranial and craniofacial skeleton (orbital rim, zygoma, & adjacent bone).

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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3

KELYNIAM

K182711 510(k) Summary

| Date Prepared:

Purpose:20MAY2019
Purpose of the
Submission:The purpose for the Premarket Notification 510(k) is for authorization to add additional features to the
currently cleared (devices) base implant or base implant with Prefusion Holes. The additional features do not
alter the intended therapeutic use of the subject device, the technological characteristic nor do they affect the
safety and effectiveness of the subject devices relative to the predicates. The additional features are intended
to respond to requests by surgeons to facilitate the surgical application of the implant(s) and do not introduce
any new technological issues. The base implant, as well as the proposed new features is fabricated from a
billet block of natural implant grade Polyether ether ketone (PEEK) Thermoplastic Polymer. This is the same
material currently used by the listed predicate device organizations.
Submitter Information:
Submitter:Kelyniam Global Inc. (KGI), 97 River Road, Suite A, Canton, Connecticut 06019
Tel: (800) 280-8192
Fax: (501) 641-2000
Official
Correspondent:Eric Boyea, Director of Quality & Regulatory Affairs
Toll Free: (800) 280-8192 x 701
Tel: (860) 352-5736
Email: eboyea@kelyniam.com
Device Information
Trade Name:• Customized Craniofacial Implant (CCI) and Customized Skull Implant (CSI)
Common Name:
Classification
Information:• Customized Cranial Implant or Craniofacial/Skull Implant
• Panel: Neurology / Product Code: GWO / Classification: Class II in accordance with 21 CFR 882.5320,
Preformed Alterable Cranioplasty Plate
Predicate
Devices:• Primary Predicate - K121153 Stryker PEEK Customized Cranial Implant Kit
• Secondary Predicate - K053199 Synthes Patient Specific Cranial/Craniofacial Implant (PSCI)
• Tertiary Predicate - K103582 Kelyniam Global Inc. (KGI) Customized Skull Implant (CSI)
• Quaternary Predicate - K121755 Kelyniam Global Inc. (KGI) Customized Craniofacial Implant (CCI)
Device
Description (with
included features
previously
cleared):Customized Craniofacial Implant (CCI) and Customized Skull Implant (CSI) is an individually sized and shaped
implantable prosthetic plates intended to fill a bony void or defect area in a specific patient's cranial and
craniofacial skeleton (orbital rim, zygoma, & adjacent bone), ranging from 2 mm to 10 mm thick (typically
4mm thick based on the patient CT Scan imaging data) x 25mm to 250 mm wide x 25 mm to 250 mm long. A
Customized Skull Implant (CSI) is intended to fill a bony void or defect area in a specific patient's skull whereas
a Customized Craniofacial Implants (CCI) is intended to fill a bony void or defect area in a specific patient's
facial region of the skull, excluding the Maxilla (upper jaw area surrounding the teeth only) and Mandible,
which are both considered load bearing areas of the facial region of the skull. The size, asymmetrical shape,
thickness, contour, and edge profile are design elements of the non-load bearing patient-specific Base Implant
that are used to support the base implant in the bony void or defect area while providing for a "Precise Fit".
The single patient use base implant is (1) fabricated from a billet block of natural implant grade Polyether
ether ketone (PEEK) Thermoplastic Polymer using the patient's CT Scan imaging data, (2) provided clean but
non-sterile for steam sterilization prior to implantation at a hospital or surgical site with neurosurgery
capabilities, and (3) attached to the native bone using commercially available cranioplasty hardware and
fasteners. The additional features listed below are additional design elements that may be added to the Base
Implant and Base Implant with Perfusion Holes, as requested by the Physician.
The Base Implant, as defined above (as previously cleared on K103582 and K121755).
Device Information (Continued)
Additional
Features
(Subject of this
submission):Image: Integrated Fixation System (IFS) or IFS Tabs
Image: A Temporal Cutback
Image: A Multi-Part Implant
Indications for
Use:The Customized Craniofacial Implant (CCI) and Customized Skull Implant (CSI) is intended to fill a bony void or
defect area in a patient's specific cranial and craniofacial skeleton (orbital rim, zygoma, & adjacent bone).
Statement of
Substantial
Equivalence:The KGI subject devices are intended to fill a bony void or defect area in a patient's specific Cranial and
craniofacial skeleton and are substantially equivalent in indications for use, technology, and material to
K121153 Stryker PEEK Customized Cranial Implant Kit (Primary), K053199 Synthes Patient Specific
Cranial/Craniofacial Implant (PSCI) (Secondary), K103582 KGI Customized Skull Implant (CSI) (Tertiary), and
K121755 KGI Customized Craniofacial Implant (CCI) (Quaternary).
Comparison of
Technological
Characteristics
with the
Predicate
Device(s):The KGI subject devices are manufactured from implant grade Polyether ether ketone Thermoplastic Polymer
material, known hereafter as PEEK, sold non-sterile, and is intended to fill a bony void or defect area in a patient's
specific Cranial and craniofacial skeleton. The additional features, as listed above, are incorporated in the Base
Implant during the design phase and CNC Machined from a billet block of PEEK. The additional features are
intended to respond to requests by surgeons to facilitate the surgical application of the implant(s) and do not

Perfusion Holes are a design element that allow the passage of fluid to an organ or tissue (as previously cleared on K103582 and K121755).

4

KELYNIAM

K182711 510(k) Summary

introduce any new technological issues. See Device Comparison Chart below for details. 1

Subject Devices vs Predicate Devices Comparison Chart with included Additional Features

Subject DeviceSubject DevicePrimary PredicateSecondary PredicateTertiary PredicateQuaternary Predicate
ManufacturerKelyniam Global Inc. (KGI)StrykerSynthesKelyniam Global Inc. (KGI)
510(k) #K182711K121153K053199K103582K121755
DescriptionCustomized Craniofacial
Implant (CCI)Customized Skull
Implant (CCI)PEEK Customized Craniofacial
Implant KitPatient Specific Cranial/
Craniofacial Implant (PSCI)Customized Skull
Implant (CSI)Customized Craniofacial
Implant (CCI)
Indications for UseIs intended to fill a bony void or defect
area in a patient's specific cranial and
craniofacial skeleton (orbital rim, zygoma,
& adjacent bone)Is intended to be used to
replace bony voids in the
cranial/craniofacial skeletonIs intended to replace
bony voids in the Cranial/
craniofacial skeletonIs intended to fill a bony void or defect
area in a patient's specific cranial and
craniofacial skeleton
MaterialInvibio Inc PEEK-Optima LT-1® and Evonik
Vestakeep i4®Invibio Inc PEEK-Optima LT-1®CP Titanium and PEEKInvibio Inc PEEK-Optima LT-1®
Technical
SpecificationPlate - Custom sized to each patient using
CT scan dataCustomized patient-specific
implant based on CT scan dataImplants are
preformed/pre-shaped to
fit the anatomy of the
patientCustom sized to each patient using CT scan
data
SterilizationProvided Non-sterileProvided Non-sterileProvided Non-sterileProvided Non-sterile
Product CodeGWO (882.5320, Preformed Alterable
Cranioplasty Plate)GWOGXNGXN (882.5330, Preformed Non-alterable
Cranioplasty Plate)
ClassificationClass IIClass IIClass IIClass II
Perfusion HolesXXX-XX
IFSXX----
Temporal CutbackXX----
Multi-Part ImplantXX-X--

5

KELYNIAM

K182711 510(k) Summary

Performance Data
Performance
Data
Biocompatibility
Testing:
Performance
data has been
provided in
support of the
substantial
equivalence
determination• Biocompatibility was leveraged from previously cleared devices. A risk assessment was conducted to evaluate
the impact of design changes on the biocompatibility of subject device. The results demonstrate that the
subject device meets biological safety requirements per ISO 10993-1 for permanently implanted devices that
have tissue/bone and cerebrospinal fluid contact.
Performance
Testing Bench:
Performance
data has been
provided in
support of the
verification &
validation testing
conducted for a
determination of
substantially
equivalence. The
subject devices
are safe,
effective, and
substantially
equivalent to the
predicate
devices.• Invibio PEEK Optima LT-1® and Evonik Vestakeep i4® Material Specifications and Certification of
Analysis/Certification of Compliance
o ASTM F2026-16 Standard Specification for Polyether ether ketone (PEEK) Polymers for Surgical Implant
Applications.
o PEEK Certification of Analysis/Certification of Compliance are reviewed and accepted against approved
specifications at each receipt as part of receiving inspection activities.
• Cleaning Validation testing was conducted in accordance with the following:
o ANSI/AAMI ST72:2011 Bacterial endotoxins, Test methods, routine monitoring, and alternatives to batch
testing.
o USP , USP , EP 2.6.14, and JP 4.01. USP Bacterial Endotoxin Test (BET).
• Steam Sterilization Validation testing was conducted in accordance with the following:
o ANSI/AAMI/ISO 17665-1:2006, Sterilization of health care products - Moist heat - Part 1 - Requirements for
the development, validation, routine control of a sterilization process for medical devices, Annex D.
o ANSI/AAMI/ISO 14937:2009, Sterilization of health care products, general requirements for
characterization of a sterilizing agent & development, validation, and routine control of a sterilization
process for medical devices, Annex D.
• Mechanical Testing Validation
o There is no industry accepted standard governing mechanical testing for non-load bearing implantable
prosthetic plates. A Mechanical Testing Validation Protocol was developed by KGI to validate the subject
devices.
• Ship Testing Validation testing was conducted in accordance with the following:
Summary on
Non-Clinical
Testing:o FedEx Packaging Testing Under 150Lb (Same as ITSA-2A-2011 Packaged-Products 150 lb (68 kg) or Less)
The safety and compatibility of passive implants in the Magnetic Resonance (MR) environment concern
magnetically induced displacement force and torque, radio frequency (RF) heating, and image artifacts. The
static magnetic field of the MR system induces displacement forces and torques on magnetic materials: The
Kelyniam Global Inc. (KGI) implants are electrically nonconductive or a nonmagnetic item and poses no known
hazards in all MR environments. The KGI Customized Craniofacial (CCI) and Customized Skull (CSI) Implants are
MR Safe.
Summary on
Clinical Testing:Clinical Testing was determined not applicable for Kelyniam Global Inc. Customized Craniofacial Implant (CCI)
and Customized Skull Implant (CSI).
Conclusion:The biocompatibility testing, steam sterilization testing, cleaning testing, mechanical testing, and ship testing of
the subject devices with and without the proposed features was performed and the results of these tests as
well as additional product related validations (all samples passed the acceptance criteria) support the device is
safe and effective and substantially equivalent to the predicate devices.