K Number
K183581
Device Name
Codman Disposable Perforators
Date Cleared
2019-01-20

(30 days)

Product Code
Regulation Number
882.4305
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Codman Disposable Perforator is for use in perforating the cranium. When properly used, it is designed to automatically disengage once perforation is accomplished and when pressure is removed from the drill point.
Device Description
The Codman Disposable Perforators are pre-assembled, single-use, sterile devices that are designed to perforate the cranium. When properly used, the Disposable Perforators are designed to automatically disengage once perforation is accomplished and when pressure is removed from the drill point. They are designed with a Hudson end and are available in three color-coded sizes: - 14mm (blue ABS sleeve) – product number: 26-1221 - 11mm (green ABS sleeve) product number: 26-1222 ● - 9mm (yellow ABS sleeve) product number: 26-1223 ●
More Information

Not Found

No
The description focuses on mechanical disengagement based on pressure and does not mention any AI/ML components or algorithms.

No.
The device is described as a tool for perforating the cranium, not for treating a disease or condition. Its function is purely surgical and mechanical.

No
The device's intended use is to "perforate the cranium," which is a surgical action, not a diagnostic one. It is an instrument for performing a procedure, not for identifying the presence or nature of a disease or condition.

No

The device description clearly indicates it is a physical, single-use, sterile device designed to perforate the cranium, made of materials like ABS, and available in different sizes. It is a hardware device, not software.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health.
  • Device Function: The Codman Disposable Perforator is a surgical tool designed to physically create a hole in the cranium (skull). It is used directly on the patient's body during a procedure.
  • Lack of Diagnostic Testing: The device does not perform any tests on biological samples to diagnose, monitor, or screen for a medical condition. Its function is purely mechanical and procedural.

The description clearly indicates it's a surgical instrument for perforating the cranium, which falls under the category of surgical devices, not IVDs.

N/A

Intended Use / Indications for Use

The Codman Disposable Perforator is for use in perforating the cranium. When properly used, it is designed to automatically disengage once perforation is accomplished and when pressure is removed from the drill point.

Product codes (comma separated list FDA assigned to the subject device)

HBF

Device Description

The Codman Disposable Perforators are pre-assembled, single-use, sterile devices that are designed to perforate the cranium. When properly used, the Disposable Perforators are designed to automatically disengage once perforation is accomplished and when pressure is removed from the drill point. They are designed with a Hudson end and are available in three color-coded sizes:

  • 14mm (blue ABS sleeve) – product number: 26-1221
  • 11mm (green ABS sleeve) product number: 26-1222 ●
  • 9mm (yellow ABS sleeve) product number: 26-1223 ●

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

cranium

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

Study type: Sterilization Validation
Key results: A full dose mapping study has been performed to ensure there are no new issues relating to the safety or effectiveness of the products. Results from the dose mapping study have demonstrated that the alternate sterilization cycle is suitable and does not raise new issues of safety and effectiveness for the finished devices.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K791101, K071931

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 882.4305 Powered compound cranial drills, burrs, trephines, and their accessories.

(a)
Identification. Powered compound cranial drills, burrs, trephines, and their accessories are bone cutting and drilling instruments used on a patient's skull. The instruments employ a clutch mechanism to disengage the tip of the instrument after penetrating the skull to prevent plunging of the tip into the brain.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image contains the logos of the Department of Health & Human Services and the U.S. Food & Drug Administration (FDA). The Department of Health & Human Services logo is on the left, and the FDA logo is on the right. The FDA logo is a blue square with the letters "FDA" in white, followed by the words "U.S. Food & Drug Administration" in blue.

January 20, 2019

Integra LifeSciences Corp. Jocelyn Raposo Associate Director, Regulatory Affairs 11 Cabot Blvd Mansfield, Massachusetts 02048

Re: K183581

Trade/Device Name: Codman Disposable Perforators Regulation Number: 21 CFR 882.4305 Regulation Name: Powered Compound Cranial Drills, Burrs, Trephines, And Their Accessories Regulatory Class: Class II Product Code: HBF Dated: December 20, 2018 Received: December 21, 2018

Dear Jocelyn Raposo:

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 statutes and regulations administered by other Federal agencies. You must comply with all the Act's

1

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.htm); good manufacturing practice requirements as set forth in the quality systems (OS) 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 C. Krueger -S

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

Enclosure

2

| DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration | Form Approved: OMB No. 0910-0120
Expiration Date: 06/30/2020
See PRA Statement below. |
|-------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|
| Indications for Use | |
| 510(k) Number (if known) | |
| K183581 | |
| Device Name | |

Codman Disposable Perforator

Indications for Use (Describe)

The Codman Disposable Perforator is for use in perforating the cranium. When properly used, it is designed to automatically disengage once perforation is accomplished and when pressure is removed from the drill point.

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) CONTINUE ON A SEPARATE PAGE IF NEEDED. This section applies only to requirements of the Paperwork Reduction Act of 1995. DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW. The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to: Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov "An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

FORM FDA 3881 (7/17)

Page 1 of 1

PSC Publishing Sevices (301) 443-6740 EF

3

Section 5 - 510(k) Summary

| I. Submitter | Integra LifeSciences Corp.
11 Cabot Blvd.
Mansfield, MA 02048 | |
|--------------|---------------------------------------------------------------------|----------------------------------|
| | Establishment Registration Number: 1226348 | |
| | Primary Contact:
Phone: | Jocelyn Raposo
(781) 971-5688 |
| | Secondary Contact:
Phone: | Jennifer Siu
(781) 971-5692 |

Date of Preparation: December 19, 2018

II. Device(s)

Device Proprietary NameCodman Disposable Perforators
Common NamePerforators
Classification NameDrills, Burrs, Trephines & Accessories
(Compound, Powered) (21 CFR 882.4305)
Regulatory ClassificationII
Product CodeHBF

III. Predicate

The predicate devices for this submission are:

Device(s)

The predicate devices for this submission are:

510(k) NumberDate ClearedTitle
K791101Aug. 28, 1979Codman Disposable Perforator
(14mm)
K071931Oct. 22, 2007Codman Disposable Perforators
(11mm & 9mm)

IV. Device Description(s) The Codman Disposable Perforators are pre-assembled, single-use, sterile devices that are designed to perforate the cranium. When properly used, the Disposable Perforators are designed to automatically disengage once perforation is accomplished and when pressure is removed from the drill point. They are designed with a Hudson end and are available in three color-coded sizes:

  • 14mm (blue ABS sleeve) – product number: 26-1221
  • 11mm (green ABS sleeve) product number: 26-1222 ●
  • 9mm (yellow ABS sleeve) product number: 26-1223 ●

4

V. Indications for Use

The Indications for Use statement of the proposed device remains identical to the predicate devices'.

| Equivalence
Comparison | Codman Disposable
Perforators (Predicates) | Codman Disposable
Perforators (Subject of This
Submission) |
|---------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Indications for Use | The Codman Disposable
Perforator is for use in
perforating the cranium.
When properly used, it is
designed to automatically
disengage once perforation is
accomplished and when
pressure is removed from the
drill point. | The Codman Disposable
Perforator is for use in
perforating the cranium.
When properly used, it is
designed to automatically
disengage once perforation is
accomplished and when
pressure is removed from the
drill point. |

VI. Comparison to Predicate Device

The proposed Codman Disposable Perforators are identical to the currently marketed Codman Disposable Perforators (K791101 & K071931) except for the alternate gamma irradiation sterilization cycle proposed in this 510(k). The indications for use, design, principle of operation, performance, packaging, and shelf life remain identical to the predicate devices.

Substantial Equivalence Comparison
CharacteristicCodman Disposable
Perforators (Predicates)Codman Disposable
Perforators (Subject of
This Submission)
ManufacturerCodman & Shurtleff, Inc.Identical
Classification PanelNeurologyIdentical
Classification NameDrills, Burrs, Trephines &
Accessories (Compound,
Powered) (21 CFR
882.4305)Identical
Indications for UseThe Codman Disposable
Perforator is for use in
perforating the cranium.
When properly used, it is
designed to automatically
disengage once
perforation is
accomplished and when
pressure is removed from
the drill point.Identical
Operating PrincipleWith adequate pressure
applied on the perforator
point, engagement should
occur as the Hudson End
is rotated in a driver. Once
pressure is removed from
the drill point the device is
designed to disengage.Identical
ImplantNoIdentical
Single Use OnlyYesIdentical

5

VII.

Data

Performance

Special 510(k) Premarket Notification
Codman Disposable Perforators
Substantial Equivalence Comparison
CharacteristicCodman Disposable
Perforators (Predicates)Codman Disposable
Perforators (Subject of
This Submission)
Design9 mm Perforator
consisting of outer and
inner body drill, drill
driver, compression
spring, drive pin, molded
sleeve, snap bearing,
flanged nyliner
11mm Perforator
consisting of outer and
inner body drill, drill
driver, compression
spring, drive pin, molded
sleeve, snap bearing,
flanged nyliner
14mm Perforator
consisting of outer and
inner body drill, drill
driver, compression
spring, drive pin, molded
sleeve, snap bearing,
flanged nylinerIdentical
Shelf Life5 yearsIdentical
Sterilization MethodGammaIdentical
Sterility Assurance Level
(SAL)10-6Identical
PackagingPETG Blister Tray with
heat-sealed lid placed into
a unit boxIdentical

There were no changes made that affect the Codman Disposable Perforators' indications for use, principle of operation, performance, packaging, or shelf life. The only difference between the predicate and proposed devices is the use of an alternate gamma irradiation sterilization cycle to sterilize the products. There is no change to the sterilization dose parameters (25kGy-50kGy). The products continue to meet a SAL of 10-6 with the new cycle. A full dose mapping study has been performed to ensure there are no new issues relating to the safety or effectiveness of the products.

Please see the Summary of Testing table below for acceptance criteria and testing results.

Table Summary of Testing
TestTest Method /
PurposeAcceptance CriteriaResult
Full Dose Mapping
ValidationEstablish a new
gamma radiation
sterilization cycle in
compliance with
ISO 11137-1Dose Uniformity Ratio: