K Number
K201153
Device Name
Tisuthes e-PTFE Surgical Patch
Date Cleared
2023-06-13

(1139 days)

Product Code
Regulation Number
878.3300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
TisuthesTM e-PTFE Surgical Patches are indicated for facial plastic and reconstructive surgery.
Device Description
Tisuthes™ e-PTFE Surgical Patches are intended for facial plastic and reconstruction surgery. The device is provided sterile. The device is available in the forms of sheets, blocks and preformed three-dimensional forms (chin, nasal, temporal piriform and malar) with multiple sizes.
More Information

Not Found

No
The device description and performance studies focus on the material properties and biological compatibility of e-PTFE surgical patches, with no mention of AI or ML.

Yes
The device is described as a surgical patch for facial plastic and reconstructive surgery, which implies it directly treats or corrects a medical condition, fitting the definition of a therapeutic device.

No

This device is described as surgical patches, sheets, blocks, and preformed three-dimensional forms intended for facial plastic and reconstructive surgery, indicating it is an implantable medical device for treatment, not diagnosis.

No

The device description clearly states it is a physical implant made of e-PTFE, available in various forms and sizes, and the performance studies listed are for physical and biological properties of the material and device. There is no mention of software components.

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

Here's why:

  • Intended Use: The intended use is for "facial plastic and reconstructive surgery." This describes a surgical procedure performed directly on a patient's body.
  • Device Description: The device is a physical implant ("sheets, blocks and preformed three-dimensional forms") made of e-PTFE, intended to be surgically placed.
  • Lack of IVD Characteristics: An IVD device is used to examine specimens (like blood, urine, tissue) taken from the human body to provide information about a physiological state, health, disease, or congenital abnormality. This device does not perform any such analysis of specimens.
  • Performance Studies: The performance studies listed are related to the physical and biological properties of the implant material and its sterilization, not to the analysis of biological specimens.

Therefore, based on the provided information, the TisuthesTM e-PTFE Surgical Patches are a surgical implant, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

TisuthesTM e-PTFE Surgical Patches are intended for facial plastic and reconstructive surgery.

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

OWR, FTL

Device Description

TisuthesTM e-PTFE Surgical Patches are intended for facial plastic and reconstruction surgery. The device is provided sterile.

The device is available in the forms of sheets, blocks and preformed three-dimensional forms (chin, nasal, temporal piriform and malar) with multiple sizes.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

facial

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)

Non-Clinical Tests Performed:

  • A F754-08 (Reapproved 2015) Standard Specification For Implantable Polytetrafluoroethylene (PTFE) Sheet, Tube, And Rod Shapes Fabricated From Granular Molding Powders
  • F881-94 (Reapproved 2014) Standard Specification For Silicone Elastomer Facial Implants
  • ISO 14630 Fourth Edition 2012-12-01 Non-Active Surgical Implants -- General Requirements
  • ISO 10993-1 Fifth Edition 2018-08 Biological Evaluation Of Medical Devices -Part 1: Evaluation And Testing Within A Risk Management Process
  • ISO 10993-3 Third Edition 2014-10-1 Biological Evaluation Of Medical Devices - Part 3: Tests For Genotoxicity, Carcinogenicity And Reproductive Toxicity
  • ISO 10993-4 Third Edition 2017-04 Biological Evaluation Of Medical Devices--Part 4: Selection Of Tests For Interactions With Blood
  • ISO10993-5 Third Edition 2009-06-01 Biological Evaluation Of Medical Devices - Part 5: Tests For In Vitro Cytotoxicity
  • ISO 10993-6 Third Edition 2016-12-01 Biological Evaluation Of Medical Devices -- Part 6: Tests For Local Effects After Implantation
  • ISO 10993-7:2008(R)2012 Biological Evaluation Of Medical Devices - Part 7: Ethylene Oxide Sterilization Residuals
  • ISO 10993-10 Third Edition 2010-08-01 Biological Evaluation Of Medical Devices - Part 10: Tests For Irritation And Skin Sensitization
  • ISO 10993-11 Third Edition 2017-09 Biological Evaluation Of Medical Devices -Part 11: Tests For Systemic Toxicity
  • ISO 11135:2014 Sterilization Of Health-Care Products - Ethylene Oxide -Requirements For The Development, Validation And Routine Control Of A Sterilization Process For Medical 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.

K021889, K091011

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

§ 878.3300 Surgical mesh.

(a)
Identification. Surgical mesh is a metallic or polymeric screen intended to be implanted to reinforce soft tissue or bone where weakness exists. Examples of surgical mesh are metallic and polymeric mesh for hernia repair, and acetabular and cement restrictor mesh used during orthopedic surgery.(b)
Classification. Class II.

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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" followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in a smaller font.

June 13, 2023

Shanghai Suokang Medical Implants Co., Ltd. Lixinhua Lixinhua Deputy General Manager Building 2, No. 613, Suide Rd., Putuo Region, Shanghai, 200311. P.R. China Shanghai, Shanghai 200000 China

Re: K201153

Trade/Device Name: Tisuthes e-PTFE Surgical Patch Regulation Number: 21 CFR 878.3300 Regulation Name: Surgical Mesh Regulatory Class: Class II Product Code: OWR, FTL Dated: Mav 22, 2021 Received: May 27, 2021

Dear Lixinhua Lixinhua:

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/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

David Krause -S

David Krause, Ph.D. Deputy Director OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K201153

Device Name TisuthesTM e-PTFE Surgical Patch

Indications for Use (Describe)

TisuthesTM e-PTFE Surgical Patches are indicated for facial plastic and reconstructive surgery.

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)

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)

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Section 5 - 510(k) Summary

Date of Summary Preparation: 2020.11.19

1. Submitter's Identifications

Submitter's Name: Shanghai Suokang Medical Implants Co., Ltd. Address: Building 2, No. 613, Suide Rd., Putuo District,Shanghai,China

Contact Person: Lixinhua Contact Email: surgithes@vip.sina.com

Phone number: +86 21 6608 2766 ext.812

Fax number: +86 66082138

2. Correspondent's Identifications

Correspondent's Name: Shanghai Suokang Medical Implants Co., Ltd. Address: Building 2, No. 613, Suide Rd., Putuo District, Shanghai,China Contact Person: Lixinhua Contact Email: surgithes@vip.sina.com Phone number: +86 21 6608 2766 ext.812 Fax number: +86 66082138

3. Name of the Device

Device Classification Name: Mesh, Surgical, Polymeric Product Code: FTL , OWR

Product Name: Tisuthes™ e-PTFE Surgical Patch Trade Name: Tisuthes™ e-PTFE Surgical Patch Common Name: Surgical mesh Classification Panel: General & Plastic Surgery Product Code: FTL , OWR Device Classification: Class II

4. The Predicate Devices

K021889

Trade/Device Name: Surgiform Augmentation Material

K091011

Trade/Device Name: PureForm ePTFE Facial Implants (Nasal, Chin, Malar)

5. Device Description

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5.1 Tisuthes™ e-PTFE Surgical Patches are intended for facial plastic and reconstruction surgery. The device is provided sterile.

The device is available in the forms of sheets, blocks and preformed three-dimensional forms (chin, nasal, temporal piriform and malar) with multiple sizes.

5.2. Symbol

TP: Expanded Polytetrafluoroethylene (e-PTFE) Surgical Patch (Brand Name:

Tisuthes)

5.3 Product numbers definition

5.3.1 Marking method

TP:

Image /page/4/Figure/9 description: The image shows a diagram with labels for different codes. The top line is labeled "Serial number" and is connected to "X...XX". The middle line is labeled "Category number" and is connected to "X". The bottom line is labeled "Product code" and is connected to "TP".

Category number: S: Soft Patch

R: Block

N: Nasal implants

C: Chin implants

M: Malar implants

F: Piriform implants

T: Temporal implants

5.4 Model and Specification

| Spc. | a
(mm) | b
(mm) | c
(mm) | d
(mm) | Tolerance | Diagram |
|-------|-----------|-----------|-----------|-----------|-----------|--------------------------------|
| TPS01 | 60 | 40 | 1 | / | ±10% | Image: Diagram of a soft patch |
| TPS02 | 60 | 40 | 2 | / | ±10% | |
| TPS03 | 60 | 40 | 3 | / | ±10% | |
| TPS04 | 60 | 40 | 4 | / | ±10% | |
| TPS05 | 80 | 60 | 1 | / | ±10% | |
| TPS06 | 80 | 60 | 2 | / | ±10% | |
| TPS07 | 80 | 60 | 3 | / | ±10% | |
| TPS08 | 80 | 60 | 4 | / | ±10% | |

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TPS09140601/±10%
TPS10140602/±10%
TPS11140603/±10%
TPS12140604/±10%
Block (TPR)
a
(mm)b
(mm)c
(mm)d
(mm)Tolerance
Spc.Diagram
TPR0170205/±10%
TPR0270208/±10%
TPR0360503/±10%
TPR0460405/±10%
TPR0570158/±10%
TPR0670156/±10%
TPR0770155/±10%
TPR08100505/±10%
TPR09100508/±10%
Nasal implants (TPN)
Spc.a
(mm)b
(mm)c
(mm)d
(mm)ToleranceDiagram
TPN1155165.520±10%
TPN126511520±10%
TPN135511520±10%
TPN1455116.520±10%
TPN155012510±10%
TPN1650126.510±10%
TPN176012510±10%
Chin implants (TPC)
Spc.a
(mm)b
(mm)c
(mm)d
(mm)ToleranceDiagram
TPC015540815±10%
TPC0255401215±10%
TPC0355401015±10%Image: Diagram of a lens with labels a, b, c, and d
TPC046025815±10%Image: Diagram of a lens with labels a, b, c, and d
TPC0560251015±10%Image: Diagram of a lens with labels a and d
TPC065540815±10%Image: Diagram of a lens with labels b and c
TPC076242815±10%
TPC0862421015±10%Image: Diagram of a lens with labels a and d
TPC096040815±10%Image: Diagram of a lens with labels a, b, c, and d
TPC1050185.515±10%Image: Diagram of a lens with labels a, b, c, and d
TPC114210515±10%Image: Diagram of a lens with labels a, c, and d
TPC125528815±10%
TPC1355281015±10%
TPC1455281215±10%Image: Diagram of TPC14
TPC156028815±10%Image: Diagram of TPC15
TPC1660281015±10%Image: Diagram of TPC16
TPC1760281215±10%Image: Diagram of TPC17
Malar implants(TPM)
Spc.a (mm)b (mm)c (mm)d (mm)ToleranceDiagram
TPM0160285/±10%Image: Diagram of TPM01
TPM0260285/±10%Image: Diagram of TPM02
Piriform Implants (TPF)
Spc.a (mm)b (mm)c (mm)d (mm)ToleranceDiagram
TPF0125225/±10%Image: Diagram of TPF01
TPF0325228/±10%Image: Diagram of TPF03
TPF0225225/±10%Image: Diagram of TPF02
TPF0425228/±10%Image: Diagram of TPF04

6

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6. Intended Use of Device

Tisuthes™ e-PTFE Surgical Patches are intended for facial plastic and reconstruction surgery.

8

7. Summary of Substantial Equivalence

ProductProposed devicePredicate devicePredicate device
TisuthesTM ePTFE Surgical Patch K201153Surgiform Augmentation Material K021889Surgiform's PureForm ePTFE Impants K091011
Indication for useTisuthesTM e-PTFE Surgical Patches are intended for facial plastic and reconstructive surgery.For Plastic and Reconstructive Surgery.PureForm ePTFE Facial Implants are indicated for use in facial plastic and reconstructive surgery.
ContraindicationsCardiovascular defects Tempormandibular joint (TMJ reconstructions) Cosmetic lip filler Dermal placementCardiovascular defects Tempormandibular joint (TMJ reconstructions) Cosmetic lip filler Dermal placementTempormandibular joint (TMJ reconstructions) Dermal placement
Materiale-PTFEe-PTFEe-PTFE
Design principleAugmentation or repair of the soft tissueAugmentation or repair of the soft tissueAugmentation or repair of the soft tissue
ShapesThe device is available in the forms of sheets, blocks, and preformed three-dimensional forms (chin, nasal, temporal piriform and malar) with multiple sizes.Flat sheets and Carvable blockPre-formed 3-D shapes (chin, nasal, malar and para-nasal) in multiple sizes.
Physical characteristicsDimension (mm)Sheets:
Length: 60, 80,140;
Width: 40, 60;
Thickness: 1, 2, 3, 4.

Blocks:
Length: 60, 70, 100;
Width: 15, 20, 40, 50; | Sheets:
Length: 80, 190;
Width: 30, 70, 170;
Thickness: 0.35, 1, 2, 3.

Blocks:
Length: 60, 70;
Width: 15, 30, 50, 100; |

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Thickness: 3, 5, 6, 8.Thickness: 5, 6, 8, 10.
Nasal implants[1]: (TPN11~TPN17)ASIAN STRAIGHT NASAL DORSUM
a: 50, 55, 60;Item
CodeDim A
(mm)Dim B
(mm)Dim C
(mm)Dim D
(mm)
b: 11, 12, 16;4AND0350.07.59.54.0
c: 5, 5.5,6.5;4AND0450.08.010.04.0
d: 10, 20.5AND0250.07.59.55.0
6AND0250.08.010.06.0
ASIAN CURVED NASAL DORSUM
Item
CodeDim A
(mm)Dim B
(mm)Dim C
(mm)Dim D
(mm)
4AND0150.09.57.54.0
4AND0250.010.08.04.0
5AND0150.09.57.55.0
6AND0150.010.08.06.0
Chin implants:CHIN IMPLANTS
a: 42, 55, 60, 62;Item
CodeDim A
(mm)Dim B
(mm)Dim C
(mm)Dim D
(mm)
b: 10, 18, 25, 28, 40, 42;1EC0152.938.17.713.5
c: 5, 5.5, 8, 10, 12;1EC0259.342.98.214.8
d: 12.1EC0366.047.49.516.9
Malar implants:MALAR IMPLANTS (RIGHT AND LEFT)
a: 60;Item
CodeDim A
(mm)Dim B
(mm)Dim C
(mm)
b: 28;1ML0135.018.03.5
c: 5.1ML0245.423.05.0
1ML0349.424.05.7
1ML0455.027.15.8
Piriform implantsASIAN PARA-NASAL
a: 25;Item
CodeDim A
(mm)Dim B
(mm)Dim C
(mm)
b: 22;4PN0120.018.04.0
c: 5, 8.5PN0120.018.05.0
6PN0121.019.06.0

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Pore Size (microns)>1520-4020-40
Provided sterileYesYesYes
Re-sterilizationNot recommendedMay be sterilized up to 3 timesMay be sterilized up to 3 times

8. Substantial Equivalence:

Substantial Equivalence discussion:

The proposed devices and the predicated device the same classification information, same specifications, same performance effectiveness. The Model of Proposed Device is included in the Model of Predicate for use of proposed device is included in the predicated devices are as safe, as effective and perform as well as the predicate device. Therefore the proposed devices are Substantially Equivalent (SE) to the predicate device which is US legally market device.

11

9. Non-Clinical Tests Performed:

  • A F754-08 (Reapproved 2015) Standard Specification For Implantable Polytetrafluoroethylene (PTFE) Sheet, Tube, And Rod Shapes Fabricated From Granular Molding Powders
  • F881-94 (Reapproved 2014) Standard Specification For Silicone Elastomer Facial Implants

  • ISO 14630 Fourth Edition 2012-12-01 Non-Active Surgical Implants -- General Requirements

  • ISO 10993-1 Fifth Edition 2018-08 Biological Evaluation Of Medical Devices -Part 1: Evaluation And Testing Within A Risk Management Process

  • ISO 10993-3 Third Edition 2014-10-1 Biological Evaluation Of Medical Devices - Part 3: Tests For Genotoxicity, Carcinogenicity And Reproductive Toxicity

  • ISO 10993-4 Third Edition 2017-04 Biological Evaluation Of Medical Devices--Part 4: Selection Of Tests For Interactions With Blood

  • ISO10993-5 Third Edition 2009-06-01 Biological Evaluation Of Medical Devices - Part 5: Tests For In Vitro Cytotoxicity

  • ISO 10993-6 Third Edition 2016-12-01 Biological Evaluation Of Medical Devices -- Part 6: Tests For Local Effects After Implantation

  • ISO 10993-7:2008(R)2012 Biological Evaluation Of Medical Devices - Part 7: Ethylene Oxide Sterilization Residuals

  • ISO 10993-10 Third Edition 2010-08-01 Biological Evaluation Of Medical Devices - Part 10: Tests For Irritation And Skin Sensitization

  • ISO 10993-11 Third Edition 2017-09 Biological Evaluation Of Medical Devices -Part 11: Tests For Systemic Toxicity

  • ISO 11135:2014 Sterilization Of Health-Care Products - Ethylene Oxide -Requirements For The Development, Validation And Routine Control Of A Sterilization Process For Medical Devices

10. Conclusion:

The proposed devices of Tisuthes™ e-PTFE Surgical Patch are determined to be Substantially Equivalent (SE) to the predicate devices.

--- End of this section ---