K Number
K223024
Device Name
MedCAD AccuPlan System
Manufacturer
Date Cleared
2023-03-07

(159 days)

Product Code
Regulation Number
872.4120
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The MedCAD® AccuPlan® System is intended for use as a software system and image segmentation system for the transfer of imaging information from a medical scanner such as a CT based system. The input data file is processed by the MedCAD® AccuPlan® System and the result is an output data file that may then be provided as digital models or used as input to a rapid prototyping portion of the system that produces physical outputs including anatomical models, surgical guides, and dental splints for use in maxillofacial surgery. The surgical guides and dental splints are intended to be used for the maxillofacial bone in maxillofacial surgery. The MedCAD® AccuPlan® System is also intended as a pre-operative software tool for simulating / evaluating surgical treatment options.
Device Description
The MedCAD® AccuPlan® System is a collection of software and associated additive manufacturing equipment intended to provide a variety of outputs to support orthognathic or reconstructive surgery. The system uses electronic medical images of the patient's anatomy or stone castings made from the patient anatomy with input from the physician, to manipulate original patient images for planning and executing surgery. The patient specific outputs from the system includes anatomical models, dental splints, surgical guides, and patient-specific case reports. Following the MedCAD® Quality System and specific Work Instructions, trained employees utilize Commercial Off-The-Shelf (COTS) software to manipulate 3-D medical scan images which can include Computed Tomography (CT), Cone Beam CT (CBCT), and/or 3-D scan images from patient physical models (stone models of the patient's teeth) to create patient-specific physical and digital outputs. The process requires clinical input and review from the physician during planning and prior to delivery of the final outputs. While the process and dataflow vary somewhat based on the requirements of a given patient and physician, the following description outlines the functions of key sub-components of the system, and how they interact to produce the defined system outputs. It should be noted that the system is operated only by trained MedCAD employees, and the physician does not directly input information. The physician provides input for model manipulation and interactive feedback through viewing of digital models of system outputs that are modified by the engineer during the planning session. The MedCAD® AccuPlan® System is made up of 4 individual pieces of software for the design and various manufacturing equipment integrated to provide a range of anatomical models (physical and digital), dental splints, surgical guides, and patient-specific planning reports for reconstructive surgery in the maxillofacial region. The MedCAD® AccuPlan® System requires an input 3-D image file from medical imaging systems (i.e. - CT) and/or implant file. This input is then used, with support from the prescribing physician to provide the following potential outputs to support reconstructive surgery. Each system output is designed with physician input and reviewed by the physician prior to finalization. All outputs are used only with direct physician involvement to reduce the criticality of the outputs. System outputs include: - Anatomical Models - Surgical Guides - Dental Splints - Patient-Specific Case Reports The purpose of this submission was to add titanium cutting / drilling guides to the family of available patient specific outputs. Cutting and drilling instruments can only be used with titanium cutting / drilling guides. Polymer guides are to be used for marking and positioning of anatomy only.
More Information

No
The summary describes software for image processing and manipulation by trained employees with physician input, and additive manufacturing. There is no mention of AI or ML.

No.
The system is used for pre-operative planning and producing anatomical models, surgical guides, and dental splints, which are tools to support surgery, not direct therapeutic interventions themselves.

No

Explanation: The device is described as a software system and associated additive manufacturing equipment used for transferring imaging information, segmenting images, and planning/simulating surgical treatments (pre-operative). It produces outputs like anatomical models, surgical guides, and dental splints. While it processes medical images, its primary intent is not to diagnose conditions but to assist in surgical planning and produce physical aids for surgery. It is explicitly stated as a "pre-operative software tool for simulating / evaluating surgical treatment options".

No

The device description explicitly states that the system is a "collection of software and associated additive manufacturing equipment" and produces "physical outputs including anatomical models, surgical guides, and dental splints." This indicates the system includes hardware components beyond just software.

Based on the provided text, the MedCAD® AccuPlan® System is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • MedCAD® AccuPlan® System's Function: The system processes medical imaging data (CT, CBCT, 3D scans) and physical models to create outputs like anatomical models, surgical guides, and dental splints. These outputs are used in vivo (within the body) during surgery or for pre-operative planning and simulation.
  • Lack of Specimen Analysis: The system does not analyze biological specimens from the patient. Its input is imaging data and physical models, not bodily fluids or tissues.

Therefore, the MedCAD® AccuPlan® System falls under the category of a medical device used for surgical planning and the creation of patient-specific surgical aids, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The MedCAD® AccuPlan® System is intended for use as a software system and image segmentation system for the transfer of imaging information from a medical scanner such as a CT based system. The input data file is processed by the MedCAD® AccuPlan® System and the result is an output data file that may then be provided as digital models or used as input to a rapid prototyping portion of the system that produces physical outputs including anatomical models, surgical guides, and dental splints for use in maxillofacial surgery. The surgical guides and dental splints are intended to be used for the maxillofacial bone in maxillofacial surgery. The MedCAD® AccuPlan® System is also intended as a pre-operative software tool for simulating / evaluating surgical treatment options.

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

DZJ, LLZ

Device Description

The MedCAD® AccuPlan® System is a collection of software and associated additive manufacturing equipment intended to provide a variety of outputs to support orthognathic or reconstructive surgery. The system uses electronic medical images of the patient's anatomy or stone castings made from the patient anatomy with input from the physician, to manipulate original patient images for planning and executing surgery. The patient specific outputs from the system includes anatomical models, dental splints, surgical guides, and patient-specific case reports.

Following the MedCAD® Quality System and specific Work Instructions, trained employees utilize Commercial Off-The-Shelf (COTS) software to manipulate 3-D medical scan images which can include Computed Tomography (CT), Cone Beam CT (CBCT), and/or 3-D scan images from patient physical models (stone models of the patient's teeth) to create patient-specific physical and digital outputs. The process requires clinical input and review from the physician during planning and prior to delivery of the final outputs. While the process and dataflow vary somewhat based on the requirements of a given patient and physician, the following description outlines the functions of key sub-components of the system, and how they interact to produce the defined system outputs. It should be noted that the system is operated only by trained MedCAD employees, and the physician does not directly input information. The physician provides input for model manipulation and interactive feedback through viewing of digital models of system outputs that are modified by the engineer during the planning session.

The MedCAD® AccuPlan® System is made up of 4 individual pieces of software for the design and various manufacturing equipment integrated to provide a range of anatomical models (physical and digital), dental splints, surgical guides, and patient-specific planning reports for reconstructive surgery in the maxillofacial region.

The MedCAD® AccuPlan® System requires an input 3-D image file from medical imaging systems (i.e. - CT) and/or implant file. This input is then used, with support from the prescribing physician to provide the following potential outputs to support reconstructive surgery. Each system output is designed with physician input and reviewed by the physician prior to finalization. All outputs are used only with direct physician involvement to reduce the criticality of the outputs.

System outputs include:

  • Anatomical Models
  • Surgical Guides
  • Dental Splints
  • Patient-Specific Case Reports

The purpose of this submission was to add titanium cutting / drilling guides to the family of available patient specific outputs. Cutting and drilling instruments can only be used with titanium cutting / drilling guides. Polymer guides are to be used for marking and positioning of anatomy only.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

medical scanner such as a CT based system, Computed Tomography (CT), Cone Beam CT (CBCT), and/or 3-D scan images from patient physical models (stone models of the patient's teeth)

Anatomical Site

maxillofacial bone

Indicated Patient Age Range

Not Found

Intended User / Care Setting

trained employees utilized Commercial Off-The-Shelf (COTS) software / trained MedCAD employees, and the physician does not directly input information. The physician provides input for model manipulation and interactive feedback through viewing of digital models of system outputs that are modified by the engineer during the planning session. / trained personnel with active support from the surgeon.

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)

Performance Testing:

  • Test: Wear Debris Testing
    • Test Method Summary: Cutting / drilling instruments were used on a worst-case titanium surgical guide. The quantity of wear debris generation was characterized.
    • Results: PASS. The wear debris generated by the subject device is less than that reported in the literature to be safe.
  • Test: Fit and Form Validation
    • Test Method Summary: Subject devices from historical cases were manufactured. The manufactured devices were optically scanned to verify alignment with the 3D model. Evaluation of fit was also validated by fitting the guide over the corresponding defect in a representative anatomical model.
    • Results: PASS. All samples met the predetermined acceptance criteria.

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.

K192282

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.

K181241, K220357

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.4120 Bone cutting instrument and accessories.

(a)
Identification. A bone cutting instrument and accessories is a metal device intended for use in reconstructive oral surgery to drill or cut into the upper or lower jaw and may be used to prepare bone to insert a wire, pin, or screw. The device includes the manual bone drill and wire driver, powered bone drill, rotary bone cutting handpiece, and AC-powered bone saw.(b)
Classification. Class II.

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March 7, 2023

MedCAD % Linda Braddon CEO Secure BioMed Evaluations 7828 Hickory Flat Highway Suite 120 Woodstock, Georgia 30188

Re: K223024

Trade/Device Name: MedCAD® AccuPlan® System Regulation Number: 21 CFR 872.4120 Regulation Name: Bone cutting instrument and accessories Regulatory Class: Class II Product Code: DZJ, LLZ Dated: February 6, 2023 Received: February 7, 2023

Dear Linda Braddon:

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,

Bobak Shirmohammadi -S

For Michael E. Adjodha, M.ChE. Assistant Director DHT1B: Division of Dental and ENT Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental 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) K223024

Device Name MedCAD® AccuPlan® System

Indications for Use (Describe)

The MedCAD® AccuPlan® System is intended for use as a software system and image segmentation system for the transfer of imaging information from a medical scanner such as a CT based system. The input data file is processed by the MedCAD® AccuPlan® System and the result is an output data file that may then be provided as digital models or used as input to a rapid prototyping portion of the system that produces physical outputs including anatomical models, surgical guides, and dental splints for use in maxillofacial surgery. The surgical guides and dental splints are intended to be used for the maxillofacial bone in maxillofacial surgery. The MedCAD® AccuPlan® System is also intended as a pre-operative software tool for simulating / evaluating surgical treatment options.

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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Image /page/3/Picture/0 description: The image shows the logo for MedCAD. The logo is composed of the word "Med" in a serif font, followed by "CAD" in a sans-serif font. The "CAD" portion of the logo is in a teal color and is slightly offset from the "Med" portion.

K223024 510(k) Summary MedCAD® AccuPlan® System

March 7, 2023

Sponsor

MedCAD 501 S 2nd Ave, Suite A-1000 Dallas, TX 75226 (214) 453-8864 x305

Contacts

Secure BioMed Evaluations Linda Braddon, Ph.D. Justin Gracyalny, MSE 7828 Hickory Flat Highway Suite 120 Woodstock, GA 30188 770-837-2681 Regulatory(@SecureBME.com

Name of Device and Classification Name

Device Name: MedCAD® AccuPlan® System Regulation Name: Bone Cutting Instruments and Accessories Regulation Number: 872.4120 Product Code: Primary - DZJ; Secondary - LLZ Classification Panel: Dental

Predicate Device(s)

MedCAD® AccuPlan® System (K192282)

Reference Device(s)

KLS Martin Individual Patient Solutions (IPS) Planning System (K181241) MedCAD® AccuShape® Titanium Patient-Specific Cranial Plate (K220357)

Indication for Use:

The MedCAD® AccuPlan® System is intended for use as a software system and image segmentation system for the transfer of imaging information from a medical scanner such as a CT based system. The input data file is processed by the MedCAD® AccuPlan® System and the result is an output data file that may then be provided as digital models or used as input to a rapid prototyping portion of the system that produces physical outputs including anatomical models, surgical guides, and dental splints for use in maxillofacial surgery. The surgical guides and dental splints are intended to be used for the maxillofacial bone in maxillofacial surgery. The MedCAD® AccuPlan® System is also intended as a pre-operative software tool for simulating /evaluating surgical treatment options.

4

Image /page/4/Picture/0 description: The image shows the logo for MedCAD. The word "Med" is in a serif font and is black. The word "CAD" is in a sans-serif font, is white, and is on a blue-green background. There is a registered trademark symbol in the upper right corner of the blue-green background.

Device Description

The MedCAD® AccuPlan® System is a collection of software and associated additive manufacturing equipment intended to provide a variety of outputs to support orthognathic or reconstructive surgery. The system uses electronic medical images of the patient's anatomy or stone castings made from the patient anatomy with input from the physician, to manipulate original patient images for planning and executing surgery. The patient specific outputs from the system includes anatomical models, dental splints, surgical guides, and patient-specific case reports.

Following the MedCAD® Quality System and specific Work Instructions, trained employees utilize Commercial Off-The-Shelf (COTS) software to manipulate 3-D medical scan images which can include Computed Tomography (CT), Cone Beam CT (CBCT), and/or 3-D scan images from patient physical models (stone models of the patient's teeth) to create patient-specific physical and digital outputs. The process requires clinical input and review from the physician during planning and prior to delivery of the final outputs. While the process and dataflow vary somewhat based on the requirements of a given patient and physician, the following description outlines the functions of key sub-components of the system, and how they interact to produce the defined system outputs. It should be noted that the system is operated only by trained MedCAD employees, and the physician does not directly input information. The physician provides input for model manipulation and interactive feedback through viewing of digital models of system outputs that are modified by the engineer during the planning session.

The MedCAD® AccuPlan® System is made up of 4 individual pieces of software for the design and various manufacturing equipment integrated to provide a range of anatomical models (physical and digital), dental splints, surgical guides, and patient-specific planning reports for reconstructive surgery in the maxillofacial region.

The MedCAD® AccuPlan® System requires an input 3-D image file from medical imaging systems (i.e. - CT) and/or implant file. This input is then used, with support from the prescribing physician to provide the following potential outputs to support reconstructive surgery. Each system output is designed with physician input and reviewed by the physician prior to finalization. All outputs are used only with direct physician involvement to reduce the criticality of the outputs.

System outputs include:

  • Anatomical Models ●
  • Surgical Guides
  • Dental Splints ●
  • Patient-Specific Case Reports .

The purpose of this submission was to add titanium cutting / drilling guides to the family of available patient specific outputs. Cutting and drilling instruments can only be used with titanium cutting / drilling guides. Polymer guides are to be used for marking and positioning of anatomy only.

Sterilization Validation

Sterlization validation was conducted in accordance with international standard ISO 17665 and FDA guidance document "Reprocessing Medical Devices in Health Care Settings: Validation Methods and Labeling." to a sterility Assurance Level (SAL) of 1x10". All test method acceptance criteria were met.

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Image /page/5/Picture/0 description: The image shows the logo for MedCAD. The text "Med" is in a large, bold, black serif font. To the right of "Med" is "CAD" in a smaller, white sans-serif font, set against a teal, rectangular background. A registered trademark symbol is in the upper right corner of the teal rectangle.

Biocompatibility Validation

Biocompatibility validation was conducted in accordance with international standard ISO 10993-1 and FDA guidance document Use of International Standard ISO 10993-1, "Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process". The results of the testing adequately address biocompatibility for the output devices and their intended use.

Performance Testing

Performance testing for the MedCAD® AccuPlan® System is summarized in the table below:

TestTest Method SummaryResults
Wear Debris
TestingCutting / drilling instruments were used on a
worst-case titanium surgical guide. The quantity
of wear debris generation was characterized.PASS
The wear debris
generated by the subject
device is less than that
reported in the literature
to be safe.
Fit and Form
ValidationSubject devices from historical cases were
manufactured. The manufactured devices were
optically scanned to verify alignment with the
3D model. Evaluation of fit was also validated
by fitting the guide over the corresponding
defect in a representative anatomical model.PASS
All samples met the
predetermined
acceptance criteria.

Substantial Equivalence

MedCAD® AccuPlan® System is substantially equivalent to the identified predicate based on indications for use, principles of operation, technological characteristics, inputs, and outputs. Minor differences in the surgical planning and manufacturing processes are verified and validated in the performance data in accordance with the intended use.

The input is images from medical scanners, dental models, and/or implants files. Physical outputs include dental splints and surgical guides. Biocompatible materials are used in the subject devices.

All devices are intended to aid in maxillofacial surgeries. These systems are intended to be utilized by trained employees with the approval by the physician.

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Med CAD

COMPARISON OF TECHNOLOGICAL CHARACTERISITICS
MedCAD® AccuPlan® SystemMedCAD® AccuPlan® System
510(k) NumberK223024K192282
Indications for UseThe MedCAD® AccuPlan® System is
intended for use as a software system
and image segmentation system for the
transfer of imaging information from a
medical scanner such as a CT based
system. The input data file is processed
by the MedCAD® AccuPlan® System
and the result is an output data file that
may then be provided as digital models
or used as input to a rapid prototyping
portion of the system that produces
physical outputs including anatomical
models, surgical guides, and dental
splints for use in maxillofacial surgery.
The surgical guides and dental splints
are intended to be used for the
maxillofacial bone in maxillofacial
surgery. The MedCAD® AccuPlan®
System is also intended as a pre-
operative software tool for simulating /
evaluating surgical treatment options.The MedCAD® AccuPlan® System is
intended for use as a software system
and image segmentation system for the
transfer of imaging information from a
medical scanner such as a CT based
system. The input data file is processed
by the MedCAD® AccuPlan® System
and the result is an output data file that
may then be provided as digital models
or used as input to a rapid prototyping
portion of the system that produces
physical outputs including anatomical
models, surgical guides, and dental
splints for use in maxillofacial surgery.
The surgical guides and dental splints
are intended to be used for the
maxillofacial bone in maxillofacial
surgery. The MedCAD® AccuPlan®
System is also intended as a pre-
operative software tool for simulating /
evaluating surgical treatment options.
Preoperative softwareYesYes
Additive manufacturing
of splints, guides, and
modelsYesYes
Data inputsImages from medical scannersImages from medical scanners
Data outputsOutput for dental splints, surgical
guides, and anatomical modelsOutput for dental splints, surgical
guides, and anatomical models
Physical outputsDental splints, surgical guides,
anatomical models, and patient-specific
case reportsDental splints, surgical guides,
anatomical models, and patient-specific
case reports
MaterialsBiocompatible polymers and Ti-6Al-4V
ELI Titanium Alloy per ASTM F136Biocompatible polymers
SterilizationProvided non-sterile and is steam
sterilized by the end-userProvided non-sterile and is steam
sterilized by the end-user
Manufacturing MethodAdditive ManufacturingAdditive Manufacturing
Patient ContactSurgical Guides: Implant - Tissue /
Bone; Limited (