(71 days)
Indications for interlocking intramedullary nails include simple long bone fractures; severely comminuted, spiral, large oblique and segmental fractures; nonunions and malunions; polytrauma and multiple fractures, prophylactic nailing of impending pathologic fractures; reconstruction, following tumor resection and grafting; supracondylar fractures; bone lengthening and shortening. Interlocking intramedullary nails are indicated for fixation of fractures that occur in and between the proximal and distal third of the long bones being treated.
In addition to the indications for interlocking intramedullary nails, devices that contain holes/slots proximally to accept screws that thread into the femoral head for compression and rotational stability (i.e. Femoral/Recon Antegrade Nail) are indicated for the following: subtrochanteric fractures with lesser trochanteric involvement; ipsilateral femoral shaft/neck fractures; and intertrochanteric fractures.
In addition to the indications for interlocking intramedullary nails, devices that utilize a retrograde femoral surgical approach (i.e. Retrograde/Tibial and Supracondylar Nails) are indicated for the following: severely comminuted supracondylar fractures with or without difficult intra-articular extension; fractures that require opening the knee joint to stabilize the femoral condylar segment; fractures above total knee implants.
The Titanium Nail System is intended to be removed upon fracture healing.
The Titanium Nail System includes femoral and tibial nails and screws. All components are manufactured from titanium alloy.
This document describes the Titanium Nail System, a device for fixing long bone fractures. However, it does not contain information about acceptance criteria or a study proving device performance using the requested metrics.
Instead, the document details a 510(k) premarket notification to the FDA, asserting that the Titanium Nail System is substantially equivalent to existing, legally marketed devices. The FDA's letter (K981529) confirms this substantial equivalence.
Therefore, I cannot populate the table or answer the specific questions regarding acceptance criteria, reported performance, sample sizes, expert qualifications, adjudication methods, MRMC studies, standalone performance, or ground truth for a performance study, as this information is not present in the provided text.
The "study" cited for the device's safety and effectiveness is its "long history of use" of the predicate devices it is compared to, rather than a specific performance study of the Titanium Nail System itself.
Here's what can be inferred from the provided text regarding the closest equivalent to "acceptance criteria" and how "performance" is "proven":
1. Acceptance Criteria and Reported Device Performance
| Acceptance Criteria | Reported Device Performance |
|---|---|
| Criterion: Substantial Equivalence to Predicate Devices | Performance: The Titanium Nail System is found to be substantially equivalent to the following predicate devices: - TriMax Antegrade and Retrograde Nails (Smith & Nephew Orthopaedics) - Kuntscher Nail (Smith & Nephew Orthopaedics) - Aim Antegrade Femoral, Retrograde Femoral and Tibial Nails (Ace) - Unreamed Femoral (URFN) and Tibial Nails (Synthes) - Retrograde Femoral Nail (Biomet) - Ace ART Femoral Nail (DePuy Ace) |
| Criterion: Indications for Use Alignment with Predicate Devices | Performance: The Titanium Nail System's indications for use (fractures of long bones, specific femoral fractures, etc.) are consistent with those of the predicate devices. |
| Criterion: Material Composition (Titanium Alloy) | Performance: All components are manufactured from titanium alloy, consistent with materials used in similar predicate devices. |
| Criterion: Design Similarity to Predicate Devices | Performance: "All of the devices listed above are similar in design to the Titanium Nail System." |
2. Sample Size for the Test Set and Data Provenance:
* N/A. No performance study with a test set is described. The "proof" is based on the long history of use of predicate devices, not a test set for the Titanium Nail System itself.
3. Number of Experts and Qualifications for Ground Truth:
* N/A. No experts were used to establish ground truth for a performance test set, as no such test set or study is detailed. The "ground truth" for substantial equivalence is based on regulatory assessment by the FDA, considering existing market data for predicate devices.
4. Adjudication Method:
* N/A. No adjudication method is described as there is no performance study where ground truth was independently established and adjudicated.
5. Multi Reader Multi Case (MRMC) Comparative Effectiveness Study:
* No. No MRMC study was performed or described. This document is focused on regulatory clearance based on substantial equivalence, not comparative effectiveness.
6. Standalone Performance Study:
* No. No standalone performance study (i.e., algorithm only without human-in-the-loop performance) was performed or described. The device is a surgical implant, not an AI algorithm.
7. Type of Ground Truth:
* The "ground truth" for the device's safety and effectiveness is fundamentally based on the "long history of use" and established clinical outcomes of the predicate devices (other intramedullary nail systems). This is a form of historical outcomes data relating to the class of devices.
8. Sample Size for the Training Set:
* N/A. This device is a physical implant, not an AI/ML model that requires a training set in the typical sense.
9. How the Ground Truth for the Training Set was Established:
* N/A. Not applicable for a physical medical device.
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Summary of Safety and Effectiveness Titanium Nail System
Substantial Equivalence Information
The Titanium Nail System is similar to the following systems:
-
- TriMax Antegrade and Retrograde Nails (Smith & Nephew Orthopaedics)
-
- Kuntscher Nail (Smith & Nephew Orthopaedics)
- Aim Antegrade Femoral, Retrograde Femoral and Tibial Nails (Ace) 3.
-
- Unreamed Femoral (URFN) and Tibial Nails (Synthes)
-
- Retrograde Femoral Nail (Biomet)
-
- Ace ART Femoral Nail (DePuy Ace)
All of the devices listed above are similar in design to the Titanium Nail System. The safety and effectiveness of the Titanium Nail System is based on the long history of use of these devices in the market place.
Device Description
The Titanium Nail System includes femoral and tibial nails and screws. All components are manufactured from titanium alloy.
Indications for Use
Indications for interlocking intramedullary nails include simple long bone fractures; severely comminuted, spiral, large oblique and segmental fractures; nonunions and malunions; polytrauma and multiple fractures, prophylactic nailing of impending pathologic fractures; reconstruction, following tumor resection and grafting; supracondylar fractures; bone lengthening and shortening. Interlocking intramedullary nails are indicated for fixation of fractures that occur in and between the proximal and distal third of the long bones being treated.
In addition to the indications for intramedullary nails, devices that contain holes/slots proximally to accept screws that thread into the femoral head for compression and rotational stability (i.e. Femoral/Recon Antegrade Nail) are indicated for the following: subtrochanteric fractures with lesser trochanteric involvement; ipsilateral femoral shaft/neck fractures; and intertrochanteric fractures.
In addition to the indications for interlocking intramedullary nails, devices that utilize a retrograde femoral surgical approach (i.e. Retrograde/Tibial and Supracondylar Nails) are indicated for the following: severely comminuted supracondylar fractures with or without difficult intra-articular extension; fractures that require opening the knee joint to stabilize the femoral condylar segment; fractures above total knee implants.
The Titanium Nail System is intended to be removed upon fracture healing.
The Titanium Nail System is substantially equivalent to the predicate devices listed above.
JG10016A/14
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Image /page/1/Picture/2 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features the department's name encircling a stylized caduceus symbol. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged around the upper portion of the seal, with the caduceus positioned in the center.
JUL તે 1638
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
Ms. JoAnn Kuhne ·Manager, Regulatory Affairs Smith & Nephew Richards, Inc. 1450 Brooks Road Memphis, Tennessee 38116
Re: K981529 Titanium Intramedullary Nail, Titanium Trade Name: Locking Screw Regulatory Class: II Product Code: JDS Dated: April 28, 1998 Received: April 29, 1998
Dear Ms. Kuhne:
We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). You may, therefore, market the device, subject to the general controls provisions The general controls provisions of the Act of the Act. include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.
If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. ਸ substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory In addition, FDA may publish further announcements action. concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.
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Page 2 - Ms. JoAnn Kuhne
This letter will allow you to begin marketing your device as described in your 510 (k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.
If you desire specific advice for your device on our labeling requlation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4659. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".
Sincerely yours,
Celia M. Witten, Ph.D., M.D. Director Division of General and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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Indications Statement
Indications for interlocking intramedullary nails include simple long bone fractures; severely comminuted, spiral, large oblique and segmental fractures, nonunions and malunions, polytrauma and multiple fractures, prophylactic nailing of impending pathologic fractures, reconstruction, following tumor resection and grafting, supracondylar fractures, bone lengthening and shortening. Interlocking intramedullary nails are indicated for fixation of fractures that occur in and between the proximal and distal third of the long bones being treated.
In addition to the indications for interlocking intramedullary nails, devices that contain holes/slots proximally to accept screws that thread into the femoral head for compression and rotational stability (i.e. Femoral/Recon Antegrade Nail) are indicated for the following: subtrochanteric fractures with lesser trochanteric involvement; ipsilateral femoral shaft/neck fractures, and intertrochanteric fractures.
In addition to the indications for interlocking intramedullary nails, devices that utilize a retrograde femoral surgical approach (i.e. Retrograde/Tibial and Supracondylar Nails) are indicated for the following: severely comminuted supracondylar fractures with or without difficult intra-articular extension; fractures that require opening the knee joint to stabilize the femoral condylar segment; fractures above total knee implants.
Prescription Use
(Per 21 CFR 801.109)
Aisole
5: Olk) Numbe
§ 888.3030 Single/multiple component metallic bone fixation appliances and accessories.
(a)
Identification. Single/multiple component metallic bone fixation appliances and accessories are devices intended to be implanted consisting of one or more metallic components and their metallic fasteners. The devices contain a plate, a nail/plate combination, or a blade/plate combination that are made of alloys, such as cobalt-chromium-molybdenum, stainless steel, and titanium, that are intended to be held in position with fasteners, such as screws and nails, or bolts, nuts, and washers. These devices are used for fixation of fractures of the proximal or distal end of long bones, such as intracapsular, intertrochanteric, intercervical, supracondylar, or condylar fractures of the femur; for fusion of a joint; or for surgical procedures that involve cutting a bone. The devices may be implanted or attached through the skin so that a pulling force (traction) may be applied to the skeletal system.(b)
Classification. Class II.