K Number
K983009
Device Name
BSM- BONE SUBSTITUTE MATERIAL
Manufacturer
Date Cleared
1998-11-25

(89 days)

Product Code
Regulation Number
882.5300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
a-BSM™ Bone Substitute Material is a synthetic calcium phosphate hydroxyapatitic material intended to be implanted for use in the filling, repair, reconstruction and augmentation of burr holes, contiguous craniotomy cuts, and other defects in craniofacial bones including fronto-orbital, malar and mental areas with a surface area no larger than 25cm².
Device Description
ETEX x-BSM™ Bone Substitute Material for Cranioplasty is a self-setting, synthetic calcium phosphate hydroxyapatitic powder that hardens in an aqueous environment at body temperature. The a-BSMM powder is mixed with saline at the time of use and the resulting paste is applied directly to the defect site. Prior to implantation, it remains moldable for several hours. After implantation, the material hardens in approximately one hour. The material is dimensionally stable during setting, and has been demonstrated to be highly biocompatible with mammalian tissues. After implantation, the material resorbs and is replaced by natural bone. As supplied, each transparent plastic pouch of a-BSMTM Bone Substitute Material contains a unit dose of sterile a-BSM™ Bone Substitute Material (dry white powder) contained within an elastomeric mixing bulb (available in 0.5, 1.0, 2.5, 5.0, 10 and 25 gram dose sizes); a sterile syringe, a 16 gauge needle, and a vial containing sterile saline; and Instructions for Use. The saline is injected aseptically into the mixing bulb and the material is mixed by kneading the bulb with the fingers. The material can be shaped into the desired form prior to application or shaped in situ in the defect. &-BSM™ Bone Substitute Material is synthesized from reagent grade inorganic raw materials composed of salts of calcium and phosphates. There are no substances of biological origin used in the synthesis or processing of the product. No additional preservatives or medicinal substances are present.
More Information

Not Found

No
The device description and performance studies focus on the material properties and biological interactions of a bone substitute material. There is no mention of any computational analysis, algorithms, or learning processes.

Yes
The device is described as a "Bone Substitute Material" intended for "filling, repair, reconstruction and augmentation of burr holes, contiguous craniotomy cuts, and other defects in craniofacial bones." Its function is to facilitate the natural bone tissue regeneration, which clearly indicates a therapeutic purpose.

No
The device is a bone substitute material used for filling, repairing, reconstructing, and augmenting craniofacial bones. It is a therapeutic device, not a diagnostic one.

No

The device is a physical bone substitute material, not software. The description details its chemical composition, physical properties, and how it is mixed and applied.

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

Here's why:

  • Intended Use: The intended use clearly states that the material is "intended to be implanted for use in the filling, repair, reconstruction and augmentation of burr holes, contiguous craniotomy cuts, and other defects in craniofacial bones". This describes a surgical implant used directly on the patient's body.
  • Device Description: The description details a "self-setting, synthetic calcium phosphate hydroxyapatitic powder that hardens in an aqueous environment at body temperature" and is "applied directly to the defect site". This further reinforces its use as an implantable material.
  • Lack of Diagnostic Function: There is no mention of this device being used to examine specimens derived from the human body (like blood, urine, tissue samples) to provide information for the diagnosis, prevention, monitoring, treatment, or alleviation of disease.

IVD devices are used in vitro (outside the body) to analyze samples for diagnostic purposes. This device is used in vivo (inside the body) as a structural material for bone repair.

N/A

Intended Use / Indications for Use

a-BSM™ Bone Substitute Material is a synthetic calcium phosphate hydroxyapatitic material intended to be implanted for use in the filling, repair, reconstruction and augmentation of burr holes, contiguous craniotomy cuts, and other defects in craniofacial bones including fronto-orbital, malar and mental areas with a surface area no larger than 25cm2.

It is intended for single use, permanent implantation. It is supplied in sterile kit form, and is not intended to be resterilized. Use of a-BSM™ Bone Substitute Material with other legally marketed devices for these indications has not yet been evaluated. a-BSMM Bone Substitute Material is not designed or sold for any use except as indicated.

Product codes

GXP

Device Description

ETEX x-BSM™ Bone Substitute Material for Cranioplasty is a self-setting, synthetic calcium phosphate hydroxyapatitic powder that hardens in an aqueous environment at body temperature. The a-BSMM powder is mixed with saline at the time of use and the resulting paste is applied directly to the defect site. Prior to implantation, it remains moldable for several hours. After implantation, the material hardens in approximately one hour. The material is dimensionally stable during setting, and has been demonstrated to be highly biocompatible with mammalian tissues. After implantation, the material resorbs and is replaced by natural bone.

As supplied, each transparent plastic pouch of a-BSMTM Bone Substitute Material contains a unit dose of sterile a-BSM™ Bone Substitute Material (dry white powder) contained within an elastomeric mixing bulb (available in 0.5, 1.0, 2.5, 5.0, 10 and 25 gram dose sizes); a sterile syringe, a 16 gauge needle, and a vial containing sterile saline; and Instructions for Use. The saline is injected aseptically into the mixing bulb and the material is mixed by kneading the bulb with the fingers. The material can be shaped into the desired form prior to application or shaped in situ in the defect. &-BSM™ Bone Substitute Material is synthesized from reagent grade inorganic raw materials composed of salts of calcium and phosphates. There are no substances of biological origin used in the synthesis or processing of the product. No additional preservatives or medicinal substances are present.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

burr holes, contiguous craniotomy cuts, and other defects in craniofacial bones including fronto-orbital, malar and mental areas

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)

3.1 Physico-Chemical Testing
Analyses were performed on the predicate device to determine its chemical and crystalline composition relative to the characterization of a-BSM™ Bone Substitute Material. These tests included Fourier Transformed Infrared Spectroscopy, X-ray Diffraction Analysis, Calcium: Phosphorus ratio, Solubility Determination and mechanical properties. Comparison of the results of these tests indicate very similar composition, nearly identical crystallinity, and similar solubility - both materials are very nearly insoluble.

Both materials consist of salts of calcium phosphate which, when mixed in an aqueous environment and allowed to harden at body temperature, cure into hydroxyapatite in nonexothermic reactions. Comparing infrared spectroscopy results of both products supports the premise that the type and level of chemical bonding is very similar between the two products. In X-ray Diffraction analysis of the two products, comparison demonstrates that both materials are composed of Hydroxyapatite in the crystalline phase and largely predominant portion of the samples, with both containing an amorphous component. Calcium : phosphorus ratios of the two products were determined and found to be similar. A comparison of solubility properties of the two products was made on hardened samples under simulated physiologic conditions. The results indicate that both materials are only slightly soluble. ETEX believes these results are strongly suggestive of chemically and physically equivalent products.

3.2 Biocompatibility
A variety of tests and evaluations were performed on a-BSM™ to ascertain possible effects of the introduction of this material into mammalian systems or tissues. The tests performed and brief results or conclusions are listed below.

  • Mutation Assay (Ames Test)
    No increase in mutation reversion frequencies were observed.
  • Micronucleus Test
    No clastogenic effects (chromosome breakage) were noted.
  • Hemolysis Assay
    No negative effects observed. In fact, a-BSM™ treated samples showed a decrease in hemolysis.
  • MEM Elution Test
    This test of cytotoxicity showed no negative effects.
  • USP Systemic Toxicity Test
    No negative systemic effects observed.
  • Delayed Contact Sensitization Test
    This test of skin sensitization showed no effects beyond that of control articles.
  • Pyrogen Test
    a-BSM™ was determined to be nonpyrogenic by the rabbit pyrogen test.
  • Intracutaneous Toxicity Test
    After injection of a-BSM™ extracts, there was no evidence of irritation or toxicity beyond that of control articles.
  • Muscle Implantation
    Two weeks after implantation of x-BSM™ into rabbit muscle sites, there was no macroscopic evidence of tissue irritation. Microscopic evaluation showed slight cellular effects when compared with control articles.
  • Bacterial Endotoxin (LAL) Evaluation
    This alternate method of testing for pyrogenic effects of an article showed no measurable endotoxins in a-BSM™, and demonstrated that the product did not artificially affect the test results by inhibition or activation of the reagents used.
  • Chronic Safety/Efficacy Study
    One year after implantation of x-BSM™ into surgically created bone defects in dog femurs, clinical and histopathologic evaluation of the repair sites demonstrated that new bone growth had occurred to an extent equal to that of autografts, and included remodeling of the bone tissue. There were no significant adverse findings.
  • Histology and Histomorphometry Evaluation
    A comparative in vivo study with a-BSM™ and autograft implanted into a canine femoral defect model demonstrated equivalent new bone replacement of the implant material at each timepoint for this one year study.
  • Biomechanical Strength Testing
    In a comparative study with a-BSM™ and autograft as bone substitute materials in a canine femoral defect model, the biomechanical strength (torsion loading to fracture) of the samples were equivalent at each timepoint for this one year study.

3.3 Conclusions of Testing
The physico-chemical testing and biocompatibility evaluation performed on a-BSM™ Bone Substitute Material for Cranioplasty demonstrate that it is similar to the predicate device in terms of its chemical and crystalline composition, and that it shows an excellent biocompatibility and safety profile, with no significant adverse observations on any of a variety of subcellular, cellular, tissue, and systemic challenges.

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

Not Found

Predicate Device(s)

K953339

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 882.5300 Methyl methacrylate for cranioplasty.

(a)
Identification. Methyl methacrylate for cranioplasty (skull repair) is a self-curing acrylic that a surgeon uses to repair a skull defect in a patient. At the time of surgery, the surgeon initiates polymerization of the material and forms it into a plate or other appropriate shape to repair the defect.(b)
Classification. Class II (performance standards).

0

NOV 25 1998

K983009

510(k) SUMMARY

a-BSMTM Bone Substitute Material for Cranioplasty

SUBMITTER INFORMATION 1.

  • 1.1 Name: ETEX Corporation
  • 1.2 ETEX Corporation Address: University Park at MIT 350 Massachusetts Avenue, 4th Floor Cambridge, Massachusetts 02139 U.S.A.
  • 1.3 Telephone: 617-577-7270 FAX: 617-577-7170
  • 1.4 Contact: Michael Schuttenberg Director, Quality Assurance / Regulatory Affairs 1.5 Summary
  • Monday, November 16, 1998 Preparation Date:

DEVICE INFORMATION 2.

  • a-BSMTM Bone Substitute Material for Cranioplasty 2.1 Proprietary Name:
  • Bone Graft Material, Bone Cement, Bone Substitute 2.2 Common Names: Material
  • 2.3 Classification Methyl Methacrylate for Cranioplasty, Code GXP Name and Code: Predicate Device: BoneSource™ Hydroxyapatite Cement 2.4 K953339, Osteogenics, Inc. 510(k) No.:

2.5 Description of Device

ETEX x-BSM™ Bone Substitute Material for Cranioplasty is a self-setting, synthetic calcium phosphate hydroxyapatitic powder that hardens in an aqueous environment at body temperature. The a-BSMM powder is mixed with saline at the time of use and the resulting paste is applied directly to the defect site. Prior to implantation, it remains moldable for several hours. After implantation, the material hardens in approximately one hour. The material is dimensionally stable during setting, and has been demonstrated to be highly biocompatible with mammalian tissues. After implantation, the material resorbs and is replaced by natural bone.

1

As supplied, each transparent plastic pouch of a-BSMTM Bone Substitute Material contains a unit dose of sterile a-BSM™ Bone Substitute Material (dry white powder) contained within an elastomeric mixing bulb (available in 0.5, 1.0, 2.5, 5.0, 10 and 25 gram dose sizes); a sterile syringe, a 16 gauge needle, and a vial containing sterile saline; and Instructions for Use. The saline is injected aseptically into the mixing bulb and the material is mixed by kneading the bulb with the fingers. The material can be shaped into the desired form prior to application or shaped in situ in the defect. &-BSM™ Bone Substitute Material is synthesized from reagent grade inorganic raw materials composed of salts of calcium and phosphates. There are no substances of biological origin used in the synthesis or processing of the product. No additional preservatives or medicinal substances are present.

2.6 Intended Use

a-BSM™ Bone Substitute Material is a synthetic calcium phosphate hydroxyapatitic material intended to be implanted for use in the filling, repair, reconstruction and augmentation of burr holes, contiguous craniotomy cuts, and other defects in craniofacial bones including fronto-orbital, malar and mental areas with a surface area no larger than 25cm3.

It is intended for single use, permanent implantation. It is supplied in sterile kit form, and is not intended to be resterilized. Use of a-BSM™ Bone Substitute Material with other legally marketed devices for these indications has not yet been evaluated. a-BSMM Bone Substitute Material is not designed or sold for any use except as indicated.

2.7 Substantial Equivalence to Predicate Device

a - BSM™ Bone Substitute Material is believed to be substantially equivalent to BoneSource™ in terms of design, materials, function, and intended use. Both materials are sterile, self-setting calcium phosphate powders that cure into hydroxyapatite after addition of an aqueous vehicle. This similarity in composition results in a similar degree of biocompatibility for both products. Both materials set in nonexothermic reactions. Both materials are intended for non-load-bearing bone defect filling indications in the craniofacial area. The information below briefly discusses those tests performed that support a determination of substantial equivalence.

2

NOV 19 1998 17:42 FR ETEX CORP

TESTING USED FOR SUBSTANTIAL EQUIVALENCE EVALUATION 3.

3.1 Physico-Chemical Testing

Analyses were performed on the predicate device to determine its chemical and crystalline composition relative to the characterization of a-BSM™ Bone Substitute Material. These tests included Fourier Transformed Infrared Spectroscopy, X-ray Diffraction Analysis, Calcium: Phosphorus ratio, Solubility Determination and mechanical properties. Companson of the results of these tests indicate very similar composition, nearly identical crystallinity, and similar solubility - both materials are very nearly insoluble.

Both materials consist of salts of calcium phosphate which, when mixed in an aqueous environment and allowed to harden at body temperature, cure into hydroxyapatite in nonexothermic reactions. Comparing infrared spectroscopy results of both products supports the premise that the type and level of chemical bonding is very similar between the two products. In X-ray Diffraction analysis of the two products, comparison demonstrates that both materials are composed of Hydroxyapatite in the crystalline phase and largely predominant portion of the samples, with both containing an amorphous component. Calcium : phosphorus ratios of the two products were determined and found to be similar. A comparison of solubility properties of the two products was made on hardened samples under simulated physiologic conditions. The results indicate that both materials are only slightly soluble. ETEX believes these results are strongly suggestive of chemically and physically equivalent products.

3.2 Biocompatibility

A variety of tests and evaluations were performed on a-BSM™ to ascertain possible effects of the introduction of this material into mammalian systems or tissues. The tests performed and brief results or conclusions are listed below.

Mutation Assay (Ames Test)

No increase in mutation reversion frequencies were observed.

Micronucleus Test

No clastogenic effects (chromosome breakage) were noted.

Hemolysis Assay

No negative effects observed. In fact, a-BSM™ treated samples showed a decrease in hemolysis.

510(k) Summary - Page 3 of 6 ETEX 510(k) for a-BSM™ Bone Substitute Material for Cranioplasty

3

MEM Elution Test

This test of cytotoxicity showed no negative effects.

USP Systemic Toxicity Test

No negative systemic effects observed.

Delayed Contact Sensitization Test

This test of skin sensitization showed no effects beyond that of control articles.

Pyrogen Test

a-BSM™ was determined to be nonpyrogenic by the rabbit pyrogen test.

Intracutaneous Toxicity Test

After injection of a-BSM™ extracts, there was no evidence of irritation or toxicity beyond that of control articles.

Muscle Implantation

Two weeks after implantation of x-BSM™ into rabbit muscle sites, there was no macroscopic evidence of tissue irritation. Microscopic evaluation showed slight cellular effects when compared with control articles.

Bacterial Endotoxin (LAL) Evaluation

This alternate method of testing for pyrogenic effects of an article showed no measurable endotoxins in a-BSM™, and demonstrated that the product did not artificially affect the test results by inhibition or activation of the reagents used.

Chronic Safety/Efficacy Study

One year after implantation of x-BSM™ into surgically created bone defects in dog femurs, clinical and histopathologic evaluation of the repair sites demonstrated that new bone growth had occurred to an extent equal to that of autografts, and included remodeling of the bone tissue. There were no significant adverse findings.

4

Histology and Histomorphometry Evaluation

A comparative in vivo study with a-BSM™ and autograft implanted into a canine femoral defect model demonstrated equivalent new bone replacement of the implant material at each timepoint for this one year study.

Biomechanical Strength Testing

In a comparative study with a-BSM™ and autograft as bone substitute materials in a canine femoral defect model, the biomechanical strength (torsion loading to fracture) of the samples were equivalent at each timepoint for this one year study.

Conclusions of Testing 3.3

The physico-chemical testing and biocompatibility evaluation performed on a-BSM™ Bone Substitute Material for Cranioplasty demonstrate that it is similar to the predicate device in terms of its chemical and crystalline composition, and that it shows an excellent biocompatibility and safety profile, with no significant adverse observations on any of a variety of subcellular, cellular, tissue, and systemic challenges.

For the above reasons, which are summarized in the following table comparing equivalence factors, ETEX believes that a-BSM™ Bone Substitute Material is substantially equivalent to BoneSource™ and possesses no properties which raise additional questions of safety relating to the intended use of the product.

.
.

5

COMPARISON TABLE OF SUBSTANTIAL EQUIVALENCE

ITEMα-BSM™BoneSource™
DesignSelf-setting calcium
phosphate cement which
hardens in aqueous
environment at 37 °CSelf-setting calcium
phosphate cement which
hardens in aqueous
environment at 37 °C
Composition, after
hardeningHydroxyapatite, with
amorphous componentHydroxyapatite, with
amorphous component
Intended UseUse in the filling, repair,
reconstruction and
augmentation of burr holes,
contiguous craniotomy cuts,
and other defects in
craniofacial bones including
fronto-orbital, malar and
mental areas with a surface
area no larger than 25cm2.Use in the repair of
neurosurgical burr holes,
contiguous craniotomy cuts
and other cranial defects
with a surface area no larger
than 25 cm2 per defect.
BoneSource is also indicated
for augmentation or
restoration of bony contour
in the craniofacial skeleton
including the fronto-orbital,
malar and mental areas.
How SuppliedSterile, nonpyrogenic
powder contained in
elastomeric mixing bulb to
be mixed at time of
implantation.Sterile, nonpyrogenic
powder contained in vial to
be mixed at time of
implantation.
Preparation MethodSterile saline injected into
mixing bulb, powder mixed
by kneading bulb, paste
removed and implanted.Powder placed into mixing
vessel, sterile solution
added, powder mixed with
spatula, paste implanted
Pot Life after mixingDoes not harden at room
temperature, if moist5 - 30 minutes dependent
upon diluent
Hardening Time in bodyOne hourUp to four hours
Solubility Product$6 x 10^{-54}$$6 x 10^{-67}$

α-BSMTM and BoneSource™

ETEX 510(k) for a-BSM™ Bone Substitute Material for Cranioplasty

6

Image /page/6/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which is a staff with two snakes coiled around it. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES-USA" are arranged in a circular pattern around the caduceus symbol. The logo is black and white.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV 2 5 1998

Mr. Michael Schuttenberg Director, Quality Assurance and Regulatory Affairs ETEX Corporation 350 Massachusetts Avenue, 4th Floor Cambridge, Massachusetts 02139

K983009 · Re: Trade Name: α-BSM™ Bone Substitute Material for Cranioplasty Requlatory Class: II Product Code: GXP Dated: August 26, 1998 Received: Auqust 28, 1998

Dear Mr. Schuttenberg:

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 of the Act. 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.

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. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical General regulation (21 CFR Part 820) and that, Devices: through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP requlation 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.

7

Page 2 - Mr. Michael Schuttenberg

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 regulation (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

Director Division of General and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

8

PREMARKET NOTIFICATION

DEVICE NAME AND INTENDED USE STATEMENT

Device Name: a-BSMTM Bone Substitute Material for Cranioplasty

Indications/ Intended Uses:

a-BSM™ Bone Substitute Material is a synthetic calcium phosphate hydroxyapatitic material intended to be implanted for use in the filling, repair, reconstruction and augmentation of burr holes, contiguous craniotomy cuts, and other defects in craniofacial bones including fronto-orbital, malar and mental areas with a surface area no larger than 25cm².

PLEASE DO NOT WRITE BELOW THIS LINE--CONTINUE ON ANOTHER PAGE IF NECESSARY

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use

or

Over-the -Counter Use

scally

(Division Sign-Off)
Division of General Restorative Devices
510(k) Number K983009