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APTUS® Cannulated Compression Screws and headed Cannulated Compression Screws are intended for the treatment of fractures, osteotomies and arthrodesis of bones with the appropriate screw size.

APTUS® K-Wire System is intended for use in fixation of bone fractures, for bone reconstruction, and as guide pins for insertion of other implants.

The subject device includes APTUS Cannulated Compression Screws in thread diameters 1.7 mm, 2.2 mm, 3.0 mm, 5.0 mm, and APTUS headed Cannulated Compression Screws in diameters 2.2 mm, 3.0 mm, 5.0 mm, and 7.0 mm. APTUS Cannulated Compression Screws are headless screws that incorporate threads with different pitch on the head and tip of the screws; this difference in pitch provides compression as the screw is inserted. APTUS headed Cannulated Compression Screws have conventional bone screw heads that apply compression between the threads and the head. Both types of screws provide compression of the bone segments upon insertion of the screw. Additionally, all subject device screws have a triangular SpeedTip® shape designed to improve cutting and insertion torque and an internal hexalobular instrument face.

The APTUS Cannulated Compression Screws and APTUS headed Cannulated Compression Screws come in partially threaded and fully threaded designs. The 1.7 mm diameter screws are provided in overall lengths ranging from 8 mm to 20 mm. The 2.2 mm diameter screw are provided in overall lengths ranging from 10 mm to 40 mm. The 3.0 mm diameter screws are provided in overall lengths ranging from 10 mm to 40 mm. The 4.0 mm diameter screws are provided in overall lengths ranging from 16 mm to 60 mm. The 5.0 mm diameter screws are provided in overall lengths ranging from 24 mm to 70 mm. The 7.0 mm diameter screws are provided in overall lengths ranging from 30 mm to 140 mm.

The subject device 1.7 mm, 2.2 mm, 4.0 mm, 5.0 mm, and 7.0 mm thread diameter APTUS Cannulated Compression Screws and APTUS headed Cannulated Compression screws are used with the corresponding subject device K-wires (0.6, 0.8, 1.1, 1.25, 1.6, and 2.2 mm, respectively). The subject device screws also are compatible with the Medartis K-wires cleared under K092038. Similarly, the subject device K-wires are compatible with the APTUS Cannulated Compression Screws cleared under K133460 and K110658.

This submission also includes the corresponding washers for APTUS headed Cannulated Compression Screws.

The subject device cannulated compression screws and washers are manufactured from titanium allov conforming to ASTM F136 Standard Specification for Wrought Titanium-61 anadium ELI (Extra Low Interstitial) Alloy for Surgical Implant Applications (UNS R56401). The subject device K-wires are manufactured from stainless steel conforming to ASTM F138 Standard Specification for Wrought 18Chromium-14Nickel-2.5Molybdenum Stainless Steel Bar and Wire for Surgical Implants (UNS S31673).

All subject devices are provided non-sterile to the end user. The subject devices are single-use only.

This document describes a 510(k) premarket notification for Medartis AG's APTUS Cannulated Compression Screws, APTUS headed Cannulated Compression Screws, and APTUS K-Wire System. This is a submission for medical devices that are typically evaluated based on substantial equivalence to predicate devices, rather than strict performance against predefined acceptance criteria for a new clinical indication. Therefore, the information you've requested regarding acceptance criteria and a study proving those criteria are met is not directly applicable in the context of this 510(k) submission as it would be for a novel diagnostic AI device.

Instead, the submission focuses on demonstrating that the new devices are "substantially equivalent" to already legally marketed predicate devices. This is typically done through comparisons of:

• Intended Use/Indications for Use: Ensuring the new device is used for the same purpose and in similar patient populations as the predicate.
• Technological Characteristics: Comparing materials, design, operating principles, and performance.
• Performance Data: This is usually non-clinical testing (e.g., mechanical, biocompatibility, sterilization) to show that any differences in technological characteristics do not raise new questions of safety or effectiveness. Clinical data are often not required for 510(k) submissions unless deemed necessary to address a specific safety or effectiveness concern.

Given this context, I will address your points based on the information provided in the document, interpreting "acceptance criteria" through the lens of "substantial equivalence" as demonstrated by the non-clinical performance data.

1. A table of acceptance criteria and the reported device performance

Since this is a 510(k) submission for substantial equivalence rather than a device with a novel performance claim requiring specific clinical acceptance criteria, the document does not present a table of acceptance criteria in the manner you might expect for a diagnostic AI device. Instead, "acceptance criteria" are implicitly met by demonstrating that the device performs equivalently to the predicates in specific engineering tests.

The document states that performance data relied upon "include: biocompatibility referenced from K133460, K110658, K092038, and K193633; moist heat sterilization (to be performed by the end user) also referenced from K133460, K110658, and K193633; X-ray beam sterilization, packaging, and sterile barrier shelf life referenced from K191848 and K 193633; and mechanical testing according to ASTM F543 Standard Specification and Test Methods for Metallic Medical Bone Screws."

This implies that the "acceptance criteria" are compliance with recognized standards and demonstrated equivalence to predicate devices.

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

The document primarily refers to non-clinical testing (biocompatibility, sterilization, mechanical testing). For such tests, the "sample size" is typically defined by the requirements of the specific ASTM standards or other test protocols. The document does not specify the exact number of devices tested for each non-clinical performance test (e.g., how many screws were subjected to ASTM F543).

• Data Provenance: The document does not specify the country of origin for the non-clinical test data. Given Medartis AG is based in Switzerland and their consultant PaxMed International, LLC is in the USA, it's likely the testing was conducted in ISO-accredited labs in one of these regions or globally. The data would be considered prospective in the sense that the tests were conducted specifically for this submission to demonstrate the device's characteristics against a standard or predicate.
• Clinical data: The document explicitly states: "Clinical data were not provided in this submission." Therefore, there is no "test set" of patient data for clinical evaluation.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

Not applicable. Since no clinical data was provided and the evaluation relies on non-clinical testing and substantial equivalence to predicates, there was no "ground truth" to be established by clinical experts in the context of this 510(k) submission.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

Not applicable, as there was no clinical test set requiring adjudication.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

Not applicable. This device is a bone fixation fastener and K-wire system, not an AI or diagnostic imaging device.

6. If a standalone (i.e. algorithm only without human-in-the loop performance) was done

Not applicable. This is not an algorithm or AI device.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

For the non-clinical performance data, the "ground truth" or reference is established by recognized industry standards (e.g., ASTM F543) and the established safety and effectiveness profile of the predicate devices. The mechanical properties are compared against benchmark values or the performance of the predicate. Biocompatibility relies on the known properties of the materials used in accordance with established standards.

8. The sample size for the training set

Not applicable. This is not an AI/machine learning device that requires a training set.

9. How the ground truth for the training set was established

Not applicable. This is not an AI/machine learning device.

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