BIOABSORBABLE INTERFERENCE SCREW MEGAFIX

K013107 · Karl Storz Endoscopy · HWC · Feb 26, 2002 · Orthopedic

Device Facts

• Record ID: K013107
• Device Name: BIOABSORBABLE INTERFERENCE SCREW MEGAFIX
• Applicant: Karl Storz Endoscopy
• Product Code: HWC · Orthopedic
• Decision Date: Feb 26, 2002
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 888.3040
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The KSEA Bioabsorbable Interference Screw MegaFix" is intended for use by qualified surgeons for tibial and femoral fixation (primary anchorage) of tendon grafts in human cruciate ligament reconstruction.

Device Story

The KSEA Bioabsorbable Interference Screw MegaFix is a biocompatible and biodegradable bone fixation fastener. It is used by surgeons during cruciate ligament reconstruction procedures to provide primary anchorage for tendon grafts in the tibia and femur. The device functions as a mechanical fastener to secure the graft in place while the ligament heals. It is intended for clinical use in an operating room setting.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Biocompatible and biodegradable material; threaded bone fixation fastener; Class II device (Product Code: HWC).

Indications for Use

Indicated for tibial and femoral fixation (primary anchorage) of tendon grafts in human cruciate ligament reconstruction by qualified surgeons.

Regulatory Classification

Identification

A smooth or threaded metallic bone fixation fastener is a device intended to be implanted that consists of a stiff wire segment or rod made of alloys, such as cobalt-chromium-molybdenum and stainless steel, and that may be smooth on the outside, fully or partially threaded, straight or U-shaped; and may be either blunt pointed, sharp pointed, or have a formed, slotted head on the end. It may be used for fixation of bone fractures, for bone reconstructions, as a guide pin for insertion of other implants, or it may be implanted through the skin so that a pulling force (traction) may be applied to the skeletal system.

Submission Summary (Full Text)

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Image /page/0/Picture/0 description: The image shows the logo for STORZ. The logo is in black and white and features the word "STORZ" in large, bold letters. Below the word "STORZ" is the text "Karl Storz Endoscopy" in a smaller font. The logo is simple and clean, and it is likely used to identify the company or its products.

## 510(k) SUMMARY OF SAFETY AND EFFEC

## FEB 2 6 2002

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of the Safe Medical Devices Act (SMDA) of 1990 and 21 CFR 807.92. All data included in this document is accurate and complete to the best of KSEA's knowledge.

| Applicant: | Karl Storz Endoscopy - America, Inc.<br>600 Corporate Pointe Drive<br>Culver City, CA 90230<br>[phone] |
|------------------------|---------------------------------------------------------------------------------------------------------------|
| Contact: | James A. Lee, Ph.D.<br>Regulatory Affairs Specialist |
| Device Identification: | Common Name:<br>Bioabsorbable Interference Screw |

Trade Name: (optional) KSEA Bioabsorbable Interference Screw MegaFix™

Indication: The KSEA Bioabsorbable Interference Screw MegaFix" is intended for use by qualified surgeons for tibial and femoral fixation (primary anchorage) of tendon grafts in human cruciate ligament reconstruction.

Device Description: The KSEA Bioabsorbable Interference Screw MegaFix" is biocompatible and biodegradable.

Substantial Equivalence: The KSEA Bioabsorbable Interference Screw MegaFix" is substantially equivalent to the predicate devices since the basic features and intended use are similar. The minor differences between the KSEA Bioabsorbable Interference Screw and the predicate devices raise no new issues of safety and effectiveness, as these minor differences have no effect on the performance, function or intended use of the device.

Signed:

James A. Lee, Ph.D. Regulatory Affairs Specialist

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Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three stripes forming its body and wing. The eagle faces right and is positioned within a circle. Encircling the eagle are the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

## FEB 2 6 2002

Karl Storz Endoscopy James A. Lee, Ph.D. Regulatory Affairs Specialist 600 Corporate Pointe, 5th Floor Culver City, California 90230-7600

Re: K013107

Trade Name: KSEA Bioabsorbable Interference Screw Megafix™ Regulation Number: 888.3040 Regulation Name: Smooth or threaded metallic bone fixation fastener Regulatory Class: II Product Code: HWC Dated: December 12, 2001 Received: December 13, 2001

Dear Dr. Lee:

We have reviewed your Section 510(k) premarket 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) 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. 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 (PMA), 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 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 requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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Page 2 - Dr. James Lee

This letter will allow you to begin marketing your device as described in your Section 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 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at [phone]. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, «Misbranding by reference to premarket notification» (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely vours.

Sincerely yours,

L. Mark A. Matheron

Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Image /page/3/Picture/0 description: The image shows the logo for Karl Storz Endoscopy. The logo is in black and white and features the word "STORZ" in large, bold letters. Below the word "STORZ" is the text "Karl Storz Endoscopy" in a smaller font. The logo is simple and modern.

510(k) Number (if known): Not yet assigned

Ko/3107

Device Name: KSEA Bioabsorbable Interference Screw MegaFix™

Indications for Use: The KSEA Bioabsorbable Interference Screw, MegaFix™ is intended for use by qualified surgeons for tibial and femoral fixation (primary anchorage) of tendon grafts in human cruciate ligament reconstruction.

## (PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

*(Division Sign-Off)*

Division of General, Restorative
and Neurological Devices

| 510(k) Number | K013107 |
|----------------------------------------|---------|
| Prescription Use: (Per 21 CFR 801.109) | Yes |
| OR Over-The-Counter Use: | No |

(Optional Format 1-2-96)qe. | of |

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