JAX-TCP

K033552 · Smith & Nephew, Inc. · MQV · Jun 10, 2004 · Orthopedic

Device Facts

• Record ID: K033552
• Device Name: JAX-TCP
• Applicant: Smith & Nephew, Inc.
• Product Code: MQV · Orthopedic
• Decision Date: Jun 10, 2004
• Decision: SESE
• Submission Type: Abbreviated
• Regulation: 21 CFR 888.3045
• Device Class: Class 2

Intended Use

The Jax-tcp granules may be used alone or can be mixed with the gel to create a cohesive mass that can be applied to the defect site. The gel is contradicted for use without the use of the granules. When used together, the granules and gel should be combined in a 1:1 ratio. JAX-tcp is indicated only for bony voids or gaps that are not intrinsic to the stability of the bony structure. JAX-tcp is indicated to be gently packed into bony voids or gaps of the skeletal system, (i.e., the extremities, spine, and pelvis). These defects may be surgically created osseous defects or osseous defects created from traumatic injury to the bone. JAX-tcp provides a filler that is resorbed and is replaced with bone during the healing process.

Device Story

JAX-tcp is a single-use, sterile bone void filler; consists of surgical grade beta-tricalcium phosphate granules and a hydrogel handling medium. Clinician mixes granules and gel in 1:1 ratio to create cohesive mass or uses granules alone. Applied by packing into non-structural bony voids or gaps in extremities, spine, or pelvis. Device resorbs over time, replaced by natural bone during healing. Used in surgical settings by orthopedic surgeons.

Clinical Evidence

No clinical data. Substantial equivalence supported by bench testing and materials data comparing JAX-tcp to predicate calcium salt-based bone void fillers.

Technological Characteristics

Materials: surgical grade beta-tricalcium phosphate granules and hydrogel. Form: granules (1cc to 30cc). Principle: resorbable bone void filler. Sterilization: sterile supply.

Indications for Use

Indicated for bony voids or gaps in the skeletal system (extremities, spine, pelvis) not intrinsic to structural stability. Suitable for surgically created osseous defects or traumatic bone injuries. Contraindicated to use gel without granules.

Regulatory Classification

Identification

A resorbable calcium salt bone void filler device is a resorbable implant intended to fill bony voids or gaps of the extremities, spine, and pelvis that are caused by trauma or surgery and are not intrinsic to the stability of the bony structure.

Special Controls

*Classification.* Class II (special controls). The special control for this device is the FDA guidance document entitled “Class II Special Controls Guidance: Resorbable Calcium Salt Bone Void Filler Device; Guidance for Industry and FDA.” See § 888.1(e) of this chapter for the availability of this guidance.

Submission Summary (Full Text)

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JUN 1 0 2004

K033552

# 510(K) SUMMARY OF SAFETY AND EFFECTIVENESS Jax-tcp

Contact Person and Address Kim Kelly Project Manager, Clinical and Regulatory Affairs Smith & Nephew, Inc., Orthopaedic Division 1450 East Brooks Road Memphis, TN 38116 [phone]

#### Device Description

JAX-tcp is a single-use bone void filler consisting of two components: surgical grade ßtricalcium phosphate granules and a hydrogel, used as a handling medium. The product is supplied sterile in quantities ranging from 1cc to 30cc.

Device Classification Name & Product Code Resorbable calcium salt bone void filler device (§888.3045): Orthopedics/87/MQV

#### Indications for Use

The Jax-tcp granules may be used alone or can be mixed with the gel to create a cohesive mass that can be applied to the defect site. The gel is contradicted for use without the use of the granules. When used together, the granules and gel should be combined in a 1:1 ratio.

JAX-tcp is indicated only for bony voids or gaps that are not intrinsic to the stability of the bony structure. JAX-tcp is indicated to be gently packed into bony voids or gaps of the skeletal system, (i.e., the extremities, spine, and pelvis). These defects may be surgically created osseous defects or osseous defects created from traumatic injury to the bone. JAX-tcp provides a filler that is resorbed and is replaced with bone during the healing process.

#### Performance Data

A review of the test data indicated that JAX-tcp is equivalent to other predicate calcium salt based bone void fillers currently used clinically.

#### Substantial Equivalence Information

The intended use; base material of the granules; use of a hydrogel; and select performance properties of the Jax-tcp product are substantially equivalent to commercially available predicate bone void filler products. The product is adequately supported by the substantial equivalence information, materials data, and testing results provided within the Premarket Notification.

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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 circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized symbol that resembles an abstract human figure or a bird in flight, composed of three curved lines.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

## JUN 1 0 2004

Ms. Kim P. Kelly MS. Rt. Manager. Regulatory & Clinical Affairs Smith & Nephew, Inc. Orthopaedic 1450 Brooks Road Memphis, TN 38116

K033552 Re:

> Trade Name: Jax-tcp Regulation Number: 21 CFR 888.3045 Regulation Name: Resorbable calcium salt bone void filler Regulatory Class: II Product Code: MQV Dated: April 30, 2004 Reccived: May 3, 2004

Dear Ms. Kelly:

We have reviewed your Section 510(k) premarket notification of intent to market the device We have reviewed your Section 910(t) premaince is substantially equivalent (for the referenced above and have determined the do needicate devices marketed in
indications for use stated in the enclosure) to legally marketed in the Medical Device indications for use stated in the chelosars, to regionent date of the Medical Device interstate commence prior to May 20, 1970, and salessions with the provisions of Amendments, of to devices that have been rocastly of require approval of a prematken the Federal Food, Drug, and Cosmene Act (10) and the device, subject to the general approval application (1147). 1 our 110). 1 our 1105 provisions of the Act include controls provisions of the Act. The gentire, of devices, good manufacturing practice, requirements for anilian reading misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III If your device is crassified (see aoore) inst controls. Existing major regulations affecting (PMA), if may be subject to such additional controllar controllations, Title 21, Parts 800 to 898. In the Coderal your device can be found in the Code of Peacharting your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not Please be advised that FDA Sissuance of a substantal vice complies with other requirements mean that FDA nas made a decemination is administered by other Federal agencies.
of the Act or any Federal statutes and regulations administed to sessible of the Act of any rederal statutes and reginatents, including, but not limited to: registration You must comply with an the Ace STQ (21 CFR Part 801); good manufacturing practices and listing (21 CFR Part 607), labeling (21 CFR Part 820), and if

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Page 2 – Ms. Kim P. Kelly

applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

This letter will allow you to begin marketing your device as described in your Section
ing the subserver and a The ED to finding of whitestial equivalence of your de This letter will allow you to begin manketing your as who aquivalence of your device and thus 510(k) prematket notification: "The 1 DA mitting or bassification 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), If you desire specific advice for your device on our lacksing of got processe note the regulation please contact the Office of Comphance ar (50) - 101 - 107 Part 807.97). You
entitled, "Misbranding by reference to premarket notification the Ast from the entitled, "Misoranding by reference to promation on your responsibilities under the Act its tall f may obtain of Small Manufacturers, International and Consumer Assistance at its toll-free Division of Simall Manator [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Mark A. Milkerso

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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## INDICATIONS FOR USE STATEMENT

510(k) Number (if known): K033552

Device Name:Jax-tcp

### Indications for Use:

The Jax-tcp granules may be used alone or can be mixed with the gel to create a cohesive mass
of the Jax-tcp granules may be mand in and stadisted for use without the use of The Jax-tcp granules may be used alone the can be nineanian of a contraction of the use of the that can be applied to the delect one. The granules and gel should be combined in a 1:1 ratio.
In a 1:1 ratio.

granates and only for bony voids or gaps that are not intrinsic to the stability of the stablity of the JAX-tcp is indicated only for bony volus or gaps that bony voids or gaps of the bony structure. JAX-TCP is indicated to be gently portugio in these defects may be surgically skeletal system, li.e., the extremities, spiric, and point in matic injury to the bone.
created osseous defects or osseous defects created from traumatic injury the bealing created osseous delects of osseous and is replaced with bone during the healing process.

Mark A. Millhurn

Division of General, Restorative, and Neurological Devices

**510(k) Number** K033552

### Concurrence of CDRH, Office of Device Evaluation

Prescription Use __ X_____________________________________________________________________________________________________________________________________________________________________________ (Per 21 CFR 801.109)

OR

Over-The Counter Use _________________________________________________________________________________________________________________________________________________________