The Shotel Ankle Arthrodesis Nail System is intended for the following: - Charcot Foot - Avascular necrosis of the talus - Failed total ankle arthroplasty - Trauma (malunited tibial pilon fracture) - Severe deformity or instability as a result of talipes equinoivarus, cerebral vascular accident, paralysis or other neuromuscular disease - Revision ankle arthrodesis - Neuroarthropathy - Rheumatoid arthritis - Osteoarthritis - Pseudoarthrosis - Post-Traumatic arthrosis - Previously infected arthrosis - Severe end stage degenerative arthritis - Severe defects after tumor resection - Pantalar arthrodesis
Device Story
Implantable intramedullary fusion nail system; includes curved fusion nails, bone screws, and nail caps. Used for primary ankle fusion; surgeon-operated in clinical setting. Nail features 6 screw holes for fixation; 4 distal cross-locking holes allow static or dynamic orientation. Components manufactured from titanium Ti-6Al-4V; single-use. Surgeon selects nail diameter and screw length to achieve bone fixation; nail caps allow length adjustment. Provides mechanical stability to facilitate bone fusion; benefits patient by correcting deformity and stabilizing joint.
Clinical Evidence
Bench testing only. Performance testing included primary stiffness, fusion-site compression, primary bending stiffness, and mechanical/fatigue testing per ASTM F1264. Pyrogen testing confirmed implants meet the 20 EU/device limit.
Technological Characteristics
Intramedullary fixation rod system. Materials: Titanium Ti-6Al-4V. Principle: Mechanical bone fixation via intramedullary nail and cross-locking screws. Form factor: Curved nail with 6 screw holes, 5mm diameter screws, and adjustable nail caps. Sterilization: Offered sterile and non-sterile.
Indications for Use
Indicated for patients requiring ankle fusion due to Charcot foot, avascular necrosis of the talus, failed total ankle arthroplasty, trauma (malunited tibial pilon fracture), severe deformity/instability (talipes equinoivarus, CVA, paralysis, neuromuscular disease), revision ankle arthrodesis, neuroarthropathy, rheumatoid arthritis, osteoarthritis, pseudoarthrosis, post-traumatic arthrosis, previously infected arthrosis, severe end-stage degenerative arthritis, severe defects after tumor resection, or pantalar arthrodesis.
Regulatory Classification
Identification
An intramedullary fixation rod is a device intended to be implanted that consists of a rod made of alloys such as cobalt-chromium-molybdenum and stainless steel. It is inserted into the medullary (bone marrow) canal of long bones for the fixation of fractures.
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Image /page/0/Picture/1 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.
Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
September 13, 2017
Biopro, Inc. % Al Memmolo President Convergent Clinical, Inc. 6648 Surf Crest St. Carlsbad, California 92011
Re: K163627
Trade/Device Name: Shotel Ankle Arthrodesis Nail System Regulation Number: 21 CFR 888.3020 Regulation Name: Intramedullary Fixation Rod Regulatory Class: Class II Product Code: HSB Dated: August 10, 2017 Received: August 11, 2017
Dear Al Memmolo:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate 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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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); medical device reporting (reporting of medical devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in
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the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to
http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.
You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.
Sincerely,
# Vincent J. Devlin -S
for
Mark N. Melkerson Director Division of Orthopedic Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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Form Approved: OMB No. 0910-0120
Expiration Date: January 31, 2017 See PRA Statement below.
DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration
## Indications for Use
510(k) Number (if known) K163627
Device Name Shotel Ankle Arthrodesis Nail System
Indications for Use (Describe)
The Shotel Ankle Arthrodesis Nail System is intended for the following:
- Charcot Foot
- Avascular necrosis of the talus
- Failed total ankle arthroplasty ●
- . Trauma (malunited tibial pilon fracture)
- Severe deformity or instability as a result of talipes equinoivarus, cerebral vascular accident, paralysis or other neuromuscular disease
- Revision ankle arthrodesis
- Neuroarthropathy
- Rheumatoid arthritis
- Osteoarthritis
- Pseudoarthrosis
- Post-Traumatic arthrosis
- Previously infected arthrosis
- Severe end stage degenerative arthritis
- Severe defects after tumor resection
- o Pantalar arthrodesis
Type of Use (Select one or both, as applicable)
[X] Prescription Use (Part 21 CFR 801 Subpart D) Subpart C)
[ ] Over-The-Counter Use (21 CFR 801
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Image /page/2/Picture/35 description: The image shows the logo for BIOPRO, which stands for Biologically Oriented Prostheses. Below the logo, the text "Shotel Ankle Arthrodesis Nail System" is displayed. The logo and text are in a simple, professional font.
Premarket Notification 510(k)
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Image /page/3/Picture/1 description: The image shows the logo for Biopro, which stands for Biologically Oriented Prostheses. The logo is in black and white, with the word "BIOPRO" in large, bold letters. The "O" in "BIOPRO" is split in half, with one half being black and the other half being white. Above the word "BIOPRO" are the words "BIOLOGICALLY ORIENTED PROSTHESES" in smaller letters.
#### GENERAL INFORMATION
| APPLICANT: | BioPro, Inc.<br>2929 Lapeer Road<br>Port Huron, MI 48060 |
|-----------------|--------------------------------------------------------------|
| CONTACT PERSON: | Al Memmolo<br>Convergent Clinical, Inc<br>Carlsbad, CA 92011 |
Date Prepared: August 10, 2017
## Device Description
| TRADE NAME: | Shotel Ankle Arthrodesis Nail System |
|--------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| COMMON NAME: | Intramedullary Nail |
| PRODUCT CODE: | HSB - Rod, Fixation, Intramedullary And Accessories |
| CLASSIFICATION: | Class II – 21 CFR § 888.3020 – Intramedullary Fixation Rod |
| PREDICATE DEVICES: | Ascension® Ankle Fusion Nail System - K100925<br>Howmedica Osteonics Asnis III Cannulated Screw System (K000080)<br>Nexa Orthopedics Nexa Bone Screw System (K053394) |
## Product Description
The Shotel Ankle Arthrodesis Nail System is an implantable intramedullary system of fusion nails, bone screws, a nail cap and a set of instruments for primary ankle fusion. The curved fusion nail has 6 screw holes that can accommodate up to 6 bone screws and is available in seven (7) diameters in two configurations, left and right. The four (4) distal cross locking holes provide the surgeon with either a static or dynamic cross locking hole in alternative 90 degree orientation configurations. The 5mm fixation bone screws are offered in 27 lengths and the nail caps are available in two configurations; standard nail cap length and a plus 5 mm nail cap length affording the surgeon the ability to slightly adjust the final nail assembly length. All three implant components are manufactured from titanium Ti-6Al-4V and are single use only. Components are offered sterile and non-sterile.
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Image /page/4/Picture/1 description: The image shows the logo for BIOPRO, which stands for Biologically Oriented Prostheses. The logo is in black and white, with the letters "BIO" in white on a black background and the letters "PRO" in black on a white background. The letters are in a bold, sans-serif font. The logo is simple and modern.
## INDICATIONS FOR USE
The Shotel Ankle Arthrodesis Nail System is intended for the following:
- . Charcot Foot
- Avascular necrosis of the talus
- . Failed total ankle arthroplasty
- Trauma (malunited tibial pilon fracture) ●
- . Severe deformity or instability as a result of talipes equinoivarus, cerebral vascular accident, paralysis or other neuromuscular disease
- . Revision ankle arthrodesis
- . Neuroarthropathy
- Rheumatoid arthritis
- . Osteoarthritis
- . Pseudoarthrosis
- Post-Traumatic arthrosis
- . Previously infected arthrosis
- Severe end stage degenerative arthritis
- . Severe defects after tumor resection
- Pantalar arthrodesis
## TECHNOLOGICAL CHARACTERISTICS
The Shotel Ankle Arthrodesis Nail System has similar physical and technological characteristics to the predicate devices since all implantable devices are manufactured from the same material and have the same principle of operation; fixation of fractures, fusions, or osteotomies, of bones.
## Performance Data
All necessary testing has been performed with the Shotel Ankle Arthrodesis Nail System to assure substantial equivalence to the predicate devices. Testing included primary stiffness, fusion-site compression, primary bending stiffness and mechanical and fatigue testing in accordance with ASTM F1264. Pyrogen testing was performed on the subject implants and it was confirmed that the implants meet the 20 EU/device testing limit.
## SUBSTANTIAL EQUIVALENCE
Upon reviewing the technical information provided in this submission and comparing intended use, principle of operation, performance data, and overall technological characteristics, the Shotel Ankle Arthrodesis Nail System is determined to be substantially equivalent to existing legally marketed devices.
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.