K192112 · International Life Sciences · FTL · Sep 27, 2019 · General, Plastic Surgery
Device Facts
Record ID
K192112
Device Name
FlexBand Plus
Applicant
International Life Sciences
Product Code
FTL · General, Plastic Surgery
Decision Date
Sep 27, 2019
Decision
SESE
Submission Type
Special
Regulation
21 CFR 878.3300
Device Class
Class 2
Attributes
Therapeutic
Indications for Use
Artelon® FlexBand, FlexPatch, and FlexBand Plus Tissue Reinforcement products are intended for use in general surgical procedures for reinforcement of soft tissue where weakness exists. Artelon® FlexBand, FlexPatch, and FlexBand Plus are also intended for reinforcement of soft tissues that are repaired by suture or suture anchors, during tendon repair surgery including reinforcement of rotator cuff, patellar, Achilles, biceps, or quadriceps tendons. Artelon® FlexBand, FlexBand Plus are not intended to replace normal body structure or provide the full mechanical strength to support the rotator cuff, patellar, Achilles, biceps, or quadriceps tendons. Sutures, used to repair the tear, and sutures or bone anchors, used to attach the bone, provide mechanical strength for the tendon repair. Artelon® Tissue Reinforces soft tissue and provides a degradable scaffold that is incorporated into the patient's own tissue.
Device Story
FlexBand Plus is a knitted surgical mesh made of polycaprolactone-based polyurethaneurea fibers; designed for soft tissue reinforcement. Device acts as a degradable scaffold incorporated into patient tissue. Subject device adds pre-attached sutures to mesh ends and a backing card for packaging; otherwise identical to predicate. Used in surgical settings by physicians. Mesh is sutured to soft tissue to provide reinforcement; does not replace structural integrity of tendons. Benefits include scaffold support during healing. Supplied sterile in peel pouches.
Clinical Evidence
No clinical data. Bench testing only. Performed suture retention, suture strength, dimensional, transit, and packaging testing on sterilized product to validate modifications.
Technological Characteristics
Knitted mesh; material: polycaprolactone-based polyurethaneurea. Dimensions: 0.03cm, 0.05cm, 0.07cm widths; 8cm, 16cm, 34cm lengths. Supplied sterile via E-Beam. Includes pre-attached sutures and backing card. Non-active, degradable scaffold.
Indications for Use
Indicated for general surgical soft tissue reinforcement and reinforcement of soft tissues repaired by suture/anchors during tendon repair (rotator cuff, patellar, Achilles, biceps, quadriceps). Not for replacing body structure or providing full mechanical strength for tendon repair.
Regulatory Classification
Identification
Surgical mesh is a metallic or polymeric screen intended to be implanted to reinforce soft tissue or bone where weakness exists. Examples of surgical mesh are metallic and polymeric mesh for hernia repair, and acetabular and cement restrictor mesh used during orthopedic surgery.
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September 27, 2019
International Life Sciences Tiffini Wittwer Regulatory Affairs 2252 Northwest Parkway SE Marietta, Georgia 30067
Re: K192112
Trade/Device Name: FlexBand Plus Regulation Number: 21 CFR 878.3300 Regulation Name: Surgical Mesh Regulatory Class: Class II Product Code: FTL Dated: August 27, 2019 Received: August 30, 2019
Dear Tiffini Wittwer:
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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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
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requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.
For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
For Cindy Chowdhury, Ph.D., M.B.A. Acting Assistant Director DHT4B: Division of Infection Control and Plastic Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health
Enclosure
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## Indications for Use
510(k) Number (if known) K192112
Device Name FlexBand, FlexPatch, and FlexBand Plus
Artelon® FlexBand, FlexBand Plus Tissue Reinforcement products are intended for use in general surgical procedures for reinforcement of soft tissue where weakness exists.
Artelon® FlexBand, FlexPatch, and FlexBand Plus are also intended for reinforcement of soft tissues that are repaired by suture or suture anchors, during tendon repair surgery including reinforcement of rotator cuff, patellar, Achilles, biceps, or quadriceps tendons.
Artelon® FlexBand, FlexBand Plus are not intended to replace normal body structure or provide the full mechanical strength to support the rotator cuff, patellar, Achilles, biceps, or quadriceps tendons. Sutures, used to repair the tear, and sutures or bone anchors, used to attach the bone, provide mechanical strength for the tendon repair. Artelon® Tissue Reinforces soft tissue and provides a degradable scaffold that is incorporated into the patient's own tissue.
| Type of Use (Select one or both, as applicable) | |
|-------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------|
| | <span> <span style="text-decoration: underline;">Prescription Use</span> (Part 21 CFR 801 Subpart D) </span> |
| | <span> Over-The-Counter Use (21 CFR 801 Subpart C) </span> |
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| Submitter: | International Life Sciences DBA Artelon®<br>2252 Northwest Pkwy SE, Suite G<br>Marietta, GA 30067 | | FlexBand™ Plus | Artelon Tissue | Analysis of Difference |
|----------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------|
| Date Prepared | July 31, 2019 | | (Subject Device) | Reinforcement | |
| Contact Person: | Tiffini Wittwer, MPH<br>Director Regulatory Affairs<br>Phone: 707.799.6732<br>E-mail: twittwer@mededge.io | | | (Predicate Device) | |
| Trade Name: | FlexBand Plus™ | 510(k) Number | To be determined | K071887 | |
| Common Name: | Mesh, Surgical, Polymeric devices | Decision Date | | | |
| Classification: | Class II | Manufacturer | International Life<br>Sciences | International Life Sciences | |
| Product Code: | FTL, 21 CFR 878.3300 | Classification | Class II | Class II | |
| Predicate Device(s): | The subject device is equivalent to the following devices:<br>• K071887 - FlexBand™ (formerly called Artelon® Tissue<br>Reinforcement) | Product Code | FTL | FTL | |
| Device Description: | FlexBand™ and FlexBand™ Plus products are a knitted mesh<br>made from ARTELON® fibers. Artelon® fiber is made of<br>polycaprolactone-based polyurethaneurea. The construction<br>permits the mesh to be cut into any desired shape or size without<br>unraveling.<br>The Flexband Plus™ devices have a suture attached to each end<br>of the ARTELON® mesh strips. The pre-loaded suture is<br>intended to improve usability in the operating room. The sutured<br>FlexBand™ Plus is packaged with two commercial (off-the-shelf)<br>stainless steel passing needles. The device is supplied sterile, one<br>product per package, in double layer peel pouch packaging.<br>The FlexBand™ and FlexBand Plus™ devices are available in<br>several sizes; 0.03cm, 0.05cm, and 0.07cm widths in lengths of<br>8cm, 16cm, and 34cm for each width. | Regulation | 21 CFR 878.3300 | 21 CFR 878.3300 | |
| Indication for Use: | Artelon® FlexBand, FlexPatch, and FlexBand Plus Tissue<br>Reinforcement products are intended for use in general surgical<br>procedures for reinforcement of soft tissue where weakness<br>exists.<br>Artelon® FlexBand, FlexPatch, and FlexBand Plus are also<br>intended for reinforcement of soft tissues that are repaired by<br>suture or suture anchors, during tendon repair surgery including<br>reinforcement of rotator cuff, patellar, Achilles, biceps, or<br>quadriceps tendons.<br>Artelon® FlexBand, FlexPatch, and FlexBand Plus are not<br>intended to replace normal body structure or provide the full<br>mechanical strength to support the rotator cuff, patellar, Achilles,<br>biceps, or quadriceps tendons. Sutures, used to repair the tear,<br>and sutures or bone anchors, used to attach the tissue to the bone. | Indications for Use | Same | Artelon® Tissue Reinforcement is<br>intended for use in general surgical<br>procedures for reinforcement of soft<br>tissue where weakness exists.<br>Artelon® Tissue Reinforcement is<br>also intended for reinforcement of<br>soft tissues that are repaired by<br>suture or suture anchors, during<br>tendon repair surgery including<br>reinforcement of rotator cuff,<br>patellar, Achilles, biceps, or<br>quadriceps tendons.<br>Artelon® Tissue Reinforcement is<br>not intended to replace normal body<br>structure or provide the full<br>mechanical strength to support the<br>rotator cuff, patellar, Achilles,<br>biceps, or quadriceps tendons.<br>Sutures, used to repair the tear, and<br>sutures or bone anchors, used to<br>attach the tissue to the bone, provide | |
| | | | | | |
| | | mechanical strength for the tendon<br>repair. Artelon® Tissue<br>Reinforcement reinforces soft tissue<br>and provides a degradable scaffold<br>that is incorporated into the patient's<br>own tissue. | | | |
| Intended Use | Same | Soft tissue reinforcement | | | |
| Material | Same | polycaprolactone-based<br>polyurethaneurea | | | |
| Available Sizes | Same | 0.3 x 8cm<br>0.3 x 16 cm<br>0.3 x 32 cm<br>0.5 x 8 cm<br>0.5 x 16 cm<br>0.5 x 32 cm<br>0.7 x 8 cm<br>0.7 x 16 cm<br>0.7 x 32 cm | | | |
| Suture Attached | Yes | No | Suture retention testing,<br>suture strength testing,<br>and user validation<br>testing demonstrate that<br>the difference does not<br>create additional risk to<br>safety and effectiveness<br>of the subject device | | |
| Packaging<br>Configuration | Device is placed on<br>backing card and put<br>into pouch | Device is placed directly in pouch | Transit testing and<br>packaging validation<br>demonstrate that the<br>difference does not<br>create additional risk to<br>safety and effectiveness<br>of the subject device | | |
| Sterilization<br>Method | Same | E-Beam | | | |
| Single Use Only | Same | Yes | | | |
| Risk Analysis: | A risk analysis was performed for the modifications done for<br>the subject device, in accordance to ISO 14971:2012 Medical<br>Devices – Applications of Risk Management to Medical<br>Devices and International Life Sciences Risk Management SOP | | | | |
## 510(k) Summary:
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provide mechanical strength for the tendon repair. Artelon® Tissue Reinforcement reinforces soft tissue and provides a degradable scaffold that is incorporated into the patient's own tissue.
Technological The devices are used in surgical procedures where soft tissue Characteristics: reinforcement is needed. During the surgical procedure the user will suture the device to the desired soft tissues. The material provides a physical scaffold and degrades over time leaving the healed intact tissue in place. The differences between the predicate and the subject device, is the addition of pre-attached sutures to the end of each device and the addition of a backing card to hold the device in the packaging. The predicate and subject devices are available in the exact same sizes.
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of suture and packaging. Based on risk identification, verification and validation activities were carried out to ensure the risk acceptability criteria have been met and the risks have been mitigated. All testing was performed on sterilized product. Performance Testing: Based on the risks identified, the following tests were
performed on the FlexBand Plus™:
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| Suture retention testing Suture strength testing Dimensional testing Transit testing Packaging testing | |
|--------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Conclusions: | The changes made to the previously cleared FlexBand™ devices do not raise different questions regarding the safety and effectiveness of the device. FlexBand Plus™ is substantially equivalent to the predicate devices. This conclusion is based upon the devices' identical intended use, indications for use, principles of operation, fundamental scientific technology, and performance specifications. The changes made were tested using the same acceptance criteria as the predicate device and demonstrated that there are no new risks and the device is substantially equivalent. The conclusions of testing demonstrate that the device is as safe, as effective, and performs as well as or better than the legally marketed device. |
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.
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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.