NanoHive Medical Lumbar Interbody System

K231241 · NanoHive Medical, LLC · MAX · Jul 12, 2023 · Orthopedic

Device Facts

• Record ID: K231241
• Device Name: NanoHive Medical Lumbar Interbody System
• Applicant: NanoHive Medical, LLC
• Product Code: MAX · Orthopedic
• Decision Date: Jul 12, 2023
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 888.3080
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The NanoHive Medical Lumbar Interbody System, with a microscopic roughened surface and micro and nano-scale features, is indicated for use in skeletally mature patients with Degenerative Disc Disease (DDD) at one or two contiguous levels from L2-S1. DDD is defined as discogenic back pain with degeneration of the disc confirmed by patient history and radiographic studies. Patients should have received 6 months of non-operative treatment with the devices. The devices. The device must be used with supplemental fixation. These DDD patients may also have up to Grade I spondylolisthesis or retrolisthesis at the involved level(s). It is indicated to be used with autograft bone and allograft bone comprised of cancellous and/or corticocancellous bone (hereafter bone graft).

Device Story

NanoHive Medical Lumbar Interbody System consists of interbody fusion cages manufactured via additive manufacturing from Ti-6Al-4V titanium. Implants feature a highly porous core with solid cephalad/caudal endplates and teeth for stability. Surfaces possess micro and nano-scale roughened features to facilitate fusion. Available in various sizes, lordotic configurations, and geometries to match patient anatomy. Used by surgeons in spinal fusion procedures; implanted at L2-S1 levels. Requires supplemental fixation and bone graft (autograft/allograft). Provides structural support to the intervertebral space to promote fusion in patients with degenerative disc disease. Benefits include spinal stabilization and alignment correction.

Clinical Evidence

Bench testing only. Performance evaluated via static and dynamic axial compression (ASTM F2077), static and dynamic compression shear (ASTM F2077), and subsidence testing (ASTM F2267). Results confirm mechanical strength is sufficient for intended use and equivalent to predicate devices.

Technological Characteristics

Material: Ti-6Al-4V titanium. Manufacturing: Additive manufacturing. Design: Highly porous core with solid endplates; micro/nano-scale surface features. Mechanical testing standards: ASTM F2077, ASTM F2267. Sterilization: Pre-sterile, single-use.

Indications for Use

Indicated for skeletally mature patients with Degenerative Disc Disease (DDD) at one or two contiguous levels from L2-S1. DDD defined as discogenic back pain with degeneration confirmed by history and radiography. Patients must have failed 6 months of non-operative treatment. Includes patients with up to Grade I spondylolisthesis or retrolisthesis. Must be used with supplemental fixation and autograft/allograft bone.

Regulatory Classification

Identification

An intervertebral body fusion device is an implanted single or multiple component spinal device made from a variety of materials, including titanium and polymers. The device is inserted into the intervertebral body space of the cervical or lumbosacral spine, and is intended for intervertebral body fusion.

Special Controls

*Classification.* (1) Class II (special controls) for intervertebral body fusion devices that contain bone grafting material. The special control is the FDA guidance document entitled “Class II Special Controls Guidance Document: Intervertebral Body Fusion Device.” See § 888.1(e) for the availability of this guidance document.(2) Class III (premarket approval) for intervertebral body fusion devices that include any therapeutic biologic (e.g., bone morphogenic protein). Intervertebral body fusion devices that contain any therapeutic biologic require premarket approval. (c) *Date premarket approval application (PMA) or notice of product development protocol (PDP) is required.* Devices described in paragraph (b)(2) of this section shall have an approved PMA or a declared completed PDP in effect before being placed in commercial distribution.

Predicate Devices

• HD Lumbar Interbody System (K170676)
• EIT Cellular Titanium® ALIF, TLIF, T/PLIF Cages (K201605)
• LnK Lumbar Interbody Fusion Cage System (K181380)
• IO™ Expandable Lumbar Interbody Fusion System (K210800)
• Curiteva Lumbar Interbody Fusion System (K181589)

Submission Summary (Full Text)

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July 12, 2023

NanoHive Medical LLC % Nathan Wright, MS Engineer & Regulatory Specialist Empirical Technologies 4628 Northpark Drive Colorado Springs, Colorado 80918

Re: K231241

Trade/Device Name: NanoHive Medical Lumbar Interbody System Regulation Number: 21 CFR 888.3080 Regulation Name: Intervertebral Body Fusion Device Regulatory Class: Class II Product Code: MAX Dated: May 15, 2023 Received: May 15, 2023

Dear Nathan Wright:

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

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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 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 (QS) 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 ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely,

# Brent Showalter -S

Brent Showalter, Ph.D. Assistant Director DHT6B: Division of Spinal Devices OHT6: Office of Orthopedic Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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#### Indications for Use

Submission Number (if known)

K231241

Device Name

NanoHive Medical Lumbar Interbody System

Indications for Use (Describe)

The NanoHive Medical Lumbar Interbody System, with a microscopic roughened surface and micro and nano-scale features, is indicated for use in skeletally mature patients with Degenerative Disc Disease (DDD) at one or two contiguous levels from L2-S1. DDD is defined as discogenic back pain with degeneration of the disc confirmed by patient history and radiographic studies. Patients should have received 6 months of non-operative treatment with the devices. The devices. The device must be used with supplemental fixation. These DDD patients may also have up to Grade I spondylolisthesis or retrolisthesis at the involved level(s). It is indicated to be used with autograft bone and allograft bone comprised of cancellous and/or corticocancellous bone (hereafter bone graft).

Type of Use (Select one or both, as applicable)

> | Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

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# 510(K) SUMMARY

| Submitter's Name: | NanoHive Medical LLC |
|--------------------------------|-----------------------------------------------------------------------------------------|
| Submitter's Address: | 12 Gill Street, Suite 4500<br>Woburn, Massachusetts 01801 |
| Submitter's Telephone: | 844-943-5433 |
| Contact Person: | Nathan Wright MS<br>Empirical Technologies<br>719-351-0248<br>[e-mail] |
| Date Summary was Prepared: | May 15, 2023 |
| Trade or Proprietary Name: | NanoHive Medical Lumbar Interbody System |
| Device Classification Name: | Intervertebral Fusion Device With Bone Graft, Lumbar |
| Classification & Regulation #: | Class II per 21 CFR §888.3080 |
| Product Code: | MAX |
| Classification Panel: | Orthopedic – Spinal (DHT6B) |

## DESCRIPTION OF THE DEVICE SUBJECT TO PREMARKET NOTIFICATION:

The NanoHive Medical Lumbar Interbody System, including the Hive™ PL Interbody System, the Hive™ TL Interbody System, and the Hive™ AL Interbody System, consists of interbody fusion cages made from Ti-6Al-4V implant-grade titanium using additive manufacturing technology. The titanium takes the form of a highly porous core which is surrounded at the cephalad and caudal ends by protective solid titanium endplates. The implant is anatomic in shape and has teeth to ensure placement is maintained after implantation. The interbody cages have a microscopic roughened surface with micro and nano-scale features. The micro and nano features are on all surfaces of the cage, including the superior, inferior, and peripheral surfaces, as well as each member of the internal cell structure. The NanoHive Medical Lumbar Interbody System are offered in a variety of lengths, widths and cross sectional geometries to accommodate patient anatomy and surgical approach. The implants of the NanoHive Medical Lumbar Interbody System are also offered in various lordotic configurations to ensure proper stability and alignment of the spine for differing patient anatomy. The implants are provided pre-sterile, in validated sterile packaging, and are one-time use only.

The purpose of this submission is to additional implant size options and sterile packaging configurations to the system.

# INDICATIONS FOR USE

The NanoHive Medical Lumbar Interbody System, with a microscopic roughened surface and micro and nanoscale features, is indicated for use in skeletally mature patients with Degenerative Disc Disease (DDD) at one or two contiguous levels from L2-S1. DDD is defined as discogenic back pain with degeneration of the disc confirmed by patient history and radiographic studies. Patients should have received 6 months of non-operative treatment prior to treatment with the devices. The device must be used with supplemental fixation. These DDD patients may also have up to Grade I spondylolisthesis at the involved level(s). It is indicated to be used with autograft bone and allograft bone comprised of cancellous and/or corticocancellous bone (hereafter bone graft).

### TECHNOLOGICAL CHARACTERISTICS

The subject and predicate devices have nearly identical technological characteristics and the minor differences do not raise any new issues of safety and effectiveness. Specifically, the following characteristics are identical between the subject and predicates:

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- Indications for Use ●
- Principle of Operation
- Structural Support Mechanism ●
- . Materials
- . Sterility
- Sizes
- Manufacturing and Biocompatibility ●

#### Predicate Devices

| 510k Number | Trade or Proprietary or Model Name | Manufacturer | Predicate Type |
|-------------|----------------------------------------------------|----------------------------------------|----------------|
| K170676 | HD Lumbar Interbody System | HD LifeSciences, LLC | Primary |
| K201605 | EIT Cellular Titanium® ALIF, TLIF,<br>T/PLIF Cages | EIT Emerging Implant Technologies GmbH | Additional |
| K181380 | LnK Lumbar Interbody Fusion Cage<br>System | L&K BIO210800MED Co., Ltd. | Additional |
| K210800 | IO™ Expandable Lumbar Interbody<br>Fusion System | MiRus, LLC | Additional |
| K181589 | Curiteva Lumbar Interbody Fusion<br>System | Curiteva, LLC | Additional |

# PERFORMANCE DATA

The NanoHive Medical Lumbar Interbody System has been tested in the following test modes:

- Static & Dynamic Axial Compression per ASTM F2077 ●
- Static & Dynamic Compression Shear per ASTM F2077 ●
- Subsidence per ASTM F2267

The results of this non-clinical testing show that the strength of the NanoHive Medical Lumbar Interbody System is sufficient for its intended use and is substantially equivalent to legally marketed predicate devices.

#### CONCLUSION

The overall technology characteristics and mechanical performance data lead to the conclusion that NanoHive Medical Lumbar Interbody System is substantially equivalent to the predicate device.