TRACERS BONE CEMENT OPACIFIER

K023445 · Parallax Medical, Inc. · MYU · Mar 11, 2003 · Neurology

Device Facts

• Record ID: K023445
• Device Name: TRACERS BONE CEMENT OPACIFIER
• Applicant: Parallax Medical, Inc.
• Product Code: MYU · Neurology
• Decision Date: Mar 11, 2003
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 882.5300
• Device Class: Class 2

Indications for Use

TRACERS Bone Cement Opacifier is intended for use as an additive to Secour Acrylic Resin or Codman Cranioplastic™ (Type I - Slow Set) to provide radiopacity for imaging purposes.

Device Story

TRACERS Bone Cement Opacifier is a radiopaque additive powder mixed with Codman Cranioplastic or Secour Acrylic Resin monomer (powder) prior to polymerization with the liquid component. The device enables visualization of the resin material under imaging during cranioplasty procedures. It is used by surgeons in clinical settings to assist in the accurate placement and monitoring of bone cement. The resulting mixture provides radiopacity, allowing healthcare providers to confirm the location and integrity of the implant post-operatively.

Clinical Evidence

No clinical data provided; substantial equivalence is based on design and technological characteristics.

Technological Characteristics

Barium sulfate powder additive. Designed for manual mixing with acrylic resin monomers (Codman Cranioplastic or Secour Acrylic Resin) prior to polymerization. Provides radiopacity to the final cured resin matrix.

Indications for Use

Indicated for use as a radiopaque additive to Secour Acrylic Resin or Codman Cranioplastic (Type I - Slow Set) to assist in visualization and placement of bone cement during cranioplasty procedures.

Regulatory Classification

Identification

Methyl methacrylate for cranioplasty (skull repair) is a self-curing acrylic that a surgeon uses to repair a skull defect in a patient. At the time of surgery, the surgeon initiates polymerization of the material and forms it into a plate or other appropriate shape to repair the defect.

Predicate Devices

• TRACERS Bone Cement Opacifier (K991893)

Reference Devices

• Codman Cranioplastic (K8736989)
• Secour Acrylic Resin (K994022)

Submission Summary (Full Text)

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# IV. 510(k) Summary

KC0234Y5

This summary of safety and effectiveness is being submitted in accordance with the requirements of the Safe Medical Devices Act of 1990 and 21 CFR §807.92.

#### Date Prepared A.

October 11, 2002

MAR 11 2003

#### B. General Information

Manufacturer: Parallax Medical. Inc. 940 Disc Drive Scotts Valley, CA 95066-4544

Contact: Linda Bradley Manager, Regulatory and Clinical Affairs [phone], ext 251 (phone) [phone] (fax)

#### C. Device Information

| Trade Name: | TRACERS Bone Cement Opacifier |
|------------------------|-----------------------------------------------------------------|
| Common Name: | Barium Sulfate |
| Device Classification: | II |
| Classification Name: | Accessory, Barium Sulfate, Methyl Methacrylate for Cranioplasty |
| Product Code(s): | MYU |

#### D. Predicate Device Identification

The subject device is substantially equivalent to TRACERS Bone Cement Opacifier (K991893).

#### E. Intended Use

TRACERS Bone Cement Opacifier is intended for use as an additive to Secour Acrylic Resin or Codman Cranioplastic™ (Type I - Slow Set) to provide radiopacity for imaging purposes.

#### Product Description E

TRACERS Bone Cement Opacifier is an additive to be used with Codman Cranioplastic (K8736989) or Secour Acrylic Resin (K994022) to provide radiopacity to the resin and assist in placement and visualization of material. The TRACERS Bone Cement Opacifier is added to the Cranioplastic or Secour monomer (powder) prior to mixing with the Cranioplastic or Secour polymer (liquid). The end product (Cranioplastic or Secour and Tracer particles) is substantially equivalent to Cranioplastic and Secour alone.

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### Substantial Equivalence G.

The subject device is equivalent in intended use, design, and technological characteristics to TRACERS Bone Cement Opacifier (K991893).

# H. Summary

Based on the information provided in this notification, the subject device is substantially equivalent to the predicate devices in intended use, technological characteristics, and design.

## l. Signature of Preparer

The 510(k) summary was prepared and submitted by the following Parallax Medicanemployee

Medical employee:

Linda Bradley

Manager, Regulatory and Clinical Affairs

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Image /page/2/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 words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" arranged around the perimeter. Inside the circle is an abstract symbol resembling an eagle or bird in flight, composed of three stylized, curved lines.

Public Health Service

MAR 11 2003

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Ms. Linda Bradley Manager, Regulatory and Clinical Affairs Parallax Medical. Inc. 940 Disc Drive Scotts Valley, CA 95066

Re: K023445

Trade/Device Name: Tracers Bone Cement Opacifier Regulation Number: 21 CFR 882.5300 Regulation Name: Methyl methacrylate for cranioplasty Regulatory Class: II Product Code: MYU Dated: February 13, 2003 Received: February 14, 2003

Dear Ms. Bradley:

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. Insting 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 - Ms. Linda Bradley

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), please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act 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 yours.

Mark McMillan

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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# Statement of Indications for Use III.

# Indications for Use

510(k) Number (if known): K023445

Device Name: TRACERS Bone Cement Opacifier

Indications for Use:

TRACERS® Bone Cement Opacifier is intended for use as an additive to Secour™ Acrylic Resin or Codman Cranioplastic™ (Type I -- Slow Set) to provide radiopacity for imaging purposes.

(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 | K023445 |
|---------------|---------|
|---------------|---------|

| Prescription Use | OR | Over-The Counter Use |
|----------------------|----|--------------------------|
| (Per 21 CFR 801.109) | | (Optional Format 1-2-96) |