EL CAPITAN Anterior Lumber Interbody System

K192492 · Astura Medical, LLC · OVD · Apr 21, 2020 · Orthopedic

Device Facts

• Record ID: K192492
• Device Name: EL CAPITAN Anterior Lumber Interbody System
• Applicant: Astura Medical, LLC
• Product Code: OVD · Orthopedic
• Decision Date: Apr 21, 2020
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 888.3080
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The EL CAPITAN Anterior Lumbar Interbody System is indicated for intervertebral body fusion procedures in skeletally mature patients with degenerative disc disease (DDD) of the lumbar spine at one or two contiguous levels from L1-L2 to L5-S1. DDD is defined as discogenic pain with degeneration of the disc confirmed by history and radiographic studies. These DDD patients may also have up to Grade I spondylolisthesis at the involved level(s). EL CAPITAN System implants are to be used with autogenous bone graft and supplemental fixation. Patients should have at least six (6) months of non-operative treatment prior to treatment with an intervertebral cage. The EL CAPITAN Spacer and Plate assembly are an integrated interbody fusion device intended for stand-alone use when used with all titanium alloy screws. When anchors, the assembly is intended for use with additional supplemental fixation that has been cleared by the FDA for use in the lumbar spine. Hyperlordotic interbody devices (>20° lordosis) must be used with supplemental fixation (e.g. posterior fixation) that has been cleared by the FDA for use in the Lumbar spine.

Device Story

Modular intervertebral body fusion device; 2-piece design with interchangeable spacer and plate components; features interlocking mechanism and spring-loaded latch for intraoperative assembly. Hollow center accommodates autogenous bone graft to promote arthrodesis. Implanted by surgeons in clinical settings to replace autogenous bone graft blocks, reducing donor site complications. Provides structural support to vertebral endplates. Used with supplemental fixation; stand-alone use permitted only with specific titanium alloy screws. Benefits patients by facilitating spinal fusion in DDD cases.

Clinical Evidence

No clinical studies were performed. Substantial equivalence is supported by non-clinical bench testing including static and dynamic compression (ASTM F2077, F1717), static and dynamic compression shear (ASTM F2077, F1717), subsidence (ASTM F2267), and expulsion testing.

Technological Characteristics

Modular interbody fusion device. Materials: PEEK-OPTIMA LT120HA, Tantalum (ASTM F560), Titanium Alloy (ASTM F136), Nitinol (ASTM F2063). Features hollow center for bone graft. Integrated spacer and plate assembly with spring-loaded latch. Stand-alone capability dependent on screw material.

Indications for Use

Indicated for intervertebral body fusion in skeletally mature patients with lumbar degenerative disc disease (DDD) at 1-2 contiguous levels (L1-S1). Includes patients with up to Grade I spondylolisthesis. Requires 6 months prior non-operative treatment. Must be used with autogenous bone graft and supplemental fixation (stand-alone use permitted only with titanium alloy screws).

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

• HALF DOME Posterior Lumbar Interbody System (K152512)
• Half Dome (K163481)
• Half Dome (K172947)
• Half Dome (K182877)
• Biomet Fusion System (K141791)
• Biomet Fusion System (K163543)
• Medtronic Pyramid Fixation System (K013665)
• NuVasive BASE Interfixated System (K170592)
• Stryker AVS (K143163)
• Core-Link M3 (K180814)

Submission Summary (Full Text)

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April 21, 2020

Astura Medical, LLC Mr. Parker Kelch Quality Manager 3186 Lionshead Ave, Suite 100 Carlsbad, California 92010

Re: K192492

Trade/Device Name: EL CAPITAN Anterior Lumber Interbody System Regulation Number: 21 CFR 888.3080 Regulation Name: Intervertebral Body Fusion Device Regulatory Class: Class II Product Code: OVD Dated: April 10, 2020 Received: April 13, 2020

Dear Mr. Kelch:

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 requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part

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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, Ph.D. Acting 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

510(k) Number (if known)

## K192492

Device Name

EL CAPITAN Anterior Lumbar Interbody System

## Indications for Use (Describe)

The EL CAPITAN Anterior Lumbar Interbody System is indicated for intervertebral body fusion procedures in skeletally mature patients with degenerative disc disease (DDD) of the lumbar spine at one or two contiguous levels from L1-L2 to L5-S1. DDD is defined as discogenic pain with degeneration of the disc confirmed by history and radiographic studies. These DDD patients may also have up to Grade I spondylolisthesis at the involved level(s). EL CAPITAN System implants are to be used with autogenous bone graft and supplemental fixation. Patients should have at least six (6) months of non-operative treatment prior to treatment with an intervertebral cage.

The EL CAPITAN Spacer and Plate assembly are an integrated interbody fusion device intended for stand-alone use when used with all titanium alloy screws. When anchors, the assembly is intended for use with additional supplemental fixation that has been cleared by the FDA for use in the lumbar spine.

Hyperlordotic interbody devices (>20° lordosis) must be used with supplemental fixation (e.g. posterior fixation) that has been cleared by the FDA for use in the Lumbar spine.

| Type of Use (Select one or both, as applicable) | | |
|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------|-----------------------------------------------------------------------------|
| <table style="border:none"><tr><td><span> ☑ Prescription Use (Part 21 CFR 801 Subpart D) </span></td><td><span> ☐ Over-The-Counter Use (21 CFR 801 Subpart C) </span></td></tr></table> | <span> ☑ Prescription Use (Part 21 CFR 801 Subpart D) </span> | <span> ☐ Over-The-Counter Use (21 CFR 801 Subpart C) </span> |
| <span> ☑ Prescription Use (Part 21 CFR 801 Subpart D) </span> | <span> ☐ Over-The-Counter Use (21 CFR 801 Subpart C) </span> | |

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## 510(k) Summary

In accordance with 21 CFR 807.92 of the Federal Code of Regulations

| Date Prepared | April 10, 2020 |
|------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Submitted By | Astura Medical<br>3186 Lionshead Ave, Suite 100<br>Carlsbad, CA 92010<br>Phone: [phone] |
| Contact | Parker Kelch<br>3186 Lionshead Ave, Suite 100<br>Carlsbad, CA 92010<br>Phone: [phone] x413<br>Email: [e-mail] |
| Trade Name | EL CAPITAN Anterior Lumbar Interbody Fusion |
| Common Name | Intervertebral body fusion device |
| Classification Name | Intervertebral body fusion device - lumbar |
| Class | II |
| Product Code | OVD |
| CFR Section | 21 CFR section 888.3080 |
| Device Panel | Orthopedic |
| Primary Predicate Device | HALF DOME Posterior Lumbar Interbody System (K152512) |
| Additional Predicate Device(s) | Half Dome (K163481, K172947, K182877)<br>Biomet Fusion System (K141791, K163543)<br>Medtronic Pyramid Fixation System (K013665)<br>NuVasive BASE Interfixated System (K170592)<br>Stryker AVS (K143163)<br>Core-Link M3 (K180814) |
| Device Description | The EL CAPITAN Anterior Lumbar Interbody devices are implants<br>developed for the substitution of the classical autogenous bone graft<br>blocks. The cages assist to avoid complications related to the bone graft<br>donation site (chronic pain, hematoma, infection, bone removal from the<br>donor site making it impossible to remove bone again, quality of the iliac<br>bone, accessing a healthy donor site that may become an unhealthy site,<br>hernias by the incision). The Spacers are a 2-piece modular design which<br>allows for interchangeable plate and spacer components. The plate and<br>spacer components contain interlocking features in addition to a spring-<br>loaded latch mechanism which allows for intraoperative assembly prior to<br>implantation. The spacer components are available in a range of<br>footprints and heights, and the plates are offered in multiple fixation<br>types and sizes to suit the individual pathology and anatomical conditions<br>of the patient. The implants have a hollow center to allow placement of<br>autogenous bone graft. The superior and inferior surfaces are open to<br>promote contact of the bone graft with the vertebral end plates, allowing<br>bone growth (arthrodesis) |
| Materials | PEEK-OPTIMA LT120HA (PEEK-OPTIMA HA Enhanced) – MAF 2227<br>Tantalum per ASTM F560<br>Titanium Alloy (Ti6-AL4-V ELI) per ASTM F136<br>Nitinol #1 (ASTM F2063) |
| Substantial Equivalence<br>Claimed to Predicate<br>Devices | The EL CAPITAN Anterior Lumbar Interbody System is substantially<br>equivalent to the predicate devices in terms of intended use, design,<br>materials used, mechanical safety and performances. |
| Indications for Use | The EL CAPITAN Anterior Lumbar Interbody System is indicated for<br>intervertebral body fusion procedures in skeletally mature patients with<br>degenerative disc disease (DDD) of the lumbar spine at one or two<br>contiguous levels from L1-L2 to L5-S1. DDD is defined as discogenic pain<br>with degeneration of the disc confirmed by history and radiographic<br>studies. These DDD patients may also have up to Grade I<br>spondylolisthesis or retrolisthesis at the involved level(s). EL CAPITAN<br>System implants are to be used with autogenous bone graft and<br>supplemental fixation. Patients should have at least six (6) months of<br>non-operative treatment prior to treatment with an intervertebral cage.<br>The EL CAPITAN Spacer and Plate assembly are an integrated interbody<br>fusion device intended for stand-alone use when used with all titanium<br>alloy screws. When used with anchors, the assembly is intended for use<br>with additional supplemental fixation that has been cleared by the FDA<br>for use in the lumbar spine.<br>Hyperlordotic interbody devices (>20° lordosis) must be used with<br>supplemental fixation (e.g. posterior fixation) that has been cleared by<br>the FDA for use in the Lumbar spine. |
| Non-clinical Test<br>Summary | The following analyses were conducted:<br>• Static Compression ASTM F2077<br>• Dynamic Compression ASTM F1717<br>• Static Compression Shear ASTM F2077<br>• Dynamic Compression Shear ASTM F1717<br>• Subsidence ASTM F2267<br>• Expulsion<br>The results of these evaluations indicate that the EL CAPITAN implants<br>are equivalent to predicate devices. |
| Clinical Test Summary | No clinical studies were performed |
| Conclusions: Non-Clinical<br>and Clinical | Astura Medical considers the EL CAPITAN Anterior Lumbar Interbody<br>System to be equivalent to the predicate devices listed above. This<br>conclusion is based upon the devices' similarities in principles of<br>operation, technology, materials and indications for use. |

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